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1. Low versus standard calorie and protein feeding in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group trial (NUTRIREA-3)

Author: Jean Reignier, Gaetan Plantefeve, Jean-Paul Mira, Laurent Argaud, Pierre Asfar, Nadia Aissaoui, Julio Badie, Nicolae-Vlad Botoc, Laurent Brisard, Hoang-Nam Bui, Delphine Chatellier, Louis Chauvelot, Alain Combes, Christophe Cracco, Michael Darmon, Vincent Das, Matthieu Debarre, Agathe Delbove, Jérôme Devaquet, Louis-Marie Dumont, Olivier Gontier, Samuel Groyer, Laurent Guérin, Bertrand Guidet, Yannick Hourmant, Samir Jaber, Fabien Lambiotte, Christophe Leroy, Philippe Letocart, Benjamin Madeux, Julien Maizel, Olivier Martinet, Frédéric Martino, Virginie Maxime, Emmanuelle Mercier, Mai-Anh Nay, Saad Nseir, Johanna Oziel, Walter Picard, Gael Piton, Jean-Pierre Quenot, Florian Reizine, Anne Renault, Jack Richecoeur, Jean-Philippe Rigaud, Francis Schneider, Daniel Silva, Michel Sirodot, Bertrand Souweine, Fabienne Tamion, Nicolas Terzi, Didier Thévenin, Guillaume Thiery, Nathalie Thieulot-Rolin, Jean-Francois Timsit, Francois Tinturier, Patrice Tirot, Thierry Vanderlinden, Isabelle Vinatier, Christophe Vinsonneau, Sebastian Voicu, Jean-Baptiste Lascarrou, Amélie Le Gouge, Damien Contou, Olivier Pajot, Paul Jaubert, Nathalie Marin, Marie Simon, Martin Cour, Satar Mortaza, Vincent Souday, Marie Lemerle, Sylvain Malfroy, Fernando Berdaguer Ferrari, Bertrand Rozec, Didier Gruson, Charline Sazio, Suzanne Champion, Florence Boissier, Anne Veinstein, Loredana Baboi, Jean-Christophe Richard, Hodane Yonis, Loïc Le Guennec, Lucie Lefevre, Juliette Chommeloux, Guillaume Hékimian, Virginie Lemiale, Eric Mariotte, Sandrine Valade, Joanna Tirolien, Yannick Fedun, Charles Cerf, Guillaume Tachon, Jérôme Roustan, Sylvie Vimeux, Michel Bonnivard, Nadia Anguel, David Osman, Karim Asehnoune, Antoine Roquilly, Fouad Belafia, Matthieu Conseil, Moussa Cisse, Bouras Chaouki, Rémi Espenel, Christine Brasse, Sébastien Ena, Arnaud Delahaye, Jeremy Castanera, Thierry Dulac, Philippe Petua, Yoann Zerbib, Clément Brault, Djillali Annane, Rania Bounab, Nicholas Heming, Thierry Boulain, Sophie Jacquier, Grégoire Muller, Raphael Favory, Sébastien Préau, Julien Poissy, Alexandre Massri, Floriane Lissonde, Hadrien Winiszewski, Thibault Vieille, Marine Jacquier, Marie Labruyère, Pascal Andreu, Jean-Marc Tadié, Laetitia Bodenes, Danièle Combaux, David Luis, Antoine Marchalot, Jean-Etienne Herbrecht, Raphaël Clere-Jehl, David Schnell, Jérôme Aboad, David Bougon, Etienne Escudier, Elisabeth Coupez, Claire Dupuis, Zoe Demailly, Louis-Marie Galerneau, Jonathan Chelly, Franck Pourcine, Ly Van Vong, Sonia Abid, Etienne De Montmollin, Romain Sonneville, Christophe Guitton, Nicolas Chudeau, Mickaël Landais, Vincent Pages, Caroline Séjourné, Imen Rahmani, Ghada Sbouj, Bruno Megarbane, Nicolas Deye, Isabelle Malissin, Motricité, interactions, performance UR 4334 / Movement - Interactions - Performance (MIP), Le Mans Université (UM)-Nantes Université - UFR des Sciences et Techniques des Activités Physiques et Sportives (Nantes Univ - UFR STAPS), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre hospitalier Argenteuil (CH Argenteuil), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Nord Franche-Comté [Hôpital de Trévenans] (HNFC), CH de Saint-Malo [Broussais], Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Service de Réanimation Médicale [CHU Bordeaux], CHU Bordeaux [Bordeaux]-Hôpital Pellegrin, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Hôpital de la Croix-Rousse [CHU - HCL], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier d'Angoulême (CH Angoulême), Hopital Saint-Louis [AP-HP] (AP-HP), Centre Hospitalier Intercommunal André Grégoire [Montreuil] (CHI André Gregoire), Centre hospitalier Saint-Brieuc, Centre hospitalier Bretagne Atlantique (Morbihan) (CHBA), Hôpital Foch [Suresnes], Hôpital Louis Mourier - AP-HP [Colombes], Hôpitaux de Chartres [Chartres], Centre hospitalier de Montauban (CH Montauban), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Pharmacoépidémiologie et évaluation des soins [iPLesp] (PEPITES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre hospitalier [Valenciennes, Nord], Centre Hospitalier Emile Roux [AP-HP], Hôpital Jacques Puel - Bourran [Rodez] (HJPB), Centre Hospitalier de Bigorre [Tarbes], CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Unité de Soins Intensifs [CHU La Réunion], Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Hôpital Raymond Poincaré [Garches], Infection et inflammation (2I), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche sur l'interculturalité et la circulation médiatique des savoirs (CRICS (EA_3965)), Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Régional d'Orléans (CHRO), CHU Lille, Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576 (UGSF), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Hôpital Avicenne [AP-HP], Centre hospitalier de Pau, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( UR 3920) (PCVP / CARDIO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer (LabEx LipSTIC), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro Dijon, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Université de Montpellier (UM), Département d'épidémiologie, biostatistique et recherche clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Université de Bourgogne (UB), Centre Hospitalier Universitaire [Rennes], Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Centre Hospitalier de Beauvais, Centre hospitalier de Dieppe, Les Hôpitaux Universitaires de Strasbourg (HUS), Hôpital Delafontaine, Centre Hospitalier de Saint-Denis [Ile-de-France], Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Hypoxie et PhysioPathologie (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Hospitalier de Lens, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Intensive Care Unit, Groupe Hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77000, Melun, CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre Hospitalier Le Mans (CH Le Mans), Institut Catholique de Lille (ICL), Université catholique de Lille (UCL), Centre de recherche en éducation de Nantes (CREN), Le Mans Université (UM)-Université de Nantes - UFR Lettres et Langages (UFRLL), Université de Nantes (UN)-Université de Nantes (UN), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Centre Hospitalier de Béthune (CH Béthune), GHT de l'Artois, Service d'Anesthésie-Réanimation [AP-HP Hôpitaux Saint-Louis Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), and French Ministry of Health.
Subjects: Pulmonary and Respiratory Medicine, [SDV]Life Sciences [q-bio]
Abstract: Also written with the NUTRIREA-3 Trial Investigators and the Clinical Research in Intensive Care and Sepsis (CRICS-TRIGGERSEP) Group; International audience; BackgroundThe optimal calorie and protein intakes at the acute phase of severe critical illness remain unknown. We hypothesised that early calorie and protein restriction improved outcomes in these patients, compared with standard calorie and protein targets.MethodsThe pragmatic, randomised, controlled, multicentre, open-label, parallel-group NUTRIREA-3 trial was performed in 61 French intensive care units (ICUs). Adults (≥18 years) receiving invasive mechanical ventilation and vasopressor support for shock were randomly assigned to early nutrition (started within 24 h after intubation) with either low or standard calorie and protein targets (6 kcal/kg per day and 0·2–0·4 g/kg per day protein vs 25 kcal/kg per day and 1·0–1·3 g/kg per day protein) during the first 7 ICU days. The two primary endpoints were time to readiness for ICU discharge and day 90 all-cause mortality. Key secondary outcomes included secondary infections, gastrointestinal events, and liver dysfunction. The trial is registered on ClinicalTrials.gov, NCT03573739, and is completed.FindingsOf 3044 patients randomly assigned between July 5, 2018, and 8 Dec 8, 2020, eight withdrew consent to participation. By day 90, 628 (41·3%) of 1521 patients in the low group and 648 (42·8%) of 1515 patients in the standard group had died (absolute difference –1·5%, 95% CI –5·0 to 2·0; p=0·41). Median time to readiness for ICU discharge was 8·0 days (IQR 5·0–14·0) in the low group and 9·0 days (5·0–17·0) in the standard group (hazard ratio [HR] 1·12, 95% CI 1·02 to 1·22; p=0·015). Proportions of patients with secondary infections did not differ between the groups (HR 0·85, 0·71 to 1·01; p=0·06). The low group had lower proportions of patients with vomiting (HR 0·77, 0·67 to 0·89; p
Published: 2023
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2. Senior-COVID-Rea Cohort Study: A Geriatric Prediction Model of 30-day Mortality in Patients Aged over 60 Years in ICU for Severe COVID-19

Author: Falandry, C., Bitker, L., Abraham, P., Subtil, F., Collange, V., Balança, B., Haïne, M., Guichon, C., Leroy, C., Simon, M., Malapert, A., Pialat, J. B., Jallades, L., Lepape, A., Friggeri, A., Thiolliere, F., Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-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 Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Hôpital de la Croix-Rousse [CHU - HCL], Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Edouard Herriot [CHU - HCL], Université de Lyon, Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Médipôle Lyon-Villeurbanne (MLV), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord-Ouest de Villefranche-sur-Saône [Gleize] (HNOVS), Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'anesthésie-réanimation [Centre Hospitalier Lyon Sud - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and CarMeN, laboratoire
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], geriatric parameters, COVID-19, triage, intensive care
Abstract: International audience; The SARS-COV2 pandemic induces tensions on health systems and ethical dilemmas. Practitioners need help tools to define patients not candidate for ICU admission. A multicentre observational study was performed to evaluate the impact of age and geriatric parameters on 30-day mortality in patients aged ≥60 years of age. Patients or next of kin were asked to answer a phone questionnaire assessing geriatric covariates 1 month before ICU admission. Among 290 screened patients, 231 were included between March 7 and May 7, 2020. In univariate, factors associated with lower 30-day survival were: age (per 10 years increase; OR 3.43, [95%CI: 2.13-5.53]), ≥3 CIRS-G grade ≥2 comorbidities (OR 2.49 [95%CI: 1.36-4.56]), impaired ADL, (OR 4.86 [95%CI: 2.44-9.72]), impaired IADL8 (OR 6.33 [95%CI: 3.31-12.10], p\textless0.001), frailty according to the Fried score (OR 4.33 [95%CI: 2.03-9.24]) or the CFS ≥5 (OR 3.79 [95%CI: 1.76-8.15]), 6-month fall history (OR 3.46 [95%CI: 1.58-7.63]). The final multivariate model included age (per 10 years increase; 2.94 [95%CI:1.78-5.04], p\textless0.001) and impaired IADL8 (OR 5.69 [95%CI: 2.90-11.47], p\textless0.001)). Considered as continuous variables, the model led to an AUC of 0.78 [95% CI: 0.72, 0.85]. Age and IADL8 provide independent prognostic factors for 30-day mortality in the considered population. Considering a risk of death exceeding 80% (82.6% [95%CI: 61.2% - 95.0%]), patients aged over 80 years with at least 1 IADL impairment appear as poor candidates for ICU admission.
Published: 2022
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3. Plasma Amyloid Beta Predicts Conversion to Dementia in Subjects with Mild Cognitive Impairment: The BALTAZAR Study

Author: Hanon, Olivier, Vidal, Jean-Sébastien, Lehmann, Sylvain, Bombois, Stéphanie, Allinquant, Bernadette, Baret-Rose, Christiane, Tréluyer, Jean-Marc, Abdoul, Hendy, Gelé, Patrick, Delmaire, Christine, Blanc, Frédéric, Mangin, Jean-François, Buée, Luc, Touchon, Jacques, Hugon, Jacques, Vellas, Bruno, Galbrun, Evelyne, Benetos, Athanase, Berrut, Gilles, Paillaud, Elena, Wallon, David, Castelnovo, Giovanni, Volpe-Gillot, Lisette, Paccalin, Marc, Robert, Philippe, Godefroy, Olivier, Camus, Vincent, Belmin, Joël, Vandel, Pierre, Novella, Jean-Luc, Duron, Emmanuelle, Rigaud, Anne-Sophie, Schraen-Maschke, Susanna, Gabelle, Audrey, Groupe hospitalier Broca, AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Maladie d'Alzheimer : marqueurs génétiques et vasculaires, neuropsychologies (EA 4468), Université Paris Descartes - Paris 5 (UPD5)-Groupe hospitalier Broca, Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Evaluation thérapeutique et pharmacologie périnatale et pédiatrique (EA_7323), Université Paris Descartes - Paris 5 (UPD5), CIC - Mère Enfant Necker Cochin Paris Centre (CIC 1419), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Necker - Enfants Malades [AP-HP], Unité de recherche clinique / Centre d'investigation clinique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP], Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA), Service Instrumentation Conception Caractérisation (LAAS-I2C), Laboratoire d'analyse et d'architecture des systèmes (LAAS), Université Toulouse 1 Capitole (UT1), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse 1 Capitole (UT1), Université Fédérale Toulouse Midi-Pyrénées, Université Paris-Saclay, Lille Neurosciences & Cognition - U 1172 (LilNCog), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Lille, NeuroTMULille International Laboratory [Lille] (UNIV LILLE / TMU), Université de Lille, Excellence Laboratory LabEx DISTALZ, Centres Mémoire de Ressources et de Recherche Montpellier (CMRR), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Institut du Vieillissement, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, CHU Toulouse [Toulouse], Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Emile Roux [AP-HP], Service de Gériatrie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Motricité, interactions, performance EA 4334 / Movement - Interactions - Performance (MIP), Le Mans Université (UM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR des Sciences et Techniques des Activités Physiques et Sportives (UFR STAPS), Université de Nantes (UN)-Université de Nantes (UN), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Cancer Research and Personalized Medicine - CARPEM [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Necker - Enfants Malades [AP-HP], Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Hôpital Léopold-Bellan, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université de Poitiers, CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), Université de Picardie Jules Verne (UPJV), CHU Amiens-Picardie, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), CHU Charles Foix [AP-HP], Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hôpital Paul Brousse, Université Paris Cité (UPCité), Institut des Neurosciences de Montpellier (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre d'Investigation Clinique - Innovation Technologique de Lille - CIC 1403 - CIC 9301 (CIC Lille), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Service NEUROSPIN (NEUROSPIN), Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Centre Mémoire de Ressources et de Recherches (CMRR), Université de Montpellier (UM), Université de Toulouse (UT)-Université de Toulouse (UT), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Motricité, interactions, performance UR 4334 / Movement - Interactions - Performance (MIP), Le Mans Université (UM)-Nantes Université - UFR des Sciences et Techniques des Activités Physiques et Sportives (Nantes Univ - UFR STAPS), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Mémoire de Ressources et de Recherche [Nice] (CMRR Nice), Université Nice Sophia Antipolis (1965 - 2019) (UNS), and COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre Hospitalier Universitaire de Nice (CHU Nice)-Université Côte d'Azur (UCA)
Subjects: Psychiatry and Mental health, Cellular and Molecular Neuroscience, Developmental Neuroscience, Epidemiology, Health Policy, Neurology (clinical), Geriatrics and Gerontology, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; INTRODUCTION: Blood-based biomarkers are the next challenge for Alzheimer's disease (AD) diagnosis and prognosis. METHODS: Mild cognitive impairment (MCI) participants (N = 485) of the BALTAZAR study, a large-scale longitudinal multicenter cohort, were followed-up for 3 years. A total of 165 of them converted to dementia (95% AD). Associations of conversion and plasma amyloid beta (Aβ)1-42 , Aβ1-40 , Aβ1-42 /Aβ1-40 ratio were analyzed with logistic and Cox models. RESULTS: Converters to dementia had lower level of plasma Aβ1-42 (37.1 pg/mL [12.5] vs. 39.2 [11.1] , P value = .03) and lower Aβ1-42 /Aβ1-40 ratio than non-converters (0.148 [0.125] vs. 0.154 [0.076], P value = .02). MCI participants in the highest quartile of Aβ1-42 /Aβ1-40 ratio (>0.169) had a significant lower risk of conversion (hazard ratio adjusted for age, sex, education, apolipoprotein E \epsilon4, hippocampus atrophy = 0.52 (95% confidence interval [0.31-0.86], P value = .01). DISCUSSION: In this large cohort of MCI subjects we identified a threshold for plasma Aβ1-42 /Aβ1-40 ratio that may detect patients with a low risk of conversion to dementia within 3 years.
Published: 2022
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4. Risk and Protective Factors of Lifetime Cocaine-Associated Chest Pain

Author: Virgile Clergue-Duval, Louise Nicolas-Sacy, Emily Karsinti, El-Hadi Zerdazi, Jean-Louis Laplanche, Georges Brousse, Andries T. Marees, Eske M. Derks, Patrick Henry, Frank Bellivier, Florence Vorspan, Vanessa Bloch, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Clinique, Psychanalyse, Développement (CliPsyD), Université Paris Nanterre (UPN), Centre Hospitalier Emile Roux [AP-HP], Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA), Service d'Addictologie et Pathologie Duelles [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, VU University Medical Center [Amsterdam], Tournayre, Christophe, and Economics
Subjects: medicine.medical_specialty, Acute coronary syndrome, chest pain, Multivariate analysis, medicine.medical_treatment, RC435-571, cocaine, Single-nucleotide polymorphism, 030204 cardiovascular system & hematology, Chest pain, Logistic regression, acute coronary syndrome, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, single nucleotide polymorphism, Internal medicine, medicine, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, ALDH2, Psychiatry, Harm reduction, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, opioid maintenance treatment, GUCY1A3, Brief Research Report, medicine.disease, Confidence interval, Stimulant, Psychiatry and Mental health, rs2238151, medicine.symptom, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Introduction: Cocaine users often present with repetitive events of cocaine-associated chest pain (CACP), clinically resembling acute coronary syndromes. The aim of the study is to describe the specific risk factors for CACP.Method: Cocaine users (n = 316) were recruited for a multicenter cross-sectional study. Lifetime CACP history, sociodemographic factors, and lifetime use of cocaine and other substances were assessed. Thirty single nucleotide polymorphisms (SNPs) of NOS3, ROCK2, EDN1, GUCY1A3, and ALDH2 genes, suggested by the literature on coronary spasms, were selected. The associations with CACP history were tested using the chi-square test, Student's t-test and logistic regression.Results: Among the 316 subjects [78.5% men, mean age 37.5 years, (standard-deviation ±8.7)], 190 (60.1%) were daily cocaine users and 103 (32.6%) reported a lifetime CACP history. Among those with a lifetime CACP history, the median was 10 events per individual. In multivariate analysis, lifetime CACP history was associated with daily cocaine use [odds-ratio (OR) 3.24; 95% confidence intervals (1.29–9.33)], rapid route of cocaine use [OR 2.33 (1.20–4.64) vs. intranasal use], and lifetime amphetamine use [daily amphetamine use: OR 2.80 (1.25–6.32) and non-daily amphetamine use: OR 2.14 (1.15–4.04) vs. never used]. Patients with lifetime opioid maintenance treatment (OMT) reported significantly less lifetime CACP history [OR 0.35 (0.16–0.76)]. None of the selected SNPs was associated with CACP history after multiple testing corrections.Conclusions: Clinical variables describing the intensity of stimulant use were positively associated with lifetime CACP history, while OMT was negatively associated with it. Specific harm reduction strategies can target these risk factors.
Published: 2021
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5. Risk factors associated with day-30 mortality in patients over 60 years old admitted in ICU for severe COVID-19: the Senior-COVID-Rea Multicentre Survey protocol

Author: Claire, Falandry, Amélie, Malapert, Mélanie, Roche, Fabien, Subtil, Julien, Berthiller, Camille, Boin, Justine, Dubreuil, Christine, Ravot, Laurent, Bitker, Paul, Abraham, Vincent, Collange, Baptiste, Balança, Sylvie, Goutte, Céline, Guichon, Emilie, Gadea, Laurent, Argaud, David, Dayde, Laurent, Jallades, Alain, Lepape, Jean-Baptiste, Pialat, Arnaud, Friggeri, Fabrice, Thiollière, Marine, Thieux, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-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 Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Université de Lyon, Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Délégation à la Recherche Clinique et à l'Innovation [Lyon] (DRCI), Hôpital de la Croix-Rousse [CHU - HCL], Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Edouard Herriot [CHU - HCL], Médipôle Lyon-Villeurbanne, Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Centre de recherche en neurosciences de Lyon (CRNL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), L'Hôpital Nord-Ouest [Villefranche sur Saône], Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'anesthésie-réanimation [Centre Hospitalier Lyon Sud - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Senior-COVID-Rea study Group: Christophe Leroy, Anne-Claire Lukaszewicz, Thomas Rimmelé, Marie Simon, Charles-Hervé Vacheron, Hodane Yonis, Antoine Garnier-Crussard, Max Haïne, Loredana Baboi, Camille Boin, Valérie Cerro, David Dayde, Justine Dubreuil, Carlos El Khoury, Emilie Gadéa-Deschamps, Marie-Catherine Fromont, Audrey Gelot, Anthéa Loïez, Amélie Malapert, Céline Monard, Maya Perrou, Laetitia Paradisi-Prieur, Marion Provent, Mélanie Roche, Gulsum Sahin, Ghyslaine Thao, Marine Thieux., Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CarMeN, laboratoire, Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre International de Recherche en Infectiologie (CIRI), and École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL)
Subjects: intensive & critical care, SARS-CoV-2, geriatric medicine, [SDV]Life Sciences [q-bio], Intensive Care, COVID-19, Middle Aged, [SDV] Life Sciences [q-bio], Intensive Care Units, Risk Factors, Surveys and Questionnaires, Prohibitins, Humans, Multicenter Studies as Topic, France, Aged
Abstract: International audience; INTRODUCTION: With the spread of COVID-19 epidemic, health plans must be adapted continuously. There is an urgent need to define the best care courses of patients with COVID-19, especially in intensive care units (ICUs), according to their individualised benefit/risk ratio. Since older age is associated with poorer short-term and long-term outcomes, prediction models are needed, that may assist clinicians in their ICU admission decision. Senior-COVID-Rea was designed to evaluate, in patients over 60 years old admitted in ICU for severe COVID-19 disease, the impact of age and geriatric and paraclinical parameters on their mortality 30 days after ICU admission. METHODS AND ANALYSIS: This is a multicentre survey protocol to be conducted in seven hospitals of the Auvergne-Rhône-Alpes region, France. All patients over 60 years old admitted in ICU for severe COVID-19 infection (or their legally acceptable representative) will be proposed to enter the study and to fill in a questionnaire regarding their functional and nutritional parameters 1 month before COVID-19 infection. Paraclinical parameters at ICU admission will be collected: lymphocytes and neutrophils counts, high-fluorescent lymphoid cells and immature granulocytes percentages (Sysmex data), D-dimers, C-reactive protein, lactate dehydrogenase (LDH), creatinine, CT scan for lung extension rate as well as clinical resuscitation scores, and the delay between the first signs of infection and ICU admission. The primary outcome will be the overall survival at day 30 post-ICU admission. The analysis of factors predicting mortality at day 30 will be carried out using univariate and multivariate logistic regressions. Multivariate logistic regression will consider up to 15 factors.The ambition of this trial, which takes into account the different approaches of geriatric vulnerability, is to define the respective abilities of different operational criteria of frailty to predict patients' outcomes. ETHICS AND DISSEMINATION: The study protocol was ethically approved. The results of the primary and secondary objectives will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04422340.
Published: 2021
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6. Risk factors and events in the adult intensive care unit associated with pain as self-reported at the end of the intensive care unit stay

Author: Pierre Kalfon, Mohamed Boucekine, Philippe Estagnasie, Marie-Agnès Geantot, Audrey Berric, Georges Simon, Bernard Floccard, Thomas Signouret, Mélanie Fromentin, Martine Nyunga, Juliette Audibert, Adel Ben Salah, Bénédicte Mauchien, Achille Sossou, Marion Venot, René Robert, Arnaud Follin, Anne Renault, Maïté Garrouste-Orgeas, Olivier Collange, Quentin Levrat, Isabelle Villard, Didier Thevenin, Julien Pottecher, René-Gilles Patrigeon, Nathalie Revel, Coralie Vigne, Elie Azoulay, Olivier Mimoz, Pascal Auquier, Karine Baumstarck, IPREA Study Group, Hôpital Louis Pasteur [Chartres], Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Hôpital Ambroise Paré [AP-HP], Service d'anesthésie - réanimation chirurgicale [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse, CH de Troyes, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Européen de Marseille (HEM), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Victor Provo, Centre Hospitalier Emile Roux [AP-HP], Service d'Anesthésie-Réanimation [AP-HP Hôpitaux Saint-Louis Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHRU Brest - Département d'Anesthésie Réanimation (CHU - BREST - DAR), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre hospitalier Saint-Joseph [Paris], CHU Strasbourg, service de réanimation, groupe hospitalier de la Rochelle-Ré-Aunis, Hôpital Beaujon [AP-HP], Centre Hospitalier de Lens, Hôpital de Hautepierre [Strasbourg], Centre Hospitalier d'Auxerre, Hôpital Pasteur [Nice] (CHU), Hôpital Nord [CHU - APHM], Pharmacologie des anti-infectieux (PHAR), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), IPREA Study Group: Karine Vie, Gwenaëlle Lannuzel, Hélène Bout, Jean-Philippe Parthiot, Isabelle Chazal, Philippe Charve, Caroline Prum, Jean-Pierre Quenot, Nora Perrot, Francis Augier, Niloufar Behechti, Claudine Cocusse, Céline Foulon, Laurence Goncalves, Abdesselem Hanchi, Etienne Legros, Ana Isabel Mercier, Nicolas Meunier-Beillard, Nathalie Nuzillat, Alicia Richard, Claire Boulle, Benjamin Kowalski, Elisa Klusek, Tarek Sharshar, Andrea Polito, Caroline Duvallet, Sonia Krim, Nicolas Girard, Cécile Jourdain, Stéphane Techer, Corinne Chauvel, Corinne Bruchet, Johanna Temime, Stéphanie Beaussart, Fabienne Jarosz, Jullien Crozon-Clauzel, Serge Olousouzian, Sylvie Pereira, Loïc Argentin, Valérie Cerro, Déborah Levy, Sébastien Andre, Christophe Guervilly, Laurent Papazian, Myriam Moussa, Stéphanie Renoult, Delphine Biet, Steve Novak, Jean-Christophe Orban, Aminata Diop, Carole Ichai, Antoine Tesniere, Jean-Pascal Goupil, Frédérique Laville, Nadège Rutter, Sandie Brochon, Kelly Tiercelet, Julien Amour, Nora Ait-Hamou, Marjorie Leger, Virginie Souppart, Emilie Griffault, Marie-Line Debarre, Céline Deletage, Anne-Laure Guerin, Carole Guignon, Sabrina Seguin, Christophe Hart, Kathy Dernivoix, Caroline Wuiot, Karine Sanches, Stéphane Hecketsweiler, Catherine Sylvestre-Marconville, Vincent Gardan, Stéphanie Deparis-Dusautois, Yana Chaban, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), and Centre hospitalier d'Auxerre (CHA)
Subjects: Male, Multivariate analysis, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Critical Care and Intensive Care Medicine, law.invention, 0302 clinical medicine, Risk Factors, law, Surveys and Questionnaires, Cluster Analysis, Generalized estimating equation, Patient-reported outcome, Pain Measurement, Aged, 80 and over, Univariate analysis, Chest drain, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Middle Aged, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, Intensive care unit, 3. Good health, Intensive Care Units, Adult intensive care unit, Female, France, Central venous catheter, Discomfort, medicine.medical_specialty, Critical Illness, Pain, Statistics, Nonparametric, 03 medical and health sciences, medicine, Humans, Pain Management, Aged, business.industry, Research, IPREA, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Length of Stay, Critical care, 030228 respiratory system, Life support, Multivariate Analysis, Emergency medicine, Quality of Life, Self Report, business, Intra-hospital transport
Abstract: BackgroundThe short-term and long-term consequences of the most frequent painful procedures performed in the ICU are unclear. This study aimed to identify the risk factors associated with pain-related discomfort perceived by critically ill patients during the whole ICU stay as self-reported by patients at the end of their ICU stay.MethodsThe study involved 34 ICUs. Adult patients who survived an ICU stay of 3 calendar days or more were eligible for inclusion. Discomforts, including the pain-related discomfort, were assessed using the French 18-item questionnaire on discomfort in ICU patients, the “Inconforts des Patients de REAnimation” (IPREA). Patients scored each item from 0 (minimal discomfort) to 10 (maximal discomfort). Associations between patient characteristics at ICU admission, life support therapies and main potentially painful procedures performed during the ICU stay and pain-related discomfort scores assessed at the end of the ICU stay were analyzed.ResultsPatients with complete IPREA questionnaires (n = 2130) were included. The median pain-related discomfort score was 3 (IQR 0–5). From the univariate analysis, pain-related discomfort scores were negatively correlated with age and positively correlated with ICU stay duration; surgical patients reported significant higher pain-related discomfort scores than medical patients; chest drain insertion, chest drain removal, use of bladder catheter, central venous catheter (CVC) insertion, complex dressing change, and intra-hospital transport were associated with pain-related discomfort scores. From the multivariate analyses using generalized estimating equations models, only age, chest drain removal, use of a bladder catheter, CVC insertion, and intra-hospital transport were the main risk factors associated with pain-related discomfort scores.ConclusionPatients who underwent chest drain removal, bladder catheter, CVC insertion, and intra-hospital transport during their ICU stay reported higher pain-related discomfort scores (with respect to the whole ICU stay and assessed at the end of their ICU stay) than patients who did not experience these events. This study may pave the way for further targeted studies aiming at investigating a causal link between these common procedures in the ICU and adult critically ill patients’ perceptions of their ICU stay regarding recalled pain.Trial Registration: Clinicaltrials.gov Identifier NCT02442934, retrospectively registered on May 13, 2015
Published: 2020
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7. T-piece versus pressure-support ventilation for spontaneous breathing trials before extubation in patients at high risk of reintubation: protocol for a multicentre, randomised controlled trial (TIP-EX)

Author: Jean-Paul Mira, Jeremy Bourenne, Agathe Delbove, René Robert, Gaetan Beduneau, Jean-Pierre Frat, Jérôme Devaquet, Arnaud Gacouin, Laurence Dangers, Nicolas Terzi, Stéphanie Ragot, Guylaine Labro, Antoine Romen, Gael Pradel, Christophe Leroy, Jean Reignier, Laurent Argaud, Rémi Coudroy, Quentin Levrat, Stephan Ehrmann, Jean-Pierre Quenot, Emmanuel Vivier, Guillaume Lacave, Christophe Guitton, Marie-Ange Azais, Alexandre Lautrette, Mai-Anh Nay, Anahita Rouzé, Damien Contou, Martin Dres, Gwenaël Prat, Jean Dellamonica, Arnaud W. Thille, Nicholas Sedillot, Béatrice Lacombe, Université de Lille, CNRS, Centre hospitalier universitaire de Poitiers [CHU Poitiers], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Tours [CHRU Tours], Centre Hospitalier Victor Dupouy, Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion], Centre hospitalier de Pau, Centre Hospitalier Le Mans (CH Le Mans), Centre Hospitalier de Versailles André Mignot [CHV], CHU Dijon, CIC - CHU Henri Mondor, Centre Hospitalier Universitaire [Grenoble] [CHU], CHRU Brest - Service de Réanimation Médicale [CHU - BREST - Réa Med], Centre Hospitalier Emile Muller [Mulhouse] [CH E.Muller Mulhouse], Centre hospitalier universitaire de Nantes [CHU Nantes], Service d'anesthésie et réanimation chirurgicale [Nantes], Service de réanimation médicale [CHU Rouen], Centre Hospitalier Universitaire de Nice [CHU Nice], Centre Hospitalier Régional d'Orléans [CHRO], Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille], Centre hospitalier Bretagne Atlantique (Morbihan) [CHBA], Hôpital Cochin [AP-HP], Hôpital de la Timone [CHU - APHM] [TIMONE], Centre Jean Perrin [Clermont-Ferrand] [UNICANCER/CJP], Hôpital Edouard Herriot [CHU - HCL], Hôpital Foch [Suresnes], Centre hospitalier Saint Joseph - Saint Luc [Lyon], Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon [CHD Vendée], Centre Hospitalier Emile Roux [AP-HP], INSERM CIC 0802 [INSERM - CHU de Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire Félix-Guyon [Saint-Denis, La Réunion, France], Centre Hospitalier de Versailles André Mignot (CHV), Service de Réanimation Médicale (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Groupe Hospitalier Bretagne Sud (GHBS), Centre Hospitalier Henri Mondor d'Aurillac, Unité de soins intensifs médicaux [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), CHRU Brest - Service de Réanimation Médicale (CHU - BREST - Réa Med), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital Charles Nicolle [Rouen], Unité de Recherche Clinique de la Côte d’Azur [Nice] (URRIS UR2CA), Université Côte d'Azur (UCA), Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Hospitalier Régional d'Orléans (CHRO), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre hospitalier Bretagne Atlantique (Morbihan) (CHBA), Centre Hospitalier Fleyriat [Bourg en Bresse], Unité de Soins Intensifs [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Aix Marseille Université (AMU), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Hospices Civils de Lyon (HCL), Centre Hospitalier de La Rochelle (CHR), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon, Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), REVA research network, CarMeN, laboratoire, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche Clinique de la Côte d’Azur (URRIS UR2CA), Centre Hospitalier Universitaire de Nice (CHU Nice)-Université Côte d'Azur (UCA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: medicine.medical_treatment, [SDV]Life Sciences [q-bio], Pressure support ventilation, law.invention, Spontaneous breathing trial, Positive-Pressure Respiration, 03 medical and health sciences, Work of breathing, 0302 clinical medicine, Randomized controlled trial, law, Informed consent, medicine, respiratory medicine (see thoracic medicine), Humans, 030212 general & internal medicine, adult intensive & critical care, respiratory physiology, Mechanical ventilation, business.industry, Intensive Care, General Medicine, Intensive care unit, Respiration, Artificial, 3. Good health, [SDV] Life Sciences [q-bio], 030228 respiratory system, Anesthesia, Breathing, Airway Extubation, Medicine, France, business, Ventilator Weaning
Abstract: IntroductionIn intensive care unit (ICU), the decision of extubation is a critical time because mortality is particularly high in case of reintubation. To reduce that risk, guidelines recommend to systematically perform a spontaneous breathing trial (SBT) before extubation in order to mimic the postextubation physiological conditions. SBT is usually performed with a T-piece disconnecting the patient from the ventilator or with low levels of pressure-support ventilation (PSV). However, work of breathing is lower during PSV than during T-piece. Consequently, while PSV trial may hasten extubation, it may also increase the risk of reintubation. We hypothesise that, compared with T-piece, SBT performed using PSV may hasten extubation without increasing the risk of reintubation.Methods and analysisThis study is an investigator-initiated, multicentre randomised controlled trial comparing T-piece vs PSV for SBTs in patients at high risk of reintubation in ICUs. Nine hundred patients will be randomised with a 1:1 ratio in two groups according to the type of SBT. The primary outcome is the number of ventilator-free days at day 28, defined as the number of days alive and without invasive mechanical ventilation between the initial SBT (day 1) and day 28. Secondary outcomes include the number of days between the initial SBT and the first extubation attempt, weaning difficulty, the number of patients extubated after the initial SBT and not reintubated within the following 72 hours, the number of patients extubated within the 7 days following the initial SBT, the number of patients reintubated within the 7 days following extubation, in-ICU length of stay and mortality in ICU, at day 28 and at day 90.Ethics and disseminationThe study has been approved by the central ethics committee ‘Ile de France V’ (2019-A02151-56) and patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.Trial registration numberNCT04227639.
Published: 2020
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8. Functional decline in geriatric rehabilitation ward; is it ascribable to hospital acquired infection? A prospective cohort study

Author: Sylvie Bastuji-Garin, Cynthia Engels, Etienne Audureau, Marie Laurent, Eveline Liuu, Elena Paillaud, Jean-Philippe David, Nadia Oubaya, Florence Canoui-Poitrine, Lola Corsin, IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Henri Mondor, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris-Est Créteil Val-de-Marne - Institut de formation en ergothérapie (UPEC IFE), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), and Tapia, Claudia
Subjects: medicine.medical_specialty, Activities of daily living, Geriatric rehabilitation, medicine.medical_treatment, Comorbidity, lcsh:Geriatrics, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Elderly, Interquartile range, Internal medicine, Activities of Daily Living, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Geriatric Assessment, Acquired hospital infection functional decline, Aged, Geriatrics, Aged, 80 and over, Rehabilitation, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, business.industry, Incidence (epidemiology), [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, medicine.disease, Hospitals, Europe, lcsh:RC952-954.6, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Research Article
Abstract: Background In some European countries, including France, older patients with functional decline in acute units are transferred to geriatric rehabilitation units. Some patients may not benefit from their stay in a geriatric rehabilitation unit and paradoxically worsened their functional status. Previous prognostic models of functional decline are based on only baseline parameters. However, some events can occur during rehabilitation and modify the association between baseline parameters and rehabilitation performance such as heart failure episode, falls or hospital-acquired infection (HAI). The incidence of functional decline in these units and factors associated with this decline have not been clearly identified. Methods We used a prospective cohort of consecutive patients aged ≥75 years admitted to a geriatric rehabilitation unit in a French university hospital. The main endpoint was functional decline defined by at least an one-point decrease in Activities of Daily Living (ADL) score during the stay. Baseline social and geriatric characteristics were recorded and comorbidities were sought by the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). During follow-up, hospital-acquired infection (HAI) was recorded, as was ADL score at discharge. Multivariate logistic regression and mediation analyses were used to identify factors associated with ADL decrease. Results Among the 252 eligible patients, 160 (median age 84 years [interquartile range (IQR) 80–88] had available ADL scores at baseline (median score 7 [IQR 4–10]) and at discharge (median 9 [6–12]). Median CIRS-G score was 11 [8–13], 23 (14%) had a pulmonary HAI; 28 (17.5%) showed functional decline. On multivariable analysis, functional decline was associated with comorbidities (global CIRS-G score, P = 0.02, CIRS-G for respiratory disease [CIRS-G-R] ≥2, P = 0.02, or psychiatric disease, P = 0.02) and albumin level p = 0.03). Significant associations were found between functional decline and CIRS-G-R (OR 3.07 [95%CI 1.27–7.41], p = 0.01), between functional decline and pulmonary HAI (OR 3.12 [1.17–8.32],p = 0.02), and between CIRS-G-R and pulmonary HAI (OR 12.9[4.4–37.7], p = 0.0001). Theses associations and the reduced effect of CIRS-G-R on functional decline after adjusting for pulmonary HAI (OR 2.26 [0.83–6.16], p = 0.11) suggested partial mediation of pulmonary HAI in the relation between CIRS-G-R and functional decline. Conclusion Baseline comorbidities were independently associated with functional decline in patients hospitalized in a geriatric rehabilitation unit. Pulmonary HAI may have mediated this association. We need to better identify patients at risk of functional decline before transfer to a rehabilitation unit and to test the implementation of modern and individual programs of rehabilitation outside the hospital for these patients.
Published: 2020
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9. A decrease in brown adipose tissue activity is associated with weight gain during chemotherapy in early breast cancer patients

Author: Emilie Gadéa, Angeline Ginzac, Ioana Molnar, Marion Chanchou, Xavier Durando, B. Barres, Charles Merlin, Bruno Coudert, Emilie Thivat, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre d'Investigation Clinique [CHU Clermont-Ferrand] (CIC 1405), Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Département de Médecine nucléaire, Centre Jean PERRIN, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département d'oncologie médicale [Centre Georges-François Leclerc], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, and GINZAC, Angeline
Subjects: 0301 basic medicine, Cancer Research, medicine.medical_treatment, Docetaxel, Brown adipose tissue, Weight Gain, Gastroenterology, 0302 clinical medicine, Breast cancer, Adipose Tissue, Brown, Surgical oncology, Positron Emission Tomography Computed Tomography, Early breast cancer, [SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Lost Weight, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Neoadjuvant Therapy, 3. Good health, medicine.anatomical_structure, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Female, medicine.symptom, Research Article, Adult, medicine.medical_specialty, [SDV.CAN]Life Sciences [q-bio]/Cancer, Antineoplastic Agents, Breast Neoplasms, lcsh:RC254-282, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Fluorodeoxyglucose F18, Internal medicine, Genetics, medicine, Humans, Aged, Chemotherapy, business.industry, Energy metabolism, Trastuzumab, medicine.disease, 030104 developmental biology, business, Weight gain, Thermogenesis
Abstract: Background A decrease in thermogenesis is suspected to be implicated in the energy expenditure reduction during breast cancer treatment. This study aimed to investigate the impact of chemotherapy on the metabolic activity of brown adipose tissue (BAT) and the link with weight variation. Methods This was an ancillary analysis of a multicentre trial involving 109 HER2+ breast cancer patients treated with neoadjuvant chemotherapy. A centralised review of 18F-FDG uptake intensity (SUVmax) in specific BAT regions (cervical and supraclavicular) was conducted on two PET-CT scans for each patient (before and after the first course of chemotherapy). Results Overall, after one course of chemotherapy a significant decrease of 4.4% in 18F-FDG-uptake intensity was observed. It was not correlated to initial BMI, age or season. During chemotherapy, 10.1% (n = 11) of the patients lost weight (− 7.7 kg ± 3.8 kg; ie, − 9.4% ± 3.7%) and 29.4% (n = 32) gained weight (+ 5.1 kg ± 1.7 kg; ie, + 8.5% ± 2.6%). Among these subgroups, only the patients who had gained weight underwent a significant decrease (13.42%) in 18F-FDG uptake intensity (p = 0.042). Conclusion This study is the first to highlight in a large cohort of patients the negative impact of chemotherapy on brown adipose tissue activity. Weight gain during chemotherapy could thus potentially be explained in part by a decrease in brown adipose tissue activity.
Published: 2020
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10. Circulating 20S proteasome for assessing protein energy wasting syndrome in hemodialysis patients

Author: Marine Freist, Elodie Gentes, Carole Philipponnet, Mohamed Hadj Abdelkader, Bruno Pereira, Aurélien Piraud, Cyril Garrouste, Anne-Elisabeth Heng, Julien Aniort, Unité de Nutrition Humaine (UNH), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Néphrologie - Hémodialyses [CHU Clermont-Ferrand], Pôle RHEUNNIRS [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Dept Clin Nutr, Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Unité de Biostatistiques, Direction de la Recherche Clinique (DRCI)
Subjects: Male, 0301 basic medicine, dialyse, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 030232 urology & nephrology, Muscle Proteins, Biochemistry, protéasome, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Gastroenterology, 0302 clinical medicine, Medicine and Health Sciences, 2. Zero hunger, Multidisciplinary, Protein energy wasting, Muscle Analysis, Middle Aged, C-Reactive Proteins, Muscle atrophy, atrophie musculaire, 3. Good health, Hospitalization, Bioassays and Physiological Analysis, Nephrology, Creatinine, Medicine, Female, patient, Hemodialysis, medicine.symptom, Research Article, Proteasome Endopeptidase Complex, medicine.medical_specialty, Science, Nutritional Status, Circulating Proteasome, Research and Analysis Methods, Protein-Energy Malnutrition, 03 medical and health sciences, Signs and Symptoms, Renal Dialysis, Internal medicine, Medical Dialysis, medicine, Humans, Mortality, Survival rate, Nutrition, Aged, Wasting Syndrome, business.industry, Biology and Life Sciences, Proteins, Protein Complexes, Proteasomes, medicine.disease, perte d'énergie, Patient Outcome Assessment, 030104 developmental biology, Proteasome, Clinical Medicine, Atrophy, Complication, business, Biomarkers, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Kidney disease
Abstract: International audience; Protein energy wasting (PEW) including muscle atrophy is a common complication in chronic hemodialysis patients. The ubiquitin proteasome system (UPS) is the main proteolytic system causing muscle atrophy in chronic kidney disease and proteasome 20S is the catalytic component of the UPS. Circulating proteasome 20S (c20S proteasome) is present in the blood and its level is related to disease severity and prognosis in several disorders. We hypothesized that c20S proteasome could be related with muscle mass, other PEW criteria and their evolution in hemodialysis patients. Stable hemodialysis patients treated at our center for more than 3 months were followed over 2 years. C20S proteasome assay was performed at baseline. Biological and clinical data were collected, muscle mass was assessed by multi-frequency bio-impedancemetry, and nutritional scores were calculated at baseline, 1 year and 2 years. Hospitalizations and mortality data were collected over the 2 years. Forty-nine patients were included. At baseline, the c20S proteasome level was 0.40 [0.26-0.55] mu g/ml. Low muscle mass as defined by a lean tissue index (LTI) < 10th in accordance with the International Society of Renal Nutrition and Metabolism guidelines was observed in 36% and PEW in 62%. Increased c20S proteasome levels were related with LTI at baseline (R = 0.43, p = 0.004) and with its 2 year-variation (R = -0.56, p = 0.003). Two-year survival rate was not different between higher and lower c20S proteasome values (78.9 vs 78.4%, p = 0.98 log-rank test). C20S proteasome is not a good marker for assessing nutritional status in hemodialysis patients and predicting patient outcomes.
Published: 2020
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11. Choix de dire ou de taire le décès d’un proche à un patient

Author: Truong-Minh, Emmanuelle, Zambon, Sabine, Laboratoire lorrain de psychologie et neurosciences de la dynamique des comportements (2LPN), Université de Lorraine (UL), Centre Hospitalier Emile Roux [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: [SHS.PSY]Humanities and Social Sciences/Psychology, ComputingMilieux_MISCELLANEOUS
Abstract: National audience
Published: 2019

12. Treatment-Induced Cardiotoxicity in Breast Cancer: A Review of the Interest of Practicing a Physical Activity

Author: Ioana Molnar, Xavier Durando, Martine Duclos, Emilie Gadéa, Romain Trésorier, Judith Passildas, Catherine Abrial, Angeline Ginzac, Emilie Thivat, Imagerie Moléculaire et Stratégies Théranostiques - Clermont Auvergne (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), Centre Jean Perrin, CRLCC Jean Perrin, Centre Hospitalier Emile Roux, Unité de Nutrition Humaine - Clermont Auvergne (UNH), Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne (UCA), Service de Médecine du Sport et des Explorations Fonctionnelles, CHU Clermont-Ferrand, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de Nutrition Humaine (UNH), Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service Médecine du Sport et Explorations Fonctionnelles [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], and CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand]
Subjects: Cancer Research, medicine.medical_specialty, Anthracycline, Side effect, Population, Antineoplastic Agents, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Trastuzumab, medicine, Humans, Anthracyclines, 030212 general & internal medicine, Intensive care medicine, education, HER2-positive breast cancer, Exercise, Cardiotoxicity, education.field_of_study, business.industry, Physical activity, Cancer, General Medicine, medicine.disease, 3. Good health, Discontinuation, Oncology, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Patient Compliance, Female, business, medicine.drug
Abstract: International audience; Physical activity is known to prevent the occurrence of cancer and decrease the risk of breast cancer. At diagnosis of breast cancer, fewer than half of the patients reach the international recommendation for physical activity. However, breast cancer patients, and particularly HER2+ breast cancer patients, are exposed to treatment-induced cardiotoxicity because of a side effect of 2 molecules used in standard therapy to treat these tumors, i.e., anthracycline and trastuzumab. Cardiotoxicity can sometimes lead to discontinuation of the treatment and even to the development of cardiovascular diseases. Exercise is known to protect the cardiovascular system in the healthy population. Consequently, being physically active during treatment appears to be a way to prevent the negative impact of cancer treatment on the heart in this population. In particular, aerobic exercising could have a protective effect against treatment-induced cardiotoxicity. A supervised physical activity program seems to be the best way for breast cancer patients to be active during treatment. However, there is very little information, and in particular a lack of guidelines, on exercising available to patients. The interventional trials that have been conducted on this topic are very heterogeneous and no standard recommendations have been made available for cancer patients thus far. An effective physical activity program needs to take each patient’s barriers and motivations into account in order to encourage the practice of physical activity throughout treatment. To ensure the success of the program, it is essential to facilitate adherence and especially maintain motivation. Further studies are needed to determine what practice guidelines oncologists should give their patients.
Published: 2019
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13. Être ou ne pas être un atelier thérapeutique

Author: Truong-Minh, Emmanuelle, Anna, Soubigou, Alarcon, Natividad, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire lorrain de psychologie et neurosciences de la dynamique des comportements (2LPN), and Université de Lorraine (UL)
Subjects: [SHS.PSY]Humanities and Social Sciences/Psychology, ComputingMilieux_MISCELLANEOUS
Abstract: National audience
Published: 2018

14. Grande dépendance et politique de maintien à domicile : quels contours pour l’intervention des psychologues à domicile ?

Author: Truong-Minh, Emmanuelle, Laboratoire lorrain de psychologie et neurosciences de la dynamique des comportements (2LPN), Université de Lorraine (UL), Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), FFPP-Fédération Française des Psychologues et de Psychologie, and TRUONG-MINH, Emmanuelle
Subjects: [SHS.PSY] Humanities and Social Sciences/Psychology, [SHS.PSY]Humanities and Social Sciences/Psychology, ComputingMilieux_MISCELLANEOUS
Abstract: National audience
Published: 2018

15. Weight Evolution During Endocrine Therapy for Breast Cancer in Postmenopausal Patients: Effect of Initial Fat Mass Percentage and Previous Adjuvant Treatments

Author: Xavier Durando, Angeline Ginzac, Béatrice Morio, Judith Passildas, Catherine Abrial, Martine Duclos, Marie-Ange Mouret-Reynier, Yves Boirie, Isabelle Van Praagh, Emilie Gadéa, Emilie Thivat, Pascale Dubray-Longeras, Fabrice Kwiatkowski, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Unité de Nutrition Humaine (UNH), Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service Médecine du Sport et Explorations Fonctionnelles [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Imagerie Moléculaire et Stratégies Théranostiques - Clermont Auvergne (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), Centre Jean Perrin, CRLCC Jean Perrin, Unité de Nutrition Humaine - Clermont Auvergne (UNH), Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne (UCA), Service de médecine du sport et des explorations fonctionnelles, Centre Hospitalier Universitaire de Clermont-Ferrand, Centre Hospitalier Emile Roux, and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL)
Subjects: Postmenopausal breast cancer, Cancer Research, medicine.medical_specialty, Antineoplastic Agents, Hormonal, medicine.medical_treatment, Body water, Population, adjuvant treatment, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Weight loss, Internal medicine, medicine, [SDV.MHEP.AHA]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Longitudinal Studies, 030212 general & internal medicine, education, Aged, education.field_of_study, Chemotherapy, body composition, business.industry, endocrine therapy, Body Weight, Weight change, fat mass, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Middle Aged, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, medicine.disease, 3. Good health, Postmenopause, Oncology, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Lean body mass, Female, medicine.symptom, business, Bioelectrical impedance analysis, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract: Background Weight changes during adjuvant treatment for early-stage breast cancer has been associated with a poor prognosis. The long-term evolution of body composition during adjuvant treatment for breast cancer, in particular, endocrine therapy, is not well known, and new data on this topic are required. The present study assessed the evolution of weight and body composition among 33 postmenopausal breast cancer patients receiving endocrine therapy after standard adjuvant chemotherapy that included taxanes. Patients and Methods Dual-energy x-ray absorptiometry was used to measure the fat and lean body mass. Body water was assessed using multifrequency bioelectrical impedance analysis. The Hospital Anxiety and Depression questionnaire and the short version of the International Physical Activity Questionnaire were also administered. Results During endocrine therapy, 5 of the 33 patients (15.2%) lost weight and 12 (36.4%) gained weight. The overall average gain was 2.0 ± 5.5 kg (P = .04). During this period, the fat mass, lean body mass, and body water increased. The factors linked to fat mass gain included an excess fat mass (≥ 36%) before treatment and weight loss during chemotherapy. In the overall period of adjuvant cancer treatment, 30% of the population gained > 5% of their initial weight. The average gain was the same as that during the endocrine therapy period (2.0 ± 5.4 kg; P = .031) and was characterized by an increase in total lean body mass, mainly localized in the trunk region. Conclusion Endocrine therapy appears as a pivotal period in weight and body composition management. Overfat and obese patients and those who lose weight during chemotherapy were more subject to weight and fat mass gain during endocrine therapy.
Published: 2018
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16. Plasma amyloid levels within the Alzheimer's process and correlations with central biomarkers

Author: Nathalie Sastre, Cécile Adam, Didier Hannequin, Sophie Chauvelier, Marie–Ange Cariot, Hermine Lenoir, Laure Caillard, Djamila Krabchi, Léna Joffredo, Jean-Marc Tréluyer, Olivier Hanon, Françoise Lala, Frédéric Bloch, Bruno Vellas, Stéphanie Bombois, Laurence Hugonot–Diener, Philippe-Henri Robert, Céline Guillemaud, Xavier Delbeuck, Julien Dumurgier, Jean-François Mangin, Nathalie Charasz, Jean-Luc Novella, Vincent Camus, Pierre Anthony, Sylvain Lehmann, Anne-Sophie Rigaud, Audrey Gabelle, Clémence Boully, Lisette Volpe–Gillot, Jacques Touchon, Jacques Boddaert, Vincent Deramecourt, Giovanni Castelnovo, Yasmina Boudali, Marie Chupin, S. Schraen-Maschke, Olivier Guerin, Joël Belmin, Isabelle Saulnier, Valérie Chauviré, Nathalie Schwald, Salim Gherabli, Philippe Robert, Sarah Benisty, Candice Picard, Marie Laurent, Foucaud du Boisgueheneuc, Florien Labourée, Gabiel Abitbol, Sophie Haffen, Patrick Gelé, Hélène Briault, Jean Luc Novella, François Sellal, Claire Gervais, Marie–Agnès Picat, Anne Chawakilian, Marie–Thérèse Rabus, Pierre Jean Ousset, Galdric Orvoen, Thierry Dantoine, Pierre Vandel, Jaques Hugon, Rezki Daheb, Jean-Sébastien Vidal, David Wallon, Diane Dupuy, Karl Mondon, Lisette Volpe-Gillot, Adeline Rollin Sillaire, Christine Delmaire, Frédéric Blanc, Emmanuelle Duron, Anna Kearney–Schwartz, Evelyne Galbrun, Florence Latour, Christine Perret–Guillaume, Florence Moulin, C. Bayle, Sylvie Pariel, Jean-Philippe David, Mohamed Abdellaoui, Stéphanie Libercier, Valérie Gissot, Bernadette Allinquant, Jean-Yves Gaubert, Elena Paillaud, Jean–Marc Michel, Caroline Hommet, Gilles Berrut, Luc Buée, Eliana Alonso, Agnès Devendeville, Anne–Cécile Troussiere, Marie–Anne Mackowiak, Yann Spivac, Jacques Hugon, Pascaline Cassagnaud, Olivier Martinaud, Marion Paulin, Claire Paquet, Matthieu Plichart, Guillaume Sacco, Olivier Godefroy, Sophie Pichierri, Athanase Benetos, M.-L. Seux, Marc Paccalin, Edouard Chaussade, Centre de Mémoire de Ressources et de Recherche [Paris Broca], AP-HP - Hôpital Broca [Paris], Maladie d'Alzheimer : marqueurs génétiques et vasculaires, neuropsychologies (EA 4468), Université Paris Descartes - Paris 5 (UPD5)-Groupe hospitalier Broca, Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Lille Neurosciences & Cognition - U 1172 (LilNCog (ex-JPARC)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Mémoire de Ressources et de Recherche [Hôpitaux Civils de Colmar, Strasbourg], Hôpitaux Civils de Colmar, CATI Multicenter Neuroimaging Platform (CATI), Université Paris-Saclay, Centres Mémoire de Ressources et de Recherche Montpellier (CMRR), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Centre Mémoire de Ressources et de Recherche Paris Nord Ile-de-France (CMRR), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Mémoire de Ressources et de Recherche [CHU de Toulouse, Hôpital Purpan], Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Centre Hospitalier Emile Roux [AP-HP], Centres Mémoire de Ressources et de Recherche [CHRU Nancy] (CMRR de Lorraine), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Mémoire de Ressources et de Recherche [CHU de Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service de médecine interne [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Mémoire de Ressources et Recherche - CMRR [Haute-Normandie], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Hôpital Léopold-Bellan, Centre Mémoire de Ressources et de Recherche [CHRU de Poitiers La Miletrie], CHRU de Poitiers La Miletrie [Poitiers], Centre Mémoire de Ressources et de Recherche [Nice] (CMRR Nice), Université Côte d'Azur (UCA)-Centre Hospitalier Universitaire de Nice (CHU Nice)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Centre Mémoire de Ressources et de Recherche [CHU Amiens], CHU Amiens-Picardie, Centre de Mémoire de Ressources et de Recherches [Limoges] (CMRR Limoges), CHU Limoges-CH Esquirol [Limoges] (CH Esquirol), Centre Mémoire de Ressources et de Recherche [CHRU de Tours Hôpital Bretonneau], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau [Tours], Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Gériatrique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Mémoire de Ressources et de Recherche [CHRU de Besançon] (CMRR), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques [CHRU de Besançon], Laboratoire de Neurosciences Intégratives et Cliniques - UFC (EA 481) (NEURO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre de Mémoire de Ressource et Recherche [Champagne-Ardenne-Reims] (CMRR Reims - Champagne-Ardenne), Hôpital Maison Blanche, Centre Hospitalier Universitaire de Reims (CHU Reims)-Centre Hospitalier Universitaire de Reims (CHU Reims)-Fédération nationale des Centres de Mémoire de Ressources et de Recherche (FCMRR), Vieillissement, Fragilité (VIEFRA - EA 3797), Université de Reims Champagne-Ardenne (URCA), French Ministry of Health (Programme Hospitalier de Recherche Clinique [PHRC 2009/01-04 and PHRC-13-0404]), Fondation Plan Alzheimer, Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre Hospitalier Universitaire de Nice (CHU Nice)-Université Côte d'Azur (UCA), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)-Hôpital Bretonneau [Tours], Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de gériatrie à orientation cardiologique [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Lille Neurosciences & Cognition - U 1172 (LilNCog), Centre Mémoire [CHU de Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Nice Sophia Antipolis (1965 - 2019) (UNS), Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), Université de Picardie Jules Verne (UPJV), Laboratoire de Neurosciences Intégratives et Cliniques - UFC (UR 481) (NEURO), DE CARVALHO, Philippe, 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), Centre de Psychiatrie et Neurosciences (U894), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Male, 0301 basic medicine, Apolipoprotein E, Epidemiology, [SDV]Life Sciences [q-bio], 0302 clinical medicine, Cerebrospinal fluid, Prospective Studies, Prospective cohort study, Aged, 80 and over, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Health Policy, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Middle Aged, Alzheimer's disease, Mental Status and Dementia Tests, Magnetic Resonance Imaging, [SDV] Life Sciences [q-bio], Psychiatry and Mental health, Biomarker (medicine), Female, Cohort study, medicine.medical_specialty, Amyloid, 03 medical and health sciences, Cellular and Molecular Neuroscience, Amyloid β peptides, Developmental Neuroscience, Alzheimer Disease, Internal medicine, mental disorders, medicine, Humans, Dementia, Cognitive Dysfunction, Plasma biomarkers, CSF biomarkers, Aged, Amyloid beta-Peptides, business.industry, Mild cognitive impairment, Plasma levels, medicine.disease, 030104 developmental biology, Endocrinology, Csf biomarkers, Neurology (clinical), Geriatrics and Gerontology, business, Biomarkers, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; INTRODUCTION:Diagnostic relevance of plasma amyloid β (Aβ) for Alzheimer's disease (AD) process yields conflicting results. The objective of the study was to assess plasma levels of Aβ42 and Aβ40 in amnestic mild cognitive impairment (MCI), nonamnestic MCI, and AD patients and to investigate relationships between peripheral and central biomarkers.METHODS:One thousand forty participants (417 amnestic MCI, 122 nonamnestic MCI, and 501 AD) from the Biomarker of AmyLoïd pepTide and AlZheimer's diseAse Risk multicenter prospective study with cognition, plasma, cerebrospinal fluid (CSF), and magnetic resonance imaging assessments were included.RESULTS:Plasma Aβ1-42 and Aβ1-40 were lower in AD (36.9 [11.7] and 263 [80] pg/mL) than in amnestic MCI (38.2 [11.9] and 269 [68] pg/mL) than in nonamnestic MCI (39.7 [10.5] and 272 [52] pg/mL), respectively (P = .01 for overall difference between groups for Aβ1-42 and P = .04 for Aβ1-40). Globally, plasma Aβ1-42 correlated with age, Mini-Mental State Examination, and APOE ε4 allele. Plasma Aβ1-42 correlated with all CSF biomarkers in MCI but only with CSF Aβ42 in AD.DISCUSSION:Plasma Aβ was associated with cognitive status and CSF biomarkers, suggesting the interest of plasma amyloid biomarkers for diagnosis purpose.Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.
Published: 2018
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17. Stories and Narrative Analyzes in Health field

Author: Moulin, Pierre, Lefebvre des Noëttes, Véronique, Domenech-Gorca, Gwenaël, Levinson, Sharman, Moreau, Emilie, Giami, Alain, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Marie Préau, and Arnaud Siméone
Subjects: Stories, Health, récits, [SHS.PSY]Humanities and Social Sciences/Psychology, santé, analyses narratives, Sexuality, Narratives analyzes, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, sexualité
Abstract: International audience; L’importance des récits n’est plus à démontrer en sciences humaines et sociales. La pensée narrative représente en effet un mode de pensée dominant pour le sens commun (Bruner, 1991) permettant de rendre le monde intelligible, d’intégrer l’inconnu dans la vie quotidienne, en ordonnant des événements disparates sous forme d’histoires que les individus échangent chaque jour entre eux. De même, dans le champ sanitaire,l’exercice médical ou psychologique consiste à (faire) produire et à interpréter quotidiennement des récits centrés sur la santé et la maladie dans une visée diagnostique et/ou thérapeutique. Apparue dans les années 1990 en opposition à l’« Evidence Based Medicine », la « Narrative Based Medicine » – la « médecine narrative », ou « médecine basée sur les narrations » – vise explicitement à revaloriser la parole, la subjectivité et l’expérience de la maladie grave, appréhendée du côté des profanes ou des professionnels de santé, comme voie d’accès privilégiée de connaissance des objets santé, maladie et médecine (Charon, 2015). Le présent chapitre propose une réflexion théorique, épistémologique et méthodologique sur les approches narratives en médecine et en psychologie de la santé, à partir de quelques exemples pris dans différentsdomaines de la santé, et principalement issus de la thématique de la sexualité. Il s’agit notamment de clarifier l’intérêt et les limites de l’analyse narrative, d’interroger ses liens éventuels avec les méthodes quantitatives et d’expliciter concrètement les procédures d’analyse employées par le chercheur aux prises avec des matériaux discursifs.
Published: 2018

18. Paroles de psychologues auprès de patients sans parole

Author: Truong-Minh, Emmanuelle, Gili, Gaëlle, Chailley, Julie, Leroux, Christine, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut des Matériaux, de Microélectronique et des Nanosciences de Provence (IM2NP), Aix Marseille Université (AMU)-Université de Toulon (UTLN)-Centre National de la Recherche Scientifique (CNRS), FFPP- Fédération Française des Psychologues et de Psychologie, Laboratoire lorrain de psychologie et neurosciences de la dynamique des comportements (2LPN), Université de Lorraine (UL), and Université de Toulon (UTLN)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)
Subjects: [SHS.PSY]Humanities and Social Sciences/Psychology, ComputingMilieux_MISCELLANEOUS
Abstract: National audience
Published: 2017

19. Transmission de l’identité professionnelle à travers un double regard praticien – enseignant-chercheur: L’identité professionnelle du psychologue s’enseigne-t-elle ?

Author: de Montalembert, Marie, Truong-Minh, Emmanuelle, Laboratoire Psychologie de la Perception (LPP - UMR 8242), Université Paris Descartes - Paris 5 (UPD5)-Centre National de la Recherche Scientifique (CNRS), Laboratoire lorrain de psychologie et neurosciences de la dynamique des comportements (2LPN), Université de Lorraine (UL), Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and FFPP- Fédération Française des Psychologues et de Psychologie
Subjects: [SHS.PSY]Humanities and Social Sciences/Psychology, ComputingMilieux_MISCELLANEOUS
Abstract: National audience
Published: 2017

20. CKD complications in kidney-transplanted patients going back to dialysis: impact on patients outcomes

Author: Cyril Garrouste, Mohamed Hadj Abdelkader, Aurelien Mulliez, Myriam Isnard, Julien Aniort, Youssef Ali, Anne Elisabeth Heng, Didier Aguilera, Saleh Kaysi, Marc Bouiller, Unité de Nutrition Humaine (UNH), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Centre Hospitalier Jacques Lacarin, American University of Beirut Faculty of Medicine and Medical Center (AUB), Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), Service de Néphrologie - Hémodialyses [CHU Clermont-Ferrand], Pôle RHEUNNIRS [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], and CHU Clermont-Ferrand-CHU Clermont-Ferrand
Subjects: Nephrology, Adult, Male, medicine.medical_specialty, Complications, Time Factors, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 030232 urology & nephrology, 030204 cardiovascular system & hematology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Renal Dialysis, Risk Factors, Chronic kidney disease, Internal medicine, medicine, Humans, Treatment Failure, Renal Insufficiency, Chronic, Intensive care medicine, Survival rate, Dialysis, Kidney transplantation, Aged, Retrospective Studies, Kidney, business.industry, Middle Aged, medicine.disease, Kidney Transplantation, Log-rank test, Hospitalization, medicine.anatomical_structure, Arterial blood, Female, Graft failure, France, business, Biomarkers, Kidney disease
Abstract: International audience; Aims The management of chronic kidney disease (CKD) complications is not always adequate in patients with a failed kidney transplant. We aimed to evaluate the frequency of CKD complications and assess whether they may lead to worse outcomes in this patient population.Method We analyzed 49 kidney transplant recipients with a failed transplant (T+) and matched non-transplanted patients (T-) starting dialysis between 2000 and 2010 in five dialysis centers in France. CKD complications at dialysis initiation, hospitalizations and death were recorded and compared between the two groups.Results At dialysis initiation, T+ patients were more likely to have bicarbonate < 22 mmol/l (77.6 vs. 22.0%, p < 0.01), phosphate > 1.5 mmol/l (77.6 vs. 59.2%, p = 0.03), arterial blood pressure > 130/80 mmHg (75.5 vs. 93.9%, p = 0.01), body mass index < 23 (59.2 vs. 32.7%, p = 0.01) and albumin < 38 g/l (69.4 vs. 36.7%) than T-patients. T+ patients were hospitalized more frequently in the year following dialysis initiation (40.8 +/- 7.0 vs. 16.3 +/- 5.3%, log rank p = 0.01) and 5-year survival rate was lower than in T-patients (82.1 +/- 6.2 vs. 64.0 +/- 7.4%, log rank p = 0.02). However risk of hospitalization and mortality was lesser after adjustments for CKD complications.Conclusion Despite regular follow-up by nephrologists, CKD complications before initiation of dialysis are more frequent in T+ patients than in T-patients. A better management of CKD complications in T+ patients could improve outcomes after dialysis initiation.
Published: 2017
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21. Manier les normes sans normativité : quelle position pour les psychologues ?

Author: Emmanuelle Truong-Minh, Laboratoire lorrain de psychologie et neurosciences de la dynamique des comportements (2LPN), Université de Lorraine (UL), Centre Hospitalier Emile Roux [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, [SHS.PSY]Humanities and Social Sciences/Psychology, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2017
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22. Validation of Anatomical Models to Study Aerosol Deposition in Human Nasal Cavities

Author: François Jamar, Sandrine Le Guellec, Stephane Gatier, Gregory Reychler, Lara Leclerc, Patrice Diot, Laurent Vecellio, Deborah Le Pennec, Jérémie Pourchez, Maria Cabrera, Laurent Pitance, Marc Durand, Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), DTF-Aerodrug, DTF, DTF-Médical, Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Service de pneumologie, Université de Tours, Service Pneumologie Cliniques Universitaires Saint Luc, Université Catholique de Louvain = Catholic University of Louvain (UCL), Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Médecine Nucléaire Cliniques Universitaires Saint Luc, Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours (UT), Université Catholique de Louvain (UCL), and Centre Hospitalier Emile Roux
Subjects: Adult, Male, Models, Anatomic, Nasal cavity, Pathology, medicine.medical_specialty, Materials science, aerosol, medicine.medical_treatment, nebulizer, nasal, Pharmaceutical Science, Young Adult, Aerosol deposition, In vivo, Paranasal Sinuses, otorhinolaryngologic diseases, medicine, Humans, Deposition (phase transition), [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, Pharmacology (medical), Radionuclide Imaging, anatomical model, Aerosols, Pharmacology, Nebulizers and Vaporizers, Organic Chemistry, Nasal Sprays, respiratory system, Aerosol, Nebulizer, medicine.anatomical_structure, Nasal spray, [SDV.TOX]Life Sciences [q-bio]/Toxicology, Technetium Tc 99m Pentetate, Molecular Medicine, Nasal administration, Nasal Cavity, Tomography, X-Ray Computed, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Research Paper, Biotechnology, Biomedical engineering
Abstract: International audience; PurposeIntranasal deposition of aerosols is often studied using in vitro nasal cavity models. However, the relevance of these models to predict in vivo human deposition has not been validated. This study compared in vivo nasal aerosol deposition and in vitro deposition in a human plastinated head model (NC1) and its replica constructed from CT-scan (NC2).MethodsTwo nebulizers (Atomisor Sonique® and Easynose®) were used to administer a 5.6 μm aerosol of 99mTc-DTPA to seven healthy volunteers and to the nasal models. Aerosol deposition was quantified by γ-scintigraphy in the nasal, upper nasal cavity and maxillary sinus (MS) regions. The distribution of aerosol deposition was determined along three nasal cavity axes (x, y and z).ResultsThere was no significant difference regarding aerosol deposition between the volunteers and NC1. Aerosol deposition was significantly lower in NC2 than in volunteers regarding nasal region (p
Published: 2013
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23. Effets d’une complémentation de 3 semaines par la citrulline (Cit) sur le turn over protéique chez des patients âgés dénutris

Author: Christian Aussel, Jean-Claude Melchior, Faure, J., Paul, M., Canouï-Poitrine, F., Yves Boirie, Forasassi, C., Guery, E., Le Corvoisier, P., Neveux, N., Astier, A., Raynaud-Simon, A., Stephane Walrand, Cynober, L., Bouillanne, O., Faculté des Sciences Pharmaceutiques et Biologiques, Hôpital Raymond Poincaré [AP-HP], Département de Pharmacie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Santé Publique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Université Paris Est Créteil, Unité de Nutrition Humaine (UNH), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Institut National de la Recherche Agronomique (INRA), Département Nutrition Clinique, CHU Clermont-Ferrand, Hôpital Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Henri Mondor, AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Département de Gérontologie, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris (AP-HP), Centre Hospitalier Emile Roux [AP-HP], Société Francophone Nutrition Clinique et Métabolisme (SFNEP). FRA., Société Française de Nutrition (SFN). FRA., Institut National de la Recherche Agronomique (INRA)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université, CHU Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and CHU Henri Mondor [Créteil]
Subjects: personne âgée, sarcopenie, dénutrition, synthèse protéique, Alimentation et Nutrition, citrulline, Food and Nutrition, Médecine humaine et pathologie, Human health and pathology, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Forum des prix SFN - Impact des facteurs environnementaux et génétiques sur la consommation et l'utilisation des nutriments; National audience; Introduction et but de l’étude : La prise en charge nutritionnelle de la sarcopénie et de la dénutrition est souvent peu efficace chez la personne âgée, notamment à cause de la résistance à l’anabolisme protéique postprandial. La Cit stimule la synthèse protéique musculaire chez le rat âgé et chez l’homme jeune. Le but de cette étude est de mesurer si la Cit est efficace sur le turn over protéique des patients âgés dénutris (PAD) hospitalisés. Matériel et méthodes : Cette étude prospective (PHRC National 2007, ClinicalTrials.gov Identifier: NCT00714675), randomisée et multicentrique a inclus 29 PAD hospitalisés en soins de suite gériatrique. Ils recevaient tous, pendant 20 jours, par voie orale, soit 10 g de Cit soit un mélange iso-azoté de 6 acides aminés (AAs) non essentiels (AANE). Le turn over protéique corps entier, la vitesse de synthèse fractionnaire de l’albumine (VSFA) et la séquestration splanchnique ont été mesurés le 21ème jour par une technique de dilution isotopique utilisant la 13C-Leucine et la 3D-Leucine, chez des patients à jeun depuis 12 heures et en situation postprandiale. Résultats et Analyse statistique : 24 patients ont terminé l’étude. Il n’y a pas de modification du turn over protéique et de la synthèse protéique corps entier (NOLD). La VSFA n’est pas modifiée. En revanche, il existe une tendance à la diminution de l’extraction splanchnique des AAs chez les patients traités par la Cit (Cit : 45.2 [26.2;58.4], AANE : 60.3 [48.3 ;69.7] en %/j, p
Published: 2016

24. Diagnostic Delay Is Associated with a Greater Risk of Early Surgery in a French Cohort of Crohn’s Disease Patients

Author: Vered Abitbol, Bruno Lesgourgues, Laurent Peyrin-Biroulet, Stanislas Chaussade, Stéphane Nahon, Thierry Paupard, Pierre Lahmek, Service d’hépato-gastro-entérologie [CH Le Raincy-Montfermeil], Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier de Dunkerque, Service de Gastro-entérologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Hépato-gastro-entérologie [CHRU Nancy], and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
Subjects: Male, Delayed Diagnosis, Time Factors, Physiology, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Constriction, Pathologic, Kaplan-Meier Estimate, Cohort Studies, 0302 clinical medicine, Crohn Disease, Prospective Studies, Young adult, Prospective cohort study, Colectomy, Digestive System Surgical Procedures, Crohn's disease, Enterostomy, Gastroenterology, 3. Good health, Diagnostic delay, Jejunum, Quartile, 030220 oncology & carcinogenesis, Cohort, Female, 030211 gastroenterology & hepatology, France, Immunosuppressive Agents, Cohort study, medicine.drug, Adult, Risk, medicine.medical_specialty, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Humans, Tumor Necrosis Factor-alpha, business.industry, Adalimumab, medicine.disease, Infliximab, Surgery, Methotrexate, business, Intestinal Obstruction
Abstract: International audience; To investigate whether a diagnostic delay is associated with a poor outcome in Crohn's disease (CD).Medical and socioeconomic characteristics as well as medications and need for surgery of consecutive CD adults patients followed in three referral centers were prospectively recorded using an electronic database (Focus_MICIA (R)). A long diagnostic delay was defined by the upper quartile. We compared patients with long diagnostic delay to those with earlier diagnosis regarding the time to: (1) first intestinal surgery, (2) first use of immunosuppressants (IMSs), and (3) first use of anti-tumor necrosis factor (anti-TNF) therapy using the Kaplan-Meier test and the log-rank test.A total of 497 patients with CD (53.6 % women) were analyzed. Median diagnostic delay was 5 months (IQR 25-75 %: 2-13 months). Median follow-up was 9 years (IQR 4-16.2), and 148 (29.8 %) patients had major surgery. There were no significant differences between patients with late and early diagnosis regarding age at diagnosis, disease phenotype, need for IMS therapy, and need for anti-TNF therapy. Time to first major surgery was shorter in patients with late diagnosis (p = 0.05).In this large multicenter prospective cohort of French CD patients, a long diagnostic delay (> 13 months) increased the risk of early surgery. No associated factors could be identified in this study.
Published: 2016
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25. Impact of acoustic airflow nebulization on intrasinus drug deposition of a human plastinated nasal cast: New insights into the mechanisms involved

Author: Valérie Forest, Marc Durand, Gérald Aubert, Laurent Navarro, Jérémie Pourchez, Philippe Rusch, Sandrine Le Guellec, Michèle Cottier, Oto-Rhino-Laryngologie, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Interdisciplinaire des Nanoparticules Aérosolisées (LINA-ENSME), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Institut Fédératif de Recherche en Sciences et Ingénierie de la Santé (IFRESIS-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-IFR143, Centre Ingénierie et Santé (CIS-ENSMSE), Laboratoire Antibiologie, CHU Saint-Etienne, Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), DTF-Aerodrug, DTF, Département Biomécanique et Biomatériaux (DB2M-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), Service d'Histologie Embryologie, CHRU Saint-Etienne, Centre Hospitalier Emile Roux, Faculté de Médecine de Tours, Université Jean Monnet, Toucas, Andrée-Aimée, and Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Models, Anatomic, Drug deposition, Nasal cavity, Pathology, medicine.medical_specialty, Materials science, Maxillary sinus, [SPI.GPROC] Engineering Sciences [physics]/Chemical and Process Engineering, Airflow, Pharmaceutical Science, 02 engineering and technology, Acoustic airflow, Plastination, 03 medical and health sciences, 0302 clinical medicine, Acoustic rhinometry, Paranasal Sinuses, otorhinolaryngologic diseases, medicine, Humans, [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, 030223 otorhinolaryngology, Aerosols, Air Movements, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Aerosol therapy, medicine.diagnostic_test, Healthy subjects, Acoustics, respiratory system, 021001 nanoscience & nanotechnology, Paranasal sinuses, medicine.anatomical_structure, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Gentamicins, Nasal Cavity, Rhinomanometry, 0210 nano-technology, Biomedical engineering
Abstract: Purpose The impact of 100 Hz (Hertz) acoustic frequency airflow on sinus drug deposition of aerosols was investigated using a human plastinated nasal cast. The influence of drug concentration and endonasal anatomical features on the sinus deposition enhanced by the 100 Hz acoustic airflow was also examined. Methods Plastinated models were anatomically, geometrically and aerodynamically validated (endoscopy, CT scans, acoustic rhinometry and rhinomanometry). Using the gentamicin as a marker, 286 experiments of aerosol deposition were performed. Changes of airborne particles metrology produced under different nebulization conditions (100 Hz acoustic airflow and gentamicin concentration) were also examined. Results Aerodynamic and geometric investigations highlighted a global behaviour of plastinated models in perfect accordance with a nasal decongested healthy subject. The results of intrasinus drug deposition clearly demonstrated that the aerosols can penetrate into the maxillary sinuses. The 100 Hz acoustic airflow led to increase the deposition of drug into the maxillary sinuses by a factor 2–3 depending on the nebulization conditions. A differential intrasinus deposition of active substance depending on maxillary ostium anatomical features and drug concentration was emphasized. Conclusion The existence of a specific transport mechanism of penetration of nebulized particles delivered with acoustic airflow was proposed.
Published: 2011
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26. Plastinated nasal model: a new concept of anatomically realistic cast

Author: Michèle Cottier, Philippe Rusch, Bruno Louis, Jérémie Pourchez, André Coste, Jean François Pouget, Marc Durand, Jean Michel Prades, Daniel Isabey, Oto-Rhino-Laryngologie, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Fédératif de Recherche en Sciences et Ingénierie de la Santé (IFRESIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-IFR143, Laboratoire Interdisciplinaire des Nanoparticules Aérosolisées (LINA-ENSME), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), INSERM U955, équipe 13, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Biomécanique cellulaire et respiratoire (BCR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), Radio-Diagnostic et Imagerie Médicale (RDIM), Clinique Mutualiste Saint-Etienne, CHU Saint-Etienne, Service d'Histologie Embryologie, CHRU Saint-Etienne, (1) Centre Hospitalier Emile Roux Le Puy, (2) Université Jean Monnet, (3) Université Paris 12, (4) Clinique Mutualiste Saint Etienne, (5) CHU Saint Etienne, and Toucas, Andrée-Aimée
Subjects: Male, Models, Anatomic, Biomimetic materials, Vacuum, Maxillary sinus, [SPI.GPROC] Engineering Sciences [physics]/Chemical and Process Engineering, Polymers, nasal airway cast, MESH: Rhinomanometry, MESH: Models, Anatomic, 03 medical and health sciences, 0302 clinical medicine, Plastination, Acoustic rhinometry, Aerosol deposition, maxillary sinuses, Biomimetic Materials, otorhinolaryngologic diseases, medicine, Humans, [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, 030223 otorhinolaryngology, Nose, [SDV.IB] Life Sciences [q-bio]/Bioengineering, MESH: Humans, plastination, medicine.diagnostic_test, business.industry, MESH: Biomimetic Materials, Healthy subjects, General Medicine, Anatomy, respiratory system, anatomic model, MESH: Male, Rhinomanometry, MESH: Polymers, medicine.anatomical_structure, Otorhinolaryngology, 030220 oncology & carcinogenesis, MESH: Vacuum, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, business, MESH: Female
Abstract: International audience; BACKGROUND: For many years, researchers have been interested in investigating airflow and aerosol deposition in the nasal cavities. The nasal airways appear to be a complex geometrical system. Thus, in vitro experimental studies are frequently conducted with a more or less biomimetic nasal replica. AIM: This study is devoted to the development of an anatomically realistic nose model with bilateral nasal cavities, i.e. nasal anatomy, airway geometry and aerodynamic properties as close as possible to in vivo behaviour. METHODS: A specific plastination technique of cephalic extremities was developed by the Anatomy Laboratory at the Saint-Etienne University in the last 10 years. The plastinated models obtained were anatomically, geometrically and aerodynamically validated using several techniques (endoscopy, CT scans, acoustic rhinometry and rhinomanometry). RESULTS: Our plastination model exhibited a high level of anatomic quality, including a very good mucosa preservation. Aerodynamical and geometrical investigations highlighted a global behaviour of plastinated models perfectly in accordance with a nasal decongested healthy subject. CONCLUSIONS: The present plastination model provides a realistic cast of nasal airways, and may be a useful tool for nasal flow, drug delivery and aerosol deposition studies.
Published: 2011
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27. Impact of acoustic airflow on intrasinus drug deposition: New insights into the vibrating mode and the optimal acoustic frequency to enhance the delivery of nebulized antibiotic

Author: Laurent Navarro, Amira El Merhie, Lara Leclerc, Jérémie Pourchez, Nathalie Prevot, Marc Durand, Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Centre Hospitalier Emile Roux [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Drug deposition, Materials science, Maxillary sinus, Acoustics, Airflow, intrasinus deposition, Pharmaceutical Science, Vibration, behavioral disciplines and activities, 81mKr-gas ventilation, Drug Delivery Systems, medicine, otorhinolaryngologic diseases, Deposition (phase transition), Humans, [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, Radionuclide Imaging, Sound wave, Sinus (anatomy), Administration, Intranasal, Nebulizers and Vaporizers, Krypton Radioisotopes, high frequency, Maxillary Sinus, respiratory system, Anti-Bacterial Agents, respiratory tract diseases, medicine.anatomical_structure, Sound, Breathing, sense organs, Gentamicins, vibrating acoustic airflow, low frequency, Pulmonary Ventilation, Acoustic frequency
Abstract: International audience; Aim: We investigated the impact of vibrating acoustic airflow, the high frequency (f ≥ 100 Hz) and the low frequency (f ≤ 45 Hz) sound waves, on the enhancement of intrasinus drug deposition.Methods: 81mKr-gas ventilation study was performed in a plastinated human cast with and without the addition of vibrating acoustic airflow. Similarly, intrasinus drug deposition in a nasal replica using gentamicin as a marker was studied with and without the superposition of different modes of acoustic airflow.Results: Ventilation experiments demonstrate that no sinus ventilation was observed without acoustic airflow although sinus ventilation occurred whatever the modes of acoustic airflow applied. Intrasinus drug deposition experiments showed that the high frequency acoustic airflow led to 4-fold increase in gentamicin deposition into the left maxillary sinus and to 2-fold deposition increase into the right maxillary sinus. Besides, the low frequency acoustic airflow demonstrated a significant increase of 4-fold and 2-fold in the right and left maxillary sinuses respectively.Conclusion: We demonstrated the benefit of different modes of vibrating acoustic airflow for maxillary sinus ventilation and intrasinus drug deposition. The degree of gentamicin deposition varies as a function of frequency of the vibrating acoustic airflow and the geometry of the ostia.
Published: 2015
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28. Diagnostic delay in a French cohort of Crohn's disease patients

Author: Stanislas Chaussade, Pierre Lahmek, Bruno Lesgourgues, Cécile Poupardin, Vered Abitbol, Laurent Peyrin-Biroulet, Stéphane Nahon, Service d’hépato-gastro-entérologie [CH Le Raincy-Montfermeil], Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hépato-gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département de gastroentérologie, Hôpital Cochin [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Multivariate analysis, Delayed Diagnosis, Time Factors, Referral, Adolescent, [SDV]Life Sciences [q-bio], Disease, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Crohn Disease, Risk Factors, Medicine, Humans, Prospective Studies, Young adult, Prospective cohort study, business.industry, Incidence (epidemiology), Incidence, Gastroenterology, General Medicine, 3. Good health, Diagnostic delay, Socioeconomic deprivation, Crohn's disease, Quartile, Socioeconomic Factors, 030220 oncology & carcinogenesis, Cohort, Disease Progression, 030211 gastroenterology & hepatology, Female, France, business, Follow-Up Studies
Abstract: Diagnostic delay is frequent in Crohn's disease (CD) and may partly depend on socioeconomic status. The aim of this study was to determine the diagnostic delay and to identify associated risk factors, including socioeconomic deprivation in a French cohort of CD patients. Methods Medical and socioeconomic characteristics of all consecutive CD patients followed in 2 referral centers between September 2002 and July 2012 were prospectively recorded using an electronic database. Diagnostic delay was defined as the time period (months) from the first symptom onset to CD diagnosis. A long diagnostic delay was defined by the upper quartile of this time period. Univariate and multivariate analyses were performed to identify the baseline characteristics of patients associated with a long diagnostic delay. Results Three hundred and sixty-four patients with CD (mean age = 29.2 ± 12.6 years, 40.8% men) were analyzed. Median diagnostic delay was 5 months, and a long diagnostic delay was more than 12 months. Fifty-six patients (15.3%) had perianal lesions, and 28 patients (8.6%) had complicated disease at diagnosis. None of the following factors were associated with a long diagnostic delay: age, gender, CD location and behavior, marital and educational, language understanding, geographic origin and socioeconomic deprivation score measured by the EPICES score. Conclusion In this French referral center-based cohort of CD patients, the median diagnostic delay was 5 months. None of the baseline characteristics of the CD, including socioeconomic deprivation, influenced diagnostic delay in this cohort.
Published: 2014
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29. Particle Deposition in a Child Respiratory Tract Model: In Vivo Regional Deposition of Fine and Ultrafine Aerosols in Baboons

Author: Iolanda Albuquerque-Silva, Laurent Vecellio, Marc Durand, John Avet, Déborah Le Pennec, Michèle de Monte, Jérôme Montharu, Patrice Diot, Michèle Cottier, Francis Dubois, Jérémie Pourchez, Institut Fédératif de Recherche en Sciences et Ingénierie de la Santé (IFRESIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-IFR143, Centre Ingénierie et Santé (CIS-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), DTF-Aerodrug, DTF, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Lyon, Faculté de Médecine, Université Jean Monnet [Saint-Étienne] (UJM), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université François Rabelais, CHRU et DTF-Aerodrug (Tours), Centre Hospitalier Emile Roux (Le Puy en Velay), Université De Lyon (Lyon), CHU, Université Jean Monnet (Saint Etienne), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Chatagnon, Amélie, and Université Jean Monnet - Saint-Étienne (UJM)
Subjects: Pathology, Respiratory System, 0302 clinical medicine, Medicine and Health Sciences, scintigraphy, Comparative Anatomy, Respiratory system, 0303 health sciences, child, Multidisciplinary, Inhalation, Chemistry, Radiology and Imaging, Radiation Exposure, Deposition (aerosol physics), medicine.anatomical_structure, Models, Animal, Medicine, Anatomy, Research Article, Biotechnology, medicine.medical_specialty, [SPI.GPROC] Engineering Sciences [physics]/Chemical and Process Engineering, Radiation Biophysics, Science, Biophysics, Biomedical Engineering, Bioengineering, Research and Analysis Methods, 03 medical and health sciences, In vivo, medicine, Animals, Humans, [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, Particle Size, airborne particles, 030304 developmental biology, Aerosols, baboon, Radiochemistry, Biology and Life Sciences, Bioethics, respiratory tract, Aerosol, 030228 respiratory system, Animal Studies, Medical Devices and Equipment, Particle size, deposition pattern, Clinical Medicine, Papio, Particle deposition, Respiratory tract
Abstract: International audience; To relate exposure to adverse health effects, it is necessary to know where particles in the submicron range deposit in the respiratory tract. The possibly higher vulnerability of children requires specific inhalation studies. However, radio-aerosol deposition experiments involving children are rare because of ethical restrictions related to radiation exposure. Thus, an in vivo study was conducted using three baboons as a child respiratory tract model to assess regional deposition patterns (thoracic region vs. extrathoracic region) of radioactive polydisperse aerosols ([d16-d84], equal to [0.15 μm-0.5 μm], [0.25 μm-1 μm], or [1 μm-9 μm]). Results clearly demonstrated that aerosol deposition within the thoracic region and the extrathoraic region varied substantially according to particle size. High deposition in the extrathoracic region was observed for the [1 μm-9 μm] aerosol (72% ± 17%). The [0.15 μm-0.5 μm] aerosol was associated almost exclusively with thoracic region deposition (84% ± 4%). Airborne particles in the range of [0.25 μm-1 μm] showed an intermediate deposition pattern, with 49% ± 8% in the extrathoracic region and 51% ± 8% in the thoracic region. Finally, comparison of baboon and human inhalation experiments for the [1 μm-9 μm] aerosol showed similar regional deposition, leading to the conclusion that regional deposition is species-independent for this airborne particle sizes.
Published: 2014
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30. Assessing sinus aerosol deposition: benefits of SPECT-CT imaging

Author: Michèle Cottier, Lara Leclerc, Nathalie Prevot, Laurent Vecellio, Jérémie Pourchez, Marc Durand, Sandrine Le Guellec, Institut Fédératif de Recherche en Sciences et Ingénierie de la Santé (IFRESIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-IFR143, Centre Ingénierie et Santé (CIS-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), DTF-Aerodrug, DTF, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université François Rabelais de Tours (DTF-Aerodrug, Faculté de Médecine), Centre Hospitalier Emile Roux, Le Puy en Velay, Université Jean Monnet, Saint Etienne., Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), and Chatagnon, Amélie
Subjects: Male, Models, Anatomic, Nasal cavity, Rhinology, Pathology, medicine.medical_specialty, Materials science, Maxillary sinus, [SPI.GPROC] Engineering Sciences [physics]/Chemical and Process Engineering, Pharmaceutical Science, aerosoltherapy, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Drug Delivery Systems, Imaging, Three-Dimensional, Administration, Inhalation, Paranasal Sinuses, medicine, otorhinolaryngologic diseases, Humans, [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, Particle Size, SPECT/CT imaging, Sinus (anatomy), Nose, Aerosols, Tomography, Emission-Computed, Single-Photon, business.industry, Aerosol, medicine.anatomical_structure, Deposition (aerosol physics), Paranasal sinuses, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Nasal Cavity, Tomography, X-Ray Computed, Nuclear medicine, business, aerosol deposition
Abstract: International audience; Purpose: Aerosol inhalation therapy is one of the methods to treat rhinosinusitis. However the topical drug delivery to the posterior nose and paranasal sinuses shows only limited efficiency. A precise sinusal targeting remains a main challenge for aerosol treatment of sinus disorders. This paper proposes a comparative study of the nasal deposition patterns of micron and submicron particles using planar gamma-scintigraphy imaging vs. a new 3-dimensional (3D) imaging approach based on SPECT-CT measurements. Methods: Radiolabelled nebulizations have been performed on a plastinated model of human nasal cast coupled with a respiratory pump. First, the benefits provided by SPECT-CT imaging were compared with 2D gamma-scintigraphy and radioactive quantification of maxillary sinus lavage as reference for the sonic 2.8 μm aerosol sinusal deposition. Then, the impact on nasal deposition of various airborne particle sizes was assessed. Results: The 2D methodology overestimates aerosol deposition in the maxillary sinuses by a factor 9 whereas the 3D methodology is in agreement with the maxillary sinus lavage reference methodology. Then with the SPECT-CT approach we highlighted that the higher particle size was mainly deposited in the central nasal cavity contrary to the submicron aerosol particles (33.8 ± 0.6% of total deposition for the 2.8 μm particles vs. 1 ± 0.3% for the 230 nm particles). Conclusion: Benefits of SPECT/CT for the assessment of radiolabelled aerosol deposition in rhinology are clearly demonstrated. This 3D methodology should be preferentially used for scintigraphic imaging of sinusal deposition in Human.
Published: 2014
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31. Inhalation therapy: Inhaled corticosteroids in ENT, development and technical challenges of powder inhalers, nebulisers synchronized with breathing and aerosol size distribution

Author: Le Guen, P., Peron, N., Durand, M., Pourchez, J., Cavaillon, P., Reychler, G., Vecellio, L., Dubus, J.C., Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Service de pneumologie B, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), Centre Hospitalier Emile Roux, Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées ( LINA-ENSMSE ), École des Mines de Saint-Étienne ( Mines Saint-Étienne MSE ), Institut Mines-Télécom [Paris]-Institut Mines-Télécom [Paris]-CIS, Centre Ingénierie et Santé ( CIS-ENSMSE ), Institut Mines-Télécom [Paris]-Institut Mines-Télécom [Paris], Service Pneumologie Cliniques Universitaires Saint Luc, Université Catholique de Louvain ( UCL ), DTF-Aerodrug, DTF, Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Médecine Infantile [Hôpital Nord - APMH], Hôpital Nord [CHU - APHM], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Centre Ingénierie et Santé (CIS-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Université Catholique de Louvain = Catholic University of Louvain (UCL), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7), and Université Catholique de Louvain (UCL)
Subjects: Nasal spray, [SDV.TOX]Life Sciences [q-bio]/Toxicology, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, [ SDV.TOX ] Life Sciences [q-bio]/Toxicology, Dry-powder inhalers, [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, [ SPI.GPROC ] Engineering Sciences [physics]/Chemical and Process Engineering, Particle size distribution, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Inhaled treatment
Abstract: International audience; The working group on aerosol therapy (GAT) of the Société de Pneumologie de Langue Française (SPLF) has organized its third Aerosolstorming in 2012. During one single day, different aspects of inhaled therapies have been treated and are detailed in two articles, this one being the second. This text deals with the indications of inhaled corticosteroids in ENT, the development and technical challenges of powder inhalers, the advantages and disadvantages of each type of technologies to measure the particle sizes of inhaled treatments.
Published: 2013
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32. Sociocultural Integration in Mergers and Acquisitions: Unresolved Paradoxes and Directions for Future Research

Author: Niels Noorderhaven, Audrey Rouzies, Muriel Durand, Mark E. Mendenhall, Shlomo Y. Tarba, Duncan Angwin, Dave Bouckenooghe, Mikael Søndergaard, Sergio Luis Seloti, Noelia-Sarah Reynolds, Yaakov Weber, Gary Kokk, Kathleen Park, Philippe Very, Melanie E. Hassett, Samia Chreim, Günter K. Stahl, Haim Benyamini, H. Emre Yildiz, Riikka M. Sarala, Christof Miska, Nicola Mirc, Emanuel Gomes, Hellebore Capital Management, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, stratégie, Centre de Recherche en Management (CRM), Université Toulouse 1 Capitole (UT1), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut d'Administration des Entreprises - Toulouse (IAE)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse 1 Capitole (UT1), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut d'Administration des Entreprises - Toulouse (IAE)-Centre National de la Recherche Scientifique (CNRS), Melbourne Graduate School of Education [Melbourne] (MGSE), University of Melbourne, Research Group: Organization, and Department of Management
Subjects: Strategic planning, HUMAN capital, business.industry, 05 social sciences, Geography, Planning and Development, Management styles, BUSINESS -- Research, INDUSTRIAL management, Human capital, CONSOLIDATION & merger of corporations, Dominance (economics), 0502 economics and business, Political Science and International Relations, Mergers and acquisitions, Economics, [SHS.GESTION]Humanities and Social Sciences/Business administration, 050211 marketing, Business and International Management, Marketing, Sociocultural evolution, Human resources, business, 050203 business & management, Stock (geology), STRATEGIC planning
Abstract: Despite decades of research, the key factors for success in mergers and acquisitions (M&As) and the reasons why M&As often fail remain poorly understood. While attempts to explain M&A success and failure have traditionally focused on strategic and financial factors, an emergent field of inquiry has been directed at the sociocultural and human resources issues involved in the integration of acquired or merging firms. This research has sought to explain M&A performance and underperformance in terms of the impact that variables such as cultural fit, management style similarity, the pattern of dominance between merging firms, the acquirer's degree of cultural tolerance, and the social climate surrounding a takeover have on the postmerger integration process. In this article, we attempt to take stock of, and synthesize, the findings from research on sociocultural and human resources integration in M&A, to identify conflicting perspectives and unresolved questions as well as several underresearched areas, and then use our analyses to propose an agenda for the next stage of research in this field.
Published: 2013
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33. Impact of MMAD, acoustic airflow and breathing patterns on intrasinus drug deposition in a realistic nasal cast

Author: Leclerc, L., Jérémie POURCHEZ, Aubert, G., Vecellio, L., Durand, M., Structure Fédérative de Recherche - Institut Fédératif de Recherche en Sciences et Ingénierie de la Santé (SFR IFRESIS), Université Jean Monnet [Saint-Étienne] (UJM), Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Ingénierie des Biomatériaux et des Particules Inhalées (BIOPI-ENSMSE), Laboratoire Antibiologie, CHU Saint-Etienne, Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: [SDV.IB]Life Sciences [q-bio]/Bioengineering, [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2013

34. Generation and characterization of radiolabelled nanosized carbonaceous aerosols for human inhalation studies

Author: Francis Dubois, Michèle Cottier, Marc Durand, Iolanda M.D. Albuquerque-Silva, Anthony Clotagatide, Jérémie Pourchez, Laurent Vecellio, Institut Fédératif de Recherche en Sciences et Ingénierie de la Santé (IFRESIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-IFR143, Laboratoire Interdisciplinaire des Nanoparticules Aérosolisées (LINA-ENSME), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Centre Ingénierie et Santé (CIS-ENSMSE), Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Service d'Histologie Embryologie, CHRU Saint-Etienne, DTF-Aerodrug, DTF, Oto-Rhino-Laryngologie, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Médecine Nucléaire, CHU Saint-Etienne, CHU de Saint-Etienne, Université Jean Monnet, DTF Aerodrug, Université François Rabelais, and INSERM U1100-EA6305
Subjects: Fluid Flow and Transfer Processes, Atmospheric Science, Supersaturation, Environmental Engineering, Inhalation, Chemistry, Mechanical Engineering, Condensation, Radiochemistry, Nucleation, Nanoparticle, Residence time (fluid dynamics), Pollution, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Aerosol, Environmental chemistry, Particle-size distribution, [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, ELPI, Radiolabelled nanosized aerosols, Radioactive aerosol, Technegas
Abstract: International audience; New insights on the output of a commercial Technegas generator were proposed in order to optimize the generation of a radioactive nanosized aerosol for human inhalation studies. Parameters influencing Technegas generated aerosols (i.e. gaseous atmosphere, generation temperature and storage duration) were analyzed by a combination of size-fractionation and gamma-scintigraphy detection to determine the aerosol aerodynamic-related distributions. It was found that the total radioactivity per mass and number concentrations of aerosols was mostly influenced by the burn temperature, while the radiolabelling of particles was mostly driven by their surface area. 99mTc labeled nanosized carbonaceous primary particles appear mainly to result from nucleation/condensation of the supersaturated vapor during the burning step, and then coalesce into larger particles due to coagulation processes during the residence time in the expansion chamber. We showed that the burn temperature and the aerosol residence time were the main parameters influencing the particle size distribution. Under optimized operating conditions, the amount of radiolabelled nanoparticles substantially increased since the radioactivity median aerodynamic diameter was reduced by half (250 nm--GSD of 2.5) compared with the standard operating conditions of the Technegas generator (450 nm--GSD of 3.4).
Published: 2013
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35. Citrulline enhances myofibrillar constituents expression of skeletal muscle and induces a switch in muscle energy metabolism in malnourished aged rats

Author: Béatrice Morio, Philippe Chafey, Servane Le Plénier, Christophe Moinard, Voahangy Randrianarison-Huetz, C. Faure, Christian Aussel, Philippe Noirez, Luc Cynober, Prévention et traitement de la perte protéique musculaire en situation de résistance à l'anabolisme (PRETRRAM - EA 4466), Université Paris Descartes - Paris 5 (UPD5), Unité de Nutrition Humaine (UNH), Institut National de la Recherche Agronomique (INRA)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université, Plateforme protéomique 3P5 [Institut Cochin] (3P5), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UFR STAPS, service interhospitalier de Biochimie, Hôpital de l'Hotel Dieu, A- P H-P, service biologie, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Stress Cellulaire : Physiopathologie, Stratégies Nutritionnelles et Thérapeutiques Innovantes (EA 4466), Université Paris Descartes - Paris 5 (UPD5)-Faculté des Sciences Pharmaceutiques et Biologiques, APPERT Institute, Fondation Le Lous, Clermont Université-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Recherche Agronomique (INRA), Centre Hospitalier Emile Roux, Prévention et traitement de la perte protéique musculaire en situation de résistance à l'anabolisme ( PRETRRAM - EA 4466 ), Université Paris Descartes - Paris 5 ( UPD5 ), Unité de Nutrition Humaine ( UNH ), Institut National de la Recherche Agronomique ( INRA ) -Université d'Auvergne - Clermont-Ferrand I ( UdA ) -Clermont Université, Plateforme protéomique 3P5 [Institut Cochin] ( 3P5 ), Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Stress Cellulaire : Physiopathologie, Stratégies Nutritionnelles et Thérapeutiques Innovantes ( EA 4466 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Faculté des Sciences Pharmaceutiques et Biologiques, Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Proteomics, Glycogenolysis, Arginine, Proteome, 030309 nutrition & dietetics, [ SDV.AEN ] Life Sciences [q-bio]/Food and Nutrition, Muscle Proteins, arginine, Biochemistry, Rats, Sprague-Dawley, Random Allocation, chemistry.chemical_compound, Citrulline, Glycolysis, Myofibrillar proteins, myosin heavy-chain, 2. Zero hunger, 0303 health sciences, dysfunction, Energetic metabolism, protein-synthesis, Animal proteomics, Mitochondrial respiratory chain, medicine.anatomical_structure, Muscle, leucine, medicine.medical_specialty, proteolysis, Biology, 03 medical and health sciences, atrophy, Internal medicine, medicine, Animals, Muscle, Skeletal, Molecular Biology, 030304 developmental biology, Skeletal muscle, Metabolism, gel-electrophoresis, Diet, Rats, Citric acid cycle, Endocrinology, chemistry, identification, Energy Metabolism, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, massive intestinal resection
Abstract: We are grateful to Florence Blandel for carbonylated protein analysis. We would like to thank Morgane Le-Gall, Guilhem Clary, and Cedric Broussard for their help in the DIGE experiments and MS analysis. We also thank Professor E. Fontaine for helpful discussion.; Citrulline (Cit) actions on muscle metabolism remain unclear. Those latter were investigated using a proteomic approach on Tibialis muscles from male Sprague-Dawley rats. At 23 months of age, rats were either fed ad libitum (AL group) or subjected to dietary restriction for 12 weeks. At the end of the restriction period, one group of rats was euthanized (R group) and two groups were refed for one week with a standard diet supplemented with nonessential amino acids group or Cit (CIT group). Results of the proteomic approach were validated using targeted Western blot analysis and assessment of gene expression of the related genes. Maximal activities of the key enzymes involved in mitochondrial functioning were also determined. Cit supplementation results in a significant increase in the protein expression of the main myofibrillar constituents and of a few enzymes involved in glycogenolysis and glycolysis (CIT vs. AL and R, p < 0.05). Conversely, the expression of oxidative enzymes from Krebs cycle and mitochondrial respiratory chain was significantly decreased (CIT vs. AL, p < 0.05). However, maximal activities of key enzymes of mitochondrial metabolism were not significantly affected, except for complex 1 which presented an increased activity (CIT vs. AL and R, p < 0.05). In conclusion, Cit supplementation increases expression of the main myofibrillar proteins and seems to induce a switch in muscle energy metabolism, from aerobia toward anaerobia.
Published: 2013
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36. Evaluation of the performance of sonic nebuliser to target maxillary sinuses

Author: Le Guellec, Sandrine, Durand, Marc, Pourchez, Jérémie, Dubois, Francis, Aubert, Gérard, Chantrel, Gilles, Vecellio, Laurent, Hupin, Cloé, De Gersem, R., Reychler, Grégory, Pitance, Laurent, Le Pennec, Deborah, Diot, Patrice, Jamar, François, DTF-Aerodrug, DTF, Oto-Rhino-Laryngologie, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Fédératif de Recherche en Sciences et Ingénierie de la Santé (IFRESIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-IFR143, Laboratoire Interdisciplinaire des Nanoparticules Aérosolisées (LINA-ENSME), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Centre Ingénierie et Santé (CIS-ENSMSE), Service de Médecine Nucléaire, CHU Saint-Etienne, Laboratoire de Microbiologie, DTF-Médical, Service ORL Cliniques Universitaires Saint Luc, Université Catholique de Louvain = Catholic University of Louvain (UCL), Service de Médecine Nucléaire Cliniques Universitaires Saint Luc, Service Pneumologie Cliniques Universitaires Saint Luc, Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours, Faculté de Médecine, Service de Médecine Nucléaire et Service Pneumologie, DTF-Aerodrug et EA Aérosolthérapie et Biomédicaments à Visée Respiratoire, Centre Hospitalier Emile-Roux, Service ORL et Chirurgie Cervico-Faciale, Service de Médecine Nucléaire et Laboratoire de Microbiologie, DTF Médical, Cliniques Universitaires Saint-Luc, Service ORL, and Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: sonic nebuliser, maxillary sinuses, in vitro model, [SPI.GPROC]Engineering Sciences [physics]/Chemical and Process Engineering, respiratory system, local antibiotic delivery, human volonteer, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Abstract: International audience; Intranasal nebulisation seems to be the best therapeutic option for local antibiotic delivery, targeting infected sites beyond the nasal valve, especially for CF patients whose maxillary sinuses (MS) may be a source for bacterial inducing lung infections. In this study, we have evaluated the NL11SN sonic nebuliser (100 Hz) on MS ventilation and on aerosol deposition, in an in vitro model and in normal volunteers. Scintigraphy of 81mKr gas ventilation and of 99mTc-DTPA sonic aerosol deposition with NL11SN (DTF, France) was performed in 7 subjects. MS deposition was quantified using an image processing method. In vitro nebulisations were performed in a plastinated head model either with 99mTc-DTPA or with gentamicin. 99mTc-DTPA deposited in the MS was quantified by image processing method and gentamicin by a fluorescence polarization immunoassay. Ventilation 81mKr images show that the 100 Hz sound increases MS gas ventilation.99mTc-DTPA nebulised in volunteers was mainly deposited into nasal cavities (2/3 vs.1/3 in lungs) with 4.9±2.5% of total nasal deposition in the MS. In the plastinated head model, sonic mode of NL11SN increased the gentamicin deposition in MS by a factor 3 (P
Published: 2012
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37. Determinants of benzodiazepine use in a representative population of HIV infected individuals: the role of HIV status disclosure (ANRS-EN12-VESPA study)

Author: Perrine Roux, Lionel Fugon, Laurent Michel, France Lert, Yolande Obadia, Bruno Spire, Maria Patrizia Carrieri, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Troubles du comportement alimentaire de l'adolescent (UMR_S 669), Université Paris-Sud - Paris 11 (UP11)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de traitement des addictions, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Peer, Hal, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM - U912 INSERM - AMU - IRD ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Troubles du comportement alimentaire de l'adolescent ( UMR_S 669 ), Université Paris-Sud - Paris 11 ( UP11 ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Emile Roux, Epidémiologie, sciences sociales, santé publique ( IFR 69 ), and Université Panthéon-Sorbonne ( UP1 ) -Université Paris-Sud - Paris 11 ( UP11 ) -École des hautes études en sciences sociales ( EHESS ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Panthéon-Sorbonne ( UP1 ) -Université Paris-Sud - Paris 11 ( UP11 ) -École des hautes études en sciences sociales ( EHESS ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )
Subjects: Adult, Male, medicine.medical_specialty, Health (social science), Social Psychology, medicine.drug_class, Social Stigma, Population, HIV Infections, Truth Disclosure, Logistic regression, Anxiolytic, Benzodiazepines, 03 medical and health sciences, Social support, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Risk Factors, Humans, Medicine, 030212 general & internal medicine, education, Psychiatry, Qualitative Research, Benzodiazepine, education.field_of_study, business.industry, Public Health, Environmental and Occupational Health, Social Support, virus diseases, Life Sciences, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, medicine.disease, Anxiety Disorders, 030227 psychiatry, 3. Good health, Cross-Sectional Studies, Logistic Models, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Anxiety, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Hiv status, medicine.symptom, business, Stress, Psychological, Clinical psychology
Abstract: International audience; Objective: HIV infection may result in stressful situations such as disclosure to others and could be a mediator between seropositivity status and psychiatric illness, depression or anxiety. Several results have shown that anxiolytic use (mainly benzodiazepines) is highly prevalent in HIV-infected individuals, but few studies have highlighted to what extent this use could be associated with HIV disclosure. Design: A national cross-sectional survey representative of people living with HIV and AIDS in France enrolled 2932 individuals in 102 French HIV hospital departments. Methods: Face-to-face interviews and self-administered questions collected information about patients' experience with HIV and HIV care, including use of psychotropic drugs, social support, stigma and disclosure of HIV status. We identified factors associated with regular BDZ use (i.e. more than once a week) using a weighted logistic regression model. Results: Regular BDZ use and anxiety symptoms were reported by 16% and 29% of the patients respectively. After multiple adjustment for known correlates of BDZ use and anxiety symptoms, individuals who had disclosed their HIV status to relatives or friends were found to be more likely (OR[95%CI]= 1.78 [1.02-3.09]) to regularly use BDZ. Conclusions: These results show both to what extent disclosure to others continues to be a stressful step in the course of HIV infection and that disclosure is something which could be identified by BDZ use. They also highlight the need for appropriate case management and psychiatric care to help patients manage the consequences of disclosure.
Published: 2011
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38. Réduction des risques infectieux Chez les usagers de drogues

Author: Bello, Pierre-Yves, Ben Lakhdar, Christian, Carrieri, Maria Patrizia, Costes, Jean-Michel, Couzigou, Patrice, Dubois-Arber, Françoise, Guichard, Anne, Jauffret-Roustide, Marie, Le Naour, Gwenola, Lucidarme, Damien, Michel, Laurent, Polomeni, Pierre, Rémy, André-Jean, Simmat-Durand, Laurence, Institut de Veille Sanitaire (INVS), UMR CNRS 8179, Centre National de la Recherche Scientifique (CNRS)-Université de Lille, Sciences et Technologies, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Observatoire Français des Drogues et des Toxicomanies, OFDT, Département d'hépatologie et de gastroentérologie, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Université de Lausanne (UNIL), Institut National de Prévention et d'Education pour la Santé (INPES), CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UMR 8211 / U988 / UM 7), École des hautes études en sciences sociales (EHESS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Triangle : action, discours, pensée politique et économique (TRIANGLE), Centre National de la Recherche Scientifique (CNRS)-Ecole Normale Supérieure Lettres et Sciences Humaines (ENS LSH)-Sciences Po Lyon - Institut d'études politiques de Lyon (IEP Lyon), Université de Lyon-Université de Lyon-Université Lumière - Lyon 2 (UL2), Service d'hépato-gastro-entérologie, Groupe Hospitalier de l'Institut Catholique Lillois, Troubles du comportement alimentaire de l'adolescent (UMR_S 669), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11), Centre de traitement des addictions, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'addictologie [Bondy], Hôpital Jean Verdier [AP-HP], Service de hépato-gastro-entérologie - cancérologie digestive [CH de Perpignan], Centre Hospitalier Saint Jean de Perpignan, Institut national de la santé et de la recherche médicale(INSERM), Duchange, Nathalie, Université de Lille, Sciences et Technologies-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lausanne = University of Lausanne (UNIL), Université Lumière - Lyon 2 (UL2)-Sciences Po Lyon - Institut d'études politiques de Lyon (IEP Lyon), Université de Lyon-Université de Lyon-Ecole Normale Supérieure Lettres et Sciences Humaines (ENS LSH)-Centre National de la Recherche Scientifique (CNRS), and Université Paris-Sud - Paris 11 (UP11)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: drogues, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, risques infectieux, Réduction des risques, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, usages
Abstract: La réduction des risques infectieux chez les usagers de drogues est un objectif de santé publique compte tenu de la prévalence élevée du VIH et du VHC constatée dans ces populations.Dès les années 1985-90, les nombreuses actions engagées par des associations et des professionnels de santé dans plusieurs pays dont la France ont abouti progressivement à des politiques publiques de réduction des risques. Elles ont permis le développement de dispositifs tels que les programmes d’échanges de seringues et les traitements de substitution aux opiacés.Un des enjeux de la réduction des risques est de s’adapter aux évolutions des pratiques et contextes de consommation de drogues ainsi qu’aux profils de consommateurs.À la demande du ministère de la Santé et des Sports, l’Inserm a coordonné une expertise collective pluridisciplinaire qui propose un bilan des connaissances sur l’évolution des usages de drogues et les dommages associés, sur les programmes de réduction des risques infectieux et leur impact à partir des données internationales. Une attention particulière a été portée à la situation des femmes et des détenus.
Published: 2010

39. Validation d’une batterie brève d’évaluation des praxies gestuelles pour consultation Mémoire. Évaluation chez 419 témoins, 127 patients atteints de troubles cognitifs légers et 320 patients atteints d’une démence

Author: E Galbrun, C Moroni, groupe de réflexion sur les praxies du Cmrr Ile-de-France Sud, F Mahieux-Laurent, C Fabre, A Dubrulle, Université de Lille, Hôpital Dupuytren [CHU Limoges], Centre Hospitalier Emile Roux [AP-HP], Service de Rééducation Neurologique [Saint-Didier-au-Mont-D'Or], Psychologie : Interactions, Temps, Emotions, Cognition (PSITEC) - ULR 4072 [PSITEC], CHU Charles Foix [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), SSR Val Rosay [Saint-Didier-au-Mont-D'Or], and Psychologie : Interactions, Temps, Emotions, Cognition (PSITEC) - ULR 4072 (PSITEC)
Subjects: Gynecology, medicine.medical_specialty, Validation study, business.industry, Medical screening, 05 social sciences, 050105 experimental psychology, 03 medical and health sciences, [SCCO]Cognitive science, 0302 clinical medicine, Neurology, Reference values, Medicine, 0501 psychology and cognitive sciences, Dementia diagnosis, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: Resume Introduction L’objectif de ce travail etait de construire une batterie breve d’evaluation des praxies gestuelles, pour utilisation en consultation Memoire et d’en etablir des normes. Patients et methodes La batterie comprend trois dimensions differentes : execution sur commande verbale de gestes symboliques (cinq gestes), de mimes d’action (cinq gestes) et imitation de gestes abstraits (huit gestes). Des normes ont ete etablies a partir de 419 sujets normaux. La comparaison des performances de ces normaux avec les resultats obtenus chez 320 patients atteints de demence a permis d’evaluer leurs sensibilite et specificite. Un groupe de 127 patients atteints de troubles cognitifs legers a egalement ete etudie. Resultats Des valeurs seuils ont ete proposees pour chaque dimension, basees sur les valeurs du cinquieme percentile observe dans trois classes d’âge et trois groupes de niveau culturel. La specificite des normes etablies etait elevee pour les trois dimensions. La sensibilite, en revanche, etait faible, la plus importante etant observee pour l’imitation de gestes abstraits, suivie des mimes d’action et des gestes symboliques. Dans les trois dimensions, le groupe de patients atteints d’un trouble cognitif leger presentait une frequence de scores inferieurs aux normes, intermediaire entre les sujets normaux et les patients dements. Conclusion L’instrument propose correspond bien aux buts initiaux de brievete et de haute specificite. Il peut etre utilement employe en consultation Memoire pour determiner la presence du critere « apraxie » du diagnostic de demence et donc y contribuer, a cote des autres elements de l’examen clinique et neuropsychologique.
Published: 2009
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40. Clonal dissemination of a CTX-M-15 beta-lactamase-producing Escherichia coli strain in the Paris area, Tunis, and Bangui

Author: M. Lavollay, Béatrice Burghoffer, A. Akpabie, T. Frank, Valérie Gautier, S. Ben Redjeb, K. Mamlouk, Raymond Bercion, Guillaume Arlet, Université Pierre et Marie Curie - Paris 6 (UPMC), Laboratoire de Microbiologie, Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Institut Pasteur de Bangui, Réseau International des Instituts Pasteur (RIIP), Unité d'Hygiène, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), This work was supported by grants from Faculté de Médecine Pierre et Marie Curie, Université Paris VI, and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: clone (Java method), Paris, Tunisia, [SDV]Life Sciences [q-bio], MESH: beta-Lactamases, Microbial Sensitivity Tests, Biology, medicine.disease_cause, Polymerase Chain Reaction, beta-Lactam Resistance, beta-Lactamases, Microbiology, law.invention, 03 medical and health sciences, Plasmid, Mechanisms of Resistance, law, Escherichia coli, medicine, Humans, Pharmacology (medical), Typing, Escherichia coli Infections, Polymerase chain reaction, 030304 developmental biology, MESH: Escherichia coli Infections, Pharmacology, 0303 health sciences, MESH: Microbial Sensitivity Tests, MESH: Humans, 030306 microbiology, MESH: Escherichia coli, Electroporation, MESH: Paris, Outbreak, MESH: Conjugation, Genetic, MESH: Polymerase Chain Reaction, 6. Clean water, MESH: beta-Lactam Resistance, Electrophoresis, Gel, Pulsed-Field, 3. Good health, Central African Republic, Multiple drug resistance, Infectious Diseases, MESH: Electrophoresis, Gel, Pulsed-Field, MESH: Central African Republic, Conjugation, Genetic, MESH: Tunisia
Abstract: One hundred twenty CTX-M-15-producing Escherichia coli strains isolated in 10 different hospitals from Paris (France), in the Hospital Charles Nicolle in Tunis (Tunisia), and in the Pasteur Institute in Bangui, Central African Republic (CAR), between 2000 and 2004 were studied. Eighty isolates, recovered from the three countries, were clonally related by repetitive extragenic palindromic PCR and pulsed-field gel electrophoresis. Various resistance profiles were identified among these clonal strains. After conjugation or electroporation of plasmids from E. coli strains representative of each profile and each geographic region, we observed seven resistance profiles in the recipient strains. Incompatibility typing showed that all the plasmids transferred from the clonal strains studied, except one, belonged to the incompatibility group FII. They all shared a multidrug resistance region (MDR) resembling the MDR region located in pC15-1a, a plasmid associated with an outbreak of a CTX-M-15-producing E. coli strain in Canada. They also shared the common backbone of an apparent mosaic plasmid, including several features present in pC15-1a and in pRSB107, a plasmid isolated from a sewage treatment plant. This study suggests that although the plasmid-borne bla CTX-M-15 gene could be transferred horizontally, its dissemination between France, Tunisia, and CAR was due primarily to its residence in an E. coli clone with a strong propensity for dissemination.
Published: 2006
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41. Tabac : comprendre la dépendance pour agir

Author: Abrous , Nora, Aubin , Henri Jean, Berlin , Ivan, Junien , Claudine, Kaminski , Monique, Le Foll , Bernard, Le Houezec , Jacques, Le Novere , Nicolas, Lefevre , Philippe, Stinus , Luis, Tassin , Jean-Pol, ORANGE, Colette, Physiopathologie du comportement, Université Bordeaux Segalen - Bordeaux 2-IFR8-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de traitement des addictions, Centre Hospitalier Emile Roux [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Pharmacologie médicale [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Génétique, chromosome et cancer, Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Tabacologie, Hôpital Albert Chenevier, Pfizer, European Bioinformatics Institute [Hinxton] (EMBL-EBI), EMBL Heidelberg, Agence Française de Sécurité Sanitaire des Produits de Santé (AFSSAPS), AFSSAPS, Interactions neuronales et comportements (INC), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Collège de France - Chaire Neuropharmacologie (INSERM U114), Collège de France (CdF (institution)), Institut national de la santé et de la recherche médicale(INSERM), Service de pharmacologie médicale [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Chaire Neuropharmacologie (INSERM U114), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Bordeaux Segalen - Bordeaux 2-IFR8-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Emile Roux, Service de pharmacologie biologique [CHU Pitié-Salpâtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Pfizer, European Bioinformatics Institute [Hinxton] ( EMBL-EBI ), European Molecular Biology Laboratory [Hinxton], Agence Française de Sécurité Sanitaire des Produits de Santé ( AFSSAPS ), Interactions neuronales et comportements ( INC ), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique ( CNRS ), Neurobiologie pharmacologique, and Collège de France ( CdF ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )
Subjects: Nicotine, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Fumeurs, Dépendance, Tabagisme, Cigarette, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: D’après l’Organisation mondiale de la santé (OMS), le tabac est actuellementresponsable de près de 5 millions de décès par an dans le monde. Lalutte contre le tabagisme est devenue une priorité de santé publique justifiantles initiatives prises au plan international telles que « Pour un monde sanstabac ». La convention-cadre proposée par l’OMS et adoptée en mai 2003par 47 états invite les pays à prendre des mesures reconnues comme efficaceset de les inscrire dans un cadre législatif (hausses des prix et des taxes,interdiction de la publicité, interdiction de fumer sur les lieux de travail et leslieux publics, campagnes d’éducation et de sensisbilisation, interdiction devente aux mineurs{).Le rapport Tobacco Control Country Profiles (TCCP) rassemblant les donnéesde 196 pays en 2003 met l’accent sur la très forte progression du tabagismedans les pays en développement. Si environ 50 % des décès surviennentactuellement dans les pays riches, 70 % concerneront les pays en développementd’ici 2020. Dans les pays riches, la prévalence du tabagisme masculinest approximativement de 35 % et de 50 % dans les pays en développementet plus de 60 % en Chine. Si le tabagisme suit son rythme actuel, le tabacsera responsable d’un milliard de décès au cours du 21e siècle. La dépendancetabagique touche actuellement 1 milliard d’individus.En France, d’après l’enquête EROPP 20021 près de 12 millions de personnesparmi les 18 à 75 ans sont des fumeurs réguliers, c’est-à-dire qu’ils fument aumoins une cigarette par jour. Le tabagisme est reconnu comme la premièrecause de mortalité évitable. Les données les plus récentes indiquent que letabac est responsable chaque année de 60 000 décès. La prévalence tabagiquechez les jeunes de 18 à 25 ans si l’on considère tous ceux qui déclarent fumerne serait-ce que de temps en temps est proche de 50 %. Ces données justi-fient pleinement la priorité politique française donnée à la lutte anti-tabaccomme celle suscitée au niveau international par l’OMS.La Mission interministérielle de lutte contre la drogue et la toxicomanie(Mildt) a souhaité interroger l’Inserm à travers la procédure d’expertisecollective pour disposer des données scientifiquement validées les plusrécentes concernant les mécanismes d’installation de la dépendance au tabacet les moyens d’y faire face au plan individuel et collectif. Une meilleurecompréhension de la dépendance et de ses déterminants devrait permettre demieux définir les politiques de prévention en particulier auprès des jeunes et d’améliorer l’aide médicale et psychologique apportée aux fumeurs grâce àl’avancée des connaissances.Le groupe d’experts réuni dans le cadre de ce travail a structuré sa réflexionautour des questions suivantes :• Quelles sont les données de prévalence sur le tabagisme et sur la dépendanceissues des études nationales et internationales ? Quels sont les résultatsdes études longitudinales sur les trajectoires des fumeurs (expérimentation,dépendance, arrêt, rechutes, arrêt définitif) ? Quels sont les modes d’installationet de maintien de la dépendance et les interactions avec la dépendance àd’autres substances psychoactives ?• Quels sont les facteurs de risque individuels impliqués dans la dépendanceau tabac (héritabilité familiale, traits de personnalité, comorbidités psychiatriques{)?• Quelles sont les données sur les gènes impliqués dans la dépendance tabagique? Existe-t-il une vulnérabilité génétique commune entre certains troublespsychiatriques (troubles de l’humeur, troubles anxieux{) et ladépendance tabagique ?• Quel est l’impact de l’exposition au tabac durant la vie fœtale dans l’installationd’une dépendance ? Quelle est l’influence de l’environnement familialet social sur l’acquisition de la dépendance au tabagisme ?• Quelles sont les données pharmacologiques concernant la nicotine et lesautres composés du tabac impliqués dans la dépendance ?• Quels sont les mécanismes d’action de la nicotine et des composés du tabacsur le système nerveux central ? Quelles sont les différentes voies de neurotransmetteursimpliquées dans la dépendance à la nicotine ? Quelles sont lesdonnées apportées par l’imagerie cérébrale ? Quels effets neurosensoriels de lanicotine ou autres composés du tabac seraient impliqués dans la dépendance?• Quelles données apportent les études chez l’animal sur le comportement dedépendance et sur le sevrage ?• Comment diagnostiquer et traiter la dépendance au tabac ? Quels sont lestraitements actuels et leur efficacité ? Quelles sont les nouvelles pistes médicamenteusesd’aide au sevrage tabagique ?L’interrogation des bases bibliographiques internationales a conduit à sélectionnerplus de 1 000 articles. Au cours de 9 séances de travail organiséesentre le mois de novembre 2002 et le mois d’octobre 2003, les experts ontprésenté une analyse critique et une synthèse des travaux publiés au planinternational sur les différents aspects de la dépendance au tabac. A partir desconnaissances validées, les experts ont proposés des recommandationsconcernant la prévention et la prise en charge du tabagisme. Ils ont soulignél’intérêt de développer des recherches pluridisciplinaires pour combler lesnombreuses lacunes identifiées au cours de leur analyse. Plusieurs communicationsont apporté des compléments de connaissances sur les effets de lanicotine, les déterminants individuels et sociaux de la dépendance et les aspects comportementaux de l'arrêt du tabac.
Published: 2004

42. [Impact of nasal colonization by methicillin-resistant Staphylococcus aureus among geriatric intermediate care facility patients].

Author: Giraud K, Chatap G, Bastuji-Garin S, and Vincent JP
Subjects: Aged, Aged, 80 and over, Anti-Bacterial Agents economics, Anti-Bacterial Agents therapeutic use, Diabetes Mellitus epidemiology, Female, France epidemiology, Hospitalization, Humans, Intermediate Care Facilities, Male, Malnutrition epidemiology, Prospective Studies, Risk Factors, Staphylococcal Infections drug therapy, Methicillin Resistance, Nasal Cavity microbiology, Staphylococcal Infections epidemiology, Staphylococcus aureus
Abstract: Objective: To evaluate the impact of nasal carriage of Methicillin Resistant Staphylococcus aureus (MRSA) on antibiotic cost, infection morbidity, mortality and length of stay in a geriatric population., Methods: 341 consecutive elderly patients (mean age 83.4 +/- 8.7 years) admitted to an intermediate care facility were prospectively include between November 1998 and October 1999. Nasal swab cultures were taken on admission., Results: In sixty patients (17.6%) no nasal swab was taken. Among the 281 patients screened, 52 were identified as MRSA carriers. The principle predictive factors were: diabetes (p=0,046), sores (p=0,03), malnutrition (p=0,02), polypathology (p=0,02) and prolongation of previous hospitalisation (p=0,09)., Conclusion: Nasal carriage of MRSA on admission to the facility was not a deleterious prognostic factor regarding duration of stay, infectious morbidity and antibiotic cost, but was associated with higher mortality risk.
Published: 2004
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43. [The value of nursing diagnosis in the management of alcohol dependence].

Author: Bonnery AM, Sabourault C, Legal M, Renaud O, Dumas N, Massignon F, Berthelon C, and Segal M
Subjects: Aftercare, Alcoholism psychology, Ambulatory Care, Anxiety etiology, Denial, Psychological, Female, Humans, Male, Middle Aged, Patient Care Planning organization & administration, Patient Care Team organization & administration, Alcoholism nursing, Alcoholism rehabilitation, Nursing Diagnosis classification
Published: 1999

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