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1. Is COPD associated with increased risk for microaspiration in intubated critically ill patients?

Author: Thècle, Degroote, Emmanuelle, Jaillette, Jean, Reignier, Farid, Zerimech, Christophe, Girault, Guillaume, Brunin, Arnaud, Chiche, Jean-Claude, Lacherade, Jean-Paul, Mira, Patrice, Maboudou, Malika, Balduyck, Saad, Nseir, Isabelle, Alves, CHU Lille, Institut Pasteur de Lille, Université de Lille, Groupe Hospitalier Paris Saint-Joseph [hpsj], IMPact de l'Environnement Chimique sur la Santé humaine (IMPECS) - ULR 4483, Maladies Rares du Développement : Génétique, Régulation et Protéomique (RADEME) - ULR 7364, Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille], Centre hospitalier universitaire de Nantes [CHU Nantes], Université de Rouen Normandie [UNIROUEN], Service de soins intensifs [CHU Rouen], Centre Hospitalier Boulogne-sur-mer, Centre Hospitalier Tourcoing, Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon [CHD Vendée], Hôpital Cochin [AP-HP], Lille Inflammation Research International Center - U 995 [LIRIC], Université de Lille, LillOA, Groupe Hospitalier Paris Saint-Joseph (hpsj), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre hospitalier universitaire de Nantes (CHU Nantes), Impact de l'environnement chimique sur la santé humaine - ULR 4483 (IMPECS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Maladies RAres du DEveloppement embryonnaire et du MEtabolisme : du Phénotype au Génotype et à la Fonction - ULR 7364 (RADEME), Lille Inflammation Research International Center - U 995 (LIRIC), and Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
Subjects: Spirometry, medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Critical Care and Intensive Care Medicine, Gastroenterology, law.invention, 03 medical and health sciences, Mechanical ventilation, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Anesthesiology, medicine, COPD, Intubation, Microaspiration, medicine.diagnostic_test, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Pneumonia, medicine.disease, respiratory tract diseases, [SDV] Life Sciences [q-bio], 030228 respiratory system, Breathing, business
Abstract: Background Although COPD patients are at higher risk for aspiration when breathing spontaneously, no information is available on the risk for microaspiration in invasively ventilated COPD patients. The aim of our study was to determine the relationship between COPD and abundant microaspiration in intubated critically ill patients. Methods This was a retrospective analysis of prospectively collected data, provided by 3 randomized controlled trials on microaspiration in critically ill patients receiving invasive mechanical ventilation for more than 48 h. Abundant microaspiration was defined as the presence of pepsin and or alpha-amylase at significant levels in tracheal aspirates. In all study patients, pepsin and alpha-amylase were quantitatively measured in all tracheal aspirates collected during a 48-h period. COPD was defined using spirometry criteria. Results Among the 515 included patients, 70 (14%) had proven COPD. Pepsin and alpha-amylase were quantitatively measured in 3873 and 3764 tracheal aspirates, respectively. No significant difference was found in abundant microaspiration rate between COPD and non-COPD patients (62 of 70 patients (89%) vs 366 of 445 (82%) patients, p = 0.25). Similarly, no significant difference was found in abundant microaspiration of gastric contents (53% vs 45%, p = 0.28), oropharyngeal secretions (71% vs 71%, p = 0.99), or VAP (19% vs 22%, p = 0.65) rates between the two groups. No significant difference was found between COPD and non-COPD patients in duration of mechanical ventilation, ICU length of stay, or ICU mortality. Conclusions Our results suggest that COPD is not associated with increased risk for abundant microaspiration in intubated critically ill patients.
Published: 2021
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2. Multicenter Evaluation of the FilmArray Blood Culture Identification 2 Panel for Pathogen Detection in Bloodstream Infections

Author: François Caméléna, Gauthier Péan de Ponfilly, Hélène Pailhoriès, Lucas Bonzon, Alexandre Alanio, Thibaut Poncin, Matthieu Lafaurie, François Dépret, Emmanuel Cambau, Sylvain Godreuil, Rachel Chenouard, Alban Le Monnier, Hervé Jacquier, Béatrice Berçot, 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, Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Groupe Hospitalier Paris Saint-Joseph (hpsj), MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques (ICAT), Université d'Angers (UA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Institut de Biologie en Santé (PHB-IRIS) [CHU Angers] (IBS), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Mycologie Moléculaire, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Hôpital Lariboisière-Fernand-Widal [APHP], Université Paris-Saclay, Centre hospitalier Saint-Joseph [Paris], Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Mycologie moléculaire - Molecular Mycology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, This study was supported by bioMérieux (Marcy L’Etoile, France), which providedconsumables. The funders had no role in study design, data collection and interpretation, ormanuscript preparation.F.C. received lecture fees from bioMérieux. F.D. received lecture fees from bioMérieuxand Sedana and grants from European Society of Intensive Care Medicine, Société Françaised’Anesthésie Reanimation, and the French Ministry of Research. A.A. received lecture feesand travel grants from Gilead Sciences and Pfizer and received grants from AgenceNationale de la Recherche. All other authors report no conflicts of interest., and bioMérieux (Marcy L’Etoile, France)European Society of Intensive Care MedicineSociété Française d’Anesthésie ReanimationFrench Ministry of Research. Gilead SciencesPfizerAgence Nationale de la Recherche
Subjects: Microbiology (medical), BCID2, [SDV.BIO]Life Sciences [q-bio]/Biotechnology, FilmArray, Physiology, [SDV]Life Sciences [q-bio], bloodstream infection, MESH: Blood Culture, BSI, MESH: Gram-Positive Bacteria, sepsis, Biofire, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, resistance gene, MESH: Gram-Negative Bacteria, molecular diagnosis, Genetics, MESH: Bacteremia, MESH: Sepsis, rapid diagnosis, genotypic identification, MESH: Humans, General Immunology and Microbiology, Ecology, Cell Biology, MESH: Bacteria, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology
Abstract: International audience; The FilmArray Blood Culture Identification 2 panel (BCID2; bioMérieux) is a fully automated PCR-based assay for identifying bacteria, fungi, and bacterial resistance markers in positive blood cultures (BC) in about 1 h. In this multicenter study, we evaluated the performance of the BCID2 panel for pathogen detection in positive BC. Conventional culture and BCID2 were performed in parallel at four tertiary-care hospitals. We included 152 positive BC-130 monomicrobial and 22 polymicrobial cultures-in this analysis. The BCID2 assay correctly identified 90% (88/98) of Gram-negative and 89% (70/79) of Gram-positive bacteria. Five bacterial isolates targeted by the BCID2 panel and recovered from five positive BC, including three polymicrobial cultures, were missed by the BCID2 assay. Fifteen isolates were off-panel organisms, accounting for 8% (15/182) of the isolates obtained from BC. The mean positive percent agreement between the BCID2 assay and standard culture was 97% (95% confidence interval, 95 to 99%), with agreement ranging from 67% for Candida albicans to 100% for 17 targets included in the BCID2 panel. BCID2 also identified the blaCTX-M gene in seven BC, including one for which no extended-spectrum β-lactamase (ESBL)-producing isolate was obtained in culture. However, it failed to detect ESBL-encoding genes in three BC. Two of the 18 mecA/C genes detected by the BCID2 were not confirmed. No carbapenemase, mecA/C, or MREJ targets were detected. The median turnaround time was significantly shorter for BCID2 than for culture. The BCID2 panel may facilitate faster pathogen identification in bloodstream infections. IMPORTANCE Rapid molecular diagnosis combining the identification of pathogens and the detection of antibiotic resistance genes from positive blood cultures (BC) can improve the outcome for patients with bloodstream infections. The FilmArray BCID2 panel, an updated version of the original BCID, can detect 11 Gram-positive bacteria, 15 Gram-negative bacteria, 7 fungal pathogens, and 10 antimicrobial resistance genes directly from a positive BC. Here, we evaluated the real-life microbiological performance of the BCID2 assay in comparison to the results of standard methods used in routine practice at four tertiary care hospitals.
Published: 2023
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3. Circovirus Hepatitis Infection in Heart-Lung Transplant Patient, France

Author: Philippe Pérot, Jacques Fourgeaud, Claire Rouzaud, Béatrice Regnault, Nicolas Da Rocha, Hélène Fontaine, Jérôme Le Pavec, Samuel Dolidon, Margaux Garzaro, Delphine Chrétien, Guillaume Morcrette, Thierry Jo Molina, Agnès Ferroni, Marianne Leruez-Ville, Olivier Lortholary, Anne Jamet, Marc Eloit, Centre Collaborateur de l'OIE de Détection et identification chez l’homme des pathogènes animaux émergents et développement d’outils pour leur diagnostic / Collaborating Center for the Detection and identification in humans of emerging animal pathogens and development of tools for their diagnoses (CCOIE-OIECC), Institut Pasteur [Paris] (IP)-Organisation Mondiale de la Santé Animale / World Organisation Animal Health [Paris] (OIE)-Université Paris Cité (UPCité), Découverte de pathogènes – Pathogen discovery, Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Groupe Hospitalier Paris Saint-Joseph (hpsj), Hôpital Cochin [AP-HP], Université Paris-Sud - Paris 11 (UP11), Hôpital Marie-Lannelongue, Institut Necker Enfants-Malades (INEM - UM 111 (UMR 8253 / U1151)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), École nationale vétérinaire - Alfort (ENVA), and This work was supported by Institut Pasteur and the Necker-Enfants malades University Hospital.
Subjects: Microbiology (medical), Epidemiology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, metagenomic next-generation sequencing, zoonoses, Infectious Diseases, mNGS, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], circoviruses, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, hepatitis, solid organ transplants, viruses, France
Abstract: International audience; In March 2022, a 61-year-old woman in France who had received a heart-lung transplant sought treatment with chronic hepatitis mainly characterized by increased liver enzymes. After ruling out common etiologies, we used metagenomic next-generation sequencing to analyze a liver biopsy sample and identified an unknown species of circovirus, tentatively named human circovirus 1 (HCirV-1). We found no other viral or bacterial sequences. HCirV-1 shared 70% amino acid identity with the closest known viral sequences. The viral genome was undetectable in blood samples from 2017–2019, then became detectable at low levels in September 2020 and peaked at very high titers (10^10 genome copies/mL) in January 2022. In March 2022, we found >10^8 genome copies/g or mL in the liver and blood, concomitant with hepatic cytolysis. We detected HCirV-1 transcripts in 2% of hepatocytes, demonstrating viral replication and supporting the role of HCirV-1 in liver damage.
Published: 2023
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4. Evaluation of ceftolozane-tazobactam susceptibility on a French nationwide collection of Enterobacterales

Author: Agnès B. Jousset, Sandrine Bernabeu, Cécile Emeraud, Rémy A. Bonnin, Alexandra Lomont, Jean Ralph Zahar, Audrey Merens, Christophe Isnard, Nathalie Soismier, Eric Farfour, Vincent Fihman, Nicolas Yin, Olivier Barraud, Hervé Jacquier, Anne-Gaëlle Ranc, Frédéric Laurent, Stéphane Corvec, Louise Ruffier d'Epenoux, Emmanuelle Bille, Nicolas Degand, Chloé Plouzeau, Thomas Guillard, Vincent Cattoir, Asaf Mizrahi, Antoine Grillon, Frédéric Janvier, Cécile Le Brun, Marlène Amara, Mathilda Bastide, Alban Lemonnier, Laurent Dortet, Centre National de Référence Associé de la Résistance aux Antibiotiques [Hôpital Bicêtre AP-HP] (CNRARA/Service de Microbiologie), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Immunologie des maladies virales, auto-immunes, hématologiques et bactériennes (IMVA-HB), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Service de Microbiologie [Hôpital Bicêtre AP-HP] (UBH : Unité de Bactériologie-Hygiène), Service de bactériologie-Virologie-Hygiène [Avicenne], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Sorbonne Paris Nord, Hôpital d'Instruction des Armées Begin, Service de Santé des Armées, Dynamique Microbienne associée aux Infections Urinaires et Respiratoires (DYNAMICURE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHI Créteil, Hôpital Foch [Suresnes], CHU Henri Mondor, Institut Gustave Roussy (IGR), CHU Limoges, Centre d'Investigation Clinique de Limoges (CIC1435), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM), Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Institut des Agents Infectieux [Lyon] (IAI), Hospices Civils de Lyon (HCL), Immunology and New Concepts in ImmunoTherapy (INCIT), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Service de bactériologie et hygiène hospitalière [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Bactériologie [CHU Nice], Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital Archet 2 [Nice] (CHU), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Bactériologie et Hygiène Hospitalière [Rennes], CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Groupe Hospitalier Paris Saint-Joseph (hpsj), MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Virulence Bactérienne Précoce : fonctions cellulaires et contrôle de l'infection aigüe et subaigüe, Université de Strasbourg (UNISTRA), Plateau technique de microbiologie, Laboratoire de bactériologie, Centre Hospitalier Universitaire de Strasbourg (CHU de Strasbourg ), Hopital d'instruction des armées Sainte-Anne [Toulon] (HIA), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Biologie [CH Versailles], Centre Hospitalier de Versailles André Mignot (CHV), This work was partially supported by MSD and bioMérieux., Pecqueret, Valérie, and CHU Henri Mondor [Créteil]
Subjects: Microbiology (medical), MESH: Escherichia coli, Ceftolozane-tazobactam, [SDV]Life Sciences [q-bio], Immunology, MESH: Tazobactam, MESH: Pseudomonas Infections, MESH: beta-Lactamases, Microbiology, MESH: Prospective Studies, [SDV] Life Sciences [q-bio], MESH: Enterobacteriaceae, carbapenemase, MESH: Cephalosporins, Enterobacterales, ESBL, MESH: Anti-Bacterial Agents, MESH: Pseudomonas aeruginosa, Immunology and Allergy, epidemiology, France, MIC
Abstract: International audience; Objectives: Ceftolozane-tazobactam (C/T) proved its efficacy for the treatment of infections caused by non-carbapenemase producing Pseudomonas aeruginosa and Enterobacterales. Here, we aimed to provide susceptibility data on large series of Enterobacterales since the revision of EUCAST categorization breakpoints in 2020.Methods: First, C/T susceptibility was determined on characterized Enterobacterales resistant to 3rd generation cephalosporins (3GC) (ESBL production or different levels of AmpC overexpression) (n=213) and carbapenem resistant Enterobacterales (CRE) (n=259) including 170 carbapenemase producers (CPE). Then, 1,632 consecutive clinical Enterobacterales responsible for infection were prospectively collected in 23 French hospitals. C/T susceptibility was determined by Etest® (biomérieux) and broth microdilution (BMD) (Sensititre™, Thermo Scientific) to perform method comparison.Results: Within the collection isolates, 88% of 3GC resistant strains were susceptible to C/T, with important variation depending on the resistance mechanism: 93% vs 13% susceptibility for CTX-M and SHV-ESBL producers, respectively. Only 20% of the CRE were susceptible to C/T. Among CPE, 80 % of OXA-48-like producers were susceptible to C/T, whereas all metallo-β-lactamase producers were resistant. The prospective study revealed that 95.6% of clinical isolates were susceptible to C/T. Method comparison performed on these 1,632 clinical isolates demonstrated 99 % of categorization agreement between MIC to C/T determined by Etest® compared to BMD (reference) and only 74% of essential agreement.Conclusion: Overall, C/T showed good activity against wild-type Enterobacterales, AmpC producers and ESBL-producing E. coli but is less active against ESBL-producing K. pneumoniae and CRE. Etest® led to an underestimation of the MICs in comparison to BMD.
Published: 2023
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5. French practical guidelines for the diagnosis and management of idiopathic pulmonary fibrosis – 2021 update. Full-length version

Author: Vincent Cottin, Philippe Bonniaud, Jacques Cadranel, Bruno Crestani, Stéphane Jouneau, Sylvain Marchand-Adam, Hilario Nunes, Lidwine Wémeau-Stervinou, Emmanuel Bergot, Elodie Blanchard, Raphaël Borie, Arnaud Bourdin, Cécile Chenivesse, Annick Clément, Emmanuel Gomez, Anne Gondouin, Sandrine Hirschi, François Lebargy, Charles-Hugo Marquette, David Montani, Grégoire Prévot, Sébastien Quetant, Martine Reynaud-Gaubert, Mathieu Salaun, Olivier Sanchez, Bruno Trumbic, Karim Berkani, Pierre-Yves Brillet, Marion Campana, Lara Chalabreysse, Gérard Chatté, Didier Debieuvre, Gilbert Ferretti, Jean-Michel Fourrier, Nicolas Just, Marianne Kambouchner, Bertrand Legrand, Frédéric Le Guillou, Jean-Pierre Lhuillier, Anas Mehdaoui, Jean-Marc Naccache, Catherine Paganon, Martine Rémy-Jardin, Salim Si-Mohamed, Philippe Terrioux, Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre national de référence des maladies pulmonaires rares [Lyon] (CRMPM), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-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), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Pneumologie Soins Intensifs, Appareillage Respiratoire [CHU de Dijon], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), École des Hautes Études en Santé Publique [EHESP] (EHESP), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Avicenne [AP-HP], Institut Coeur Poumon [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Pessac, 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 d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Maladies génétiques d'expression pédiatrique (U933), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Trousseau [APHP], 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 Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Nouvel Hôpital Civil de Strasbourg, Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Pasteur [Nice] (CHU), Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Centre Chirurgical Marie Lannelongue (CCML)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Marseille, Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Hypoxie et Poumon : pneumopathologies fibrosantes, modulations ventilatoires et circulatoires (H&P), UFR SMBH-Université Sorbonne Paris Nord, Centre Hospitalier Régional d'Orléans (CHRO), Hospices Civils de Lyon (HCL), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Eure-Seine - Hôpital d'Evreux - Vernon (Evreux), Groupe Hospitalier Paris Saint-Joseph (hpsj), Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie (Hôpital Louis Pradel), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and 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)
Subjects: Pulmonary and Respiratory Medicine, Biopsy, Biopsie, [SDV]Life Sciences [q-bio], Fibrose pulmonaire, Pneumopathie interstitielle commune, Interstitial lung disease, Common interstitial lung disease, Pneumopathie interstitielle diffuse, Pulmonary fibrosis
Abstract: National audience; BACKGROUND: Since the previous French guidelines were published in 2017, substantial additional knowledge about idiopathic pulmonary fibrosis has accumulated. METHODS: Under the auspices of the French-speaking Learned Society of Pulmonology and at the initiative of the coordinating reference center, practical guidelines for treatment of rare pulmonary diseases have been established. They were elaborated by groups of writers, reviewers and coordinators with the help of the OrphaLung network, as well as pulmonologists with varying practice modalities, radiologists, pathologists, a general practitioner, a head nurse, and a patients’ association. The method was developed according to rules entitled "Good clinical practice" in the overall framework of the "Guidelines for clinical practice" of the official French health authority (HAS), taking into account the results of an online vote using a Likert scale. RESULTS: After analysis of the literature, 54 recommendations were formulated, improved, and validated by the working groups. The recommendations covered a wide-ranging aspects of the disease and its treatment: epidemiology, diagnostic modalities, quality criteria and interpretation of chest CT, indication and modalities of lung biopsy, etiologic workup, approach to familial disease entailing indications and modalities of genetic testing, evaluation of possible functional impairments and prognosis, indications for and use of antifibrotic therapy, lung transplantation, symptom management, comorbidities and complications, treatment of chronic respiratory failure, diagnosis and management of acute exacerbations of fibrosis. CONCLUSION: These evidence-based guidelines are aimed at guiding the diagnosis and the management in clinical practice of idiopathic pulmonary fibrosis.
Published: 2022
Full Text: View/download PDF

6. Recommandations pratiques pour le diagnostic et la prise en charge de la fibrose pulmonaire idiopathique – Actualisation 2021. Version intégrale

Author: Cottin, Vincent, Bonniaud, Philippe, Cadranel, Jacques, Crestani, Bruno, Jouneau, Stéphane, Marchand-Adam, Sylvain, Nunes, Hilario, Wémeau-Stervinou, Lidwine, Bergot, Emmanuel, Blanchard, Elodie, Borie, Raphaël, Bourdin, Arnaud, Chenivesse, Cécile, Clément, Annick, Gomez, Emmanuel, Gondouin, Anne, Hirschi, Sandrine, Lebargy, François, Marquette, Charles-Hugo, Montani, David, Prévot, Grégoire, Quetant, Sébastien, Reynaud-Gaubert, Martine, Salaun, Mathieu, Sanchez, Olivier, Trumbic, Bruno, Berkani, Karim, Brillet, Pierre-Yves, Campana, Marion, Chalabreysse, Lara, Chatté, Gérard, Debieuvre, Didier, Ferretti, Gilbert, Fourrier, Jean-Michel, Just, Nicolas, Kambouchner, Marianne, Legrand, Bertrand, Le Guillou, Frédéric, Lhuillier, Jean-Pierre, Mehdaoui, Anas, Naccache, Jean-Marc, Paganon, Catherine, Rémy-Jardin, Martine, Si-Mohamed, Salim, Terrioux, Philippe, Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre national de référence des maladies pulmonaires rares [Lyon] (CRMPM), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-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), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Pneumologie Soins Intensifs, Appareillage Respiratoire [CHU de Dijon], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), École des Hautes Études en Santé Publique [EHESP] (EHESP), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Avicenne [AP-HP], Institut Coeur Poumon [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Pessac, 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 d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Maladies génétiques d'expression pédiatrique (U933), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Trousseau [APHP], 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 Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Nouvel Hôpital Civil de Strasbourg, Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Pasteur [Nice] (CHU), Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Centre Chirurgical Marie Lannelongue (CCML)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Marseille, Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Hypoxie et Poumon : pneumopathologies fibrosantes, modulations ventilatoires et circulatoires (H&P), UFR SMBH-Université Sorbonne Paris Nord, Centre Hospitalier Régional d'Orléans (CHRO), Hospices Civils de Lyon (HCL), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Eure-Seine - Hôpital d'Evreux - Vernon (Evreux), Groupe Hospitalier Paris Saint-Joseph (hpsj), Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie (Hôpital Louis Pradel), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), 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)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Association pour l’amélioration de la prise en charge des maladies pulmonaires rares, Hospices Civils de Lyon, and Université Claude Bernard Lyon 1.
Subjects: Biopsy, Biopsie, [SDV]Life Sciences [q-bio], Fibrose pulmonaire, Pneumopathie interstitielle commune, Interstitial lung disease, Common interstitial lung disease, Pneumopathie interstitielle diffuse, Pulmonary fibrosis
Abstract: National audience; BACKGROUND: Since the previous French guidelines were published in 2017, substantial additional knowledge about idiopathic pulmonary fibrosis has accumulated. METHODS: Under the auspices of the French-speaking Learned Society of Pulmonology and at the initiative of the coordinating reference center, practical guidelines for treatment of rare pulmonary diseases have been established. They were elaborated by groups of writers, reviewers and coordinators with the help of the OrphaLung network, as well as pulmonologists with varying practice modalities, radiologists, pathologists, a general practitioner, a head nurse, and a patients’ association. The method was developed according to rules entitled "Good clinical practice" in the overall framework of the "Guidelines for clinical practice" of the official French health authority (HAS), taking into account the results of an online vote using a Likert scale. RESULTS: After analysis of the literature, 54 recommendations were formulated, improved, and validated by the working groups. The recommendations covered a wide-ranging aspects of the disease and its treatment: epidemiology, diagnostic modalities, quality criteria and interpretation of chest CT, indication and modalities of lung biopsy, etiologic workup, approach to familial disease entailing indications and modalities of genetic testing, evaluation of possible functional impairments and prognosis, indications for and use of antifibrotic therapy, lung transplantation, symptom management, comorbidities and complications, treatment of chronic respiratory failure, diagnosis and management of acute exacerbations of fibrosis. CONCLUSION: These evidence-based guidelines are aimed at guiding the diagnosis and the management in clinical practice of idiopathic pulmonary fibrosis.; Contexte :Depuis les précédentes recommandations françaises publiées en 2017, les connaissances concernant la fibrose pulmonaire idiopathique ont évolué sur de nombreux aspects.Méthodes :Des recommandations pratiques ont été établies à l’initiative du Centre coordonnateur de référence des maladies pulmonaires rares, sous l’égide de la Société de Pneumologie de Langue Française, par un groupe de coordination, un groupe de rédaction, et un groupe de lecture, impliquant l’ensemble du réseau OrphaLung, des pneumologues de divers modes d’exercice, des radiologues, des pathologistes, un médecin généraliste, un cadre de santé, et une association de patients. La méthode a respecté les règles d’élaboration des « Bonnes pratiques cliniques » selon la méthode des « Recommandations pour la pratique clinique » de la Haute Autorité de Santé, incluant un vote en ligne selon une échelle Likert.Résultats :Après une analyse bibliographique, 54 recommandations ont été formulées, améliorées, puis validées par les groupes de travail, portant sur des aspects multiples de la maladie : épidémiologie, modalités diagnostiques, critères de qualité et interprétation du scanner thoracique, indication et réalisation de la biopsie pulmonaire, bilan étiologique, modalités et indications de l’enquête familiale et de l’analyse génétique, évaluation du retentissement fonctionnel et du pronostic, indication et emploi des médicaments antifibrosants, transplantation pulmonaire, prise en charge des symptômes, comorbidités et complications, traitement de l’insuffisance respiratoire chronique, diagnostic et prise en charge des exacerbations aiguës de fibrose.Conclusion :Ces recommandations fondées sur les preuves sont destinées à guider le diagnostic et la prise en charge pratique de la fibrose pulmonaire idiopathique.
Published: 2022
Full Text: View/download PDF

7. [French practical guidelines for the diagnosis and management of IPF - 2021 update, full version]

Author: Cottin, V, Bonniaud, P, Cadranel, J, Crestani, B, Jouneau, S, Marchand-Adam, S, Nunes, H, Wémeau-Stervinou, L, Bergot, E, Blanchard, E, Borie, R, Bourdin, A, Chenivesse, C, Clément, Annick, Gomez-Quiroz, Luis E, Gondouin, A, Hirschi, S, Lebargy, F, Marquette, C.-H., Montani, D, Prévot, G, Quetant, S, Reynaud-Gaubert, M, Salaün, M, Sanchez, O, Trumbic, B, Berkani, K, Brillet, P.-Y., Campana, M, Chalabreysse, L, Chatté, G, Debieuvre, D, Ferretti, G, Fourrier, J.-M., Just, N, Kambouchner, M, Legrand, B, Le Guillou, F, Lhuillier, J.-P., Mehdaoui, A., Naccache, J.-M., Paganon, C, Rémy-Jardin, M, Si-Mohamed, S., Terrioux, P, Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre national de référence des maladies pulmonaires rares [Lyon] (CRMPM), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-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), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Pneumologie Soins Intensifs, Appareillage Respiratoire [CHU de Dijon], Centre Constitutif de Référence des Maladies Pulmonaires Rares [AP-HP Tenon], Centre national de référence des maladies pulmonaires rares [Lyon] (CRMPM)-Service de Pneumologie = Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], CHU Tenon [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 Tenon [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), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), École des Hautes Études en Santé Publique [EHESP] (EHESP), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Avicenne [AP-HP], Institut Coeur Poumon [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Pessac, 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 d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Maladies génétiques d'expression pédiatrique [CHU Trousseau] (Inserm U933), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Trousseau [APHP], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Nouvel Hôpital Civil de Strasbourg, Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Pasteur [Nice] (CHU), Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Centre Chirurgical Marie Lannelongue (CCML)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Marseille, Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Hypoxie et Poumon : pneumopathologies fibrosantes, modulations ventilatoires et circulatoires (H&P), UFR SMBH-Université Sorbonne Paris Nord, Centre Hospitalier Régional d'Orléans (CHRO), Hospices Civils de Lyon (HCL), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Eure-Seine - Hôpital d'Evreux - Vernon (Evreux), Groupe Hospitalier Paris Saint-Joseph (hpsj), Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie (Hôpital Louis Pradel), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and 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)
Subjects: Biopsie, Biopsy, [SDV]Life Sciences [q-bio], Fibrose pulmonaire, Pneumopathie interstitielle commune, Interstitial lung disease, Common interstitial lung disease, Pneumopathie interstitielle diffuse, Pulmonary fibrosis
Abstract: National audience; BACKGROUND: Since the previous French guidelines were published in 2017, substantial additional knowledge about idiopathic pulmonary fibrosis has accumulated. METHODS: Under the auspices of the French-speaking Learned Society of Pulmonology and at the initiative of the coordinating reference center, practical guidelines for treatment of rare pulmonary diseases have been established. They were elaborated by groups of writers, reviewers and coordinators with the help of the OrphaLung network, as well as pulmonologists with varying practice modalities, radiologists, pathologists, a general practitioner, a head nurse, and a patients’ association. The method was developed according to rules entitled "Good clinical practice" in the overall framework of the "Guidelines for clinical practice" of the official French health authority (HAS), taking into account the results of an online vote using a Likert scale. RESULTS: After analysis of the literature, 54 recommendations were formulated, improved, and validated by the working groups. The recommendations covered a wide-ranging aspects of the disease and its treatment: epidemiology, diagnostic modalities, quality criteria and interpretation of chest CT, indication and modalities of lung biopsy, etiologic workup, approach to familial disease entailing indications and modalities of genetic testing, evaluation of possible functional impairments and prognosis, indications for and use of antifibrotic therapy, lung transplantation, symptom management, comorbidities and complications, treatment of chronic respiratory failure, diagnosis and management of acute exacerbations of fibrosis. CONCLUSION: These evidence-based guidelines are aimed at guiding the diagnosis and the management in clinical practice of idiopathic pulmonary fibrosis.
Published: 2022
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8. 2022 Update of indications and contraindications for lung transplantation in France

Author: Jérôme Le Pavec, Christophe Pison, Sandrine Hirschi, Vincent Bunel, Pierre Mordant, Olivier Brugière, Morgan Le Guen, Anne Olland, Benjamin Coiffard, Benjamin Renaud-Picard, Adrien Tissot, Geoffrey Brioude, Raphaël Borie, Bruno Crestani, Gaétan Deslée, Sandrine Stelianides, Hervé Mal, Armelle Schuller, Loïc Falque, Gwenaëlle Lorillon, Abdellatif Tazi, Pierre Regis Burgel, Dominique Grenet, Sandra De Miranda, Anne Bergeron, David Launay, Vincent Cottin, Hilario Nunes, Dominique Valeyre, Yurdagul Uzunhan, Grégoire Prévot, Olivier Sitbon, David Montani, Laurent Savale, Marc Humbert, Elie Fadel, Olaf Mercier, Jean François Mornex, Gaëlle Dauriat, Martine Reynaud-Gaubert, Université Paris-Sud - Paris 11 (UP11), Hôpital Marie-Lannelongue, Centre Hospitalier Universitaire [Grenoble] (CHU), Les Hôpitaux Universitaires de Strasbourg (HUS), CIC Hôpital Bichat, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine, Université Paris Cité (UPCité), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de pneumologie [Hôpital Foch], Hôpital Foch [Suresnes], Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Nanomédecine Régénérative (NanoRegMed), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Strasbourg, Hôpital Nord [CHU - APHM], unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology (U1064 Inserm - CR2TI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Team 4 : Deciphering organ immune regulation in inflammation and transplantation (DORI-t) (U1064 Inserm - CR2TI), Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Service des maladies respiratoires et allergiques [CHU Reims], Centre Hospitalier Universitaire de Reims (CHU Reims), Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de réadaptation [Achères] (IdR), Service de Chirurgie Thoracique, CHU Strasbourg-Nouvel Hôpital Civil, Immunologie humaine, physiopathologie & immunothérapie (HIPI (UMR_S_976 / U976)), Service de pneumologie [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Hôpitaux Universitaires de Genève (HUG), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de référence des maladies auto-immunes systémiques rares du Nord et Nord Ouest [CHRU Lille], Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Physiologie de l'Insecte : Signalisation et Communication (PISC), Institut National de la Recherche Agronomique (INRA)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National Agronomique Paris-Grignon (INA P-G), Hôpital Avicenne [AP-HP], Centre hospitalier Saint-Joseph [Paris], Pôle Clinique des Voies respiratoires [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de pneumologie [CHU Bicêtre], Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay, Centre d'Investigation Clinique [Bron] (CIC1407), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupement Hospitalier Est [Bron], Groupe Hospitalier Paris Saint-Joseph (hpsj), and Aix Marseille Université (AMU)
Subjects: Pulmonary and Respiratory Medicine, High emergency allocation program, [SDV]Life Sciences [q-bio], Lung transplantation contraindications, Lung transplantation indications, Candidate selection
Abstract: International audience; Lung transplantation (LTx) is a steadily expanding field. The considerable developments have been driven over the years by indefatigable work conducted at LTx centers to improve donor and recipient selection, combined with multifaceted efforts to overcome challenges raised by the surgical procedure, perioperative care, and long-term medical complications. One consequence has been a pruning away of contraindications over time, which has, in some ways, complicated the patient selection process. The Francophone Pulmonology Society (Société de Pneumology de Langue Française, SPLF) set up a task force to produce up-to-date working guidelines designed to assist pulmonologists in managing end-stage respiratory insufficiency, determining which patients may be eligible for LTx, and appropriately timing LTx-center referral. The task force examined the most recent literature and evaluated the risk factors that limit patient survival after LTx. Ideally, the objectives of LTx are to prolong life while also improving quality of life. The guidelines developed by the task force apply to a limited resource and are consistent with the ethical principles described below.
Published: 2023
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9. Epidemiology of symptomatic infective anoproctitis in a population of men having sex with men (MSM)

Author: J. Lourtet-Hascoet, L. Mine, L. Spindler, B. Pilmis, M. Aubert, A. EL Mituialy, V. Vieillefond, V. de Parades, A. Le Monnier, Groupe Hospitalier Paris Saint-Joseph (hpsj), MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de Physique des Particules de Marseille (CPPM), Aix Marseille Université (AMU)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier Saint-Joseph [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université Paris-Saclay
Subjects: Microbiology (medical), [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, Infectious Diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology
Abstract: International audience
Published: 2022
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10. Hospitalization and Death in the First 30 days After Outpatient Lower Extremity Arterial Stenting

Author: Simon Jan, Yann Gouëffic, Olivier Grimaud, Nolwenn Le Meur, Observatoire régional de la santé Bretagne, Groupe Hospitalier Paris Saint-Joseph (hpsj), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), Recherche sur les services et le management en santé (RSMS), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département Méthodes quantitatives en santé publique (METIS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Université de Rennes (UR), and EHESP, SCD
Subjects: Adult, Inpatients, Endovascular intervention, Outpatient, Lower extremity arterial disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Hospitalization, Death, Postoperative Complications, Lower Extremity, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Outpatients, Humans, Radiology, Nuclear Medicine and imaging, Female, Stents, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cardiology and Cardiovascular Medicine, Complication, Rehospitalization, Retrospective Studies
Abstract: International audience; Purpose: To compare the safety of outpatient versus inpatient endovascular treatment of lower extremity arterial disease (LEAD) using real-life data.Materials and methods: This retrospective observational study used real-life data from the French national health data information system on adult patients who underwent stenting for LEAD between 2013 and 2016. The outcomes of interest were all-cause mortality, all-cause hospitalization, planned hospitalization, and unplanned hospitalization at day 3 and day 30 after the index endovascular intervention for LEAD revascularization. A propensity score was used to control for indication bias. Outcome rates in outpatient and inpatient settings were compared with the Poisson regression model. Sensitivity analyses were performed by varying the definition of the outcomes of interest.Results: During the study period, 26,715 interventions were performed among which 2819 (10.6%) were in outpatient settings. Outpatients were slightly younger than inpatients (64.73 ± 10.68 vs. 68.10 ± 11.50, respectively). The percentage of women patients was similar: 19.8% in the outpatient group and 27.2% in the inpatient group. Within 30 days after discharge, 73 patients (.31%) and 2 (.07%) patients (p = .02) died in the inpatient group and outpatient group, respectively. The death and rehospitalization rate were similar: 3.8 and 3.5 per 1000 person-months for inpatients and outpatients, respectively. No difference was observed after adjusting for patients' case-mix in the regression model (RR = .99; 95% CI [.82-1.19]).Conclusions: Outpatient stenting for LEAD did not present any additional risk of early postoperative rehospitalization or death compared with inpatient stenting.
Published: 2022
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11. Extracorporeal Membrane Oxygenation for Respiratory Failure Related to COVID-19: A Nationwide Cohort Study

Author: Nicolas, Nesseler, Guillaume, Fadel, Alexandre, Mansour, Marylou, Para, Pierre-Emmanuel, Falcoz, Nicolas, Mongardon, Alizée, Porto, Astrid, Bertier, Bruno, Levy, Cyril, Cadoz, Pierre-Grégoire, Guinot, Olivier, Fouquet, Jean-Luc, Fellahi, Alexandre, Ouattara, Julien, Guihaire, Vito-Giovanni, Ruggieri, Philippe, Gaudard, François, Labaste, Thomas, Clavier, Kais, Brini, Nicolas, Allou, Corentin, Lacroix, Juliette, Chommeloux, Guillaume, Lebreton, Michael A, Matthay, Sophie, Provenchere, Erwan, Flécher, André, Vincentelli, James T, Ross, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], 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), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Nanomédecine Régénérative (NanoRegMed), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), CHU Strasbourg, Nouvel Hôpital Civil de Strasbourg, 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), Hôpital Henri Mondor, Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Bicêtre, 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), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases, Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Bordeaux [Bordeaux], Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Hôpital Marie-Lannelongue, Groupe Hospitalier Paris Saint-Joseph (hpsj), Centre Hospitalier Universitaire de Reims (CHU Reims), Université de Reims Champagne-Ardenne (URCA), 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), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Franco-czech Laboratory for clinical research on obesity, Charles University [Prague] (CU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Rouen, Normandie Université (NU), Institut Mutualiste de Montsouris (IMM), Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion], Centre hospitalier universitaire de Poitiers (CHU Poitiers), University of California [San Francisco] (UC San Francisco), University of California (UC), Centre d'investigation Clinique [CHU Bichat] - Épidémiologie clinique (CIC 1425), 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), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Lille, ECMOSARS Investigators: Marc Pierrot, Sidney Chocron, Guillaume Flicoteaux, Philippe Mauriat, Hadrien Roze, Olivier Huet, Marc-Olivier Fischer, Claire Alessandri, Raphel Bellaïche, Ophélie Constant, Quentin de Roux, André Ly, Arnaud Meffert, Jean-Claude Merle, Lucile Picard, Elena Skripkina, Thierry Folliguet, Antonio Fiore, Nicolas d'Ostrevy, Marie-Catherine Morgan, Maxime Nguyen, Lucie Gaide-Chevronnay, Nicolas Terzi, Gwenhaël Colin, Olivier Fabre, Arash Astaneh, Justin Issard, Elie Fadel, Dominique Fabre, Antoine Girault, Iolande Ion, Jean Baptiste Menager, Delphine Mitilian, Olaf Mercier, François Stephan, Jacques Thes, Jerôme Jouan, Thibault Duburcq, Valentin Loobuyck, Sabrina Manganiello, Mouhammed Moussa, Agnes Mugnier, Natacha Rousse, Olivier Desebbe, Roland Henaine, Matteo Pozzi, Jean-Christophe Richard, Zakaria Riad, Christophe Guervilly, Sami Hraiech, Laurent Papazian, Matthias Castanier, Charles Chanavaz, Sebastien Gette, Guillaume Louis, Erick Portocarrero, Nicolas Bischoff, Antoine Kimmoun, Mathieu Mattei, Pierre Perez, Alexandre Bourdiol, Yannick Hourmant, Pierre-Joachim Mahé, Bertrand Rozec, Mickaël Vourc'h, Stéphane Aubert, Florian Bazalgette, Claire Roger, Pierre Jaquet, Brice Lortat-Jacob, Pierre Mordant, Patrick Nataf, Juliette Patrier, Morgan Roué, Romain Sonneville, Alexy Tran-Dinh, Paul-Henri Wicky, Charles Al Zreibi, Bernard Cholley, Yannis Guyonvarch, Sophie Hamada, Claudio Barbanti, Anatole Harrois, Jordi Matiello, Thomas Kerforne, Nicolas Brechot, Alain Combes, Jean Michel Constantin, Cosimo D'Alessandro, Pierre Demondion, Alexandre Demoule, Martin Dres, Muriel Fartoukh, Guillaume Hekimian, Charles Juvin, Pascal Leprince, David Levy, Charles Edouard Luyt, Marc Pineton de Chambrun, Matthieu Schmidt, Thibaut Schoell, Pierre Fillâtre, Nicolas Massart, Roxane Nicolas, Maud Jonas, Charles Vidal, Salvatore Muccio, Dario Di Perna, Bruno Mourvillier, Amedeo Anselmi, Karl Bounader, Maxime Esvan, Claire Fougerou-Leurent, Yoann Launey, Thomas Lebouvier, Alessandro Parasido, Florian Reizine, Philippe Seguin, Emmanuel Besnier, Dorothée Carpentier, Anne Olland, Fanny Bounes, Vincent Minville, Antoine Guillon, Yannick Fedun, James T Ross, Jonchère, Laurent, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), CHU Toulouse [Toulouse], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), University of California [San Francisco] (UCSF), University of California, 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)-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), Modeling & analysis for medical imaging and Diagnosis (MYRIAD), and 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)-Université Claude Bernard Lyon 1 (UCBL)
Subjects: Cohort Studies, Male, [SDV] Life Sciences [q-bio], Anesthesiology and Pain Medicine, Extracorporeal Membrane Oxygenation, [SDV]Life Sciences [q-bio], COVID-19, Humans, Respiratory Insufficiency, Pandemics, Retrospective Studies
Abstract: Background Despite expanding use, knowledge on extracorporeal membrane oxygenation support during the COVID-19 pandemic remains limited. The objective was to report characteristics, management, and outcomes of patients receiving extracorporeal membrane oxygenation with a diagnosis of COVID-19 in France and to identify pre-extracorporeal membrane oxygenation factors associated with in-hospital mortality. A hypothesis of similar mortality rates and risk factors for COVID-19 and non–COVID-19 patients on venovenous extracorporeal membrane oxygenation was made. Methods The Extracorporeal Membrane Oxygenation for Respiratory Failure and/or Heart failure related to Severe Acute Respiratory Syndrome-Coronavirus 2 (ECMOSARS) registry included COVID-19 patients supported by extracorporeal membrane oxygenation in France. This study analyzed patients included in this registry up to October 25, 2020, and supported by venovenous extracorporeal membrane oxygenation for respiratory failure with a minimum follow-up of 28 days after cannulation. The primary outcome was in-hospital mortality. Risk factors for in-hospital mortality were analyzed. Results Among 494 extracorporeal membrane oxygenation patients included in the registry, 429 were initially supported by venovenous extracorporeal membrane oxygenation and followed for at least 28 days. The median (interquartile range) age was 54 yr (46 to 60 yr), and 338 of 429 (79%) were men. Management before extracorporeal membrane oxygenation cannulation included prone positioning for 411 of 429 (96%), neuromuscular blockage for 419 of 427 (98%), and NO for 161 of 401 (40%). A total of 192 of 429 (45%) patients were cannulated by a mobile extracorporeal membrane oxygenation unit. In-hospital mortality was 219 of 429 (51%), with a median follow-up of 49 days (33 to 70 days). Among pre-extracorporeal membrane oxygenation modifiable exposure variables, neuromuscular blockage use (hazard ratio, 0.286; 95% CI, 0.101 to 0.81) and duration of ventilation (more than 7 days compared to less than 2 days; hazard ratio, 1.74; 95% CI, 1.07 to 2.83) were independently associated with in-hospital mortality. Both age (per 10-yr increase; hazard ratio, 1.27; 95% CI, 1.07 to 1.50) and total bilirubin at cannulation (6.0 mg/dl or more compared to less than 1.2 mg/dl; hazard ratio, 2.65; 95% CI, 1.09 to 6.5) were confounders significantly associated with in-hospital mortality. Conclusions In-hospital mortality was higher than recently reported, but nearly half of the patients survived. A high proportion of patients were cannulated by a mobile extracorporeal membrane oxygenation unit. Several factors associated with mortality were identified. Venovenous extracorporeal membrane oxygenation support should be considered early within the first week of mechanical ventilation initiation. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New
Published: 2022
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12. Geographical disparities of endovascular revascularisations in ambulatory setting in France from 2015 to 2019

Author: Le Meur, Nolwenn, Padilla, Cindy, Ghoroubi, Narges, Lamirault, Guillaume, Chatellier, Gilles, Gouëffic, Yann, Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Institut national d'études démographiques (INED), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), 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), 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), CIC - HEGP (CIC 1418), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Groupe Hospitalier Paris Saint-Joseph (hpsj), and EHESP, SCD
Subjects: [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Healthcare disparities, Space-time analysis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Lower extremity arterial disease, Endovascular ambulatory, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract: International audience; ObjectivesDespite evidences of efficiency and safety ambulatory endovascular revasculatisation for lower extremity arterial disease (LEAD) concerned only 5% of the interventions in France in 2016. Such low rate suggested temporal and geographical space disparities. The aim of this study was to describe the space-time development of ambulatory endovascular revascularisation for LEAD in France and investigates the contributions of health care services and population characteristics as potential determinants.MethodsA retrospective study was conducted on discharge data from French hospitals that performed endovascular procedures for LEAD between 2015 and 2019. Space-time analyses with Moran’s Index, zero-inflated Poisson regression, and clustering approaches were applied. Spatial clusters were compared on the basis of health care services and population characteristics (including poverty and single-man household as proxies of social isolation).ResultsBetween 2015 and 2019, the number of ambulatory interventions has tripled (1104 vs 3130). Out of the 86 French departments, the proportion with > 5% of ambulatory interventions increased from 10.7% to 28.7% over the study period. In 2019, the ambulatory activity in the French departments ranged from 0% to 39%. This evolution was accompanied by a northwest to northeast spatial trend. The clusters of 27 departments with a significant ambulatory activity differed from the others notably by the mortality rate of lower limb arterial thrombo-embolic diseases in male (OR=3.15 95%CI[1.2-8.1]), the proportion of single-man household aged 75 or more (OR=0.37 95%CI [0.2-0.8]), and the poverty rate of people aged 50- to 59-year-old (OR=0.69 95%CI[0.5-0.9]).ConclusionsThe development of ambulatory interventions for LEAD in France is encouraging but heterogeneous. Some determinants of this evolution are clearly population based, with a positive impact of needs to take care of the burden of LEAD but negative effects of social isolation and poverty. Research should be conducted to overcome some patients’ constraints such as isolation.
Published: 2022
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13. 3-T MR neurography of lumbo-sacral plexus in hereditary transthyretin-related amyloidosis with polyneuropathy

Author: Jérôme Hodel, Samir Benadjaoud, Mohamed Amine Benadjaoud, Jean-Pascal Lefaucheur, Violaine Planté-Bordeneuve, Groupe Hospitalier Paris Saint-Joseph (hpsj), Service de recherche en radiobiologie et en médecine régénérative (IRSN/PSE-SANTE/SERAMED), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Excitabilité nerveuse et thérapeutique (ENT), Hôpital Henri Mondor-EA 4391, Service de Physiologie Explorations Fonctionnelles-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), and ATHENA, Irsn
Subjects: Amyloid Neuropathies, Familial, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Lumbosacral Plexus, General Medicine, Hypertrophy, Magnetic Resonance Imaging, Hereditary transthyretin-related amyloidosis with polyneuropathy, Lumbo-sacral plexus, Polyneuropathies, [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, Familial amyloid polyneuropathy, Humans, Prealbumin, Radiology, Nuclear Medicine and imaging, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Asymptomatic variant carriers, MR neurography
Abstract: Our aim was to evaluate the ability of magnetic resonance neurography (MRN) of the lumbo-sacral plexus (LSP) to distinguish patients with hereditary transthyretin-related amyloidosis with polyneuropathy (ATTRv-PN) from asymptomatic variant carriers (AVC) and healthy controls and to assess its prognostic value.Three-Tesla MRN was performed in 25 consecutive ATTRv-PN patients, 18 AVC, and 10 controls including T2-w DIXON and DWI MR sequences. Two blinded readers independently assessed LSP root diameter and intraneural signal on the MRN images of each subject. MRN findings were compared between groups and correlated with clinical impairment scored on the Neuropathy Impairment Score (NIS) and the modified Polyneuropathy Disability score (mPND).The agreement between readers on MRN images was excellent (Cohen's kappa = 0.82). LSP root enlargement was significantly more frequent in ATTRv-PN patients compared to AVC (ratio = 4.38, p = 0.038). Increased LSP root intraneural signal on T2-w images was significantly more frequent in ATTRv-PN patients compared to AVC (ratio = 3.4, p = 0.016). In contrast, there were no MRN abnormalities in controls. In ATTRv-PN patients, LSP root enlargement was associated with higher mPND scores (p = 0.03) and increased intraneural signal on T2-w images was associated with significantly higher NIS and mPND scores (p = 0.004 and 0.02, respectively).MRN of the LSP can help differentiate ATTRv-PN patients from AVC. LSP root enlargement and increased intraneural signal are significantly associated with clinical impairment, suggesting potential implications for patient care.• ATTRv-PN patients showed abnormal LSP changes on MRN. • MRN of the LSP can help to differentiate ATTRv-PN patients from AVC and healthy controls. • LSP root enlargement and increased intraneural signal were significantly associated with clinical impairment in ATTRv-PN patients.
Published: 2021
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14. Inhaled ciclesonide for outpatient treatment of COVID-19 in adults at risk of adverse outcomes: a randomised controlled trial (COVERAGE)

Author: Alexandre Duvignaud, Edouard Lhomme, Racha Onaisi, Rémi Sitta, Ambre Gelley, Julie Chastang, Lionel Piroth, Christine Binquet, Julie Dupouy, Alain Makinson, Benjamin Lefèvre, Jean-Marc Naccache, Caroline Roussillon, Roland Landman, Cédrick Wallet, Sophie Karcher, Valérie Journot, Duc Nguyen, Thierry Pistone, Stéphane Bouchet, Marie-Edith Lafon, Mathieu Molimard, Rodolphe Thiébaut, Xavier de Lamballerie, Jean-Philippe Joseph, Laura Richert, Olivier Saint-Lary, Sarah Djabarouti, Linda Wittkop, Xavier Anglaret, Denis Malvy, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Statistics In System biology and Translational Medicine (SISTM), Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)- Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Sorbonne Université - Département de médecine générale, Sorbonne Université (SU), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Fédérale Toulouse Midi-Pyrénées, CIC Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Adaptation, mesure et évaluation en santé. Approches interdisciplinaires (APEMAC), Université de Lorraine (UL), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Groupe Hospitalier Paris Saint-Joseph (hpsj), 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, Institut de médecine et d'épidémiologie appliquée [AP-HP Hôpital Bichat-Claude Bernard] (IMEA), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Microbiologie Fondamentale et Pathogénicité (MFP), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases, Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), ANR-20-COVI-0040,COVERAGE,Traitement à domicile des personnes infectées par le SRAS-CoV-2 sans signe de gravité mais à risque de complications: un essai randomisé à plusieurs bras et en plusieurs étapes (MAMS) pour évaluer l'efficacité de plusieurs antiviraux(2020), Richert, Laura, Traitement à domicile des personnes infectées par le SRAS-CoV-2 sans signe de gravité mais à risque de complications: un essai randomisé à plusieurs bras et en plusieurs étapes (MAMS) pour évaluer l'efficacité de plusieurs antiviraux - - COVERAGE2020 - ANR-20-COVI-0040 - COVID-19 - VALID, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Toulouse (UT)
Subjects: Microbiology (medical), Male, [SDV.SP.MED] Life Sciences [q-bio]/Pharmaceutical sciences/Medication, Ciclesonide, [SDV.SP.MED]Life Sciences [q-bio]/Pharmaceutical sciences/Medication, Pregnenediones, Outpatients, Adults, Humans, Aged, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Inhaled corticosteroids, SARS-CoV-2, COVID-19, General Medicine, Middle Aged, COVID-19 Drug Treatment, Treatment, Oxygen, Infectious Diseases, Treatment Outcome, Randomized controlled trial, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female
Abstract: International audience; Objectives: To assess the efficacy of inhaled ciclesonide in reducing the risk of adverse outcomes in COVID-19 outpatients at risk of developing severe illness.Methods: COVERAGE is an open-label, randomized controlled trial. Outpatients with documented COVID-19, risk factors for aggravation, symptoms for ≤7 days, and absence of criteria for hospitalization are randomly allocated to either a control arm or one of several experimental arms, including inhaled ciclesonide. The primary efficacy endpoint is COVID-19 worsening (hospitalization, oxygen therapy at home, or death) by Day 14. Other endpoints are adverse events, maximal follow-up score on the WHO Ordinal Scale for Clinical Improvement, sustained alleviation of symptoms, cure, and RT-PCR and blood parameter evolution at Day 7. The trial's Safety Monitoring Board reviewed the first interim analysis of the ciclesonide arm and recommended halting it for futility. The results of this analysis are reported here.Results: The analysis involved 217 participants (control 107, ciclesonide 110), including 111 women and 106 men. Their median age was 63 years (interquartile range 59-68), and 157 of 217 (72.4%) had at least one comorbidity. The median time since first symptom was 4 days (interquartile range 3-5). During the 28-day follow-up, 2 participants died (control 2/107 [1.9%], ciclesonide 0), 4 received oxygen therapy at home and were not hospitalized (control 2/107 [1.9%], ciclesonide 2/110 [1.8%]), and 24 were hospitalized (control 10/107 [9.3%], ciclesonide 14/110 [12.7%]). In intent-to-treat analysis of observed data, 26 participants reached the composite primary endpoint by Day 14, including 12 of 106 (11.3%, 95% CI: 6.0%-18.9%) in the control arm and 14 of 106 (13.2%; 95% CI: 7.4-21.2%) in the ciclesonide arm. Secondary outcomes were similar for both arms.Discussion: Our findings are consistent with the European Medicines Agency's COVID-19 task force statement that there is currently insufficient evidence that inhaled corticosteroids are beneficial for patients with COVID-19.
Published: 2021
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15. Exposure to inorganic particles in paediatric sarcoidosis: the PEDIASARC study

Author: Véronique Houdouin, Catherine Cavalin, Antoine Deschildre, Jean-Marc Naccache, Catherine Chapelon-Abric, Céline Delestrain, Julien Haroche, Ralph Epaud, Ulrich Meinzer, Simon Chauveau, Fleur Cohen-Aubart, Mickaël Catinon, Florence Jeny, Odile Macchi, Sylvain Le Jeune, Hilario Nunes, Michel Vincent, Paul-André Rosental, Manon Brocvielle, Marie-Hélène Odièvre, Marie-Emeline Montagne, S. Mattioni, Dominique Valeyre, Karine Juvin, Annick Clement, Dominique Israël-Biet, A. Dossier, Nadia Nathan, Jacques Brouard, François Lionnet, Lucile Sesé, Rola Abou Taam, Christophe Delacourt, Marie Mittaine, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de Recherche Interdisciplinaire en Sciences Sociales (IRISSO), Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Pneumologie pédiatrique [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), CHU Pitié-Salpêtrière [AP-HP], Service de pneumologie [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Pneumologie et allergologie pédiatriques [CHU Jeanne de Flandre, Lille], Hôpital Jeanne de Flandre [Lille], Université de Lille, Service de Pneumologie et d'Allergologie Pédiatriques, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Immunologie humaine, physiopathologie & immunothérapie (HIPI (UMR_S_976 / U976)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), Service de Pneumologie, soins intensifs (Pneumo - HEGP), 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)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], CHU Tenon [AP-HP], Centre d'études européennes et de politique comparée (Sciences Po, CNRS) (CEE), Sciences Po (Sciences Po)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPC), Centre d'investigation clinique de Toulouse (CIC 1436), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de référence maladies rares des maladies pulmonaires rares de l’adulte (CHU Dijon) (CRMR des maladies pulmonaires rares de l’adulte), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hypoxie et Poumon : pneumopathologies fibrosantes, modulations ventilatoires et circulatoires (H&P), UFR SMBH-Université Sorbonne Paris Nord, Biologie Intégrée du Globule Rouge (BIGR (UMR_S_1134 / U1134)), Institut National de la Transfusion Sanguine [Paris] (INTS)-Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université des Antilles (UA)-Université Paris Cité (UPC), Centre d'histoire de Sciences Po (Sciences Po) (CHSP), Sciences Po (Sciences Po), Maladies génétiques d'expression pédiatrique (U933), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Trousseau [APHP], Observatoire du Samu Social de Paris, CHU Necker - Enfants Malades [AP-HP], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre des maladies respiratoires rares Respirare [CHI Créteil], 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), AP-HP - Hôpital Bichat - Claude Bernard [Paris], AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de médecine interne [Avicenne], Centre de Référence pour les Maladies Rhumatologiques Auto-Immunes et Systémiques [CHU Necker] (RAISE), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de pneumologie [Hôpital Foch], Hôpital Foch [Suresnes], Groupe Hospitalier Paris Saint-Joseph (hpsj), Laboratoire interdisciplinaire d'évaluation des politiques publiques (Sciences Po) (LIEPP), Centre d'études de l'emploi et du travail (CEET), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche (M.E.N.E.S.R.)-Ministère du Travail, de l'Emploi et de la Santé, contract grant sponsor: European Research Council (ERC) / SILICOSISproject / Principal investigator: Paul-André Rosental, Contract grant number: ERC2011-ADG_20110406ˆProject ID: 295817. Statistical analysis: RespiFIL funds, European Project: 295449,EC:FP7:ERC,ERC-2011-ADG_20110406,DARTCH(2012), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Institut National de la Transfusion Sanguine [Paris] (INTS)-Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université des Antilles (UA)-Université de Paris (UP), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Caen Normandie (UNICAEN), Centre d'Immunologie et de Maladies Infectieuses (CIMI), Service de Médecine Interne [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'études européennes et de politique comparée (CEE), Centre d'histoire de Sciences Po (CHSP), Service de médecine interne et d'immunologie clinique [CHU Pitié-Salpêtrière], and Centre National de la Recherche Scientifique (CNRS)-Sciences Po (Sciences Po)
Subjects: Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, paediatric interstitial lung disease, [SDV]Life Sciences [q-bio], [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Occupational Exposure, medicine, Humans, sarcoidosis, Occupational lung disease, Occupations, Child, Inorganic particles, 030304 developmental biology, 0303 health sciences, Median score, rare lung diseases, business.industry, Dust, Environmental exposure, Environmental Exposure, medicine.disease, 3. Good health, 030228 respiratory system, Metal dust, Talc, Sarcoidosis, business, occupational lung disease
Abstract: International audience; Inorganic antigens may contribute to paediatric sarcoidosis. Thirty-six patients matched with 36 healthy controls as well as a group of 21 sickle-cell disease (SCD) controls answered an environmental questionnaire. Patients' indirect exposure to inorganic particles, through coresidents' occupations, was higher than in healthy and SCD controls (median score: 2.5 (0.5-7) vs 0.5 (0-2), p=0.003 and 1 (0-2), p=0.012, respectively), especially for construction, exposures to metal dust, talc, abrasive reagents and scouring products. Wood or fossil energies heating were also linked to paediatric sarcoidosis. This study supports a link between mineral environmental exposure due to adult coresident occupations and paediatric sarcoidosis.
Published: 2021
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16. Mortality following Clostridioides difficile infection in Europe

Author: Czepiel, Jacek, Krutova, Marcela, Mizrahi, Assaf, Khanafer, Nagham, Enoch, David A., Patyi, Márta, Deptuła, Aleksander, Agodi, Antonella, Nuvials, Xavier, Pituch, Hanna, Wójcik-Bugajska, Małgorzata, Filipczak-Bryniarska, Iwona, Brzozowski, Bartosz, Krzanowski, Marcin, Konturek, Katarzyna, Fedewicz, Marcin, Michalak, Mateusz, Monpierre, Lorra, Vanhems, Philippe, Gouliouris, Theodore, Jurczyszyn, Artur, Goldman-Mazur, Sarah, Wultańska, Dorota, Kuijper, Ed J., Skupień, Jan, Biesiada, Grażyna, Garlicki, Aleksander, Universitat Autònoma de Barcelona, Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Charles University [Prague] (CU), ESCMID Study Group for Clostridioides Difficile (ESGCD), MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Groupe Hospitalier Paris Saint-Joseph (hpsj), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), 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), Hospices Civils de Lyon (HCL), Addenbrooke's Hospital, Cambridge University NHS Trust, Bács-Kiskun County Teaching Hospital, Nicolaus Copernicus University [Toruń], University of Catania [Italy], Vall d'Hebron University Hospital [Barcelona], Medical University of Warsaw - Poland, University Hospital of Cracow/Szpital Uniwersytecki w Krakowie [Poland] (SUK), Józef Babinski Hospital, Ludwik Rydygier Hospital, Leiden University Medical Center (LUMC), Universiteit Leiden, Rijksinstituut voor Volksgezondheid en Milieu (RIVM), Institut Català de la Salut, [Czepiel J] Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland. [Krutova M] Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic. ESCMID Study Group for Clostridioides Difficile (ESGCD), Basel, Switzerland. [Mizrahi A] ESCMID Study Group for Clostridioides Difficile (ESGCD), Basel, Switzerland. Service de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France. Institut Micalis UMR 1319, Université Paris-Saclay, INRAe, AgroParisTech, Châtenay Malabry, France. [Khanafer N] ESCMID Study Group for Clostridioides Difficile (ESGCD), Basel, Switzerland. Unité d’Hygiène, Epidémiologie et Prévention, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France. Centre International de Recherche en Infectiologie (CIRI), Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Université de Lyon, Lyon, France. [Enoch DA] Clinical Microbiology & Public Health Laboratory, Public Health England, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, UK. [Patyi M] Hygienic Department, Bács-Kiskun County Teaching Hospital, Bács-Kiskun, Hungary. [Nuvials X] Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de recerca SODIR, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, Vall d'Hebron Barcelona Hospital Campus, 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 Casal, Bérengère
Subjects: 0301 basic medicine, genetic structures, Clostridioides difficile infection, [SDV]Life Sciences [q-bio], Antibiotics, técnicas de investigación::métodos epidemiológicos::características de los estudios epidemiológicos::estudios epidemiológicos::estudios de casos y controles [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Logistic regression, Biochemistry, chemistry.chemical_compound, 0302 clinical medicine, Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Clostridium Infections [DISEASES], risk factors, Pharmacology (medical), 030212 general & internal medicine, Co-morbidities, General Pharmacology, Toxicology and Pharmaceutics, Outcome, Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics::Epidemiologic Studies::Case-Control Studies [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Clostridi - Europa, [SDV] Life Sciences [q-bio], Infectious Diseases, Absolute neutrophil count, outcome, localizaciones geográficas::Europa (continente) [DENOMINACIONES GEOGRÁFICAS], Microbiology (medical), medicine.medical_specialty, infecciones bacterianas y micosis::infecciones bacterianas::infecciones por bacterias grampositivas::infecciones por Clostridium [ENFERMEDADES], medicine.drug_class, 030106 microbiology, Malignancy, Geographic Locations::Europe [GEOGRAPHICALS], Microbiology, Cachexia, 03 medical and health sciences, Internal medicine, Other subheadings::Other subheadings::Other subheadings::/mortality [Other subheadings], medicine, Mortality, Creatinine, Clostridioides Clostridioides difficile infection, Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad [Otros calificadores], business.industry, lcsh:RM1-950, Case-control study, medicine.disease, mortality, co-morbidities, lcsh:Therapeutics. Pharmacology, chemistry, Risk factors, co–morbidities, Malalties bacterianes - Estudi de casos, business, Clostridioides, malignancy
Abstract: We aimed to describe the clinical presentation, treatment, outcome and report on factors associated with mortality over a 90-day period in Clostridioides difficile infection (CDI). Descriptive, univariate, and multivariate regression analyses were performed on data collected in a retrospective case-control study conducted in nine hospitals from seven European countries. A total of 624 patients were included, of which 415 were deceased (cases) and 209 were still alive 90 days after a CDI diagnosis (controls). The most common antibiotics used previously in both groups were β-lactams, previous exposure to fluoroquinolones was significantly (p = 0.0004) greater in deceased patients. Multivariate logistic regression showed that the factors independently related with death during CDI were older age, inadequate CDI therapy, cachexia, malignancy, Charlson Index, long-term care, elevated white blood cell count (WBC), C-reactive protein (CRP), bacteraemia, complications, and cognitive impairment. In addition, older age, higher levels of WBC, neutrophil, CRP or creatinine, the presence of malignancy, cognitive impairment, and complications were strongly correlated with shortening the time from CDI diagnosis to death. CDI prevention should be primarily focused on hospitalised elderly people receiving antibiotics. WBC, neutrophil count, CRP, creatinine, albumin and lactate levels should be tested in every hospitalised patient treated for CDI to assess the risk of a fatal outcome.
Published: 2021
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17. No significant difference between ceftriaxone and cefotaxime in the emergence of antibiotic resistance in the gut microbiota of hospitalized patients: A pilot study

Author: Philippe Azria, Olivier Ganansia, Jean-Claude Nguyen Van, Jean-Jacques Mourad, Olivier Jiang, Elodie Ménage, Sidonie Hubert, Alban Le Monnier, Marie-Françoise Borie, Jean-Ralph Zahar, Annabelle Mahé, Olivier Voisin, Erwan Le Lorc’h, Eloïse Trabattoni, Benoit Pilmis, Julie Lourtet-Hascoët, Assaf Mizrahi, Casal, Bérengère, MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Laboratoire de Microbiologie Clinique [AP-HP Hôpital Necker-Enfants Malades], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe Hospitalier Paris Saint-Joseph (hpsj), 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, and Groupe Hospitalier Universitaire Paris Seine-Saint-Denis (GHUPSSD)
Subjects: Male, 0301 basic medicine, Cefotaxime, [SDV]Life Sciences [q-bio], Antibiotics, Cephalosporin, Pilot Projects, Gut flora, medicine.disease_cause, Gastroenterology, Feces, 0302 clinical medicine, Prospective Studies, 030212 general & internal medicine, Aged, 80 and over, biology, Ceftriaxone, Extended spectrum beta-lactamase, General Medicine, Enterobacteriaceae, Anti-Bacterial Agents, Hospitalization, [SDV] Life Sciences [q-bio], Infectious Diseases, Female, medicine.drug, Microbiology (medical), medicine.medical_specialty, medicine.drug_class, Third generation cephalosporin, 030106 microbiology, Microbial Sensitivity Tests, Gut microbiota, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Antibiotic resistance, Internal medicine, Drug Resistance, Bacterial, Gram-Negative Bacteria, medicine, Humans, lcsh:RC109-216, Aged, Pseudomonas aeruginosa, business.industry, biology.organism_classification, Gastrointestinal Microbiome, business
Abstract: International audience; Background: Ceftriaxone and cefotaxime share a similar antibacterial spectrum and similar indications but have different pharmacokinetic characteristics. Ceftriaxone is administered once daily and 40% of its clearance is by biliary elimination, whereas cefotaxime requires three administrations per day and shows less than 10% biliary elimination. The high biliary elimination of ceftriaxone suggests a greater impact of this antibiotic on the gut microbiota than cefotaxime. The objective of this study was to compare the impact of ceftriaxone and cefotaxime on the gut microbiota. Methods: A prospective clinical trial was performed that included 55 patients treated with intravenous ceftriaxone (1 g/24 h) or cefotaxime (1 g/8 h) for at least 3 days. Three fresh stool samples were collected from each patient (days 0, 3, and 7 or at the end of intravenous treatment) to assess the emergence of third-generation cephalosporin (3GC)-resistant Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa, toxigenic Clostridioides difficile, and vancomycin-resistant enterococci. Results: The emergence of 3GC-resistant gram-negative enteric bacilli (Enterobacteriaceae) (5.9% vs 4.7%, p > 0.99), Enterococcus spp, and non-commensal microorganisms did not differ significantly between the groups. Both antibiotics reduced the counts of total gram-negative enteric bacilli and decreased the cultivable diversity of the microbiota, but the differences between the groups were not significant. Conclusion: No significant difference was observed between ceftriaxone and cefotaxime in terms of the emergence of resistance.
Published: 2021
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18. Distinctive clinical presentation and pathogenic specificities of anti-AK5 encephalitis

Author: Emmanuel Mignot, Pierre Labauge, Virginie Desestret, Matthew Murnane, Jérôme Honnorat, Claire Nocon, Clément Vialatte De Pémille, Thomas De Broucker, Anne-Laurie Pinto, Bastien Joubert, Irina Taifas, Sergio Muñiz-Castrillo, Valentin Wucher, Marie Benaiteau, Aditya Ambati, Julien Hedou, David M. Jones, Valérie Dubois, Laura Fechtenbaum, Alberto Vogrig, Dimitri Psimaras, Hospices Civils de Lyon (HCL), Institut NeuroMyoGène (INMG), 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), Stanford University, Albany Medical College, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier de Saint-Denis [Ile-de-France], Centre Hospitalier Henri Mondor d'Aurillac, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Centre Hospitalier de Dax, Hôpital d'instruction des Armées Percy, Service de Santé des Armées, Groupe Hospitalier Paris Saint-Joseph (hpsj), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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), Etablissement français du sang - Auvergne-Rhône-Alpes (EFS), and Retiveau, Nolwenn
Subjects: Male, medicine.medical_specialty, Gastroenterology, Epilepsy, Atrophy, MESH: Aged, 80 and over, proteomics, limbic encephalitis, Internal medicine, Biopsy, medicine, MESH: Autoantibodies, Humans, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Pleocytosis, Depression (differential diagnoses), MESH: Limbic Encephalitis, Aged, Autoantibodies, MESH: Aged, Aged, 80 and over, MESH: Humans, MESH: Middle Aged, medicine.diagnostic_test, business.industry, MESH: Proteomics, Limbic encephalitis, Adenylate Kinase, adenylate kinase 5, human leucocyte antigen, Original Articles, Middle Aged, medicine.disease, Hyperintensity, MESH: Male, 3. Good health, MESH: Adenylate Kinase, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Female, Neurology (clinical), business, MESH: Female, Encephalitis
Abstract: Limbic encephalitis with antibodies against adenylate kinase 5 (AK5) has been difficult to characterize because of its rarity. In this study, we identified 10 new cases and reviewed 16 previously reported patients, investigating clinical features, IgG subclasses, human leucocyte antigen and CSF proteomic profiles. Patients with anti-AK5 limbic encephalitis were mostly male (20/26, 76.9%) with a median age of 66 years (range 48–94). The predominant symptom was severe episodic amnesia in all patients, and this was frequently associated with depression (17/25, 68.0%). Weight loss, asthenia and anorexia were also highly characteristic, being present in 11/25 (44.0%) patients. Although epilepsy was always lacking at disease onset, seizures developed later in a subset of patients (4/25, 16.0%). All patients presented CSF abnormalities, such as pleocytosis (18/25, 72.0%), oligoclonal bands (18/25, 72.0%) and increased Tau (11/14, 78.6%). Temporal lobe hyperintensities were almost always present at disease onset (23/26, 88.5%), evolving nearly invariably towards severe atrophy in subsequent MRIs (17/19, 89.5%). This finding was in line with a poor response to immunotherapy, with only 5/25 (20.0%) patients responding. IgG1 was the predominant subclass, being the most frequently detected and the one with the highest titres in nine CSF-serum paired samples. A temporal biopsy from one of our new cases showed massive lymphocytic infiltrates dominated by both CD4+ and CT8+ T cells, intense granzyme B expression and abundant macrophages/microglia. Human leucocyte antigen (HLA) analysis in 11 patients showed a striking association with HLA-B*08:01 [7/11, 63.6%; odds ratio (OR) = 13.4, 95% confidence interval (CI): 3.8–47.4], C*07:01 (8/11, 72.7%; OR = 11.0, 95% CI: 2.9–42.5), DRB1*03:01 (8/11, 72.7%; OR = 14.4, 95% CI: 3.7–55.7), DQB1*02:01 (8/11, 72.7%; OR = 13.5, 95% CI: 3.5–52.0) and DQA1*05:01 (8/11, 72.7%; OR = 14.4, 95% CI: 3.7–55.7) alleles, which formed the extended haplotype B8-C7-DR3-DQ2 in 6/11 (54.5%) patients (OR = 16.5, 95% CI: 4.8–57.1). Finally, we compared the CSF proteomic profile of five anti-AK5 patients with that of 40 control subjects and 10 cases with other more common non-paraneoplastic limbic encephalitis (five with antibodies against leucine-rich glioma inactivated 1 and five against contactin-associated protein-like 2), as well as 10 cases with paraneoplastic neurological syndromes (five with antibodies against Yo and five against Ma2). These comparisons revealed 31 and seven significantly upregulated proteins in anti-AK5 limbic encephalitis, respectively mapping to apoptosis pathways and innate/adaptive immune responses. These findings suggest that the clinical manifestations of anti-AK5 limbic encephalitis result from a distinct T cell-mediated pathogenesis, with major cytotoxicity-induced apoptosis leading to a prompt and aggressive neuronal loss, likely explaining the poor prognosis and response to immunotherapy.
Published: 2021
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19. Implicit biases and differential perinatal care for migrant women: Methodological framework and study protocol of the BiP study part 3✰,✰✰

Author: Elie Azria, Priscille Sauvegrain, Olivia Anselem, Marie-Pierre Bonnet, Catherine Deneux-Tharaux, Anne Rousseau, Juliette Richetin, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe Hospitalier Paris Saint-Joseph (hpsj), Département Médico-Universitaire Obstétrique reproduction Infertilité Gynécologie Enfants [Sorbonne Université] (DMU ORIGYNE Femmes-Mères-Enfants), CHU Charles Foix [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)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Département Médico-Universitaire réanimation anesthésie médecine péri-opératoire [Sorbonne Université] (DMU DREAM), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], 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, Agence Nationale de la Recherche, ANR: ANR-17-CE36–0001, and ✰ Funding: The BiP Research program has been funded by the French Research Agency (ANR-17-CE36–0001). The ANR had no role in study design, in the data collection, analysis, and interpretation, in the report's writing, and in the decision to submit the article for publication.
Subjects: Transients and Migrants, [SDV]Life Sciences [q-bio], Infant, Newborn, Parturition, Migrant, Obstetrics and Gynecology, Clinical vignette, Implicit bias, United States, Perinatal health, Perinatal Care, Bias, Reproductive Medicine, Pregnancy, Physicians, Differential care, Humans, Female, Maternal health, Child, Health inequalities
Abstract: International audience; Background: The mechanisms of disparities in maternal and perinatal health between migrant and native women are multiple and remain poorly understood. Access to and quality of care are likely to participate in these mechanisms, and one hypothesis is the existence of implicit biases among caregivers through which ethno-racial belonging can influence medical decisions and consequently engender healthcare disparities. Their existence and their role in the generation of non-medically justified differential care have been documented in the United States apart from perinatal care, but remain largely unexplored in Europe. In this article, we present the study protocol and theoretical framework of a study that aims to test and quantify the existence of implicit bias toward African Sub-Saharan migrant women among caregivers working in the perinatal field, and to explore the association between implicit bias and differential care. Material and methods: This study is based on an online survey to which French obstetricians, midwives, and anesthetists were invited to take part. The potential existence of implicit biases toward African Sub-Saharan migrant will be quantified through a validated tool, the Implicit Association Test. Then we will assess how implicit biases are likely to influence clinical decisions and lead to differential care using clinical vignettes designed by an experts group. Discussion: Implicit bias and differential care are concept that are tricky to capture and interpret. This research program opens up in France a field of research on certain forms of health discriminations and sheds new light on the issue of social inequalities in perinatal health. Study registration: Registration in the Open Science Framework portal: https://osf.io/djva7/?view_only=c6012ace3fe94165a65b05c2dc6aff9e
Published: 2022
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20. Emergence of Ceftriaxone Resistance during a Case of Pneumococcal Meningitis with Fatal Evolution

Author: C. Couzigou, J.C. Nguyen Van, Cédric Bruel, N Engrand, Thierry Lambert, Benoit Pilmis, Assaf Mizrahi, A. Le Monnier, Jean-Christophe Marvaud, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bactéries, Pathogènes et Santé (UBaPS), Faculté de Pharmacie, Université Paris-Sud - Paris 11 (UP11)-Université Paris-Sud - Paris 11 (UP11), Groupe Hospitalier Paris Saint-Joseph (hpsj), Génomique fonctionnelle des champignons pathogènes des plantes (FungiPath), Microbiologie, adaptation et pathogénie (MAP), 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)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Université Paris-Saclay, CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), and Commissariat à l'énergie atomique et aux énergies alternatives (CEA)
Subjects: Male, Penicillin binding proteins, Microbial Sensitivity Tests, medicine.disease_cause, Dexamethasone, Microbiology, 03 medical and health sciences, 0302 clinical medicine, Cerebrospinal fluid, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Challenging Clinical Case in Antimicrobial Resistance, Streptococcus pneumoniae, Medicine, Humans, Penicillin-Binding Proteins, Pharmacology (medical), 030212 general & internal medicine, Pharmacology, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, 0303 health sciences, 030306 microbiology, business.industry, Meningitis, Pneumococcal, Ceftriaxone, Middle Aged, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Cephalosporins, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Vasculitis, Meningitis, Streptococcus pneumoniae Meningitis, medicine.drug
Abstract: We report a case of a 62-year-old man treated for Streptococcus pneumoniae meningitis by ceftriaxone and dexamethasone. After neurological improvement, neurological degradation by vasculitis occurred, despite effective concentrations of ceftriaxone in the serum and cerebrospinal fluid (CSF). S. pneumoniae with increased MICs to third-generation-cephalosporins (3GC) was isolated from the ventricular fluid 10 days after the isolation of the first strain. Isolate analysis showed that a mutation in the penicillin-binding protein 2X (PBP2X) has occurred under treatment.
Published: 2020
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21. Epidural analgesia in ICU chest trauma patients with fractured ribs: retrospective study of pain control and intubation requirements

Author: Loic Dopeux, Christelle Simon, Gaëtan Plantefève, Konstantinos Bachoumas, Bertrand Souweine, Roland De Varax, Thibault Duburcq, Julien Bohé, Francis Schneider, Jean-Baptiste Lascarrou, Alexandre Herbland, Pascale Roques, Marcel Benedit, Delphine Bregeaud, Matthieu Jabaudon, Marie-Hélène Hausermann, Aurélie Godard, Russell Chabanne, Samuel Groyer, Albrice Levrat, Frédérique Ganster, Christophe Leroy, Muriel Fartoukh, Laura Frederici, Benoit Painvin, Stephane Rouleau, Ahmed-Saïd Laggoune, Benjamin Rieu, Edouard Soum, Jean Morin, Paul Rooze, Jean-Charles Chakarian, Aurélie Joret, Hervé Dupont, Stéphanie Gelinotte, Vlad Botoc, Nathanael Eisenmann, Jean Reignier, Aurélie Le Thuaut, Toufik Kamel, Timothée Trampont, Cédric Bruel, CH de Saint-Malo [Broussais], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional d'Orléans (CHRO), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Victor Dupouy, Hôpital Saint-Louis de La Rochelle (CH La Rochelle), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Génétique, Reproduction et Développement (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), CHU Clermont-Ferrand, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier de Versailles André Mignot (CHV), Pôle de Médecine Périopératoire [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Les Hôpitaux Universitaires de Strasbourg (HUS), Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Service de réanimation polyvalente, Groupe Hospitalier Paris Saint-Joseph (hpsj), Medical and Surgical Intensive Care Unit, Groupe Hospitalier Paris Saint Joseph, Paris, Hôtel-Dieu de Nantes, CHU La Roche sur Yon, Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Service d'Anesthésie - Réanimation, Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Amiens-Picardie, Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Thérapeutiques cliniques et expérimentales des infections (EA 3826) (EA 3826), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Anesthésie Réanimation chirurgicale [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes)-Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Service des urgences [CHU Limoges], CHU Limoges, Service de Réanimation Médicale Sud, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre hospitalier de Dieppe, 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 Pontchaillou [Rennes], Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Reanimation Hôpital de Moulins Yzeure, Moulins, France, Pôle Urgences [CHU Clermont-Ferrand], Service de Pneumologie = Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and DESSAIVRE, Louise
Subjects: medicine.medical_specialty, Flail chest, Epidural analgesia, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Chest trauma, Critical Care and Intensive Care Medicine, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Anesthesiology, Medicine, Intubation, Mechanical ventilation, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, Retrospective cohort study, lcsh:RC86-88.9, medicine.disease, Intensive care unit, [SDV] Life Sciences [q-bio], 030228 respiratory system, SAPS II, Anesthesia, Injury Severity Score, business
Abstract: Background Nonintubated chest trauma patients with fractured ribs admitted to the intensive care unit (ICU) are at risk for complications and may require invasive ventilation at some point. Effective pain control is essential. We assessed whether epidural analgesia (EA) in patients with fractured ribs who were not intubated at ICU admission decreased the need for invasive mechanical ventilation (IMV). We also looked for risk factors for IMV. Study design and methods This retrospective, observational, multicenter study conducted in 40 ICUs in France included consecutive patients with three or more fractured ribs who were not intubated at admission between July 2013 and July 2015. Results Of the 974 study patients, 788 were included in the analysis of intubation predictors. EA was used in 130 (16.5%) patients, and 65 (8.2%) patients required IMV. Factors independently associated with IMV were chronic respiratory disease (P = 0.008), worse SAPS II (P P = 0.02), worse Injury Severity Score (P = 0.0003), higher respiratory rate at admission (P = 0.02), alcohol withdrawal syndrome (P P = 0.04). EA was not associated with decreases in IMV requirements, median numerical rating scale pain score, or intravenous morphine requirements from day 1 to day 7. Conclusions EA was not associated with a lower risk of IMV in chest trauma patients with at least 3 fractured ribs, moderate pain, and no intubation on admission. Further studies are needed to clarify the optimal pain control strategy in chest trauma patients admitted to the ICU, notably those with severe pain or high opioid requirements.
Published: 2020
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22. Correction to: Urine cell cycle arrest biomarkers distinguish poorly between transient and persistent AKI in early septic shock: a prospective, multicenter study (vol 24, pg 280, 2020)

Author: Titeca-Beauport, Dimitri, Daubin, Delphine, van Vong, Ly, Belliard, Guillaume, Bruel, Cedric, Alaya, Sami, Chaoui, Karim, Andrieu, Maud, Rouquette-Vincenti, Isabelle, Godde, Frederic, Pascal, Michel, Diouf, Momar, Vinsonneau, Christophe, Klouche, Kada, Maizel, Julien, DESSAIVRE, Louise, CHU Amiens-Picardie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Intensive Care Unit, Groupe Hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77000, Melun, Groupe Hospitalier Paris Saint-Joseph (hpsj), Centre hospitalier Jean Rougier, Centre Hospitalier de Dax, Centre Hospitalier Princesse Grace, Centre Hospitalier Avranches-Granville (CH Avranches-Granville), CHU Mont de Marsan, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), and Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], Hardware_INTEGRATEDCIRCUITS, ComputingMilieux_LEGALASPECTSOFCOMPUTING, ComputerApplications_COMPUTERSINOTHERSYSTEMS, Hardware_PERFORMANCEANDRELIABILITY
Abstract: International audience; An amendment to this paper has been published and can be accessed via the original article.
Published: 2020
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23. Prospective evaluation of ID NOW COVID-19 assay used as point-of-care test in an emergency department

Author: Assaf Mizrahi, Olivier Ganansia, Benoit Pilmis, Alban Le Monnier, Jean-Claude Nguyen Van, Vincent Enouf, Amir khaterchi, Camille Gerlier, Gauthier Péan de Ponfilly, Groupe Hospitalier Paris Saint-Joseph (hpsj), Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR - laboratoire coordonnateur), and Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité)
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Point-of-care testing, Sensitivity and Specificity, Article, Prospective evaluation, Isothermal amplification, COVID-19 Testing, Nasopharynx, Virology, Internal medicine, medicine, Humans, Prospective Studies, Prospective cohort study, Point-of-care test, SARS-CoV-2, Emergency department, business.industry, COVID-19, Clinical microbiology, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, Direct assay, Point-of-Care Testing, ID NOW COVID-19, Viral Transport medium, Emergency Service, Hospital, business
Abstract: BackgroundRapid testing for COVID-19 has been clearly identified as an essential component of the strategy to control the SARS-CoV-2 epidemic, worldwide. The ID NOW COVID-19 assay is a simple, user-friendly, rapid molecular biology test based on nicking and extension amplification reaction (NEAR).ObjectivesThe aim of this study was to evaluate the ID NOW COVID-19 assay when used as a point-of-care test (POCT) in our Emergency Department (ED).Type of studyThis prospective study enrolled 395 consecutive patients; paired nasopharyngeal swabs were collected from each study participant. The first swab was tested with the ID NOW COVID-19 assay at the point-of-care by ED nurses. The second swab was diluted in viral transport medium (VTM) and sent to the clinical microbiology department for analysis by both the RT-PCR Simplexa test COVID-19 Direct assay as the study reference method, and the ID NOW COVID-19 assay performed in the laboratory.ResultsNasopharyngeal swabs directly tested with the ID NOW COVID-19 assay yielded a sensitivity, specificity, PPV and NPV of 98.0%, 97.5%, 96.2% and 98.7%, respectively, in comparison with the RT-PCR study reference assay. When the ID NOW COVID-19 assay was performed in the laboratory using the VTM samples, the sensitivity decreased to 62.5% and the NPV to 79.7%. Three false negative test results were reported with the ID NOW COVID-19 assay when performed using undiluted swabs directly in the ED; these results were obtained from patients with elevated CT values (>30).ConclusionWe demonstrated that the ID NOW COVID-19 assay, performed as a point of care test in the ED using dry swabs, provides a rapid and reliable alternative to laboratory-based RT-PCR methods
Published: 2021
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24. Patient-perceived flares in rheumatoid arthritis: A sub-analysis of the STRASS treatment tapering strategy trial

Author: Laure Gossec, Martin Soubrier, Jean-Francis Maillefert, Alain Saraux, Thao Pham, Toni Alfaiate, Bruno Fautrel, David Hajage, Agnès Portier, Xavier Mariette, Florence Tubach, Thierry Schaeverbeke, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Rhumatologie [CHU Pitié Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de Rythmologie-Stimulation- Hôpital Saint-Joseph, Paris (Département de Rythmologie-Stimulation), Groupe Hospitalier Paris Saint-Joseph (hpsj), Service de Rhumatologie [CHU de la Cavale-Blanche], Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Département d’Epidémiologie et Recherche Clinique [AP-HP Hôpital Bichat - Claude Bernard] (CIC‑EC 1425), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], CRI-IMIDIATE Clinical Research Network, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Rhumatologie [Sainte- Marguerite - APHM] ( Hôpitaux Sud), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Service de Rhumatologie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service de Rhumatologie [CHU Pellegrin], Groupe hospitalier Pellegrin, Service de Rhumatologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Rhumatologie [CHU Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, AbbVie BMS Celgene Janssen MSD Novartis Pfizer/Wyeth Roche UCB, Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe Hospitalier Paris Saint-Joseph, and 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)
Subjects: Male, Questionnaires, validity, Severity of Illness Index, law.invention, Arthritis, Rheumatoid, 0302 clinical medicine, Cohen's kappa, Randomized controlled trial, Quality of life, law, Disease Exacerbation, 030212 general & internal medicine, validation, Flares, TNF-blockers, Middle Aged, Prognosis, 3. Good health, Treatment Outcome, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Rheumatoid arthritis, Disease Progression, Female, Adult, Linear mixed effect model, medicine.medical_specialty, Pain, Short form 36, Risk Assessment, Drug Administration Schedule, 03 medical and health sciences, remission, Rheumatology, Internal medicine, medicine, Humans, instrument, Patient Reported Outcome Measures, Aged, 030203 arthritis & rheumatology, Dose-Response Relationship, Drug, dmard, Tumor Necrosis Factor-alpha, business.industry, medicine.disease, criterion, digestive system diseases, disease-activity score, Physical therapy, progression, business, Kappa
Abstract: International audience; Objectives: Patient's and physician's perspective can differ in rheumatoid arthritis (RA). The aim was to define the concept of patient-reported flares.Methods: Post-hoc analysis of a randomized controlled trial of a step-down strategy in RA patients treated with anti-TNF, in DAS28-remission for >= 6 months, randomized to either "spacing" or "maintaining" anti-TNF. The occurrence of patient-reported flares (PRF) was evaluated every 3 months for 18 months by: "Over the last 3 months, did you experience symptoms suggestive of disease exacerbation?". Visits with and without PRF were compared, using a linear mixed effects model, in terms of symptoms, disability based on the Health Assessment Questionnaire, quality of life based on Short Form 36 Health Survey and DAS28 based relapses (DBR), defined as an increase of DAS28 > 0.6 and an absolute value of DAS28 > 2.6. The agreement between PRF and DBR was measured by the kappa coefficient on repeated data.Results: In all, 137 patients were analyzed: mean age 55 +/- 11 years, females 78%, mean RA duration 9.5 +/- 8.0 years. Over the 18 months, PRF concerned 27.2% of the 940 available visits. DBR and PRF were observed in 24% and 16% of 940 visits for 137 patients respectively. All the items were associated with PRF with standardized effect size between -0.58 (SF36 PCS) and 0.87 (DAS28). The agreement between PRF and DBR was moderate (kappa = 0.44).Conclusion: The concept of flare refers to more than just RA disease activity.
Published: 2017
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25. Ventilator-associated pneumonia due to Stenotrophomonas maltophilia: Risk factors and outcome

Author: Sybille Merceron, Alban Le Monnier, Wafa Ibn Saied, Maité Garrouste-Orgeas, Johana Oziel, Shidasp Siami, Guillaume Marcotte, Elie Azoulay, Laurent Papazian, Stéphane Ruckly, Jean Reignier, Jean-François Timsit, Bertrand Souweine, Michael Darmon, Carole Schwebel, Lila Bouadma, Bruno Mourvillier, Etienne de Montmollin, Jean-Pierre Bedos, 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 de Versailles André Mignot (CHV), Centre Hospitalier Universitaire [Grenoble] (CHU), Université Grenoble Alpes (UGA), Groupe Hospitalier Paris Saint-Joseph (hpsj), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Promotion et Développement de la Recherche et de l'Enseignement en Réanimation [Bobigny] (OUTCOMEREA), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Hopital Saint-Louis [AP-HP] (AP-HP), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Unité de soins intensifs médicaux et infectieux [AP-HP Hôpital Bichat-Claude-Bernard], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hôtel-Dieu de Nantes, Hôpital Nord [CHU - APHM], Aix Marseille Université (AMU), and Centre Hospitalier d'Etampes
Subjects: 0301 basic medicine, Microbiology (medical), Carbapenem, medicine.medical_specialty, medicine.medical_treatment, Stenotrophomonas maltophilia, 030106 microbiology, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Risk Factors, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Mortality, Mechanical ventilation, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, biology, business.industry, SM, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Intensive care unit, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, respiratory tract diseases, Pneumonia, Intensive Care Units, Infectious Diseases, Carbapenems, SAPS II, GNB, ICU, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, VAP, SOFA score, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, medicine.drug
Abstract: International audience; Background: Stenotrophomonas maltophilia (SM) is increasingly identified in intensive care unit (ICU). This study aim to identify risk factors for SM ventilator-associated pneumonia (VAP) and whether it affects ICU mortality METHODS: Two nested matched case-control studies were performed based in OUTCOMEREA database. The first episodes of SM-VAP patients were matched with two different control groups: VAP due to other micro-organisms (VAP-other) and Pseudomonas aeruginosa VAP (Pyo-VAP). Matching criteria were the hospital, the SAPS II, and the previous duration of mechanical ventilation (MV).Results: Of the 102 SM-VAP patients (6.2% of all VAP patients), 92 were matched with 375 controls for the SM-VAP/other-VAP matching and 84 with 237 controls for the SM-VAP/Pyo-VAP matching. SM-VAP risk factors were an exposition to ureido/carboxypenicillin or carbapenem during the week before VAP, and respiratory and coagulation components of SOFA score upper to 2 before VAP. SM-VAP received early adequate therapy in 70 cases (68.6%). Risk factors for Day-30 were age (OR = 1.03; p < 0.01) and Chronic heart failure (OR = 3.15; p < 0.01). Adequate treatment, either monotherapy or combination of antimicrobials, did not modify mortality. There was no difference in 30-day mortality, but 60-day mortality was higher in patients with SM-VAP compared to Other-VAP (P = 0.056).Conclusions: In a large series, independent risk factors for the SM-VAP were ureido/carboxypenicillin or carbapenem exposure the week before VAP, and respiratory and coagulation components of the SOFA score > 2 before VAP. Mortality risk factors of SM-VAP were age and chronic heart failure. Adequate treatment did not improve SM-VAP prognosis.
Published: 2019
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26. Biomarker cruises in sepsis: who is the CAPTAIN? Discussion on 'Circulating biomarkers may be unable to detect infection at the early phase of sepsis in ICU patients: the CAPTAIN prospective multicenter cohort study'

Author: Briassoulis, George, Briassoulis, Panagiotis, Miliaraki, Marianna, Ilia, Stavroula, Parlato, Marianna, Philippart, François, Rouquette, Alexandra, Moucadel, Virginie, Cavaillon, Jean-Marc, Misset, Benoît, Group, Combined Approach, University of Crete [Heraklion] (UOC), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Médecine intensive et réanimation - Hôpital Saint-Joseph, Paris, Groupe Hospitalier Paris Saint-Joseph (hpsj), Endotoxines, Structures et Réponses de l'hôte (ESHR), Département Microbiologie (Dpt Microbio), Institut de Biologie Intégrative de la Cellule (I2BC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Institut de Biologie Intégrative de la Cellule (I2BC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Département d’Epidémiologie et de Biostatistiques, Hôpitaux Universitaires Paris Centre, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), BIOMERIEUX, Neuropathologie expérimentale - Experimental neuropathology, Institut Pasteur [Paris] (IP)-Université Paris Descartes - Paris 5 (UPD5), CHU Rouen, Normandie Université (NU), Université de Rouen Normandie (UNIROUEN), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe Hospitalier Paris Saint-Joseph, Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Saclay-Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Saclay-Institut de Biologie Intégrative de la Cellule (I2BC), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Saclay-Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pasteur [Paris]-Université Paris Descartes - Paris 5 (UPD5), and 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)
Subjects: medicine.medical_specialty, Icu patients, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Cohort Studies, Sepsis, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, Anesthesiology, medicine, Humans, Prospective Studies, Prospective cohort study, MESH: Cohort Studies, MESH: Sepsis, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology, 0303 health sciences, MESH: Humans, business.industry, medicine.disease, MESH: Prospective Studies, 3. Good health, Intensive Care Units, Circulating biomarkers, MESH: Biomarkers, Biomarker (medicine), MESH: Intensive Care Units, Early phase, business, Biomarkers, Cohort study
Abstract: International audience
Published: 2019
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27. Management of anoperineal lesions in Crohn’s disease: a French National Society of Coloproctology national consensus

Author: F. Pigot, Paul Benfredj, B. Vinson-Bonnet, T. Higuero, Jean-Luc Faucheron, Yves Panis, David Laharie, Dominique Bouchard, Nadia Fathallah, Charlène Brochard, Laurent Siproudhis, Laurent Abramowitz, Ghislain Staumont, V. de Parades, Maison de Santé Protestante Bagatelle, Clinique Saint Jean Languedoc, Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Hôpital Bichat - Claude Bernard, CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire [Grenoble] (CHU), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Institut de Proctologie Léopold bellan, Groupe Hospitalier Paris Saint-Joseph, CHI Poissy-Saint-Germain, Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Clinique Saint-Jean Languedoc [Toulouse] (CSJL), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Groupe Hospitalier Paris Saint-Joseph (hpsj)
Subjects: Male, Anal fistula, Crohn’s disease, medicine.medical_specialty, Consensus, [SDV]Life Sciences [q-bio], Anal Canal, Disease, Perineum, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, medicine, Humans, Rectal Fistula, Societies, Medical, ComputingMilieux_MISCELLANEOUS, Anus Diseases, Crohn's disease, business.industry, General surgery, Gastroenterology, Disease Management, medicine.disease, Abscess, Colorectal surgery, 3. Good health, Treatment, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Treatment strategy, Female, 030211 gastroenterology & hepatology, Surgery, France, business, Colorectal Surgery, Algorithms, Abdominal surgery
Abstract: The French National Society of Coloproctology established national recommendations for the treatment of anoperineal lesions associated with Crohn's disease. Treatment strategies for acute abscesses, active fistulas (active denovo and still active under treatment), fistulas in remission, and rectovaginal fistulas are suggested. Recommendations have been graded following the international recommendations, and when absent, professional agreement has been established. For each situation, practical algorithms have been drawn.
Published: 2018
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28. Evaluation of the Unyvero i60 ITI® multiplex PCR for infected chronic leg ulcers diagnosis

Author: Isabelle Lazareth, B. Vidal, A. Mizrahi, Alban Le Monnier, Julie Lourtet-Hascoët, Sophie Reissier, Jean Claude Nguyen Van, Benoît Pilmis, C. Couzigou, Louise Adjiman, ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 (AGIR ), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Université de Bordeaux (UB), Centre hospitalier Saint-Joseph [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bactéries, Pathogènes et Santé (UBaPS), Faculté de Pharmacie, Université Paris-Sud - Paris 11 (UP11)-Université Paris-Sud - Paris 11 (UP11), and Groupe Hospitalier Paris Saint-Joseph (hpsj)
Subjects: Male, Microbiology (medical), Paris, Prosthesis-Related Infections, medicine.drug_class, Antibiotics, medicine.disease_cause, Sensitivity and Specificity, Microbiology, 03 medical and health sciences, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Drug Resistance, Multiple, Bacterial, Multiplex polymerase chain reaction, medicine, Bacteriology, Humans, Anaerobiosis, Prospective Studies, Prospective cohort study, Molecular Biology, 030304 developmental biology, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, 0303 health sciences, Bacteria, biology, 030306 microbiology, Pseudomonas aeruginosa, business.industry, Leg Ulcer, Pathogenic bacteria, biology.organism_classification, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Staphylococcus aureus, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, business, Multiplex Polymerase Chain Reaction
Abstract: Objectives Unyvero i60 ITI multiplex PCR (mPCR) may identify a large panel of bacteria and antibiotic resistance genes. In this study, we compared results obtained by mPCR to standard bacteriology in chronic leg ulcer (CLU) infections. Methods A prospective study, part of the interventional-blinded randomized study “ulcerinfecte” ( NCT02889926 ), was conducted at Saint Joseph Hospital in Paris. Fifty patients with a suspicion of infected CLU were included between February 2017 and September 2018. Conventional bacteriology and mPCR were performed simultaneously on deep skin biopsies. Results Staphylococcus aureus and Pseudomonas aeruginosa were the most detected pathogens. Regarding the global sensitivity, mPCR is not overcome to the standard culture. Anaerobes and slow growing bacteria were detected with a higher sensitivity rate by mPCR than standard culture. Conclusion Unyvero i60 ITI multiplex PCR detected rapidly pathogenic bacteria in infected CLU especially anaerobes and slow growing bacteria and was particularly effective for patients previously treated with antibiotics.
Published: 2020
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29. Anti-TNF Therapy Is Associated With an Increased Risk of Postoperative Morbidity After Surgery for Ileocolonic Crohn Disease

Author: Brouquet, Antoine, Maggiori, Léon, Zerbib, Philippe, Lefèvre, Jérémie, Denost, Quentin, Germain, Adeline, Cotte, Eddy, BEYER-BERJOT, Laura, Munoz-Bongrand, Nicolas, Desfourneaux, Véronique, Rahili, Amine, Duffas, Jean-Pierre, Pautrat, Karine, Denet, Christine, Bridoux, Valérie, Meurette, Guillaume, Faucheron, Jean-Luc, Loriau, Jérôme, Guillon, Françoise, Vicaut, Eric, Benoist, Stéphane, PANIS, Yves, Service de Chirurgie générale et digestive [CHU Le Kremlin-Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon, Service de Chirurgie Générale et Digestive[Lille], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Bioingénierie tissulaire (BIOTIS), Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie digestive [Bordeaux], CHU Bordeaux [Bordeaux], Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Lyon Sud, Service de Chirurgie Digestive, Hospices Civils de Lyon (HCL), Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), Department of Gastroenterological Surgery, Hop St Louis, CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Nice (CHU Nice), Chirurgie Générale et Digestive [Rangueil], CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Service de chirurgie digestive [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Centre hospitalier universitaire de Nantes (CHU Nantes), Unité de Chirurgie Colorectale, CHU Grenoble-Hôpital Michallon, Groupe Hospitalier Paris Saint-Joseph, Hépato-gastro-entérologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Université Gustave Eiffel, Hôpital Lariboisière-Fernand-Widal [APHP], Université Paris Diderot - Paris 7 (UPD7)-Hôpital Lariboisière-Fernand-Widal [APHP], Service de chirurgie digestive [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Hôpital Beaujon [AP-HP]-Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hémostase et pathologie cardiovasculaire, EA2693-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Service de Chirurgie Générale (A), CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Service de chirurgie oncologique, Service de Chirurgie Hépatobiliaire et Digestive, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut Mutualiste de Montsouris (IMM), Department of Digestive Surgery, Rouen University Hospital, Clinique de Chirurgie Digestive et Endocrinienne [CHU Nantes], Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO ), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Service de Chirurgie digestive [GH Paris Saint-Joseph], Groupe hospitalier Paris Saint-Joseph - Hôpital, Université Paris Diderot - Paris 7 (UPD7)-Hôpital Lariboisière-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Histoire Archéologie Littérature des Mondes Anciens - UMR 8164 (HALMA), Ministère de la Culture (MC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Department Colorectal Surgery, Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Groupe Hospitalier Paris Saint-Joseph (hpsj), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Histoire Archéologie Littérature des Mondes Anciens (HALMA) - UMR 8164 (HALMA), and Ministère de la Culture et de la Communication (MCC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)
Subjects: [SDV]Life Sciences [q-bio], [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; Objective: To determine the risk factors of morbidity after surgery for ileocolonic Crohn disease (CD).Summary Background Data: The risk factors of morbidity after surgery for CD, particularly the role of anti-TNF therapy, remain controversial and have not been evaluated in a large prospective cohort study. Methods: From 2013 to 2015, data on 592 consecutive patients who underwent surgery for CD in 19 French specialty centers were collected prospectively. Possible relationships between anti-TNF and postoperative overall morbidity were tested by univariate and multivariate analyses. Because treatment by anti-TNF is possibly dependent on the characteristics of the patients and disease, a propensity score was calculated and introduced in the analyses using adjustment of the inverse probability of treatment-weighted method.Results: Postoperative mortality, overall and intra-abdominal septic morbidity rates in the entire cohort were 0%, 29.7%, and 8.4%, respectively; 143 (24.1%) patients had received anti-TNF 180 min (OR = 2.71; CI 95% = 1.54–4.78, P < 0.001) and recurrent CD (OR = 1.99; CI 95% = 1.13–3.36, P = 0.017). After calculating the propensity score and adjustment according to the inverse probability of treatment-weighted method, anti-TNF Conclusions: Preoperative anti-TNF therapy is associated with a higher risk of morbidity after surgery for ileocolonic CD. This information should be considered in the surgical management of these patients, particularly with regard to the preoperative preparation and indication of temporary defunctioning stoma.
Published: 2018
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30. Anoperineal lesions in Crohn’s disease: French recommendations for clinical practice

Author: Laurent Siproudhis, Ghislain Staumont, A. Senéjoux, Yves Panis, Léon Maggiori, Charlène Brochard, Guillaume Bouguen, M. Eleouet-Kaplan, Nadia Fathallah, F. Pigot, J.-M. Suduca, B. Vinson-Bonnet, V. de Parades, Jean-Luc Faucheron, Jean-David Zeitoun, Alain Dabadie, P. Roumeguère, Laurent Abramowitz, Dominique Bouchard, Maison de Santé Protestante Bagatelle, Hôpital Bichat - Claude Bernard, CHU Pontchaillou [Rennes], Institut de Proctologie Léopold bellan, Groupe Hospitalier Paris Saint-Joseph (hpsj), CHU Grenoble, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Clinique Tivoli Ducos [Bordeaux], CHP Saint Grégoire, Foie, métabolismes et cancer, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Clinique Saint-Jean Languedoc [Toulouse] (CSJL), CHI Poissy-Saint-Germain, Groupe Hospitalier Diaconesses Croix Saint-Simon, Groupe Hospitalier Paris Saint-Joseph, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Jonchère, Laurent
Subjects: Male, Crohn’s disease, medicine.medical_treatment, Fistula, Anal Canal, Recommendations, Perineum, 0302 clinical medicine, Crohn Disease, Anal stenosis, Digestive System Surgical Procedures, Crohn's disease, medicine.diagnostic_test, Gastroenterology, Colostomy, Anal fistulas, Anus Neoplasms, Combined Modality Therapy, Colorectal surgery, Abscess, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Drainage, Female, 030211 gastroenterology & hepatology, France, Adult, Anal fistula, medicine.medical_specialty, Consensus, Anoperineal lesions, Physical examination, Guidelines, 03 medical and health sciences, Gastrointestinal Agents, medicine, Humans, Rectal Fistula, Tumor Necrosis Factor-alpha, business.industry, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Evidence-based medicine, medicine.disease, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Surgery, business
Abstract: International audience; Background: Anoperineal lesion (APL) occurrence is a significant event in the evolution of Crohn’s disease (CD). Management should involve a multidisciplinary approach combining the knowledge of the gastroenterologist, the colorectal surgeon and the radiologist who have appropriate experience in this area. Given the low level of evidence of available medical and surgical strategies, the aim of this work was to establish a French expert consensus on management of anal Crohn’s disease. These recommendations were led under the aegis of the Société Nationale Française de Colo-Proctologie (SNFCP). They report a consensus on the management of perianal Crohn’s disease lesions, including fistulas, ulceration and anorectal stenosis and propose an appropriate treatment strategy, as well as sphincter-preserving and multidisciplinary management.Methodology: A panel of French gastroenterologists and colorectal surgeons with expertise in inflammatory bowel diseases reviewed the literature in order to provide practical management pathways for perianal CD. Analysis of the literature was made according to the recommendations of the Haute Autorité de Santé (HAS) to establish a level of proof for each publication and then to propose a rank of recommendation. When lack of factual data precluded ranking according to the HAS, proposals based on expert opinion were written. Therefore, once all the authors agreed on a consensual statement, it was then submitted to all the members of the SNFCP. As initial literature review stopped in December 2014, more recent European or international guidelines have been published since and were included in the analysis.Results: MRI is recommended for complex secondary lesions, particularly after failure of previous medical and/or surgical treatments. For severe anal ulceration in Crohn’s disease, maximal medical treatment with anti-TNF agent is recommended. After prolonged drainage of simple anal fistula by a flexible elastic loop or loosely tied seton, and after obtaining luminal and perineal remission by immunosuppressive therapy and/or anti-TNF agents, the surgical treatment options to be discussed are simple seton removal or injection of the fistula tract with biological glue. After prolonged loose-seton drainage of the complex anal fistula in Crohn’s disease, and after obtaining luminal and perineal remission with anti-TNF ± immunosuppressive therapy, surgical treatment options are simple removal of seton and rectal advancement flap. Colostomy is indicated as a last option for severe APL, possibly associated with a proctectomy if there is refractory rectal involvement after failure of other medical and surgical treatments. The evaluation of anorectal stenosis of Crohn’s disease (ARSCD) requires a physical examination, sometimes under anesthesia, plus endoscopy with biopsies and MRI to describe the stenosis itself, to identify associated inflammatory, infectious or dysplastic lesions, and to search for injury or fibrosis of the sphincter. Therapeutic strategy for ARSCD requires medical–surgical cooperation.
Published: 2017
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31. A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway

Author: Sartelli, M., Kluger, Y., Ansaloni, L., Carlet, J., Brink, A., Hardcastle, T. C., Khanna, A., Chicom-Mefire, A., Rodríguez-Baño, J., Nathwani, D., Mendelson, M., Watkins, R. R., Pulcini, C., Beović, B., May, A. K., Itani, K. M. F., Mazuski, J. E., Fry, D. E., Coccolini, F., Rasxa, K., Montravers, P., Eckmann, C., Abbo, L. M., Abubakar, S., Abu-Zidan, F. M., Adesunkanmi, A. K., Al-Hasan, M. N., Althani, A. A., Ticas, J. E. A., Ansari, S., Ansumana, R., Da Silva, A. R. A. , Augustin, G. , Bala, M. , Balogh, Z. J. , Baraket, O. , Bassetti, M. , Bellanova, G. , Beltran, M. A. , Ben-Ishay, O. , Boermeester, M. A. , Brecher, S. M. , Bueno, J. , Cainzos, M. A. , Cairns, K. , Camacho-Ortiz, A. , Ceresoli, M. , Chandy, S. J. , Cherry-Bukowiec, J. R. , Cirocchi, R. , Colak, E. , Corcione, A. , Cornely, O. A. , Cortese, F. , Cui, Y. , Curcio, D. , Damaskos, D. , Dasx, K. , Delibegovic, S. , Demetrashvili, Z. be, De Simone, B. bf, De Souza, H. P. bg, De Waele, J. bh, Dhingra, S. bi, Diaz, J. J. bj, Di Carlo, I. bk, Di Marzo, F. bl, DI TOMASO, SAVERIO, S. , Dogjani, A. , Dorj, G. , Dortet, L. , Duane, T. M. , Dupont, H. , Egiev, V. N. , Eid, H. O. , Elmangory, El-Sayed Marei, H. , Enani, M. A. , Escandón-Vargas, K. , Faro, M. P. , J.r., Ferrada, P., Foghetti, D., Foianini, E., Fraga, G. P., Frattima, S., Gandhi, C., Gattuso, G., Giamarellou, E., Ghnnam, W., Gkiokas, G., Girardis, M., Goff, D. A., Gomes, C. A., Gomi, H., Gronerth, R. I. G., Guirao, X., Guzman-Blanco, M., Haque, M., Hecker, A., Hell, M., Herzog, T., Hicks, L., Kafka-Ritsch, R., Kao, L. S., Kanj, S. S., Kaplan, L. J., Kapoor, G., Karamarkovic, A., Kashuk, J., Kenig, J., Khamis, F., Khokha, V., Kiguba, R., Kirkpatrick, A. W., Kørner, H., Koike, K., Kok, K. Y. Y., Kon, K., Kong, V., Inaba, K., Ioannidis, O., Isik, A., Iskandar, K., Labbate, M., Labricciosa, F. M., Lagrou, K., Lagunes, L., Latifi, R., Lasithiotakis, K., Laxminarayan, R., Lee, J. G., Leone, M., Leppäniemi, A., Li, Y., Liang, S. Y., Liau, K. -.H., Litvin, A., Loho, T., Lowman, W., Machain, G. Mf, Maier, R. V., Manzano-Nunez, R., Marinis, A., Marmorale, C., Martin-Loeches, I., Marwah, S., Maseda, E., McFarlane, M., BEZERRA DE MELO PEREIRA NUNES, CINTIA, R. , Melotti, R. , Memish, Z. , Mertz, D. , Mesina, C. , Menichetti, F. , Mishra, S. K. , Montori, G. , Moore, E. E. , Moore, F. A. , Naidoo, NAPOLITANO, NELLO, L. , Negoi, I. , Nicolau, D. P. , Nikolopoulos, I. , Nord, C. E. , Ofori-Asenso, R. , Olaoye, I. , Omari, A. H. , Ordoñez, C. A. , Ouadii, M. , Ouedraogo, A. , Pagani, L. , Paiva, J. A. , Parreira, J. G. , Pata, F. fm, Pereira, J., Pereira, N. R., Petrosillo, N., Picetti, E., Pintar, T., Ponce-De-Leon, A., Popovski, Z., Poulakou, G., Preller, J., Guerrero, A. P., Pupelis, G., Quiodettis, M., Rawson, T. M., Reichert, M., Reinhart, K., Rems, M., Rello, J., Rizoli, S., ROBERTS, HENRI JOHAN EDUARD, Rubio-Perez, I., Ruppé, E., Sakakushev, B., Sall, I., Kafil, H. S. j, Sanders, J., Sato, N., Sawyer, R. G., T. , Scibé, R. , Scudeller, L. , Lohse, H. S. , Sganga, G. , Shafiq, N. , Shah, J. N. , Spigaglia, P. , Suroowan, S. , Tsioutis, C. , Sifri, C. D. , Siribumrungwong, B. , Sugrue, M. , Talving, P. , Tan, B. K. , Tarasconi, A. , Tascini, C. , Tilsed, J. , Timsit, J. -.F. , Tumbarello, M. , Trung, N. T. , Ulrych, J. , Uranues, S. , Velmahos, G. , Vereczkei, A. G. , Viale, P. , Estape, J. V. , Viscoli, C. , Wagenlehner, F. , Wright, B. J. , Xiao, Y. , Yuan, K. -.C. , Zachariah, S. K. , Zahar, J. R. , Mergulhão, P. , Catena, Réanimation Médico-Chirurgicale, Groupe Hospitalier Paris Saint-Joseph, University Hospital Virgen Macarena, Internal Medicine Department, Universidad de Sevilla, 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), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Service d'anesthésie - réanimation chirurgicale, 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), Klinik I für Innere Medizin und Zentrum für Klinische Studien (ZKS) 01KN0706, Universitätsklinikum Köln (Uniklinik Köln), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), CHU Amiens-Picardie, Paracelsus Medizinische Privatuniversität = Paracelsus Medical University (PMU), Université Catholique de Louvain = Catholic University of Louvain (UCL), Center for Disease Dynamics, Economics & Policy (CDDEP), Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-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)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Hartford Hospital, Department of Laboratory Medicine, Karolinska Institutet [Stockholm], Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Instituto Nacional de Matemática Pura e Aplicada (IMPA), Instituto Nacional de matematica pura e aplicada, 4th Department of Internal Medicine, ATTIKON University General Hospital, Department of Anesthesiology and Intensive Care, Friedrich-Schiller-Universität = Friedrich Schiller University Jena [Jena, Germany], Critical Care Department, Joan XXIII University Hospital, Departmet of Infectious, Parasitic and Immune-Mediated Disease, Istituto Superiore di Sanita [Rome], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Department of Internal Medicine, Geriatrics and Nephrologic Diseases, Section of Infectious Diseases, S.Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna (UNIBO), Infectious Diseases, University of Genoa (UNIGE), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Groupe Hospitalier Paris Saint-Joseph (hpsj), Universidad de Sevilla / University of Sevilla, Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Nice Sophia Antipolis (1965 - 2019) (UNS), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-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)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Istituto Superiore di Sanità (ISS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Università degli studi di Genova = University of Genoa (UniGe), Sartelli, Massimo, Kluger, Yoram, Ansaloni, Luca, Carlet, Jean, Dorj, Gereltuya, Catena, Fausto, [Sartelli, Massimo] Macerata Hosp, Dept Surg, Macerata, Italy, [Scibe, Rodolfo] Macerata Hosp, Dept Surg, Macerata, Italy, [Kluger, Yoram] Rambam Hlth Care Campus, Dept Gen Surg, Div Surg, Haifa, Israel, [Ben-Ishay, Ofir] Rambam Hlth Care Campus, Dept Gen Surg, Div Surg, Haifa, Israel, [Ansaloni, Luca] Papa Giovanni XXIII Hosp, Gen Surg Dept, Bergamo, Italy, [Coccolini, Federico] Papa Giovanni XXIII Hosp, Gen Surg Dept, Bergamo, Italy, [Ceresoli, Marco] Papa Giovanni XXIII Hosp, Gen Surg Dept, Bergamo, Italy, [Montori, Giulia] Papa Giovanni XXIII Hosp, Gen Surg Dept, Bergamo, Italy, [Carlet, Jean] World Alliance Antibiot Resistance, Paris, France, [Brink, Adrian] Milpark Hosp, Ampath Natl Lab Serv, Dept Clin Microbiol, Johannesburg, South Africa, [Brink, Adrian] Univ Cape Town, Dept Med, Div Infect Dis & HIV Med, Cape Town, South Africa, [Hardcastle, Timothy C.] Inkosi Albert Luthuli Cent Hosp, Trauma Serv, Durban, South Africa, [Hardcastle, Timothy C.] Nelson R Mandela Sch Clin Med, Dept Surg, Durban, South Africa, [Khanna, Ashish] Ctr Crit Care, Anaesthesiol Inst, Cleveland, OH USA, [Khanna, Ashish] Cleveland Clin, Dept Outcomes Res, Cleveland, OH 44106 USA, [Chicom-Mefire, Alain] Univ Buea, Dept Surg & Obstet Gynaecol, Buea, Cameroon, [Foianini, Esteban] Univ Buea, Dept Surg & Obstet Gynaecol, Buea, Cameroon, [Rodriguez-Bano, Jesus] Hosp Univ Virgen Macarena & Virge del Rocio IbiS, Unidad Clin Interctr Enfermedades Infecciosas Mic, Seville, Spain, [Rodriguez-Bano, Jesus] Univ Seville, Dept Med, Seville, Spain, [Nathwani, Dilip] Ninewells Hosp & Med Sch, Dundee, Scotland, [Mendelson, Marc] Univ Cape Town, Groote Schuur Hosp, Dept Med, Div Infect Dis & HIV Med, Cape Town, South Africa, [Watkins, Richard R.] Cleveland Clin Akron Gen, Div Infect Dis, Akron, OH USA, [Watkins, Richard R.] Northeast Ohio Med Univ, Rootstown, OH USA, [Pulcini, Celine] Lorraine Univ, EA APEMAC 4360, Nancy, France, [Pulcini, Celine] Nancy Univ Hosp, Infect Dis Dept, Nancy, France, [Beovic, Bojana] Univ Med Ctr Ljubljana, Ljubljana, Slovenia, [Beovic, Bojana] Univ Ljubljana, Fac Med, Ljubljana, Slovenia, [May, Addison K.] Vanderbilt Univ, Med Ctr, Div Trauma & Surg Crit Care, Nashville, TN USA, [Itani, Kamal M. F.] Boston Univ, Dept Surg, VA Boston Hlth Care Syst, Boston, MA 02215 USA, [Itani, Kamal M. F.] Harvard Med Sch, Boston, MA USA, [Mazuski, John E.] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA, [Fry, Donald E.] Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA, [Fry, Donald E.] Univ New Mexico, Sch Med, Albuquerque, NM 87131 USA, [Rasa, Kemal] Anadolu Med Ctr, Dept Surg, Kocaali, Turkey, [Montravers, Philippe] Bichat Claude Bernard Univ Hosp, Paris Diderot Sorbonne Cite Univ, Anesthesiol & Crit Care Med, HUPNSV, Paris, France, [Eckmann, Christian] Hannover Med Sch, Acad Hosp, Dept Gen Visceral & Thorac Surg, Peine, Germany, [Abbo, Lilian M.] Univ Miami, Miller Sch Med, Jackson Hlth Syst, Div Infect Dis, Miami, FL 33136 USA, [Abbo, Lilian M.] Bayero Univ, Dept Nursing Sci, Kano, Nigeria, [Abubakar, Salisu] UAE Univ, Coll Med & Hlth Sci, Dept Surg, Al Ain, U Arab Emirates, [Abu-Zidan, Fikri M.] Obafemi Awolowo Univ, Coll Hlth Sci, Dept Surg, Ife, Nigeria, [Al-Hasan, Majdi N.] Univ South Carolina, Sch Med, Dept Med, Div Infect Dis, Columbia, SC USA, [Althani, Asma A.] Qatar Univ, Biomed Res Ctr, Doha, Qatar, [Marei, Hany El-Sayed] Qatar Univ, Biomed Res Ctr, Doha, Qatar, [Ticas, Jorge Eduardo Alvarenga] Hosp Nacl Ros, Emergency Unit, San Salvador, El Salvador, [Ansari, Shamshul] Oita Univ, Dept Environm & Prevent Med, Fac Med, Oita, Japan, [Ansari, Shamshul] Chitwan Med Coll, Dept Microbiol, Bharatpur, Nepal, [Ansumana, Rashid] Univ Liverpool, Liverpool Sch Trop Med, Ctr Neglected Trop Dis, Bo, Sierra Leone, [Ansumana, Rashid] Njala Univ, Mercy Hosp, Res Lab, Bo, Sierra Leone, [Araujo da Silva, Andre Ricardo] Prontobaby Hosp Crianca, Infect Control Comm, Rio De Janeiro, Brazil, [Augustin, Goran] Univ Hosp Ctr, Dept Surg, Zagreb, Croatia, [Bala, Miklosh] Hadassah Hebrew Univ Med Ctr, Trauma & Acute Care Surg Unit, Jerusalem, Israel, [Balogh, Zsolt J.] John Hunter Hosp, Dept Traumatol, Newcastle, NSW, Australia, [Balogh, Zsolt J.] Univ Newcastle, Newcastle, NSW, Australia, [Baraket, Oussema] Bizerte Hosp, Dept Surg, Bizerte, Tunisia, [Bassett, Matteo] Santa Maria Misericordia Univ Hosp, Infect Dis Div, Udine, Italy, [Bellanova, Giovanni] SS Annunziata Hosp, Dept Surg, Taranto, Italy, [Beltran, Marcelo A.] Hosp San Juan Dios, Dept Gen Surg, La Serena, Chile, [Biffl, Walter L.] Queens Med Ctr, Acute Care Surg, Honolulu, HI USA, [Boermeester, Marja A.] Acad Med Ctr, Dept Surg, Amsterdam, Netherlands, [Brecher, Stephen M.] Boston Univ, Sch Med, VA Boston HealthCare Syst, Dept Pathol & Lab Med, Boston, MA 02118 USA, [Brecher, Stephen M.] Boston Univ, Sch Med, Dept Pathol & Lab Med, Boston, MA 02118 USA, [Bueno, Juan] Fdn Ctr Invest Bioprospecc & Biotecnol Biodivers, Barranquilla, Colombia, [Cainzos, Miguel A.] Hosp Clin Univ, Dept Surg, Santiago De Compostela, Spain, [Cairns, Kelly] Alfred Hlth, Pharm Dept, Melbourne, Vic, Australia, [Camacho-Ortiz, Adrian] Hosp Univ Dr Jose Eleuterio Gonzalez, Hosp Epidemiol & Infect Dis, Monterrey, Mexico, [Chandy, Sujith J.] Christian Med Coll & Hosp, Dept Pharmacol & Clin Pharmacol, Vellore, Tamil Nadu, India, [Cherry-Bukowiec, Jill R.] Univ Michigan, Dept Surg, Div Acute Care Surg, Ann Arbor, MI 48109 USA, [Cirocchi, Roberto] Univ Perugia, Dept Gen & Oncol Surg, Terni, Italy, [Colak, Elif] Hlth Sci Univ, Samsun Training & Res Hosp, Dept Gen Surg, Samsun, Turkey, [Corcione, Antonio] AORN Colli Vincenzo Monaldi Hosp, Anesthesia & Intens Care Unit, Naples, Italy, [Cornely, Oliver A.] Univ Cologne, German Ctr Infect Res DZIF, Dept Internal Med 1, Cologne Excellence Cluster Cellular Stress Respon, Cologne, Germany, [Cortese, Francesco] San Filippo Neris Hosp, Emergency Surg Unit, Rome, Italy, [Cui, Yunfeng] Tianjin Med Univ, Tianjin Nankai Hosp, Dept Surg, Nankai Clin Sch Med, Tianjin, Peoples R China, [Curcio, Daniel] Buenos Aires Univ, Infectol Inst SRL, Buenos Aires, DF, Argentina, [Damaskos, Dimitris] Royal Infirm Edinburgh NHS Trust, Dept Surg, Edinburgh, Midlothian, Scotland, [Das, Koray] Ankara Numune Training & Res Hosp, Dept Surg, Adana, Turkey, [Delibegovic, Samir] Univ Clin Ctr Tuzla, Dept Surg, Tuzla, Bosnia & Herceg, [Deme-Trashvili, Zaza] Kipshidze Cent Univ Hosp, Dept Gen Surg, Tbilisi, Georgia, [De Simone, Belinda] Cannes Hosp, Dept Digest Surg, Cannes, France, [de Souza, Hamilton Petry] Pontificia Univ Catolica Rio Grande do Sul PUCRS, Sch Med, Dept Surg, Porto Alegre, RS, Brazil, [De Waele, Jan] Ghent Univ Hosp, Dept Crit Care Med, Ghent, Belgium, [Dhingra, Sameer] Univ West Indies, Eric Williams Med Sci Complex, Sch Pharm, Fac Med Sci, Uriah Butler Highway, Champ Fleurs, Trinidad Tobago, [Diaz, Jose J.] Univ Maryland, R Adams Cowley Shock Trauma Ctr, Div Acute Care Surg, Program Trauma, Baltimore, MD 21201 USA, [Di Carlo, Isidoro] Univ Catania, Cannizzaro Hosp, Dept Surg Sci, Catania, Italy, [Di Marzo, Francesco] Versilia Hosp, Gen Surg, Usl Nordovest, Tuscany, Italy, [Di Saverio, Salomone] Maggiore Hosp, Dept Surg, Bologna, Italy, [Dogjani, Agron] Univ Hosp Trauma, Dept Surg, Tirana, Albania, [Dorj, Gereltuya] Mongolian Natl Univ Med Sci, Sch Pharm, Ulaanbaatar, Mongolia, [Dortet, Laurent] Paris Sud Univ, Bicetre Hosp, Dept Microbiol, La Kremlin Bicetre, France, [Duane, Therese M.] John Peter Smith Hlth Network, Dept Surg, Ft Worth, TX USA, [Dupont, Herve] Univ Picardie Jules Verne, CHU Amiens Picardie, Dept Anesthesie Reanimat, Amiens, France, [Dupont, Herve] Univ Picardie Jules Verne, INSERM, U1088, Amiens, France, [Egiev, Valery N.] Pirogov Russian Natl Res Med Univ, Dept Surg, Moscow, Russia, [Eid, Hani O.] Al Ain Hosp, Mediclin Middle East, Dept Emergency Med, Al Ain, U Arab Emirates, [Elmangory, Mutasim] Fed Minist Hlth, Sudan Natl Publ Hlth Lab, Khartoum, Sudan, [Enani, Mushira Abdulaziz] King Fahad Med City, Div Infect Dis, Dept Med, Riyadh, Saudi Arabia, [Escandon-Vargas, Kevin] Univ Valle, Escuela Med, Fac Salud, Cali, Colombia, [Faro Junior, Mario P.] ABC Med Sch, Dept Gen Surg Trauma, Santo Andre, SP, Brazil, [Faro Junior, Mario P.] ABC Med Sch, Emergency Surg Div, Santo Andre, SP, Brazil, [Ferrada, Paula] Virginia Commonwealth Univ, Dept Surg, Richmond, VA USA, [Foghetti, Domitilla] Pesaro Hosp, Dept Surg, Pesaro, Italy, Clin Foianini, Dept Surg, Santa Cruz, Bolivia, [Fraga, Gustavo P.] Univ Campinas Unicamp, Sch Med Sci, Dept Surg, Div Trauma Surg, Campinas, SP, Brazil, [Frattima, Sabrina] Ist Clin San Rocco Franciacorta, Brescia, Italy, [Gandhi, Chinmay] Bharati Vidyapeeth Deemed Univ Med Coll & Hosp, Dept Surg, Sangli, Maharashtra, India, [Gattuso, Gianni] C Poma Hosp, Infect Dis Dept, Mantua, Italy, [Giamarellou, Eleni] Hygeia Gen Hosp, Dept Internal Med 6, Athens, Greece, [Ghnnam, Wagih] Mansoura Univ, Mansoura Fac Med, Dept Gen Surg, Mansoura, Egypt, [Gkiokas, George] Natl & Kapodistrian Univ Athens, Aretaieion Univ Hosp, Dept Surg 2, Athens, Greece, [Girardis, Massimo] Modena Univ Hosp, Intens Care Unit, Modena, Italy, [Goff, Debbie A.] Ohio State Univ, Wexner Med Ctr, Columbus, OH 43210 USA, [Gomes, Carlos Augusto] Hosp Univ Terezinha Jesus, Dept Surg, Fac Ciencias Med & Saude Juiz de Fora, Juiz De Fora, Brazil, [Gomi, Harumi] Univ Tsukuba, Mito Kyodo Gen Hosp, Ctr Global Hlth, Mito, Ibaraki, Japan, [Guerra Gronerth, Rosio Isabel] Peruvian Navy Med Ctr, Lima, Peru, [Guirao, Xavier] Parc Tauli Univ Hosp, Dept Gen Surg, Unit Endocrine Head & Neck Surg, Sabadell, Spain, [Guirao, Xavier] Parc Tauli Univ Hosp, Dept Gen Surg, Unit Surg Infect Support, Sabadell, Spain, [Guzman-Blanco, Manuel] Hosp Privado Ctr Med Caracas, Caracas, Venezuela, [Guzman-Blanco, Manuel] Hosp Vargas Caracas, Caracas, Venezuela, [Haque, Mainul] Univ Pertahanan Nasional Malaysia, Natl Def Univ Malaysia, Unit Pharmacol, Fac Med & Def Hlth, Kuala Lumpur, Malaysia, [Reichert, Martin] Univ Pertahanan Nasional Malaysia, Natl Def Univ Malaysia, Unit Pharmacol, Fac Med & Def Hlth, Kuala Lumpur, Malaysia, [Hecker, Andreas] Univ Hosp Giessen, Dept Gen & Thorac Surg, Giessen, Germany, [Hell, Markus] Paracelsus Med Univ, Acad Teaching Lab, Clin Microbiol & Infect Control, MEDILAB Dr Mustafa Dr Richter OG, Salzburg, Austria, [Herzog, Torsten] Ruhr Univ Bochum, St Josef Hosp, Dept Surg, Bochum, Germany, [Hicks, Lauri] Ctr Dis Control & Prevent, Div Healthcare Qual Promot, Atlanta, GA USA, [Kafka-Ritsch, Reinhold] Innsbruck Med Univ, Dept Visceral Transplant & Thorac Surg, Innsbruck, Austria, [Kao, Lillian S.] Univ Texas Hlth Sci Ctr Houston, Dept Surg, Houston, TX 77030 USA, [Kanj, Souha S.] Amer Univ Beirut, Dept Internal Med, Div Infect Dis, Beirut, Lebanon, [Kaplan, Lewis J.] Univ Penn, Perelman Sch Med, Philadelphia VA Med Ctr, Dept Surg, Philadelphia, PA 19104 USA, [Kapoor, Garima] Gandhi Med Coll, Dept Microbiol, Bhopal, India, [Karamarkovic, Aleksandar] Univ Belgrade, Clin Emergency Surg, Med Fac, Belgrade, Serbia, [Kashuk, Jeffry] Tel Aviv Univ, Dept Surg, Assia Med Grp, Sackler Sch Med, Tel Aviv, Israel, [Kenig, Jakub] Jagiellonian Univ, Med Coll, Dept Gen Surg 3, Krakow, Poland, [Khamis, Faryal] Royal Hosp, Dept Internal Med, Muscat, Oman, [Khokha, Vladimir] City Hosp, Dept Emergency Surg, Mozyr, BELARUS, [Kiguba, Ronald] Makerere Univ, Dept Pharmacol & Therapeut, Coll Hlth Sci, Kampala, Uganda, [Kirkpatrick, Andrew W.] Foothills Med Ctr, Gen Acute Care Abdominal Wall Reconstruct & Traum, Calgary, AB, Canada, [Korner, Hartwig] Stavanger Univ Hosp, Dept Gastrointestinal Surg, Stavanger, Norway, [Koike, Kaoru] Kyoto Univ, Grad Sch Med, Dept Primary Care & Emergency Med, Kyoto, Japan, [Kok, Kenneth Y. Y.] Brunei Canc Ctr, Dept Surg, Jerudong Pk, Jerudong, Brunei, [Kon, Kateryna] Kharkiv Natl Med Univ, Dept Microbiol Virol & Immunol, Kharkov, Ukraine, [Kong, Victor] Edendale Hosp, Dept Surg, Pietermaritzburg, South Africa, [Inaba, Kenji] Univ Southern Calif, Los Angeles Cty & Univ So Cali fornia Med Ctr, Div Acute Care Surg & Surg Crit Care, Dept Surg, Los Angeles, CA USA, [Ioannidis, Orestis] Aristotle Univ Thessaloniki, Gen Hosp G Papanikolaou, Surg Dept 4, Med Sch, Thessaloniki, Greece, [Isik, Arda] Erzincan Univ, Dept Gen Surg, Fac Med, Erzincan, Turkey, [Iskandar, Katia] Lebanese Int Univ, Dept Pharm, Beirut, Lebanon, [Labbate, Maurizio] Univ Technol Sydney, Sch Life Sci, Sydney, NSW, Australia, [Labbate, Maurizio] Univ Technol Sydney, Inst I3, Sydney, NSW, Australia, [Labricciosa, Francesco M.] UNIVPM, Dept Biomed Sci & Publ Hlth, Unit Hyg Prevent Med & Publ Hlth, Ancona, Italy, [Lagrou, Katrien] Univ Hosp Leuven, Clin Dept Lab Med, Leuven, Belgium, [Lagrou, Katrien] Katholieke Univ Leuven, Dept Microbiol & Immunol, Leuven, Belgium, [Lagunes, Leonel] Hosp Cent Dr Ignacio Morones Prieto, San Luis Potosi, Mexico, [Latifi, Rifat] Univ Arizona, Dept Surg, Div Trauma, Tucson, AZ USA, [Lasithiotakis, Kostas] York Teaching Hosp NHS Fdn Trust, Dept Surg, York, N Yorkshire, England, [Laxminarayan, Ramanan] Ctr Dis Dynam Econ & Policy, Washington, DC USA, [Lee, Jae Gil] Yonsei Univ, Coll Med, Dept Surg, Seoul, South Korea, [Leone, Marc] Aix Marseille Univ, Hop Nord, AP HM, Dept Anaesthesiol & Crit Care, Marseille, France, [Leppaniemi, Ari] Univ Hosp Meilahti, Abdominal Ctr, Helsinki, Finland, [Li, Yousheng] Shanghai Jiao Tong Univ, Sch Med, Shanghai Peoples Hosp 9, Dept Surg, Shanghai, Peoples R China, [Liang, Stephen Y.] Washington Univ, Sch Med, Div Infect Dis, Div Emergency Med, St Louis, MO USA, [Liau, Kui-Hin] Natl Univ Singapore, Mt Elizabeth Novena Hosp, Singapore & Yong Loo Lin Sch Med, Dept Surg,Liau KH Consulting, Singapore, Singapore, [Litvin, Andrey] Immanuel Kant Balt Fed Univ, Surg Disciplines, Reg Clin Hosp, Kaliningrad, Russia, [Loho, Tonny] Univ Indonesia, Cipto Mangunkusumo Gen Hosp, Dept Clin Pathol, Div Infect Dis,Fac Med, Jakarta, Indonesia, [Lowman, Warren] Univ Witwatersrand, Sch Pathol, Vermaak Partners Pathcare Pathologists, Clin Microbiol & Infect Dis,Fac Hlth Sci, Johannesburg, South Africa, [Lowman, Warren] Wits Donald Gordon Med Ctr, Johannesburg, South Africa, [Machain, Gustavo M.] Univ Nacl Asuncion, Dept Surg, Asuncion, Paraguay, [Segovia Lohse, Helmut] Univ Nacl Asuncion, Dept Surg, Asuncion, Paraguay, [Maier, Ronald V.] Univ Washington, Dept Surg, Seattle, WA 98195 USA, [Manzano-Nunez, Ramiro] Fdn Valle Lili, Clin Res Ctr, Cali, Colombia, [Marinis, Athanasios] Tzane Gen Hosp, Dept Surg 1, Piraeus, Greece, [Marmorale, Cristina] Univ Politecn Marche, Dept Surg, Ancona, Italy, [Martin-Loeches, Ignacio] St James Univ Hosp, Trin Ctr Hlth Sci, Dept Clin Med, Wellcome Trust HRB Clin Res,MICRO, Dublin, Ireland, [Marwah, Sanjay] Postgrad Inst Med Sci, Dept Surg, Rohtak, Haryana, India, [Maseda, Emilio] Hosp Univ La Paz Madrid, Serv Anestesia & Reanimac, Madrid, Spain, [McFarlane, Michael] Univ Hosp West Indies, Dept Surg Radiol, Kingston, Jamaica, [de Melo, Renato Bessa] Ctr Hosp Sao Joao, Gen Surg Dept, Porto, Portugal, [Melotti, Maria Rita] Alma Mater Studiorum Univ Bologna, Dept Med & Surg Sci, Anesthesiol & Intens Care, Bologna, Italy, [Memish, Ziad] Minist Hlth, Prince Mohamed Bin Abdulaziz Hosp, Dept Med, Infect Dis Div, Riyadh, Saudi Arabia, [Mertz, Dominik] McMaster Univ, Dept Med, Hamilton, ON, Canada, [Mertz, Dominik] McMaster Univ, Dept Clin Epidemiol & Biostat, Dept Pathol & Mol Med, Hamilton, ON, Canada, [Mesina, Cristian] Emergency Hosp Craiova, Surg Clin 2, Craiova, Romania, [Menichetti, Francesco] Univ Hosp Pisa, Infect Dis Unit, Pisa, Italy, [Mishra, Shyam Kumar] Tribhuvan Univ, Teaching Hosp, Inst Med, Dept Microbiol, Kathmandu, Nepal, [Moore, Ernest E.] Univ Colorado, Denver 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Norio] Ehime Univ, Grad Sch Med, Dept Aeromed Serv Emergency & Trauma Care, Matsuyama, Ehime, Japan, [Sawyer, Robert G.] Western Michigan Univ, Sch Med, Dept Surg, Kalamazoo, MI 49008 USA, [Scalea, Thomas] Univ Maryland, Sch Med, Dept Trauma Surg, Baltimore, MD 21201 USA, [Scudeller, Luigia] IRCCS Policlin San Matteo Fdn, Clin Epidemiol Unit, Pavia, Italy, [Sganga, Gabriele] Univ Cattolica Sacro Cuore, Policlin A Gemelli, Dept Surg, Rome, Italy, [Shafiq, Nusrat] Postgrad Inst Med Educ & Res, Dept Pharmacol, Chandigarh, India, [Shah, Jay N.] Patan Acad Hlth Sci, Dept Surg Patan Hosp, Kathmandu, Nepal, [Spigaglia, Patrizia] Ist Super Sanita, Dept Infect Dis, Rome, Italy, [Suroowan, Shanoo] Univ Mauritius, Dept Hlth Sci, Fac Sci, Reduit, Mauritius, [Tsioutis, Constantinos] European Univ Cyprus, Sch Med, Nicosia, Cyprus, [Sifri, Costi D.] Univ Virginia Hlth Syst, Off Hosp Epidemiol Infect Prevent & Control, Charlottesville, VA USA, [Siribumrungwong, Boonying] Thammasat Univ Hosp, Thammasat 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Kolenchery, Dept Surg, Cochin, Kerala, India, [Zahar, Jean Ralph] Angers Univ, CHU Angers, Infect Control Unit, Angers, France, COMBE, Isabelle, Sartelli, M, Kluger, Y, Ansaloni, L, Carlet, J, Brink, A, Hardcastle, T, Khanna, A, Chicom-Mefire, A, Rodriguez-Bano, J, Nathwani, D, Mendelson, M, Watkins, R, Pulcini, C, Beovic, B, May, A, Itani, K, Mazuski, J, Fry, D, Coccolini, F, Rasxa, K, Montravers, P, Eckmann, C, Abbo, L, Abubakar, S, Abu-Zidan, F, Adesunkanmi, A, Al-Hasan, M, Althani, A, Ticas, J, Ansari, S, Ansumana, R, Da Silva, A, Augustin, G, Bala, M, Balogh, Z, Baraket, O, Bassetti, M, Bellanova, G, Beltran, M, Ben-Ishay, O, Biffl, W, Boermeester, M, Brecher, S, Bueno, J, Cainzos, M, Cairns, K, Camacho-Ortiz, A, Ceresoli, M, Chandy, S, Cherry-Bukowiec, J, Cirocchi, R, Colak, E, Corcione, A, Cornely, O, Cortese, F, Cui, Y, Curcio, D, Damaskos, D, Dasx, K, Delibegovic, S, Demetrashvili, Z, De Simone, B, De Souza, H, De Waele, J, Dhingra, S, Diaz, J, Di Carlo, I, Di Marzo, F, Di 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Mesina, C, Menichetti, F, Mishra, S, Montori, G, Moore, E, Moore, F, Naidoo, N, Napolitano, L, Negoi, I, Nicolau, D, Nikolopoulos, I, Nord, C, Ofori-Asenso, R, Olaoye, I, Omari, A, Ordonez, C, Ouadii, M, Ouedraogo, A, Pagani, L, Paiva, J, Parreira, J, Pata, F, Pereira, J, Pereira, N, Petrosillo, N, Picetti, E, Pintar, T, Ponce-De-Leon, A, Popovski, Z, Poulakou, G, Preller, J, Guerrero, A, Pupelis, G, Quiodettis, M, Rawson, T, Reichert, M, Reinhart, K, Rems, M, Rello, J, Rizoli, S, Roberts, J, Rubio-Perez, I, Ruppe, E, Sakakushev, B, Sall, I, Kafil, H, Sanders, J, Sato, N, Sawyer, R, Scalea, T, Scibe, R, Scudeller, L, Lohse, H, Sganga, G, Shafiq, N, Shah, J, Spigaglia, P, Suroowan, S, Tsioutis, C, Sifri, C, Siribumrungwong, B, Sugrue, M, Talving, P, Tan, B, Tarasconi, A, Tascini, C, Tilsed, J, Timsit, J, Tumbarello, M, Trung, N, Ulrych, J, Uranues, S, Velmahos, G, Vereczkei, A, Viale, P, Estape, J, Viscoli, C, Wagenlehner, F, Wright, B, Xiao, Y, Yuan, K, Zachariah, S, Zahar, J, Mergulhao, P, Catena, F, Sartelli, M., Kluger, Y., Ansaloni, L., Carlet, J., Brink, A., Hardcastle, T. C., Khanna, A., Chicom-Mefire, A., Rodríguez-Baño, J., Nathwani, D., Mendelson, M., Watkins, R. R., Pulcini, C., Beović, B., May, A. K., Itani, K. M. F., Mazuski, J. E., Fry, D. E., Coccolini, F., Rasxa, K., Montravers, P., Eckmann, C., Abbo, L. M., Abubakar, S., Abu-Zidan, F. M., Adesunkanmi, A. K., Al-Hasan, M. N., Althani, A. A., Ticas, J. E. A., Ansari, S., Ansumana, R., Da, Silva, Augustin, A. R. A., Bala, G., Balogh, M., Baraket, Z. J., Bassetti, O., Bellanova, M., Beltran, G., Ben-Ishay, M. A., Boermeester, O., Brecher, M. A., Bueno, S. M., Cainzos, J., Cairns, M. A., Camacho-Ortiz, K., Ceresoli, A., Chandy, M., Cherry-Bukowiec, S. J., Cirocchi, J. R., Colak, R., Corcione, E., Cornely, A., Cortese, O. A., Cui, F., Curcio, Y., Damaskos, D., Dasx, D., Delibegovic, K., Demetrashvili, S., Be, Z., Simone, De, Bf, B., De, Souza, Bg, H. P., De, Waele, Bh, J., Dhingra, Bi, S., Diaz, Bj, J. 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Subjects: 0301 basic medicine, antibiotic agent, antifungal agent antiinfective agent, Antifungal Agents, Drug Resistance, Declaration, Inappropriate Prescribing, 030230 surgery, Global Health, Antimicrobial Stewardship, Microbial, 0302 clinical medicine, Anti-Infective Agents, Health care, Global health, Antimicrobial stewardship, Antibiotic prophylaxis, Antibiotic stewardship, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Drug Resistance, Microbial, Public relations, Antimicrobial, Operative, Anti-Bacterial Agents, Antibiotic Prophylaxis, Humans, Surgical Procedures, Operative, Surgical Wound Infection, Surgery, Microbiology (medical), Infectious Diseases, 3. Good health, surgical infections, medicine.medical_specialty, 030106 microbiology, Guidelines, 03 medical and health sciences, Antibiotic resistance, medicine, Ventilator-associated pneumonia, Adults, Surgical Procedures, business.industry, Carbapenems, Therapy, business, hospitals, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agents and antifungal agents in hospitals worldwide especially focusing on surgical infections. As such, it is our intent to raise awareness among healthcare workers and improve antimicrobial prescribing. To facilitate its dissemination, the declaration was translated in different languages.
Published: 2017
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32. Effect of Interval (7 or 11 weeks) Between Neoadjuvant Radiochemotherapy and Surgery on Complete Pathologic Response in Rectal Cancer: A Multicenter, Randomized, Controlled Trial (GRECCAR-6)

Author: Cécile de Chaisemartin, Anne Dubois, Anne Berger, Jérôme Loriau, Philippe Rouanet, Guillaume Meurette, Mehdi Karoui, Jean-Jacques Tuech, Laurent Mineur, Eddy Cotte, Yves Panis, Emmanuel Tiret, Guillaume Piessen, Renato Lupinacci, Sylvain Kirzin, Tabassome Simon, Salma Kotti, Alain Saudemont, Jérôme Desramé, Stéphane Benoist, Bernard Meunier, Nicolas Goasgen, Jafari Mehrdad, Yann Parc, Eric Rullier, Jérémie H. Lefevre, Frédérique Peschaud, Michel Prudhomme, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU), Hôpital Saint-André, CRLCC Val d'Aurelle - Paul Lamarque, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), CHU Pontchaillou [Rennes], Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CHU Pitié-Salpêtrière [AP-HP], Hôpital Bicêtre, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, CHU Toulouse [Toulouse], 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 Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Hôpital Ambroise Paré [AP-HP], CHU Clermont-Ferrand, Groupe Hospitalier Paris Saint-Joseph (hpsj), CHU Rouen, Normandie Université (NU), Centre hospitalier universitaire de Nantes (CHU Nantes), Groupe Hospitalier Diaconesses Croix Saint-Simon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Lille Nord de France (COMUE)-UNICANCER, Hôpital Purpan [Toulouse], Groupe Hospitalier Paris Saint-Joseph, and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Male, Cancer Research, medicine.medical_specialty, Time Factors, Colorectal cancer, medicine.medical_treatment, Rectum, [SDV.CAN]Life Sciences [q-bio]/Cancer, Disease-Free Survival, law.invention, Capecitabine, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Antineoplastic Combined Chemotherapy Protocols, Clinical endpoint, Medicine, Humans, Neoadjuvant therapy, Aged, business.industry, Rectal Neoplasms, Remission Induction, Retrospective cohort study, Radiotherapy Dosage, Chemoradiotherapy, Middle Aged, medicine.disease, Neoadjuvant Therapy, 3. Good health, Surgery, medicine.anatomical_structure, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Fluorouracil, business, medicine.drug
Abstract: Purpose A pathologic complete response (pCR; ypT0N0) of a rectal tumor after neoadjuvant radiochemotherapy (RCT) is associated with an excellent prognosis. Several retrospective studies have investigated the effect of increasing the delay after RCT. The aim of this study was to evaluate the effect of increasing the interval between the end of RCT and surgery on the pCR rate. Methods GRECCAR6 was a phase III, multicenter, randomized, open-label, parallel-group controlled trial. Patients with cT3/T4 or Tx N+ tumors of the mid or lower rectum who had received RCT (45 to 50 Gy with fluorouracil or capecitabine) were included. Patients were randomly included in the 7-week or the 11-week (11w) group. Primary end point was the pCR rate defined as a ypT0N0 specimen (NCT01648894). Results A total of 265 patients from 24 centers were enrolled between October 2012 and February 2015. The majority of the tumors were cT3 (82%). After RCT, surgery was not performed in nine patients (3.4%) because of the occurrence of distant metastasis (n = 5) or other reasons. Two patients underwent local resection of the tumor scar. A total of 47 (18.6%) specimens were classified as ypT0 (four had invaded lymph nodes [8.5%]). The primary end point (ypT0N0) was not different (7 weeks: 20 of 133, 15.0% v 11w: 23 of 132, 17.4%; P = .5983). Morbidity was significantly increased in the 11w group (44.5% v 32%; P = .0404) as a result of increased medical complications (32.8% v 19.2%; P = .0137). The 11w group had a worse quality of mesorectal resection (complete mesorectum [I] 78.7% v 90%; P = .0156). Conclusion Waiting 11 weeks after RCT did not increase the rate of pCR after surgical resection. A longer waiting period may be associated with higher morbidity and more difficult surgical resection.
Published: 2016
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33. Assessment of Bowel Wall Enhancement for the Diagnosis of Intestinal Ischemia in Patients with Small Bowel Obstruction: Value of Adding Unenhanced CT to Contrast-enhanced CT

Author: Patrice Taourel, Marc Zins, Hélène Beaussier, Ingrid Millet, Anh Minh Chuong, Lucie Corno, Isabelle Boulay-Coletta, Gilles Chatellier, Jérôme Hodel, Groupe Hospitalier Paris Saint-Joseph, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Montpellier (UM), Service d’Épidémiologie et de Recherche Clinique [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), and Groupe Hospitalier Paris Saint-Joseph (hpsj)
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, media_common.quotation_subject, Youden's J statistic, Ischemia, Contrast Media, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Sensitivity and Specificity, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Young Adult, 0302 clinical medicine, McNemar's test, Intestine, Small, medicine, Contrast (vision), Humans, Radiology, Nuclear Medicine and imaging, In patient, media_common, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Reproducibility of Results, Retrospective cohort study, Middle Aged, medicine.disease, 3. Good health, Bowel obstruction, Radiographic Image Enhancement, 030220 oncology & carcinogenesis, Female, Radiology, Complication, business, Tomography, X-Ray Computed, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Intestinal Obstruction
Abstract: International audience; Purpose To determine whether adding unenhanced computed tomography (CT) to contrast material-enhanced CT improves the diagnostic performance of decreased bowel wall enhancement as a sign of ischemia complicating mechanical small bowel obstruction (SBO). Materials and Methods This retrospective study was approved by the institutional review board, which waived the requirement for informed consent. Two gastrointestinal radiologists independently performed retrospective assessments of 164 unenhanced and contrast-enhanced CT studies from 158 consecutive patients (mean age, 71.2 years) with mechanical SBO. The reference standard was the intraoperative and/or histologic diagnosis (in 80 cases) or results from clinical follow-up in patients who did not undergo surgery (84 cases). Decreased bowel wall enhancement was evaluated with contrast-enhanced images then and both unenhanced and contrast-enhanced images 1 month later. Diagnostic performance of decreased bowel wall enhancement and confidence in the diagnosis were compared between the two readings by using McNemar and Wilcoxon signed rank tests. Interobserver agreement was assessed by using κ statistics and compared with bootstrapping. Results Ischemia was diagnosed in 41 of 164 (25%) episodes of SBO. For both observers, adding unenhanced images improved decreased bowel wall enhancement sensitivity (observer 1: 46.3% [19 of 41] vs 65.8% [27 of 41], P = .02; observer 2: 56.1% [23 of 41] vs 63.4% [26 of 41], P = .45), Youden index (from 0.41 to 0.58 for observer 1 and from 0.42 to 0.61 for observer 2), and confidence score (P < .001 for both). Specificity significantly increased for observer 2 (84.5% [104 of 123] vs 94.3% [116 of 123], P = .002), and interobserver agreement significantly increased, from moderate (κ = 0.48) to excellent (κ = 0.89; P < .0001). Conclusion Adding unenhanced CT to contrast-enhanced CT improved the sensitivity, diagnostic confidence, and interobserver agreement of the diagnosis of ischemia, a complication of mechanical SBO, on the basis of decreased bowel wall enhancement. (©) RSNA, 2016.
Published: 2016
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34. Guidelines issued by the French Society of Cardiology concerning the competence, performance and environment required in the practice of diagnostic and interventional cardiac electrophysiology

Author: A. Pisapia, Michel Chauvin, Nicolas Sadoul, Daniel Gras, Pascal Defaye, Jean-Claude Daubert, Jean-Sylvain Hermida, Jean-Yves Le Heuzey, Didier Klug, Jean-Claude Deharo, Serge Cazeau, Olivier Piot, Antoine Leenhardt, Philippe Mabo, Salem Kacet, Michèle Salvador-Mazenq, Serge Boveda, Frédéric Anselme, Centre cardiologique du Nord ( CCN ), Centre cardiologique du Nord, Service de cardiologie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Clinique Pasteur et Groupe Rythmologie Stimulation Cardiaque/SFC, Clinique Pasteur [Toulouse], Service de cardiologie et maladies vasculaires, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Cardiac Stimulation and Rhythmology, CHU Grenoble, Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de cardiologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Département de Rythmologie-Stimulation- Hôpital Saint-Joseph, Paris ( Département de Rythmologie-Stimulation ), Groupe Hospitalier Paris Saint-Joseph, Cardiac Rhythm and Pacing Group, Centre cardiologique du Nord (CCN), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département de Rythmologie-Stimulation- Hôpital Saint-Joseph, Paris (Département de Rythmologie-Stimulation), Groupe Hospitalier Paris Saint-Joseph (hpsj), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
Subjects: medicine.medical_specialty, Recommandations, Cardiology, Ablation par cathéter, Compétence, Guidelines, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Competence, Internal medicine, Électrophysiologie, Humans, Medicine, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, 030212 general & internal medicine, Competence (human resources), Societies, Medical, ComputingMilieux_MISCELLANEOUS, business.industry, Cardiac Pacing, Artificial, Arrhythmias, Cardiac, General Medicine, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Electrophysiology, Treatment Outcome, Education, Medical, Graduate, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Catheter ablation, Clinical Competence, France, Electrophysiologic Techniques, Cardiac, Cardiology and Cardiovascular Medicine, business
Abstract: a Centre cardiologique du Nord, 32—36, rue des Moulins-Gemeaux, 93207 St. Denis, France b University Hospital, 76031 Rouen, France c Clinique Pasteur, 31076 Toulouse, France d Hopital de Hautepierre, 67000 Strasbourg, France e University Hospital, 35033 Rennes, France f University Hospital, 38043 Grenoble, France g La Timone University Hospital, 13385 Marseille, France h Nouvelles cliniques nantaises, 44277 Nantes, France i University Hospital, 80054 Amiens, France j University Hospital, 59037 Lille, France k Lariboisiere University Hospita
Published: 2011
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35. Predicting the risk of documented ventilator-associated pneumonia for benchmarking: Construction and validation of a score*

Author: Marie Thuong, Adrien Français, Maité Garrouste-Orgeas, Jean-François Timsit, Samir Jamali, Yves Cohen, Elie Azoulay, Arnaud de Lassence, Jean-Ralph Zahar, Molière Nguile-Makao, Carole Schwebel, Dany Goldgran-Toledano, Service de bactériologie, virologie, parasitologie et hygiène, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epidémiologie pronostique des cancers et affections graves, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Réanimation Médico-Chirurgicale, Groupe Hospitalier Paris Saint-Joseph, Medical-Surgical ICU, Hôpital de Gonesse, Service de réanimation médicale, Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Delafontaine, Unité de soins intensifs, Hôpital de Dourdan, Service de Réanimation Médico-Chirurgicale [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], CHU Colombes-Hôpital Louis Mourier - AP-HP [Colombes], INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Epidémiologie pronostique des cancers et affections graves, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-Hôpital Michallon, Service de bactériologie, virologie, parasitologie et hygiène [CHU Necker], Groupe Hospitalier Paris Saint-Joseph (hpsj), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Vesin, Aurélien
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, MESH: Pneumonia, Ventilator-Associated, MESH: Risk Assessment, Critical Care and Intensive Care Medicine, Risk Assessment, MESH: Prognosis, law.invention, 03 medical and health sciences, 0302 clinical medicine, MESH: Benchmarking, Risk Factors, MESH: Risk Factors, law, Intensive care, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Aged, MESH: Aged, Mechanical ventilation, MESH: Humans, MESH: Middle Aged, Receiver operating characteristic, business.industry, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, 030208 emergency & critical care medicine, Odds ratio, Middle Aged, Prognosis, medicine.disease, Intensive care unit, MESH: Male, Confidence interval, 3. Good health, Benchmarking, Pneumonia, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: International audience; OBJECTIVES:: To build and validate a ventilator-associated pneumonia risk score for benchmarking. The rate of ventilator-associated pneumonia varies widely with case-mix, a fact that has limited its use for measuring intensive care unit performance. METHODS:: We studied 1856 patients in the OUTCOMEREA database treated at intensive care unit admission by endotracheal intubation followed by mechanical ventilation for >48 hrs; they were allocated randomly to a training data set (n = 1233) or a validation data set (n = 623). Multivariate logistic regression was used. Calibration of the final model was assessed in both data sets, using the Hosmer-Lemeshow chi-square test and receiver operating characteristic curves. MEASUREMENTS AND MAIN RESULTS:: Independent risk factors for ventilator-associated pneumonia were male gender (odds ratio = 1.97, 95% confidence interval = 1.32-2.95); SOFA at intensive care unit admission (8 [5.81 (3.2-10.52)], no use within 48 hrs after intensive care unit admission of parenteral nutrition (2.29, 1.52-3.45), no broad-spectrum antimicrobials (2.11, 1.46-3.06); and mechanical ventilation duration (15 days (225.6, 54.3-936.7). Tests in the training set showed good calibration and good discrimination (area under the curve-receiver operating characteristic curve = 0.881), and both criteria remained good in the validation set (area under the curve-receiver operating characteristic curve = 0.848) and good calibration (Hosmer-Lemeshow chi-square = 9.98, p = .5). Observed ventilator-associated pneumonia rates varied across intensive care units from 9.7 to 26.1 of 1000 mechanical ventilation days but the ratio of observed over theoretical ventilator-associated pneumonia rates was >1 in only two intensive care units. CONCLUSIONS:: The ventilator-associated pneumonia rate may be useful for benchmarking provided the ratio of observed over theoretical rates is used. External validation of our prediction score is needed.
Published: 2009
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36. Causes-of-death analysis of patients with cardiac resynchronization therapy: an analysis of the CeRtiTuDe cohort study

Author: Marijon, Eloi, Leclercq, Christophe, Narayanan, Kumar, Boveda, Serge, Klug, Didier, Lacaze-Gadonneix, Jonathan, Defaye, Pascal, Jacob, Sophie, Piot, Olivier, Deharo, Jean-Claude, Perier, Marie-Cécile, Mulak, Genevieve, Hermida, Jean-Sylvain, Milliez, Paul, Gras, Daniel, Cesari, Olivier, Hidden-Lucet, Françoise, Anselme, Frederic, Chevalier, Philippe, Maury, Philippe, Sadoul, Nicolas, Bordachar, Pierre, Cazeau, Serge, Chauvin, Michel, Empana, Jean-Philippe, Jouven, Xavier, Daubert, Jean-Claude, Le Heuzey, Jean-Yves, Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de cardiologie et maladies vasculaires, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Clinique Pasteur et Groupe Rythmologie Stimulation Cardiaque/SFC, Clinique Pasteur [Toulouse], Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Cardiac Stimulation and Rhythmology, CHU Grenoble, Radiobiologie et épidémiologie ( DRPH/SRBE ), Institut de Radioprotection et de Sûreté Nucléaire ( IRSN ), Médicaments : Dynamique Intracellulaire et Architecture Nucléaire ( MéDIAN ), Université de Reims Champagne-Ardenne ( URCA ) -Centre National de la Recherche Scientifique ( CNRS ), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Laboratoire de Recherche en Imagerie : Méthodes d'imagerie des Échanges transcapillaires ( LRI - EA4062 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ), Société française de cardiologie, Hôpital Universitaire d'Amiens, Hôpital Universitaire de Caen, Cardiopathies et mort subite, Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Clinique Saint Gatien, Département de Cardiologie et Centre de Référence pour les Maladies Cardiaques Héréditaires, CHU Pitié-Salpêtrière [APHP], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition ( ICAN ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pitié-Salpêtrière [APHP], Service de cardiologie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Hôpital Est -Lyon, CHU Toulouse [Toulouse], Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Département de Rythmologie-Stimulation- Hôpital Saint-Joseph, Paris ( Département de Rythmologie-Stimulation ), Groupe Hospitalier Paris Saint-Joseph, Hôpital universitaire de Strasbourg, 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), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de RadioBiologie et d'Epidémiologie (IRSN/DRPH/SRBE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Centre cardiologique du Nord (CCN), Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Laboratoire de Recherche en Imagerie : Méthodes d'imagerie des Échanges transcapillaires (LRI - EA4062), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Amiens-Picardie, Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-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), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département de Rythmologie-Stimulation- Hôpital Saint-Joseph, Paris (Département de Rythmologie-Stimulation), Groupe Hospitalier Paris Saint-Joseph (hpsj), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-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)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Radiobiologie et épidémiologie (DRPH/SRBE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Médicaments : Dynamique Intracellulaire et Architecture Nucléaire (MéDIAN), Université de Reims Champagne-Ardenne (URCA)-Centre National de la Recherche Scientifique (CNRS), and Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]
Subjects: genetic structures, Sudden death, health services administration, Cardiac resynchronization, cardiovascular system, Cardioverter defibrillator, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Heart failure, cardiovascular diseases, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, Competing risk, circulatory and respiratory physiology
Abstract: International audience; AIMS: The choice of resynchronization therapy between with (CRT-D) and without (CRT-P) a defibrillator remains a contentious issue. Cause-of-death analysis among CRT-P, compared with CRT-D, patients could help evaluate the extent to which CRT-P patients would have additionally benefited from a defibrillator in a daily clinical practice. METHODS AND RESULTS: A total of 1705 consecutive patients implanted with a CRT (CRT-P: 535 and CRT-D: 1170) between 2008 and 2010 were enrolled in CeRtiTuDe, a multicentric prospective follow-up cohort study, with specific adjudication for causes of death at 2 years. Patients with CRT-P compared with CRT-D were older (P \textless 0.0001), less often male (P \textless 0.0001), more symptomatic (P = 0.0005), with less coronary artery disease (P = 0.003), wider QRS (P = 0.002), more atrial fibrillation (P \textless 0.0001), and more co-morbidities (P = 0.04). At 2-year follow-up, the annual overall mortality rate was 83.80 [95% confidence interval (CI) 73.41-94.19] per 1000 person-years. The crude mortality rate among CRT-P patients was double compared with CRT-D (relative risk 2.01, 95% CI 1.56-2.58). In a Cox proportional hazards regression analysis, CRT-P remained associated with increased mortality (hazard ratio 1.54, 95% CI 1.07-2.21, P = 0.0209), although other potential confounders may persist. By cause-of-death analysis, 95% of the excess mortality among CRT-P subjects was related to an increase in non-sudden death. CONCLUSION: When compared with CRT-D patients, excess mortality in CRT-P recipients was mainly due to non-sudden death. Our findings suggest that CRT-P patients, as currently selected in routine clinical practice, would not potentially benefit with the addition of a defibrillator
Published: 2015
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37. Computed Tomography (CT) Scanning Facilitates Early Identification of Neonatal Cystic Fibrosis Piglets

Author: Patricia Berthon, Reuben Ramphal, Joseph Moënne-Loccoz, Andrea Bähr, Pierre Sarradin, François Lecompte, Sylvie Attucci, Ignacio S. Caballero, Mustapha Si-Tahar, Thierry Villemagne, Rémi Delaunay, Nikolai Klymiuk, Mustapha Berri, Antoine Guillon, Céline Barc, Jérémy Pezant, Claire Chevaleyre, Dominique Buzoni-Gatel, Hans Adriaensen, Eckhard Wolf, Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 (CEPR), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de réanimation polyvalente, Groupe Hospitalier Paris Saint-Joseph, Infectiologie et Santé Publique (UMR ISP), Institut National de la Recherche Agronomique (INRA)-Université de Tours (UT), Plateforme d'Infectiologie Expérimentale (PFIE), Institut National de la Recherche Agronomique (INRA), Physiologie de la reproduction et des comportements [Nouzilly] (PRC), Institut National de la Recherche Agronomique (INRA)-Institut Français du Cheval et de l'Equitation [Saumur]-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Plateforme CIRE, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service anesthésie-réanimation, Gene Center and Center for Innovative Medical Models (CIMM), Foundation Vaincre la Mucoviscidose RF20130500925, Region Centre 32000604, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Infectiologie Animale et Santé Publique - IASP (Nouzilly, France), Plateforme d'Infectiologie Expérimentale (PFIE - INRA UE 1277), Centre National de la Recherche Scientifique (CNRS)-Université de Tours-Institut Français du Cheval et de l'Equitation [Saumur]-Institut National de la Recherche Agronomique (INRA), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours, Institut National de la Recherche Agronomique (INRA)-Université de Tours, Institut National de la Recherche Agronomique (INRA)-Institut Français du Cheval et de l'Equitation [Saumur]-Université de Tours-Centre National de la Recherche Scientifique (CNRS), Groupe Hospitalier Paris Saint-Joseph (hpsj), Institut National de la Recherche Agronomique (INRA)-Institut Français du Cheval et de l'Equitation [Saumur] (IFCE)-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), and ProdInra, Archive Ouverte
Subjects: Male, pig, Pathology, Cystic Fibrosis, Swine, medicine.medical_treatment, Cystic Fibrosis Transmembrane Conductance Regulator, lcsh:Medicine, Computed tomography, ileostomy, Gastroenterology, Cystic fibrosis, 0302 clinical medicine, fluids and secretions, maladie génétique, lcsh:Science, fibrose cystique, 0303 health sciences, Gastrointestinal tract, Multidisciplinary, biology, medicine.diagnostic_test, sucking pig, respiratory system, Cystic fibrosis transmembrane conductance regulator, 3. Good health, 030220 oncology & carcinogenesis, histopathology, Female, porcelet, Autre (Sciences du Vivant), Research Article, medicine.medical_specialty, [SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT], congenital, hereditary, and neonatal diseases and abnormalities, Genotype, Meconium Ileus, ileostomie, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 03 medical and health sciences, Ileostomy, tomodensitométrie, genetic disease, Intensive care, Internal medicine, medicine, Animals, porcin, 030304 developmental biology, [SDV.OT] Life Sciences [q-bio]/Other [q-bio.OT], business.industry, histopathologie, lcsh:R, medicine.disease, digestive system diseases, Animals, Newborn, Nuclear medicine, biology.protein, Histopathology, lcsh:Q, business, Tomography, X-Ray Computed, Médecine nucléaire
Abstract: Background Cystic Fibrosis (CF) is the most prevalent autosomal recessive disease in the Caucasian population. A cystic fibrosis transmembrane conductance regulator knockout (CFTR-/-) pig that displays most of the features of the human CF disease has been recently developed. However, CFTR -/- pigs presents a 100% prevalence of meconium ileus that leads to death in the first hours after birth, requiring a rapid diagnosis and surgical intervention to relieve intestinal obstruction. Identification of CFTR -/- piglets is usually performed by PCR genotyping, a procedure that lasts between 4 to 6 h. Here, we aimed to develop a procedure for rapid identification of CFTR -/- piglets that will allow placing them under intensive care soon after birth and immediately proceeding with the surgical correction. Methods and Principal Findings Male and female CFTR +/- pigs were crossed and the progeny was examined by computed tomography (CT) scan to detect the presence of meconium ileus and facilitate a rapid post-natal surgical intervention. Genotype was confirmed by PCR. CT scan presented a 94.4% sensitivity to diagnose CFTR -/- piglets. Diagnosis by CT scan reduced the birth-to-surgery time from a minimum of 10 h down to a minimum of 2.5 h and increased the survival of CFTR -/- piglets to a maximum of 13 days post-surgery as opposed to just 66 h after later surgery. Conclusion CT scan imaging of meconium ileus is an accurate method for rapid identification of CFTR -/- piglets. Early CT detection of meconium ileus may help to extend the lifespan of CFTR -/- piglets and, thus, improve experimental research on CF, still an incurable disease.
Published: 2015
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38. Increased stiffness and cell-matrix interactions of abdominal aorta in two experimental nonhypertensive models: long-term chemically sympathectomized and sinoaortic denervated rats. : Aorta structure and stiffness in rats

Author: Bouissou, Camille, Lacolley, Patrick, Dabire, Hubert, Safar, Michel, Gabella, Giorgio, Duchatelle, Véronique, Challande, Pascal, Bezie, Yvonnick, INSERM U955, équipe 3, 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 ), 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 ), Centre de diagnostic, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 ( UPD5 ), Department of Anatomy and Developmental Biology, University College of London [London] ( UCL ), Service de pathologie, Groupe Hospitalier Paris Saint-Joseph, Institut Jean Le Rond d'Alembert ( DALEMBERT ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Centre National de la Recherche Scientifique ( CNRS ), Pharmacie, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5), University College of London [London] (UCL), Institut Jean le Rond d'Alembert (DALEMBERT), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), 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 Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), and Groupe Hospitalier Paris Saint-Joseph (hpsj)
Subjects: Sino-aortic denervation, Integrins, fibronectin, Arterial Stiffness, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, Sympathectomy, [ SDV.BBM ] Life Sciences [q-bio]/Biochemistry, Molecular Biology
Abstract: International audience; RATIONALE: Sinoaortic denervated (SAD) and chemically sympathectomized (SNX) rats are characterized by a decrease in arterial distensibility without hypertension and would, thus, be relevant for analyzing arterial wall stiffening independently of blood pressure level. The fibronectin network, which plays a pivotal role in cell-matrix interactions, is a major determinant of arterial stiffness. We hypothesized that in SAD and SNX rats, arterial stiffness is increased, due to alterations of cell-matrix anchoring leading to spatial reorganization of the extracellular matrix. METHODS: The intrinsic elastic properties of the arterial wall were evaluated in vivo by the relationship between incremental elastic modulus determined by echotracking and circumferential wall stress. The changes of cell-extracellular matrix links in the abdominal aorta were evaluated by studying fibronectin, vascular integrin receptors, and ultrastructural features of the aorta by immunochemistry. RESULTS: In both experimental conditions, wall stiffness increased, associated with different modifications of cell-extracellular matrix adhesion. In SAD rats, increased media cross-sectional area was coupled with an increase of muscle cell attachments to its extracellular matrix via fibronectin and its α5-β1 integrin. In SNX rats, reduced media cross-sectional area was associated with upregulation of αv-β3 integrin and more extensive connections between dense bands and elastic fibers despite the disruption of the elastic lamellae. CONCLUSION: In aorta of SNX and SAD rats, a similar arterial stiffness is associated to different structural alterations. An increase in αvβ3 or α5β1 integrins together with the already reported increase in the proportion of less distensible (collagen) to more distensible (elastin) components in both models contributes to remodeling and stiffening of the abdominal aorta.
Published: 2014
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39. Increased stiffness and cell-matrix interactions of abdominal aorta in two experimental nonhypertensive models: long-term chemically sympathectomized and sinoaortic denervated rats

Author: Bouissou, Camille, Lacolley, Patrick, Dabire, Hubert, Safar, Michel, Gabella, Giorgio, Duchatelle, Véronique, Challande, Pascal, Bezie, Yvonnick, INSERM U955, équipe 3, 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), 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), Centre de diagnostic, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5), Department of Anatomy and Developmental Biology, University College of London [London] (UCL), Service de pathologie, Groupe Hospitalier Paris Saint-Joseph (hpsj), Institut Jean le Rond d'Alembert (DALEMBERT), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Pharmacie, and Guellaen, Georges
Subjects: Sino-aortic denervation, Integrins, fibronectin, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, Arterial Stiffness, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, Sympathectomy
Abstract: International audience; RATIONALE: Sinoaortic denervated (SAD) and chemically sympathectomized (SNX) rats are characterized by a decrease in arterial distensibility without hypertension and would, thus, be relevant for analyzing arterial wall stiffening independently of blood pressure level. The fibronectin network, which plays a pivotal role in cell-matrix interactions, is a major determinant of arterial stiffness. We hypothesized that in SAD and SNX rats, arterial stiffness is increased, due to alterations of cell-matrix anchoring leading to spatial reorganization of the extracellular matrix. METHODS: The intrinsic elastic properties of the arterial wall were evaluated in vivo by the relationship between incremental elastic modulus determined by echotracking and circumferential wall stress. The changes of cell-extracellular matrix links in the abdominal aorta were evaluated by studying fibronectin, vascular integrin receptors, and ultrastructural features of the aorta by immunochemistry. RESULTS: In both experimental conditions, wall stiffness increased, associated with different modifications of cell-extracellular matrix adhesion. In SAD rats, increased media cross-sectional area was coupled with an increase of muscle cell attachments to its extracellular matrix via fibronectin and its α5-β1 integrin. In SNX rats, reduced media cross-sectional area was associated with upregulation of αv-β3 integrin and more extensive connections between dense bands and elastic fibers despite the disruption of the elastic lamellae. CONCLUSION: In aorta of SNX and SAD rats, a similar arterial stiffness is associated to different structural alterations. An increase in αvβ3 or α5β1 integrins together with the already reported increase in the proportion of less distensible (collagen) to more distensible (elastin) components in both models contributes to remodeling and stiffening of the abdominal aorta.
Published: 2014
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40. Increased stiffness and cell-matrix interactions of abdominal aorta in two experimental nonhypertensive models: long-term chemically sympathectomized and sinoaortic denervated rats.: Aorta structure and stiffness in rats

Author: Hubert Dabiré, Veronique Duchatelle, Camille Bouissou, Patrick Lacolley, Yvonnick Bézie, Michel E. Safar, Pascal Challande, Giorgio Gabella, INSERM U955, équipe 3, 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), 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), Centre de diagnostic, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5), Department of Anatomy and Developmental Biology, University College of London [London] (UCL), Service de pathologie, Groupe Hospitalier Paris Saint-Joseph (hpsj), Institut Jean le Rond d'Alembert (DALEMBERT), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Pharmacie, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), and Groupe Hospitalier Paris Saint-Joseph
Subjects: Male, Sino-aortic denervation, Integrins, Physiology, Integrin, Integrin alpha5, 030204 cardiovascular system & hematology, Matrix (biology), Article, Extracellular matrix, 03 medical and health sciences, Vascular Stiffness, 0302 clinical medicine, fibronectin, medicine.artery, Internal Medicine, Animals, Medicine, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, Aorta, Abdominal, Rats, Wistar, Sympathectomy, Sinoatrial Node, Aorta, biology, business.industry, Abdominal aorta, Hemodynamics, Sympathectomy, Chemical, Anatomy, medicine.disease, Denervation, Extracellular Matrix, Fibronectins, Rats, Fibronectin, Disease Models, Animal, Hypertension, biology.protein, Arterial stiffness, Biophysics, Arterial Stiffness, Cardiology and Cardiovascular Medicine, business, Elastin, 030217 neurology & neurosurgery
Abstract: International audience; RATIONALE: Sinoaortic denervated (SAD) and chemically sympathectomized (SNX) rats are characterized by a decrease in arterial distensibility without hypertension and would, thus, be relevant for analyzing arterial wall stiffening independently of blood pressure level. The fibronectin network, which plays a pivotal role in cell-matrix interactions, is a major determinant of arterial stiffness. We hypothesized that in SAD and SNX rats, arterial stiffness is increased, due to alterations of cell-matrix anchoring leading to spatial reorganization of the extracellular matrix. METHODS: The intrinsic elastic properties of the arterial wall were evaluated in vivo by the relationship between incremental elastic modulus determined by echotracking and circumferential wall stress. The changes of cell-extracellular matrix links in the abdominal aorta were evaluated by studying fibronectin, vascular integrin receptors, and ultrastructural features of the aorta by immunochemistry. RESULTS: In both experimental conditions, wall stiffness increased, associated with different modifications of cell-extracellular matrix adhesion. In SAD rats, increased media cross-sectional area was coupled with an increase of muscle cell attachments to its extracellular matrix via fibronectin and its α5-β1 integrin. In SNX rats, reduced media cross-sectional area was associated with upregulation of αv-β3 integrin and more extensive connections between dense bands and elastic fibers despite the disruption of the elastic lamellae. CONCLUSION: In aorta of SNX and SAD rats, a similar arterial stiffness is associated to different structural alterations. An increase in αvβ3 or α5β1 integrins together with the already reported increase in the proportion of less distensible (collagen) to more distensible (elastin) components in both models contributes to remodeling and stiffening of the abdominal aorta.
Published: 2014
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41. Risques infectieux liés aux antibactériens : Clostridium difficile et infections fongiques invasives. [Infectious Risks linked to antibacterials: Clostridium difficile and invasive fungal infections.]

Author: Dinh, Aurelien, Le Monnier, Alban, Meynard, Jean-Luc, Tattevin, Pierre, Services des maladies infectieuses, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP Hôpital Raymond Poincaré [Garches], Laboratoire de microbiologie clinique, Groupe Hospitalier Paris Saint-Joseph, Unité sous contrat écosystème microbien digestif et santé, Institut National de la Recherche Agronomique (INRA)-Université Paris-Sud - Paris 11 (UP11), Service des maladies infectieuses et tropicales [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Fonction structure et inactivation d'ARN bactérien, Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Fonction, structure et inactivation d'ARN bactériens, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes]-Fonction, structure et inactivation d'ARN bactériens, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Groupe Hospitalier Paris Saint-Joseph (hpsj), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: SURVEILLANCE NETWORK TRANSNET, ANTIFUNGAL THERAPY, FLUCONAZOLE, DIARRHEA, DOUBLE-BLIND TRIAL, DISEASE, CELL TRANSPLANT RECIPIENTS, PROPHYLAXIS, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, EPIDEMIOLOGY, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MARROW-TRANSPLANTATION, ComputingMilieux_MISCELLANEOUS
Abstract: National audience
Published: 2013

42. Past, present and future of cardiac resynchronization

Author: Philippe Ritter, Serge Cazeau, Claude Daubert, Christophe Leclercq, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Département de Rythmologie-Stimulation- Hôpital Saint-Joseph, Paris (Département de Rythmologie-Stimulation), Groupe Hospitalier Paris Saint-Joseph, Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1-CHU Bordeaux [Bordeaux], Groupe Hospitalier Paris Saint-Joseph (hpsj), and Université Sciences et Technologies - Bordeaux 1 (UB)-CHU Bordeaux [Bordeaux]
Subjects: Adult, Male, medicine.medical_specialty, Cardiac dyssynchrony, medicine.medical_treatment, Treatment outcome, Cardiac resynchronization therapy, Stimulation cardiaque, 030204 cardiovascular system & hematology, History, 21st Century, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Heart Conduction System, Internal medicine, medicine, Animals, Humans, Cardiac Resynchronization Therapy Devices, 030212 general & internal medicine, Intensive care medicine, Ventricular dyssynchrony, Cardiac stimulation, Resynchronisation cardiaque, business.industry, Hemodynamics, Arrhythmias, Cardiac, Equipment Design, General Medicine, History, 20th Century, Middle Aged, medicine.disease, Insuffisance cardiaque, Treatment Outcome, Désynchronisation cardiaque, Clinical evidence, Cardiac resynchronization, Cardiology, cardiovascular system, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Pacemakers, Cardiology and Cardiovascular Medicine, business, Clinical evaluation, Forecasting
Abstract: International audience; The growing interest in dyssynchrony and cardiac resynchronization therapy has opened the field of cardiac stimulation to new haemodynamic indications. French investigators have played a key role in the formulation of new concepts, all arising from clinical observations, and the development (in collaboration with industry) and clinical evaluation of resynchronization devices. This review summarizes recent knowledge and perspectives pertaining to atrial, atrioventricular and ventricular dyssynchrony and resynchronization. Some of these concepts have been validated by robust clinical evidence, on the basis of which scientific recommendations have been formulated. Other concepts have been less successful but probably merit further attention.
Published: 2012
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43. Endocardial acceleration (sonR) vs. ultrasound-derived time intervals in recipients of cardiac resynchronization therapy systems

Author: Gaël Jauvert, Philippe Mabo, Marc Burban, Lionel Giorgis, Lotfi Senhadji, Erwan Donal, Amel Amblard, Alfredo Hernandez, Christophe Leclercq, Serge Cazeau, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorin Group [Clamart], Département de Rythmologie-Stimulation- Hôpital Saint-Joseph, Paris (Département de Rythmologie-Stimulation), Groupe Hospitalier Paris Saint-Joseph, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Groupe Inparys, CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), This study was sponsored by Sorin Group/Ela Medical, and supported, in part, by a grant from the French National Research Agency (ANR-08-TECS013)., Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Groupe Hospitalier Paris Saint-Joseph (hpsj)
Subjects: Male, Aortic valve, Sound Spectrography, Time Factors, MESH: Echocardiography, Doppler, medicine.medical_treatment, Endocardial acceleration, 030204 cardiovascular system & hematology, Doppler echocardiography, MESH: Stroke Volume, 0302 clinical medicine, MESH: Aged, 80 and over, Diastole, Mitral valve, Medicine, Prospective Studies, 030212 general & internal medicine, MESH: Cardiac Resynchronization Therapy Devices, Aged, 80 and over, MESH: Aged, Cardiac resynchronization therapy, Ejection fraction, MESH: Middle Aged, medicine.diagnostic_test, Cardiac cycle, MESH: Diastole, Heart, Middle Aged, MESH: Systole, Echocardiography, Doppler, medicine.anatomical_structure, Aortic Valve, Cardiology, cardiovascular system, Heart sounds, Mitral Valve, Female, MESH: Sound Spectrography, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Systole, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), Internal medicine, Humans, Cardiac Resynchronization Therapy Devices, Aged, Heart Failure, MESH: Humans, business.industry, MESH: Time Factors, Stroke Volume, MESH: Mitral Valve, MESH: Male, MESH: Prospective Studies, MESH: Heart, MESH: Heart Failure, business, MESH: Aortic Valve, MESH: Female
Abstract: International audience; AIMS: Optimization of cardiac resynchronization therapy (CRT) requires the gathering of cardiac functional information. An accurate timing of the phases of the cardiac cycle is key in the optimization process. METHODS AND RESULTS: We compared Doppler echocardiography to an automated system, based on the recording of sonR (formerly endocardial acceleration), in the detection of mitral and aortic valves closures and measurements of the duration of systole and diastole. We prospectively studied, under various conditions of cardiac stimulation, 75 recipients of CRT systems (69% men), whose mean age was 72 ± 9.2 years, left ventricular ejection fraction 35 ± 11%, baseline QRS duration 154 ± 29 ms, and New York Heart Association functional class 3.0 ± 0.7. We simultaneously recorded (i) sonR, detected by a non-invasive piezoelectric micro-accelerometer sensor clipped onto an electrode located in the parasternal region, (b) electrocardiogram, and (c) Doppler audio signals, using a multichannel data acquisition and analysis system. The correlation between timing of mitral and aortic valve closure by sonR vs. Doppler signals was examined by linear regression analysis. Correlation coefficients and the average absolute error were calculated. A concordance in the timing of the mitral (r = 0.86, error = 9.7 ms) and aortic (r = 0.93, error = 9.7 ms) valves closure was observed between the two methods in 94% of patients. Similarly, sonR and the Doppler-derived measurements of systolic (r = 0.85, error = 13.4 ms) and diastolic (r = 0.99, error = 12 ms) interval durations were concordant in 80% of patients. CONCLUSION: A high concordance was found between sonR and the cardiac ultrasound in the timings of aortic and mitral valve closures and in the estimation of systolic and diastolic intervals durations. These observations suggest that sonR could be used to monitor cardiac function and adaptively optimize CRT systems.
Published: 2011
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44. Opinions of families, staff, and patients about family participation in care in intensive care units

Author: Aurélien Vesin, Cédric Bruel, Frédérique Diaw, Sandie Brochon, François Philippart, Vincent Willems, Benoit Misset, Jean Carlet, Marie-Luce Moulard, Alexis Tabah, Isaline Coquet, Maité Garrouste-Orgeas, Jean-François Timsit, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Réanimation Médico-Chirurgicale, Groupe Hospitalier Paris Saint-Joseph, INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-Hôpital Michallon, Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Groupe Hospitalier Paris Saint-Joseph (hpsj), and Vesin, Aurélien
Subjects: Male, medicine.medical_specialty, Critical Care, Attitude of Health Personnel, Anxiety, Critical Care and Intensive Care Medicine, Hospital Anxiety and Depression Scale, law.invention, Family centered care, 03 medical and health sciences, 0302 clinical medicine, Nursing, Professional-Family Relations, law, Intensive care, medicine, Humans, Family, Prospective Studies, 030212 general & internal medicine, Depression (differential diagnoses), Aged, Depression, business.industry, Community Participation, 030208 emergency & critical care medicine, Consumer Behavior, Middle Aged, Intensive care unit, 3. Good health, Family nursing, Intensive Care Units, Telephone interview, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Family Relations, France, medicine.symptom, business, Attitude to Health
Abstract: International audience; PURPOSE: The aims of the study were to assess opinions of caregivers, families, and patients about involvement of families in the care of intensive care unit (ICU) patients; to evaluate the prevalence of symptoms of anxiety and depression in family members; and to measure family satisfaction with care. MATERIALS AND METHODS: Between days 3 and 5, perceptions by families and ICU staff of family involvement in care were collected prospectively at a single center. Family members completed the Hospital Anxiety and Depression Scale (HADS) and a satisfaction scale (Critical Care Family Needs Inventory). Nurses recorded care provided spontaneously by families. Characteristics of patient-relative pairs (n = 101) and ICU staff (n = 45) were collected. Patients described their perceptions of family participation in care during a telephone interview, 206 +/- 147 days after hospital discharge. RESULTS: The numbers of patient-relative pairs for whom ICU staff reported favorable perceptions were 101 (100%) of 101 for physicians, 91 (90%) for nurses, and 95 (94%) for nursing assistants. Only 4 (3.9%) of 101 families refused participation in care. Only 14 (13.8%) of 101 families provided care spontaneously. The HADS score showed symptoms of anxiety in 58 (58.5%) of 99 and of depression in 26 (26.2%) of 99 family members. The satisfaction score was high (11.0 +/- 1.25). Among patients, 34 (77.2%) of 44 had a favorable perception of family participation in care. CONCLUSIONS: Families and ICU staff were very supportive of family participation in care. Most patients were also favorable to care by family members.
Published: 2010
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45. Attributable mortality of ventilator-associated pneumonia: respective impact of main characteristics at ICU admission and VAP onset using conditional logistic regression and multi-state models

Author: Bertrand Souweine, Maité Garrouste-Orgeas, Christophe Clec’h, Jean-Ralph Zahar, Christophe Adrie, Samir Jamali, Elie Azoulay, Bernard Allaouchiche, Molière Nguile-Makao, Jean-François Timsit, Dany Goldgran-Toledano, Alexis Tabah, Adrien Français, Epidémiologie pronostique des cancers et affections graves, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de bactériologie, virologie, parasitologie et hygiène, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Réanimation Médico-Chirurgicale, Groupe Hospitalier Paris Saint-Joseph, Surgical ICU, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Medical-Surgical ICU, Hôpital Gonesse, Service de réanimation médicale, Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), General ICU, Hôpital Delafontaine, Hôpital de Dourdan, Service d'anesthésie-réanimation [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-Hôpital Michallon, Service de bactériologie, virologie, parasitologie et hygiène [CHU Necker], Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe Hospitalier Paris Saint-Joseph (hpsj), Centre Hospitalier de Gonesse, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Clinique de réanimation médicale, and Vesin, Aurélien
Subjects: Male, medicine.medical_specialty, Databases, Factual, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Logistic regression, Severity of Illness Index, 03 medical and health sciences, Patient Admission, 0302 clinical medicine, Intensive care, Internal medicine, Severity of illness, medicine, Humans, Hospital Mortality, Prospective Studies, 030212 general & internal medicine, Intensive care medicine, Prospective cohort study, Mechanical ventilation, business.industry, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, Length of Stay, Middle Aged, medicine.disease, bacterial infections and mycoses, Confidence interval, 3. Good health, respiratory tract diseases, Intensive Care Units, Logistic Models, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Cohort study
Abstract: International audience; PURPOSE: Methods for estimating the excess mortality attributable to ventilator-associated pneumonia (VAP) should handle VAP as a time-dependent covariate, since the probability of experiencing VAP increases with the time on mechanical ventilation. VAP-attributable mortality (VAP-AM) varies with definitions, case-mix, causative microorganisms, and treatment adequacy. Our objectives here were to compare VAP-AM estimates obtained using a traditional cohort analysis, a multistate progressive disability model, and a matched-cohort analysis; and to compare VAP-AM estimates according to VAP characteristics. METHODS: We used data from 2,873 mechanically ventilated patients in the Outcomerea((R)) database. Among these patients from 12 intensive care units, 434 (15.1%) experienced VAP; of the remaining patients, 1,969 (68.5%) were discharged alive and 470 (16.4%) died. With the multistate model, VAP-AM was 8.1% (95% confidence interval [95%CI], 3.1-13.1%) for 120 days' complete observation, compared to 10.4% (5.6-24.5%) using a matched-cohort approach (2,769 patients) with matching on mechanical ventilation duration followed by conditional logistic regression. VAP-AM was higher in surgical patients and patients with intermediate (but not high) Simplified Acute Physiologic Score II values at ICU admission. VAP-AM was significantly influenced by time to VAP but not by resistance of causative microorganisms. Higher Logistic Organ Dysfunction score at VAP onset dramatically increased VAP-AM (to 31.9% in patients with scores above 7). CONCLUSION: A multistate model that appropriately handled VAP as a time-dependent event produced lower VAP-AM values than conditional logistic regression. VAP-AM varied widely with case-mix. Disease severity at VAP onset markedly influenced VAP-AM; this may contribute to the variability of previous estimates.
Published: 2010
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46. Managing intensive care units: Make LOVE, not war!

Author: Maité Garrouste-Orgeas, Jean Carlet, Marie-Françoise Dumay, Jean-François Timsit, Benoit Misset, Bertrand Guidet, Frédérique Diaw, Réanimation polyvalente, Université Paris Descartes - Paris 5 ( UPD5 ) -Groupe Hospitalier Paris Saint-Joseph, Institut d'oncologie/développement Albert Bonniot de Grenoble ( INSERM U823 ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Epidémiologie des maladies infectieuses et modélisation ( ESIM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Réanimation Médicale [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Réanimation médicale, CHU Grenoble-Hôpital Michallon-Hôpital Michallon, INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Université Paris Descartes - Paris 5 (UPD5)-Groupe Hospitalier Paris Saint-Joseph, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Réanimation médicale, Université Paris Descartes - Paris 5 (UPD5)-Groupe Hospitalier Paris Saint-Joseph (hpsj), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Vesin, Aurélien
Subjects: Quality management, Quality Assurance, Health Care, Attitude of Health Personnel, media_common.quotation_subject, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Nursing, Professional-Family Relations, Intensive care, Intervention (counseling), Health care, Humans, Medicine, 030212 general & internal medicine, media_common, Patient Care Team, Clinical governance, Teamwork, business.industry, Communication, 030208 emergency & critical care medicine, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Professional-Patient Relations, 3. Good health, Intensive Care Units, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Feasibility Studies, Position paper, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Patient Participation, business, Attitude to Health, Program Evaluation
Abstract: International audience; OBJECTIVE: Describe a program set up in a French intensive care unit (ICU) aimed at improving communication inside the team and communication information given to patients and their relatives; explain how those actions can improve communication inside the ICU and ultimately why it could improve patient's outcome. DESIGN AND METHODS: Position paper. INTERVENTION: Progressive implementation of multifaceted quality improvement program. RESULTS: The program Leadership, Ownership, Values, and Evaluation (LOVE) was developed over 10 years. It was usually well accepted by the members of the team, patients, and relatives, in particular the 24-hour visiting program that was prospectively evaluated. Information and decisions were shared with the patients or more often with the relatives, who became for some of them really "part of the team." Additional actions such as participation to some of the simplest cares by the families are under investigation. A prospective evaluation of such programs, although difficult to perform, remains probably necessary. CONCLUSION: Quality of life within the ICU is based on many factors including a strong and positive leadership, an absolute respect of individuals, and a rigorous evaluation of quality of care, which could influence heavily the quality of life in the ICU for patients, relatives, and health care professionals and facilitate team work. Whether this could really influence outcome remains to be demonstrated.
Published: 2010
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47. Association between hypernatraemia acquired in the ICU and mortality: a cohort study

Author: Samir Jamali, Yves Cohen, Adrien Français, Elie Azoulay, Michael Darmon, Anne-Sylvie Dumenil, Jean-François Timsit, Maité Garrouste-Orgeas, Molière Nguile-Makao, Bernard Allaouchiche, Bertrand Souweine, Christine Cheval, Dany Goldgran-Toledano, Christophe Adrie, Service de réanimation médicale, Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Medical ICU, CHU Saint-Etienne, INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-Hôpital Michallon, Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), General ICU, Hôpital Delafontaine, Service de Réanimation Médico-Chirurgicale [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Réanimation Médico-Chirurgicale, Groupe Hospitalier Paris Saint-Joseph, Medical-Surgical ICU, Hôpital Gonesse, Service de réanimation chirurgicale [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Hôpital de Dourdan, Medical-surgical ICU, Centre Hospitalier d’Hyères, Surgical ICU, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe Hospitalier Paris Saint-Joseph (hpsj), Centre Hospitalier de Gonesse, and Vesin, Aurélien
Subjects: Male, medicine.medical_specialty, Pediatrics, 030204 cardiovascular system & hematology, Severity of Illness Index, law.invention, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, law, Risk Factors, Internal medicine, Severity of illness, medicine, Prevalence, Humans, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Simplified Acute Physiology Score, Prospective cohort study, Aged, Retrospective Studies, Transplantation, Sex Characteristics, Hypernatremia, business.industry, Sodium, Retrospective cohort study, Middle Aged, medicine.disease, Prognosis, Intensive care unit, 3. Good health, Survival Rate, Intensive Care Units, Nephrology, SAPS II, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Cohort study
Abstract: International audience; BACKGROUND: The aim of this study is to describe the prevalence and outcomes of intensive care unit (ICU)-acquired hypernatraemia (IAH). METHODS: A retrospective analysis was performed on a prospectively collected database fed by 12 ICUs. Subjects are unselected patients with ICU stay >48 h. Mild and moderate to severe hypernatraemia were defined as serum sodium >145 and >150 mmol/L, respectively. IAH was hypernatraemia occurring >/=24 h after ICU admission in patients with normal serum sodium at ICU admission. RESULTS: Of the 8441 patients, 301 were excluded because they had hypernatraemia at ICU admission. Of the remaining 8140 patients, 901 (11.1%) experienced mild hypernatraemia, and 344 (4.2%) experienced moderate to severe hypernatraemia. Factors independently associated with IAH were male gender, severity at admission as assessed by the Simplified Acute Physiology Score version II (SAPS II), and organ failure or life-supporting treatment at ICU admission. Unadjusted hospital mortality was 15.2% in patients without hypernatraemia compared to 29.5% in patients with mild IAH and 46.2% in those with moderate to severe IAH (P < 0.0001). When any degree of IAH was handled as a time-dependent variable in a subdistribution hazard model, the subdistribution hazard ratio (SHR) for ICU mortality was 4.26 [95% confidence interval (CI), 3.74-4.84]. After stratification by centre and adjustment for confounders, both mild IAH and moderate to severe IAH were independently associated with mortality [SHR 2.03 (95% CI 1.73-2.39) and 2.67 (95% CI 2.19-3.26), respectively]. CONCLUSION: IAH is frequent and associated with mortality after adjustment on severity at ICU admission.
Published: 2010
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48. Quality of life in patients aged 80 or over after ICU discharge

Author: Jean Carlet, Jean-François Timsit, Maité Garrouste-Orgeas, Alexis Tabah, Alain Leplège, Benoit Misset, Adrien Français, François Philippart, Cédric Bruel, Vincent Willems, BMC, Ed., Service de réanimation polyvalente, Groupe Hospitalier Paris Saint-Joseph (hpsj), Cytokines et Inflammation, Institut Pasteur [Paris] (IP), Epidémiologie pronostique des cancers et affections graves, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Recherches Epistémologiques et Historiques sur les Sciences Exactes et les Institutions Scientifiques (REHSEIS (UMR_7596)), Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Paris 5 (UPD5), Groupe Hospitalier Paris Saint-Joseph, Institut Pasteur [Paris], Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Université Joseph Fourier - Grenoble 1 (UJF) - Institut National de la Santé et de la Recherche Médicale (INSERM), Université Joseph Fourier - Grenoble 1 (UJF) - CHU Grenoble - Hôpital Michallon, Recherches Epistémologiques et Historiques sur les Sciences Exactes et les Institutions Scientifiques (REHSEIS), and Université Paris Diderot - Paris 7 (UPD7) - Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, Pediatrics, Letter, Activities of daily living, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Hospital Bed Capacity, 300 to 499, MESH : Aged, MESH : Prospective Studies, Critical Care and Intensive Care Medicine, Hospitals, Special, law.invention, MESH : Hospital Bed Capacity, 300 to 499, 0302 clinical medicine, MESH: Aged, 80 and over, Quality of life, law, Medicine, MESH : Female, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Aged, 80 and over, MESH: Aged, education.field_of_study, Mortality rate, MESH: Paris, MESH : Paris, MESH: Follow-Up Studies, Intensive care unit, Patient Discharge, 3. Good health, Intensive Care Units, Cohort, Female, MESH : Patient Discharge, MESH : Intensive Care Units, Paris, medicine.medical_specialty, MESH : Hospitals, Special, MESH : Male, Population, 03 medical and health sciences, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, MESH : Aged, 80 and over, education, Aged, MESH: Humans, business.industry, Research, MESH: Patient Discharge, MESH : Humans, MESH: Hospitals, Special, MESH: Quality of Life, MESH : Follow-Up Studies, 030208 emergency & critical care medicine, MESH : Quality of Life, MESH: Hospital Bed Capacity, 300 to 499, MESH: Prospective Studies, MESH: Male, Quality of Life, Observational study, MESH: Intensive Care Units, business, MESH: Female, Follow-Up Studies
Abstract: International audience; INTRODUCTION: Our objective was to describe self-sufficiency and quality of life one year after intensive care unit (ICU) discharge of patients aged 80 years or over. METHODS: We performed a prospective observational study in a medical-surgical ICU in a tertiary non-university hospital. We included patients aged 80 or over at ICU admission in 2005 or 2006 and we recorded age, admission diagnosis, intensity of care, and severity of acute and chronic illnesses, as well as ICU, hospital, and one-year mortality rates. Self-sufficiency (Katz Index of Activities of Daily Living) was assessed at ICU admission and one year after ICU discharge. Quality of life (WHO-QOL OLD and WHO-QOL BREF) was assessed one year after ICU discharge. RESULTS: Of the 115 consecutive patients aged 80 or over (18.2% of admitted patients), 106 were included. Mean age was 84 +/- 3 years (range, 80 to 92). Mortality was 40/106 (37%) at ICU discharge, 48/106 (45.2%) at hospital discharge, and 73/106 (68.9%) one year after ICU discharge. In the 23 patients evaluated after one year, self-sufficiency was unchanged compared to the pre-admission status. Quality of life evaluations after one year showed that physical health, sensory abilities, self-sufficiency, and social participation had slightly worse ratings than the other domains, whereas social relationships, environment, and fear of death and dying had the best ratings. Compared to an age- and sex-matched sample of the general population, our cohort had better ratings for psychological health, social relationships, and environment, less fear of death and dying, better expectations about past, present, and future activities and better intimacy (friendship and love). CONCLUSIONS: Among patients aged 80 or over who were selected at ICU admission, 80% were self-sufficient for activities of daily living one year after ICU discharge, 31% were alive, with no change in self-sufficiency and with similar quality of life to that of the general population matched on age and sex. However, these results must be interpreted cautiously due to the small sample of survivors.
Published: 2010
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49. Mathematical Modeling of Electrocardiograms: A Numerical Study

Author: Serge Cazeau, Nejib Zemzemi, Jean-Frédéric Gerbeau, Muriel Boulakia, Miguel Angel Fernández, Numerical simulation of biological flows (REO), Laboratoire Jacques-Louis Lions (LJLL), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Inria Paris-Rocquencourt, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Département de Rythmologie-Stimulation- Hôpital Saint-Joseph, Paris (Département de Rythmologie-Stimulation), Groupe Hospitalier Paris Saint-Joseph (hpsj), CardioSense3D, and Groupe Hospitalier Paris Saint-Joseph
Subjects: bidomain equation, Mathematical optimization, Computer science, Quantitative Biology::Tissues and Organs, Physics::Medical Physics, Biomedical Engineering, Action Potentials, 030204 cardiovascular system & hematology, monodomain equation, 01 natural sciences, Stability (probability), Sensitivity and Specificity, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, sensitivity analysis, Heart Conduction System, Applied mathematics, Humans, heart-torso coupling, Sensitivity (control systems), Diagnosis, Computer-Assisted, 0101 mathematics, Laplace's equation, Partial differential equation, Computer simulation, Numerical analysis, mathematical modeling, Reproducibility of Results, Domain decomposition methods, 12-lead electrocardiogram, 010101 applied mathematics, ionic model, numerical simulation, cardiac electrophysiology, [MATH.MATH-NA]Mathematics [math]/Numerical Analysis [math.NA], Numerical stability
Abstract: International audience; This report deals with the numerical simulation of electrocardiograms (ECG). Our aim is to devise a mathematical model, based on partial differential equations, which is able to provide realistic 12-lead ECGs. The main ingredients of this model are classical: the bidomain equations coupled to a phenomenological ionic model in the heart, and a generalized Laplace equation in the torso. The obtention of realistic ECGs relies on other important features --- including heart-torso transmission conditions, anisotropy, cell heterogeneity and His bundle modeling --- that are discussed in detail. The numerical implementation is based on state-of-the-art numerical methods: domain decomposition techniques and second order semi-implicit time marching schemes, offering a good compromise between accuracy, stability and efficiency. The numerical ECGs obtained with this approach show correct amplitudes, shapes and polarities, in all the 12 standard leads. The relevance of every modeling choice is carefully discussed and the numerical ECG sensitivity to the model parameters investigated.
Published: 2010
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50. Curbing methicillin-resistant Staphylococcus aureus in 38 French hospitals through a 15-year institutional control program

Author: Jarlier, Vincent, Trystram, David, Brun-Buisson, Christian, Fournier, Sandra, Carbonne Berger, Anne, Marty, Laurence, Andremont, Antoine, Arlet, Guillaume, Buu-Hoi, Annie, Carlet, Jean, Decré, Dominique, Gottot, Serge, Gutmann, Laurent, Joly-Guillou, Marie-Laure, Legrand, Erick, Nicolas-Chanoine, Marie-Hélène, Soussy, Claude-James, Wolff, Michel, Lucet, Jean-Christophe, Aggoune, Michelle, Brücker, Gilles, Régnier, Bernard, de France, Collégiale, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Emergence de la résistance bactérienne in vivo (EA3964), Université Paris Diderot - Paris 7 (UPD7), Université Pierre et Marie Curie - Paris 6 (UPMC), Réanimation Médico-Chirurgicale, Groupe Hospitalier Paris Saint-Joseph, Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité d'Epidémiologie Clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Centre de Recherche des Cordeliers (CRC (UMR_S 872)), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP), Université d'Angers (UA), Groupe d'Études Remodelage Osseux et bioMatériaux (GEROM), Service de Microbiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de recherche biomédicale Bichat-Beaujon (CRB3), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Soins Intensifs et de Maladies Infectieuses, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Hôpital Bichat - Claude Bernard, Hôpital Delafontaine, Objectif Recherche Vaccin Sida, Service de réanimation médicale et infectieuse, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Groupe Hospitalier Paris Saint-Joseph (hpsj)
Subjects: Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, Pediatrics, Meticillin, [SDV]Life Sciences [q-bio], Prevalence, Drug resistance, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Intensive care, Epidemiology, Internal Medicine, medicine, Infection control, Humans, 030212 general & internal medicine, Hospitals, Teaching, 0303 health sciences, Infection Control, 030306 microbiology, business.industry, Incidence (epidemiology), Teaching, Staphylococcal Infections, Methicillin-resistant Staphylococcus aureus, Hospitals, 3. Good health, Emergency medicine, France, business, medicine.drug
Abstract: International audience; BACKGROUND: The Assistance Publique-Hôpitaux de Paris (AP-HP) institution administers 38 teaching hospitals (23 acute care and 15 rehabilitation and long-term care hospitals; total, 23 000 beds) scattered across Paris and surrounding suburbs in France. In the late 1980s, the proportion of methicillin resistance among clinical strains of Staphylococcus aureus (MRSA) reached approximately 40% at AP-HP.METHODS: A program aimed at curbing the MRSA burden was launched in 1993, based on passive and active surveillance, barrier precautions, training, and feedback. This program, supported by the strong commitment of the institution, was reinforced in 2001 by a campaign promoting the use of alcohol-based hand-rub solutions. An observational study on MRSA rate was prospectively carried out from 1993 onwards. RESULTS: There was a significant progressive decrease in MRSA burden (-35%) from 1993 to 2007, whether recorded as the proportion (expressed as percentage) of MRSA among S aureus strains (41.0% down to 26.6% overall; 45.3% to 24.2% in blood cultures) or incidence of MRSA cases (0.86 down to 0.56 per 1000 hospital days). The MRSA burden decreased more markedly in intensive care units (-59%) than in surgical (-44%) and medical (-32%) wards. The use of ABHR solutions (in liters per 1000 hospital days) increased steadily from 2 L to 21 L (to 26 L in acute care hospitals and to 10 L in rehabilitation and long-term care hospitals) following the campaign. CONCLUSION: A sustained reduction of MRSA burden can be obtained at the scale of a large hospital institution with high endemic MRSA rates, providing that an intensive program is maintained for a long period.
Published: 2010
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