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1. Cardiac screening before returning to elite sport after SARS-CoV-2 infection

Author: Hédon, Christophe, Schnell, Frédéric, Sosner, Philippe, Chagué, Frédéric, Schuster, Iris, Julia, Marc, Duparc, Alexandre, Guy, Jean-Michel, Molinari, Nicolas, Michaux, Lionel, Cransac, Frédéric, Cade, Stéphane, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Pontchaillou [Rennes], 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), Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE), Université de Poitiers, Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Saint Jean de Perpignan, Hôpital Rangueil, CHU Toulouse [Toulouse], CHU Bordeaux [Bordeaux], Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut Montpelliérain Alexander Grothendieck (IMAG), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Médecine de précision par intégration de données et inférence causale (PREMEDICAL), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Clinique du Millénaire - Oc Santé [Montpellier], Oc Santé [Montpellier], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and None
Subjects: Male, Adult, SARS-CoV-2, [SDV]Life Sciences [q-bio], COVID-19, Heart, General Medicine, Young Adult, Myocarditis, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Athletes, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], Screening, Humans, Female, Cardiology and Cardiovascular Medicine, Return-to-play
Abstract: International audience; Background: SARS-CoV-2 infection can induce cardiac damage. Therefore, in the absence of clear data, a cardiac evaluation was recommended for athletes before returning to play after recent SARS-CoV-2 infection.Aim: To assess the proportion of anomalies detected by this cardiac screening.Methods: We reviewed the medical files of elite athletes referred for cardiac evaluation before returning to play after a non-hospitalized SARS-CoV-2 infection (based on a positive polymerase chain reaction or antigen test) from March 2020 to July 2021 in 12 French centres.Results: A total of 554 elite athletes (professional or national level) were included (median age 22 years, 72.0% male). An electrocardiogram (ECG), echocardiogram and exercise test were performed in 551 (99.5%), 497 (89.7%) and 293 (52.9%) athletes, respectively. We found anomalies with a potential link with SARS-CoV-2 infection in four ECGs (0.7%), three echocardiograms (0.6%) and three exercise tests (1.0%). Cardiac magnetic resonance imaging was performed in 34 athletes (6.1%), mostly due to abnormal first-line examinations, and was abnormal in one (2.9%). The rates of those abnormalities were not higher among athletes with cardiac symptoms or more severe forms of non-hospitalized SARS-CoV-2 infection. Only one athlete had a possible SARS-CoV-2 myocarditis and sport was temporally contraindicated. None had a major cardiac event declared during the follow-up.Conclusion: The proportion of cardiac involvement after non-hospitalized forms of SARS-CoV-2 infection in athletes are very low. Systematic cardiac screening before returning to play seems to be unnecessary.
Published: 2022
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2. Optimization of biologics to reduce treatment failure in inflammatory bowel diseases

Author: Anne Breton, Frédérick Barreau, Emmanuel Mas, Cyrielle Gilletta De Saint-Joseph, Aurélie Bourchany, Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, Département de Gastroentérologie, Hôpital Rangueil, CHU de Toulouse, Institut de Recherche en Santé Digestive (IRSD ), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CCSD, Accord Elsevier, Service Diabétologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Gastroentérologie et pancréatologie [CHU Toulouse], and Pôle Maladies de l'appareil digestif [CHU Toulouse]
Subjects: 0301 basic medicine, Drug, medicine.medical_specialty, media_common.quotation_subject, Drug Resistance, Drug resistance, Antibodies, Monoclonal, Humanized, 030226 pharmacology & pharmacy, Inflammatory bowel disease, law.invention, Efficacy, 03 medical and health sciences, 0302 clinical medicine, Gastrointestinal Agents, Randomized controlled trial, law, Drug Discovery, medicine, Humans, Treatment Failure, Intensive care medicine, media_common, Pharmacology, Biological Products, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, medicine.diagnostic_test, Tumor Necrosis Factor-alpha, business.industry, Inflammatory Bowel Diseases, medicine.disease, 3. Good health, 030104 developmental biology, Therapeutic drug monitoring, Monoclonal, Trough level, Ustekinumab, Drug Monitoring, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Moderate to severe inflammatory bowel disease patients can fail to respond to conventional therapy and/or to biologic treatment. In the era of TNFα antagonists and other non-anti-TNF biologic drugs, it is important to review the literature on biologic treatment failure, which could be defined as primary non-response, secondary loss of response and intolerance. Therapeutic drug monitoring (TDM), that is, drug trough level and antidrug antibodies, should enable to determine the mechanisms of treatment failure and to optimize drug efficacy. There is a consensus on reactive TDM at the time of loss of response. Proactive TDM could be of interest during induction and/or maintenance, but randomized controlled trials are required.
Published: 2020
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3. Effectiveness and Safety of a Prolonged Hemodynamic Support by the IVAC2L System in Healthy and Cardiogenic Shock Pigs

Author: Clément Delmas, Jean Porterie, Géraldine Jourdan, Frank Lezoualc'h, Romain Arnaud, Stéphanie Brun, Hugo Cavalerie, Grégoire Blanc, Bertrand Marcheix, Olivier Lairez, Patrick Verwaerde, Jeanne Mialet-Perez, Institut des Maladies Métaboliques et Casdiovasculaires (UPS/Inserm U1297 - I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), STROMALab, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement Français du Sang-Centre National de la Recherche Scientifique (CNRS), 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), Mialet-Perez, Jeanne, Hôpital Rangueil, and CHU Toulouse [Toulouse]
Subjects: safety, IVAC2L, mechanical circulatory support, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, efficiency, RC666-701, cardiogenic shock, Diseases of the circulatory (Cardiovascular) system, Cardiology and Cardiovascular Medicine, porcine model, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract: BackgroundMechanical circulatory supports are used in case of cardiogenic shock (CS) refractory to conventional therapy. Several devices can be employed, but are limited by their availability, benefit risk-ratio, and/or cost.AimsTo investigate the feasibility, safety, and effectiveness of a long-term support by a new available device (IVAC2L) in pigs.MethodsExperiments were carried out in male pigs, divided into healthy (n = 6) or ischemic CS (n = 4) groups for a median support time of 34 and 12 h, respectively. IVAC2L was implanted under fluoroscopic and TTE guidance under general anesthesia. CS was induced by surgical ligation of the left anterior descending artery. An ipsilateral lower limb reperfusion was created with the Solopath® system. Reperfusion was started after 1 h of support in healthy pigs and upon IVAC2L insertion in CS pigs. Hemodynamic and biological parameters were monitored before and during the whole period of support in each group.ResultsOccurrence of an ipsilateral lower limb ischemia was systematic in healthy and CS pigs in a few minutes after IVAC2L implantation, and could be reversed by the arterial reperfusion, as demonstrated by distal transcutaneous pressure in oxygen (TcPO2) and lactate normalization. IVAC2L support decreased pulmonary capillary wedge pressure (PCWP) (15.3 ± 0.3 vs. 7.5 ± 0.9 mmHg, p < 0.001), increased systolic blood pressure (SBP) (70 ± 4.5 vs. 101.3 ± 3.1 mmHg, p < 0.01), and cardiac output (CO) (4.0 ± 0.3 vs. 5.2 ± 0.6 l/min, p < 0.05) in CS pigs; at CS onset and after 12 h of support, without effects on heart rate or pulmonary artery pressure (PAP). Non-sustained ventricular arrhythmias were frequent at implantation (50%). A non-significant hemolysis was observed under support in CS pigs. Bleedings were frequent at the insertion and/or operating sites (30%).ConclusionLong-term support by IVAC2L is feasible and associated with a significant hemodynamic improvement in a porcine model. These preclinical data open the door for a study of IVAC2L in human ischemic CS, keeping in mind the need for systematic reperfusion of the lower limb and the associated risk of bleeding.
Published: 2022
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4. Diuretic vs. placebo in intermediate-risk acute pulmonary embolism: a randomized clinical trial

Author: Roger Rosario, Jacques Mansourati, Clément Delmas, Gwénolé Rohel, Pierre-André Natella, Sylvie Bastuji-Garin, Muriel Paul, Pascal Lim, Jean-Luc Dubois-Randé, Anne Bernard, Olivier Lairez, Bernard Tardy, Olivier Sanchez, Caroline Biendel, Nicolas Meneveau, Romain Gallet, Tabassome Simon, Pierre Coste, Hélène Bouvaist, Gilles Chatelier, Mustapha Sebbane, Fabrice Ivanes, Damien Fard, Richard Layese, Francis Couturaud, 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 des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), F-Crin Innovte [CHU Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Department of Cardiology, University Hospital Jean Minjoz, Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( UR 3920) (PCVP / CARDIO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Departement de Cardiologie [Hôpital Saint-Joseph - Marseille], Aix Marseille Université (AMU)-Hôpital Saint-Joseph [Marseille], CHU Grenoble, Institut de neurophysiopathologie (INP), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Université de Brest (UBO), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), CHU Bordeaux [Bordeaux], Université de Bordeaux (UB), Santé Ingénierie Biologie Saint-Etienne (SAINBIOSE), Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Université de Tours (UT), CHU Henri Mondor [Créteil], Hôpital Henri Mondor, 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), Clinical Research Unit (URC Mondor), Hôpitaux Universitaires Henri-Mondor AP-HP, IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), 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), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), INSERM U1059, SAINBIOSE - Santé, Ingénierie, Biologie, Saint-Etienne (SAINBIOSE-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Cardiology, Hôpital Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], CHU Toulouse [Toulouse], and CHU Henri Mondor
Subjects: Randomization, medicine.medical_treatment, Ventricular Dysfunction, Right, [SDV]Life Sciences [q-bio], Critical Care and Intensive Care Medicine, Placebo, law.invention, Randomized controlled trial, Double-Blind Method, law, Furosemide, medicine, Humans, Diuretics, business.industry, General Medicine, medicine.disease, Pulmonary embolism, Blood pressure, Treatment Outcome, Anesthesia, Acute Disease, Diuretic, Bolus (digestion), Cardiology and Cardiovascular Medicine, business, Pulmonary Embolism, medicine.drug
Abstract: Aims The role of diuretics in patients with intermediate-risk pulmonary embolism (PE) is controversial. In this multicentre, double-blind trial, we randomly assigned normotensive patients with intermediate-risk PE to receive either a single 80 mg bolus of furosemide or a placebo. Methods and results Eligible patients had at least a simplified PE Severity Index (sPESI) ≥1 with right ventricular dysfunction. The primary efficacy endpoint assessed 24 h after randomization included (i) absence of oligo-anuria and (ii) normalization of all sPESI items. Safety outcomes were worsening renal function and major adverse outcomes at 48 hours defined by death, cardiac arrest, mechanical ventilation, or need of catecholamine. A total of 276 patients underwent randomization; 135 were assigned to receive the diuretic, and 141 to receive the placebo. The primary outcome occurred in 68/132 patients (51.5%) in the diuretic and in 49/132 (37.1%) in the placebo group (relative risk = 1.30, 95% confidence interval 1.04–1.61; P = 0.021). Major adverse outcome at 48 h occurred in 1 (0.8%) patients in the diuretic group and 4 patients (2.9%) in the placebo group (P = 0.19). Increase in serum creatinine level was greater in diuretic than placebo group [+4 µM/L (−2; 14) vs. −1 µM/L (−11; 6), P Conclusion In normotensive patients with intermediate-risk PE, a single bolus of furosemide improved the primary efficacy outcome at 24 h and maintained stable renal function. In the furosemide group, urine output increased, without a demonstrable improvement in heart rate, systolic blood pressure, or arterial oxygenation. ClinicalTrials.gov identifier NCT02268903.
Published: 2022
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5. Correlation of Nailfold Capillaroscopy Findings with History of Digital Ulcer on Same Finger: Results of SCLEROCAP Study

Author: Carine, Boulon, Fanny, Velardo, Sophie, Blaise, Marion, Mangin, Joelle Decamps-Le, Chevoir, Patricia, Senet, Isabelle, Lazareth, Nathalie, Baudot, Laurent, Tribout, Bernard, Imbert, François-Xavier, Lapebie, Loubna, Dari, Philippe, Lacroix, Marie-Elise, Truchetet, Julien, Seneschal, Anne, Solanilla, Estibaliz, Lazaro, Isabelle, Quéré, Marc-Antoine, Pistorius, Julien, Asselineau, Edouard, Lhomme, Patrick, Carpentier, Joël, Constans, Hôpital Saint-André [CHU de Bordeaux], Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Centre Hospitalier Universitaire Grenoble Alpes (CHU Grenoble Alpes), Service de dermatologie et allergologie [CHU Tenon], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Saint-Joseph, Assistance Publique-Hôpitaux de Paris, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Rangueil, CHU Toulouse [Toulouse], Epidémiologie des Maladies Chroniques en zone tropicale (EpiMaCT), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-OmégaHealth (ΩHealth), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Service de rhumatologie, hôpital Pellegrin, CHU Bordeaux [Bordeaux], Service de dermatologie Hôpital Saint-André Bordeaux, Hôpital Haut-Lévêque [CHU de Bordeaux], Hôpital Saint Eloi, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and Hôpital Hôtel-Dieu de Nantes - Centre Hospitalier Universitaire de Nantes (Hôpital Hôtel-Dieu de Nantes - CHU de Nantes)
Subjects: Male, Scleroderma, Systemic, Capillaroscopy, Microcirculation, Digital ulcer, Cell Biology, Biochemistry, Capillaries, Microscopic Angioscopy, Fingers, Cross-Sectional Studies, Nails, Skin Ulcer, Finger ischemia, Humans, Systemic sclerosis, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Prospective Studies, Cardiology and Cardiovascular Medicine, Ulcer
Abstract: International audience; Systemic sclerosis may be complicated by digital ulcers. Nailfold capillaroscopy on one finger might reflect an increased risk of digital ulcer (DU). In the present study we studied the correlations between a history of ulcer and capillary findings on the finger.Method: This study is part of Sclerocap, a multicenter study aiming at validating prospectively the prognostic value of Maricq's and Cutolo's capillaroscopic classifications during a three-year longitudinal follow-up. A history of past or present digital ulcer was recorded at inclusion and nailfold capillaroscopy was performed. Elementary findings as well as Cutolo and Maricq's classifications were assessed.Results: 387 patients were included in Sclerocap (327 females, 60 males) and 3096 fingers were examined by capillaroscopy at inclusion: 316 fingers (10%) belonging to 113 patients had a history of DU. Late Cutolo's stage was statistically correlated with a history of DU, both by univariate: OR 2.08 [1.09-3.96] and multivariate analysis: OR 1.97 [1.06-3.63]. Among the elemental abnormalities, only edema and decreased capillary density were correlated with a history of DU by multivariate analysis: respectively OR 1.92 [1.17-3.16] and 0.65 [0.49-0.85].Conclusion: This cross-sectional study in a large cohort of patients with systemic sclerosis shows a correlation between a history of digital ulcer and edema, a decrease in capillary density and the late stage in Cutolo's classification. The extent of capillary abnormalities on one finger is associated with a history of local digital ulcer. Capillaroscopy might be used to predict the risk of DU but these results need first to be confirmed by prospective studies.
Published: 2022
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6. Non-invasive diagnosis and follow-up of chronic infection with Hepatitis C Virus

Author: Stéphane Chevaliez, Sarah Shili-Masmoudi, Lucile Moga, Isaac Ruiz, Nathalie Ganne-Carrié, Albert Tran, M. Bourlière, Christophe Bureau, Victor de Lédinghen, Alain Luciani, Hôpital l'Archet, Centre Hospitalier Universitaire de Nice (CHU Nice), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Bordeaux Research In Translational Oncology [Bordeaux] (BaRITOn), Université de Bordeaux (UB)-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Henri Mondor, 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 Avicenne [AP-HP], Université Sorbonne Paris Nord, Hôpital Rangueil, CHU Toulouse [Toulouse], Hôpital Saint-Joseph [Marseille], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Malbec, Odile
Subjects: Liver Cirrhosis, HBsAg, medicine.medical_specialty, Hepatitis C virus, [SDV]Life Sciences [q-bio], Hepacivirus, medicine.disease_cause, Gastroenterology, Virus, Fibrosis, Internal medicine, medicine, Humans, Hepatology, business.industry, Liver Diseases, virus diseases, Hepatitis C, Chronic, medicine.disease, Hepatitis C, digestive system diseases, [SDV] Life Sciences [q-bio], Chronic infection, Liver, HBeAg, Hepatocellular carcinoma, Elasticity Imaging Techniques, Portal hypertension, Persistent Infection, business, Follow-Up Studies
Abstract: Diagnosis of chronic hepatitis B virus (HBV) infection, initial staging of infection and monitoring of treated and untreated patients are mainly based on clinical, biological and imaging criteria allowing a complete non-invasive management for the majority of patients. Along to the conventional virological tools, rapid diagnostic tests and blotting paper tests for HBV DNA are validated alternatives. After diagnosis, the initial work-up should include HIV, HCV and HDV serologies, HBeAg status, and HBsAg and HBV DNA quantification. Assessment of severity (inflammation and fibrosis) is based on ALT serum levels and non-invasive evaluation of liver fibrosis by elastography or blood tests, which must be interpreted cautiously using specific cut-offs and taking into account ALT levels. Taken together, these parameters allow disease classification and treatment decision. Decision of hepatocellular carcinoma screening by ultra-sound every six months may be difficult in non-cirrhotic patients and the use of risk-scores such as PAGE-B is encouraged. Chronic HBV infection often has a dynamic and often unpredictable profile and regular monitoring is mandatory. In untreated patients, regular (3-12 months) follow-up should include ALT and HBV DNA serum levels. Periodical HBsAg quantification and non-invasive evaluation of liver fibrosis may refine disease outcome and prognosis. In treated patients, checking efficacy is mainly based on HBV DNA negativity. In patients with advanced fibrosis, evolution of liver stiffness can be useful for portal hypertension evaluation, but its improvement should not be considered to stop hepatocellular carcinoma screening. Finally, new parameters (HBV RNA, HBcrAg) are promising but their use is still restricted for research.
Published: 2022
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7. Mitral Valve Infective Endocarditis after Trans-Catheter Aortic Valve Implantation

Author: Vassili Panagides, David del Val, Mohamed Abdel-Wahab, Norman Mangner, Eric Durand, Nikolaj Ihlemann, Marina Urena, Costanza Pellegrini, Francesco Giannini, Piotr Scislo, Zenon Huczek, Martin Landt, Vincent Auffret, Jan Malte Sinning, Asim N. Cheema, Luis Nombela-Franco, Chekrallah Chamandi, Francisco Campelo-Parada, Erika Munoz-Garcia, Howard C Herrmann, Luca Testa, Won-Keun Kim, Juan Carlos Castillo, Alberto Alperi, Didier Tchetche, Antonio L. Bartorelli, Samir Kapadia, Stefan Stortecky, Ignacio Amat-Santos, Harindra C. Wijeysundera, John Lisko, Enrique Gutiérrez-Ibanes, Vicenç Serra, Luisa Salido, Abdullah Alkhodair, Ugolino Livi, Tarun Chakravarty, Stamatios Lerakis, Victoria Vilalta, Ander Regueiro, Rafael Romaguera, Utz Kappert, Marco Barbanti, Jean-Bernard Masson, Frédéric Maes, Claudia Fiorina, Antonio Miceli, Susheel Kodali, Henrique B. Ribeiro, Jose Armando Mangione, Fabio Sandoli de Brito, Guglielmo Mario Actis Dato, Francesco Rosato, Maria-Cristina Ferreira, Valter Correia de Lima, Alexandre Siciliano Colafranceschi, Alexandre Abizaid, Marcos Antonio Marino, Vinicius Esteves, Julio Andrea, Roger R. Godinho, Fernando Alfonso, Helene Eltchaninoff, Lars Søndergaard, Dominique Himbert, Oliver Husser, Azeem Latib, Hervé Le Breton, Clement Servoz, Isaac Pascual, Saif Siddiqui, Paolo Olivares, Rosana Hernandez-Antolin, John G. Webb, Sandro Sponga, Raj Makkar, Annapoorna S. Kini, Marouane Boukhris, Philippe Gervais, Axel Linke, Lisa Crusius, David Holzhey, Josep Rodés-Cabau, Université Laval [Québec] (ULaval), Universität Leipzig [Leipzig], Technische Universität Dresden = Dresden University of Technology (TU Dresden), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Rigshospitalet [Copenhagen], Copenhagen University Hospital, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Deutsches Herzzentrum München (DHM), Ospedale San Raffaele, Medical University of Warsaw - Poland, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], 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), 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 Rangueil, CHU Toulouse [Toulouse], UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Département cardiovasculaire, Universität Leipzig, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: MESH: Endocarditis, Catheters, MESH: Humans, Endocarditis, MESH: Heart Valve Prosthesis, Aortic Valve Insufficiency, Aortic Valve Stenosis, MESH: Aortic Valve Insufficiency, MESH: Mitral Valve, Transcatheter Aortic Valve Replacement, Treatment Outcome, Risk Factors, MESH: Risk Factors, Aortic Valve, Heart Valve Prosthesis, Humans, Mitral Valve, [SDV.IB]Life Sciences [q-bio]/Bioengineering, MESH: Transcatheter Aortic Valve Replacement, MESH: Catheters, Cardiology and Cardiovascular Medicine, 610 Medicine & health, MESH: Aortic Valve, MESH: Aortic Valve Stenosis, MESH: Treatment Outcome
Abstract: Scarce data exist on mitral valve (MV) infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). This multicenter study included a total of 579 patients with a diagnosis of definite IE after TAVI from the IE after TAVI International Registry and aimed to evaluate the incidence, characteristics, management, and outcomes of MV-IE after TAVI. A total of 86 patients (14.9%) had MV-IE. These patients were compared with 284 patients (49.1%) with involvement of the transcatheter heart valve (THV) only. Two factors were found to be associated with MV-IE: the use of self-expanding valves (adjusted odds ratio 2.49, 95% confidence interval [CI] 1.23 to 5.07, p = 0.012), and the presence of an aortic regurgitation >= 2 at discharge (adjusted odds ratio 3.33; 95% CI 1.43 to 7.73, p < 0.01). There were no differences in IE timing and causative microorganisms between groups, but surgical management was significantly lower in patients with MV-IE (6.0%, vs 21.6% in patients with THV-IE, p = 0.001). All-cause mortality rates at 2-year follow-up were high and similar between patients with MV-IE (51.4%, 95% CI 39.8 to 64.1) and patients with THV-IE (51.5%, 95% CI 45.4 to 58.0) (log-rank p = 0.295). The factors independently associated with increased mortality risk in patients with MV-IE were the occurrence of heart failure (adjusted p < 0.001) and septic shock (adjusted p < 0.01) during the index hospitalization. One of 6 IE episodes after TAVI is localized on the MV. The implantation of a self-expanding THV and the presence of an aortic regurgitation >= 2 at discharge were associated with MV-IE. Patients with MV-IE were rarely operated on and had a poor prognosis at 2-year follow-up. (C) 2022 Elsevier Inc. All rights reserved.
Published: 2022
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8. Elafibranor improves diet-induced nonalcoholic steatohepatitis associated with heart failure with preserved ejection fraction in Golden Syrian hamsters

Author: Emmanuel Brousseau, Rémy Burcelin, Thierry Sulpice, Virgile Richard, Mélanie Bouchet, Thierry Leste-Lasserre, Audrey Chabrat, Natalia Breyner, Clément Costard, Mathieu Petitjean, Li Chen, Julie Maupoint, François Briand, Caroline Dubroca, Physiogenex, Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale (U1215 Inserm - UB), Université de Bordeaux (UB)-Institut François Magendie-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des Maladies Métaboliques et Casdiovasculaires (UPS/Inserm U1297 - I2MC), 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), Hôpital Rangueil, and CHU Toulouse [Toulouse]
Subjects: Liver Cirrhosis, Male, 0301 basic medicine, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Diastole, Hamster, 030209 endocrinology & metabolism, Heart failure, Fructose, Diet, High-Fat, digestive system, 03 medical and health sciences, Chalcones, 0302 clinical medicine, Endocrinology, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Non-alcoholic Fatty Liver Disease, Fibrosis, Internal medicine, medicine, Animals, PPAR alpha, PPAR delta, Nonalcoholic steatohepatitis, Ejection fraction, Mesocricetus, business.industry, Elafibranor, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, digestive system diseases, Disease Models, Animal, Cholesterol, 030104 developmental biology, Liver, Hepatocytes, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Diastolic dysfunction, Peroxisome proliferator-activated receptor alpha, Propionates, business, Heart failure with preserved ejection fraction
Abstract: International audience; Background: Cardiovascular disease is the leading cause of deaths in nonalcoholic steatohepatitis (NASH) patients. Mouse models, while widely used for drug development, do not fully replicate human NASH nor integrate the associated cardiac dysfunction, i.e. heart failure with preserved ejection fraction (HFpEF). To overcome these limitations, we established a nutritional hamster model developing both NASH and HFpEF. We then evaluated the effects of the dual peroxisome proliferator activated receptor alpha/delta agonist elafibranor developed for the treatment of NASH patients.Methods: Male Golden Syrian hamsters were fed for 10 to 20 weeks with a free choice diet, which presents hamsters with a choice between control chow diet with normal drinking water or a high fat/high cholesterol diet with 10% fructose enriched drinking water. Biochemistry, histology and echocardiography analysis were performed to characterize NASH and HFpEF. Once the model was validated, elafibranor was evaluated at 15 mg/kg/day orally QD for 5 weeks.Results: Hamsters fed a free choice diet for up to 20 weeks developed NASH, including hepatocyte ballooning (as confirmed with cytokeratin-18 immunostaining), bridging fibrosis, and a severe diastolic dysfunction with restrictive profile, but preserved ejection fraction. Elafibranor resolved NASH, with significant reduction in ballooning and fibrosis scores, and improved diastolic dysfunction with significant reduction in E/A and E/E' ratios.Conclusion: Our data demonstrate that the free choice diet induced NASH hamster model replicates the human phenotype and will be useful for validating novel drug candidates for the treatment of NASH and associated HfpEF.
Published: 2021
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9. Epidemiology of transthyretin amyloid cardiomyopathy (ATTR-CM) in France, a study based on the systeme national des donnees de sante (SNDS) the French nationwide claims database

Author: M. Slama, S. Fievez, Thibaud Damy, V. Algalarrondo, I. Durand-Zaleski, A. Granghaud, C. Rault, Philippe Charron, G. Bourel, B. De Neuville, F. Pelcot, M. Bartoli, J. Rudant, Olivier Lairez, H. Lilliu, 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), Département d'Information Médicale [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Rangueil, CHU Toulouse [Toulouse], Association Française Contre l’Amylose (AFCA), Unité de recherche clinique en économie de la santé [Paris] (URC Eco), Délégation de la Recherche Clinique et de l’Innovation [Paris] (DRCI), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Inbeeo, Pfizer, CHU Pontchaillou [Rennes], Datagnosis, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Pfizer France -SAS, DESSAIVRE, Louise, CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, 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, Université Toulouse III - Paul Sabatier (UT3), and Université Fédérale Toulouse Midi-Pyrénées
Subjects: medicine.medical_specialty, biology, business.industry, [SDV]Life Sciences [q-bio], [SDV] Life Sciences [q-bio], Transthyretin, Family medicine, Epidemiology, medicine, biology.protein, Claims database, Cardiology and Cardiovascular Medicine, business, Amyloid cardiomyopathy, ComputingMilieux_MISCELLANEOUS
Abstract: Transthyretin (TTR) Amyloid Cardiomyopathy (ATTR-CM) is a rare, progressively debilitating, fatal disease with poor prognosis caused by amyloid deposition of fibrils derived from the serum protein TTR in the extracellular matrix of the heart. As amyloid infiltration in the heart progresses, atrial and ventricular walls thicken and become restrictive, resulting in diastolic dysfunction and further progression leads to heart failure, usually with preserved ejection fraction. Systolic dysfunction occurs in the late stages of the disease. Cardiac symptoms and conduction abnormalities also become increasingly clinically apparent (e.g. fatigue, shortness of breath, syncope or arrhythmias) with progression over time. Epidemiology of ATTR-CM is poorly understood as there are few existing studies that estimate its frequency in the general population. We aimed to estimate the prevalence and the incidence of ATTR-CM in France between 2011 and 2017, to describe demographic characteristics of incident cases and to assess patient survival. We used data from the SNDS database, which collects all national health insurance and hospital discharge data. As there is no specific ICD-10 marker code for ATTR -CM used in the SNDS, ATTR-CM diagnosis required both an amyloidosis and a cardiovascular condition, not necessarily reported at the same visit. Diagnostic date was defined when the features from amyloidosis and cardiovascular conditions were selected as events. Patients with a probable AL form of the disease were excluded. To remain conservative, patients younger than 50 yo were also excluded. Between 2011 and 2017, 4,815 patients with incident ATTR-CM were identified. Incidence rate was multiplied by more than 3 times, from 0.5 / 100,000 person-year in 2011 to 1.8 / 100,000 person-year in 2017, reaching 1,225 new cases in 2017. Sex-ratio remained stable (2:1). Most of the 4,815 identified patients were older than 70 yo. In the group ATTR CM >70 y.o, there were 3 times more men than women. Median age at diagnosis was 84.0 for women and 82.0 for men. The range of 80–89 yo represents about 50% of diagnose rate in overall population. Median survival was 33.7 months overall with minor differences between gender. Survival probability was 0.69 a year after diagnosis, 0.58 two years after, 0.48 three years after, and 0.41 four years after. Using exponential modeling the life expectancy of this population would be about 4 years for the 20 next years. This study is, to our knowledge, the first estimate of ATTR-CM incidence rates based upon an analysis of a national claims database. Our findings are consistent with existing data concerning the frequency of amyloidosis, even though were only identified the ICD-10 coded diagnosed cases, leading to possible underestimation of the full prevalence of the disease in France. SNDS demonstrated to be a scientifically valid data base to follow-up the standard of care of ATTR-CM. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Pfizer France - SAS
Published: 2021

10. Reproducibility of reading echocardiographic parameters to assess severity of mitral regurgitation. Insights from a French multicentre study

Author: Coisne, Augustin, Aghezzaf, Samy, Edmé, Jean-Louis, Bernard, Anne, Ma, Iria, Bohbot, Yohann, Di Lena, Chloé, Nicol, Martin, Lavie Badie, Yoan, Eyharts, Damien, Seemann, Aurélien, Falaise, Claire, Ternacle, Julien, Nguyen, A, Montier, Geraldine, Hubert, Arnaud, Montaigne, David, Donal, Erwan, Dreyfus, Julien, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Impact de l'environnement chimique sur la santé humaine - ULR 4483 (IMPECS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires (RNMCD - U1011), 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), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Université de Tours (UT), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Centre cardiologique du Nord (CCN), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Nouvelle Clinique de Tours Saint Gatien-Alliance [Tours] (CTSGA), CHU Henri Mondor, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), All participants are members of the French Society of Cardiovascular Imaging., CCSD, Accord Elsevier, Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 (RNMCD), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de Rangueil, CHU Toulouse [Toulouse], Clinique Saint Gatien, 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), 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 Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 (RNMCD), CHU Henri Mondor [Créteil], Hôpital Rangueil, and Université de Tours
Subjects: [SDV.IB] Life Sciences [q-bio]/Bioengineering, Transthoracic echocardiography, education, Concordance, Insuffisance mitrale, Échocardiographie transthoracique, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Agreement, Mitral regurgitation
Abstract: International audience; Background - Poor reproducibility in assessment of mitral regurgitation (MR) has been reported. Aim - To investigate the robustness of echocardiographic MR assessment in 2019, based on improvements in technology and the skill of echocardiographists regarding MR quantification. Methods - Reproducibility in parameters of MR severity and global rating were tested using transthoracic echocardiography in 25 consecutive patients independently analysed by 16 junior and senior cardiologists specialized in echocardiography (400 analyses per parameter). Results - Overall interobserver agreement for mechanism definition, effective regurgitant orifice area (EROA) and regurgitant volume (RVol) was moderate, and was lower in secondary MR. Interobserver agreement was substantial for EROA [0.61, 95% confidence interval (CI) 0.45-0.75] and moderate for RVol with the PISA method (0.50, 95% CI 0.33-0.56) in senior physicians and was fair in junior physicians (0.33, 95% CI 0.19-0.51 and 0.36, 95% CI 0.36-0.43, respectively). Using a multiparametric approach, overall interobserver agreement for grading MR severity was fair (0.30), was slightly better in senior than in junior physicians (0.31 vs. 0.28, respectively) with substantial or almost perfect agreement more frequently observed in senior versus junior physicians (52% vs. 36%, respectively). Conclusion - Reproducible transthoracic echocardiography MR quantification remains challenging in 2019, despite the expected high skills of echocardiographers regarding MR at the time of dedicated percutaneous intervention. The multiparametric approach does not entirely alleviate the substantial dispersion in measurement of MR severity parameters, whereas reader experience seems to partially address the issue. Our study emphasizes the continuing need for multimodality imaging and education in the evaluation of MR among cardiologists.
Published: 2020
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11. Effects of a 6-month self-rehabilitation programme in addition to botulinum toxin injections and conventional physiotherapy on limitations of patients with spastic hemiparesis following stroke (ADJU-TOX): protocol study for a randomised controlled, investigator blinded study

Author: Isabelle Laffont, Nicolas Roche, Brigitte Perrouin-Verbe, Nicolas Bayle, Nabila-Yasmine Domingo-Saidji, Djamel Bensmail, Marie-Eve Isner, Patrick Dehail, Emmanuel Coudeyre, Dominic Pérennou, Jean-Christophe Daviet, Frédéric Pellas, Céline Bonnyaud, F. Muller, François Boyer, Jacques Ropers, Philippe Marque, Philippe Gallien, Pierre Decavel, Claire Aymard, Médecine Physique et de Réadaptation [Rennes] (Pôle Saint-Hélier), Laboratoire de Neurosciences Intégratives et Cliniques - UFC (UR 481) (NEURO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service Médecine physique et de réadaptation [CHU Toulouse], Pôle Neurosciences [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Physiologie et physiopathologie de la motricité chez l'homme, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR70-Institut National de la Santé et de la Recherche Médicale (INSERM), École nationale supérieure d'architecture de Nantes (ENSA Nantes), Service de Médecine Physique et de Réadaptation [CHU Limoges], CHU Limoges, Service de médecine gériatrique, CHU Bordeaux [Bordeaux]-Groupe Hospitalier Sud-Hôpital Xavier Arnozan, Service médecine physique et réadaptation neurologique, Hôpital Saint-Jacques, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Unité de Nutrition Humaine (UNH), Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Laboratoire de Psychologie et NeuroCognition (LPNC ), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Euromov (EuroMov), Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Agence Française de Sécurité Sanitaire des Produits de Santé (AFSSAPS), AFSSAPS, Plateforme nouvelles technologies, Hôpital Raymond Poincaré [AP-HP], Service de Pneumologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel Dieu, Service de médecine physique et réadaptation [Hôpital Rangueil - Toulouse], Laboratoire de Neurosciences Intégratives et Cliniques - UFC (EA 481) (NEURO), Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Imagerie cérébrale et handicaps neurologiques, Institut des sciences du cerveau de Toulouse. (ISCT), Université Toulouse - Jean Jaurès (UT2J)-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 National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-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 National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Nutrition Humaine - Clermont Auvergne (UNH), Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne (UCA), Laboratoire de Psychologie et NeuroCognition (LPNC), Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Hôpital Universitaire Raymond-Poincaré, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Hôtel Dieu, Hôpital de Rangueil, and CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]
Subjects: Male, 030506 rehabilitation, Botulinum Toxins, medicine.medical_treatment, 0302 clinical medicine, Clinical Protocols, Quality of life, Informed consent, Protocol, Stroke, Rehabilitation, Stroke Rehabilitation, General Medicine, Middle Aged, Combined Modality Therapy, Botulinum toxin, 3. Good health, Female, medicine.symptom, 0305 other medical science, medicine.drug, Adult, medicine.medical_specialty, Adolescent, education, Botulinum Toxin, Goal Attainment Scaling, Rehabilitation Medicine, Young Adult, 03 medical and health sciences, medicine, Humans, Spasticity, Spasticity Management, Physical Therapy Modalities, Aged, Self-rehabilitation, business.industry, medicine.disease, Self Care, Mood, Paraparesis, Spastic, Physical therapy, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: IntroductionHome-based self-rehabilitation programmes combined with botulinum toxin injections (BTIs) appear to be a relevant approach to increase the recommended intensive rehabilitation of patients with spasticity following a stroke. The literature highlights a lack of evidence of beneficial effects of this adjuvant therapy to reduce limitations of patients with stroke. The aim of this study is to assess the effects of a 6-month self-rehabilitation programme in adjunction to BTI, in comparison with BTI alone, to reduce limitations of patients with spasticity following a stroke.Methods and analysis220 chronic patients will participate to this multicentre, prospective, randomised, controlled, assessor blinded study. All patients will benefit from two successive BTI (3 months apart), and patients randomised in the self-rehabilitation group will perform in adjunction 6 months of self-rehabilitation at home. All patients continue their conventional physiotherapy. The main outcome is the primary treatment goal (PTG), which will be determined jointly by the patient and the medical doctor using Goal Attainment Scaling. Impairments and functions, quality of life, mood and fatigue will be assessed. Botulinum toxin will be injected into the relevant muscles according to the PTG. Patients in the self-rehab group will be taught the self-rehabilitation programme involving respectively 10 min of stretching, 10 min of strengthening and 10 min of task-oriented exercises, corresponding to their PTG. Compliance to the self-rehabilitation programme will be monitored.Ethics and disseminationPatients will sign written informed consent. Ethical approval was obtained from ethics committee. The results will be disseminated in a peer-reviewed journal and presented at international congresses. The results will also be disseminated to patients.Trial registration numberNCT02944929.
Published: 2018
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12. Cyclosporine before PCI in Patients with Acute Myocardial Infarction

Author: Marc Metge, Gérald Vanzetto, David Garcia-Dorado, Martine Gilard, Philippe Dubois, Fabrice Prunier, Frédéric Moulin, Thierry Unterseeh, Gilles Grollier, Marie-Claude Morice, Arnaud Sudre, Philippe Gabriel Steg, Pierre Coste, Nathan Mewton, Thien-Tri Cung, P. Staat, Fabien de Poli, Marc J. Claeys, Meier Elbaz, Inesse Boussaha, Hervé Le Breton, Jean-Luc Dubois-Randé, Cyrille Bergerot, Patrice Guerin, Pascal Motreff, Guillaume Cayla, Denis Angoulvant, Olivier Roth, Nicolas Delarche, Michel Ovize, Christophe Piot, Grégoire Rangé, Jean-François Aupetit, Magnus Hansson, Eric Bonnefoy-Cudraz, Yves Cottin, P Coussement, Paul Barragan, Thierry Beard, Loic Belle, Olivier Morel, Vincent Malquarti, Didier Blanchard, Christophe Tron, Geneviève Derumeaux, Patrice Colin, Bernard Jouve, Omar Ider, Jean-Noël Labèque, Jérôme Clerc, Eskil Elmér, Claire Jossan, Gilles Rioufol, Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Les Hôpitaux Universitaires de Strasbourg (HUS), Université de Montpellier (UM), Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon (HCL), Cellules Dendritiques, Immunomodulation et Greffes, Université de Tours (UT), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Department of Cardiology (Cardio - BORDEAUX), CHU Bordeaux [Bordeaux], Radiopharmaceutiques biocliniques, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Hémostase, bio-ingénierie et remodelage cardiovasculaires (LBPC), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut Galilée-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Cardiologie, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Laboratoire de Protection et Remodelage du Myocarde (PMRM), Université d'Angers (UA)-Université d'Angers (UA), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier de la région d'Annecy, Centre Hospitalier Privé Beauregard. (CHPB), Centre hopitalier Privé, Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Institut de Génomique Fonctionnelle (IGF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), 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), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle Cardiologie Interventionnelle / Coro-scanner / IRM Cardiaque, Clinique Saint Gatien, Hôpital Louis Pradel, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cardioprotection, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Cardiology, University Hospital of Rangueil, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Galilée, Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), 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 Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Hôpital Arnaud de Villeneuve, Université de Tours, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Hospices Civils de Lyon ( HCL ), Department of Cardiology ( Cardio - BORDEAUX ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de cardiologie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), Hémostase, bio-ingénierie et remodelage cardiovasculaires ( LBPC ), Université Paris Diderot - Paris 7 ( UPD7 ) -Université Paris 13 ( UP13 ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut Galilée, Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), CHU Angers-PRES Université Nantes Angers Le Mans ( UNAM ), Laboratoire de Protection et Remodelage du Myocarde ( PMRM ), Université d'Angers ( UA ) -Université d'Angers ( UA ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Centre Hospitalier Privé Beauregard. ( CHPB ), Optimisation des régulations physiologiques ( ORPHY (EA 4324) ), Université de Brest ( UBO ) -Institut Brestois du Numérique et des Mathématiques ( IBNM ), Université de Brest ( UBO ) -Université de Brest ( UBO ), Institut de Génomique Fonctionnelle ( IGF ), Centre National de la Recherche Scientifique ( CNRS ) -Université Montpellier 2 - Sciences et Techniques ( UM2 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), 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 ), 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 ), Cardiovasculaire, métabolisme, diabétologie et nutrition ( CarMeN ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hospices Civils de Lyon ( HCL ) -Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Institut National de la Recherche Agronomique ( INRA ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bourgogne (UB)-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Myocardial Infarction, Infarction, Heart failure, Kaplan-Meier Estimate, Injections, Cyclophilins, Electrocardiography, Double-Blind Method, General & Internal Medicine, Internal medicine, medicine, Humans, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, cardiovascular diseases, Myocardial infarction, Mortality, Enzyme Inhibitors, Ventricular remodeling, Stroke, Aged, Ventricular Remodeling, Unstable angina, business.industry, percutaneous coronary intervention, Percutaneous coronary intervention, 11 Medical And Health Sciences, General Medicine, Middle Aged, medicine.disease, Combined Modality Therapy, 3. Good health, Injections, Intravenous, Conventional PCI, Cyclosporine, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Human medicine, Intravenous, business
Abstract: International audience; BACKGROUND: Experimental and clinical evidence suggests that cyclosporine may attenuate reperfusion injury and reduce myocardial infarct size. We aimed to test whether cyclosporine would improve clinical outcomes and prevent adverse left ventricular remodeling. METHODS: In a multicenter, double-blind, randomized trial, we assigned 970 patients with an acute anterior ST-segment elevation myocardial infarction (STEMI) who were undergoing percutaneous coronary intervention (PCI) within 12 hours after symptom onset and who had complete occlusion of the culprit coronary artery to receive a bolus injection of cyclosporine (administered intravenously at a dose of 2.5 mg per kilogram of body weight) or matching placebo before coronary recanalization. The primary outcome was a composite of death from any cause, worsening of heart failure during the initial hospitalization, rehospitalization for heart failure, or adverse left ventricular remodeling at 1 year. Adverse left ventricular remodeling was defined as an increase of 15% or more in the left ventricular end-diastolic volume. RESULTS: A total of 395 patients in the cyclosporine group and 396 in the placebo group received the assigned study drug and had data that could be evaluated for the primary outcome at 1 year. The rate of the primary outcome was 59.0% in the cyclosporine group and 58.1% in the control group (odds ratio, 1.04; 95% confidence interval [CI], 0.78 to 1.39; P=0.77). Cyclosporine did not reduce the incidence of the separate clinical components of the primary outcome or other events, including recurrent infarction, unstable angina, and stroke. No significant difference in the safety profile was observed between the two treatment groups. CONCLUSIONS: In patients with anterior STEMI who had been referred for primary PCI, intravenous cyclosporine did not result in better clinical outcomes than those with placebo and did not prevent adverse left ventricular remodeling at 1 year. (Funded by the French Ministry of Health and NeuroVive Pharmaceutical; CIRCUS ClinicalTrials.gov number, NCT01502774; EudraCT number, 2009-013713-99.)
Published: 2015
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13. Acute Myocardial Infarction

Author: Puymirat , Etienne, Simon , Tabassome, Cayla , Guillaume, Cottin , Yves, Elbaz , Meyer, Coste , Pierre, Lemesle , Gilles, Motreff , Pascal, Popovic , Batric, Khalife , Khalife, Labèque , Jean, Perret , Thibaut, Le Ray , Christophe, Orion , Laurent, Jouve , Bernard, Blanchard , Didier, Peycher , Patrick, Silvain , Johanne, Steg , Philippe Gabriel, Goldstein , Patrick, Gueret , Pascal, Belle , Loic, Aissaoui , Nadia, Ferrières , Jean, Schiele , François, Danchin , Nicolas, 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), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Department of Cardiology, University Hospital of Rangueil, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre Hospitalier du Pays d'Aix, Pôle Cardiologie Interventionnelle / Coro-scanner / IRM Cardiaque, Clinique Saint Gatien, Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de cardiologie, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), SAMU 59 et Pôle de l'Urgence, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Cardiologie, Centre hospitalier de la région d'Annecy, 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), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de cardiologie [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)-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 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), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Pharmacology, URCEST, CHU Saint-Antoine [APHP], Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ), Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] ( PEC2 ), Université de Bourgogne ( UB ) -Université Bourgogne Franche-Comté ( UBFC ), Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Hôpital de Rangueil, Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), CHU Gabriel Montpied ( CHU ), Institut Pascal - Clermont Auvergne ( IP ), Sigma CLERMONT ( Sigma CLERMONT ) -Université Clermont Auvergne ( UCA ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Epidémiologie et anlyses en santé publique: risques, maladies chroniques et handicaps, Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Service de cardiologie [HEGP], Assistance publique - Hôpitaux de Paris (AP-HP)-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), Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Gabriel Montpied (CHU), Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), 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), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), 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), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), 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), 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), 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)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Hôpital Rangueil
Subjects: [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, cardiovascular diseases, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; BACKGROUND: ST-segment-elevation myocardial infarction (STEMI) and non-ST-segment-elevation myocardial infarction (NSTEMI) management has evolved considerably over the past 2 decades. Little information on mortality trends in the most recent years is available. We assessed trends in characteristics, treatments, and outcomes for acute myocardial infarction in France between 1995 and 2015.
Published: 2017
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14. The efficacy of transcutaneous electrical nerve stimulation on the improvement of walking distance in patients with peripheral arterial disease with intermittent claudication: study protocol for a randomised controlled trial: the TENS-PAD study

Author: Vincent Gremeaux, Marc Labrunee, Thibaut Guiraud, Jean-Michel Senard, Damien Garrigues, Mélanie Riédel, Florent Besnier, Institut des Maladies Métaboliques et Cardiovasculaires ( I2MC ), Université Paul Sabatier - Toulouse 3 ( UPS ) -Hôpital de Rangueil-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Réeducation Cardio-Vasculaire et Pulmonaire [Clinique de Saint-Orens], Clinique Saint-Orens, Service de Pharmacologie Clinique du CHU de Toulouse, Université Paul Sabatier - Toulouse 3 ( UPS ), Pôle Rééducation - Réadaptation (Médecine Physique et Réadaptation) (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Plateforme d’Investigation Technologique [Centre d’Investigation Clinique 1432 module Plurithématique - Dijon] ( PIT ), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre d'Investigation Clinique 1432 (Dijon) - Module Plurithématique : Périnatalité Cancérologie Handicap et Ophtalmologie ( CIC-P803 ), Université de Bourgogne ( UB ) -Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de réadaptation cardio-vasculaire (Centre Ylang Ylang de La Réunion), Centre Ylang Ylang, Service de médecine physique et réadaptation [Hôpital Rangueil - Toulouse], Hôpital de Rangueil, Ministry of Health, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pharmacologie Clinique, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Plateforme d’Investigation Technologique [Centre d’Investigation Clinique 1432 module Plurithématique - Dijon] (PIT), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre d'Investigation Clinique 1432 (Dijon) - Module Plurithématique : Périnatalité Cancérologie Handicap et Ophtalmologie (CIC-P803), Université de Bourgogne (UB)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction Générale de l'Organisation des Soins (DGOS)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction Générale de l'Organisation des Soins (DGOS)
Subjects: exercise pressor reflex, Male, Time Factors, medicine.medical_treatment, Medicine (miscellaneous), Walking, 030204 cardiovascular system & hematology, law.invention, Study Protocol, association task-force, 0302 clinical medicine, Clinical Protocols, Randomized controlled trial, Quality of life, law, Pharmacology (medical), Prospective Studies, Aged, 80 and over, Transcutaneous electrical nerve stimulation, 2. Zero hunger, lcsh:R5-920, Exercise Tolerance, Rehabilitation, american-college, VO2 max, Middle Aged, Combined Modality Therapy, Exercise Therapy, 3. Good health, Treatment Outcome, Research Design, Transcutaneous Electric Nerve Stimulation, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Female, France, medicine.symptom, lcsh:Medicine (General), management, Adult, skin, medicine.medical_specialty, Adolescent, cutaneous blood-flow, prevalence, Placebo, Peripheral Arterial Disease, Young Adult, 03 medical and health sciences, Double-Blind Method, medicine, Humans, Aged, practice guidelines, Physical activity, business.industry, Endothelial function, Recovery of Function, Intermittent Claudication, low-frequency, Intermittent claudication, [ SDV.NEU ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Physical therapy, business, Claudication, 030217 neurology & neurosurgery, healthy-subjects
Abstract: Background In patients with peripheral arterial disease (PAD), walking improvements are often limited by early pain onset due to vascular claudication. It would thus appear interesting to develop noninvasive therapeutic strategies, such as transcutaneous electrical nerve stimulation (TENS), to improve the participation of PAD patients in rehabilitation programmes, and thus improve their quality of life. Our team recently tested the efficacy of a single 45-min session of 10-Hz TENS prior to walking. TENS significantly delayed pain onset and increased the pain-free walking distance in patients with class-II PAD. We now seek to assess the efficacy of a chronic intervention that includes the daily use of TENS for 3 weeks (5 days a week) on walking distance in Leriche-Fontaine stage-II PAD patients. Methods/design This is a prospective, double-blind, multicentre, randomised, placebo-controlled trial. One hundred subjects with unilateral PAD (Leriche-Fontaine stage II) will be randomised into two groups (1:1). For the experimental group (TENS group): the treatment will consist of stimulation of the affected leg (at a biphasic frequency of 10 Hz, with a pulse width of 200 μs, maximal intensity below the motor threshold) for 45 min per day, in the morning before the exercise rehabilitation programme, for 3 weeks, 5 days per week. For the control group (SHAM group): the placebo stimulation will be delivered according to the same modalities as for the TENS group but with a voltage level automatically falling to zero after 10 s of stimulation. First outcome: walking distance without pain. Secondary outcomes: transcutaneous oxygen pressure (TcPO2) measured during a Strandness exercise test, peak oxygen uptake (VO2 peak), endothelial function (EndoPAT®), Ankle-brachial Pressure Index, Body Mass Index, lipid profile (LDL-C, HDL-C, triglycerides), fasting glycaemia, HbA1c level, and the WELCH questionnaire. Discussion TENS-PAD is the first randomised controlled trial that uses transcutaneous electrical therapy as an adjuvant technique to improve vascular function in the treatment of PAD. If the results are confirmed, this technique could be incorporated into the routine care in cardiovascular rehabilitation centers and used in the long term by patients to improve their walking capacity. Trial registration ClinicalTrials.gov, ID: NCT02678403. Registered on 9 February 2016. Sponsor: Toulouse University Hospital. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1997-1) contains supplementary material, which is available to authorized users.
Published: 2017
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15. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial

Author: Sandrine Andrieu, Sophie Guyonnet, Nicola Coley, Christelle Cantet, Marc Bonnefoy, Serge Bordes, Lawrence Bories, Marie-Noëlle Cufi, Thierry Dantoine, Jean-François Dartigues, Françoise Desclaux, Audrey Gabelle, Yannick Gasnier, Alain Pesce, Kristel Sudres, Jacques Touchon, Philippe Robert, Olivier Rouaud, Philippe Legrand, Pierre Payoux, Jean-Paul Caubere, Michael Weiner, Isabelle Carrié, Pierre-Jean Ousset, Bruno Vellas, Lauréane Brigitte, Catherine Faisant, Françoise Lala, Julien Delrieu, Hélène Villars, Emeline Combrouze, Carole Badufle, Audrey Zueras, Christophe Morin, Gabor Abellan Van Kan, Charlotte Dupuy, Yves Rolland, Céline Caillaud, Bertrand Fougère, Sherry Willis, Sylvie Belleville, Brigitte Gilbert, Francine Fontaine, Isabelle Marcet, Fleur Delva, Alexandra Foubert, Sandrine Cerda, Marie Noëlle-Cuffi, Corinne Costes, Patrick Manckoundia, Valérie Quipourt, Sophie Marilier, Evelyne Franon, Marie-Laure Pader, Marie-France Basset, Bruno Lapoujade, Valérie Faure, Michael Li, Yung Tong, Christine Malick-Loiseau, Evelyne Cazaban-Campistron, Colette Blatge, Cécile Laubarie-Mouret, Isabelle Saulnier, Jean-Pierre Clément, Marie-Agnès Picat, Laurence Bernard-Bourzeix, Stéphanie Willebois, Iléana Désormais, Noëlle Cardinaud, Pierre Livet, Pascale Rebaudet, Claire Gédéon, Catherine Burdet, Flavien Terracol, Stéphanie Roth, Sylvie Chaillou, Sandrine Louchart, Nicolas Lebrun, Nadège Barro-Belaygues, Karim Bennys, Aurélia Romano, Lynda Touati, Cécilia Marelli, Cécile Pays, Franck Le Duff, Claire Gervais, Sébastien Gonfrier, Danièle Begorre, Christian Carpuat, Khaled Khales, Jean-François Lefebvre, Samira Misbah El Idrissi, Pierre Skolil, Jean-Pierre Salles, Carole Dufouil, Stéphane Lehéricy, Marie Chupin, Jean-François Mangin, Ali Bouhayia, Michèle Allard, Frédéric Ricolfi, Dominique Dubois, Marie Paule, Bonceour Martel, François Cotton, Alain Bonafé, Stéphane Chanalet, Françoise Hugon, Fabrice Bonneville, Christophe Cognard, François Chollet, Thierry Voisin, Sophie Peiffer, Anne Hitzel, Michel Zanca, Jacques Monteil, Jacques Darcourt, Laurent Molinier, Hélène Derumeaux, Nadège Costa, Christian Vincent, Bertrand Perret, Claire Vinel, Pascale Olivier-Abbal, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, CHU Toulouse [Toulouse], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hopital de Tarbes, Service de Gériatrie (CHARLES FOIX - Gériatrie), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Hopital de castres, CHU Limoges, CHU Bordeaux [Bordeaux], Hopital Lavaur, Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital Princesse Grace [Monaco], Centre hospitalier de Montauban, Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Cognition Behaviour Technology (CobTek), Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Institut Claude Pompidou [Nice] (ICP - Nice)-Centre Hospitalier Universitaire de Nice (CHU Nice), Centre Mémoire Ressources et Recherche [Dijon] (CMRR Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Institut National de la Recherche Agronomique (INRA), Department of Nuclear Medicine, CHU de Toulouse (CHU), Centre de Recherche Pierre Fabre, University of California [San Francisco] (UCSF), University of California, Service d'Etudes du Comportement des Matériaux de Conditionnement (SECM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Interactions, transferts, ruptures artistiques et culturels - EA 6301 (InTRu), Université de Tours, École de sages-femmes Baudelocque (ESF Baudelocque), Université Paris Descartes - Paris 5 (UPD5), Gérontopôle, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Genetique medicale, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine gériatrique (CHU de Dijon - Centre gériatrique de Champmaillot - EHPAD), Cabinet médical [Dijon], Cabinet médical, Handicap, Activité, Vieillissement, Autonomie, Environnement (HAVAE), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Sciences et Société, Historicité, Éducation et Pratiques (EA S2HEP), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre de Mémoire de Ressources et de Recherches [Limoges] (CMRR Limoges), CHU Limoges-CH Esquirol [Limoges] (CH Esquirol), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], Centre d'EPistémologie et d'ERgologie Comparatives - UMR 7304 (CEPERC), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Centre de droit privé fondamental (CDPF), Université de Strasbourg (UNISTRA)-L'europe en mutation : histoire, droit, économie et identités culturelles, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Neurologie, Université Montpellier 1 (UM1)-Hôpital Guy de Chauliac-Centre Mémoire Ressources Recherche Languedoc - Roussillon, Laboratoire d'Informatique Médicale (LIM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), The Smithsonian Museum Conservation Institute, Chercheur indépendant, Centre Léon Bérard [Lyon], Neuroépidémiologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [APHP], Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Service de neuroradiologie, imagerie des urgences [CHU de Dijon], Urgence et post-urgence psychiatrique, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Pasteur [Nice] (CHU), Imagerie cérébrale et handicaps neurologiques, Institut des sciences du cerveau de Toulouse. (ISCT), Université Toulouse - Jean Jaurès (UT2J)-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 National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-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 National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), 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 Diderot - Paris 7 (UPD7), Service de Médecine Nucléaire [Toulouse], CHU Toulouse [Toulouse]-Hôpital Rangueil, Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Transporteurs en Imagerie et Radiothérapie en Oncologie (TIRO - UMR E4320), Service Hospitalier Frédéric Joliot (SHFJ), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-UMR E4320 (TIRO-MATOs), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA), Service de l'Information Médicale, CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Centre de Physiopathologie Toulouse Purpan ex IFR 30 et IFR 150 (CPTP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université de Toulouse (UT), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Charles Foix [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Centre hospitalier de Montauban (CH Montauban), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), 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)-Centre Hospitalier Universitaire de Nice (CHU Nice)-Institut Claude Pompidou [Nice] (ICP - Nice)-Université Côte d'Azur (UCA), Service de Médecine Nucléaire - Rangueil [CHU Toulouse], Pôle imagerie médicale [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre de Recherche Pierre Fabre (Centre de R&D Pierre Fabre), PIERRE FABRE, University of California [San Francisco] (UC San Francisco), University of California (UC), Université de Tours (UT), Université Paris Descartes - École de sages-femmes Baudelocque (UPD ESF Baudelocque), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Centre d'EPistémologie et d'ERgologie Comparatives (CEPERC), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Montpellier 1 (UM1)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Mémoire Ressources Recherche Languedoc - Roussillon, Université de Rennes (UR), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Institut des Neurosciences de Montpellier (INM), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Nucléaire - Pierre-Paul Riquet [CHU Toulouse], Hôpital Gui de Chauliac [CHU Montpellier], Transporteurs et Imagerie, Radiothérapie en Oncologie et Mécanismes biologiques des Altérations du Tissu Osseux (TIRO-MATOs - UMR E4320), Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-UMR E4320 (TIRO-MATOs), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Côte d'Azur (UCA)-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)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Côte d'Azur (UCA), Département d'Information Médicale [CHU Toulouse], Pôle Santé publique et médecine publique [CHU Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), French Ministry of Health, Pierre Fabre Research Institute, Gerontopole, Exhonit Therapeutics, Avid Radiopharmaceuticals, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute [Basel], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Gérontopôle, Department of Geriatrics, Centre Hospitalier Universitaire de Toulouse, Geriatrics Department, Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), hopital de Foix, U897, Memory Research Resource Center for Alzheimer's Disease, Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Centre Hospitalier Princesse Grace, Hopital Montauban, Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Centre Hospitalier Universitaire de Nice (CHU Nice)-Institut Claude Pompidou [Nice] (ICP - Nice), Memory Research Resource Center, Neurology Department, Laboratoire de Biochimie et Nutrition Humaine, AGROCAMPUS OUEST, Department of Nuclear Medicine, National Institute of Neurosurgery, Toulouse NeuroImaging Centre, Centre Hospitalier Universitaire de Purpan (CHU Purpan), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Toulouse [Toulouse], Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-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), UMR E4320 (TIRO-MATOs), Université Côte d'Azur (UCA)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Côte d'Azur (UCA)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Service Hospitalier Frédéric Joliot (SHFJ), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), and Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)
Subjects: Male, [SDV]Life Sciences [q-bio], Placebo-controlled study, Neuropsychological Tests, decline, law.invention, 0302 clinical medicine, Cognition, Randomized controlled trial, prevention, law, Medicine, 030212 general & internal medicine, Cognitive decline, alzheimers-disease, risk, chemistry.chemical_classification, Aged, 80 and over, education.field_of_study, Eicosapentaenoic acid, 3. Good health, Exercise Therapy, Treatment Outcome, Female, performance, Polyunsaturated fatty acid, medicine.medical_specialty, brain, Population, Placebo, 03 medical and health sciences, Double-Blind Method, Fatty Acids, Omega-3, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, education, plasma, Aged, clinical-trials, Memory Disorders, Cognitive Behavioral Therapy, business.industry, Clinical trial, chemistry, Dietary Supplements, Physical therapy, Neurology (clinical), business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, gait speed, 030217 neurology & neurosurgery, dementia
Abstract: Summary Background No large trials have been done to investigate the efficacy of an intervention combining a specific compound and several lifestyle interventions compared with placebo for the prevention of cognitive decline. We tested the effect of omega 3 polyunsaturated fatty acid supplementation and a multidomain intervention (physical activity, cognitive training, and nutritional advice), alone or in combination, compared with placebo, on cognitive decline. Methods The Multidomain Alzheimer Preventive Trial was a 3-year, multicentre, randomised, placebo-controlled superiority trial with four parallel groups at 13 memory centres in France and Monaco. Participants were non-demented, aged 70 years or older, and community-dwelling, and had either relayed a spontaneous memory complaint to their physician, limitations in one instrumental activity of daily living, or slow gait speed. They were randomly assigned (1:1:1:1) to either the multidomain intervention (43 group sessions integrating cognitive training, physical activity, and nutrition, and three preventive consultations) plus omega 3 polyunsaturated fatty acids (ie, two capsules a day providing a total daily dose of 800 mg docosahexaenoic acid and 225 mg eicosapentaenoic acid), the multidomain intervention plus placebo, omega 3 polyunsaturated fatty acids alone, or placebo alone. A computer-generated randomisation procedure was used to stratify patients by centre. All participants and study staff were blinded to polyunsaturated fatty acid or placebo assignment, but were unblinded to the multidomain intervention component. Assessment of cognitive outcomes was done by independent neuropsychologists blinded to group assignment. The primary outcome was change from baseline to 36 months on a composite Z score combining four cognitive tests (free and total recall of the Free and Cued Selective Reminding test, ten Mini-Mental State Examination orientation items, Digit Symbol Substitution Test, and Category Naming Test) in the modified intention-to-treat population. The trial was registered with ClinicalTrials.gov (NCT00672685). Findings 1680 participants were enrolled and randomly allocated between May 30, 2008, and Feb 24, 2011. In the modified intention-to-treat population (n=1525), there were no significant differences in 3-year cognitive decline between any of the three intervention groups and the placebo group. Between-group differences compared with placebo were 0·093 (95% CI 0·001 to 0·184; adjusted p=0·142) for the combined intervention group, 0·079 (−0·012 to 0·170; 0·179) for the multidomain intervention plus placebo group, and 0·011 (−0·081 to 0·103; 0·812) for the omega 3 polyunsaturated fatty acids group. 146 (36%) participants in the multidomain plus polyunsaturated fatty acids group, 142 (34%) in the multidomain plus placebo group, 134 (33%) in the polyunsaturated fatty acids group, and 133 (32%) in the placebo group had at least one serious emerging adverse event. Four treatment-related deaths were recorded (two in the multidomain plus placebo group and two in the placebo group). The interventions did not raise any safety concerns and there were no differences between groups in serious or other adverse events. Interpretation The multidomain intervention and polyunsaturated fatty acids, either alone or in combination, had no significant effects on cognitive decline over 3 years in elderly people with memory complaints. An effective multidomain intervention strategy to prevent or delay cognitive impairment and the target population remain to be determined, particularly in real-world settings. Funding French Ministry of Health, Pierre Fabre Research Institute, Gerontopole, Exhonit Therapeutics, Avid Radiopharmaceuticals.
Published: 2017
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16. Clinical outcomes 1 year after empiric 131I therapy for hyperthyroid disorders

Author: Vija Racaru, Lavinia, Fontan, Charlotte, Bauriaud-Mallet, Mathilde, Brillouet, Séverine, Caselles, Olivier, Zerdoud, Slimane, Bastié, Delphine, Vallot, Delphine, Caron, Philippe, Bardiès, Manuel, Courbon, Frédéric, Centre de Recherches en Cancérologie de Toulouse (CRCT), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Nucléaire [Toulouse], CHU Toulouse [Toulouse]-Hôpital Rangueil, Centre de Recherche en Cancérologie / Nantes - Angers (CRCNA), Centre hospitalier universitaire de Nantes (CHU Nantes)-Faculté de Médecine d'Angers-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Centre National de la Recherche Scientifique (CNRS)-Hôpital Laennec-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôtel-Dieu de Nantes, Departement /u563 : Oncogenèse, Signalisation et Innovation thérapeutique, Centre de Physiopathologie Toulouse Purpan ex IFR 30 et IFR 150 (CPTP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut Claudius Regaud, CHU Toulouse [Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut Claudius Regaud
Subjects: endocrine system, endocrine system diseases, MESH: France/epidemiology, Goiter Nodular, Graves Disease, Hyperthyroidism, Risk Factors, Radiotherapy Dosage, [SDV.CAN]Life Sciences [q-bio]/Cancer
Abstract: International audience; Radioiodine is a therapeutic option in Europe for Graves' disease (GD) and toxic multinodular goiter (MNG).PURPOSE:To compare empiric and calculated I activities using 2013 EANM recommendations. To look for predictive factors of therapeutic response to an empiric activity of I. To assess clinical situations favoring calculated treatment modalities.PATIENTS AND METHODS:Prospective monocentric study of clinical outcomes at 1 year follow-up in 86 patients with GD and MNG who received empiric I therapeutic activities (348-939 MBq). Differences between empiric and calculated activities were confronted to clinical outcomes. Physicians were not aware of the calculated activity at the time of prescription.RESULTS:One year after treatment, 9% (5/57) of GD patients and 7% (2/29) of MNG patients were still in a hyperthyroid state. Thyroid volume was reduced by 67% for GD and by 50% for MNG. In GD, empiric I activities were higher than calculated ones (564±131 vs. 316±319 MBq, P26 ml for GD; >40 ml for MNG) was associated with persistent hyperthyroidism.CONCLUSION:Empirically administered I for GD and MNG was associated with very high efficacy in thyroid function control and no side effects. Thyroid volume reduction did not preclude treatment efficacy. Activity calculation could be a useful method for treating patients with GD and thyroid volumes higher than 26 ml or patients with MNG and thyroid volumes higher than 40 ml. A selective approach based on pretherapeutic thyroid volume and radioiodine biokinetics might improve treatment success.
Published: 2017
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17. Niveau d’activité physique et contrôle ambulatoire de l’hypertension artérielle. Résultats de l’étude pilote « Acti-HTA »

Author: Sosner, Philippe, Ott, Julien, Steichen, O., Bally, Stéphane, Krummel, Thierry, Brucker, M., Lequeux, Benoît, Dourmap, Caroline, Llaty, P., LE COZ, Sylvie, Baguet, S., Miranne, A., Labrunée, M., Grémeaux, Vincent, Lopez-Sublet, M., Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) ( MOVE ), Université de Poitiers, Service de néphrologie [Centre hospitalier de Haguenau], Centre hospitalier de Haguenau, Service de Médecine Interne [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Service de néphrologie - dialyse [Centre hospitalier Métropole Savoie - Chambéry], Centre Hospitalier Métropole Savoie [Chambéry], Service de néphrologie et hémodialyse [CHU de Strasbourg], CHU Strasbourg, Service de néphrologie [Centre hospitalier de Valence], Centre hospitalier de Valence, Service de cardiologie [CHU de Poitiers], CHU de Poitiers, Service de cardiologie et maladies vasculaires [CHU de Rennes], CHU Pontchaillou [Rennes], Service de néphrologie - dialyse [Centre hospitalier de Saint-Nazaire], Centre hospitalier de Saint-Nazaire, groupe hospitalier Mutualiste, Faculté de Médecine et de Pharmacie - Université de Poitiers, Service de médecine physique et réadaptation [Hôpital Rangueil - Toulouse], Hôpital de Rangueil, Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de médecine interne [Avicenne], Hôpital Avicenne, Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) (MOVE), 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 hospitalier universitaire de Poitiers (CHU Poitiers), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Groupe Hospitalier Mutualiste [Grenoble] (GHM), Université de Poitiers - Faculté de Médecine et de Pharmacie, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Avicenne [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Activité physique, Caloric expenditure, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, High blood pressure, Physical activity, Hypertension, Home blood pressure measurement, Dépense énergétique, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Hypertension artérielle, Automesure tensionnelle
Abstract: Retour sur les 34èmes Journées de l’Hypertension Artérielle; International audience; While physical activity (PA) is recommended for high blood pressure management, the level of PA practice of hypertensive patients remains unclear. We aimed to assess the association between the level of both PA and blood pressure of individuals consulting in 9 hypertension specialist centres. Eighty-five hypertensive patients were included (59 ± 14 years, 61% men, 12% smokers, 29% with diabetes). Following their consultation, they performed home blood pressure measurement (HBPM) over 7 days (2 in the morning+2 in the evening), they wrote in a dedicated form their daily activities to estimate the additional caloric expenditure using Acti-MET device (built from International physical Activity Questionnaire [IPAQ]). Thus, patients completed a self-administered questionnaire "score of Dijon" (distinguishing active subjects with a score>20/30, from sedentary 20/30, des sédentaires < 10/30). Les hypertendus contrôlés en AMT (< 135/85 mm Hg) (55 % des sujets), en comparaison aux non contrôlés, étaient plus âgés, avaient une tendance non significative à une dépense calorique déclarée plus élevée (4959 ± 5045 kcal/semaine vs 4048 ± 4199 kcal/semaine, p = 0,3755) et leur score de Dijon (19,44 ± 5,81 vs 18,00 ± 4,32, p = 0,2094) montrait une proportion de sujets « actifs » plus importante (48,9 % vs 34,2 %, p = 0,1773). En conclusion, nos résultats ont objectivé une « tendance » à une AP déclarée plus importante pour les sujets dont l’HTA est contrôlée. Ceci nous encourage à poursuivre par une étude qui inclurait davantage de sujets et dont l’AP serait évaluée par le port pendant 7 jours d’un capteur de type accéléromètre (méthode objective).
Published: 2015
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18. Whole-Body Strength Training Using a Huber Motion Lab in Coronary Heart Disease Patients

Author: Guiraud, Thibaut, Labrunée, Marc, Pillard, Fabien, Granger, Richard, Bousquet, Marc, Richard, Lisa, Boned, Anne, Pathak, Atul, Gayda, Mathieu, Grémeaux, Vincent, Centre de Rééducation Cardiovasculaire et Pulmonaire [Clinique Saint Orens - Toulouse), Clinique Saint-Orens, Institut des Maladies Métaboliques et Cardiovasculaires ( I2MC ), Université Paul Sabatier - Toulouse 3 ( UPS ) -Hôpital de Rangueil-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de médecine physique et réadaptation [Hôpital Rangueil - Toulouse], Hôpital de Rangueil, Service de Pharmacologie Clinique du CHU de Toulouse, Université Paul Sabatier - Toulouse 3 ( UPS ), Centre EPIC [Institut de Cardiologie de Montréal], Université de Montréal [Montréal]-Montreal Heart Institute - Institut de Cardiologie de Montréal, Plateforme d’Investigation Technologique [Centre d’Investigation Clinique 1432 module Plurithématique - Dijon] ( PIT ), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre d'Investigation Clinique 1432 (Dijon) - Module Plurithématique : Périnatalité Cancérologie Handicap et Ophtalmologie ( CIC-P803 ), Université de Bourgogne ( UB ) -Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Pôle Rééducation - Réadaptation (Médecine Physique et Réadaptation) (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), LPG Systems, Valence, France, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), 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), CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service de Pharmacologie Clinique, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Hôpital Purpan [Toulouse], Université de Montréal (UdeM)-Montreal Heart Institute - Institut de Cardiologie de Montréal, Plateforme d’Investigation Technologique [Centre d’Investigation Clinique 1432 module Plurithématique - Dijon] (PIT), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre d'Investigation Clinique 1432 (Dijon) - Module Plurithématique : Périnatalité Cancérologie Handicap et Ophtalmologie (CIC-P803), Université de Bourgogne (UB)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)
Subjects: endurance, cardiovascular prevention, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, myocardial-infarction, failure, intermittent exercise, resistance exercise, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, lipid oxidation, Physiologic Responses, Oxygen Uptake, Substrate Oxidation, Coronary Heart Disease, skeletal-muscle, cardiac-rehabilitation, secondary prevention
Abstract: International audience; Objective: The aim of this study was to investigate safety, tolerance, relative exercise intensity, and muscle substrate oxidation during sessions performed on a Huber Motion Lab in coronary heart disease patients.Design: After an assessment of (V) over dotO(2) peak, 20 coronary heart disease patients participated in two different exercises performed in random order at 40% and 70% (W40 and W70) of the maximal isometric voluntary contraction.Results: No significant arrhythmia or abnormal blood pressure responses occurred during either session, and no muscle soreness was reported within 48 hrs posttest. The authors found a difference between W40 and W70 sessions for mean (standard deviation) ventilation (25.1% [8%] and 32.1% [9%] of maximal ventilation, respectively; P = 0.04) and a small difference for mean (standard deviation) heart rate (73 [7] and 79 [8] beats/min, respectively; P < 0.01). When compared with the W40, the W70 was associated with higher active energy expenditure (2.4 [0.6] and 3.1 [0.9] Kcal/min, respectively; P < 0.0001) and a similar mean (standard deviation) oxygen uptake (5.5 [1] and 6.6 [1] ml/min per kilogram, respectively; P = 0.07). The qualitative percentages of carbohydrates and lipids oxidized were 71% and 29%, respectively, at W40 and 91% and 9%, respectively, at W70.Conclusions: Both protocols, which consisted of repeating 6-sec phases of contractions with 10 secs of passive recovery on the Huber Motion Lab, seemed to be well tolerated, safe, and feasible in this group of coronary heart disease patients.
Published: 2015
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19. Physical activity level and home blood pressure measurement: Pilot study 'Acti-HTA'

Author: S. Bally, M. Lopez-Sublet, Olivier Steichen, Vincent Gremeaux, Philippe Sosner, P. Llaty, M. Brucker, S. Le Coz, Benoit Lequeux, A. Miranne, C. Dourmap, Club des jeunes hypertensiologues, Thierry Krummel, J. Ott, S. Baguet, M. Labrunee, université de Bourgogne, CAPS, Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) (MOVE), Université de Poitiers, Service de néphrologie [Centre hospitalier de Haguenau], Centre hospitalier de Haguenau, Service de Médecine Interne = Hôpital de jour de médecine [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), Service de néphrologie - dialyse [Centre hospitalier Métropole Savoie - Chambéry], Centre Hospitalier Métropole Savoie [Chambéry], Service de néphrologie et hémodialyse [CHU de Strasbourg], CHU Strasbourg, Service de néphrologie [Centre hospitalier de Valence], Centre hospitalier de Valence, Service de cardiologie [CHU de Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de néphrologie - dialyse [Centre hospitalier de Saint-Nazaire], Centre hospitalier de Saint-Nazaire, Groupe Hospitalier Mutualiste [Grenoble] (GHM), Université de Poitiers - Faculté de Médecine et de Pharmacie, Service Médecine physique et de réadaptation [CHU Toulouse], Pôle Neurosciences [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine interne [Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) ( MOVE ), Service de Médecine Interne [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], CHU de Poitiers, Service de cardiologie et maladies vasculaires [CHU de Rennes], groupe hospitalier Mutualiste, Faculté de Médecine et de Pharmacie - Université de Poitiers, Service de médecine physique et réadaptation [Hôpital Rangueil - Toulouse], Hôpital de Rangueil, Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Avicenne, 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), and CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]
Subjects: medicine.medical_specialty, Evening, Physical activity, Dépense énergétique, Hypertension artérielle, Caloric expenditure, High blood pressure, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Diabetes mellitus, Medicine, Motor activity, Morning, Automesure tensionnelle, Gynecology, Blood pressure management, business.industry, Home blood pressure measurement, Objective method, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Activité physique, Blood pressure, Hypertension, Physical therapy, Cardiology and Cardiovascular Medicine, business
Abstract: While physical activity (PA) is recommended for high blood pressure management, the level of PA practice of hypertensive patients remains unclear. We aimed to assess the association between the level of both PA and blood pressure of individuals consulting in 9 hypertension specialist centres. Eighty-five hypertensive patients were included (59 ± 14 years, 61% men, 12% smokers, 29% with diabetes). Following their consultation, they performed home blood pressure measurement (HBPM) over 7 days (2 in the morning+2 in the evening), they wrote in a dedicated form their daily activities to estimate the additional caloric expenditure using Acti-MET device (built from International physical Activity Questionnaire [IPAQ]). Thus, patients completed a self-administered questionnaire "score of Dijon" (distinguishing active subjects with a score>20/30, from sedentary, Alors que la pratique régulière d’une activité physique (AP) est recommandée en cas d’hypertension artérielle (HTA), le niveau d’AP des sujets hypertendus reste mal connu. Notre objectif était d’étudier l’association entre le niveau d’AP et le caractère contrôlé ou non de l’HTA de sujets vus en consultation dans 9 centres spécialisés en HTA. Quatre-vingt-cinq sujets hypertendus ont été inclus (59 ± 14 ans, 61 % d’hommes, 12 % fumeurs, 29 % diabétiques). Au décours de leur consultation, une automesure tensionnelle (AMT) sur 7 jours (2 mesures le matin + 2 le soir) était réalisée, ainsi qu’un compte rendu de leurs activités quotidiennes permettant d’estimer la dépense calorique additionnelle à l’aide d’une réglette Acti-MET extrapolée du questionnaire international d’activités physiques (IPAQ). Les sujets complétaient ensuite un auto-questionnaire « score de Dijon » sur 30 points (distinguant les sujets actifs, score > 20/30, des sédentaires < 10/30). Les hypertendus contrôlés en AMT (< 135/85 mm Hg) (55 % des sujets), en comparaison aux non contrôlés, étaient plus âgés, avaient une tendance non significative à une dépense calorique déclarée plus élevée (4959 ± 5045 kcal/semaine vs 4048 ± 4199 kcal/semaine, p = 0,3755) et leur score de Dijon (19,44 ± 5,81 vs 18,00 ± 4,32, p = 0,2094) montrait une proportion de sujets « actifs » plus importante (48,9 % vs 34,2 %, p = 0,1773). En conclusion, nos résultats ont objectivé une « tendance » à une AP déclarée plus importante pour les sujets dont l’HTA est contrôlée. Ceci nous encourage à poursuivre par une étude qui inclurait davantage de sujets et dont l’AP serait évaluée par le port pendant 7 jours d’un capteur de type accéléromètre (méthode objective).
Published: 2015
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20. Radiolabeling of [18F]-fluoroethylnormemantine and initial in vivo evaluation of this innovative PET tracer for imaging the PCP sites of NMDA receptors

Author: Charlotte Fontan, Mathieu Tafani, Carine Pestourie, Djilali Adel, A.S. Salabert, Pierre Payoux, Mathieu Alonso, Caroline Fonta, Hafid Belhadj-Tahar, Imagerie cérébrale et handicaps neurologiques (ICHN), Institut des sciences du cerveau de Toulouse. (ISCT), Université Toulouse - Jean Jaurès (UT2J)-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 National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-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 National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Nucléaire [Toulouse], CHU Toulouse [Toulouse], Centre de recherche cerveau et cognition (CERCO), 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 National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherches en Cancérologie de Toulouse (CRCT), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Imagerie in vivo de l'expression des gènes, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie cérébrale et handicaps neurologiques, CHU Toulouse [Toulouse]-Hôpital Rangueil, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut des sciences du cerveau de Toulouse. (ISCT), 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 National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Nucléaire - Pierre-Paul Riquet [CHU Toulouse], Pôle imagerie médicale [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), and Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, Fluorine Radioisotopes, Cancer Research, Pathology, medicine.medical_specialty, Metabolic Clearance Rate, Phencyclidine, Pharmacology, Receptors, N-Methyl-D-Aspartate, Rats, Sprague-Dawley, 03 medical and health sciences, 0302 clinical medicine, Memantine, In vivo, medicine, Animals, Tissue Distribution, Radiology, Nuclear Medicine and imaging, 030304 developmental biology, 0303 health sciences, Chemistry, [SCCO.NEUR]Cognitive science/Neuroscience, Radiosynthesis, Brain, Colocalization, Rats, 3. Good health, Kinetics, Isotope Labeling, Positron-Emission Tomography, Autoradiography, Molecular Medicine, NMDA receptor, Radiopharmaceuticals, 030217 neurology & neurosurgery, Ex vivo, Immunostaining, medicine.drug
Abstract: The N-methyl-D-aspartate receptor (NMDAr) is an ionotropic receptor that mediates excitatory transmission. NMDAr overexcitation is thought to be involved in neurological and neuropsychiatric disorders such as Alzheimer disease and schizophrenia. We synthesized [(18)F]-fluoroethylnormemantine ([(18)F]-FNM), a memantine derivative that binds to phencyclidine (PCP) sites within the NMDA channel pore. These sites are primarily accessible when the channel is in the active and open state.Radiosynthesis was carried out using the Raytest® SynChrom RD fluorination module. Affinity of this new compound was determined by competition assay. We ran a kinetic study in rats and computed a time-activity curve based on a volume-of-interest analysis, using CARIMAS® software. We performed an ex vivo autoradiography, exposing frozen rat brain sections to a phosphorscreen. Adjacent sections were used to detect NMDAr by immunohistochemistry with an anti-NR1 antibody. As a control of the specificity of our compound for NMDAr, we used a rat anesthetized with ketamine. Correlation analysis was performed with ImageJ software between signal of autoradiography and immunostaining.Fluorination yield was 10.5% (end of synthesis), with a mean activity of 3145 MBq and a specific activity above 355 GBq/μmol. Affinity assessment allowed us to determine [(19)F]-FNM IC50 at 6.1 10(-6)M. [(18)F]-FMN concentration gradually increased in the brain, stabilizing at 40 minutes post injection. The brain-to-blood ratio was 6, and 0.4% of the injected dose was found in the brain. Combined ex vivo autoradiography and immunohistochemical staining demonstrated colocalization of NMDAr and [(18)F]-FNM (r=0.622, p0.0001). The highest intensity was found in the cortex and cerebellum, and the lowest in white matter. A low and homogeneous signal corresponding to unspecific binding was observed when PCP sites were blocked with ketamine.[(18)F]-FNM appears to be a promising tracer for imaging NMDAr activity for undertaking preclinical studies in perspective of clinical detection of neurological or neuropsychological disorders.
Published: 2015
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21. Genotoxicity and repair: the cytolethal distending toxin model

Author: Elisabeth Bezine, Yoann Fedor, Julien Vignard, Elisa Boutet-Robinet, Bernard Salles, Gladys Mirey, Génotoxicité & Signalisation (ToxAlim-GS), ToxAlim (ToxAlim), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Recherche Agronomique (INRA)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Recherche Agronomique (INRA), Contaminants & Stress Cellulaire (ToxAlim-COMICS), and Hôpital Rangueil. FRA.
Subjects: [SDV]Life Sciences [q-bio]
Abstract: National audience; The Cytolethal Distending Toxin (CDT) is a virulence factor produced by many pathogenic bacteria (Escherichia coli, Helicobacter hepaticus ...) colonizing the oral cavity, the gastrointestinal tract, the liver etc. The presence in the gut of genotoxin producing bacteria, such as E. coli, could be a predisposing factor for the development of cancer, including colon cancer responsible of 500 000 deaths per year in the world. CDT was discovered in clinical isolates from patients with diarrhea caused by an E. coli infection. CDT is essential for H. hepaticus and C. jejuni to sustainable colonize the gastrointestinal tract and induce severe mucosal and liver inflammation, in mouse models. In addition, the expression of CDT by H. hepaticus leads to dysplasic liver nodules. It is therefore important to characterize the CDT mechanism of action in eukaryotic cells. CDT induces DNA double-strand breaks (DSB), leading to cell cycle arrest, activation of DNA repair mechanisms and increased cell death by apoptosis. The induction of DSB by CDT activates a signal pathway similar to the one observed in response to irradiation. However, we have shown that at low doses of CDT (1000 times lower than those used in the literature), single-strand breaks are induced in S phase, leading to a replicative stress before DSB production. These damages cause the activation of a pathway involving RPA, ATR and CHK1 proteins, characteristic of a replicative stress, before activation of the ATM kinase. Our future goals are to characterize 1- the cell sensitivity, according to the cell cycle phases, 2- the type of damage, and 3- (the) DNA repair mechanism(s) involved in response of such damages.
Published: 2013

22. Optimizing ciprofloxacin dosing in intensive care unit patients through the use of population pharmacokinetic-pharmacodynamic analysis and Monte Carlo simulations

Author: Georges Houin, Jean-Marie Conil, Bernard Georges, Dalia Khachman, S. Saivin, Céline M. Laffont, Pierre-Louis Toutain, ToxAlim (ToxAlim), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Recherche Agronomique (INRA), Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Pole Anesthesie Reanimation, Hôpital Rangueil, Institut Fédératif de Recherche 150 - Bio-Médicale de Toulouse, Biostat, Université Fédérale Toulouse Midi-Pyrénées, Institut National de la Recherche Agronomique (INRA), Lab Pharmacocinet & Toxicol Clin, Inst Federatif Biol, Centre Hospitalier Universitaire de Purpan (CHU Purpan), Toxicologie Alimentaire (UTA), Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, khachman, Dalia, Conil, Jean-Marie, Georges, Bernard, Saivin, Sylvie, Houin, Georges, Laffont, Céline, Institut National de la Recherche Agronomique ( INRA ), Centre Hospitalier Universitaire de Purpan ( CHU Purpan ), Toxicologie Alimentaire ( UTA ), Institut National de la Recherche Agronomique ( INRA ) -Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Lab Biostat, INPT,UPS,EIP, Université Paul Sabatier - Toulouse 3 ( UPS ), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse III - Paul Sabatier (UT3)
Subjects: Acinetobacter baumannii, Male, Serum, Time Factors, [SDV]Life Sciences [q-bio], medicine.disease_cause, 030226 pharmacology & pharmacy, law.invention, 0302 clinical medicine, pharmacokinetic-pharmacodynamic target attainment rate, Ciprofloxacin, law, Pharmacology (medical), mutant selection window, Aged, 80 and over, 0303 health sciences, education.field_of_study, biology, Middle Aged, Intensive care unit, Anti-Bacterial Agents, 3. Good health, Intensive Care Units, Infectious Diseases, Pseudomonas aeruginosa, Female, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, intensive care unit patients, Adolescent, Critical Illness, Population, Microbial Sensitivity Tests, Young Adult, 03 medical and health sciences, Antibiotic resistance, Pharmacokinetics, Internal medicine, medicine, Humans, Intensive care medicine, education, Aged, Pharmacology, Models, Statistical, [ SDV ] Life Sciences [q-bio], 030306 microbiology, business.industry, biology.organism_classification, Pharmacodynamics, Gram-Negative Bacterial Infections, business
Abstract: Objectives: To explore different ciprofloxacin dosage regimens for the treatment of intensive care unit (ICU) patients with respect to clinical outcome and the development of bacterial resistance for the major Gramnegative pathogens. Methods: A population pharmacokinetic model was first developed on ciprofloxacin serum concentrations obtained in 102 ICU patients. Then, based on this model, pharmacokinetic–pharmacodynamic Monte Carlo simulations (MCSs) were carried out to explore the appropriateness of different ciprofloxacin dosage regimens in ICU patients. The defined targets were free AUC24/MIC ≥90 h (as a predictor of clinical outcome) and TMSW ≤20% (as a predictor of selecting resistance), where TMSW is the time spent within the mutant selection window over 24 h. Two simulation trials were conducted: Trial 1 took into account the whole MIC distribution for each causative pathogen in line with empirical antibiotherapy; Trial 2 used MIC breakpoints given by the Antibiogram Committee of the French Microbiology Society in order to treat the ‘worst-case’ scenario. Results: Trial 1 showed that for Pseudomonas aeruginosa and Acinetobacter baumannii, the common dosage regimens of 400 mg twice or three times a day did not achieve the desired target attainment rates (TARs) with respect to TMSW, while suboptimal TARs were found for AUC24/MIC. Trial 2 showed that ≤18% of patients reached the target of TMSW ≤20% for MIC breakpoints of 0.5 and 1 mg/L, regardless of the administered dose. Conclusions: Based on the mutant selection window concept, our simulations truly question the use of ciprofloxacin for the treatment of P. aeruginosa and A. baumannii infections in ICU patients due to the potential for developing resistance.
Published: 2011
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23. Prevention of progression to dementia in the elderly: Rationale and proposal for a health-promoting memory consultation (an IANA task force)

Author: J. P. Aquino, G. Abellan Van Kan, Bruno Dubois, P.J. Ousset, Yves Rolland, T. Hergueta, Sandrine Andrieu, Jacques Touchon, J. F. Dartigues, Bruno Vellas, Thierry Dantoine, Florence Portet, Claude Jeandel, Bernard Chamontin, Sophie Gillette-Guyonnet, Christophe Arbus, P. Ritz, B. Fraysse, Claudine Berr, F. Lala, C. Sanz, H. Hanaire, S. Lagleyre, Maria Soto, Philippe Robert, Serge Bismuth, J. P. Becq, Fati Nourhashemi, Hôpital La Grave-Casselardit [Toulouse], CHU Toulouse [Toulouse], Epidémiologie et Analyses en Santé Publique : risques, maladies chroniques et handicap (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'épidémiologie et santé publique, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Clinique de la Porte verte, Service de médecine générale, Pathologies du système nerveux : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), Médecine interne et hypertension artérielle, CHU Toulouse [Toulouse]-Hôpital Rangueil, Service de Médecine Gériatrique [CHU Limoges], CHU Limoges, Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR99-ISPED, Centre de neuropsychologie et du langage, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Purpan, Service de Diabétologie - Maladies Métaboliques - Nutrition, CHU Toulouse [Toulouse]-Hôpital de Rangueil, Centre de Prévention et de Traitement des Maladies liées au Vieillissement, Centre Antonin Balmès, Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Service de médecine interne B, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Centre Mémoire de Ressources et de Recherche [Nice] (CMRR Nice), Université Côte d'Azur (UCA)-Centre Hospitalier Universitaire de Nice (CHU Nice)-Université Nice Sophia Antipolis (... - 2019) (UNS), and COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)
Subjects: Male, Gerontology, medicine.medical_specialty, Aging, Health Services for the Aged, Population, Medicine (miscellaneous), Health Promotion, Ambulatory Care Facilities, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Memory, Risk Factors, Health care, medicine, Internal Medicine, Humans, Mass Screening, Dementia, 030212 general & internal medicine, Cognitive decline, education, Referral and Consultation, Mass screening, Aged, Aged, 80 and over, Geriatrics, Memory Disorders, education.field_of_study, Nutrition and Dietetics, business.industry, Public health, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, medicine.disease, 3. Good health, Neurology, Private practice, Disease Progression, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Public Health, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery
Abstract: International audience; Alzheimer's disease (AD) is the most frequent form of dementia and according to the most recent estimation it affects nearly 27 million people in the world. The onset of the disease is generally insidious. It is becoming increasingly evident that the underlying pathophysiological mechanisms are active long before the appearance of the clinical symptoms of the disease. In the current context, it is important to develop strategies to delay the onset of cognitive decline. Delaying the onset by 5 years would reduce the prevalence by half at term, and a delay of 10 years would reduce it by three-quarters. The effectiveness of currently suggested preventive approaches remains to be confirmed, but certain strategies could be applied straight away to at-risk subjects. We propose that a health-promoting memory consultation should be set up for elderly persons who have attended a specialized memory consultation and in whom the diagnosis of dementia and of AD in particular, has not been established by standardized tools. Through this consultation, they would be offered full multidimensional investigation of all aspects of their health status, follow-up could be organized, general practitioners in private practice could be made more conscious of this population and the elderly could be made more aware of the risk factors to which they are exposed. The development of an information policy for the elderly would meet a present need. In our reflection, we must take into account the question of how to give this preventive consultation its due place in the healthcare pathway of the elderly person in order to ensure coordinated follow-up with all the other health professionals involved. The principle of the health-promoting memory consultation is undergoing validation in a large French multicentre preventive trial in 1200 frail elderly persons aged 70 years followed for three years, the Multidomain Alzheimer Preventive Trial (MAPT).
Published: 2008
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24. KBA.62: a useful marker for primary and metastatic melanomas

Author: Sophie Le Guellec, Philippe Rochaix, Paul Carle, Pierre Payoux, Séverine Valmary-Degano, Talal Al Saati, François Launay, Laurence Lamant, Serge Boulinguez, Frédéric Lauwers, Pierre Brousset, Cécile Pages, Laboratoire d'Anatomie Pathologique [Purpan], CHU Toulouse [Toulouse], Institut Claudius Regaud, CRLCC Institut Claudius Regaud, Plateau technique d'Histopathologie Expérimentale, Institut Claude de Préval (ICP), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Service de dermatologie, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service de chirurgie plastique et maxillo-faciale, CHU Purpan, Toulouse, Service de Médecine Nucléaire [Toulouse], CHU Toulouse [Toulouse]-Hôpital Rangueil, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire d'anatomie pathologique [Besancon], Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz-Université de Franche-Comté ( UFC ), Institut de Physique Nucléaire d'Orsay ( IPNO ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de Physique Nucléaire et de Physique des Particules du CNRS ( IN2P3 ) -Centre National de la Recherche Scientifique ( CNRS ), Imagerie cérébrale et handicaps neurologiques, Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service d'anatomie pathologique et histologie-cytologie [Rangueil], Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Hôpital de Rangueil, Université Sciences et Technologies - Bordeaux 1, Centre de Recherche en Cancérologie de Toulouse ( CRCT ), and Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse]-Institut National de la Santé et de la Recherche Médicale ( INSERM )
Subjects: MESH: Neoplasm Proteins, Pathology, Skin Neoplasms, MESH : Immunohistochemistry, MESH: Lymphatic Metastasis, MESH : S100 Proteins, MESH: Antigens, Neoplasm, MESH: Lymph Nodes, MESH : Antigens, Neoplasm, Metastasis, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Antibodies, Monoclonal, 030207 dermatology & venereal diseases, 0302 clinical medicine, MESH : Tumor Markers, Biological, Lymph node, Melanoma, MESH : Lymph Nodes, Micrometastasis, S100 Proteins, Antibodies, Monoclonal, MESH : Lymphatic Metastasis, Immunohistochemistry, 3. Good health, Neoplasm Proteins, medicine.anatomical_structure, 030220 oncology & carcinogenesis, MESH : Antibodies, Monoclonal, Lymphatic Metastasis, Lymph, MESH : Sensitivity and Specificity, MESH: S100 Proteins, Melanoma-Specific Antigens, medicine.medical_specialty, MESH: Melanoma, Sentinel lymph node, MESH : Melanoma, [SDV.CAN]Life Sciences [q-bio]/Cancer, Sensitivity and Specificity, Pathology and Forensic Medicine, 03 medical and health sciences, MESH : Neoplasm Proteins, Antigens, Neoplasm, medicine, Biomarkers, Tumor, Humans, Desmoplastic melanoma, MESH: Humans, business.industry, MESH: Skin Neoplasms, MESH : Skin Neoplasms, MESH : Humans, MESH : Melanoma-Specific Antigens, MESH: Immunohistochemistry, medicine.disease, MESH: Sensitivity and Specificity, MESH: Melanoma-Specific Antigens, MESH: Tumor Markers, Biological, Lymph Nodes, business
Abstract: International audience; We previously described a novel antimelanoma antibody, designated KBA.62. However, review of the literature showed that only a few studies have reported on this antibody. We report our experience in the diagnosis of melanoma using KBA.62 and its value in both primary and metastatic conditions. In addition to conventional melanomas, we included desmoplastic and spindle cell melanomas, whose diagnosis can be challenging. We also focus on identification of malignant cells in sentinel lymph node biopsies using KBA.62, by comparison with anti-S-100 protein and HMB-45 antibodies, because discrepancies in sensitivity and specificity of melanoma markers have given rise to numerous studies aiming to determine the best panel for the evaluation of sentinel lymph node from patients with melanoma. Overall, KBA.62 was positive in 93% of primary and metastatic melanomas. Interestingly, the 12 cases of desmoplastic and spindle cell melanomas had strongly positive results. In addition, the results of our study performed on a series of 215 sentinel lymph nodes showed that the sensitivity of anti-S-100 protein and KBA.62 antibodies in detecting occult metastasis was similar. Moreover, KBA.62 identified 6 patients (3%) who had confirmed sentinel lymph node metastasis but were negative for HMB-45. The resolution was higher with KBA.62 than that observed with anti-S-100 protein antibody, as the nonmelanocytic positive cells for KBA.62 in lymph nodes were only represented by endothelial cells, which therefore constituted an intrinsic positive control. We conclude that KBA.62 antibody is a useful additional marker for melanoma, specifically in desmoplastic/spindle cell cases and in the context of micrometastasis in sentinel lymph node.
Published: 2008
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25. Whole-body strength training with Huber Motion Lab and traditional strength training in cardiac rehabilitation: A randomized controlled study

Author: Atul Pathak, Daniel Rivière, Fabien Pillard, Marc Labrunee, Mathieu Gayda, Thibaut Guiraud, Vincent Gremeaux, Frédéric Sanguignol, Davy Laroche, Jean-Michel Senard, Florent Besnier, L. Richard, Réeducation Cardio-Vasculaire et Pulmonaire [Clinique de Saint-Orens], Clinique Saint-Orens, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine physique et réadaptation [Hôpital Rangueil - Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service d'exploration de la fonction respiratoire et de médecine du sport, CHU Toulouse [Toulouse], Pôle Rééducation - Réadaptation (Médecine Physique et Réadaptation) (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinique de Bondigoux, Clinique Pasteur, Clinique Pasteur [Toulouse], Montreal Heart Institute - Institut de Cardiologie de Montréal, Centre EPIC [Institut de Cardiologie de Montréal], Université de Montréal (UdeM)-Montreal Heart Institute - Institut de Cardiologie de Montréal, Institut des Maladies Métaboliques et Cardiovasculaires ( I2MC ), Université Paul Sabatier - Toulouse 3 ( UPS ) -Hôpital de Rangueil-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Université de Montréal [Montréal]-Montreal Heart Institute - Institut de Cardiologie de Montréal
Subjects: Adult, Male, medicine.medical_specialty, Strength training, medicine.medical_treatment, Cardiac rehabilitation, Coronary Disease, Isometric exercise, 030204 cardiovascular system & hematology, Isometric contraction, law.invention, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Randomized controlled trial, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, law, Heart rate, Humans, Medicine, Orthopedics and Sports Medicine, Muscle Strength, Muscle, Skeletal, Exercise, Aged, Rehabilitation, business.industry, Resistance training, Resistance Training, 030229 sport sciences, Middle Aged, Anthropometry, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Chest Press, Physical therapy, Female, business
Abstract: International audience; BACKGROUND:Isometric strengthening has been rarely studied in patients with coronary heart disease (CHD), mainly because of possible potential side effects and lack of appropriate and reliable devices.OBJECTIVE:We aimed to compare 2 different modes of resistance training, an isometric mode with the Huber Motion Lab (HML) and traditional strength training (TST), in CHD patients undergoing a cardiac rehabilitation program.DESIGN:We randomly assigned 50 patients to HML or TST. Patients underwent complete blinded evaluation before and after the rehabilitation program, including testing for cardiopulmonary exercise, maximal isometric voluntary contraction, endothelial function and body composition.RESULTS:After 4 weeks of training (16 sessions), the groups did not differ in body composition, anthropometric characteristics, or endothelial function. With HML, peak power output (P=0.035), maximal heart rate (P
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26. Revised French guidelines for the diagnosis and management of migraine in adults and children

Author: Dominique Valade, Christian Lucas, Gilles Géraud, Anne Donnet, Michel Lanteri-Minet, Service d'Evaluation et de Traitement de la Douleur [Cimiez], Hôpital Cimiez [Nice] (CHU), Neuro-Dol (Neuro-Dol), Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Urgence Cephalees, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département Neurologie [CHU Toulouse], Pôle Neurosciences [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Neurologie et Pathologie Neurovasculaire, Hôpital Roger Salengro [Lille], Centre d’évaluation et de traitement de la douleur [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Neurologie, CHU Toulouse [Toulouse]-Hôpital Rangueil, and BMC, Ed.
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, Hormone Replacement Therapy, Migraine Disorders, medicine.medical_treatment, Pain medicine, Alternative medicine, Clinical Neurology, Context (language use), Disease, Chronic Migraine, medicine, Humans, Pain Management, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Child, Psychiatry, ComputingMilieux_MISCELLANEOUS, Aged, Analgesics, Cognitive Behavioral Therapy, business.industry, Methodology, General Medicine, Middle Aged, medicine.disease, 3. Good health, Cognitive behavioral therapy, Anesthesiology and Pain Medicine, Migraine, Practice Guidelines as Topic, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], France, Neurology (clinical), Headaches, medicine.symptom, business
Abstract: Background Sponsor These revised guidelines were prepared at the request of the Societe Francaise d'Etude des Migraines et des Cephalees (SFEMC; French Society for the Study of Migraine Headache). They are a revision of the professional guidance on the “Diagnosis and therapeutic management of migraine in adults and children: clinical and economic aspects” published by the ANAES in 2002 and revised in 2012. Scope of the guidlines. These guidelines concern the overall management of migraine, diagnostic and therapeutic strategies, economic aspects of the disease and its treatments, menstrual (catamenial) migraine, migraine in pregnancy, migraine and oral contraception, migraine and the menopause. Headaches other than migraine will not be discussed except in the context of differential diagnosis. Other subjects not discussed in these guidelines include diseases associated with migraine apart from psychiatric problems, risk factors, migraine and smoking, chronic migraine rare forms and complications of migraine.
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27. The D-HCM score, a new diagnostic tool for distinguishing hypertrophic cardiomyopathy from hypertensive cardiopathy.

Author: Domain G, Biscond M, Dognin N, Strube C, Mondoly P, Réant P, Sarrazin JF, Galinier M, Champagne J, Rollin A, Carrié D, Cochet H, Lairez O, Philippon F, Ferrières J, Maury P, and Steinberg C
Subjects: Humans, Female, Male, Retrospective Studies, Diagnosis, Differential, Middle Aged, Echocardiography, Follow-Up Studies, Aged, Cardiomyopathy, Hypertrophic diagnosis, Cardiomyopathy, Hypertrophic complications, Cardiomyopathy, Hypertrophic physiopathology, Electrocardiography, Hypertension diagnosis, Hypertension complications, Hypertension physiopathology
Abstract: Aim: The diagnosis of hypertrophic cardiomyopathy (HCM) with moderate hypertrophy is challenging. Hypertensive heart disease (HHD) is the most common differential diagnosis that mimics the LVH of HCM. The aim of this study was to compare the QRS duration in HCM and HHD to create a novel diagnostic tool to identify primary HCM., Methods and Results: We conducted an international retrospective multicentre study enrolling patients with true HCM and HHD. A total of 547 individuals with HCM and 139 with HHD were included. The median QRS duration was significantly shorter in HCM than in HHD (88 ms [80-94] vs. 98 ms [88-108]; P < 0.01). Multivariable logistic regression identified for the novel diagnostic HCM (D-HCM) score: absence of antihypertensive drugs (+2); family history of unexplained sudden death (+2); QRS duration [<95 ms] = +1; maximum wall thickness (mm) [≥17] = +1. A cumulative QRS-HCM score ≥2 supports the diagnostic certainty of true HCM with a sensitivity of 79%, specificity of 99%, negative predictive value (NPV) of 55%, and positive predictive value (PPV) of 99%., Conclusion: The QRS duration in patient with HCM is significantly shorter compared with patients with HHD-related LVH. QRS duration can be used as a diagnosis marker to distinguish between HCM and HHD. The D-HCM score is a novel, simple, and accurate diagnosis tool for HCM patients with mild to moderate phenotypes., (© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
Published: 2024
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28. Transcatheter Edge-to-Edge Repair for Severe Isolated Tricuspid Regurgitation: The Tri.Fr Randomized Clinical Trial.

Author: Donal E, Dreyfus J, Leurent G, Coisne A, Leroux PY, Ganivet A, Sportouch C, Lavie-Badie Y, Guerin P, Rouleau F, Diakov C, van der Heyden J, Lafitte S, Obadia JF, Nejjari M, Karam N, Bernard A, Neylon A, Pierrard R, Tchetche D, Ghostine S, Ducrocq G, Si Moussi T, Jeu A, Peltier M, Cosyns B, Le Dolley Y, Habib G, Auffret V, Le Ven F, Picard F, Piriou N, Laperche T, Galli E, Istratoaie S, Jouan J, Bonnet G, de Groote P, Anselmi A, Trochu JN, and Oger E
Abstract: Importance: Correction of tricuspid regurgitation using tricuspid transcatheter edge-to-edge repair (T-TEER) in addition to guideline-directed optimized medical therapy (OMT) may improve clinical outcomes., Objective: To evaluate the efficacy of T-TEER + OMT vs OMT alone in patients with severe, symptomatic tricuspid regurgitation., Design, Setting, and Participants: Investigator-initiated, prospective, randomized (1:1) trial evaluating T-TEER + OMT vs OMT alone in adult patients with severe, symptomatic tricuspid regurgitation. The trial was conducted at 24 centers in France and Belgium (March 2021 to March 2023; latest follow-up in April 2024)., Intervention: Patients were randomized to T-TEER + OMT or OMT alone., Main Outcomes and Measures: The primary outcome was a composite clinical end point at 1 year comprising change in New York Heart Association class, change in patient global assessment, or occurrence of major cardiovascular events. Tricuspid regurgitation severity was the first of 6 secondary outcomes analyzed in a hierarchical closed-testing procedure, including Kansas City Cardiomyopathy Questionnaire (KCCQ) score, patient global assessment, and a composite outcome of all-cause death, tricuspid valve surgery, KCCQ score improvement, or time to hospitalization for heart failure., Results: Of 300 enrolled patients (mean age, 78 [SD, 6] years, 63.7% women), 152 were allocated to T-TEER + OMT and 148 to OMT alone. At 1 year, 109 patients (74.1%) in the T-TEER + OMT group had an improved composite score compared with 58 patients (40.6%) in the OMT-alone group. Massive or torrential tricuspid regurgitation was found in 6.8% of patients in the T-TEER + OMT group and in 53.5% of those in the OMT-alone group (P < .001). Mean overall KCCQ summary score at 1 year was 69.9 (SD, 25.5) for the T-TEER + OMT group and 55.4 (SD, 28.8) for the OMT-alone group (P < .001). The win ratio for the composite secondary outcome was 2.06 (95% CI, 1.38-3.08) (P < .001)., Conclusions and Relevance: T-TEER reduces tricuspid regurgitation severity and improves a composite score driven by improved patient-reported outcome measures in patients with severe, symptomatic tricuspid regurgitation., Trial Registration: ClinicalTrials.gov Identifier: NCT04646811.
Published: 2024
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29. Management of conduction disease and arrhythmias in patients with cardiac amyloidosis: A position paper from the Working Group of Cardiac Pacing and Electrophysiology of the French Society of Cardiology.

Author: Lellouche N, Defaye P, Algalarrondo V, Gandjbakhch E, Fauchier L, Champ-Rigot L, Delsarte L, Extramiana F, Marijon E, Martins R, Probst V, Garcia R, Combes S, Taieb J, Ait Said M, Mette C, Piot O, Boveda S, Klug D, Guenancia C, Sacher F, and Maury P
Published: 2024
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30. Development of a new digital sexual health assessment tool to help patients better understand the factors involved in their sexual disorders - "The Sexual Dysfunction Evaluation Tool" (SEXDET).

Author: Burté C, Bei S, Becquet E, Huyghe E, and Maziashvili T
Abstract: Introduction: A visual digital tool called SEXual Dysfunction Evaluation Tool (SEX-DET) was created for assessing the causes of sexual dysfunction, based on a biopsychosocialsexual and relational schema, to assist patients in understanding the relative influence of the various factors contributing to their sexual dysfunction. The aim of this study was to evaluate satisfaction of this tool in sexual dysfunction patients and practitioners., Methods: A satisfaction study of the SEX-DET was performed in 50 patients (20 F, 30 M) consulting for a sexual trouble and 3 practitioners. The main reasons for consultation were erectile dysfunction (36%) and desire disorder (30%)., Results: All the participants agreed that the SEX-DET helped them to understand the origin their trouble (46% strongly, 42% moderately, 12% somewhat), the various factors involved (56% strongly, 22% moderately and 18% somewhat) and the management of their trouble (6% strongly, 47% moderately, 33% somewhat). Overall, 94% of participants found that the SEX-DET was easy to use (58% strongly, 16% moderately and 20% somewhat). Practitioners acknowledged the user-friendly interface, its critical role in improving patients' understanding and providing a comprehensive visualization of the dimensions associated with sexual dysfunction, even if one practitioner threatened the tool's intrinsic inclination to oversimplify complex data., Conclusion: SEX-DET enabled to improve patients' understanding of their trouble and helped practitioners in structuring better communication during consultations communication regarding sexual dysfunction. The shortcomings of this study was its focus on short-term outcomes, self-reported data, and the absence of control group., Competing Interests: Disclosure of interest The authors declare that they have no competing interest., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Published: 2024
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31. Automatized quantitative electrocardiography from digitized paper electrocardiograms: A new avenue for risk stratification in patients with Brugada syndrome.

Author: Laporte PL, Vaglio M, Denjoy I, Maison-Blanche P, Coquard C, El Bèze N, Maury P, Hermida A, Klug D, Maltret A, Badilini F, Leenhardt A, and Extramiana F
Abstract: Background: Arrhythmic risk stratification is a major challenge in Brugada syndrome. Studies have evaluated risk stratification based on manually measured electrocardiogram (ECG) parameters at baseline and/or after drug challenge., Aim: To assess the predictive value of multiple ECG parameters measured automatically from digitized paper ECGs., Methods: During a prospective, multicentre cohort study that included patients with Brugada syndrome with type 1 ECG (spontaneously or drug-induced), paper ECGs were digitized and analysed. Major events were sudden cardiac death, aborted cardiac arrest and appropriate implantable cardioverter-defibrillator (ICD) therapy in the ventricular fibrillation (VF) zone. The predictive value of clinical and ECG parameters was assessed using univariable and multivariable Cox models., Results: ECGs from 301 patients (74% male, mean age 43.1±13.3years, mean follow-up 7.1±5.6years) were analysed. Major events occurred in 6% of patients before diagnosis and 8% during follow-up. Two baseline ECG parameters were independently associated with major events: QRS prolongation in lead V1>113ms (hazard ratio [HR] 3.49, 95% confidence interval [CI] 1.72-7.09; P<0.001) and S duration on DI>33.5ms (HR 3.56, 95% CI 1.52-8.31; P<0.01). In drug-induced patients, changes in the Tpeak-Tend interval on V2 were associated with major events (HR 4.69, 95% CI 1.21-18.17; P=0.014)., Conclusion: Paper ECG datasets could be used for automatic quantitative ECG measurements. We confirmed the association of previously described parameters with events and identified useful new parameters. Multi-parametric ECG quantification may be used to assess risk in patients with Brugada syndrome., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
Published: 2024
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32. Liver transplantation plus chemotherapy versus chemotherapy alone in patients with permanently unresectable colorectal liver metastases (TransMet): results from a multicentre, open-label, prospective, randomised controlled trial.

Author: Adam R, Piedvache C, Chiche L, Adam JP, Salamé E, Bucur P, Cherqui D, Scatton O, Granger V, Ducreux M, Cillo U, Cauchy F, Mabrut JY, Verslype C, Coubeau L, Hardwigsen J, Boleslawski E, Muscari F, Jeddou H, Pezet D, Heyd B, Lucidi V, Geboes K, Lerut J, Majno P, Grimaldi L, Levi F, Lewin M, and Gelli M
Subjects: Female, Humans, Male, Middle Aged, Combined Modality Therapy, Immunosuppressive Agents therapeutic use, Immunosuppressive Agents administration & dosage, Prospective Studies, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Colorectal Neoplasms pathology, Colorectal Neoplasms drug therapy, Liver Neoplasms drug therapy, Liver Neoplasms secondary, Liver Neoplasms surgery, Liver Transplantation
Abstract: Background: Despite the increasing efficacy of chemotherapy, permanently unresectable colorectal liver metastases are associated with poor long-term survival. We aimed to assess whether liver transplantation plus chemotherapy could improve overall survival., Methods: TransMet was a multicentre, open-label, prospective, randomised controlled trial done in 20 tertiary centres in Europe. Patients aged 18-65 years, with Eastern Cooperative Oncology Group performance score 0-1, permanently unresectable colorectal liver metastases from resected BRAF-non-mutated colorectal cancer responsive to systemic chemotherapy (≥3 months, ≤3 lines), and no extrahepatic disease, were eligible for enrolment. Patients were randomised (1:1) to liver transplantation plus chemotherapy or chemotherapy alone, using block randomisation. The liver transplantation plus chemotherapy group underwent liver transplantation for 2 months or less after the last chemotherapy cycle. At randomisation, the liver transplantation plus chemotherapy group received a median of 21·0 chemotherapy cycles (IQR 18·0-29·0) versus 17·0 cycles (12·0-24·0) in the chemotherapy alone group, in up to three lines of chemotherapy. During first-line chemotherapy, 64 (68%) of 94 patients had received doublet chemotherapy and 30 (32%) of 94 patients had received triplet regimens; 76 (80%) of 94 patients had targeted therapy. Transplanted patients received tailored immunosuppression (methylprednisolone 10 mg/kg intravenously on day 0; tacrolimus 0·1 mg/kg via gastric tube on day 0, 6-10 ng/mL days 1-14; mycophenolate mofetil 10 mg/kg intravenously day 0 to <2 months and switch to everolimus 5-8 ng/mL), and postoperative chemotherapy, and the chemotherapy group had continued chemotherapy. The primary endpoint was 5-year overall survival analysed in the intention to treat and per-protocol population. Safety events were assessed in the as-treated population. The study is registered with ClinicalTrials.gov (NCT02597348), and accrual is complete., Findings: Between Feb 18, 2016, and July 5, 2021, 94 patients were randomly assigned and included in the intention-to-treat population, with 47 in the liver transplantation plus chemotherapy group and 47 in the chemotherapy alone group. 11 patients in the liver transplantation plus chemotherapy group and nine patients in the chemotherapy alone group did not receive the assigned treatment; 36 patients and 38 patients in each group, respectively, were included in the per-protocol analysis. Patients had a median age of 54·0 years (IQR 47·0-59·0), and 55 (59%) of 94 patients were male and 39 (41%) were female. Median follow-up was 59·3 months (IQR 42·4-60·2). In the intention-to-treat population, 5-year overall survival was 56·6% (95% CI 43·2-74·1) for liver transplantation plus chemotherapy and 12·6% (5·2-30·1) for chemotherapy alone (HR 0·37 [95% CI 0·21-0·65]; p=0·0003) and 73·3% (95% CI 59·6-90·0) and 9·3% (3·2-26·8), respectively, for the per-protocol population. Serious adverse events occurred in 32 (80%) of 40 patients who underwent liver transplantation (from either group), and 69 serious adverse events were observed in 45 (83%) of 54 patients treated with chemotherapy alone. Three patients in the liver transplantation plus chemotherapy group were retransplanted, one of whom died postoperatively of multi-organ failure., Interpretation: In selected patients with permanently unresectable colorectal liver metastases, liver transplantation plus chemotherapy with organ allocation priority significantly improved survival versus chemotherapy alone. These results support the validation of liver transplantation as a new standard option for patients with permanently unresectable liver-only metastases., Funding: French National Cancer Institute and Assistance Publique-Hôpitaux de Paris., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)
Published: 2024
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33. Hematological features and alternate diagnoses in critically ill thrombotic antiphospholipid syndrome patients.

Author: Azoulay LD, Frapard T, Larcher R, Pène F, Argaud L, Mayaux J, Jamme M, Coudroy R, Mathian A, Gibelin A, Azoulay E, Tandjaoui-Lambiotte Y, Dargent A, Beloncle FM, Raphalen JH, Bréchot N, de Prost N, Devaquet J, Contou D, Gaugain S, Trouiller P, Grangé S, Ledochowski S, Lemarie J, Faguer S, Degos V, Frere C, Quentric P, Moyon Q, Luyt CE, Combes A, Amoura Z, and Pineton de Chambrun M
Subjects: Humans, Female, Middle Aged, Male, Retrospective Studies, Adult, Thrombosis etiology, Intensive Care Units, France epidemiology, Hospital Mortality, Anemia blood, Anemia complications, Anemia etiology, ADAMTS13 Protein blood, Platelet Count, Antiphospholipid Syndrome complications, Antiphospholipid Syndrome blood, Critical Illness, Thrombocytopenia complications, Thrombocytopenia blood, Thrombotic Microangiopathies blood, Thrombotic Microangiopathies etiology, Thrombotic Microangiopathies complications
Abstract: Objectives: Severe thrombotic antiphospholipid syndrome (APS) frequently affects the kidney, heart, and central nervous system. The precise frequency, clinical picture, differential diagnoses, and outcome of APS-related hematological involvement are lacking, especially in patients requiring ICU admission. This study aimed to describe the hematological manifestations associated with critically ill thrombotic APS patients and catastrophic antiphospholipid syndrome., Methods: This French, national, multicenter, retrospective study, conducted, from January 2000 to September 2018, included all APS patients admitted to 24 participating centers' ICUs with any new thrombotic manifestation. The prevalence of hematological manifestations and their associated outcomes were studied., Results: One hundred and thirty-four patients, female 72%, median [IQR] age 45 [34-56] years, with 152 episodes were included. Anemia was present in 95% of episodes and thrombocytopenia in 93%. The lowest values for hemoglobin and platelets were 7.1 [6.3-8.8] g/dL and 38 [21-60] g/L, respectively. The lowest platelet count below 20 g/L was significantly associated with a higher in-ICU mortality rate (50%, p < 0.0001). A thrombotic microangiopathy syndrome (TMA) syndrome was seen in 16 patients (12%) and was associated with higher in-hospital mortality (p = 0.05). Median ADAMTS-13 levels were 44% [27-74]. Anti-ADAMTS13 antibodies were tested in 11 patients and found negative in all. A suspicion of heparin-induced thrombocytopenia (HIT) was raised in 66 patients but only four patients were classified as definite HIT. Disseminated intravascular coagulation (DIC) was seen in 51% of patients., Conclusion: Thrombocytopenia is very frequent in severe APS patients and may be related to TMA, HIT, or DIC. Deciphering the mechanisms of thrombocytopenia is decisive in CAPS patients. Key Points • Thrombocytopenia is the hallmark laboratory finding in CAPS. • A complete thrombotic microangiopathy pattern is infrequent in CAPS patients. • Alternate diagnoses of CAPS, especially heparin-induced thrombocytopenia, need to be adequately investigated., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)
Published: 2024
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34. Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies.

Author: Elkrief L, Hernandez-Gea V, Senzolo M, Albillos A, Baiges A, Berzigotti A, Bureau C, Murad SD, De Gottardi A, Durand F, Garcia-Pagan JC, Lisman T, Mandorfer M, McLin V, Moga L, Nery F, Northup P, Nuzzo A, Paradis V, Patch D, Payancé A, Plaforet V, Plessier A, Poisson J, Roberts L, Salem R, Sarin S, Shukla A, Toso C, Tripathi D, Valla D, Ronot M, and Rautou PE
Subjects: Humans, Hypertension, Portal diagnosis, Hypertension, Portal therapy, Hypertension, Portal etiology, Hypertension, Portal complications, Risk Factors, Anticoagulants therapeutic use, Liver Cirrhosis complications, Liver Cirrhosis diagnosis, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage therapy, Gastrointestinal Hemorrhage diagnosis, Pregnancy, Female, Quality of Life, Portal Vein, Venous Thrombosis diagnosis, Venous Thrombosis therapy
Abstract: Portal vein thrombosis (PVT) refers to the development of a non-malignant obstruction of the portal vein, its branches, its radicles, or a combination. This Review first provides a comprehensive overview of all aspects of PVT, namely the specifics of the portal venous system, the risk factors for PVT, the pathophysiology of portal hypertension in PVT, the interest in non-invasive tests, as well as therapeutic approaches including the effect of treating risk factors for PVT or cause of cirrhosis, anticoagulation, portal vein recanalisation by interventional radiology, and prevention and management of variceal bleeding in patients with PVT. Specific issues are also addressed including portal cholangiopathy, mesenteric ischaemia and intestinal necrosis, quality of life, fertility, contraception and pregnancy, and PVT in children. This Review will then present endpoints for future clinical studies in PVT, both in patients with and without cirrhosis, agreed by a large panel of experts through a Delphi consensus process. These endpoints include classification of portal vein thrombus extension, classification of PVT evolution, timing of assessment of PVT, and global endpoints for studies on PVT including clinical outcomes. These endpoints will help homogenise studies on PVT and thus facilitate reporting, comparison between studies, and validation of future studies and trials on PVT., Competing Interests: Declaration of interests VHG has received speaker fees from Gore Medical and Cook Medical. ADG has received consulting fees from Astrazeneca and Swedish Orphan Biovitrum. MR serves as consultant from Quantum Surgical (fees paid to institution) and has received speaker fees from Servier, Guerbet, GE Healthcare, Ipsen, Angiodynamics, and AstraZeneca. FN has received speaker fees from Advanz and Permanyer. VML serves as consultant from AstraZaneca and has received speaker fees and travel support from Albireo Ipsen. AB serves as consultant for Boehringer Ingelheim and has received speaker fees from GE Healthcare and Hologic. AA has served as a lecturer for Boehringer-Ingelheim and Gore Medical. AN has received research funding from MSD-Avenir and consulting fees from Abbvie and Janssen. MM serves as a lecturer for AbbVie, Ipsen, Echosens, Gilead Sciences, and Gore Medical, and has received travel support from AbbVie and Gilead Sciences. DP has served as lecturer for Boehringer-Ingelheim and Gore Medical. DT has received research grants from Boehringer-Ingelheim and Novartis and has served as lecturer for Gore Medical. JCGP has received speaker fees from Gore Medical and research grants from Mallinkrodt and AstraZeneca. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
Published: 2024
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35. Recommendations for the diagnosis and evaluation of premature ejaculation.

Author: Huyghe E, Grellet L, Faix A, Almont T, Cuzin B, and Burte C
Subjects: Humans, Male, Practice Guidelines as Topic, Premature Ejaculation diagnosis, Premature Ejaculation physiopathology, Premature Ejaculation psychology
Abstract: Objectives: The Association Interdisciplinaire Post-Universitaire de Sexologie (AIUS) has brought together a panel of experts to draw up French recommendations for the management of premature ejaculation. This article presents the recommendations for the diagnosis and evaluation of premature ejaculation., Methods: Systematic review of the literature between 01/1995 and 02/2022. Using the method of recommendations for clinical practice (RPC)., Results: We recommend using the SIAMS definition for everyday clinical practice. PE is defined as: (i) a persistent and recurrent subjective perception of loss of control (management) of the ejaculatory mechanism in the presence of appropriate erotic stimuli; (ii) subjective, PE-related distress induced in the patient and sexual dissatisfaction or PE-related anorgamy in the partner; (iii) a short intravaginal ejaculatory latency time, whether subjectively perceived by the patient and the partner or objectively measured as less than 180seconds (generally). We suggest that the same definition be applied to practices other than vaginal penetration, such as masturbation, oral or anal intercourse, as well as to non-heterosexual contexts. We suggest using information reported by the patient, possibly supplemented by assessment tests/questionnaires (IPE, PEP, PEDT). We recommend investigating the presence of other sexual dysfunctions, in particular erectile dysfunction (ED), as well as any sexual dysfunctions of partners. We recommend taking a medical and psychosexological history, and carrying out a targeted physical examination in patients complaining of PE., Conclusion: These recommendations should help to improve the management of PE., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Published: 2024
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36. Management of biliary tract cancers in early-onset patients: A nested multicenter retrospective study of the ACABI GERCOR PRONOBIL cohort.

Author: Lebeaud A, Antoun L, Paccard JR, Edeline J, Bourien H, Fares N, Tournigand C, Lecomte T, Tougeron D, Hautefeuille V, Viénot A, Henriques J, Williet N, Bachet JB, Smolenschi C, Hollebecque A, Macarulla T, Castet F, Malka D, Neuzillet C, Vernerey D, Boilève A, and Turpin A
Subjects: Humans, Male, Female, Retrospective Studies, Middle Aged, Adult, Aged, Gallbladder Neoplasms mortality, Gallbladder Neoplasms therapy, Gallbladder Neoplasms pathology, Age of Onset, Adenocarcinoma mortality, Adenocarcinoma therapy, Adenocarcinoma pathology, Bile Duct Neoplasms mortality, Bile Duct Neoplasms therapy, Bile Duct Neoplasms pathology, Prognosis, Kaplan-Meier Estimate, Progression-Free Survival, Cholangiocarcinoma mortality, Cholangiocarcinoma therapy, Cholangiocarcinoma pathology, Biliary Tract Neoplasms mortality, Biliary Tract Neoplasms pathology, Biliary Tract Neoplasms therapy
Abstract: Background & Aims: Accumulating data has shown the rising incidence and poor prognosis of early-onset gastrointestinal cancers, but few data exist on biliary tract cancers (BTC). We aimed to analyse the clinico-pathological, molecular, therapeutic characteristics and prognosis of patients with early onset BTC (EOBTC, age ≤50 years at diagnosis), versus olders., Methods: We analysed patients diagnosed with intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, and gallbladder adenocarcinoma between 1 January 2003 and 30 June 2021. Baseline characteristics and treatment were described in each group and compared. Progression-free survival, overall survival and disease-free survival were estimated in each group using the Kaplan-Meier method., Results: Overall, 1256 patients were included, 188 (15%) with EOBTC. Patients with EOBTC demonstrated fewer comorbidities (63.5% vs. 84.5%, p < .0001), higher tumour stage (cT3-4: 50.0% vs. 32.3%, p = .0162), bilobar liver involvement (47.8% vs. 32.1%, p = .0002), and metastatic disease (67.6% vs. 57.5%, p = .0097) compared to older. Patients with EOBTC received second-line therapy more frequently (89.5% vs. 81.0% non-EOBTC, p = .0224). For unresectable patients with BTC, median overall survival was 17.0 vs. 16.2 months (p = .0876), and median progression-free survival was 5.8 vs. 6.0 months (p = .8293), in EOBTC vs. older. In advanced stages, fewer actionable alterations were found in EOBTC (e.g., IDH1 mutations [7.8% vs. 16.6%]; FGFR2-fusion [11.7% vs. 8.9%]; p = .029)., Conclusions: Patients with EOBTC have a more advanced disease at diagnosis, are treated more heavily at an advanced stage but show similar survival. A distinctive molecular profile enriched for FGRF2 fusions was found., (© 2024 The Authors. Liver International published by John Wiley & Sons Ltd.)
Published: 2024
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37. Evaluation of an automated platform for the detection of HEV RNA in plasma and stool.

Author: Sottil P, Lhomme S, Saune K, El Hayani S, Oliveira-Mendes K, Peron JM, Kamar N, Izopet J, and Abravanel F
Subjects: Humans, Sensitivity and Specificity, Plasma virology, Molecular Diagnostic Techniques methods, Feces virology, RNA, Viral isolation & purification, RNA, Viral blood, RNA, Viral analysis, RNA, Viral genetics, Hepatitis E virus isolation & purification, Hepatitis E virus genetics, Hepatitis E diagnosis, Hepatitis E virology, Hepatitis E blood, Automation, Laboratory
Abstract: Introduction: We evaluated the performance of the automated Altostar HEV RNA platform for detecting HEV RNA., Methods and Results: Clinical performance was determined by testing 81 plasma samples and 10 fecal samples manually quantified previously with the Realstar RT-PCR assay using the Magnapure instrument for extraction. The assays were concordant for 79/81 plasma samples (97.5%) and 10/10 (100%) fecal samples. The two plasma samples that tested negative with the Altostar assay had a very low HEV RNA concentration (1.6 and 1.4 log 10 IU/ml). Quantitative results obtained with the automated platform and the manual workflow were highly correlated (ρ= 0.98, p<0.01). The intra-run and inter-run standard deviation were 0.09 IU/ml and 0.13 IU/ml respectively. The assay was linear from 2 to 6 log IU/ml. The limit of detection determined by Probit analysis with the WHO HEV RNA standard was 7.6 [95% CI: 4.4-52.5] IU/ml., Conclusions: The Altostar platform enables highly accurate testing for the detection of HEV RNA in stool and the quantification of HEV RNA in plasma. This allowed us to shorten turnaround times and to save time for the technical staff., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
Published: 2024
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38. Management of adult intestinal stomas: The 2023 French guidelines.

Author: Aubert M, Buscail E, Duchalais E, Cazelles A, Collard M, Charleux-Muller D, Jeune F, Nuzzo A, Pellegrin A, Theuil L, Toutain A, Trilling B, Siproudhis L, Meurette G, Lefevre JH, Maggiori L, and Mege D
Subjects: Humans, France, Adult, Practice Guidelines as Topic, Colostomy, Surgical Stomas adverse effects, Postoperative Complications prevention & control
Abstract: Aim: Digestive stoma are frequently performed. The last French guidelines have been published twenty years ago. Our aim was to update French clinical practice guidelines for the perioperative management of digestive stoma and stoma-related complications., Methods: A systematic literature review of French and English articles published between January 2000 and May 2022 was performed. Only digestive stoma for fecal evacuation in adults were considered. Stoma in children, urinary stoma, digestive stoma for enteral nutrition, and rare stoma (Koch, perineal) were not included., Results: Guidelines include the surgical landmarks to create digestive stoma (ideal location, mucocutaneous anastomosis, utility of support rods, use of prophylactic mesh), the perioperative clinical practice guidelines (patient education, preoperative ostomy site marking, postoperative equipment, prescriptions, and follow-up), the management of early stoma-related complications (difficulties for nursing, high output, stoma necrosis, retraction, abscess and peristomal skin complications), and the management of late stoma-related complications (stoma prolapse, parastomal hernia, stoma stenosis, late stoma retraction). A level of evidence was assigned to each statement., Conclusion: These guidelines will be very useful in clinical practice, and allow to delete some outdated dogma., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Published: 2024
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39. Twelve years after: The french national network on rare head and neck tumours (REFCOR).

Author: Gasne C, Atallah S, Dauzier E, Thariat J, Fakhry N, Verillaud B, Classe M, Vergez S, Moya-Plana A, Costes-Martineau V, Righini C, de Gabory L, Digue L, Dupin C, Ferrand FR, Even C, and Baujat B
Subjects: Humans, Melanoma, Head and Neck Neoplasms epidemiology, Head and Neck Neoplasms therapy, Salivary Gland Neoplasms pathology, Carcinoma, Adenoid Cystic pathology, Adenocarcinoma, Paranasal Sinus Neoplasms pathology
Abstract: Background: Rare cancers constitute less than 10% of head and neck cancers and lack sufficient evidence for standardized care. The French Rare Head and Neck Cancer Expert Network (REFCOR) as established a national database to collect data on these rare cancers. This study aims to describe patient and tumour characteristics in this database., Methods: Prospective data collection was conducted across multiple centers. Survival analyses were performed using Kaplan Meier method and Log Rank test. Odds ratios were used for comparing proportions., Results: A total of 7208 patients were included over a period of 10 years. The most frequent histologies were: Not Otherwise Specified (NOS) adenocarcinoma 13 %, adenoid cystic carcinoma 12 %, squamous cell carcinoma of rare locations 10 %, mucoepidermoid carcinoma 9 %, intestinal-type adenocarcinoma (8 %). Tumours were located in sinonasal area (38 %); salivary glands (32 %); oral cavity / oropharynx / nasopharynx (16 %); larynx / hypopharynx (3 %); ears (1 %); others (3 %). Tumours were predominantly classified as T4 (23 %), N0 (54 %), and M0 (62 %). Primary treatment approach involved tumour resection (78 %) and / or radiotherapy (63 %). Patients with salivary gland cancers exhibited better 5-year overall survival (OS) rates (p < 0.05), and lower recurrence rates compared to patients with sinonasal, laryngeal/ hypopharyngeal cancers. No significant differences were observed in the other comparisons. Acinar cell carcinoma demonstrated the best OS while mucous melanoma had the poorest prognosis., Conclusion: Melanoma, carcinoma NOS, and sinonasal undifferenciated carcinoma still have poor prognoses. Efforts are being made, including training and guidelines, to expand network coverage (REFCOR, EURACAN), improve data collection and contribute to personalized therapies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Published: 2024
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40. [Optimizing the management of heart failure: structuring the care pathway].

Author: Blesse V, Itier R, Galtier G, Fournier P, Massot M, Ayot S, Galinier M, and Roncalli J
Subjects: Humans, Hospitals, University, Critical Pathways, Heart Failure therapy
Abstract: The incidence of chronic heart failure continues to rise in Western countries, justifying the implementation of an optimized multidisciplinary organization based on medical and nursing convergence. Around the main heart failure, assistance and transplantation unit at Toulouse University Hospital, several structures have been put in place to better manage heart failure patients and improve their care pathway., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Published: 2024
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41. Tofacitinib for Patients with Anti-TNF Refractory Ulcerative Proctitis: A Multicentre Cohort Study from the GETAID.

Author: Uzzan M, Nachury M, Nuzzo A, Amiot A, Caron B, Benezech A, Buisson A, Bouguen G, Le Berre C, Reenaers C, Le Cosquer G, Savoye G, Charkaoui M, Vidon M, Guillo L, Fumery M, Peyrin-Biroulet L, Kirchgesner J, and Bouhnik Y
Subjects: Humans, Retrospective Studies, Quality of Life, Tumor Necrosis Factor Inhibitors therapeutic use, Proctitis drug therapy, Piperidines, Pyrimidines
Abstract: Background: Although ulcerative proctitis [UP] can dramatically impair quality of life, treatment efficacy has been poorly investigated in UP as it was historically excluded from phase 2/3 randomised controlled trials in ulcerative colitis. Our aim was to assess the effectiveness and safety of tofacitinib for the treatment of UP., Methods: We conducted a retrospective, multicentre study in 17 GETAID centres, including consecutive patients with UP treated with tofacitinib. The primary endpoint was steroid-free remission between Week 8 and Week 14, defined as a partial Mayo score of 2 [and no individual subscore above 1]. Secondary outcomes included clinical response and steroid-free remission after induction and at 1 year., Results: All the 35 enrolled patients previously received anti-tumour necrosis factor [TNF] therapy and 88.6% were exposed to at least two lines of biologics. At baseline, the median partial Mayo score was 7 (intequartile range [IQR] [5.5-7]). After induction [W8-W14], 42.9% and 60.0% of patients achieved steroid-free remission and clinical response, respectively. At 1 year, the steroid-free clinical remission and clinical response rates were 39.4% and 45.5%, respectively, and 51.2% [17/33] were still receiving tofacitinib treatment. Survival without tofacitinib withdrawal was estimated at 50.4% (95% confidence interval [CI] [35.5-71.6]) at 1 year. Only a lower partial Mayo at baseline was independently associated with remission at induction (0dds ratio [OR] = 0.56 for an increase of 1, (95% CI [0.33-0.95], p = 0.03). Five [14.3%] adverse events were reported, with one leading to treatment withdrawal [septic shock secondary to cholecystitis]., Conclusion: Tofacitinib may offer a therapeutic option for patients with refractory UP., (© The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Published: 2024
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42. Kidney biopsy for the diagnosis and treatment of kidney diseases. Recommendations from the French speaking Society of Nephrology (SFNDT) and French National Authority for Health (HAS) 2022

Author: de Laforcade L, Bobot M, Boffa JJ, Bovy C, Cartery C, Chauveau D, Gueutin V, Isnard-Bagnis C, Jourde Chiche N, Karras A, Meftah A, Müller C, Sié P, Stehlé T, Vrigneaud L, Vuiblet V, and Guerrot D
Subjects: Humans, France, Kidney pathology, Biopsy, Nephrology, Kidney Diseases diagnosis, Kidney Diseases therapy, Kidney Diseases pathology
Abstract: Kidney Biopsy (KB) is a crucial diagnostic tool in the field of renal diseases and is routinely performed in nephrology departments. A previous survey conducted by the Société Francophone de Néphrologie Dialyse Transplantation (SFNDT) revealed significant disparities in clinical practices, sometimes conflicting with the existing literature and recently published recommendations. In response, the SFNDT wished to promote the development of best practice guidelines, under the auspices of the French National Authority for Health (HAS), to establish a standardized framework for performing kidney biopsies in France.
Published: 2024
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43. Adalimumab in Biologic-naïve Patients With Crohn's Disease After Resolution of an Intra-abdominal Abscess: A Prospective Study From the GETAID.

Author: Bouhnik Y, Pineton de Chambrun G, Lambert J, Nachury M, Seksik P, Altwegg R, Vuitton L, Stefanescu C, Nancey S, Aubourg A, Serrero M, Filippi J, Desseaux K, Viennot S, Abitbol V, Boualit M, Bourreille A, Giletta C, Buisson A, Roblin X, Dib N, Malamut G, Amiot A, Fumery M, Louis E, Elgharabawy Y, and Peyrin-Biroulet L
Subjects: Humans, Male, Adult, Female, Adalimumab therapeutic use, Prospective Studies, Abscess drug therapy, Treatment Outcome, Recurrence, Crohn Disease complications, Crohn Disease drug therapy, Abdominal Abscess drug therapy, Biological Products therapeutic use
Abstract: Background & Aims: The management of intra-abdominal abscesses complicating Crohn's disease (CD) is challenging, and surgery with delayed intestinal resection is often recommended. The aims of this study were to estimate the success rate of adalimumab (ADA) in patients with CD with an intra-abdominal abscess resolved without surgery, and to identify predictive factors for success., Methods: A multicenter, prospective study was conducted in biologic-naïve patients with CD with resolved intra-abdominal abscess treated with ADA with a 2-year follow-up. The primary endpoint was ADA failure at week (W) 24 defined as a need for steroids after W12, intestinal resection, abscess recurrence, and clinical relapse. Secondary post-hoc endpoint was the long-term success defined as the survival without abscess relapse or intestinal resection at W104. The factors associated with ADA failure at W24 and W104 were identified using a logistic and a Cox regression, respectively., Results: From April 2013 to December 2017, 190 patients from 27 GETAID centers were screened, and 117 were included in the analysis. Fifty-eight patients (50%) were male, and the median age at baseline was 28 years. At W24, 87 patients (74%; 95% confidence interval [CI], 65.5%-82.0%; n = 117) achieved ADA success. Among the 30 patients with ADA failure, 15 underwent surgery. At W104, the survival rate without abscess recurrence or surgery was 72.9% (95% CI, 62.1%-79.8%; n = 109). Abscess drainage was significantly associated with ADA failure at W24 (odds ratio, 4.18; 95% CI, 1.06-16.5; P =0 .043). Disease duration (hazard ratio [HR], 1.32; 95% CI, 1.09-1.59; P = .008), abscess drainage (HR, 5.59; 95% CI, 2.21-14.15; P = .001), and inflammatory changes in mesenteric fat (HR, 0.4; 95% CI, 0.17-0.94; P = .046) were significantly associated with ADA failure at W104., Conclusion: Provided that the abscess was carefully managed before initiating medical treatment, this study showed the high efficacy of ADA in the short and long term in biologic-naïve patients with CD complicated by an intra-abdominal abscess., Clinicaltrials: gov, Number: NCT02856763., (Copyright © 2023 AGA Institute. Published by Elsevier Inc. All rights reserved.)
Published: 2023
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44. Robotic pyeloplasty learning curve for a pediatric surgeon without previous laparoscopic pyeloplasty experience.

Author: Planchamp T, Bento L, Mouttalib S, Belbahri I, Coustets B, Aissa DA, and Abbo O
Subjects: Child, Humans, Infant, Kidney Pelvis surgery, Learning Curve, Urologic Surgical Procedures methods, Treatment Outcome, Retrospective Studies, Ureteral Obstruction surgery, Robotic Surgical Procedures methods, Laparoscopy methods, Surgeons
Abstract: Robotic pyeloplasty has become a technique of choice for pyelo-ureteral junction syndrome treatment in children. Less invasive than open surgery, robotic pyeloplasty also has a lower learning curve than laparoscopic pyeloplasty. This is how a new generation of surgeons without previous laparoscopic pyeloplasty experience has begun training in robotics. To assess the robotic assisted pyeloplasty learning curve for a pediatric surgeon only trained in open pyeloplasty, and to investigate if that mode of practice is safe and effective. Data were collected from all children operated on for pyelo-ureteral junction syndrome by the same surgeon in our center between 2015 and 2021. Cases were divided into 4 groups of 14 consecutive procedures to analyze the learning curve. Fifty-six patients were operated on, with a median (IQR) age, weight, and hospital stay of 9 years and 1 month old (3.5), 29 kg (17.3), and 3 days (2), respectively. The mean ± SD operative times were 146.5 ± 39.3, 123.2 ± 48.1, 103.1 ± 29.5, and 141.7 ± 25.0 min, with a unique significant difference between groups 1 and 3 (p = 0.007**). Only two intraoperative and nine postoperative complications were observed. The surgery was successful in 98% cases. Our study shows that a significant improvement in surgical time could be achieved in the first 30 cases, safely and efficiently even without previous laparoscopic pyeloplasty experience.Level of evidence: III., (© 2023. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Published: 2023
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45. Comparison of Paravalvular Leak in SAPIEN 3 and EVOLUT PRO Valves in Transcatheter Aortic Valve Replacement: A Multicenter Registry.

Author: Matta A, Regueiro A, Urena M, Nombela-Franco L, Riche M, Rodriguez-Gabella T, Amat-Santos I, Chamandi C, Akiki T, Gabani R, Vera-Urquiza R, Lhermusier T, Bouisset F, Carrié D, and Campelo-Parada F
Subjects: Humans, Aortic Valve surgery, Prosthesis Design, Registries, Retrospective Studies, Treatment Outcome, Aortic Valve Stenosis complications, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement
Abstract: Paravalvular leak (PVL), conduction disturbances, and vascular complications remain the most common complications after TAVR. To address these adverse outcomes, the third generation of transcatheter heart valves has been developed. The last generation prosthesis provides an outer pericardial wrap for enhanced sealing and PVL prevention. This study aimed to compare the incidence and severity of PVL and 1-year survival after TAVR using SAPIEN 3 with those using EVOLUT PRO. An observational retrospective analysis was conducted in 1,481 patients who underwent TAVR for symptomatic severe aortic stenosis in 6 different European centers. The primary end point was to assess the frequency and severity of PVL at 30 days after TAVR. The secondary end point was to compare 1-year survival using EVOLUT PRO with that using SAPIEN 3. SAPIEN 3 transcatheter heart valve was implanted in 78.3% of study participants (n = 1,160) whereas EVOLUT PRO was implanted in 21.7% (n = 321). PVL is more commonly observed in patients treated with EVOLUT PRO at prehospital discharge (55.1% vs 37.3%) and at 1-month (51% vs 41.4%) and 1-year (51.3% vs 39.3%) follow-up. This difference mainly concerns low-grade (mild/trace) PVL. The frequency of high-degree (moderate/severe) PVL was almost similar in both groups throughout the study period (5.3% vs 5.8% before hospital discharge, 4% vs 3.1% at 1 month, and 3.2% vs 4.9% at 1 year). No significant difference in survival over 1 year has been observed (hazard ratio 0.73 [0.33 to 1.63], p = 0.442) (Graphical abstract). In conclusion, the detection rate of PVL after TAVR with third-generation heart valves remains high, and there are no major differences between the devices regarding the frequency of significant (moderate/severe) PVL and survival., Competing Interests: Declaration of Competing Interest Dr. Regueiro has served as a proctor for Abbott and Meril Life. Dr. Nombela-Franco has served as a proctor for Abbott and as a consultant for Edwards Lifesciences Inc. and Boston Scientific. Dr. Amat-Santos serves as a proctor for Boston Scientific and Meril Life. The remaining authors have no competing interests to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)
Published: 2023
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46. Induction failure in granulomatosis with polyangiitis: a nationwide case-control study of risk factors and outcomes.

Author: Sorin B, Iudici M, Guerry MJ, Samson M, Bielefeld P, Maillet T, Nouvier M, Karras A, Meyer L, Lavigne C, Régent A, Durel CA, Fabre M, Charles P, Raimbourg Q, Lanteri A, Pugnet G, Rivière F, Pineton de Chambrun M, Cacoub P, Le Guenno G, Jourdain P, Mekinian A, Paule R, Dion J, Legendre P, Cohen P, Guillevin L, Puéchal X, and Terrier B
Subjects: Male, Humans, Female, Middle Aged, Retrospective Studies, Case-Control Studies, Treatment Outcome, Rituximab therapeutic use, Cyclophosphamide therapeutic use, Risk Factors, Remission Induction, Granulomatosis with Polyangiitis complications, Granulomatosis with Polyangiitis drug therapy, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Abstract: Objective: To identify characteristics of granulomatosis with polyangiitis (GPA) associated with induction failure, describe salvage therapies and their efficacy., Methods: We conducted a nationwide retrospective case-control study of GPA with induction failure between 2006 and 2021. Each patient with induction failure was randomly paired to three controls matched for age, sex and induction treatment., Results: We included 51 patients with GPA and induction failure (29 men and 22 women). At induction therapy, median age was 49 years. Twenty-seven patients received intravenous cyclophosphamide (ivCYC) and 24 rituximab (RTX) as induction therapy. Patients with ivCYC induction failure more frequently had PR3-ANCA (93% vs 70%, P = 0.02), relapsing disease (41% vs 7%, P < 0.001) and orbital mass (15% vs 0%, P < 0.01) compared with controls. Patients with disease progression despite RTX induction therapy more frequently had renal involvement (67% vs 25%, P = 0.02) with renal failure (serum creatinine >100 µmol/l in 42% vs 8%, P = 0.02) compared with controls. After salvage therapy, remission was achieved at 6 months in 35 (69%) patients. The most frequent salvage therapy was switching from ivCYC to RTX (or vice versa), showing an efficacy in 21/29 (72%). Remission was achieved in nine (50%) patients with inappropriate response to ivCYC, while in patients with progression after RTX induction, remission was achieved in four (100%) who received ivCYC (with or without immunomodulatory therapy), but only in three (50%) after adding immunomodulatory therapy alone., Conclusion: In patients with induction failure, characteristics of GPA, salvage therapies and their efficacy vary according to induction therapy and failure modality., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Published: 2023
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47. Cardiac Death After Transcatheter Aortic Valve Replacement With Contemporary Devices.

Author: Mesnier J, Ternacle J, Cheema AN, Campelo-Parada F, Urena M, Veiga-Fernandez G, Nombela-Franco L, Munoz-Garcia AJ, Vilalta V, Regueiro A, Del Val D, Asmarats L, Del Trigo M, Serra V, Bonnet G, Jonveaux M, Rezaei E, Matta A, Himbert D, de la Torre Hernandez JM, Tirado-Conte G, Fernandez-Nofrerias E, Vidal P, Alfonso F, Gutierrez-Alonso L, Oteo JF, Belahnech Y, Mohammadi S, Philippon F, Modine T, and Rodés-Cabau J
Subjects: Humans, Stroke Volume, Risk Factors, Ventricular Function, Left, Treatment Outcome, Arrhythmias, Cardiac therapy, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac etiology, Aortic Valve diagnostic imaging, Aortic Valve surgery, Transcatheter Aortic Valve Replacement adverse effects, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery
Abstract: Background: The burden of cardiac death after transcatheter aortic valve replacement (TAVR), particularly from advanced heart failure (HF) and sudden cardiac death (SCD), remains largely unknown., Objectives: This study sought to evaluate the incidence and predictors of SCD and HF-related death in TAVR recipients treated with newer-generation devices., Methods: This study included a total of 5,421 consecutive patients who underwent TAVR with newer-generation devices using balloon (75.7%) or self-expandable (24.3%) valves., Results: After a median follow-up of 2 (IQR: 1-3) years, 976 (18.0%) patients had died, 50.8% from cardiovascular causes. Advanced HF and SCD accounted for 11.6% and 7.5% of deaths, respectively. Independent predictors of HF-related death were atrial fibrillation (HR: 2.17; 95% CI: 1.47-3.22; P < 0.001), prior pacemaker (HR: 1.79; 95% CI: 1.10-2.92; P = 0.01), reduced left ventricular ejection fraction (HR: 1.08 per 5% decrease; 95% CI: 1.01-1.14; P = 0.02), transthoracic approach (HR: 2.50; 95% CI: 1.37-4.55; P = 0.003), and new-onset persistent left bundle branch block (HR: 1.85; 95% CI: 1.14-3.02; P = 0.01). Two baseline characteristics (diabetes, HR: 1.81; 95% CI: 1.13-2.89; P = 0.01; and chronic kidney disease, HR: 1.72; 95% CI: 1.02-2.90; P = 0.04) and 3 procedural findings (valve in valve, HR: 2.17; 95% CI: 1.01-4.64; P = 0.04; transarterial nontransfemoral approach, HR: 2.23; 95% CI: 1.23-4.48; P = 0.01; and periprocedural ventricular arrhythmia, HR: 7.19; 95% CI: 2.61-19.76; P < 0.001) were associated with an increased risk of SCD after TAVR., Conclusions: Advanced HF and SCD accounted for a fifth of deaths after TAVR in contemporary practice. Potentially treatable factors leading to increased risk of HF deaths and SCD were identified, such as arrhythmia/dyssynchrony factors for HF and valve-in-valve TAVR or periprocedural ventricular arrhythmias for SCD., Competing Interests: Funding Support and Author Disclosures Dr Mesnier was supported by a research grant from Fédération Française de Cardiologie. Dr Belahnech was supported by a research grant from Aula Vall d’Hebron. Dr Rodés-Cabau holds the Research Chair “Fondation Famille Jacques Larivière” for the Development of Structural Heart Disease Interventions; and has received institutional research grants and consultant/speaker fees from Edwards Lifesciences and Medtronic. Dr Ternacle has served as a consultant for Abbott. Dr Modine has served as a consultant for Abbott, Edwards Lifesciences, and Medtronic. Dr Nombela-Franco has served as a proctor for Abbott and Edwards Lifesciences. Dr Reguiero has served as a proctor for Abbott. Dr Himbert has served as a proctor for Abbott and Edwards Lifesciences. Dr Asmarats has received speaker fees from Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Published: 2023
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48. Late Bleeding Events in Patients Undergoing Percutaneous Coronary Intervention in the Workup Pre-TAVR.

Author: Avvedimento M, Campelo-Parada F, Munoz-Garcia E, Nombela-Franco L, Fischer Q, Donaint P, Serra V, Veiga G, Gutiérrez E, Esposito G, Vilalta V, Alperi A, Regueiro A, Asmarats L, Ribeiro HB, Matta A, Munoz-Garcia A, Tirado-Conte G, Urena M, Metz D, Rodenas-Alesina E, de la Torre Hernandez JM, Fernandez-Nofrerias E, Pascual I, Vidal-Cales P, Arzamendi D, Campanha-Borges DC, Trinh KH, Côté M, Faroux L, and Rodés-Cabau J
Subjects: Humans, Female, Aged, Aged, 80 and over, Male, Treatment Outcome, Hemorrhage chemically induced, Catheters, Percutaneous Coronary Intervention adverse effects, Transcatheter Aortic Valve Replacement adverse effects
Abstract: Background: In patients undergoing percutaneous coronary intervention (PCI) in the work-up pre-transcatheter aortic valve replacement (TAVR), the incidence and clinical impact of late bleeding events (LBEs) remain largely unknown., Objectives: This study sought to determine the incidence, clinical characteristics, associated factors, and outcomes of LBEs in patients undergoing PCI in the work-up pre-TAVR., Methods: This was a multicenter study including 1,457 consecutive patients (mean age 81 ± 7 years; 41.5% women) who underwent TAVR and survived beyond 30 days. LBEs (>30 days post-TAVR) were defined according to the Valve Academic Research Consortium-2 criteria., Results: LBEs occurred in 116 (7.9%) patients after a median follow-up of 23 (IQR: 12-40) months. Late bleeding was minor, major, and life-threatening or disabling in 21 (18.1%), 63 (54.3%), and 32 (27.6%) patients, respectively. Periprocedural (<30 days post-TAVR) major bleeding and the combination of antiplatelet and anticoagulation therapy at discharge were independent factors associated with LBEs (P ≤ 0.02 for all). LBEs conveyed an increased mortality risk at 4-year follow-up compared with no bleeding (43.9% vs 36.0; P = 0.034). Also, LBE was identified as an independent predictor of all-cause mortality after TAVR (HR: 1.39; 95% CI: 1.05-1.83; P = 0.020)., Conclusions: In TAVR candidates with concomitant significant coronary artery disease requiring percutaneous treatment, LBEs after TAVR were frequent and associated with increased mortality. Combining antiplatelet and anticoagulation regimens and the occurrence of periprocedural bleeding determined an increased risk of LBEs. Preventive strategies should be pursued for preventing late bleeding after TAVR, and further studies are needed to provide more solid evidence on the most safe and effective antithrombotic regimen post-TAVR in this challenging group of patients., Competing Interests: Funding Support and Author Disclosures Dr Rodés-Cabau holds the Research Chair “Fondation Famille Jacques Larivière” for the Development of Structural Heart Disease Interventions (Laval University); and has received institutional research grants and speaker/consultant fees from Edwards Lifesciences and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Published: 2023
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49. Calprotectin is a contributor to and potential therapeutic target for vascular calcification in chronic kidney disease.

Author: Amaya-Garrido A, Brunet M, Buffin-Meyer B, Piedrafita A, Grzesiak L, Agbegbo E, Del Bello A, Ferrandiz I, Ardeleanu S, Bermudez-Lopez M, Fedou C, Camus M, Burlet-Schiltz O, Massines J, Buléon M, Feuillet G, Alves M, Neau E, Casemayou A, Breuil B, Saulnier-Blache JS, Denis C, Voelkl J, Glorieux G, Hobson S, Arefin S, Rahman A, Kublickiene K, Stenvinkel P, Bascands JL, Faguer S, Valdivielso JM, Schanstra JP, and Klein J
Subjects: Humans, Animals, Mice, Aged, Leukocyte L1 Antigen Complex, Alarmins, Vascular Calcification, Renal Insufficiency, Chronic complications, Kidney Failure, Chronic
Abstract: Vascular calcification is an important risk factor for cardiovascular (CV) mortality in patients with chronic kidney disease (CKD). It is also a complex process involving osteochondrogenic differentiation of vascular smooth muscle cells (VSMCs) and abnormal deposition of minerals in the vascular wall. In an observational, multicenter European study, including 112 patients with CKD from Spain and 171 patients on dialysis from France, we used serum proteome analysis and further validation by ELISA to identify calprotectin, a circulating damage-associated molecular pattern protein, as being independently associated with CV outcome and mortality. This was confirmed in an additional cohort of 170 patients with CKD from Sweden, where increased serum calprotectin concentrations correlated with increased vascular calcification. In primary human VSMCs and mouse aortic rings, calprotectin exacerbated calcification. Treatment with paquinimod, a calprotectin inhibitor, as well as pharmacological inhibition of the receptor for advanced glycation end products and Toll-like receptor 4 inhibited the procalcifying effect of calprotectin. Paquinimod also ameliorated calcification induced by the sera of uremic patients in primary human VSMCs. Treatment with paquinimod prevented vascular calcification in mice with chronic renal failure induced by subtotal nephrectomy and in aged apolipoprotein E-deficient mice as well. These observations identified calprotectin as a key contributor of vascular calcification, and increased circulating calprotectin was strongly and independently associated with calcification, CV outcome, and mortality in patients with CKD. Inhibition of calprotectin might therefore be a promising strategy to prevent vascular calcification in patients with CKD.
Published: 2023
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50. Five-year Results from the Prospective, Multicenter, Observational SOUNDS Study of Patients with Overactive Bladder Treated with the InterStim System for Sacral Neuromodulation.

Author: Chartier-Kastler E, Le Normand L, Ruffion A, Saussine C, Braguet R, Rabut B, Ragni E, Perrouin-Verbe MA, Pierrevelcin J, Rousseau T, Gamé X, Tanneau Y, Dargent F, Biardeau X, Graziana JP, Stoica G, Brassart E, Fourmarier M, Yaghi N, Capon G, Ferchaud J, Berrogain N, Peyrat L, Pecoux F, Bryckaert PE, Karsenty G, Song S, Keller DUJ, and Cornu JN
Subjects: Humans, Quality of Life, Prospective Studies, Treatment Outcome, Urinary Incontinence, Urge therapy, Urinary Incontinence, Urge etiology, Urinary Bladder, Overactive, Electric Stimulation Therapy adverse effects, Electric Stimulation Therapy methods
Abstract: Background: Although sacral neuromodulation (SNM) for overactive bladder (OAB) is an established therapy, there is a lack of high-quality, long-term data on real-life practice., Objective: To report on real-life therapeutic effectiveness, quality of life (QoL), disease severity, and safety as well as patient-reported symptom bother after approximately 5 yr of follow-up., Design, Setting, and Participants: A total of 291 OAB patients were enrolled at 25 French sites according to local standard of care. Sacral neuromOdUlation with InterStim therapy for intractable lower uriNary tract DySfunctions (SOUNDS) enrolled both de novo and replacement patients, and a total of 229 patients were permanently implanted., Outcome Measurements and Statistical Analysis: Over the course of the study, patients were followed up six times with two follow-ups in the year after implantation and annually thereafter. Of the patients, 154 completed the final follow-up after a mean of 57.7 ± 3.9 mo., Results and Limitations: The mean number of daily leaks in urinary urge incontinence (UI) patients was reduced from 4.4 ± 3.3 at baseline to 1.8 ± 2.6 after 5 yr in de novo and from 5.4 ± 4.9 to 2.2 ± 3.0 in replacement patients (both p < 0.001). Likewise, the number of voids in urinary frequency patients was reduced compared with baseline (de novo: reduced from 12.6 ± 4.0 [baseline] to 9.6 ± 4.3 [5 yr]; replacements: reduced from 11.5 ± 4.3 [baseline] to 9.2 ± 3.1 [5 yr]; both p < 0.05). Complete continence rates after 5 yr were 44% (25/57) in de novo and 33% (5/15) in replacement UI patients, and 68% (39/57) and 67% (10/15) of UI patients were categorized as therapy responders by showing a >50% improvement in leaks. Disease severity (Urinary Symptom Profile domain 2), Numeric Rating Scale-based symptom bother, and disease-specific QoL (Ditrovie) improved significantly in both groups at all visits (p < 0.001). Adverse events related to device or procedure occurred in 51% (140/274) of patients, with 66% (152/229) of the events being classified as minor (Clavien-Dindo grade I and II). Surgical revisions were reported in 39% (89/229), which include permanent explants in 15% (34/229) of patients., Conclusions: SOUNDS demonstrates the sustained effectiveness and QoL improvements of SNM in OAB patients after 5 yr in real-world conditions while maintaining an acceptable safety profile consistent with literature., Patient Summary: This study confirmed that French overactive bladder patients had a sustained symptom and bother reduction, and improvements in quality of life up to 5 yr after sacral neuromodulation device implantation., (Copyright © 2023. Published by Elsevier B.V.)
Published: 2023
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