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1. Urea Level and Depression in Patients with Chronic Kidney Disease

Author: Hélène Levassort, Julie Boucquemont, Oriane Lambert, Sophie Liabeuf, Solene M. Laville, Laurent Teillet, Abdel-Hay Tabcheh, Luc Frimat, Christian Combe, Denis Fouque, Maurice Laville, Christian Jacquelinet, Catherine Helmer, Natalia Alencar de Pinho, Marion Pépin, Ziad A. Massy, and on behalf of CKD-REIN Study Collaborators
Subjects: chronic kidney disease, urea, depression, kidney brain axis, Medicine
Abstract: Depression is common in patients with chronic kidney disease (CKD). Experimental studies suggest the role of urea toxicity in depression. We assessed both the incidence of antidepressant prescriptions and depressive symptoms (measured by CESD (Center for Epidemiologic Depression) scale) in 2505 patients with CKD (Stage 3–4) followed up over 5 years in the Chronic Kidney Disease Renal Epidemiology and Information Network (CKD-REIN) cohort. We used a joint model to assess the association between the serum urea level and incident antidepressant prescriptions, and mixed models for the association between the baseline serum urea level and CESD score over the 5-year follow-up. Among the 2505 patients, 2331 were not taking antidepressants at baseline. Of the latter, 87 started taking one during a median follow-up of 4.6 years. After adjustment for confounding factors, the hazard ratio for incident antidepressant prescription associated with the serum urea level (1.28 [95%CI, 0.94,1.73] per 5 mmol/L increment) was not significant. After adjustment, the serum urea level was associated with the mean change in the CESD score (β = 0.26, [95%CI, 0.11,0.41] per 5 mmol/L increment). Depressive symptoms burden was associated with serum urea level unlike depression events. Further studies are needed to draw firm conclusions and better understand the mechanisms of depression in CKD.
Published: 2024
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2. Persistent eosinopenia is associated with in-hospital mortality among older patients: unexpected prognostic value of a revisited biomarker

Author: Bethsabee Partouche, Marion Pepin, Pauline Mary de Farcy, Jean-Emmanuel Kahn, Bruno Sawczynski, Laurent Lechowski, Laurent Teillet, Frederic Barbot, Marie Herr, and Benjamin Davido
Subjects: Eosinopenia, Geriatrics, Bacterial infection, Outcome, Mortality, RC952-954.6
Abstract: Abstract Introduction Infection is one of the major causes of mortality and morbidity in older adults. Available biomarkers are not associated with prognosis in older patients. This study aimed to analyze the value of eosinopenia (eosinophil count
Published: 2021
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3. Relevance of Cardiovascular Risk Factors Screening in People Aged over 65 Years: Results from a Large French Urban Population (The CARVAR92 Study)

Author: Marion Pépin, Marie Hauguel-Moreau, Hélène Hergault, Alain Beauchet, Christophe Rodon, Tristan Cudennec, Laurent Teillet, Olivier Dubourg, and Nicolas Mansencal
Subjects: Male, Aging, Urban Population, Cardiovascular Diseases, Risk Factors, Heart Disease Risk Factors, Hypertension, Humans, Female, Geriatrics and Gerontology, Aged
Abstract: Background: Cardiovascular disease is the leading cause of death and disability in older people. Traditional cardiovascular risk factors (CVRFs) still have an impact on cardiovascular risk among older people. Nevertheless, screening campaigns rarely target subjects aged over 65 years. This study aimed to assess the distribution and relevance of conventional CVRF screening in people aged over 65 years. Methods: Between 2007 and 2018, among a screening CVRF campaign in the western suburbs of Paris (32,692 subjects), we individualized 6,577 subjects aged 65 years and over. All conventional CVRFs have been systematically assessed. Results: The screening allowed to suspect hypertension in a larger proportion of subjects over 65 years compared to subjects under 65 years (27% vs. 18%, p < 0.0001). Hypertension control was higher in women compared to men but not significantly different in the age-groups (p = 0.91). Screening for diabetes mellitus was positive in 3% of older subjects and 2.4% in younger (p = 0.005). Risk assessment with dedicated score (SCORE O.P.) allowed to move toward a low-risk estimation, resulting in the diminution of intermediate risk group in women over 65 years (from 68 to 61%, p < 0.001). Conclusions: Screening CVRFs especially hypertension remains relevant in people aged over 65 years as it enables to detect unknown CVRFs in numerous subjects. Increasing awareness of CVRFs may be the first step to CVRF control, which is known to be efficient on cardiovascular mortality and functional autonomy in later life.
Published: 2022
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4. Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial

Author: Aurélien Dinh, Jacques Ropers, Clara Duran, Benjamin Davido, Laurène Deconinck, Morgan Matt, Olivia Senard, Aurore Lagrange, Sabrina Makhloufi, Guillaume Mellon, Victoire de Lastours, Frédérique Bouchand, Emmanuel Mathieu, Jean-Emmanuel Kahn, Elisabeth Rouveix, Julie Grenet, Jennifer Dumoulin, Thierry Chinet, Marion Pépin, Véronique Delcey, Sylvain Diamantis, Daniel Benhamou, Virginie Vitrat, Marie-Christine Dombret, Bertrand Renaud, Christian Perronne, Yann-Erick Claessens, José Labarère, Jean-Pierre Bedos, Philippe Aegerter, Anne-Claude Crémieux, Julie ATTAL-BEHAR, Sébastien BEAUNE, Thierry CHINET, Tristan CUDENNEC, Marine DE LAROCHE, Albane DE THEZY, Jennifer DUMOULIN, Caroline DUPONT, Elise FERCOT, Violaine GIRAUT, Ségolène GREFFE, Julie GRENET, Caroline GUYOT, Jean-Emmanuel KAHN, Sylvie LABRUNE, Marie LACHATRE, Sophie MOULIAS, Charlotte NALINE, Marion PEPIN, Elisabeth ROUVEIX, Marine SAHUT-D'IZARN, Abel SEFSSAFI, Laurent TEILLET, Jean-Pierre BRU, Jacques GAILLAT, Vincent GAUTIER, Cécile JANSSEN, Leonardo PAGANI, Virginie VITRAT, Malika ABDERRAHMANE, Juliette CAMUSET, Catherine LEGALL, Pascale LONGUET-FLANDRES, Anne-Marie MENN, Victoire DE LASTOURS, Marie LECRONIER, Gwenolée PREVOST, Charles BURDET, Ouda DERRADJI, Lelia ESCAUT, Etienne HINGLAIS, Philippe LEBRAS, Edouard LEFEVRE, Mathilde NOAILLON, Pauline RABIER, Maurice RAPHAEL, Elina TEICHER, Christiane VERNY, Daniel VITTECOQ, Benjamin WYPLOSZ, Michèle BEN HAYOUN, Françoise BRUN-VEZINET, Enrique CASALINO, Christophe CHOQUET, Marie-Christine DOMBRET, Xavier DUVAL, Nadhira HOUHOU, Véronique JOLY, Xavier LESCURE, Manuela POGLIAGHI, Christophe RIOUX, Yazdan YAZDANPANAH, Elsa BARROS, Belinda BEGGA, Sébastien BOUKOBZA, Houria BOUREDJI, Imad CHOUAHI, Isabelle DELACROIX, Antoine FROISSART, Valérie GARRAIT, Elsa NGWEM, Catherine PHLIPPOTEAU, Sepehr SALEHABADI, Cécile TOPER, Florent VINAS, Marie AMSILLI, Olivier EPAULARD, Patricia PAVESE, Isabelle PIERRE, Jean-Paul STAHL, Jérôme AULAGNIER, Julie CELERIER, Roxana COJOCARIU, Emmanuel MATHIEU, Charlotte RACHLINE, Yoland SCHOINDRE, Thomas SENE, Christelle THIERRY, Caroline APARICIO, Véronique DELCEY, Amanda LOPES, Marjolaine MORGAND, Pierre SELLIER, Guy SIMONEAU, Catherine CHAKVETADZE, Sylvain DIAMANTIS, Arnaud GAUTHIER, Kaoutar JIDAR, Béatrice JOURDAIN, Jean-Francois BOITIAUX, Patrick DESCHAMPS, Edouard DEVAUD, Bruno PHILIPPE, Ruxandra-Oana CALIN, Tomasz CHROBOCZEK, Benjamin DAVIDO, Laurène DECONINCK, Pierre DE TRUCHIS, Aurore LAGRANGE, Sabrina MAKHLOUFI, Morgan MATT, Guillaume MELLON, Olivia SENARD, Daniel BENHAMOU, Claire CHAPUZET, Laure CHAUFFREY, Manuel ETIENNE, Luc-Marie JOLY, Bérengère OBSTOY, Mathieu SALAUN, Luc THIBERVILLE, Julie TILLON, Diane BOLLENS, Julie BOTTERO, Pauline CAMPA, Gäelle COSQUERIC, Bénédicte LEFEBVRE, Zineb OUAZENE, Jérôme PACANOWSKI, Dominique PATERON, Nadia VALIN, Caroline COMPAIN, Hugues CORDEL, Benoit DOUMENC, Elena FOIS, Nicolas GAMBIER, Marie-Aude KHUONG, Elisa PASQUALONI, and Marie POUPARD
Subjects: medicine.medical_specialty, education.field_of_study, business.industry, Pneumonia severity index, Incidence (epidemiology), Population, General Medicine, 030204 cardiovascular system & hematology, Amoxicillin, medicine.disease, Placebo, 03 medical and health sciences, Pneumonia, 0302 clinical medicine, Community-acquired pneumonia, Internal medicine, medicine, 030212 general & internal medicine, education, Adverse effect, business, medicine.drug
Abstract: Summary Background Shortening the duration of antibiotic therapy for patients admitted to hospital with community-acquired pneumonia should help reduce antibiotic consumption and thus bacterial resistance, adverse events, and related costs. We aimed to assess the need for an additional 5-day course of β-lactam therapy among patients with community-acquired pneumonia who were stable after 3 days of treatment. Methods We did this double-blind, randomised, placebo-controlled, non-inferiority trial (the Pneumonia Short Treatment [PTC]) in 16 centres in France. Adult patients (aged ≥18 years) admitted to hospital with moderately severe community-acquired pneumonia (defined as patients admitted to a non-critical care unit) and who met prespecified clinical stability criteria after 3 days of treatment with β-lactam therapy were randomly assigned (1:1) to receive β-lactam therapy (oral amoxicillin 1 g plus clavulanate 125 mg three times a day) or matched placebo for 5 extra days. Randomisation was done using a web-based system with permuted blocks with random sizes and stratified by randomisation site and Pneumonia Severity Index score. Participants, clinicians, and study staff were masked to treatment allocation. The primary outcome was cure 15 days after first antibiotic intake, defined by apyrexia (temperature ≤37·8°C), resolution or improvement of respiratory symptoms, and no additional antibiotic treatment for any cause. A non-inferiority margin of 10 percentage points was chosen. The primary outcome was assessed in all patients who were randomly assigned and received any treatment (intention-to-treat [ITT] population) and in all patients who received their assigned treatment (per-protocol population). Safety was assessed in the ITT population. This study is registered with ClinicalTrials.gov, NCT01963442, and is now complete. Findings Between Dec 19, 2013, and Feb 1, 2018, 706 patients were assessed for eligibility, and after 3 days of β-lactam treatment, 310 eligible patients were randomly assigned to receive either placebo (n=157) or β-lactam treatment (n=153). Seven patients withdrew consent before taking any study drug, five in the placebo group and two in the β-lactam group. In the ITT population, median age was 73·0 years (IQR 57·0–84·0) and 123 (41%) of 303 participants were female. In the ITT analysis, cure at day 15 occurred in 117 (77%) of 152 participants in the placebo group and 102 (68%) of 151 participants in the β-lactam group (between-group difference of 9·42%, 95% CI −0·38 to 20·04), indicating non-inferiority. In the per-protocol analysis, 113 (78%) of 145 participants in the placebo treatment group and 100 (68%) of 146 participants in the β-lactam treatment group were cured at day 15 (difference of 9·44% [95% CI −0·15 to 20·34]), indicating non-inferiority. Incidence of adverse events was similar between the treatment groups (22 [14%] of 152 in the placebo group and 29 [19%] of 151 in the β-lactam group). The most common adverse events were digestive disorders, reported in 17 (11%) of 152 patients in the placebo group and 28 (19%) of 151 patients in the β-lactam group. By day 30, three (2%) patients had died in the placebo group (one due to bacteraemia due to Staphylococcus aureus, one due to cardiogenic shock after acute pulmonary oedema, and one due to heart failure associated with acute renal failure) and two (1%) in the β-lactam group (due to pneumonia recurrence and possible acute pulmonary oedema). Interpretation Among patients admitted to hospital with community-acquired pneumonia who met clinical stability criteria, discontinuing β-lactam treatment after 3 days was non-inferior to 8 days of treatment. These findings could allow substantial reduction of antibiotic consumption. Funding French Ministry of Health.
Published: 2021
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5. [Knowledge of residents about delirium and its management in the elderly and restless patient]

Author: Hélène, Levassort, Tristan, Cudennec, Pauline, Courtois-Amiot, Laurent, Teillet, and Marion, Pépin
Abstract: Delirium is frequent and serious, while it is often avoidable. Previous studies revealed a caregivers lack of knowledge about this syndrome concerning diagnosis and therapeutic management. In France, residents are often in first line to manage delirium patients. The purpose of this study is therefore to assess residents' level of knowledge about delirium and its therapeutic management in the elderly. Our study is a national survey carried out between June and December 2019 using a self-administrated survey derived from the 2009 Haute Autorité de santé (HAS) recommendations about delirium. The primary endpoint was the global score obtained by residents. The secondary endpoints were the score in different fields of competence (general knowledge, diagnostic, therapeutic) and the comparison of the resident's score according to their formation. One hundred eighty-two residents from 23 specialties and 18 different cities were represented. Residents were involved in more than 97% of the cases, while 45% of them were unaware of the HAS recommendations. Mean score to the survey was 68/100, and therapeutic management seemed the most difficult step, especially when the symptoms of delirium were severe. Our study highlights the benefit of practical training during internship to improve the level of knowledge on delirium. This study suggests the need for specific teaching on delirium. Training both theoretical and practical seems to be the most effective method. Development of a national educational program about delirium and its management could be proposed to improve residents awareness and develop their skill. Increasing the number of mobile geriatric teams and strengthen their action could also be a concrete option to improve delirium management. Finally, we could imagine the development of a pocket tool to offer a practical bedside help for clinicians. The development of such a tool would require further studies to evaluate its relevance and effectiveness.
Published: 2022

6. Présentation clinique et performance de la bandelette urinaire pour le diagnostic d’infection urinaire en population gériatrique

Author: M. Laycuras, L. Leichowski, E. Fercot, Laurent Teillet, Sophie Moulias, Z. Mekerta, A. de Thezy, A. Dinh, M. Gourdon, A.-L. Coudert, Florence Muller, C.-L. Peng, Marion Pépin, Frédérique Bouchand, B. Davido, M. Le Crane, M. Rottman, B. Denis, R. Mahamdia, J. L. Gaillard, M. Coudert, Clara Duran, Z. Seridi, and V. Sivadon-Tardy
Subjects: Gynecology, 0303 health sciences, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Infection urinaire, 030306 microbiology, business.industry, Gastroenterology, Internal Medicine, Medicine, 030212 general & internal medicine, business
Abstract: Resume Introduction L’infection urinaire (IU) constitue la deuxieme cause d’infection bacterienne communautaire chez le sujet âge. Ce diagnostic est difficile car les symptomes sont souvent atypiques. Nous presentons les caracteristiques des patients ayant une IU parmi une population geriatrique (signes fonctionnels urinaires et/ou syndrome infectieux). Nous avons egalement evalue la sensibilite et la specificite de la bandelette urinaire (BU) pour le diagnostic d’IU dans cette population. Patients et methode Nous avons realise une etude observationnelle, prospective, monocentrique, d’avril 2017 a janvier 2018, incluant tous les patients hospitalises en geriatrie, presentant des signes fonctionnels urinaires et/ou un syndrome infectieux sans point d’appel, pour lesquels un examen cytobacteriologique des urines (ECBU) a ete demande. Une BU etait systematiquement realisee pour tous ces patients. Les caracteristiques cliniques et biologiques des patients ont ete etudiees selon le diagnostic definitif. En outre, les resultats des BU ont ete compares a ceux des ECBU en cas de diagnostic final d’IU. Resultats Au total, 165 patients ont ete inclus. Parmi eux, 67 (40,6 %) avaient une IU et 98 (59,4 %) avaient un autre diagnostic. Il y avait significativement plus de femmes ( p p La BU presentait une sensibilite elevee (92 %) et une VPN elevee (91 %) interessantes dans notre population. Conclusion En cas d’IU chez le sujet âge, peu de criteres sont discriminants avec une autre origine. Par ailleurs, une BU negative suggere l’absence d’IU en raison de sa bonne valeur predictive negative.
Published: 2019
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7. Bloodstream infections in older population: epidemiology, outcome, and impact of multidrug resistance

Author: Aurélien Dinh, Danielle Saadeh, Laurent Teillet, Frédérique Bouchand, Hugues Michelon, Jean-Louis Gaillard, Elsa Salomon, Clara Duran, Marine de Laroche, Jean-Laurent Lequintrec, Lesly Fellous, and Zineb Seridi
Subjects: 0301 basic medicine, Microbiology (medical), Male, medicine.medical_specialty, medicine.drug_class, 030106 microbiology, Antibiotics, medicine.disease_cause, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Medical microbiology, Risk Factors, Internal medicine, Drug Resistance, Multiple, Bacterial, Sepsis, Epidemiology, Medicine, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, Geriatrics, Aged, 80 and over, Respiratory tract infections, Bacteria, business.industry, Retrospective cohort study, General Medicine, bacterial infections and mycoses, Anti-Bacterial Agents, Infectious Diseases, Carriage, Staphylococcus aureus, Female, France, business, human activities
Abstract: Bloodstream infections (BSIs) among older patients are frequent with high rate of mortality. Infections with multidrug-resistant organisms (MDRO) are associated with higher mortality than with susceptible microorganisms. We aimed to evaluate the prevalence of MDRO infection during BSI in older population and the factors associated with unfavorable outcome. This study is a retrospective cohort of all BSI episodes occurring among older patients (> 65yo), from April 1, 2010, to December 31, 2016, in a French university hospital for geriatric medicine. A total of 255 BSI episodes were analyzed. Mean age was 86.3±6.5 years, and sex ratio (M/F) was 0.96. Main comorbidities were orthopedic device (26.7%), active neoplasia (24.3%), and diabetes mellitus (18.4%). Main primary sites of infection were urinary tract infections (56.9%), respiratory tract infections (10.6%), intra-abdominal infections (7.1%), and skin and soft tissue infections (4.7%). Main bacteria identified were Escherichia coli (45.1%), Staphylococcus aureus (14.1%), enterococci (10.7%), coagulase-negative staphylococci (CoNS) (5.5%), and streptococci (5.1%). MDROs were involved in 17.2% of BSI (gram-negative bacilli: 9.0%; CoNS: 4.3%; and methicillin-resistant S. aureus (MRSA): 3.9%). The main factor associated with MDRO BSI was colonization with MDRO (OR=6.29; 95%CI=2.9-14.32). Total mortality was 18.4% and significantly higher in case of initial severity (OR=3.83; 95%CI=1.75-8.38), healthcare-associated infection (OR=5.29; 95%CI=1.11-25.30), and MRSA BSI (OR=9.16; 95%CI=1.67-50.16). BSI due to MDRO is frequent in older population and is strongly associated with carriage of MDRO. Healthcare-associated BSI, severe episodes, and BSI due to MRSA are associated with unfavorable outcome. In these cases, a broad-spectrum antibiotic should be promptly initiated.
Published: 2020

8. Rehospitalization following a stay in geriatric rehabilitation wards: rates and predictive factors

Author: Florence Muller, Laurent Lechowski, D. Tortrat, Marie Tardivel, and Laurent Teillet
Subjects: Male, Paris, medicine.medical_specialty, Geriatric rehabilitation, Hospital Departments, Patient Readmission, Humans, Medicine, Biological Psychiatry, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Public health, Rehabilitation, Age Factors, Mean age, Length of Stay, After discharge, Rehabilitation care, Neuropsychology and Physiological Psychology, Telephone interview, Geriatrics, Case-Control Studies, Emergency medicine, Delirium, Female, Neurology (clinical), Geriatrics and Gerontology, medicine.symptom, business, Forecasting
Abstract: Hospitalization in the elderly patients is highly associated with morbi-mortality. Geriatric post-acute and rehabilitation care wards are designed to provide care and to implement life project of elderly patients. Objective of this study was to characterize rehospitalizations after a stay in geriatric post-acute and rehabilitation care wards. METHODS The study was retrospective, case-control, including all the patients hospitalized in the 4 geriatric post-acute and rehabilitation care wards of a hospital in Paris (France) and returned at home. Data collection was carried out on the basis of the hospitalization report and the information system of the hospital. Rehospitalizations were documented by the information system as well as by telephone interview. We compared patients according to whether they had been rehospitalized or not within 60 days after discharge. RESULTS Out of a total of 1,063 stays during a 12 months period, 435 (41%) were discharged at home. Re-admission rate was 10.1% at 30 days and 18.4% at 90 days. Mean age of rehospitaliszed patients was 87.2 years ± 5.3 vs 87.9 years ± 5.8 for non-rehospitalized patients. Patients rehospitalized had more often a delirium during the prior hospitalization. CONCLUSION Unplanned rehospitalisation is a major public health issue and should be prevented particularly after a stay in a geriatric post-acute and rehabilitation care wards.
Published: 2018
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9. Auteurs

Author: Laetitia, Amalou, Cédric, Annweiler, Élise, Artaud-Macari, Alexis, Arvin-Bérod, Patrick, Assayag, Maria, Bailleul, Emma, Bajeux, Grégory, Baptista, Martine, Barateau, Bernard, Bauduceau, Laetitia, Beernaert, Joël, Belmin, Athanase, Bénétos, Michel, Benoit, Hubert, Blain, Sylva, Blazkova, Wanda, Blervaque, Sylvie, Bonin-Guillaume, Mylène, Bonnaire, Marc, Bonnefoy, Mathilde, Bordage, Lyse, Bordier, Chokri, Boubakri, Didier, Bouccara, Anne-Sophie, Boureau, Bruneau, Marie-Andrée, Pierre-Emmanuel, Cailleaux, Priscille, Carvalho, Philippe, Chassagne, Aline, Corvol, Matthieu, Coulongeat, Antoine, Cuvelier, Sandra, De Breucker, Laure, De Decker, Tristan, De Nattes, Amandine, Dessertennes, Audrey, De Vos, Benoît, de Wazières, Frédéric, Di Fiore, Aurélien, Dinh, Cristiano, Donadio, Jean-Michel, Dorey, Jean, Doucet, Olivier, Drunat, Feriel, Fennira, Claire, Falandry, Juliette, Fontaine, Thibaut, Fraisse, Patrick, Friocourt, Tamàs, Fülöp, Julien, Gaudric, Jean-Bernard, Gauvain, Gaëtan, Gavazzi, Xavier, Gbaguidi, Charles-Emmanuel, Geffroy, Christian, Geny, Édouard, Georgeton, Baptiste, Gérard, Angélique, Giacomini, Mathilde, Gisselbrecht, Alice, Gochard-Rodrigues, Bernard, Goichot, Régis, Gonthier, Odile, Goria, Adrien, Grancher, Béatrice, Guérin, Dominique, Guerrot, Olivier, Hanon, Charlotte, Havreng-Théry, Réjean, Hébert, Mathieu, Herrmann, Patrick, Hidoux, Jérémie, Huet, Witold, Jarzebowski, Olivier, Jeanjean, Georges, Kaltenbach, Alain, Koskas, Pierre, Krolak-Salmon, Carmelo, Lafuente-Lafuente, Pierre-Olivier, Lang, Martine, Le Noc Soudani, Amandine, Lecarpentier, Laurent, Lechowski, Pierre-Olivier, Lefebvre, Anne, Léger, Caroline, Lemaitre, Thierry, Lequerré, Anaïs, Lesourd, Pierre, Lutzler, Arach, Madjlessi, Éric, Maeker, Emmanuel, Maheu, Patrick, Manckoundia, Nathalie, Maubourguet, Sylvie, Meaume, Anne, Michel, Boubacar, Mohamed, Hélène, Montialoux, Sophie, Moulias, France, Mourey, Stéphane, Nacache, Sylvain, N'Guyen, Charlotte, Nouhaud, Jean-Luc, Novella, Christel, Oasi, Marine, Olivieri, Bruno, Oquendo, Mourad, Ould Slimane, Marc, Paccalin, Elena, Paillaud, Frédéric, Pamoukdjian, Sylvie, Pariel, Erika, Parmentier-Decrucq, Christine, Perret-Guillaume, Mélissa-Asli, Petit, François, Pinoche, Julien, Poissy, Valérie, Pouysségur, Isabelle, Prêcheur, Alain, Putot, Yasmine, Rassam-Hasso, Agathe, Raynaud-Simon, Clothilde, Riquier, Frédéric, Roca, Jean, Roche, Pierre-Alexandre, Roger, Nathalie, Salles, Patricia, Senet, Dominique, Somme, Carmen, Suna-Enache, Alain, Tavildari, Achille, Tchalla, Laurent, Teillet, Lise, Teisseire, Cathy, Théry, Éric, Vérin, Maurice, Viala, Marguerite, Vignon, Olivier, Vittecoq, Eugenia, Volpentesta, Lise, Willems, Alberto, Zalar, Sabrina, Aït, Gilles, Albrand, Jean-Pierre, Aquino, André, Aurengo, Odile, Baugé-Faraldi, Nadine, Bazin, Jean-Louis, Beaudeux, Xavier, Belenfant, Lotfi, Ben Slama, Athanase, Benetos, Jean-Marc, Bereder, Gilles, Berrut, François, Blanchard, Jacques, Boddaert, Christophe, Bouché, Rabia, Boulahssass, Isabelle, Bourdel-Marchasson, Anne, Bruhat, Marie-Andrée, Bruneau, Agnès, Camus, Corinne, Capet, Emmanuelle, Champion, Dominique, Chavanne, Patrick, Chérin, Florence, Chopin, Thierry, Constans, Pascal, Couturier, Véronique, Cressot, Laure, de Decker, Anne-Sophie, De Saint-Léger, Benoit, De Wazières, Philippe, Denormandie, Violaine, Derambure, Laurent, Druesne, Bernard, Durand-Gasselin, Richard, Durant, Marc, Faraldi, Anne-Laure, Fauchais, Audrey, Fel, Éric, François, Florent, François, Éric, Frau, Jacques, Gaillat, Danièle, Ganem-Chabenet, David, Gaucher, Pierre, Gauthier, Gaël, Gendron, Armelle, Gentric, Laura, Goodrich, Isabelle, Got, Etty, Grynberg, Jean-Michel, Guérin, Olivier, Guerin, Karine, Guignery-Kadri, Bernard, Guillot, Victor, Haddad, Pierre, Haond, Cyril, Hazif-Thomas, Jacqueline, Henry, François, Héron, Géraldine, Heurteux, Caroline<ce:sup loc='post">†</ce:sup>, Hommet, Marc, Humbert, Cécile, Hvostoff, Jean-Marc, Jacquot, Claude, Jeandel, Nadir, Kadri, Norelyakin, Kara, Aïda, Kerkeni, Aïni, Khris, Kiyoka, Kinugawa, Rémy, Klein, Emmanuel, Krupka, Marc, Labétoulle, Gilles, Lascault, Julien, Le Guen, Cédric, Le Guillou, Véronique, Lefebvre des Noëttes, Daniel, Letonturier, Caroline, Levasseur, Jean-Pierre, Louvel, Emmanuelle, Magny, Nicolas-Dominique, Manchon, Dominique, Manière, Jean, Mariani, Sophie, Marilier, Thierry, Marquet, Charlotte, Mathon, Emmanuel, Mazen, Anthony, Mézière, Pierre, Michel Jean, Christelle, Mischis-Troussard, Anne-Sophie, Moiziard, A., Morais José, Robert, Moulias, Andy, Musat, Angela, Musat, Cathy, Nabet, Henry, Noguès, Fati, Nourhashémi, Fannie, Onen, Hakki, Onen S., Yves, Otmezguine, Béatrice, Pallot-Prades, Marie-Pierre, Pancrazi, Maxime, Patout, Éric, Pautas, Jérôme, Pellerin, Renaud, Péquignot, Benoît, Pernot, Anne, Petit, Pierre<ce:sup loc='post">†</ce:sup>, Pfitzenmeyer, Benoît, Plaud, Emilie, Puget, François, Puisieux, Lucie, Quibel, Muriel, Rainfray, Cyrielle, Rambaud, Vincent, Rialle, Yves, Rolland, Jean-Nicolas, Royal, Guillaume, Savard, Jean-Pierre, Schuster, Denise, Strubel, Catherine, Terrat, Catherine, Terret, Jean-Étienne, Terrier, Daniel, Tessier, Sarah, Thomas, Thierry, Thomas, Christophe, Trivalle, Lucie, Valembois, Bruno, Vellas, Éric, Verin, Marc, Verny, Marie, Vetel Jean, Pierre, Veyssier, Thomas, Vogel, and Fabienne, Wirotius
Published: 2023
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10. Oral Teicoplanin as an Alternative First-Line Regimen in Clostridium difficile Infection in Elderly Patients: A Case Series

Author: Hugues Michelon, Maryvonne Villart, Laurent Teillet, Frédérique Bouchand, Benjamin Davido, Jérôme Salomon, Céline Leplay, Aurélien Dinh, and Jean-Laurent Le Quintrec
Subjects: Male, 0301 basic medicine, medicine.medical_specialty, 030106 microbiology, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Recurrence, Internal medicine, Humans, Medicine, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Adverse effect, Aged, 80 and over, Geriatrics, Clostridioides difficile, business.industry, Teicoplanin, General Medicine, biochemical phenomena, metabolism, and nutrition, Clostridium difficile, Anti-Bacterial Agents, carbohydrates (lipids), Regimen, Immunology, Clostridium Infections, Vancomycin, Female, France, business, medicine.drug
Abstract: Elderly patients are more susceptible to Clostridium difficile infections (CDIs). Despite existing guidelines, there is no specific treatment for CDI in geriatrics. Vancomycin is commonly used in the treatment of CDI. Teicoplanin is an alternative glycopeptide which recently received marketing authorization approval for CDI in Europe. Evaluate the potential interest of oral teicoplanin and assess whether such treatment could potentially become an alternative treatment in mild to severe CDIs in elderly patients. A prospective monocentric study was conducted over 10 months (from December 2015 to October 2016) in a geriatric unit (Sainte Perine, AP-HP, Paris, France). According to the remote infectious disease specialist, some hospitalized patients suffering from CDI and aged over 65 years received oral teicoplanin 200 mg twice a day (highest dose recommended). The clinical response to teicoplanin and relapses after treatment were evaluated. Patients were monitored up to 90 days after teicoplanin administration, and analyzed in non-responder imputation analysis. Eleven patients received teicoplanin among 19 CDIs during the study time period. In non-responder imputation analysis, 90.9% (n = 10) successfully responded to oral teicoplanin. The rate of relapse observed after a 90-day follow-up was 36.4%. Patients reported no drug-related adverse effects. Oral teicoplanin is a glycopeptide that could be proposed as an alternative to other recommended drugs for CDI. In our case series, teicoplanin seems to be an effective therapy as a first-line regimen for CDI in geriatrics. Such treatment has good acceptability in geriatrics, considering it can be taken orally twice a day.
Published: 2017
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11. Unusually High PSA Level Allows Diagnosis of a Metastatic Prostate Cancer in Older Man

Author: Marion Pépin, M. Clua, J. Idoux, S. Ngo, T. Cudennec, and Laurent Teillet
Subjects: Oncology, medicine.medical_specialty, Screening test, medicine.diagnostic_test, business.industry, Cancer, Computed tomography, medicine.disease, Prostate cancer, Antigen, Internal medicine, medicine, Hormonal therapy, business
Abstract: Prostate cancer is now the most commonly diagnosed cancer amongst men in France despite the absence of a generalized screening program. Prostate-specific antigen (PSA) level can be used as a screening test. We report the case of an 86-year-old patient, whose metastatic prostate cancer was diagnosed on an unusually high PSA level (over 5000µg/L), without urologic signs. The diagnostic was then confirmed by a thoracicabdominal-pelvic CT scan, which found diffuse metastases, before hormonal therapy started.
Published: 2020
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12. Off-label use of midazolam in older inpatients: analysis of prescribing practices in a French hospital (MIDnight study)

Author: Bruno Le Dastumer, Mathilde Gourdon, Laurent Teillet, Cécile Pons‐Peyneau, Marie Herr, Hugues Michelon, Hôpital Sainte Perine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de recherche en épidémiologie et santé des populations (CESP), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay
Subjects: Male, genetic structures, [SDV]Life Sciences [q-bio], Off-label use, 030226 pharmacology & pharmacy, 0302 clinical medicine, SAFER, Hypnotics and Sedatives, heterocyclic compounds, Pharmacology (medical), Practice Patterns, Physicians', Geriatrics, Aged, 80 and over, Analgesics, Hospitals, behavioral disturbances, 3. Good health, Editorial, midazolam, Premedication, Female, France, medicine.symptom, benzodiazepine, medicine.drug, medicine.medical_specialty, medicine.drug_class, Sedation, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MEDLINE, Drug Prescriptions, 03 medical and health sciences, Midnight, medicine, Humans, Medical prescription, Adverse effect, Aged, Anesthetics, Pharmacology, Benzodiazepine, Inpatients, business.industry, geriatric medicine, Off-Label Use, Drug Utilization, Dilemma, Anti-Anxiety Agents, Family medicine, Emergency medicine, Midazolam, business, 030217 neurology & neurosurgery
Abstract: International audience; Midazolam is a short-acting benzodiazepine approved for sedation and anesthesia induction. Recent data suggested that midazolam may also be used in off-label indications such as treatment of behavioral and psychological disturbances in older people. Given the scarcity of published data and a lack of evidence in older people in such indications, midazolam raises concern because it may also cause serious-related adverse events. To provide a better understanding of its real-life use in geriatrics, we examined the prescribing practices of midazolam in French older inpatients. Of the 460 patients aged 65 years and over hospitalized at the time of the study, 21 had a prescription of midazolam (5%) which was mainly prescribed for anxiolysis (n = 12), premedication before painful procedures (n = 5), and agitation (n = 4). Midazolam was often prescribed “as required,” and the median duration of prescription was 6 months. This work results in a better knowledge and information about the use of midazolam in older people. These prescribing practices, which are not anecdotal, also plead for age-specific guidelines for the treatment of behavioral and psychological disturbances.
Published: 2020
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13. Usage et évaluation des prescriptions antibiotiques en gériatrie

Author: Jérôme Salomon, B. Davido, Aurélien Dinh, Laurent Teillet, and Jean Laurent Le Quintrec
Subjects: 0301 basic medicine, medicine.medical_specialty, medicine.drug_class, business.industry, Risk of infection, 030106 microbiology, Antibiotics, General Medicine, Antibiotic prescription, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Infectious disease (medical specialty), Geriatric population, medicine, 030212 general & internal medicine, Medical prescription, Intensive care medicine, business
Abstract: Due to the high risk of infection, the geriatric population is regularly subjected to antibiotics. Faced with bacterial resistance, particularly among elderly dependent patients, it is essential to promote proper use and correct prescription of antibiotics. A study evaluated antibiotic prescription in a geriatric hospital with 598 beds and highlighted the importance of collaboration between geriatricians and infectious disease specialists.
Published: 2016
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14. Representation and practice about «chimical restraints»: qualitative study with 50 health worker

Author: Brice Colombier, Laurent Teillet, Florence Muller, Tristan Cudennec, Sophie Moulias, Delphine Preulier, and Niccolo Curatolo
Subjects: Adult, Male, Attitude of Health Personnel, Middle Aged, Drug Utilization, Benzodiazepines, Young Adult, Neuropsychology and Physiological Psychology, Geriatrics, Surveys and Questionnaires, Humans, Hypnotics and Sedatives, Ethnology, Female, France, Neurology (clinical), Sociology, Geriatrics and Gerontology, Health worker, Humanities, Biological Psychiatry, Antipsychotic Agents
Abstract: Le terme « contention chimique », en anglais chemical restraints, semble etre utilise en pratique, mais de perception heterogene entre les differents professionnels de sante francais. Il se rapproche, dans la litterature, de l’utilisation des psychotropes pour les comportements perturbateurs. La methode de recherche qualitative basee sur des entretiens semi-diriges a pour objectif de decrire la comprehension du terme « contention chimique » aupres du personnel medical et paramedical en geriatrie. Ce terme est compris, peu employe au quotidien, inexact pour certains car « les medicaments n’attachent pas ». Le terme « contention physique » a une realite plus visible. Le terme « sedation de symptomes psychocomportementaux » est plus usite et de connotation moins culpabilisante. En pratique, la contention chimique peut correspondre a l’utilisation en urgence de benzodiazepines ou neuroleptiques, par voie injectable, avec des posologies permettant la sedation d’un patient sans son consentement.
Published: 2015
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15. Potentially inappropriate prescription of antidepressants in old people: characteristics, associated factors, and impact on mortality

Author: Florence Muller de Schongor, Laurent Lechowski, Jean-Marie Robine, Marie Herr, Laurent Teillet, Joël Ankri, Jean-Jacques Arvieu, Anne Hiance-Delahaye, Service de gériatrie [AP-HP Hôpital Sainté Périne], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpital Sainte Perine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Département Hospitalier d’Epidémiologie et de Santé Publique [Hôpitaux Universitaires de Paris Ile-de-France Ouest], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Mécanismes moléculaires dans les démences neurodégénératives (MMDN), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UMR 8211 / U988 / UM 7), École des hautes études en sciences sociales (EHESS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Faraldo, Beatrice, Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-AP-HP Hôpital Sainte Perine, Biologie du Développement et Reproduction (BDR), Institut National de la Recherche Agronomique (INRA)-Institut National Agronomique Paris-Grignon (INA P-G), COordination pour la Mesure de la Performance et l'Amélioration de la Qualité ( Hôpital, Patient, Sécurité, Territoire) (COMPAQ(HSPT) - U988), École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR), AG2R La Mondiale [Paris] (Direction des Etudes), Prévoyance Individuelle et IARD [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-École pratique des hautes études (EPHE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Montpellier (UM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École pratique des hautes études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)
Subjects: Male, Databases, Factual, [SDV]Life Sciences [q-bio], Inappropriate Prescribing, Comorbidity, community care, 0302 clinical medicine, Epidemiology, Risk of mortality, Prevalence, Drug Interactions, 030212 general & internal medicine, Aged, 80 and over, Antidepressive Agents, 3. Good health, [SDV] Life Sciences [q-bio], Psychiatry and Mental health, Clinical Psychology, antidepressants, Population study, epidemiology, Female, France, medicine.medical_specialty, 03 medical and health sciences, Internal medicine, medicine, Humans, Medical prescription, Mortality, Adverse effect, Geriatric Assessment, Aged, Polypharmacy, Psychiatric Status Rating Scales, Depressive Disorder, Proportional hazards model, business.industry, medicine.disease, adverse events, 030227 psychiatry, Cross-Sectional Studies, Logistic Models, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Multivariate Analysis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Geriatrics and Gerontology, business, Gerontology
Abstract: Background:The increasing use of antidepressants (ADs) has raised concerns about their inappropriate use in old people.Objective:To examine the prevalence of potentially inappropriate prescribing (PIP) of ADs, their associated factors, and their impact on mortality in a sample of old people in France.Methods:The analysis used data from the SIPAF study, a cross-sectional study consisting of 2,350 people aged ≥ 70 years. Trained nurses interviewed participants at home between 2008 and 2010. Information was collected concerning socio-demographic and health characteristics, including medication use. The study population consisted of the 318 AD users from the SIPAF study (13.5%). PIP of ADs was defined according to national and international criteria. Factors associated with PIP of ADs were assessed using a multivariate logistic regression model. The influence of PIP of ADs on mortality was assessed using a Cox model (median follow-up 2.8 years).Results:Among the SIPAF study, 71% of AD users were female and the mean age was 84 ± 7 years. Selective serotonin reuptake inhibitors (SSRIs) were the most prescribed ADs (19.8%). We found PIP of ADs in 36.8% of the study population, mainly the co-prescription of diuretics with SSRIs (17.6%) and the prescription of tricyclics (12.9%). PIP of ADs was associated with polypharmacy (aOR5-9 drugs 2. 61, 95% CI 1.11–6.16 and aOR≥10 drugs 2.69, 95% CI 1.06–6.87) and comorbidity (aOR3-4 chronic diseases 2.59, 95%CI 1.04–6.44 and aOR≥5 chronic diseases 2.33, 95%CI 0.94–5.79), and increased the risk of mortality during follow-up (aHR 2.30, 95%CI 1.28–4.12).Conclusions:This study shows that more than one third of AD prescriptions may be inappropriate in old people. PIP of ADs was related to polypharmacy and comorbidity and increased mortality among AD users.
Published: 2017
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16. Anticiper la fin de vie

Author: Charlotte Naline, Rodolphe Daire, Amélie Aregui, Adèle de Malherbe, Lucie Aubert, Laurent Teillet, Tristan Cudennec, Charlotte Braga, and Sophie Moulias
Subjects: General Medicine
Published: 2014
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17. Laparoscopy versus EVAR for the Treatment of Abdominal Aortic Aneurysms in the Octogenarian

Author: Laurent Teillet, Marc Coggia, Isabelle Di Centa, Tristan Cudennec, Isabelle Javerliat, Marc Dennery, Raphaël Coscas, and Olivier Goëau-Brissonnière
Subjects: Male, medicine.medical_specialty, Multivariate analysis, Comorbidity, Demographic data, Risk Factors, medicine, Humans, Statistical analysis, High surgical risk, Endovascular treatment, Laparoscopy, Aged, 80 and over, medicine.diagnostic_test, business.industry, Endovascular Procedures, General Medicine, Aortic surgery, Surgery, Treatment Outcome, Operative time, Female, Cardiology and Cardiovascular Medicine, business, Aortic Aneurysm, Abdominal
Abstract: Octogenarians are considered at high surgical risk for the treatment of abdominal aortic aneurysms (AAA). The laparoscopic aortic surgery (LAS) and the endovascular treatment (EVAR) are 2 minimum invasive techniques whose objective is to limit the operative traumatism. The objective of this study was to compare our results with short- and medium-term results with these 2 techniques in the octogenarians.Between January 2002 and December 2012, the data of 674 operated consecutive AAA (315 LAS, 172 EVAR, and 187 open surgeries) were collected prospectively. Eighty-seven patients aged ≥80 years presenting a favorable anatomy were treated by LAS or EVAR. Twenty-five patients aged ≥85 years with a favorable anatomy were excluded because we generally did not propose LAS to them. Statistical analysis compared the demographic data and the results of the 2 groups. The principal criterion of judgment (PCJ) was the combined rate of mortality and severe systemic complications (MSSC) at 30 days. An uni/multivariate model was used to determine the factors associated with the occurrence of the PCJ. The data were expressed as means and standard deviations. A P value ≤0.05 was considered significant.Sixty-two patients (90% men, age 81.8 ± 1.4 years) were included. There were 31 EVAR and 31 LAS. The 2 groups were comparable concerning the demographic data, the comorbidities, and the aneurysmal anatomies. There was a nonsignificant tendency to higher rates of mortality (9.7 vs. 3.2%, P = 0.3) and MSSC at 30 days (16.1 vs. 3.2%, P = 0.09) in the LAS group. During the operation, LAS was associated with a longer operative time (289 ± 85 vs. 152 ± 57 min, P 0.0001), more blood losses (1,073 ± 763 vs. 148 ± 194 mL, P 0.0001), and more transfusions (2.0 ± 3.0 vs. 0.9 ± 1.1 units, P = 0.048). In the postoperative period, the patients operated by LAS had longer reanimation and hospitalization stays (12.9 ± 13.1 vs. 7.0 ± 2.5 days, P = 0.02; and 3.3 ± 4.4 vs. 0.6 ± 0.7 days, P = 0.002; respectively). However, in multivariate analysis, an operative duration300 min was the only variable associated with the PCJ (P = 0.05). With a follow-up of 9.0 ± 10.7 month, there were 2 reinterventions in the EVAR group, whereas with a follow-up of 38.0 ± 23.9 month, no reintervention was observed in the LAS group.In the short run, EVAR significantly reduces the operative traumatism in comparison with LAS in the octogenarian presenting an AAA with a favorable anatomy. However, the choice of the technique is not independently predictive of MSSC at 30 days. When a durable repair is desirable, LAS remains a possible option in the octogenarian with a good general condition presenting a favorable aneurysmal anatomy.
Published: 2014
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18. Management of patients over 80 years of age treated with resection for localised colon cancer: Results from a French referral centre

Author: Astrid Lièvre, Christophe Penna, Laurent Teillet, Robert Malafosse, Stéphane Benoist, Bernard Nordlinger, Tristan Cudennec, Philippe Rougier, Frédérique Peschaud, Valérie Laurent, Jean-Nicolas Vaillant, Céline Lepère, Catherine Julié, and Emmanuel Mitry
Subjects: Male, medicine.medical_specialty, Colorectal cancer, medicine.medical_treatment, Humans, Medicine, Stage (cooking), Medical prescription, Referral and Consultation, Colectomy, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, Chemotherapy, Hepatology, business.industry, Mortality rate, General surgery, Gastroenterology, Perioperative, medicine.disease, Combined Modality Therapy, Surgery, Survival Rate, Treatment Outcome, Colonic Neoplasms, Referral centre, Female, France, Morbidity, Metastasectomy, business, Follow-Up Studies
Abstract: Background Few data are available on management of very elderly colon cancer patients, especially concerning the parameters of therapeutic decisions and the role of geriatricians. Methods We retrospectively reviewed the charts of patients over 80 years of age who underwent surgery for a localised colon cancer in a French academic hospital. Results A total of 176 patients underwent surgery (postoperative morbidity and mortality rates: 25% and 6.7%). Adjuvant chemotherapy was discussed at a multidisciplinary team meeting for 91% of stage III patients, but only 13.5% of them were treated. Twenty-five patients relapsed: 19 were discussed at the multidisciplinary meeting and 16 were treated (5 had a metastasectomy). Despite their increase with time, geriatric assessments were infrequent, 17% (33% after 2006), and had no impact on postoperative morbi-mortality. Median overall survival and recurrence-free survival were 65.3 months and 65.1 months, respectively. Age, emergency surgery, and Charlson comorbidity index were independent prognostic factors. Conclusion Selected elderly colon cancer patients have significant access to surgery. However, postoperative morbi-mortality rates remain high and adjuvant chemotherapy rarely prescribed. Perioperative geriatric assessment, especially before surgery, should be routinely proposed to these patients to evaluate its impact on postoperative morbi-mortality and prescription of adjuvant treatment.
Published: 2014
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19. 36. La place du PET-scan dans le diagnostic de la maladie de Horton

Author: Dany Vythilingum, Laurent Teillet, Annabella Tiboul, Marie Breton, Sophie Balesdent, and Laurent Lechowski
Subjects: media_common.quotation_subject, General Medicine, Art, Humanities, media_common
Published: 2018
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20. L’importance de l’association gériatres-réanimateurs

Author: Laurent Teillet, Tristan Cudennec, Cyril Charron, Sophie Moulias, and Antoine Vieillard-Baron
Subjects: business.industry, Medicine, General Medicine, business
Published: 2013
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21. First year prognosis of patients hospitalized in an acute geriatric ward with a known dementia or newly diagnosed

Author: D. Tortrat, B. Denis, Marine Le Crane, L. Grandcollot, Laurent Teillet, Anne-Laure Vétillard, Florence Muller de Schongor, Sophie Van Pradelles, Lucie Aubert, Laurent Lechowski, and Zina Seridi
Subjects: Gynecology, medicine.medical_specialty, business.industry, Institutionalization, Newly diagnosed, Prognosis, Neuropsychology and Physiological Psychology, Quality of Life, Humans, Medicine, Dementia, Prospective Studies, Neurology (clinical), Geriatrics and Gerontology, business, Biological Psychiatry
Abstract: In France, only a third of demented patients have an established diagnostic of dementia. Hospitalization is often an opportunity to perform a diagnostic of dementia. Real benefits for patients of such a diagnostic process are unknown. The objective of the study was to observe prognosis of elderly patients hospitalized in geriatric courses in terms of mortality, hospitalization rate and entry into an institution. This was a monocentric prospective study with a one-year follow-up of 90 patients hospitalized in an acute geriatric ward with either dementia known by general practitioner, either diagnosed during the hospitalization according to DSM IV criteria. A one year follow-up by phone has been conducted. From a consecutive set of 159 inpatients for 18 weeks, we included in this study 49 patients with a known dementia (group 1, mean age 85.7±4.6 years, mean Mini-mental state examination (MMSE) score 12.4±6.2) and 41 patients with dementia diagnosed during hospitalization (group 2, mean age 88.4±6.4 years, mean MMSE score 16.1±6.5). Differences between the two groups were significant for age (p0.03) and MMSE score (p0.02). One-year mortality rate was near 30% in the 2 groups. Rate of institutionalization was 33% in group 1 and 49% in group 2 (not statistically significant). There was a significant difference in number of days spent at home between group 1 and group 2, respectively 190.9±159.9 days vs 111.1±148.1 days (p0.03). Demented patients previously diagnosed lived longer at home at one year than patients newly diagnosed. These results tend to support the diagnosis of dementia in very elderly patients with multiple comorbidities. Conditions of living at home, in particular the quality of life, should be the object of further studies.
Published: 2013
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22. [Antibiotic prescription usage and assessment in geriatric patients]

Author: Aurélien, Dinh, Benjamin, Davido, Jérôme, Salomon, Jean-Laurent, Le Quintrec, and Laurent, Teillet
Subjects: Aged, 80 and over, Geriatric Nursing, Drug Resistance, Multiple, Bacterial, Humans, Interdisciplinary Communication, Bacterial Infections, France, Prospective Studies, Intersectoral Collaboration, Prescription Drug Overuse, Aged, Anti-Bacterial Agents
Abstract: Due to the high risk of infection, the geriatric population is regularly subjected to antibiotics. Faced with bacterial resistance, particularly among elderly dependent patients, it is essential to promote proper use and correct prescription of antibiotics. A study evaluated antibiotic prescription in a geriatric hospital with 598 beds and highlighted the importance of collaboration between geriatricians and infectious disease specialists.
Published: 2016

23. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study

Author: Odile Fremin-Batteux, Juliette Clarissou-Philippe, Benoît Jauhlac, Severine Guyetand, Jacques Gasnault, Corinne Haioun, Liamine Aissaoui, Marie-Christine Pages, Marie-Pierre Fos, Christian Rose, Didier Hubert, Marie-Rose Rothe, N. Bouziges, Benoît Huc, François Devianne, Sabine Bidart, Anne Forest, Kevin Bertrand, Mohamed Eldeghedy, Annick Verhaeghe, Caroline Malderet, Anne Bertrou, Bernard Guerquin, Catherine Duche, Muriel Archambaud, Rabea Cotteret, Olivier Toullalan, Yves Devaux, Smail Bergheul, Valérie Sivadon-Tardy, Pierre-Gilles Merville, Geneviève Blanchard-Marche, Didier Raoult, Bernard Hory, Florence Richardin, Evelyne Belle, Mohamed Menouar, K Guitteaud, Mohamad Mohty, Ambroise Montcriol, Max Laurin, Aurélia Picard, Jean-Paul Mira, Marie-Charlotte Chopin, Richard Bonnet, Michel Wolff, Sébastien Maillez, Jeanne Maugein, Véronique Leblond, Nicola Walid, Bernard Gauche, Mathieu Evillard, Hassen Jeddi, Anne Bourlet, Isabelle Grawey, Thierry Jault, Sandrine Hiret, Valerie Gaborieau, Véronique Boin-Gay, An Kim, Thierry Constans, Jean-François Gaide, Martine Giraud, Eric Meaudre Desgouttes, Alain Fur, Abdallah Maakaroun, Olivier Matray, Bertrand Maubert, Frédérique Péchinot, Aurelie Garbi, Claire Delbrouck, Benoît Grandclerc, Vincent Cadiergue, Hervé Lécuyer, Bernadette Grignon, Thierry Bensaid, Nicole Constantin, Yannick Chevalier, Hassène Rahmani, Thierry Levent, Joelle Desliers, Florence Van de Velde, Xavier Adhoute, Clara Andriau, Christophe Charasse, Rémi Vatan, Benoît Martha, Alain Lecis, Didier Albert, Romain Jacobs, Hélène Lefranc, Christian Martin, Nasseur Rezgui, Bertrand Pigeon, Catherine Le Henaff, Dominique Cassignard, Françoise Cotes, Eric Pujade Lauraine, Jean-François Gattault, Nicole Ferreira-Maident, Noémie Jourde-Chiche, Hélène Garrec, Olivier Darchen, Carole Schwebel, Marie-Christine Bezian, Patrick Daoud, Tsouria Becaid, Simone Laluque, David Broche, Christine Boisselier, Pascale Martres, Sarah Hammami, Brigitte Olivier, Jean-Marie Nkunzimana, Eric Monlun, Isabelle Marterl-Lafay, Marion Carboni, Marie-Françoise Mattei, Sandrine Castelin, Isabelle Barillot, Marie-Noelle Cufi, Thomas Kaiser, Catherine Herry, Pascal Hutin, Jean-Pierre Bronowicki, Bernard Branger, Pierre Thomas, Elie Zagdoun, Anne Goquelin, Ziad Assaf, Ingrid Croquet, Bruno Pozzetto, Thomas Similowski, Anne-Isabelle Briere, Marie-Thérèse Albertini, Mariam Blaka, Christelle Tassot, Anne Gaschet, Jean-Philippe Lavigne, Antoine Pujol, Philippe Colombat, Edouard Devaud, Hana Talabani-Boizot, François Barière, Anne-Marie Cordier, Philippe Gueudet, Georges Simon, Anne-Sophie Lipovac, Françoise Bandaly, Anne Beauplet-Lepage, Sylvie Prince, Charlotte Jouzel, Jean-Luc Deboutin, Patrick Zavadil, Louis Puybasset, Marie-Cécile Petit, Loïc Guillevin, Kamel Touati, Christophe Ntalu Nkato, Sylvie Carette, Jacques Vaucel, Chantal Delasalle, Marine Gross Goupil, Laurent Gutmann, Christiane Payen, Annick Barboteau, Firouzé Bani-Sadr, Christophe Legendre, Philippe Roulier, Elie Azria, Ibrahim Farah, Isabelle Rouquette-Vincent, Anne-Sophie Erena-Penet, Philippe Labadie, Eric Josien, Aicha Derragui, Mathieu Legrand, Odile Beyne-Rauzy, Jean-Marc Nabholtz, Marie-Joelle Demarcq, Olivier Garosi, Michel Deiber, Fabrice Chaix, Bertrand Souweine, Anne Collignon, Gisèle Renard, Mickael Jego, Gilles Bernardin, Anne Allart, Jocelyn Barrier, Marc Vasse, Philippe Ménager, Marc Wurmser, Abderkader Ouazir, Olivier Gontieron, Yvon Berland, Sébastien Trouiller, David Leysenne, Christophe Ozanon, Fanny Autret, Tahar Saghi, Loïc Dopeux, Sophie Benoit-Coustou, T. Fraisse, Christine Maillard, Karine Nikodijevic, Georges Kaltenbach, Angéline Jamet, Philippe Aucher, Julie Bottero, Marie-Claude Piffaut, Marianne Besnard, Florence Courillon, Marie Bonfils, Christine Ghevaert, Marie Destors, Eliette Jeanmaire, Franck Zerbib, Manuel-Luis Gameiro, T Prazuck, Laurent Mandin, Olivier Guisset, Marguerite Fines, Toufik Feddal, Agnès Jouffret, Louis Mesnard, Thomas Bourrée, Hasinrina Razafimahefa, Sylvestre Tigaud, Vincent Estève, Philippe Malherbe, Jean-Michel Salord, Pascal Adam, Bertrand Rozec, Michel Fuillet, Olivier Lemenand, Denis Quinsat, Ana Danalaché, Véronique Vialette, François Brosset, Patrick Messner Pellenc, Nicolas Heisel, Edouard Girard, Régine Martin, Olivier Garesslin, Catherine Mille, Alexandre Gascon, Marc Nicolino, Laurence Mouly, Claire Fabre, Bénédicte Ponceau, Marie-Etiennette Emeriau, Pascal Cathebras, Bérangère Bernardaud, Michèle Pérouse de Montclos, O. Arsene, Karine Grenet, Yazdan Yazdanpanah, Sten De Witte, Anne Scemla, Laurence Bouillet, Christophe Burucoa, Vincent Loffeier, Séverine Visentin, Luc Desfrere, Miloud Arabi, Frédérique Costa, Sylvie Lechat, Ali Chekroun, Raymond Ruimy, Marie, Jérôme Bizet, Xavier Nassif, Baihas Dib, Patrick Bert-Marcaz, Laurent Martin Lefèvre, Nicholas Sedillot, Blandine Cattier, Emilie Boidin, Daniel Sondag, Aude Bourrouillou, Alain Noirot, Franck Desemerie, Fréderic Heluwaert, Catherine Tamalet, Marc G. 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Costa, Chandrah Goburdhun, Bernard Gressier, Alban Michaud-herbst, Franck Charlier, Moussa Hecham, Luc Boulain, Hélène Corneloup, Alix Greder Belan, Nicolas Boussekey, Claire-Antoinette Dupuy, Yannick Rouquet, Benoit Renard, Benifla Jl, Etienne Javouhey, Michèle Granier, Marie-Christine Jaffarbandjee, Emilie Piet, Benoît Bergues, Claire Malbrunot, Catherine Tiry, Philippe Mérigot, Mouna Ben Soltana, Chantal Roure Sobas, Florian Radenac, Yves Thomas, Agathe Blaise, Sylvie De Martino, Laurence Legout, Gabriel Choukroun, Jean-François Muir, Peggy Dupretz, Patrick Dupont, François Guichart, Julie Jean, Jean-Michel Descamps, Bernard Kittschke, Anne Gruson, Gerard Viquesnel, Marie Keller, Pascal Chavanet, Françis Vallet, Yvan Vaschalde, Jean-Luc Hanouz, Gerard Lina, Françoise Loison, Simon Vincent, Jean-Paul Thellier, Moncef Afi, Dominique Zagozda, Hélène Sokeng-Affoule, Marc Le Bideau, Jean-François Loriferne, Alain Gravet, Sophie Deprecq, Tarik Naceur, Severine Mielczarek, René-Jean Bensadoun, Bernard Karkous, Yves Bléher, Jocelyne Poulain, Véronique Goulet, Laurence Nicolet, Sophie Arista, Antônio Lúcio Teixeira, Jean-François Schved, Laurent Nicolet, Claire Lecomte, Faiza Benddif-Fin, Michel Aumersier, Laurence Burc-Struxiano, Maxime Thouvenin, Samia Harbi, Mathieu Detave, Catherine Rebeyrotte, Jean-Paul Kisterman, Bruno Berdin, Pascal Vincent, Laurent Argaud, Elisabeth Parisi-Duchene, Geneviève Julienne, Fernanda Farto-Bensasson, Georges-Fabrice Blum, Sad Gaizi, Tali-Anne Szwebel, Raphaël Lepeule, Marie-Thérèse Climas, Anne-Françoise Dillies, Amar Boudhane, Umberto Simeoni, Pierre-François Dequin, Gérard Oliviero, Alain Gourlaouen, Caroline Piau, Marie-France Lutz-Murphy, Benoît Claude, Jean-Paul Aubry, Nadine Dubosc-Marchenay, Kamilla Chraibi, Emmanuelle Heusse, Sylvain Le Chevallier, Nathalie Brieu, Farid Sifaoui, Lorraine Letranchant, Hélène Durox, Jean-Pierre Lagasse, Adel Ghedira, Xavier Roubert, Fatma Magdoud, Hélène Jean-Pierre, Etienne Carbonelle, Olivier Dereeper, Lionel Carbillon, Christophe Billy, Mélanie Roblin, Marie-José Kodzin, Philippe Niel, Solène Makdessi, Matteo Vassallo, Maryse Archambaud, Fabian Haccourt, Didier Blaise, Stéphane Bourgeois, Elena Marcu, Charles Kubiak, Brisse Castel, François Guinet, Marie Pouzoullic, Frédérique Nathan-Bonnet, Vincent Gendrin, Céline Becherrawy, Aline Secher, Pierre Abgueguen, Clarence Eloy, Jean-Marc Tourani, Frédéric Klapczynski, Bernard Montmasson, Philippe Real, Joanna Pofelski, Yves Welker, Karim Krechiem, Eric Caumes, Martine Elena-Daumas, Christophe Saigne, Gilles Hittinger, Chantal Delesalle, Jonathan Messika, Fabrice Lesage, Daniela Pop, Daniel Coetmeur, Renato Colamarino, Chetaou Mahaza, Patrick Plésiat, Isabelle Fredenucci, Mylène Baret, Guy Mager, Pascale Chavel, Isabelle Labourdette, Anne-Claude Menguy, Nicolas Fortineau, Ludovic Le Sec, Valérie Gauduchon, Francis Barraud, Nicolas Letellier, Didier Vincent, Janine Frey, Philippe Riegel, Michel Pavic, Jean-Luc Fabre, Jean-Pierre Fauchart, Alain Goudeau, Stéphanie Husson-Wetzel, Philippe Eymerit, Mohamed Camara, Nathalie Seta, Elisabeth Carole Ngo Bell, Philippe Repellin, Laurent Alric, Vincent Leroy, Françoise Delisle Mizon, Jean-Philippe Emond, Marie-Françoise Borie, Lise Crémet, Wladimir Chelle, Elisabeth Brottier-Mancini, Bernard Garrigues, Claire Letellier, Loïc Geffray, Frédéric Méchaï, Julien Bador, Benoit Guery, Alain-Charles Fouilhoux, Corinne Dagada, Pierre Duhaut, Julien Goustille, Arnaud Sément, Francis Carcenac, Isabelle Girard-Buttaz, Claire Chapuzet, Fabienne Jouatte, Bruno Riou, Fabrice Hayoun, Chloé Di Meglio, Youssef Ali, Michel Leneveu, Nathalie Montagne, Yves Garcera, Audrey Moustache, Pierre-Eric Danin, Geneviève Le Lay, Dominique Courouge-Dorcier, Isabelle Worcel, Emmanuel Morelon, Vincent Pestre, Jean-Pierre Vilque, Jean-Christophe Paquet, Lucien Bodson, Anne-Marie Forest, Fabrice Pierre, Christian Pommier, Fabien Dutasta, Pierre Fournel, Stéphanie Courtois, Elodie Dubois, Serge Vanden Einjden, Patrick Honderlick, Pascal Richette, Fabienne Tamion, Véronique Chassy, Richard Megbemado, Anne-Marie Le Reste, Bernard Simian, Henri Osman, Anthony Texier, Badih Ayach, François Simon, Jean-Michel Filloux, Béatrice Dubourdieu, Jean-Claude Semet, Sarah Kubab, Tawfiq Henni, Patrick Dudeffant, Delphine Hequet, Olivier Mimoz, Marc Auburtin, Amélie Chabrol, Mickael Bonnan, Caroline Léonnet, Claire Wintenberger, Serge Ilunga, Patrice Lanba, Sophie Rosello, Alexandre Damage, Flore Bouche, Michel Thibault, Frederic Faibis, Chantal Dhennain, Jean-Philippe Talarmin, Armelle Lamour, Remi Boussier, Fabien Garnier, Marie-Laure Brival, Nourredine Hedjem, Philippe Vande-perre, Raphaël Coint, Jean-Claude Reveil, Eva Weinbronn, Emmanuelle Lavalard, Alexandra Fille, Françoise Le Turdu, Lionel Leroux, Jean-Yves Lefrant, Jean Berthet, Radia Bouaziz, Alain Ravaud, Sylvaine Rousseau, Yacine Merrouche, Alain Le Coustumier, Bertrand Guider, Gisèle Dewulf, Jean-Marc Faucheux, Jacques Piquet, Franck Leibinger, Charles Cerf, Robin Stephan, Jean-Philippe Redonnet, Jean-Paul Stahl, Ella Dzeing, Simona Pavel, Guy Vernet, Ghada Hatem, Samer Kayal, Jacques Deschamps, Dominique Descamps, Marion Levast, Marc Bouiller, Sylvie Dargere, Claire Dingremont, Stéphane Gaudry, François Maillot, Sylvie Odent, Nathalie Cervantes, Hélène Zanaldi, Laurence Gachassin, Olivier Ruyer, David Patin, Benoît Cazenave, Pascal Jacquier, Michelle Boyer, Béatrice Berteaux, Virginie Zarrouk, Jacques Bor, Isabelle Legoff, Hélène Albinet, Florence Rousseau, Gilles Pialoux, Guenaelle Salaun-Beretta, Alexandra Moura, Véronique Vernet Garnier, Didier Lepelletier, Pierre-Alexandre Hauss, Joëlle Belaisch-Amart, Didier Lepeletier, Jacob Xavier, Aline Nare, Annie Motard-Picheloup, Alain Améri, Bertrand Lioger, Jean-Valère Malfuson, Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Listeria - National Reference Center Listeria (CNRL), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria / WHO Collaborating Centre Listeria (CC-OMS / WHO-CC), Institut Pasteur [Paris] (IP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Département de Médecine interne [Lariboisière], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Biologie des Infections - Biology of Infection, Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), Institut Pasteur [Paris] (IP), Infectious Disease Department [Saint Maurice], Agence Nationale de la Santé Publique [Saint-Maurice] (ANSP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, MONALISA study group, Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency., ROZIER, marie-Claire, CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections (CNRL), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria - Biologie des Infections (CCOMS), CHU Pitié-Salpêtrière [APHP], Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Institut Pasteur [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections ( CNRL ), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre collaborateur de l'OMS (CCOMS) des Listeria ( CCOMS ), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Lariboisière, Biologie des Infections, Institut Pasteur [Paris]-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources ( ICAReB ), Agence Nationale de la Santé Publique [Saint-Maurice] ( ANSP ), Assistance Publique - Hôpitaux de Paris, Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes - Paris 5 ( UPD5 ), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris]-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)
Subjects: Bacteremia/epidemiology/mortality, 0301 basic medicine, Male, Pediatrics, bacteraemia, Infectious Disease Transmission, [SDV]Life Sciences [q-bio], Bacteremia, France/epidemiology, Infant, Newborn, Diseases, Foodborne Diseases, Meningoencephalitis, Pregnancy, Risk Factors, Vertical, Medicine, Listeriosis, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, ddc:618, diabetes, alcoholism, Hazard ratio, Foodborne Diseases/microbiology, immuno suppressive therapies, Prognosis, 3. Good health, [SDV] Life Sciences [q-bio], Hospitalization, Infectious Diseases, isolates, Population Surveillance, Female, France, Listeria monocytogenes/classification/isolation & purification, Cohort study, Adult, medicine.medical_specialty, 030106 microbiology, Notifiable disease, Listeriosis/diagnosis/epidemiology/microbiology, Context (language use), macromolecular substances, 03 medical and health sciences, Humans, study, Aged, [ SDV ] Life Sciences [q-bio], business.industry, Public health, cirrhosis, Infant, Newborn, Infant, Diseases/epidemiology/microbiology, HIV, Mandatory Reporting, Newborn, medicine.disease, Listeria monocytogenes, infection, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious/epidemiology/microbiology, Meningoencephalitis/epidemiology/microbiology/mortality, Observational study, business, prognostic, mellitus
Abstract: International audience; Evidence before this study We searched PubMed on June 30, 2016, for English-language cohort studies published since Jan 1, 1980, of patients with invasive listeriosis worldwide with the keywords " listeria " , " listeriosis " , " maternal " , and " neurolisteriosis ". Studies had to include epidemiological or clinical data on listeriosis. All clinical forms of infection were included (bacteraemia, neurolisteriosis, and maternal–neonatal infection). Host risk factors for listeriosis have been well identified, but the clinical features and prognostic factors of the disease are based on retrospective studies compiling heterogeneous data or random collected cases. Furthermore, no clinical trial has ever been done and medical management is not evidence based. Added value of the study Our study is the first prospective clinical study focusing on all forms of invasive listeriosis. The study is based on a national mandatory system that allowed the nearly complete capture of microbiologically proven cases. The study shows a higher burden of listeriosis than reported before: more than 80% of infected mothers experienced major fetal or neonatal complications (fetal loss, very high prematurity, early or late onset disease); only 39% of patients with neurolisteriosis survived and fully recovered. The study provides important new data to improve management and predict outcome in listeriosis, such as determination of the time window for fetal losses (
Published: 2016
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24. Geriatric factors analyses from FFCD 2001-02 phase III study of first-line chemotherapy for elderly metastatic colorectal cancer patients

Author: Faiza Khemissa, Jean-François Seitz, J. Cretin, Olivier Bouché, Laurent Teillet, Dominique Genet, Jean-Baptiste Bachet, Jean-Louis Jouve, Olivier Boulat, Dany Gargot, Thierry Lecomte, Céline Lepère, Mohamed Ramdani, Gilles Breysacher, Christophe Locher, Iradj Sobhani, Emilie Maillard, Emmanuel Mitry, Thomas Aparicio, Dominique Auby, Roger Faroux, Mohamed Gasmi, Laetitia Stefani, Service de Gastro-entérologie [Avicenne], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Fédération Francophone de la Cancérologie Digestive, FFCD, CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpitaux Civils Colmar, Service d'oncologie digestive et hépato-gastro-entérologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Image et ville (IV), Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique (CNRS), Département de cancérologie et d'hématologie, CHU Grenoble-Hôpital Michallon, Service Hépato-gastroentérologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Département de Médecine, Centre Hospitalier Libourne, Centre Hospitalier Départemental Les Oudairies, Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique (MEPPOT - U1147), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC), Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gastro-entérologie [Henri Mondor AP-HP, Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Institut Curie [Paris], Lipides - Nutrition - Cancer [Dijon - U1231] (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, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris 13 (UP13)-Hôpital Avicenne, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Centre hospitalier de Libourne, Service de gastroentérologie et cancérologie digestive [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service de gastro-entérologie - Hôpital Henri Mondor, Institut Curie, Université Paris 13 ( UP13 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Avicenne, Centre d'Investigation Clinique [Rennes] ( CIC ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Reims ( CHU Reims ), Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Image et ville ( IV ), Université Louis Pasteur - Strasbourg I-Centre National de la Recherche Scientifique ( CNRS ), Institut d'Electronique et de Télécommunications de Rennes ( IETR ), Université de Nantes ( UN ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National des Sciences Appliquées - Rennes ( INSA Rennes ) -CentraleSupélec-Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Régional Universitaire de Tours ( CHRU TOURS ), Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique ( MEPPOT - U1147 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Lipides - Nutrition - Cancer [Dijon - U1231] ( LNC ), Université de Bourgogne ( UB ) -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 ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Oncology, Male, Cancer Research, medicine.medical_specialty, Multivariate analysis, Colorectal cancer, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, Kaplan-Meier Estimate, Prognostic factors, Irinotecan, Disease-Free Survival, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 03 medical and health sciences, 0302 clinical medicine, Carcinoembryonic antigen, Elderly, Quality of life, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Karnofsky Performance Status, Neoplasm Metastasis, Prospective cohort study, Geriatric Assessment, Aged, Aged, 80 and over, Chemotherapy, biology, business.industry, medicine.disease, 3. Good health, Treatment Outcome, Fluorouracil, 030220 oncology & carcinogenesis, biology.protein, Quality of Life, Camptothecin, Female, business, Colorectal Neoplasms, medicine.drug
Abstract: IF 6.163; International audience; AIM:Several predictors of metastatic colorectal cancer (mCRC) outcomes have been described. Specific geriatric characteristics could be of interest to determine prognosis.METHOD:Elderly patients (75+) with previously untreated mCRC were randomly assigned to receive infusional 5-fluorouracil-based chemotherapy, either alone (FU) or in combination with irinotecan (IRI). Geriatric evaluations were included as an optional procedure. The predictive value of geriatric parameters was determined for the objective response rate (ORR), progression-free survival (PFS) and overall survival (OS).RESULTS:From June 2003 to May 2010, the FFCD 2001-02 randomised trial enrolled 282 patients. A baseline geriatric evaluation was done in 123 patients; 62 allocated to the FU arm and 61 to the IRI arm. The baseline Charlson index was ≤1 in 75%, Mini-Mental State Examination was ≤27/30 in 31%, Geriatric Depression Scale was >2 in 10% and Instrumental Activities of Daily Living (IADL) was impaired in 34% of the patients. Multivariate analyses revealed that no geriatric parameter was predictive for ORR or PFS. Normal IADL was independently associated with better OS. The benefit of doublet chemotherapy on PFS differed in subgroups of patients ≤80 years, with unresected primary tumour, leucocytes >11,000 mm3 and carcinoembryonic antigen >2N. There was a trend towards better OS in patients with normal IADL.CONCLUSION:The autonomy score was an independent predictor for OS. A trend toward a better efficacy of doublet chemotherapy in some subgroups of patients was reported and should be further explored.
Published: 2016
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25. Transfusion-transmitted hepatitis E in a misleading context of autoimmunity and drug-induced toxicity

Author: Anne-Laure Vétillard, Marie-Pierre Férey, Stéphanie Haim-Boukobza, Asma Jeblaoui, Elisabeth Pélissier, Gilles Pelletier, Laurent Teillet, and Anne-Marie Roque-Afonso
Subjects: Male, Context (language use), Liver injury, medicine.disease_cause, Autoimmune Diseases, Autoimmunity, medicine, Humans, Aged, Aged, 80 and over, Hepatitis, Hepatology, Transmission (medicine), business.industry, Transfusion, Transfusion Reaction, Drug-induced liver toxicity, Middle Aged, medicine.disease, Hepatitis E, Drug induced toxicity, Immunology, Viral Markers, Female, Chemical and Drug Induced Liver Injury, business
Abstract: Hepatitis E is currently diagnosed after all other causes of hepatitis have been excluded. Moreover, HEV testing is not performed to prevent blood transmission in developed countries. We report here on the case of a patient with acute hepatitis while receiving potentially hepatotoxic medications for autoimmune disorders, with low-level autoimmune markers and negative ‘‘standard’’ viral markers; it was finally determined that he was suffering from transfusion-transmitted hepatitis E. 2012 European Association for the Study of the Liver. Published
Published: 2012
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26. La personne de confiance en médecine générale

Author: Sophie Moulias, Brice Colombier, Laurent Teillet, and Rodolphe Daire
Subjects: General Medicine
Abstract: ■ Le theme de la personne de confiance ne s'est pas implante dans la pratique des medecins generalistes ■ Leur relation au long cours avec les patients les place pourtant dans une position privilegiee pour aborder ce sujet ■ La personne de confiance semble pouvoir permettre d'ameliorer la qualite des soins ■ Divers facteurs limitant la designation de la personne de confiance temoignent des insuffisances actuelles du dispositif.
Published: 2012
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27. Mise en œuvre d’une procédure de désignation d’une personne de confiance

Author: Sophie Moulias, Aurélie Todeschi, Laurent Teillet, Éric Bertrand, Magali Dumont, and Yasmina Welter
Subjects: General Medicine
Published: 2012
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28. La tuberculose du patient âgé

Author: Tristan Cudennec, Anne-Laure Vétillard, and Laurent Teillet
Subjects: General Medicine
Published: 2012
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29. Mise en place d’une activité de conciliation médicamenteuse d’entrée dans une unité de gériatrie aiguë et analyse des divergences non intentionnelles

Author: Maryvonne Villart, Hugues Michelon, Fabienne Marteau, Laurent Lechowski, Nolwenn Rio-Clément, Sophie Balesdent, Laurent Teillet, Camille Tardy, Lesly Fellous, and Dany Vythilingum
Subjects: Pharmacology (medical)
Abstract: Introduction La conciliation medicamenteuse (CM) est un processus de recueil d’informations permettant d’optimiser la prescription lors de l’entree du patient notamment en reduisant les erreurs medicamenteuses. Les divergences sont le resultat de la comparaison du bilan medicamenteux optimise (BMO) et de l’ordonnance des medicaments a l’admission (OMA). Ces divergences peuvent etre intentionnelles (DI) de la part du prescripteur, ou au contraire non intentionnelles (DNI). L’objectif de ce travail est de presenter les differentes divergences observees 3 mois apres la mise en place de cette activite sur 29 lits de geriatrie aigue de notre etablissement. Materiels et methode L’activite de CM a ete effectuee avec l’aide d’un externe en pharmacie encadre par un pharmacien senior. Dans les 48 h apres l’admission dans le service, une revue exhaustive des traitements pris par le patient avant l’hospitalisation a ete realisee grâce a diverses sources d’informations (dossier patient, entretien patient/pharmacien d’officine, ordonnances …) puis comparee a l’OMA prescrite dans PHEDRA®. Un tableau Excel® nous a permis de compiler pour chaque patient les donnees demographiques, les sources utilisees (nature, nombre), le BMO (nombre de lignes), l’OMA (nombre de lignes) et les divergences observees (nombre, nature et type). Resultats et discussion Sur les 3 mois d’activite, 106 patients ont ete concilies, dont 7 patients concilies deux fois suite a leurs readmissions dans le service. L’âge moyen des patients etait de 88 ± 4,6 ans avec un ratio H/F = 0,41. Les CM ont ete realisees dans les premieres 24 h (87 %) ou dans les 24–48 h (13 %) apres l’admissions des patients. En moyenne, 5 sources d’informations ont permis d’etablir le BMO. Les sources les plus consultees etaient le dossier patient papier et informatise (99 %), le courrier d’hospitalisation externe (93 %), les ordonnances du patient (86 %) et le pharmacien d’officine (65 %). Un total de 875 lignes dans les BMO a ete compare aux 877 lignes retrouvees dans les OMA. Parmi les 553 divergences relevees, 499 etaient intentionnelles (90 %) dont 44 % non documentees et 54 non intentionnelles (10 %). Les DNI detectees entre le BMO et l’OMA etaient reparties de la facon suivante : 42 medicaments omis a l’admission, 11 modifications de posologies (8 posologies infra-therapeutiques et 3 posologies supra-therapeutiques) et 1 substitution d’une association medicamenteuse par une autre contenant un principe actif a action pharmacologique differente. Les therapeutiques les plus concernees par des DNI sont les medicaments a visee digestive et metabolique (27,8 %), cardiovasculaire (20,4 %) et neurologique (14,8 %). Le temps moyen par conciliation a ete de 100 ± 28 minutes par patient. Conclusion La mise en place de la CM a permis une contribution significative de la pharmacie aupres des medecins et des soignants. Au-dela de confirmer l’interet de cette activite dans la prevention de l’iatrogenie medicamenteuse, en particulier chez le sujet âge polypathologique et polymedique, ce travail demontre la necessite d’etendre et de perenniser l’activite au sein de notre etablissement geriatrique.
Published: 2017
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30. Impact of low-molecular-weight heparin practice guidelines in a geriatric hospital

Author: Laurent Teillet, Lydie d’Arailh, Marie-Line Gaubert-Dahan, Florence Muller, and Laurent Lechowski
Subjects: Male, medicine.medical_specialty, Inservice Training, Metabolic Clearance Rate, Hospital Departments, Drug Administration Schedule, medicine, Humans, Practice Patterns, Physicians', Biological Psychiatry, Aged, Aged, 80 and over, Gynecology, Evidence-Based Medicine, Dose-Response Relationship, Drug, business.industry, Anticoagulants, Heparin, Low-Molecular-Weight, Neuropsychology and Physiological Psychology, Geriatrics, Female, France, Guideline Adherence, Neurology (clinical), Drug Monitoring, Geriatrics and Gerontology, business
Abstract: The purpose of this study was to assess the impact of good use of anticoagulants guidelines implementation on low molecular weight heparin (LMWH) prescription in a french geriatric hospital. This interventional "before and after" study was conduced by the same geriatrician on a d-day in 2006 and 2009. Guidelines for anticoagulant's prescription based on selected references in the literature was established by an expert's consensus and implemented in 2008. Data were collected in all departments at the Sainte-Perine geriatric hospital for each patient with an LMWH prescription. Assessment was based on quality judgment criteria (indication, dosage, treatment duration, biological monitoring of LMWH). Data were collected for 72 prescriptions prior to the guidelines implementation and for 54 after. Sex-ratio, mean age and percentage of LMWH prescription did not differ significantly between the two periods. There was a better conformity for LMWH dosage prescription (p = 0.002) and biological monitoring prescription (p = 0.036) after the guidelines implementation. Conformity of LMWH indication and treatment duration were improved but the difference remained not significant (respectively p = 0.49 and p = 0.80). Implementing guidelines for LMWH use in geriatrics can improve quality of prescription. The impact was effective but limited. These guidelines are now in general use in the Sainte-Perine hospital.
Published: 2011
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31. Les infections urinaires chez la personne âgée

Author: Laurent Teillet, Tristan Cudennec, and Charlotte Naline
Subjects: medicine.medical_specialty, business.industry, medicine.drug_class, Urinary system, Antibiotics, Renal function, General Medicine, urologic and male genital diseases, Fluid intake, Sex factors, Internal medicine, Medicine, business, Asymptomatic bacteriuria
Abstract: In the elderly, urinary tract infections are frequent. Diagnosis is not always evident because symptoms are often absent. In doubt, a urinary strip evaluation must be performed. Prevention begins with simple lifestyle and dietary rules, such as good voiding and adequate fluid intake. Asymptomatic bacteriuria is treated only in certain cases. Other urinary tract infections require antibiotics, which must be adapted to renal function.
Published: 2014
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32. Use of a simplified geriatric evaluation in thoracic oncology

Author: Sophie Moulias, Thierry Chinet, Sylvie Labrune, Tristan Cudennec, Laurent Teillet, Violaine Giraud, and Thierry Gendry
Subjects: Male, Pulmonary and Respiratory Medicine, Cancer Research, medicine.medical_specialty, Lung Neoplasms, medicine.medical_treatment, Symptomatic treatment, Comorbidity, Internal medicine, Thoracic Oncology, medicine, Health Status Indicators, Humans, Lung cancer, Geriatric Assessment, Aged, Aged, 80 and over, Chemotherapy, business.industry, Respiratory disease, Cancer, medicine.disease, Surgery, Radiation therapy, Oncology, Geriatric oncology, Female, business
Abstract: Management of elderly patients with bronchial cancer should take into account specific factors linked to the patient's age, and the presence of co-morbidities. A geriatric evaluation enables us to use relevant information in the therapeutic decision-making process. However, the Comprehensive Geriatric Assessment described in the literature is tedious and time-consuming. We describe the use of a simplified geriatric evaluation (SGE), in 57 patients aged ≥75 years (mean age: 80.8 years) with thoracic cancer, before discussing therapeutic options with colleagues from various departments. This evaluation enabled us to classify the patients into four groups: group 1 consisted of patients in a good general state; group 2+ comprised patients with no more than two stabilized co-morbidities or one poorly or non-stabilized co-morbidity; group 2− comprised patients with more than two stabilized co-morbidities, or at least two poorly or non-stabilized co-morbidities; group 3 consisted of frail patients. The three patients in group 1 did not have any negative factors that could complicate their management and therefore received anti-tumor therapy. The 15 patients in group 3 were considered to have co-morbidities or functional alterations that were too advanced for them to benefit from anti-tumor therapy, and received symptomatic treatment only. Among the 39 patients in the intermediary groups 2+ and 2−, 24 underwent surgery, chemotherapy or radiotherapy (21 (87.5%) patients in group 2+ and 3 (20.0%) patients in group 2−). These data suggest that the SGE is an important aid to decision-making in the management of elderly patients with bronchial cancer.
Published: 2010
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33. Patterns of Loss of Basic Activities of Daily Living in Alzheimer Patients: A Cross-Sectional Study of the French REAL Cohort

Author: Laurent, Lechowski, Sophie, Van Pradelles, Marine, Le Crane, Lydie, d'Arailh, Danièle, Tortrat, Laurent, Teillet, Bruno, Vellas, and C, Cantet
Subjects: Male, Gerontology, Activities of daily living, Bathing, Cross-sectional study, Cognitive Neuroscience, Neuropsychological Tests, Cohort Studies, Cognition, Alzheimer Disease, Activities of Daily Living, Humans, Medicine, Aged, Aged, 80 and over, business.industry, Cognitive disorder, Mean age, Middle Aged, medicine.disease, Psychiatry and Mental health, Cross-Sectional Studies, Socioeconomic Factors, Cohort, Disease Progression, Linear Models, Female, France, Geriatrics and Gerontology, Alzheimer's disease, business, human activities, Cohort study
Abstract: Background/Aims: To characterize loss of basic activities of daily living (BADL) in 687 Alzheimer’s disease (AD) community-dwelling patients included in the French REAL cohort. Methods: Patients had mild to moderately severe AD, and the mean age was 77.8 years. Patterns of loss of the 6 BADL were described at inclusion using the Lawton scale. Results: With 6 binary BADL scores, each patient presented at inclusion a set of losses. For 53% of women, the sets of losses were included within each other or were identical, adding losses in physical ambulation, grooming, bathing, dressing, toilet and feeding, respectively. For 47% of men, a similar sequence was identified, with loss of dressing occurring secondly. A global cohesion of sets of losses was found for 87% of women and 86% of men. The Lawton scale is very useful for the assessment of AD patients.
Published: 2010
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34. Les programmes d'éducation à la santé semblent efficaces pour bien vieillir

Author: Bruno Corman, Vincent Vanbockstael, Laurent Teillet, and Sylvie Lauque
Subjects: Health (social science), Geriatrics and Gerontology, Gerontology
Abstract: Pour reussir son vieillissement en restant en bonne sante et autonome le plus longtemps possible, un mode de vie sain evitant les facteurs de risque des grandes pathologies doit etre adopte precocement et maintenu. Il n’est toutefois jamais trop tard pour bien faire. Modifier des comportements meme tardivement peut s’averer benefique pour la sante. Les differents travaux resumes dans cet article montrent que les personnes qui reduisent leurs facteurs de risque vieillissent en meilleure sante, retardent la survenue de la dependance et changent leur mode de consommation de soins. Ces actions de promotion visant a ameliorer les comportements positifs peuvent etre ciblees sur certains aspects de la sante, tels que la nutrition, l’activite physique, le sommeil, la prise de medicaments ou etre integrees dans des programmes globaux couvrant plusieurs de ces domaines.
Published: 2008
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35. Les pathologies digestives

Author: Laurent Teillet
Published: 2016
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36. Liste des auteurs

Author: Jean-Pierre Aquino, Tristan Cudennec, Lucette Barthélémy, Sandrine Andrieu, Joël Ankri, Laurence Arrouy, Lucie Aubert, Joseph John Baranes, Béatrice Barret, Élodie Baudry, Catherine Bayle, Sébastien Beaune, Anne-Marie Beguin, Mathilde Beguin, Alain Bérard, Antonin Blanckaert, Dominique Bonnet Zamponi, Walid Bouaziz, Didier Bouccara, Julie Bouchara, Marie-Anne Brieu, Christophe Bula, Philippe Caillet, Laurent Cambon, Gauthier Caron-Thibault, Barbara Carrère, Pierre-Marie Chapon, Kevin Charras, Philippe Chassagne, Anita Chevallier, Roland Chevrier, Andrée Coconnier, Marc Cohen, Niccolo Curatolo, Rodolphe Daire, Adèle De Malherbe, Jocelyne de Rotrou, Philippe Dejardin, Mathilde Demory, Bertrand Denis, Sandrine Derville, Marie-Odile Desana, Élodie Driessen, Bernard Duportet, Delphine Dupré-Lévêque, Charlotte Dupuy, Catherine Durpoix, Sandra Eclancher, Begum Errol Forestier, Laurent Farag, Gwenaelle Fauchard, Nathalie Faucher, Dorin Feteanu, Romain Forestier, Françoise Forette, Alain Françon, Marie-Françoise Fuchs, Tamas Fulop, Gaëtan Gavazzi, Marie Geoffroy, Xavier Gervais, Paule Giron, Marie-Christine Godart, Oliver Guérin, Philippe Guillet, Claire Guitton, Fabrice Gzil, Didier Halimi, Marc Harboun, Pascale Hautin, Bernard Hervy, Mathieu Houles, Sidonie Hubert, Laurence Hugonot-Diener, Julie Hugues, Philippe Hugues, Nicole Jacquin-Mourain, Claude Jeandel, Anne-Catherine Jothy, Georges Kaltenbach, Vincent Lapierre, Pierre-Olivier Lefebvre, Sylvie Legrain, Julien Le Guen, Aurélie Lemaire, Christine Lesure, Arach Madjlessi, Évelyne Malaquin-Pavan, Marie-Agnès Manciaux, Marie-Laure Martin, Nathalie Maubourguet, Pascal Menecier, Alexis Mohebi, Jean-Manuel Morvillers, Valérie Motte, Sophie Moulias, Araceli Muela Garcia, Florence Muller, Mathilde Noaillon, Michel Nogues, Fabrice Nouvel, Delphine Paccard, Éléna Paillaud, Hélène Péan, Cécilia Pedepeyrau, Étienne Pigné, Stéphanie Pin, Hervé Platel, Frédéric Prate, Giuliana Rapagnani, Agathe Raynaud-Simon, Daniel Reguer, Jacqueline Renkes, Valérie Reznikoff, Philippe Robert, Jean-Marie Robine, Élisabeth Rogez, Yves Rolland, Monique Rothan-Tondeur, Guillaume Sacco, Pascale Saint-Gaudens, Jean-Claude Salord, Elisé Schmitt, Brigitte Sifaoui, Dominique Somme, Lartigue Sophie, Olivier Suzanne, Laurent Teillet, Antonio Teixeira, Anne Lyse Thillard, Karim Tifratène, Sarah Trotet, Bruno Vellas, Christiane Verny, Marc Verny, Géraldine Viatour, Ève Vilaine, Marion Villez, Hélène Vincent, and Thomas Vogel
Published: 2016
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37. Avant-propos

Author: Laurent Teillet
Published: 2016
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38. Patterns of Loss of Abilities in Instrumental Activities of Daily Living in Alzheimer’s Disease: The REAL Cohort Study

Author: Philippe Robert, B. Denis, Philippe Chassagne, Matthieu de Stampa, Laurent Teillet, Bruno Vellas, Laurent Lechowski, and D. Tortrat
Subjects: Male, Gerontology, Activities of daily living, Cognitive Neuroscience, Disease, Neuropsychological Tests, Severity of Illness Index, Cohort Studies, Alzheimer Disease, Surveys and Questionnaires, Activities of Daily Living, medicine, Humans, Dementia, Grading (education), Cognitive disorder, medicine.disease, Psychiatry and Mental health, Housekeeping, Cohort, Female, Psychomotor Disorders, Geriatrics and Gerontology, Psychology, human activities, Follow-Up Studies, Cohort study
Abstract: Background/Aims: To determine patterns of loss of abilities in instrumental activities of daily living (IADL) in community-dwelling women with Alzheimer’s disease (AD). Methods: Sixteen French university hospitals included 471 consecutive women with mild to moderately severe AD (Mini-Mental State Examination scores between 10 and 26) from April 2000 to June 2002 in the noninterventional REAL cohort. At inclusion, 6 and 12 months, IADL were assessed with the Lawton scale. Patterns of loss of abilities in the 8 IADL of the Lawton scale were described using Lawton binary grading. Results: At inclusion, 56.7% of the patients shared the same pattern of loss of abilities and 84.3% had this pattern or variants of it. Frequencies of the 8 incapacities were: 80.7% to do the grocery shopping, 76.0% to take medication, 72.2% to prepare meals, 41.4% to travel on public transportation even when assisted, 40.6% to manage purchases, 30.1% to launder small items, 14.2% to participate in some housekeeping tasks and 11.0% to answer the telephone. Conclusion: In this study including 471 community-dwelling women with AD of the French REAL cohort, the loss of the 8 IADL, assessed with the Lawton binary grading, was homogeneous for more than four fifths of the patients.
Published: 2007
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39. Traitement médical des diverticulites aiguës non compliquées

Author: Jean-Luc Schmit, Arnaud Bourreille, Didier Loiseau, Laurent Teillet, Jean Boyer, and Philippe Montravers
Subjects: medicine.medical_specialty, business.industry, General surgery, Gastroenterology, MEDLINE, medicine, General Medicine, Diverticulitis, Complication, business, medicine.disease
Published: 2007
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40. Social Cognition: An Early Impairment in Dementia of the Alzheimer Type

Author: Bénédicte Dieudonné, Laurent Teillet, Marc Verny, Philippe Fossati, Jacqueline Nadel, and Claire-Marie Verdon
Subjects: Adult, Male, medicine.medical_specialty, Intention, Neuropsychological Tests, Severity of Illness Index, Association, Cognition, Alzheimer Disease, Social cognition, medicine, Humans, Dementia, Young adult, Social Behavior, Psychiatry, Aged, 80 and over, Cartoons as Topic, Cognitive disorder, medicine.disease, Causality, Psychiatry and Mental health, Clinical Psychology, Case-Control Studies, Educational Status, Female, Geriatrics and Gerontology, Alzheimer's disease, Psychology, Attribution, Gerontology
Abstract: Objective: A core component of social functioning is the capacity to attribute mental states to others and to understand intention as psychologic cause. The hypothesis of this study was that dementia of the Alzheimer type (DAT) patients show an impaired understanding of psychologic cause although they remain able to understand physical causality. Methods: To test this hypothesis, 20 elderly adults with DAT, 20 healthy age-matched controls, and 20 healthy young adults were presented a cartoon task requiring them to process physical or psychologic cause of events. Results: Patients with DAT at onset scored significantly lower than controls when they had to reason about psychologic causation, while they did not differ for reasoning about physical causation. Consistent with these results, patients with DAT showed significantly lower scores in psychologic reasoning as compared with their scores for physical causality. Instead young and elderly healthy adults scored similarly for the 2 types of causality and the 2 groups did not differ in their scores. These results suggest that impaired understanding of intention in others may be considered as an early socio-cognitive index of onset of DAT. A post hoc division of the group of patients with DAT into 2 subgroups according to Mini Mental State (MMS) scores showed that the group with the more severe MMS scores not only had lower scores for psychologic causality but also showed impairment in reasoning about physical causality involving persons. Physical causality involving objects remained relatively preserved. Conclusions: The remarkable deficit in attribution of intention in our patients with DAT at onset and the following deterioration of their performance in reasoning about physical causality with persons may reflect progressive dysfunction of the superior temporal sulcus in Alzheimer disease.
Published: 2007
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41. [A geriatrics unit with a 24 hour visiting policy]

Author: Adèle, de Malherbe, Sophie, Moulias, Tristan, Cudennec, and Laurent, Teillet
Subjects: Humans, France, Visitors to Patients, Hospital Units, Organizational Policy, Aged
Abstract: As hospitals' visiting times are extended, patients' families and friends are granted an ever more important place. The nursing team of an acute geriatrics unit open 24/7 examined the place and the role of patients' families and friends and their involvement in care.
Published: 2015

42. Urea transporter expression in aging kidney and brain during dehydration

Author: Ghislaine Geelen, Marie-Marcelle Trinh-Trang-Tan, Bruno Corman, and Laurent Teillet
Subjects: Aging, Vasopressin, medicine.medical_specialty, Physiology, Urea transporter, Aquaporins, Thirst, Kidney Concentrating Ability, chemistry.chemical_compound, Physiology (medical), Internal medicine, medicine, Animals, Urea, Aging brain, Dehydration, Aquaporin 4, Kidney Medulla, Kidney, Water Deprivation, biology, Chemistry, Osmolar Concentration, Brain, Membrane Transport Proteins, Rats, Inbred Strains, medicine.disease, Rats, Arginine Vasopressin, medicine.anatomical_structure, Endocrinology, biology.protein, Urine osmolality, Female, medicine.symptom
Abstract: Aging is commonly associated with defective urine-concentrating ability. The present study examined how the kidney and the brain of senescent (30-mo-old) female WAG/Rij rats respond to dehydration induced by 2 days of water deprivation in terms of urea transporter (UT) regulation. In euhydrated situation, senescent rats exhibited similar vasopressin plasma level but lower urine osmolality and papillary urea concentration and markedly reduced kidney UT-A1, UT-A3, and UT-B1 abundances compared with adult (10-mo-old) rats. Senescent rats responded to dehydration similarly to adult rats by a sixfold increase in vasopressin plasma level. Their papillary urea concentration was doubled, without, however, attaining that of dehydrated adult rats. Such an enhanced papillary urea sequestration occurred with a great fall of both UT-A1 and UT-A3 abundances in the tip of inner medulla and an increased UT-A1 abundance in the base of inner medulla. UT-A2 and UT-B1 were unchanged. These data suggest that the inability of control and thirsted senescent rats to concentrate urine as much as their younger counterparts derives from lower papillary urea concentration. In aging brain, UT-B1 abundance was increased twofold together with a fourfold increase in aquaporin-4 abundance. Dehydration did not alter the abundance of these transporters.
Published: 2003
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43. Correction of age-related polyuria by dDAVP: molecular analysis of aquaporins and urea transporters

Author: Sophie Combet, Jean-Marc Verbavatz, Nancy Geffroy, Laurent Teillet, Bruno Corman, Bernhard Dick, Marie-Marcelle Trinh-Trang-Tan, and Véronique Berthonaud
Subjects: Aging, medicine.medical_specialty, Vasopressin, Physiology, Urinary system, Gene Expression, Urine, Aquaporins, Renal Agents, urologic and male genital diseases, Urine flow rate, Polyuria, Internal medicine, Arginine vasopressin receptor 2, medicine, Animals, Urea, Deamino Arginine Vasopressin, Aquaporin 3, Kidney Medulla, Kidney, Aquaporin 2, Membrane Glycoproteins, urogenital system, Chemistry, Osmolar Concentration, Membrane Transport Proteins, Rats, Inbred Strains, Water-Electrolyte Balance, Aquaporin 6, Rats, Endocrinology, medicine.anatomical_structure, Female, Nitric Oxide Synthase, medicine.symptom, Carrier Proteins, Corticosterone, hormones, hormone substitutes, and hormone antagonists
Abstract: Senescent female WAG/Rij rats exhibit polyuria without obvious renal disease or defects in vasopressin plasma level or V2receptor mRNA expression. Normalization of urine flow rate by 1-desamino-8-d-arginine vasopressin (dDAVP) was investigated in these animals. Long-term dDAVP infusion into 30-mo-old rats reduced urine flow rate and increased urine osmolality to levels comparable to those in control 10-mo-old rats. The maximal urine osmolality in aging rat kidney was, however, lower than that in adult kidney, despite supramaximal administration of dDAVP. This improvement involved increased inner medullary osmolality and urea sequestration. This may result from upregulation of UT-A1, the vasopressin-regulated urea transporter, in initial inner medullary collecting duct (IMCD), but not in terminal IMCD, where UT-A1 remained low. Expression of UT-A2, which contributes to medullary urea recycling, was greatly increased. Regulation of IMCD aquaporin (AQP)-2 (AQP2) expression by dDAVP differed between adult and senescent rats: the low AQP2 abundance in senescent rats was normalized by dDAVP infusion, which also improved targeting of the channel; in adult rats, AQP2 expression was unaltered, suggesting that IMCD AQP2 expression is not regulated by dDAVP directly. Increased AQP3 expression in senescent rats may also be involved in improved urine-concentrating capacity owing to higher basolateral water and urea reabsorption capacity.
Published: 2003
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44. Personne de confiance et maladie d’Alzheimer

Author: Sophie Moulias, Laurent Teillet, Wassila Moussous, Tristan Cudennec, and Brice Colombier
Subjects: General Medicine
Published: 2012
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45. Le point de vue des patients sur la personne de confiance

Author: Tristan Cudennec, Sophie Moulias, Laurent Teillet, and Mostafa Ait Tadrart
Subjects: General Medicine
Published: 2012
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46. [Anticipating the end of life]

Author: Amélie, Aregui, Charlotte, Naline, Rodolphe, Daire, Adèle, de Malherbe, Charlotte, Braga, Lucie, Aubert, Laurent, Teillet, Sophie, Moulias, and Tristan, Cudennec
Subjects: Treatment Refusal, Right to Die, Humans, France, Advance Directives, Aged
Abstract: For patients at the end of life, caregivers must sometimes make choices between prolonging life and quality of life. There are several tools to assist in the decision-making process and the implementation, notably with regard to the limiting of active treatment. The issues to consider include limiting or stopping treatment, Leonetti's law with advance directives and the fight against unreasonable obstinacy and, more recently, the "mandate for future protection". The patient must always remain the focus and be allowed to express their wishes, if they want to, directly or with the help of a third party.
Published: 2015

47. Cellular signaling, AGE accumulation and gene expression in hepatocytes of lean aging rats fed ad libitum or food-restricted

Author: Sabine S. Gouraud, Laurent Teillet, Bruno Corman, Hilaire Bakala, and P. Ribière
Subjects: Glycation End Products, Advanced, Senescence, Aging, medicine.medical_specialty, Vasopressin, Vasopressins, Gene Expression, Biology, Glucagon, Internal medicine, Gene expression, Cyclic AMP, medicine, Animals, Rats, Wistar, Receptor, Cells, Cultured, Angiotensin II, Body Weight, digestive, oral, and skin physiology, Organ Size, Rats, Endocrinology, Liver, Hepatocytes, Female, Signal transduction, Food Deprivation, Glucagon receptor, Signal Transduction, Developmental Biology
Abstract: The effects of food restriction on liver glucagon and vasopressin V1a receptors, on AGE accumulation and on gene expression were investigated in 10- and 30-month-old WAG/Rij female rats fed ad libitum or chronically food-restricted by 30%. The age-related increase in glucagon and vasopressin V1a receptor density, as well as the rise in glucagon-induced cAMP generation was prevented by the restriction. AGE accumulation, characteristic of the aging process, was normalized in food-restricted animals. Gene expression determined with rat Atlas cDNA Expression Arrays containing 1176 cDNA indicates that a few genes exhibited a greater than twofold change in mRNA ratios with age. Most down-regulated genes were related to oxidative metabolism of lipids, and most of the up-regulated genes were concerned with the cell cycle and transcription factors. Chronic food restriction partially prevents these changes in gene expression and induces up- and down-regulation of several mRNAs which are not modified with age in ad libitum fed rats.
Published: 2002
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48. [Urinary tract infections in the elderly]

Author: Charlotte, Naline, Tristan, Cudennec, and Laurent, Teillet
Subjects: Male, Sex Factors, Risk Factors, Urinary Tract Infections, Humans, Female, Aged, Anti-Bacterial Agents
Abstract: In the elderly, urinary tract infections are frequent. Diagnosis is not always evident because symptoms are often absent. In doubt, a urinary strip evaluation must be performed. Prevention begins with simple lifestyle and dietary rules, such as good voiding and adequate fluid intake. Asymptomatic bacteriuria is treated only in certain cases. Other urinary tract infections require antibiotics, which must be adapted to renal function.
Published: 2014

49. [Not Available]

Author: Arnaud, Bourreille, Philippe, Montravers, Jean, Boyer, Jean-Luc, Schmit, Laurent, Teillet, and Didier, Loiseau
Published: 2014

50. Glucagon and vasopressin V1a receptor signaling in hepatocytes from aging rats

Author: Bruno Corman, T. Tordjmann, Alain Morel, Sabine S. Gouraud, L. Preisser, and Laurent Teillet
Subjects: Intracellular Fluid, Receptors, Vasopressin, Aging, Vasopressin, medicine.medical_specialty, Cell Count, Biology, Glucagon, Internal medicine, Cyclic AMP, medicine, Animals, Glucose homeostasis, Receptor, Pancreatic hormone, Cell Size, Rats, Arginine Vasopressin, Glucose, Endocrinology, Hepatocytes, Calcium, Female, Signal transduction, Glucagon receptor, hormones, hormone substitutes, and hormone antagonists, Homeostasis, Signal Transduction, Developmental Biology
Abstract: Glucose tolerance is reduced with age. The relationship between this change in glucose homeostasis and signaling of glucagon and vasopressin V1a receptors was investigated in hepatocytes isolated from 10- and 30-month-old female WAG/Rij rats. Binding capacity of hepatocytes for 125I glucagon and 3H vasopressin increased 2- and 1.8-fold, respectively, between 10 and 30 months. Intracellular cAMP accumulation induced by glucagon was 40% greater in hepatocytes of aging rats than of adults, although EC50 were similar in the two groups. Conversely, phosphodiesterases activity and nucleotides leakage out of the cells were unchanged with age. The rise in intracellular calcium consecutive to the stimulation of V1a receptor was comparable in adult and senescent animals. Finally, glucose release by hepatocyte suspensions was greater in senescent than in adult animals in absence as in presence of glucagon. These experiments suggest that increase in glucagon receptor expression and cAMP generation would contribute to the impaired glucose tolerance characteristic of the aging process.
Published: 2001
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