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331 results on '"MESH: Predictive Value of Tests"'

1. Assessment of left ventricular dyssynchrony by speckle tracking echocardiography in children with duchenne muscular dystrophy

Author: Olivier Cazorla, Charlene Bredy, Marie Vincenti, Catherine Barrea, Albano Melli, Alain Lacampagne, Pascal Amedro, Jérémy Fauconnier, Kathleen Lavastre, Pierre Meyer, Lucie Gamon, Audrey Agullo, Nicolas Lanot, Hamouda Abassi, François Rivier, Thibault Mura, Gregoire De La Villeon, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Cliniques Universitaires Saint-Luc [Bruxelles], Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), Herrada, Anthony, UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, and UCL - (SLuc) Service de cardiologie pédiatrique
Subjects: Male, medicine.medical_specialty, Cardiac dyssynchrony, Adolescent, Heart Ventricles, Duchenne muscular dystrophy, Heart failure, Speckle tracking echocardiography, Ventricular Dysfunction, Left, Predictive Value of Tests, MESH: Child, Internal medicine, DMD, MESH: Ventricular Dysfunction, Left, MESH: Muscular Dystrophy, Duchenne, medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, Child, Ventricular dyssynchrony, Speckle tracking, MESH: Adolescent, MESH: Humans, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Reproducibility of Results, Paediatrics, medicine.disease, MESH: Male, MESH: Predictive Value of Tests, MESH: Prospective Studies, Muscular Dystrophy, Duchenne, MESH: Reproducibility of Results, Echocardiography, Cardiology, MESH: Echocardiography, MESH: Heart Ventricles, business, Cardiology and Cardiovascular Medicine, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Purpose-Prognosis of Duchenne muscular dystrophy (DMD) is related to cardiac dysfunction. Two dimensional-speckle tracking echocardiography (2D-STE) has recently emerged as a non-invasive functional biomarker for early detection of DMD-related cardiomyopathy. This study aimed to determine, in DMD children, the existence of a left ventricle (LV) dyssynchrony using 2D-STE analysis.Methods-This prospective controlled study enrolled 25 boys with DMD (mean age 11.0±3.5 years) with normal LV ejection fraction and 50 age-matched controls. Three measures were performed to assess LV mechanical dyssynchrony: the opposing-wall delays (longitudinal and radial analyses), the modified Yu index, and the time-to-peak delays of each segment. Feasibility and reproducibility of 2D-STE dyssynchrony were evaluated. Results-All three mechanical dyssynchrony criteria were significantly higher in the DMD group than in healthy subjects: (1) opposing-wall delays in basal inferoseptal to basal anterolateral segments (61.4±45.3 msec vs. 18.3±50.4 msec, Prespectively) and in mid inferoseptal to mid anterolateral segments (58.6±35.3 msec vs. 42.4±36.4 msec, Prespectively), (2) modified Yu index (33.3±10.1 msec vs. 28.5±8.1 msec, P, respectively), and (3) most of time-to-peak values, especially in basal and mid anterolateral segments. Feasibility was excellent and reliability was moderate to excellent, with ICC values ranging from 0.49 to 0.97.Conclusion-Detection of LV mechanical dyssynchrony using 2D-STE analysis is an easily and reproducible method in pediatrics. The existence of an early LV mechanical dyssynchrony visualized using 2D-STE analysis in children with DMD before the onset of cardiomyopathy represents a perspective for future pediatric drug trials in the DMD-related cardiomyopathy prevention. Clinical Trial Registration-Clinicaltrials.gov NCT02418338. Post-hoc study, registered on April 16, 2015.
Published: 2021
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2. Is the Natural Anatomical Evolution of Type B Intramural Hematomas Reliable to Identify the Patients at Risk of Aneurysmal Progression?

Author: Julien Mancini, Pierre-Antoine Barral, Arnaud Blanchard, Mariangela De Masi, Philippe Piquet, Laurence Bal, David Lagier, Marine Gaudry, Sonia Bolomey, Alexis Jacquier, Hôpital de la Timone [CHU - APHM] (TIMONE), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biostatistique et technologies de l'information et de la communication (BioSTIC) - [Hôpital de la Timone - APHM] (BiosTIC ), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), and Dupuis, Christine
Subjects: Male, Time Factors, Computed Tomography Angiography, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, MESH: Risk Assessment, 030218 nuclear medicine & medical imaging, MESH: Aged, 80 and over, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, MESH: Aneurysm, Dissecting, Computed tomography angiography, Aged, 80 and over, MESH: Aged, Aortic dissection, Hematoma, MESH: Middle Aged, medicine.diagnostic_test, General Medicine, Middle Aged, MESH: Predictive Value of Tests, Aortic Aneurysm, [SDV] Life Sciences [q-bio], Predictive value of tests, Disease Progression, cardiovascular system, Female, MESH: Disease Progression, Aortic diameter, Radiology, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Aortography, Lumen (anatomy), Risk Assessment, 03 medical and health sciences, Aneurysm, Predictive Value of Tests, medicine, Humans, MESH: Aortography, Aged, Retrospective Studies, MESH: Humans, business.industry, MESH: Time Factors, MESH: Retrospective Studies, Retrospective cohort study, medicine.disease, MESH: Male, MESH: Computed Tomography Angiography, MESH: Aortic Aneurysm, body regions, MESH: Hematoma, Aortic Dissection, Surgery, business, MESH: Female
Abstract: International audience; Background: The natural history of type B intramural hematomas is little-known. Aneurysmal progression or an aortic dissection occurs in 15 to 20% of the cases. The study of the natural anatomical evolution could help identify the patients at risk of unfavorable evolution.Methods: All the patients monitored for a type B intramural hematoma between 2009 and 2018 were included in this monocentric retrospective study. Computed tomography angiography centerline measurement of diameters was obtained in various points of aortic segmentation on day (D) 0 and at one month (M1). Aortic volumes (lumen, intramural hematoma, and total volume) were calculated. The circulating volume was calculated using the volume rendering method. The volume of the intramural hematoma was measured using a manual section-by-section segmentation tool, and the total volume was obtained by summing up the two preceding volumes. Two groups of patients were compared: group 1 (favorable anatomical evolution) and group 2 (unfavorable anatomical evolution).Results: Between January 2008 and August 2018, 25 patients were managed for a type B intramural hematoma in our center. After an average follow-up of 15.5 months (1-52), 13 patients (52%) presented a favorable evolution and 12 (48%) an unfavorable evolution. At M1, a significant increase of the luminal diameters (37 mm vs. 32 mm; P < 0.01) and a significant reduction in the longitudinal extension (19 mm vs. 26 mm; P < 0.01) were observed. The maximum aortic diameter evolved significantly between D0 and M1 in the unfavorable evolution group (49 mm vs. 44 mm, respectively; P = 0.038). Such a difference was not found in the favorable evolution group (37.4 vs. 37.1, respectively; P = 0.552). An overall significant reduction in the total aortic volume (166 cm3 vs. 219 cm3; P < 0.01), the circulating volume (124 cm3 vs. 145 cm3; P = 0,026), and the volume of the hematoma (42 cm3 vs. 39 cm3; P < 0.01) was observed. The circulating volume decreased significantly between D0 and M1 in the favorable evolution group (110 cm3 vs. 135 cm3; P = 0.05), whereas no difference was noted in the unfavorable group (142 cm3 vs, 157 cm3; P = 0.24).Conclusions: The progression of the maximum aortic diameter and of the circulating volume after one month of follow-up could be predictive factors of the poor long-term evolution of type B intramural hematomas.
Published: 2020
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3. High negative predictive value of RT-PCR in patients with high likelihood of SARS-CoV-2 infection

Author: S. Galmiche, S. Fernandes-Pellerin, M.N. Ungeheuer, O. Schwartz, M. Attia, B. Hoen, J.-P. Lanoix, T. Guimard, J.-M. Chapplain, F. Goehringer, J.-F. Faucher, P. Chavanet, F. Cazenave-Roblot, T. Prazuck, Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Université Paris Cité (UPCité)-Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Paris Cité (UPCité)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Centre de Recherche Translationnelle - Center for Translational Science (CRT), Institut Pasteur [Paris]-Université Paris Cité (UPCité), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), Virus et Immunité - Virus and immunity, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Vaccine Research Institute (VRI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Génétique Moléculaire des Virus à ARN - Molecular Genetics of RNA Viruses (GMV-ARN (UMR_3569 / U-Pasteur_2)), Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR), The study was funded by Institut Pasteur, Fondation BTP Plus, and Fondation Total. Several laboratories participating in the study receive funding from the Labex IBEID (ANR-10-LABX-62-IBEID), REACTing and the INCEPTION project (PIA/ANR-16-CONV-0005) for studies focusing on emerging viruses. OS lab is funded by Institut Pasteur, ANRS, Sidaction, the Vaccine Research Institute (ANR- 10-LABX-77), 'TIMTAMDEN' ANR-14-CE14-0029, 'CHIKV-Viro- Immuno' ANR-14-CE14-0015-01 and the Gilead HIV cure program., CORSER-2A study group: J-P Lanoix, T Guimard, J-M Chapplain, F Goehringer, J-F Faucher , P Chavanet , F Cazenave-Roblot , T Prazuck, We would like to thank collaborators at the Institut Pasteur, Linda Sangari, Sophie Chaouche, Dr Charlotte Renaudat at the ICAReB platform, Thomas Obadia at the Bioinformatics and Biostatistics Hub, Cassandre von Platen and Tan-Phuc Buivan at the Center for Translational Sciences., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-08-BLAN-0046,REACTING,Reactivity of inorganic radicals in aqueous solution(2008), ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016), ANR-10-LABX-0077,VRI,Initiative for the creation of a Vaccine Research Institute(2010), ANR-14-CE14-0029,TIMTAMDEN,Rôle des récepteurs TIM et TAM dans l'infection des cellules cibles par le virus de la dengue(2014), ANR-14-CE14-0015,CHIKV-Viro-Immuno,Multiplication et Relation avec l'hôte du virus Chikungunya(2014), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Paris Cité (UPCité)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), DESSAIVRE, Louise, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, Blanc - Reactivity of inorganic radicals in aqueous solution - - REACTING2008 - ANR-08-BLAN-0046 - BLANC - VALID, Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs - - INCEPTION2016 - ANR-16-CONV-0005 - CONV - VALID, Laboratoires d'excellence - Initiative for the creation of a Vaccine Research Institute - - VRI2010 - ANR-10-LABX-0077 - LABX - VALID, Appel à projets générique - Rôle des récepteurs TIM et TAM dans l'infection des cellules cibles par le virus de la dengue - - TIMTAMDEN2014 - ANR-14-CE14-0029 - Appel à projets générique - VALID, Appel à projets générique - Multiplication et Relation avec l'hôte du virus Chikungunya - - CHIKV-Viro-Immuno2014 - ANR-14-CE14-0015 - Appel à projets générique - VALID, Virus et Immunité - Virus and immunity (CNRS-UMR3569), Vaccine Research Institute [Créteil, France] (VRI), and Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR - laboratoire coordonnateur)
Subjects: 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), [SDV]Life Sciences [q-bio], RT-PCR, Sensitivity and Specificity, Article, Predictive Value of Tests, MESH: Reverse Transcriptase Polymerase Chain Reaction, Medicine, Humans, MESH: COVID-19, High likelihood, In patient, MESH: SARS-CoV-2, ComputingMilieux_MISCELLANEOUS, MESH: Humans, business.industry, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2, COVID-19, Virology, Predictive value, MESH: Predictive Value of Tests, MESH: Sensitivity and Specificity, [SDV] Life Sciences [q-bio], Infectious Diseases, Real-time polymerase chain reaction, business
Abstract: International audience
Published: 2022
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4. Worldwide Diagnostic Reference Levels for Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging

Author: Cole B. Hirschfeld, Maurizio Dondi, Thomas N.B. Pascual, Mathew Mercuri, Joao Vitola, Ganesan Karthikeyan, Nathan Better, John J. Mahmarian, Salah E. Bouyoucef, Henry Hee-Seung Bom, Vikram Lele, Vincent Peter C. Magboo, Erick Alexánderson, Adel H. Allam, Mouaz H. Al-Mallah, Albert Flotats, Scott Jerome, Philipp A. Kaufmann, Osnat Luxenburg, S. Richard Underwood, Madan M. Rehani, Jenia Vassileva, Diana Paez, Andrew J. Einstein, A.J. Einstein, T.N.B. Pascual, D. Paez, M. Dondi, N. Better, S.E. Bouyoucef, G. Karthikeyan, R. Kashyap, V. Lele, V.P.C. Magboo, J.J. Mahmarian, J.B. Meeks, M. Mercuri, F. Mut, M.M. Rehani, J.V. Vitola, E. Alexanderson, A. Allam, M.H. Al-Mallah, H. Bom, A. Flotats, S. Jerome, P.A. Kaufmann, O. Luxenburg, J. Mahmarian, L.J. Shaw, S.R. Underwood, J. Vitola, W. Amouri, H. Essabbah, S.S. Gassama, K.B. Makhdomi, G.I.E. El Mustapha, N. El Ouchdi, N. Qaïs, N. Soni, W. Vangu, R.M. Abazid, B. Adams, V. Agarwal, M.A. Alfeeli, N. Alnafisi, L. Bernabe, G.G. Bural, T. Chaiwatanarat, J.M. Chandraguptha, G.J. Cheon, I. Cho, A.S. Dogan, M. Eftekhari, A. Frenkel, I. Garty, S. George, P. Geramifar, H. Golan, S. Habib, R. Hussain, H. Im, H.-J. Jeon, T. Kalawat, W.J. Kang, F. Keng, A. Klaipetch, P.G. Kumar, J. Lee, W.W. Lee, I. Lim, C.M.M. Macaisa, G. Malhotra, B.R. Mittal, M.H. Mohammad, P. Mohan, I.D. Mulyanto, D. Nariman, U.N. Nayak, K. Niaz, G. Nikolov, J.M. Obaldo, E. Ozturk, J.M. Park, S. Park, C.D. Patel, H.K. Phuong, A.P. Quinon, T.R. Rajini, Y. Saengsuda, J. Santiago, H.B. Sayman, A.S. Shinto, V. Sivasubramaniyan, M.H. Son, P. Sudhakar, G.M.S. Syed, N. Tamaki, K. Thamnirat, T. Thientunyakit, S. Thongmak, D.N. Velasco, A. Verma, U. Vutrapongwatana, Y. Wang, K.S. Won, Z. Yao, T. Yingsa-nga, R. Yudistiro, K.T. Yue, N. Zafrir, S.C. Adrian, D. Agostini, S. Aguadé, G. Armitage, M. Backlund, M. Backman, M. Baker, M.T. Balducci, C. Bavelaar, M. Berovic, F. Bertagna, R. Beuchel, A. Biggi, G. Bisi, R. Bonini, A. Bradley, L. Brudin, I. Bruno, E. Busnardo, R. Casoni, A. Choudhri, C. Cittanti, R. Clauss, D.C. Costa, M. Costa, K. Dixon, M. Dziuk, N. Egelic, I. Eriksson, G. Fagioli, D.B. de Faria, L. Florimonte, A. Francini, M. French, E. Gallagher, I. Garai, O. Geatti, D. Genovesi, L. Gianolli, A. Gimelli, E. del Giudice, S. Halliwell, M.J. Hansson, C. Harrison, F. Homans, F. Horton, D. Jędrzejuk, J. Jogi, A. Johansen, H. Johansson, M. Kalnina, M. Kaminek, A. Kiss, M. Kobylecka, M. Kostkiewicz, J. Kropp, R. Kullenberg, T. Lahoutte, O. Lang, Y.H. Larsson, M. Lázár, L. Leccisotti, N. Leners, O. Lindner, R.W. Lipp, A. Maenhout, L. Maffioli, C. Marcassa, B. Martins, P. Marzullo, G. Medolago, C.G. Mendiguchía, S. Mirzaei, M. Mori, B. Nardi, S. Nazarenko, K. Nikoletic, R. Oleksa, T. Parviainen, J. Patrina, R. Peace, C. Pirich, H. Piwowarska-Bilska, S. Popa, V. Prakash, V. Pubul, L. Puklavec, S. Rac, M. Ratniece, S.A. Rogan, A. Romeo, M. Rossi, D. Ruiz, N. Sabharwal, B.G. Salobir, A.I. Santos, S. Saranovic, A. Sarkozi, R.P. Schneider, R. Sciagra, S. Scotti, Z. Servini, L.R. Setti, S.-Å. Starck, D. Vajauskas, J. Veselý, A. Vieni, A. Vignati, I.M. Vito, K. Weiss, D. Wild, M. Zdraveska-Kochovska, R.N. Agüro, N. Alvarado, C.M. Barral, M. Beretta, I. Berrocal, J.F. Batista Cuellar, T-M. Cabral Chang, L.O. Cabrera Rodríguez, J. Canessa, G. Castro Mora, A.C. Claudia, G.F. Clavelo, A.F. Cruz Júnior, F.F. Faccio, K.M. Fernández, J.R. Gomez Garibo, U. Gonzalez, P. González E, M.A. Guzzo, J. Jofre, M. Kapitán, G. Kempfer, J.L. Lopez, T. Massardo V, I. Medeiros Colaco, C.T. Mesquita, M. Montecinos, S. Neubauer, L.M. Pabon, A. Puente, L.M. Rochela Vazquez, J.A. Serna Macias, A.G. Silva Pino, F.Z. Tártari Huber, A.P. Tovar, L. Vargas, C. Wiefels, A. Aljizeeri, R.J. Alvarez, D. Barger, W. Beardwood, J. Behrens, L. Brann, D. Brown, H. Carr, K. Churchwell, G.A. Comingore, J. Corbett, M. Costello, F. Cruz, T. Depinet, S. Dorbala, M. Earles, F.P. Esteves, E. Etherton, R.J. Fanning, J. Fornace, L. Franks, H. Gewirtz, K. Gulanchyn, C.-L. Hannah, J. Hays, J. Hendrickson, J. Hester, K. Holmes, A. Johnson, C. Jopek, H. Lewin, J. Lyons, C. Manley, J. Meden, S. Moore, W.H. Moore, V. Murthy, R. Nace, D. Neely, L. Nelson, O. Niedermaier, D. Rice, R. Rigs, K. Schiffer, E. Schockling, T. Schultz, T. Schumacker, B. Sheesley, A. Sheikh, B. Siegel, A.M. Slim, J. Smith, M. Szulc, N. Tanskersley, P. Tilkemeier, G.D. Valdez, R. Vrooman, D. Wawrowicz, D.E. Winchester, A. Alcheikh, B. Allen, E. Atkins, J. Bevan, C. Bonomini, J. Christiansen, L. Clack, E. Craig, H. Dixson, I. Duncan, S. Fredericks, S. Gales, R. Hampson, T. Hanley, K. Hartcher, J. Hassall, B. Kelley, S. Kelly, T. Kidd, T. de Kort, G. Larcos, W. Macdonald, C. McGrath, E. Murdoch, S. O'Malley, M. O'Rourke, M. Pack, R. Pearce, R. Praehofer, S. Ramsay, L. Scarlett, K. Smidt, F. Souvannavong, K. Taubman, G. Taylor, K. Tse, S. Unger, J. Weale, Columbia University Irving Medical Center (CUIMC), New York Presbyterian Hospital, International Atomic Energy Agency [Vienna] (IAEA), McMaster University [Hamilton, Ontario], University of Toronto, All India Institute of Medical Sciences [New Delhi], The Royal Melbourne Hospital, University of Melbourne, Methodist Debakey Heart and Vascular Center [Houston, TX, USA], Houston Methodist Hospital [Houston, TX, USA], Centre Hospitalier Universitaire de Bab-el-Oued, Alger, Algérie., Chonnam National University [Gwangju], Jaslok Hospital & Research Centre, University of the Philippines (UP System), University of Santo Tomas Hospital, Instituto Nacional de Cardiologia Ignacio Chavez, Universidad Nacional Autónoma de México (UNAM), Al-Azhar University [Cairo, Egypt], Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), University of Maryland [Baltimore], University hospital of Zurich [Zurich], The Gertner Institute for Epidemiology and Health Policy Research, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, Massachusetts General Hospital [Boston], and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Subjects: medicine.medical_specialty, MESH: Radiation Dosage, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, Single-photon emission computed tomography, MESH: Tomography, Emission-Computed, Single-Photon, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Myocardial perfusion imaging, 0302 clinical medicine, MESH: Cross-Sectional Studies, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Diagnostic Reference Levels, Medical imaging, medicine, administered activity, Radiology, Nuclear Medicine and imaging, Medical physics, SPECT myocardial perfusion imaging, Protocol (science), MESH: Humans, medicine.diagnostic_test, business.industry, radiation dose reduction, diagnostic reference level, MESH: Predictive Value of Tests, 3. Good health, Predictive value of tests, Regional studies, Dose reduction, Cardiology and Cardiovascular Medicine, business, Emission computed tomography, MESH: Perfusion
Abstract: Objectives This study sought to establish worldwide and regional diagnostic reference levels (DRLs) and achievable administered activities (AAAs) for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Background Reference levels serve as radiation dose benchmarks to compare individual laboratories against aggregated data, helping to identify sites in greatest need of dose reduction interventions. DRLs for SPECT MPI have previously been derived from national or regional registries. To date there have been no multiregional reports of DRLs for SPECT MPI from a single standardized dataset. Methods Data were submitted voluntarily to the INCAPS (International Atomic Energy Agency Nuclear Cardiology Protocols Study), a cross-sectional, multinational registry of MPI protocols. A total of 7,103 studies were included. DRLs and AAAs were calculated by protocol for each world region and for aggregated worldwide data. Results The aggregated worldwide DRLs for rest-stress or stress-rest studies employing technetium Tc 99m–labeled radiopharmaceuticals were 11.2 mCi (first dose) and 32.0 mCi (second dose) for 1-day protocols, and 23.0 mCi (first dose) and 24.0 mCi (second dose) for multiday protocols. Corresponding AAAs were 10.1 mCi (first dose) and 28.0 mCi (second dose) for 1-day protocols, and 17.8 mCi (first dose) and 18.7 mCi (second dose) for multiday protocols. For stress-only technetium Tc 99m studies, the worldwide DRL and AAA were 18.0 mCi and 12.5 mCi, respectively. Stress-first imaging was used in 26% to 92% of regional studies except in North America where it was used in just 7% of cases. Significant differences in DRLs and AAAs were observed between regions. Conclusions This study reports reference levels for SPECT MPI for each major world region from one of the largest international registries of clinical MPI studies. Regional DRLs may be useful in establishing or revising guidelines or simply comparing individual laboratory protocols to regional trends. Organizations should continue to focus on establishing standardized reporting methods to improve the validity and comparability of regional DRLs.
Published: 2021
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5. Development of a bedside score to predict dengue severity

Author: A. Merlet, Carole Forfait, Myrielle Dupont-Rouzeyrol, Elise Klement-Frutos, Emilie Barsac, Cécile Cazorla, Sylvie Laumond, Daina Aubert, Jean-Paul Grangeon, Anabelle Valiame, Ann-Claire Gourinat, Catherine Inizan, Elodie Descloux, Arnaud Tarantola, Ingrid Marois, Centre hospitalier territorial Gaston-Bourret [Dumbea] (CHT), Centre hospitalier territorial Gaston-Bourret [Nouméa], Direction des affaires sanitaires et sociales de Nouvelle-Calédonie, Institut Pasteur de Nouvelle-Calédonie, Réseau International des Instituts Pasteur (RIIP), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and This work was supported by the government of New Caledonia.
Subjects: Male, Multivariate analysis, Hospital triage, MESH: Dengue, MESH: Hospitalization, Infectious and parasitic diseases, RC109-216, [SDV.IMM.II]Life Sciences [q-bio]/Immunology/Innate immunity, Dengue fever, Dengue, Medical microbiology, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, 030212 general & internal medicine, MESH: Models, Theoretical, Severity score, 0303 health sciences, Univariate analysis, Area under the curve, Prognosis, Predictive value, MESH: Predictive Value of Tests, 3. Good health, Hospitalization, Infectious Diseases, [SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Cohort, Female, MESH: Triage, Research Article, Operational tool, medicine.medical_specialty, 030231 tropical medicine, MESH: Prognosis, 03 medical and health sciences, New Caledonia, Predictive Value of Tests, medicine, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, Retrospective Studies, 030304 developmental biology, MESH: Humans, business.industry, Univariate, Outbreak, MESH: Retrospective Studies, Models, Theoretical, MESH: New Caledonia, medicine.disease, MESH: Male, Pacific, Tropical medicine, Emergency medicine, Triage, business, MESH: Female, Arboviruses
Abstract: Background In 2017, New Caledonia experienced an outbreak of severe dengue causing high hospital burden (4379 cases, 416 hospital admissions, 15 deaths). We decided to build a local operational model predictive of dengue severity, which was needed to ease the healthcare circuit. Methods We retrospectively analyzed clinical and biological parameters associated with severe dengue in the cohort of patients hospitalized at the Territorial Hospital between January and July 2017 with confirmed dengue, in order to elaborate a comprehensive patient’s score. Patients were compared in univariate and multivariate analyses. Predictive models for severity were built using a descending step-wise method. Results Out of 383 included patients, 130 (34%) developed severe dengue and 13 (3.4%) died. Major risk factors identified in univariate analysis were: age, comorbidities, presence of at least one alert sign, platelets count 9/L, prothrombin time 10 N, and previous dengue infection. Severity was not influenced by the infecting dengue serotype nor by previous Zika infection. Two models to predict dengue severity were built according to sex. Best models for females and males had respectively a median Area Under the Curve = 0.80 and 0.88, a sensitivity = 84.5 and 84.5%, a specificity = 78.6 and 95.5%, a positive predictive value = 63.3 and 92.9%, a negative predictive value = 92.8 and 91.3%. Models were secondarily validated on 130 patients hospitalized for dengue in 2018. Conclusion We built robust and efficient models to calculate a bedside score able to predict dengue severity in our setting. We propose the spreadsheet for dengue severity score calculations to health practitioners facing dengue outbreaks of enhanced severity in order to improve patients’ medical management and hospitalization flow.
Published: 2020
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6. High-intensity lipid-lowering regimens in patients with stable coronary artery disease: the intriguing question of all-cause mortality

Author: Nicolas Danchin, Tabassome Simon, Centre de Ressources Biologiques APHP-SU (PASS-CRB-APHP-SU), Unité Mixte de Service Production et Analyse de données en Sciences de la vie et en Santé (PASS), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials (FACT), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), and Sorbonne Université (SU)
Subjects: Time Factors, MESH: Registries, health care facilities, manpower, and services, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, MESH: Risk Assessment, Coronary artery disease, 0302 clinical medicine, MESH: Aged, 80 and over, prevention, Risk Factors, MESH: Risk Factors, Cause of Death, score, MESH: Fibrinolytic Agents, AcademicSubjects/MED00200, Pharmacology (medical), 030212 general & internal medicine, health care economics and organizations, ComputingMilieux_MISCELLANEOUS, Hypolipidemic Agents, MESH: Treatment Outcome, MESH: Aged, Clinical Trials as Topic, MESH: Middle Aged, MESH: Secondary Prevention, High intensity, MESH: Angiotensin-Converting Enzyme Inhibitors, MESH: Adrenergic beta-Antagonists, Lipids, MESH: Predictive Value of Tests, 3. Good health, Treatment Outcome, MESH: Angiotensin Receptor Antagonists, Cardiovascular Diseases, Cardiology, cardiovascular system, AcademicSubjects/MED00410, Lipid lowering, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, education, Down-Regulation, Acute myocardial infarction, Risk Assessment, 03 medical and health sciences, Internal medicine, Correspondence, medicine, MESH: Dual Anti-Platelet Therapy, Humans, In patient, cardiovascular diseases, MESH: ST Elevation Myocardial Infarction, MESH: Hydroxymethylglutaryl-CoA Reductase Inhibitors, MESH: Prevalence, Dyslipidemias, MESH: Humans, business.industry, MESH: Time Factors, MESH: Decision Support Techniques, medicine.disease, mortality, MESH: Male, MESH: Recurrence, MESH: France, MESH: Non-ST Elevated Myocardial Infarction, business, MESH: Female, Biomarkers, All cause mortality
Abstract: International audience; Full secondary prevention medication regimen is often under-prescribed after acute myocardial infarction.
Published: 2020
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7. Thrombophilia assessment in presence of a venous thromboembolic disease and therapeutic consequences: Evaluation of practices in general medicine (Languedoc-Roussillon Region)

Author: Isabelle Quéré, Jean-François Schved, A. Charvier, J.-P. Laroche, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), and Université Montpellier 1 (UM1)-Université de Montpellier (UM)
Subjects: Male, medicine.medical_specialty, General Practice, 030204 cardiovascular system & hematology, Thrombophilia, MESH: Prognosis, MESH: Venous Thromboembolism, 03 medical and health sciences, MESH: Referral and Consultation, 0302 clinical medicine, Venous thromboembolic disease, General Practitioners, Predictive Value of Tests, Risk Factors, MESH: Risk Factors, MESH: General Practice, Humans, Medicine, Practice Patterns, Physicians', Intensive care medicine, Referral and Consultation, ComputingMilieux_MISCELLANEOUS, MESH: Humans, MESH: Middle Aged, business.industry, MESH: Thrombophilia, Venous Thromboembolism, Middle Aged, Prognosis, medicine.disease, MESH: Male, MESH: Predictive Value of Tests, 3. Good health, MESH: General Practitioners, MESH: France, MESH: Practice Patterns, Physicians', Female, Clinical Competence, France, MESH: Clinical Competence, Cardiology and Cardiovascular Medicine, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030215 immunology
Abstract: International audience
Published: 2020
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8. Derivation, Validation, and Prognostic Utility of a Prediction Rule for Nonresponse to Clopidogrel

Author: Dominick J. Angiolillo, Davide Capodanno, Thomas O. Bergmeijer, Tabassome Simon, Dirk Sibbing, Nicolas Danchin, Jurriën M. ten Berg, Matthew J. Price, Centre de Ressources Biologiques APHP-SU (PASS-CRB-APHP-SU), Unité Mixte de Service Production et Analyse de données en Sciences de la vie et en Santé (PASS), and Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: MESH: Coronary Thrombosis, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, outcomes, MESH: Risk Assessment, 0302 clinical medicine, P2Y12, MESH: Risk Factors, risk factors, MESH: Obesity, 030212 general & internal medicine, Myocardial infarction, MESH: Treatment Outcome, 2. Zero hunger, MESH: Aged, Framingham Risk Score, MESH: Middle Aged, Clopidogrel, MESH: Predictive Value of Tests, 3. Good health, MESH: Reproducibility of Results, MESH: Myocardial Infarction, MESH: Platelet Aggregation Inhibitors, MESH: Drug Resistance, MESH: Purinergic P2Y Receptor Antagonists, Cardiology and Cardiovascular Medicine, MESH: Percutaneous Coronary Intervention, medicine.drug, medicine.medical_specialty, MESH: Diabetes Mellitus, MESH: Renal Insufficiency, Chronic, CYP2C19, genetic testing, MESH: Body Mass Index, MESH: Clinical Decision Rules, 03 medical and health sciences, Internal medicine, Diabetes mellitus, medicine, cardiovascular diseases, MESH: Age Factors, clopidogrel, MESH: Pharmacogenomic Variants, MESH: Humans, business.industry, MESH: Time Factors, MESH: Clopidogrel, medicine.disease, MESH: Databases, Factual, MESH: Male, MESH: Randomized Controlled Trials as Topic, MESH: Cytochrome P-450 CYP2C19, business, Body mass index, MESH: Female, Kidney disease
Abstract: Objectives The aim of this study was to develop a risk score integrating cytochrome P450 2C19 loss-of-function genotypes with clinical risk factors influencing clopidogrel response that would allow the identification with more precision of subjects at risk for high platelet reactivity (HPR) and adverse clinical outcomes. Background Clopidogrel is the most broadly used platelet P2Y12 inhibitor. However, a considerable number of patients achieve inadequate platelet inhibition, with persistent HPR, an established marker of increased thrombotic risk, underscoring the need for tools to help identify these subjects. Although carriers of loss-of-function alleles of the cytochrome P450 2C19 enzyme have reduced clopidogrel metabolism leading to increased rates of HPR and thrombotic complications, this explains only a fraction of the pharmacodynamic response to clopidogrel, and a number of clinical factors have also been shown to have contributing roles. Methods Three prospective and independent studies were used to: 1) develop a risk score integrating genetic and clinical factors to identify patients with HPR while on clopidogrel; 2) investigate the external validity of the risk score; and 3) define clinical outcomes associated with the risk score in a cohort of patients with myocardial infarction treated with clopidogrel. Results A risk score ABCD-GENE (Age, Body Mass Index, Chronic Kidney Disease, Diabetes Mellitus, and Genotyping) was developed incorporating 5 independent predictors of HPR: 4 clinical (age >75 years, body mass index >30 kg/m2, chronic kidney disease [glomerular filtration rate Conclusions The ABCD-GENE score is a simple tool to identify patients with HPR on clopidogrel and who are at increased risk for adverse ischemic events, including mortality, following an acute myocardial infarction. In patients with a high ABCD-GENE score, long-term oral P2Y12 inhibitors other than clopidogrel should be considered.
Published: 2020
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9. Early non-response to certolizumab pegol in rheumatoid arthritis predicts failure to achieve low disease activity at 1 year: data from a prospective observational study

Author: Jean-Michel Joubert, Alain Saraux, Francis Fagnani, René-Marc Flipo, G. Cukierman, Philippe Huot-Marchand, Jacques Massol, Bernard Combe, Salvy-Córdoba, Nathalie, Service de Rhumatologie [CHU de la Cavale-Blanche], Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), CHU Lille, Cemka-eval [Bourg La Reine], Institut Phisquare, Fondation Transplantation, Centre d'Investigation Clinique de Besançon (Inserm CIC 1431), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), UCB Pharma, Colombes, ICON plc [Lyon], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])
Subjects: Male, MESH: Antirheumatic Agents, Time Factors, MESH: Treatment Failure, lcsh:Medicine, DMARDs (biologic), Severity of Illness Index, Arthritis, Rheumatoid, Anti-TNF, 0302 clinical medicine, Immunology and Allergy, Prospective Studies, Treatment Failure, 030212 general & internal medicine, Disease activity, Certolizumab pegol, MESH: Aged, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, medicine.diagnostic_test, Middle Aged, MESH: Predictive Value of Tests, 3. Good health, MESH: Methotrexate, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Antirheumatic Agents, Erythrocyte sedimentation rate, Rheumatoid arthritis, Drug Therapy, Combination, Female, France, [SDV.IMM.IMM] Life Sciences [q-bio]/Immunology/Immunotherapy, MESH: Certolizumab Pegol, medicine.drug, Adult, medicine.medical_specialty, Immunology, Blood Sedimentation, 03 medical and health sciences, Rheumatology, Disease severity, Predictive Value of Tests, Internal medicine, MESH: Severity of Illness Index, medicine, Humans, In patient, Glucocorticoids, MESH: Blood Sedimentation, Aged, 030203 arthritis & rheumatology, MESH: Humans, business.industry, lcsh:R, MESH: Time Factors, MESH: Adult, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, Clinical disease, medicine.disease, MESH: Male, MESH: Prospective Studies, MESH: France, MESH: Drug Therapy, Combination, Methotrexate, Certolizumab Pegol, Observational study, business, MESH: Glucocorticoids, MESH: Female
Abstract: ObjectiveTo evaluate the performance of clinical criteria for predicting late treatment failure in patients with early non-response to certolizumab pegol (CZP).MethodsA protocol-specified analysis of interim data from ECLAIR, a 3-year longitudinal, prospective, observational, multicentre study of patients with active rheumatoid arthritis (RA) initiating CZP treatment in France, was conducted. Clinical measures assessed were Clinical Disease Activity Index (CDAI), Disease Activity Score-28 with erythrocyte sedimentation rate (DAS28(ESR)) and Health Assessment Questionnaire Disability Index (HAQ-DI). Early non-response was measured at 3 months (M3) and failure to achieve low disease activity (LDA) at 12 months (M12).Results574/792 enrolled patients were treated at M3. The numbers available for predictability analyses were 532 (CDAI), 434 (DAS28(ESR)) and 496 (HAQ-DI). Of the three indices evaluated, the highest predictor of non-response value was observed for the CDAI (88.8% (95% CI 81.0 to 94.1)), indicating that up to 88% of patients identified as non-responders at M3 failed to achieve LDA at M12, regardless of baseline disease severity or treatment history. The specificity for this measure was also very high (96.0%), indicating that less than 5% of patients who achieved CDAI response at M12 had not responded at M3. Similar predictability was observed for DAS28(ESR), but only in patients with high disease activity at baseline and/or those previously treated by a biological disease-modifying antirheumatic drug.ConclusionCDAI non-response at M3 is a predictor of failure to achieve the therapeutic target of LDA at M12 in patients with RA initiating treatment with CZP.
Published: 2020
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10. Distribution of de novo Donor-Specific Antibody Subclasses Quantified by Mass Spectrometry: High IgG3 Proportion Is Associated With Antibody-Mediated Rejection Occurrence and Severity

Author: Vincent Pernin, Anais Beyze, Ilan Szwarc, Nicole Bec, Céline Salsac, Esther Perez-Garcia, Georges Mourad, Pierre Merville, Jonathan Visentin, Helene Perrochia, Christian Larroque, Lionel Couzi, Moglie Le Quintrec, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU de Bordeaux Pellegrin [Bordeaux], Immunology from Concept and Experiments to Translation (ImmunoConcept), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux (UB), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), A funding was provided by Montpellier University Hospital for this study (AOI 2018)., and Retiveau, Nolwenn
Subjects: 0301 basic medicine, Gastroenterology, [SDV.IMM.II]Life Sciences [q-bio]/Immunology/Innate immunity, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Subclass, MESH: Kidney Transplantation, Kidney transplantation, 0302 clinical medicine, MESH: Risk Factors, Immunology and Allergy, MESH: Treatment Outcome, MESH: Aged, MESH: Immunoglobulin G, Proteinuria, MESH: Middle Aged, biology, MESH: Predictive Value of Tests, [SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology, [SDV.IMM.IA] Life Sciences [q-bio]/Immunology/Adaptive immunology, Antibody mediated rejection, Antibody, medicine.symptom, lcsh:Immunologic diseases. Allergy, medicine.medical_specialty, Immunology, Renal function, MESH: Graft Rejection, 03 medical and health sciences, IgG subclass, Internal medicine, MESH: Severity of Illness Index, parasitic diseases, medicine, Distribution (pharmacology), Risk factor, [SDV.IMM.II] Life Sciences [q-bio]/Immunology/Innate immunity, MESH: Humans, Mass spectrometry, business.industry, MESH: Tandem Mass Spectrometry, MESH: Adult, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, MESH: Prospective Studies, MESH: Isoantibodies, body regions, MESH: France, 030104 developmental biology, Antibody-mediated rejection, biology.protein, MESH: Biomarkers, De novo DSA, business, lcsh:RC581-607, MESH: Female, 030215 immunology
Abstract: International audience; Donor-specific antibodies (DSAs) are the main risk factor for antibody-mediated rejection (ABMR) and graft loss but could have variable pathogenicity according to their IgG subclass composition. Luminex-based test might lack sensitivity for the detection of IgG subclasses and this test does not allow quantifying the relative abundance of each IgG subclass. We investigated the precise repartition of each DSA subclass and their role in ABMR occurrence and severity, using an innovative mass spectrometry-based method. Between 2014 and 2018, we enrolled 69 patients who developed de novo DSA (n = 29 without ABMR, and n = 40 with ABMR) in two transplant centers. All IgG subclasses were detected in every samples tested: 62.7% were IgG1, 26.6% were IgG2, 6.6% were IgG3, and 4.2% were IgG4. The IgG3 proportion was significantly higher in the ABMR+ compared to the ABMR- group (8.4% vs. 5.6%, p = 0.003). The proportion of IgG1, IgG2, and IgG4 of DSA was similar between the two groups. Higher IgG3 level was associated with higher C4d deposition, higher microvascular inflammation scores, and glomerular filtration rate decline >25%. IgG3 proportion was not correlated with DSA MFI. Multivariate analysis showed that proteinuria and high level of IgG3 DSA were the only two factors independently associated with ABMR. In conclusion, de novo DSA are always composed of the four IgG subclasses, but in different proportions. High IgG3 proportion is associated with ABMR occurrence and severity and with poorer outcome, independently of DSA MFI.
Published: 2020
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11. Can energy expenditure be accurately assessed using accelerometry-based wearable motion detectors for physical activity monitoring in post-stroke patients in the subacute phase?

Author: Béatrice Ferry, Stéphane Mandigout, Jean-Christophe Daviet, Maxence Compagnat, Nicolas Vuillerme, Justine Lacroix, Handicap, Activité, Vieillissement, Autonomie, Environnement (HAVAE), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), AGeing and IMagery (AGIM), Centre National de la Recherche Scientifique (CNRS)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Joseph Fourier - Grenoble 1 (UJF)-Université Pierre Mendès France - Grenoble 2 (UPMF), Service de Médecine Physique et de Réadaptation [CHU Limoges], and CHU Limoges
Subjects: Male, Time Factors, Subacute phase, Epidemiology, physical activity, Wearable computer, 030204 cardiovascular system & hematology, Accelerometer, MESH: Aged, 80 and over, 0302 clinical medicine, Activities of Daily Living, energy expenditure, Stroke, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, MESH: Energy Metabolism, Middle Aged, stroke, MESH: Predictive Value of Tests, MESH: Reproducibility of Results, Energy expenditure, Ambulatory, Female, MESH: Calorimetry, Indirect, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, MESH: Actigraphy, Physical activity, Fitness Trackers, MESH: Stroke, 03 medical and health sciences, Predictive Value of Tests, medicine, Humans, MESH: Fitness Trackers, Exercise, Wearable sensor, Aged, MESH: Humans, business.industry, MESH: Activities of Daily Living, MESH: Time Factors, Reproducibility of Results, Calorimetry, Indirect, MESH: Adult, medicine.disease, Actigraphy, MESH: Male, monitoring, MESH: Exercise, Pedometer, Physical therapy, Energy Metabolism, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery
Abstract: International audience; Background In the subacute stroke phase, the monitoring of ambulatory activity and activities of daily life with wearable sensors may have relevant clinical applications. Do current commercially available wearable activity trackers allow us to objectively assess the energy expenditure of these activities? The objective of the present study was to compare the energy expenditure evaluated by indirect calorimetry during the course of a scenario consisting of everyday activities while estimating the energy expenditure using several commercialised wearable sensors in post-stroke patients (less than six months since stroke). Method Twenty-four patients (age 68.2 ± 13.9; post-stroke delay 34 ± 25 days) voluntarily participated in this study. Each patient underwent a scenario of various everyday tasks (transfer, walking, etc.). During the implementation, patients wore 14 wearable sensors (Armband, Actigraph GT3X, Actical, pedometer) to obtain an estimate of the energy expenditure. The actual energy expenditure was concurrently determined by indirect calorimetry. Results Except for the Armband worn on the non-plegic side, the results of our study show a significant difference between the energy expenditure values estimated by the various sensors and the actual energy expenditure when the scenario is considered as a whole. Conclusion The present results suggest that, for a series of everyday tasks, the wearable sensors underestimate the actual energy expenditure values in post-stroke patients in the subacute phase and are therefore not accurate. Several factors are likely to confound the results: types of activity, prediction equations, the position of the sensor and the hemiplegia side.
Published: 2017
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12. Exercise-based games interventions at home in individuals with a neurological disease: A systematic review and meta-analysis

Author: Wilkinson-Maitland, Courtney, Hamilton, Alan, Bourbeau, Jean, Perrault, Hélène, Jensen, Dennis, Maltais, François, Weissland, Thierry, faupin, arnaud, Leprêtre, Pierre-Marie, Coquart, Jeremy, Duhamel, Alain, Matran, Régis, Delsart, Pascal, Mounier-Vehier, Claire, Garcin, Murielle, Perrochon, Anaïck, Borel, Benoit, Istrate, Dan, Compagnat, Maxence, Daviet, Jean-Christophe, Handicap, Activité, Vieillissement, Autonomie, Environnement (HAVAE), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Activité Physique, Muscle, Santé (EA4488), Université de Lille, Droit et Santé, Equipe GEOD, Groupe d'étude sur l'oral et le dialogue (CLIPS-IMAG), Laboratoire d'Informatique de Grenoble (LIG), Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), Neuroépidémiologie Tropicale et Comparée (NETEC), Université de Limoges (UNILIM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Université de Technologie de Compiègne (UTC), Service de Médecine Physique et de Réadaptation [CHU Limoges], CHU Limoges, Montreal Chest Institute, McGill University Health Center [Montreal] (MUHC), Faculty of Health Sciences, Centre de Recherche, Université Laval [Québec] (ULaval), UFR STAPS, Laboratoire APERE, EA 3300, Université de Picardie Jules Verne (UPJV), Laboratoire de Biomodélisation et Ingénierie des Handicaps - EA 4322 (HANDIBIO), Université de Toulon (UTLN), Laboratory 'Adaptations physiologiques à l’exercice et réadaptation à l’effort', Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Institut d'Informatique et de Mathématiques Appliquées de Grenoble (IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), Université Lille Nord de France (COMUE), Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Bureau de Recherches Géologiques et Minières (BRGM) (BRGM), Laboratoire d'Informatique de Grenoble [2007-2015] (LIG [2007-2015]), and Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2007-2019] (Grenoble INP [2007-2019])-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2007-2019] (Grenoble INP [2007-2019])-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, 030506 rehabilitation, MESH: Quebec, medicine.medical_treatment, MESH: Physical Fitness, Psychological intervention, MESH: Pulmonary Disease, Chronic Obstructive, Disease, law.invention, 0302 clinical medicine, Randomized controlled trial, law, MESH: Obesity, Orthopedics and Sports Medicine, basketball, Stroke, intervention, MESH: Treatment Outcome, Randomized Controlled Trials as Topic, aerobic fitness, MESH: Ipratropium, evaluation, MESH: Middle Aged, Rehabilitation, field test, Virtual Reality, Middle Aged, MESH: Recovery of Function, MESH: Predictive Value of Tests, MESH: Muscarinic Antagonists, 3. Good health, Exercise Therapy, Treatment Outcome, Meta-analysis, Female, 0305 other medical science, MESH: Postmenopause, Adult, medicine.medical_specialty, MESH: Metabolic Syndrome, MEDLINE, MESH: Forced Expiratory Volume, chronic obstructive pulmonary disease, MESH: Nebulizers and Vaporizers, 03 medical and health sciences, wheelchair, MESH: Severity of Illness Index, Intervention (counseling), medicine, MESH: Exercise Therapy, Humans, MESH: Lung, Interactive video game, Aged, exercise testing, MESH: Humans, business.industry, MESH: Time Factors, ComputingMilieux_PERSONALCOMPUTING, MESH: Quality of Life, MESH: Adult, dyspnea, MESH: Vital Capacity, medicine.disease, MESH: Male, Video Games, Physical therapy, Feasibility Studies, Patient Compliance, Nervous System Diseases, MESH: Exercise Test, Home, business, MESH: Female, human activities, Neurological disorders, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery
Abstract: Objective The objective of this review was to summarize the current best evidence for the effectiveness, feasibility, user compliance and safety of exercise-based games (EBGs), including virtual reality and interactive video game interventions, for the rehabilitation of individuals with neurological disorders at home. Material and methods We identified randomized controlled trials (RCT) evaluating the effects of EBGs in neurological patients in home settings by searching 3 electronic databases (MEDLINE, SCOPUS, CENTRAL Library) from inception to March 2018. All data pertaining to participants, interventions, outcomes, supervision and cost-effectiveness were independently extracted by 2 reviewers. Risk of bias was independently assessed by 2 reviewers. Results Reports of 11 RCT studies with heterogeneous populations (i.e., stroke, Parkinson disease and multiple sclerosis) were included in the review. The treatment of experimental groups included EBGs (i.e., commercially available games such as Nintendo Wii or Dance Dance Revolution or custom-designed devices), and control groups received a controlled (i.e., conventional therapy) or uncontrolled (i.e., usual care) intervention. Across studies, EBGs at home tended to have limited effects on upper and lower limbs. We demonstrated an increased risk of participants dropping out of the program or discontinuing training in experimental groups (n = 51 participants) as compared with controls (n = 23 participants). Few adverse events (2 of 6 studies), such as minor musculoskeletal pain, were reported in balance training. Conclusions This systematic review reveals that EBGs seem a relevant alternative for rehabilitation at home because the effectiveness of these interventions was at least equivalent to conventional therapy or usual care. We give recommendations for the development of new EBG therapies.
Published: 2018
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13. Early predictors of one-year mortality in patients over 65 presenting with ANCA-associated renal vasculitis: a retrospective, multicentre study

Author: Thierry Lobbedez, Dominique Guerrot, Boris Bienvenu, Alexis Francois, Eric Hachulla, Dimitri Titeca-Beauport, Laurence Vrigneaud, Maité Daroux, David Launay, Momar Diouf, C. Lebas, Gabriel Choukroun, CHU Amiens-Picardie, Service de Néphrologie-Dialyse-Transplantation rénale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Registre de Dialyse Péritonéale de Langue Française et Hémodialyse à Domicile [Pontoise] (RDPLF-HDD), Service de Néphrologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Lille Inflammation Research International Center - U 995 (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre hospitalier [Valenciennes, Nord], Centre Hospitalier Boulogne-sur-mer, Service de Néphrologie et Transplantation rénale [CHRU-lille], Mobilités : Vieillissement, Pathologie, Santé (COMETE), Service de médecine interne [CHU Caen], Direction de la recherche clinique et de l'innovation [CHU Amiens], The authors thank Joelle Gracia, Audrey Sultan and Magaly Parsy for the help with collecting the data., Bodescot, Myriam, Service de Néphrologie-Dialyse-Transplantation [CHU Amiens-Picardie], Registre de Dialyse Péritonéale de Langue Française (RDPLF), Société savante (Pontoise), Département de Médecine interne et d'Immunologie clinique [CHRU Lille], Centre national de référence des maladies auto-immunes systémiques rares (sclérodermie systémique) [Lille], Service de Néphrologie et Médecine interne [CH Valenciennes], Service de Néphrologie [CH Boulogne-sur-Mer], Service de Néphrologie [CHRU Lille], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Service de Médecine interne [CHRU Caen], CHU Caen, and Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)
Subjects: Male, Nephrology, 030232 urology & nephrology, lcsh:RC870-923, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Elderly, Glomerulonephritis, MESH: Aged, 80 and over, 0302 clinical medicine, Interquartile range, Aged, 80 and over, MESH: Aged, education.field_of_study, Univariate analysis, MESH: France/epidemiology, ANCA, Mortality rate, Age Factors, MESH: Follow-Up Studies, MESH: Predictive Value of Tests, 3. Good health, Female, France, Infection, Vasculitis, Research Article, medicine.medical_specialty, Population, Renal function, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Humans, Mortality, education, Aged, Retrospective Studies, MESH: Age Factors, 030203 arthritis & rheumatology, MESH: Mortality/trends, MESH: Humans, MESH: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/blood, MESH: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/mortality, business.industry, MESH: Retrospective Studies, Retrospective cohort study, lcsh:Diseases of the genitourinary system. Urology, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, MESH: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis, business, MESH: Female, Follow-Up Studies
Abstract: Background The risk of early death is particularly high in patients over the age of 65 presenting with antineutrophil cytoplasmic antibody (ANCA)-associated renal vasculitis. We hypothesized that by combining disease severity markers, a comorbidity index and serious adverse event reports, we would be able to identify early predictors of one-year mortality in this population. Methods We performed a multicentre, retrospective study in the nephrology and internal medicine departments of six tertiary hospitals in northern France. A total of 149 patients (median [interquartile range (IQR)] age: 72.7 [68.5–76.8] years) presenting with ANCA-associated vasculitis and renal involvement were included between January 2002 and June 2015. The primary endpoint was the one-year mortality rate. Results Renal function was severely impaired at presentation (median [IQR] peak serum creatinine (SCr): 337 [211–522] μmol/l), and 45 patients required dialysis. The Five-Factor Score (FFS, scored as + 1 point for each poor prognostic factor (age > 65 years, cardiac symptoms, gastrointestinal involvement, SCr ≥150 μmol/L, and the absence of ear, nose, and throat involvement)) was ≥3 in 120 cases. The one-year mortality rate was 19.5%. Most of the deaths occurred before month 6, and most of these were related to severe infections. In a univariate analysis, age, a high comorbidity index, a performance status of 3 or 4, a lack of co-trimoxazole prophylaxis, early severe infection, and disease activity parameters (such as the albumin level, haemoglobin level, peak SCr level, dialysis status, and high FFS) were significantly associated with one-year mortality. In a multivariable analysis, the best predictors were a high FFS (relative risk (RR) [95% confidence interval (CI)] = 2.57 [1.30–5.09]; p = 0.006) and the occurrence of a severe infection during the first month (RR [95%CI] = 2.74 [1.27–5.92]; p = 0.01). Conclusions When considering various disease severity markers in over-65 patients with ANCA-associated renal vasculitis, we found that an early, severe infection (which occurred in about a quarter of the patients) is a strong predictor of one-year mortality. A reduction in immunosuppression, the early detection of infections, and co-trimoxazole prophylaxis might help to reduce mortality in this population. Electronic supplementary material The online version of this article (10.1186/s12882-018-1102-3) contains supplementary material, which is available to authorized users.
Published: 2018
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14. Psoriatic arthritis screening by the dermatologist: development and first validation of the 'PURE-4 scale'

Author: M. Bagot, D. Lons Danic, Etienne Audureau, Michel Richard, N. Gouyette, F. Roux, Alain Cantagrel, E. Dernis, Denis Jullien, Pascal Claudepierre, Thierry Passeron, P. Hilliquin, Frédéric Lioté, Laboratoire d'Investigation Clinique (LIC), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), L'Oréal Recherche France (L'Oréal Recherche), L'OREAL, Centre Hospitalier Universitaire de Purpan (CHU Purpan), Service de Rhumatologie [CH Le Mans], Centre Hospitalier Le Mans (CH Le Mans), Centre Hospitalier Sud Francilien, Service de dermatologie, consultation d'allergologie, Hôpital Edouard-Herriot, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Biologie de l'Os et du Cartilage : Régulations et Ciblages Thérapeutiques (BIOSCAR (UMR_S_1132 / U1132)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Dermatologie [Nice], Hôpital Archet 2 [Nice] (CHU), Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, Service de rhumatologie [CHU Henri Mondor], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor
Subjects: Male, MESH: Logistic Models, MESH: Risk Assessment, Severity of Illness Index, Dactylitis, Cohort Studies, 030207 dermatology & venereal diseases, 0302 clinical medicine, MESH: Early Diagnosis, Mass Screening, MESH: Arthritis, Psoriatic, MESH: Incidence, MESH: Cohort Studies, MESH: Program Evaluation, MESH: Psoriasis, MESH: Middle Aged, Incidence, MESH: Sex Distribution, Middle Aged, MESH: Predictive Value of Tests, Infectious Diseases, Joint pain, Predictive value of tests, Area Under Curve, Female, France, medicine.symptom, Cohort study, Adult, medicine.medical_specialty, Dermatology, Risk Assessment, 03 medical and health sciences, Psoriatic arthritis, Age Distribution, Predictive Value of Tests, Psoriasis, MESH: Severity of Illness Index, medicine, Humans, MESH: Mass Screening, Sex Distribution, MESH: Age Distribution, Retrospective Studies, 030203 arthritis & rheumatology, MESH: Humans, business.industry, Arthritis, Psoriatic, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, MESH: ROC Curve, medicine.disease, Triage, MESH: Male, MESH: Dermatologists, MESH: France, Early Diagnosis, Logistic Models, ROC Curve, MESH: Area Under Curve, business, MESH: Female, [SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology, Dermatologists, Program Evaluation
Abstract: BACKGROUND Dermatologists are recommended to ask psoriasis patients about musculoskeletal complaints to allow early detection and treatment of psoriatic arthritis (PsA). Screening tools have been developed to help identify patients warranting further rheumatologic assessment, but evidence suggests room for improvement in their diagnostic value and ease of use for outpatient practice. OBJECTIVE To develop and internally validate a brief tool for dermatologists to screen patients to refer to a rheumatologist for PsA diagnosis. METHODS After the literature review, 23 items were selected, covering pain at various locations and inflammatory signs of PsA. The validation study was conducted in medically diagnosed psoriasis patients consecutively recruited between 2012 and 2014 (Saint Joseph Hospital, Paris, France). Patients were enrolled by a dermatologist who helped to complete the questionnaire. Diagnosis of PsA was established by a rheumatologist based on CASPAR criteria. Multivariate logistic regression models were performed to build the scale, assessing discrimination through sensitivity, specificity and area under the ROC curve (AUC). Final model was internally validated using bootstrapping techniques. RESULTS One hundred and sixty-eight patients were recruited, of whom nine were excluded for known PsA and 21 did not attend the rheumatologist consultation. Of 137 included patients (median age 43 years, 59.6% men), 21 (15.3%) had a PsA diagnosis. Final regression model retained four independent items, including evocative signs of dactylitis, inflammatory heel pain, bilateral buttock pain and peripheral joint pain with swelling in patients aged
Published: 2018
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15. Feasibility of systematic handgrip strength testing in digestive cancer patients treated with chemotherapy: The FIGHTDIGO study

Author: Ordan, Marie-Amélie, Mazza, Camille, Barbe, Coralie, Perrier, Marine, Botsen, Damien, Renard, Yohann, Moreau, Johanna, Brasseur, Mathilde, Taillière, Barbara, Bertin, Eric, Bouche, Olivier, Université de Reims Champagne-Ardenne (URCA), Centre Hospitalier Universitaire de Reims (CHU Reims), Institut Charles Gerhardt Montpellier - Institut de Chimie Moléculaire et des Matériaux de Montpellier (ICGM ICMMM), Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut de Chimie du CNRS (INC), Faculté de Médecine de Reims, Laboratoire Interdisciplinaire de Physique [Saint Martin d’Hères] (LIPhy), and Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])
Subjects: Male, chemotherapy, sarcopenia, MESH: Gastrointestinal Neoplasms, Predictive Value of Tests, Antineoplastic Combined Chemotherapy Protocols, Humans, muscle strength dynamometer, Prospective Studies, Aged, Gastrointestinal Neoplasms, digestive system neoplasms, MESH: Aged, Muscle Weakness, MESH: Humans, Hand Strength, feasibility study, MESH: Muscle Weakness, dynapenia, MESH: Follow-Up Studies, MESH: Predictive Value of Tests, MESH: Prospective Studies, MESH: Male, MESH: Antineoplastic Combined Chemotherapy Protocols, MESH: Hand Strength, Feasibility Studies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, MESH: Feasibility Studies, MESH: Female, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Follow-Up Studies
Abstract: International audience; BACKGROUND: Handgrip strength (HGS) is a widely studied noninvasive test. Weak strength (dynapenia) seems to be associated with high morbidity and mortality in different populations, notably oncology populations. Despite this, HGS testing is not used in daily practice in oncology. The study was aimed at evaluating the feasibility and acceptability of HGS testing in patients with digestive cancer treated with ambulatory chemotherapy. METHODS: In this prospective, single-center study, enrolled patients were followed for 6 months. Two consecutive bilateral measures were performed with a Jamar dynamometer during each patient's appointments in the unit for intravenous treatment. A questionnaire was completed by patients and medical team members. RESULTS: There were 203 consecutive patients, and 201 were recruited. In all, 1704 of 1716 measurements (99.3%) were performed, and 201 patients (99.0%) performed at least 1 measure; 190 (94.5%) performed all expected measures. One hundred sixty-four of 171 participating patients (95.9%) found the test easy to perform, and 167 (97.7%) did not find the test restrictive. All of the 14 medical team members found the test easy to perform, unrestrictive, and undisruptive in their daily practice. CONCLUSIONS: HGS testing is routinely feasible, inexpensive, and well accepted by patients and medical teams in an ambulatory digestive cancer unit.
Published: 2018
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16. Predictors of abnormal cytology among HPV-infected women in remote territories of French Guiana

Author: Jerome Ponty, Raymond Césaire, Nadia Thomas, Vincent Molinie, Claire Grenier, Valentin Dufit, Maylis Douine, Laure Bianco, Mathieu Nacher, Paul Brousse, Antoine Adenis, Dominique Catherine, Gabriel Carles, Fatiha Najioullah, Odile Kilié, Jean Luc Deshayes, Vincent Lacoste, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Service d'anatomopathologie [Fort de France, Martinique], CHU Fort de France, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Association Guyanaise Dépistage Organisé des Cancers [Cayenne] (A.G.D.O.C), Département des Centres Délocalisés de Prévention et de Soins [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Laboratoire des Interactions Virus-Hôtes [Cayenne, Guyane Française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), The present study was funded by the European Regional Development Funds (FEDER) N° Presage 30,814., and Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
Subjects: Rural Population, [SDV]Life Sciences [q-bio], Uterine Cervical Neoplasms, MESH: Genotype, 0302 clinical medicine, MESH: Rural Population, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Cytology, Genotype, Medicine, 030212 general & internal medicine, Life history, Papillomaviridae, Anamnesis, MESH: Aged, MESH: Middle Aged, lcsh:Public aspects of medicine, Obstetrics and Gynecology, virus diseases, General Medicine, MESH: Papillomavirus Vaccines, Middle Aged, Abnormal cytology, female genital diseases and pregnancy complications, MESH: Predictive Value of Tests, 3. Good health, French Guiana, Vaccination, MESH: Young Adult, 030220 oncology & carcinogenesis, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, MESH: Papillomavirus Infections/complications, MESH: DNA, Viral/analysis, Research Article, Adult, medicine.medical_specialty, Cytodiagnosis, Reproductive medicine, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Papillomavirus Infections/prevention & control, lcsh:Gynecology and obstetrics, MESH: Papillomaviridae/isolation & purification, MESH: Cytodiagnosis/statistics & numerical data, 03 medical and health sciences, Young Adult, Predictive Value of Tests, Internal medicine, MESH: French Guiana, Humans, Papillomavirus Vaccines, MESH: Papillomaviridae/genetics, Normal cytology, lcsh:RG1-991, Aged, MESH: Uterine Cervical Neoplasms/virology, MESH: Humans, business.industry, Papillomavirus Infections, MESH: Papillomavirus Infections/virology, lcsh:RA1-1270, MESH: Adult, Reproductive Medicine, DNA, Viral, MESH: Uterine Cervical Neoplasms/prevention & control, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: International audience; BACKGROUND: Cervical cancer prevention using cervical cytology is insufficiently sensitive, a significant proportion of HPV-infected women having normal cytology. The objective of the present study was to try to identify factors associated with abnormal cytology in HPV-infected women living in remote areas of French Guiana.METHODS: A study was conducted in women aged 20-65 years having HPV infections confirmed by HPV DNA detection using the GREINER-BIO-ONE kit. In addition to HPV testing, cytology was performed and classified as normal or abnormal. Demographic and life history variables, and infecting genotypes were compared between the normal and abnormal cytology groups.RESULTS: None of the demographic and life history variables were associated with cytology results. HPV genotype 53 was significantly associated with absence of cytological abnormalities whereas HPV 52, 58, 16 and perhaps 33 and 66 were independently associated with a greater risk of cytological abnormalities. When grouping HPV genotypes in different species, only species 9 (HPV 16, 31, 33, 35, 52, 58, 67) was significantly associated with abnormal cytology AOR = 5.1 (95% CI = 2.3-11.2), P
Published: 2018
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17. Plasma apolipoprotein H limits HCV replication and associates with response to NS3 protease inhibitors-based therapy

Author: Matthew L. Albert, Yoann Barthe, Armanda Casrouge, Arnaud Fontanet, Stanislas Pol, Sylvie Lagaye, Hélène Fontaine, Vincent Mallet, Philippe Sultanik, Christophe Hézode, Estelle Mottez, Laurent Abel, Etienne Gayat, Céline Dorival, Fabrice Carrat, Jean-Pierre Bronowicki, Ioannis Theodorou, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'hépatologie, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Immunobiologie des Cellules Dendritiques, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie, systèmes d'information, modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Departement d'Hépatho-Gastro-Enterologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre Hospitalier Universitaire Henri Mondor, Centre d'Immunologie Humaine (CIH), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de santé publique [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Immunité et Infection, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratory of Human Genetics of Infectious Diseases, Rockefeller University [New York]-Rockefeller Branch, Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of anesthesiology and critical care medicine, Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Département Infection et Epidémiologie - Department of Infection and Epidemiology, Institut Pasteur [Paris], The CUPIC Cohort study was sponsored and funded by The National Agency for research on Aids and Viral Hepatitis (ANRS), with support by the French Association for the Study of the Liver(AFEF). The authors also wish to acknowledge the Center for Human Immunology for its support of the research project., Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pasteur [Paris] (IP), CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Centre Hospitalier Universitaire Henri Mondor, Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR113-Université Pierre et Marie Curie - Paris 6 (UPMC), Rockefeller Branch-rockefeller university, Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Centre Hospitalier Universitaire Henri Mondor, Centre d'Immunologie Humaine ( CIH ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR113-Université Pierre et Marie Curie - Paris 6 ( UPMC ), Imagine - Institut des maladies génétiques ( IMAGINE - U1163 ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ), Biomarqueurs CArdioNeuroVASCulaires ( BioCANVAS ), Université Paris Diderot - Paris 7 ( UPD7 ) -Université Paris 13 ( UP13 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Département Infection et Epidémiologie
Subjects: Male, MESH : Aged, MESH : Prospective Studies, MESH : Viral Load, MESH : Hepatitis C, Chronic/blood, Hepacivirus, MESH : Virus Replication/drug effects, Polyethylene Glycols, MESH: Molecular Targeted Therapy, [ SDV.IMM ] Life Sciences [q-bio]/Immunology, Molecular Targeted Therapy, Prospective Studies, MESH: Ribavirin/therapeutic use, MESH : Proline/analogs & derivatives, MESH: Treatment Outcome, MESH : Hepacivirus/drug effects, MESH: Viral Nonstructural Proteins/metabolism, MESH: Middle Aged, MESH: RNA, Viral/blood, virus diseases, MESH : beta 2-Glycoprotein I/blood, Blood proteins, 3. Good health, beta 2-Glycoprotein I, Area Under Curve, MESH: Hepacivirus/genetics, Drug Therapy, Combination, Oligopeptides, Apolipoprotein H, MESH : Biomarkers/blood, MESH: Hepatitis C, Chronic/drug therapy, Proline, MESH: Hepatitis C, Chronic/blood, virological response, MESH: Proline/analogs & derivatives, MESH : Antiviral Agents/therapeutic use, Antiviral Agents, MESH : Proline/therapeutic use, Boceprevir, MESH : Recombinant Proteins/therapeutic use, Humans, chronic hepatitis C, MESH : Middle Aged, Protease Inhibitors, MESH: Interferon-alpha/therapeutic use, MESH : Predictive Value of Tests, Aged, MESH: Polyethylene Glycols/therapeutic use, MESH : Hepacivirus/genetics, MESH: Humans, Surrogate endpoint, MESH : Humans, MESH: beta 2-Glycoprotein I/blood, MESH: ROC Curve, digestive system diseases, chemistry, MESH: Protease Inhibitors/therapeutic use, Immunology, MESH: Female, Biomarkers, Time Factors, MESH : Viral Nonstructural Proteins/antagonists & inhibitors, MESH : Hepatitis C, Chronic/diagnosis, MESH : Protease Inhibitors/therapeutic use, Viral Nonstructural Proteins, Virus Replication, MESH : Polyethylene Glycols/therapeutic use, HCV protease inhibitor, Telaprevir, MESH: Virus Replication/drug effects, MESH: Proline/therapeutic use, chemistry.chemical_compound, apolipoprotein H, MESH: Hepacivirus/drug effects, MESH : RNA, Viral/blood, MESH : Female, MESH: Hepatitis C, Chronic/diagnosis, MESH : Viral Nonstructural Proteins/metabolism, MESH: Aged, Middle Aged, Viral Load, MESH: Hepacivirus/growth & development, Recombinant Proteins, MESH: Predictive Value of Tests, MESH : Hepacivirus/enzymology, Treatment Outcome, RNA, Viral, biomarker, [SDV.IMM]Life Sciences [q-bio]/Immunology, Biomarker (medicine), Female, France, MESH: Viral Load, MESH : Oligopeptides/therapeutic use, MESH : Time Factors, medicine.drug, MESH : Hepatitis C, Chronic/drug therapy, MESH : Molecular Targeted Therapy, MESH: Biomarkers/blood, MESH: Hepacivirus/enzymology, MESH : Male, MESH : Ribavirin/therapeutic use, MESH : Interferon-alpha/therapeutic use, MESH : Treatment Outcome, Biology, Predictive Value of Tests, MESH: Recombinant Proteins/therapeutic use, Ribavirin, medicine, MESH : France, NS3, MESH: Viral Nonstructural Proteins/antagonists & inhibitors, Hepatology, MESH : Drug Therapy, Combination, MESH: Time Factors, Interferon-alpha, Hepatitis C, Chronic, MESH : Hepacivirus/growth & development, MESH: Male, MESH: Prospective Studies, MESH: France, MESH: Drug Therapy, Combination, ROC Curve, MESH: Antiviral Agents/therapeutic use, MESH: Oligopeptides/therapeutic use, MESH: Area Under Curve, MESH : Area Under Curve, MESH : ROC Curve
Abstract: International audience; BACKGROUND & AIMS:Chronic infection with HCV remains a public health problem with approximately 150 million people infected worldwide. HCV intersects with lipid metabolism for replication and entry; and plasma concentrations of apolipoproteins have been identified as predictors for response to therapy. Herein, we conducted a screen of plasma proteins, including all apolipoproteins, to identify correlates of response to pegylated-interferon/ribavirin (PR) and HCV non-structural protein 3 (NS3) inhibitors (i.e., telaprevir/boceprevir) therapy in treatment-experienced cirrhotic patients from the ANRS CUPIC cohort.METHODS:We analysed 220 baseline plasma protein concentrations in 189 patients using Luminex technology and analyzed results.RESULTS:We identified baseline levels of apolipoprotein H (apoH) as a surrogate marker for sustained virological response (SVR). Notably, increased plasma concentration of apoH, used in combination with known clinical parameters, established a robust model with improved classification of patients as likely to achieve SVR (AUC = 0.77, Se = 66%, Sp = 72%, NRI = 39%). Moreover, we provide mechanistic information that indicates a previously unidentified role for apoH during viral entry. Using a human liver slices HCV infection model, we demonstrate that apoH limits replication.CONCLUSION:These data support testing of new biomarker strategies for the management of cirrhotic HCV patients and expand our understanding of how apoH may intersect with HCV infection
Published: 2015
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18. An immunoproteomic approach revealed antigenic proteins enhancing serodiagnosis performance of bird fancier's lung

Author: Gabriel Reboux, Jean-Charles Dalphin, Adeline Rouzet, Benoît Valot, Laurence Millon, Thierry Balliau, Sandrine Roussel, Anne Gondouin, Paul De Vuyst, Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Génétique Quantitative et Evolution - Le Moulon (Génétique Végétale) (GQE-Le Moulon), Centre National de la Recherche Scientifique (CNRS)-AgroParisTech-Université Paris-Sud - Paris 11 (UP11)-Institut National de la Recherche Agronomique (INRA), Service de parasitologie et mycologie [CHU de Besançon], Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Service de Pneumologie [Besançon], Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Jean Minjoz-Université de Franche-Comté (UFC), Erasme Hospital, Brussels, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Besancon University Hospital [2015-A01803-46], Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Service de Pneumologie, Hôpital Jean-Minjoz, Centre Hospitalier Universitaire de Besançon, Université de Franche-Comté, Besançon, France., Génétique Quantitative et Evolution - Le Moulon (Génétique Végétale) ( GQE-Le Moulon ), Institut National de la Recherche Agronomique ( INRA ) -Université Paris-Sud - Paris 11 ( UP11 ) -AgroParisTech-Centre National de la Recherche Scientifique ( CNRS ), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), and Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB)
Subjects: Male, Proteomics, MESH : Aged, MESH: Immunoelectrophoresis, MESH : Chromatography, Liquid, law.invention, Feces, MESH: Enzyme Precursors, 0302 clinical medicine, Tandem Mass Spectrometry, MESH : Bird Fancier's Lung, Electrophoresis, Gel, Two-Dimensional, MESH: Animals, MESH: Bird Fancier's Lung, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, Electrophoresis, Agar Gel, MESH: Middle Aged, MESH: Proteomics, MESH: Feces, Precipitin, MESH : Enzyme-Linked Immunosorbent Assay, MESH: Case-Control Studies, 3. Good health, MESH: Reproducibility of Results, [ SDV.BBM.GTP ] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Area Under Curve, Recombinant DNA, Antibody, 2D electrophoresis, MESH : Case-Control Studies, Immunology, [ SDV.EE.SANT ] Life Sciences [q-bio]/Ecology, environment/Health, Avian Proteins, 03 medical and health sciences, Antigen, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Humans, Serologic Tests, MESH : Middle Aged, MESH : Predictive Value of Tests, MESH : Birds, MESH : Aged, 80 and over, Aged, MESH: Humans, MESH : Reproducibility of Results, MESH : Humans, MESH: Serologic Tests, MESH : Immunoglobulin Light Chains, Surrogate, MESH: Tandem Mass Spectrometry, MESH: Adult, MESH : Electrophoresis, Gel, Two-Dimensional, Bird fancier's lung, Allergens, MESH: ROC Curve, medicine.disease, MESH: Electrophoresis, Gel, Two-Dimensional, 030104 developmental biology, 030228 respiratory system, Case-Control Studies, MESH : Inhalation Exposure, MESH: Chromatography, Liquid, MESH: Female, [ SDV.MHEP.PSR ] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 0301 basic medicine, Immunoelectrophoresis, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Recombinant antigens, Serology, MESH : Proteomics, MESH: Aged, 80 and over, MESH: Avian Proteins, law, Immunology and Allergy, MESH : Female, MESH: Endopeptidases, MESH : Allergens, MESH: Aged, Enzyme Precursors, Inhalation Exposure, Serodiagnosis, medicine.diagnostic_test, MESH : Immunoelectrophoresis, MESH : Enzyme Precursors, MESH : Avian Proteins, MESH: Enzyme-Linked Immunosorbent Assay, Middle Aged, MESH : Adult, MESH : Endopeptidases, MESH: Predictive Value of Tests, MESH : Serologic Tests, MESH: Birds, Female, ELISA, MESH : Tandem Mass Spectrometry, MESH: Inhalation Exposure, Adult, MESH: Allergens, Immunoglobulin Light Chains, Surrogate, MESH : Male, Enzyme-Linked Immunosorbent Assay, Biology, Birds, Predictive Value of Tests, Endopeptidases, medicine, Animals, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, Two-dimensional gel electrophoresis, Reproducibility of Results, MESH : Feces, MESH: Immunoglobulin Light Chains, Surrogate, MESH: Male, MESH : Electrophoresis, Agar Gel, ROC Curve, biology.protein, MESH: Area Under Curve, MESH : Animals, MESH : Area Under Curve, MESH: Electrophoresis, Agar Gel, MESH : ROC Curve, Hypersensitivity pneumonitis, Chromatography, Liquid
Abstract: Background Bird fancier's lung (BFL) caused by repeated inhalation of avian proteins is the most common form of hypersensitivity pneumonitis. However, the exact identification of proteins involved is unknown, and serological test use for diagnosis need to be standardized. The objectives of this study were (i) to identify antigenic proteins from pigeon droppings (ii) to provide information about their location in avian matrices and (iii) to produce them in recombinant proteins to evaluate their diagnostic performances. Method Antigenic proteins of pigeon dropping extracts were investigated using 2-dimensional immunoblotting with sera from patients with BFL, asymptomatic exposed controls and healthy volunteers. We investigated the origin of these antigenic proteins by analyzing droppings, blooms and sera using a shotgun proteomic analysis. BFL-associated proteins were produced as recombinant antigens in E. coli and were assessed in ELISA with sera from patients (n = 25) and subject exposed controls (n = 30). These diagnostic performances were compared with those obtained by precipitin techniques (agar gel double diffusion, immunoelectrophoresis). Results We identified 14 antigenic proteins mainly located in droppings and blooms. These proteins were involved in either the digestive or immune systems of pigeons. Using the recombinant BFL-associated proteins: Immunoglobulin lambda-like polypeptide-1 (IGLL1: sensitivity: 76%; specificity: 100%; AUC: 0.93) and Proproteinase E (ProE: sensitivity: 84%; specificity: 80%; AUC: 0.85), the ELISA test showed better performance than precipitin assays with pigeon dropping extracts (sensitivity: 60%; specificity: 93.3%; AUC: 0.76). Conclusion IGLL1 and ProE were identified as the biomarkers of the disease. The use of these highly standardized antigens discriminates BFL cases from exposed subjects in serological assays. The results of this study offer new possibilities for the serological diagnosis of the disease. Clinical trial registration: ClinicalTrials.gov : Identifier NCT03056404 .
Published: 2017
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19. C-reactive protein: A promising biomarker in ALS?

Author: Christian R. Andres, Hélène Blasco, Stéphane Beltran, Philippe Couratier, P. Corcia, Patrick Vourc'h, Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie [CHU Limoges], CHU Limoges, Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), and Université de Limoges (UNILIM)-Université de Limoges (UNILIM)
Subjects: 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, MESH: C-Reactive Protein, Medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, MESH: Amyotrophic Lateral Sclerosis, MESH: Humans, biology, business.industry, C-reactive protein, Amyotrophic Lateral Sclerosis, Reproducibility of Results, MESH: Predictive Value of Tests, MESH: Reproducibility of Results, C-Reactive Protein, Neurology, biology.protein, Cancer research, MESH: Biomarkers, Biomarker (medicine), [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), business, 030217 neurology & neurosurgery, Biomarkers
Abstract: International audience
Published: 2017
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20. Interim PET-driven strategy in de novo diffuse large B-cell lymphoma: do we trust the driver ?

Author: Steven Le Gouill, René-Olivier Casasnovas, Laboratoire d'Hematologie [CHU Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), Service d'Hématologie Clinique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), 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), no source, Bernardo, Elizabeth, Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), 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, Université de Nantes ( UN ) -Centre hospitalier universitaire de Nantes ( CHU Nantes ), Centre de recherche de Cancérologie et d'Immunologie / Nantes - Angers ( CRCINA ), Université d'Angers ( UA ) -Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche en Santé de l'Université de Nantes ( IRS-UN ) -Centre hospitalier universitaire de Nantes ( CHU Nantes ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Lipides - Nutrition - Cancer [Dijon - U1231] ( LNC ), and 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 )
Subjects: Oncology, Time Factors, MESH : Lymphoma, Large B-Cell, Diffuse/therapy, Biochemistry, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, MESH: Fluorodeoxyglucose F18, MESH : Lymphoma, Large B-Cell, Diffuse/diagnostic imaging, Clinical Trials as Topic, MESH: Lymphoma, Large B-Cell, Diffuse/diagnostic imaging, MESH : Positron-Emission Tomography/methods, MESH : Prognosis, medicine.diagnostic_test, MESH: Lymphoma, Large B-Cell, Diffuse/classification, Hematology, Therapeutic decision making, Prognosis, MESH: Predictive Value of Tests, 3. Good health, Positron emission tomography, 030220 oncology & carcinogenesis, Predictive value of tests, MESH : Lymphoma, Large B-Cell, Diffuse/classification, Lymphoma, Large B-Cell, Diffuse, After treatment, MESH: Radiopharmaceuticals, MESH : Time Factors, medicine.medical_specialty, Immunology, Standardized uptake value, MESH: Positron-Emission Tomography/methods, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Prognosis, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Fluorodeoxyglucose F18, Predictive Value of Tests, Internal medicine, medicine, Humans, MESH : Predictive Value of Tests, MESH: Humans, business.industry, MESH : Humans, MESH: Time Factors, Cell Biology, MESH : Fluorodeoxyglucose F18, medicine.disease, Interim pet, Surgery, MESH: Lymphoma, Large B-Cell, Diffuse/therapy, Semiquantitative Method, MESH : Radiopharmaceuticals, Positron-Emission Tomography, Radiopharmaceuticals, business, Diffuse large B-cell lymphoma, 030215 immunology
Abstract: 18F-Fluorodeoxyglucose–positron emission tomography (FDG-PET) has become a central tool for both accurate initial staging and determination of prognosis after treatment of diffuse large B-cell lymphoma (DLBCL). However, the role of PET during treatment (iPET) in daily practice remains a matter of significant debate. This perspective reviews the published studies on iPET in DLBCL, including the methods used to analyze iPET, its timing, and studies of iPET-driven therapy to illuminate where daily practice may benefit from the use of iPET. When performed after 2 and/or 4 courses of immunochemotherapy, iPET has a very good negative predictive value, utilizing both visual (qualitative) and semiquantitative methods. The visual method accurately predicts outcome for patients with limited disease. The semiquantitative method, eg, the change of the difference of maximum standardized uptake value (ΔSUVmax), is for patients with advanced DLBCL, for whom iPET identifies patients with very good outcome with continuation of standard therapy. A low ΔSUVmax also helps identify patients with a risk for relapse averaging 50% and warrants review of their scheduled therapy. To date, no trial has demonstrated the superiority of an iPET-driven strategy in DLBCL. However, the very good negative and good positive predictive values of iPET support its use in daily practice as a better predictive tool than contrast-enhanced computed tomographic scan for therapeutic decision making.
Published: 2017
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21. Value of CMR in quantification of paravalvular aortic regurgitation after TAVI

Author: Alexis Theron, Roch Giorgi, Alexis Jacquier, Marc Lambert, Erwan Salaun, Gilbert Habib, Thomas Cuisset, Dominique Grisoli, Jean-Louis Bonnet, Nicolas Jaussaud, Sandrine Hubert, Frederic Collart, Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre de résonance magnétique biologique et médicale ( CRMBM ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance Publique - Hôpitaux de Marseille ( APHM ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM - U912 INSERM - AMU - IRD ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Nutrition, obésité et risque thrombotique ( NORT ), Aix Marseille Université ( AMU ) -Institut National de la Recherche Agronomique ( INRA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes ( URMITE ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR48, INSB-INSB-Centre National de la Recherche Scientifique ( CNRS ), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Département de Radiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE), Service de chirurgie cardiaque, CUISSET, Thomas, and Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: MESH : Prospective Studies, Severity of Illness Index, MESH : Aortic Valve Insufficiency, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Prospective Studies, Prospective cohort study, MESH: Multidetector Computed Tomography, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, General Medicine, MESH: Aortic Valve Insufficiency, MESH: Magnetic Resonance Imaging, Cine, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Magnetic Resonance Imaging, Cine, MESH : Postoperative Care, MESH: Predictive Value of Tests, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Reproducibility of Results, Echocardiography, Predictive value of tests, Cardiology, cardiovascular system, MESH : Severity of Illness Index, MESH : Multidetector Computed Tomography, MESH : Sensitivity and Specificity, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Transcatheter aortic, Aortic Valve Insufficiency, Magnetic Resonance Imaging, Cine, Regurgitation (circulation), MESH : Transcatheter Aortic Valve Replacement, MESH: Postoperative Care, Sensitivity and Specificity, Transcatheter Aortic Valve Replacement, cardiovascular magnetic resonance, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Internal medicine, medicine.artery, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, MESH: Severity of Illness Index, Severity of illness, Ascending aorta, Multidetector Computed Tomography, medicine, Humans, Radiology, Nuclear Medicine and imaging, MESH : Predictive Value of Tests, transcatheter aortic valve implantation, Postoperative Care, MESH: Humans, business.industry, MESH : Echocardiography, MESH : Reproducibility of Results, MESH : Humans, Reproducibility of Results, aortic stenosis, aortic regurgitation, MESH: Prospective Studies, MESH: Sensitivity and Specificity, Regurgitant fraction, MESH: Echocardiography, MESH: Transcatheter Aortic Valve Replacement, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Edwards sapien
Abstract: To assess the value of cardiac magnetic resonance (CMR) using phase-contrast velocity mapping for paravalvular aortic regurgitation (PAR) quantification., All patients undergoing transcatheter aortic valve implantation (TAVI) in our centre between November 2012 and August 2013, without CMR-contraindication were included. PAR severity was assessed 5 days after TAVI using: transthoracic echocardiography (TTE) and CMR [regurgitant volume (RV), regurgitant fraction (RF)]. Aortic regurgitation (AR) index was obtained during TAVI. Thirty of 51 patients who underwent TAVI were included (COREVALVE, n = 10; or EDWARDS SAPIEN XT, n = 20). At TTE, PAR was mild in 22, moderate in 3, and severe in 5 patients. Reliable phase-contrast images were acquired at the sino-tubular junction for SAPIEN and at the tubular portion of the ascending aorta for COREVALVE. The reproducibility of CMR was high (coefficient of correlation = 0.99 for intra- and inter-operator variability). At CMR, RV, and RF were significantly (P < 0.0005) correlated with AR severity at TTE, with mean RF values at 9.2 ± 7.6% in mild, 20.3 ± 4.2% in moderate, and 46.8 ± 10.8% in severe PAR. A cut-off value of RF < 14% at CMR accurately discriminated mild from moderate/severe (sensitivity: 100%, specificity: 82%). The mean AR index was 29.4 ± 6 for mild and 13.8 ± 5 for moderate/severe PAR. Three patients had a RF > 14% and a low AR index, CMR is a reproducible, accurate, and reliable method to assess PAR severity. CMR may allow correcting an underestimation at TTE when AR index is doubtful.
Published: 2017
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22. The HNF1B score is a simple tool to select patients for HNF1B gene analysis

Author: Stanislas Faguer, Dominique Chauveau, Antoine Huart, Joost P. Schanstra, Nicolas Chassaing, Flavio Bandin, Audrey Casemayou, Patrick Calvas, Stéphane Decramer, Arnaud Garnier, Cathie Prouheze, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre de Référence du Sud Ouest des Maladies Rénales Rares, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Unité différenciation épidermique et auto-immunité rhumatoïde (UDEAR), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), CARBILLET, Véronique, Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Toulouse [Toulouse]-Hôpital des Enfants, and Hôpital Purpan [Toulouse]
Subjects: Oncology, medicine.medical_specialty, Pathology, MESH: Kidney Diseases / diagnosis, MESH: Mutation, MESH: Biomarkers / blood, MESH: Pedigree, MESH: Phenotype, MESH: Heredity, MESH: Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pathognomonic, Internal medicine, MESH: Liver Function Tests, MESH: Gene Frequency, medicine, MESH: Patient Selection, MESH: Kidney Diseases / blood, MESH: DNA Mutational Analysis, Family history, Genetic testing, Cystic kidney, MESH: Humans, medicine.diagnostic_test, MESH: Diagnostic Imaging, business.industry, MESH: Blood Chemical Analysis, MESH: Genetic Predisposition to Disease, MESH: Decision Support Techniques, Gold standard (test), MESH: ROC Curve, MESH: Hepatocyte Nuclear Factor 1-beta / genetics, HNF1B, MESH: Kidney Diseases / pathology, MESH: Predictive Value of Tests, 3. Good health, MESH: Reproducibility of Results, MESH: France, MESH: Kidney Diseases / genetics, Nephrology, Predictive value of tests, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Area Under Curve, business, Liver function tests
Abstract: International audience; HNF1B-related disease is an emerging condition characterized by an autosomal-dominant inheritance, a 50% rate of de novo mutations, and a highly variable phenotype (renal involvement, maturity-onset diabetes of the young type 5, pancreatic hypoplasia, and urogenital tract and liver test abnormalities). Given the current lack of pathognomonic characteristics and the wide overlap with other conditions, a genetic test is the diagnostic gold standard. However, pre-genetic screening is mandatory because genetic testing has substantial costs. Our aim was to develop a HNF1B score, based on clinical, imaging, and biological variables, as a pivotal tool for rational genetic testing. A score was created using a weighted combination of the most discriminative characteristics based on the frequency and specificity in published series. The HNF1B score is calculated upon 17 items including antenatal discovery, family history, and organ involvement (kidney, pancreas, liver, and genital tract). The performance of the score was assessed by a ROC curve analysis in a 433-individual cohort containing 56 HNF1B cases. The HNF1B score efficiently and significantly discriminated between mutated and nonmutated cases (AUC 0.78). The optimal cutoff threshold for the negative predictive value to rule out HNF1B mutations in a suspected individual was 8 (sensitivity 98.2%, specificity 41.1%, and negative predictive value over 99%). Thus, the HNF1B score is a simple and accurate tool to provide a more rational approach to select patients for HNF1B screening.
Published: 2014
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23. Predicted strain coverage of a meningococcal multicomponent vaccine (4CMenB) in Europe: a qualitative and quantitative assessment

Author: Pietro Giorgio Lovaglio, Morgan Ledroit, Anna Carannante, Fabio Rigat, Maurizio Comanducci, Cecilia Fazio, Raquel Abad, Giacomo Frosi, Jamie Findlow, Dominique A. Caugant, Ulrich Vogel, Muhamed-Kheir Taha, John J. Donnelly, Duccio Medini, Jay Lucidarme, Danielle Thompson, Davide Serruto, Martin Musilek, Maria Stella, Stefanie Gilchrist, Alessandro Muzzi, Paola Stefanelli, Ala Eddine Deghmane, Luca Orlandi, Eva Hong, Stefania Bambini, Ray Borrow, Heike Claus, Giuseppe Boccadifuoco, Julio A. Vázquez, Marzia Monica Giuliani, Paula Kriz, Rino Rappuoli, Jan Oksnes, Matthias Frosch, Mariagrazia Pizza, Institute of Hygiene and Microbiology [Wuerzburg], University of Würzburg, Institut Pasteur [Paris], Instituto de Salud Carlos III [Madrid] (ISC), Health Protection Agency [Manchester], Istituto Superiore di Sanita [Rome], Norwegian Institute of Public Health [Oslo] (NIPH), National Institute of Public Health [Prague], Novartis Vaccines and Diagnostics [Siena], Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), Novartis Vaccines, Novartis Vaccines and Diagnostics., Vogel, U, Taha, M, Vazquez, J, Findlow, J, Claus, H, Stefanelli, P, Caugant, D, Kriz, P, Abad, R, Bambini, S, Carannante, A, Deghmane, A, Fazio, C, Frosch, M, Frosi, G, Gilchrist, S, Giuliani, M, Hong, E, Ledroit, M, Lovaglio, P, Lucidarme, J, Musilek, M, Muzzi, A, Oksnes, J, Rigat, F, Orlandi, L, Stella, M, Thompson, D, Pizza, M, Rappuoli, R, Serruto, D, Comanducci, M, Boccadifuoco, G, Donnelly, J, Medini, D, Borrow, R, Institut Pasteur [Paris] (IP), Istituto Superiore di Sanità (ISS), and Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB)
Subjects: MESH: Adhesins, Bacterial, MESH: Geography, Predictive Value of Test, Neisseria meningitidis, Serogroup B, Group B, MESH: Meningococcal Vaccines, MESH: Genotype, 0302 clinical medicine, Data sequences, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Quantitative assessment, 030212 general & internal medicine, 0303 health sciences, Geography, Strain (biology), MESH: Meningitis, Meningococcal, Meningococcal Vaccine, MESH: Enzyme-Linked Immunosorbent Assay, MESH: Predictive Value of Tests, Bacterial Typing Techniques, 3. Good health, Europe, MESH: Reproducibility of Results, MESH: Multilocus Sequence Typing, Infectious Diseases, Population Surveillance, SECS-S/01 - STATISTICA, MESH: Genes, Bacterial, Human, DNA, Bacterial, Genotype, Reproducibility of Result, Enzyme-Linked Immunosorbent Assay, Meningococcal Vaccines, Meningitis, Meningococcal, Biology, MESH: Bacterial Typing Techniques, MESH: Population Surveillance, Microbiology, 03 medical and health sciences, Antigen, Bacterial Typing Technique, Predictive Value of Tests, MESH: Neisseria meningitidis, Serogroup B, Humans, Typing, Adhesins, Bacterial, Antigens, Bacterial, MESH: Humans, 030306 microbiology, Reproducibility of Results, MESH: DNA, Bacterial, Bacterial adhesin, Genes, Bacterial, Multilocus sequence typing, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, MESH: Antigens, Bacterial, Multilocus Sequence Typing
Abstract: Summary Background A novel multicomponent vaccine against meningococcal capsular group B (MenB) disease contains four major components: factor-H-binding protein, neisserial heparin binding antigen, neisserial adhesin A, and outer-membrane vesicles derived from the strain NZ98/254. Because the public health effect of the vaccine, 4CMenB (Novartis Vaccines and Diagnostics, Siena, Italy), is unclear, we assessed the predicted strain coverage in Europe. Methods We assessed invasive MenB strains isolated mainly in the most recent full epidemiological year in England and Wales, France, Germany, Italy, and Norway. Meningococcal antigen typing system (MATS) results were linked to multilocus sequence typing and antigen sequence data. To investigate whether generalisation of coverage applied to the rest of Europe, we also assessed isolates from the Czech Republic and Spain. Findings 1052 strains collected from July, 2007, to June, 2008, were assessed from England and Wales, France, Germany, Italy, and Norway. All MenB strains contained at least one gene encoding a major antigen in the vaccine. MATS predicted that 78% of all MenB strains would be killed by postvaccination sera (95% CI 63–90, range of point estimates 73–87% in individual country panels). Half of all strains and 64% of covered strains could be targeted by bactericidal antibodies against more than one vaccine antigen. Results for the 108 isolates from the Czech Republic and 300 from Spain were consistent with those for the other countries. Interpretation MATS analysis showed that a multicomponent vaccine could protect against a substantial proportion of invasive MenB strains isolated in Europe. Monitoring of antigen expression, however, will be needed in the future. Funding Novartis Vaccines and Diagnostics.
Published: 2013
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24. Diagnosis Accuracy of Transcutaneous Bilirubinometry in Very Preterm Newborns

Author: Sylvain Samperiz, Maya Gebus, Thierry Debillon, Chloé Epiard, Anne Ego, Amandine Rubio, Michel Deiber, Céline Genty, Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion], Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Registre des Handicaps de l'Enfant et Observatoire Périnatal Isère, and RHEOP
Subjects: Male, Time Factors, MESH: Logistic Models, MESH: Phototherapy, chemistry.chemical_compound, 0302 clinical medicine, MESH: Bilirubin, MESH: Gestational Age, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Obstetrics, MESH: Infant, Extremely Premature, MESH: Infant, Newborn, Gestational age, Jaundice, MESH: Predictive Value of Tests, 3. Good health, Jaundice, Neonatal, Very preterm, Predictive value of tests, Infant, Extremely Premature, Female, France, medicine.symptom, Blood drawing, medicine.medical_specialty, Bilirubin, MESH: Jaundice, Neonatal, education, Gestational Age, MESH: Multivariate Analysis, 03 medical and health sciences, Neonatal Screening, Predictive Value of Tests, 030225 pediatrics, medicine, Humans, MESH: Neonatal Screening, Transcutaneous bilirubin, MESH: Humans, business.industry, MESH: Time Factors, Infant, Newborn, Phototherapy, MESH: Prospective Studies, MESH: Male, MESH: France, Logistic Models, chemistry, Pediatrics, Perinatology and Child Health, Multivariate Analysis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Developmental Biology
Abstract: Background: Transcutaneous bilirubin (TcB) is a validated test for systematic screening of neonatal hyperbilirubinemia and monitoring term and near-term infants under phototherapy. Objectives: To evaluate TcB diagnostic accuracy for very preterm neonates. Methods: Total serum bilirubin (TSB) and TcB measurements were performed prospectively in a multicenter sample of newborns Results: Altogether, 481 measurements were analyzed in 167 preterm patients. Mean GA was 27.6 ± 1.6 weeks. The rates of newborns requiring phototherapy were 52% in the first 3 days, 16% from the 4th to the 7th day, and 2% during the second week. Diagnostic performance was similar among babies with or without phototherapy. TcB sensitivity decreased over time from 100% (93.9-100.0) to 50% (1.3-98.7). Specificity showed an inverse evolution from 14.8% (7.0-26.2) to 80.7% (72.2-89.2). The best performance was that of negative predictive values which varied from 95.5 to 100.0. False negatives were rare throughout the study (0.8% of measurements). In a multivariate analysis, the only factor significantly influencing discordance between TcB and TSB was postnatal age. We did not find any impact of GA and skin color. Conclusion: Among very preterm babies, TcB measurements might be useful for screening for neonatal jaundice in the first 2 weeks of life. In case of a TcB value below the phototherapy threshold, invasive TSB quantification could be unnecessary, with potential avoidance of blood drawing.
Published: 2016
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25. Three-minute constant rate step test for detecting exertional dyspnea relief after bronchodilation in COPD

Author: Hélène Perrault, Alan Hamilton, Dennis Jensen, François Maltais, Jean Bourbeau, Courtney Wilkinson-Maitland, Benoit Borel, Activité Physique, Muscle, Santé (EA4488), Université de Lille, Droit et Santé, Montreal Chest Institute, McGill University Health Center [Montreal] (MUHC), Faculty of Health Sciences, Centre de Recherche, and Université Laval [Québec] (ULaval)
Subjects: Male, MESH: Exercise Tolerance, Time Factors, MESH: Adrenergic beta-2 Receptor Agonists, MESH: Quebec, medicine.medical_treatment, Vital Capacity, MESH: Pulmonary Disease, Chronic Obstructive, Ipratropium bromide, Severity of Illness Index, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Forced Expiratory Volume, Bronchodilation, Medicine, MESH: Double-Blind Method, 030212 general & internal medicine, Respiratory system, Lung, Saline, intervention, MESH: Treatment Outcome, Original Research, MESH: Ipratropium, MESH: Aged, COPD, MESH: Middle Aged, Cross-Over Studies, Exercise Tolerance, Inhalation, Ipratropium, Quebec, MESH: Administration, Inhalation, General Medicine, Middle Aged, MESH: Recovery of Function, MESH: Muscarinic Antagonists, MESH: Predictive Value of Tests, Bronchodilator Agents, 3. Good health, Treatment Outcome, MESH: Dyspnea, Anesthesia, Female, medicine.drug, Muscarinic Antagonists, MESH: Forced Expiratory Volume, International Journal of Chronic Obstructive Pulmonary Disease, Placebo, MESH: Cross-Over Studies, chronic obstructive pulmonary disease, MESH: Nebulizers and Vaporizers, 03 medical and health sciences, Double-Blind Method, Predictive Value of Tests, MESH: Severity of Illness Index, Administration, Inhalation, Humans, MESH: Lung, Albuterol, Adrenergic beta-2 Receptor Agonists, Aged, exercise testing, MESH: Humans, business.industry, MESH: Albuterol, Nebulizers and Vaporizers, MESH: Time Factors, Recovery of Function, MESH: Vital Capacity, dyspnea, medicine.disease, MESH: Male, respiratory tract diseases, 030228 respiratory system, Exercise Test, Salbutamol, MESH: Bronchodilator Agents, MESH: Exercise Test, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Benoit Borel,1,2 Courtney A Wilkinson-Maitland,3 Alan Hamilton,4 Jean Bourbeau,5 Hélène Perrault,6 Dennis Jensen,3,5,7 François Maltais2 1Laboratoire HAVAE, Université de Limoges, Limoges, France; 2Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, 3Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montréal, QC, 4Boehringer Ingelheim (Canada) Limited, Burlington, ON, 5Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University Health Center, Montreal, QC, 6Faculty of Health Sciences, University of Ottawa, Ottawa, ON, 7Translational Research in Respiratory Diseases Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada Background: The aim of this study was to evaluate the responsiveness of the 3-minute constant rate step test (3-MST) to detect the relief of exertional dyspnea (respiratory discomfort) after acute bronchodilation in COPD patients. Patients and methods: A total of 40 patients with moderate-to-severe COPD (mean forced expiratory volume in 1second: 45.7 (±14.7), % predicted) performed four 3-MSTs at randomly assigned stepping rates of 14, 16, 20 and 24steps/min after inhalation of nebulized ipratropium bromide (500µg)/salbutamol (2.5mg) and saline placebo, which were randomized to order. Patients rated their intensity of perceived dyspnea at the end of each 3-MST using Borg 0–10 category ratio scale. Results: A total of 37 (92.5%), 36 (90%), 34 (85%) and 27 (67.5%) patients completed all 3minutes of exercise at 14, 16, 20 and 24 steps/min under both treatment conditions, respectively. Compared with placebo, ipratropium bromide/salbutamol significantly decreased dyspnea at the end of the third minute of exercise at 14 steps/min (by 0.6±1.0 Borg 0–10 scale units, P0.05). Conclusion: The 3-MST, when performed at 14 and 16 steps/min, was responsive to detect the relief of exertional dyspnea after acute bronchodilation in patients with moderate-to-severe COPD. Keywords: chronic obstructive pulmonary disease, exercise testing, dyspnea, intervention
Published: 2016
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26. Evaluation de modèles pour prédire l’envahissement de 4 ganglions métastatiques ou plus chez les patientes atteintes d’un cancer du sein T1-T2 avec 1 à 3 ganglions sentinelles positifs

Author: Nguyen-Xuan, Huyên-Thu, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Roman Rouzier
Subjects: Ganglion sentinelle, Modèles prédictifs, MESH: Lymph Node Excision, MESH: Sentinel Lymph Node, Nomogramme, MESH: Nomograms, Curage axillaire complémentaire, MESH: Predictive Value of Tests, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Contexte : plusieurs modèles mathématiques existent pour prédire l’atteinte de 4 ganglions métastatiques ou plus dans les cancers du sein avec métastases du ganglion sentinelle (GS) : le score de Louisville, et les nomogrammes de Katz et de Helsinki. L’envahissement de plus de 3 ganglions est un élément important dans la décision de curage axillaire complémentaire et d’utilisation des tests génomiques. Objectif : évaluation des 3 scores et nomogrammes sur la population de l’étude NOTEGS afin de prédire les patientes ayant 4 ganglions métastatiques ou plus. Méthodes : cette étude prospective multicentrique incluait 3157 patientes atteintes d’un cancer du sein invasif T1-2 et ayant au moins un GS positif. La validation des 3 scores était évaluée par le calcul de la discrimination, de la calibration, du taux de faux positifs et négatifs, des sensibilités et spécificités. Résultats : parmi les 2936 patientes analysables, 502 avaient entre 1 et 3 GS positifs et ont eu un curage axillaire complémentaire. Parmi ces patientes, 75 (14,9%) avaient 4 ganglions métastatiques ou plus. Les index de concordances étaient de 0,69, 0,74 et 0,77 et les taux de faux négatifs étaient de 5,4%, 3,5% et de 4,8% pourle score de Louisville et les nomogrammes de Helsinki et de Katz respectivement. Les calibrations étaient insuffisantes pour les nomogrammes mais essentiellement aux dépens des patientes à haut risque. Le nomogramme de Katz plaçait plus de patientes dans le groupe à bas risque (46% vs 11% (Louisville) et 22% (Helsinki)). Conclusion : notre étude montre que le nomogramme de Katz est le plus adapté pour identifier les patientes à risque d'avoir plus de 3 ganglions axillaires métastatiques.
Published: 2016

27. Extensive Post-zygotic Mosaicism of KRT1 or KRT10 Mutation Mimicking Classical Epider-molytic Ichthyosis

Author: Nicolas Chassaing, Emilie Tournier, M. Severino-Freire, Nathalie Jonca, M. Pichery, Juliette Mazereeuw-Hautier, CHU Toulouse [Toulouse], Unité différenciation épidermique et auto-immunité rhumatoïde (UDEAR), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), and Hôpital Purpan [Toulouse]
Subjects: Male, DNA Mutational Analysis, MESH: Hyperkeratosis, Epidermolytic / diagnosis, 030207 dermatology & venereal diseases, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine, MESH: DNA Mutational Analysis, Skin, Genetics, Zygote, integumentary system, Ichthyosis, Mosaicism, MESH: Genetic Predisposition to Disease, MESH: Hyperkeratosis, Epidermolytic / genetics, General Medicine, MESH: Predictive Value of Tests, 3. Good health, MESH: Skin / pathology, Phenotype, 030220 oncology & carcinogenesis, Mutation (genetic algorithm), Female, MESH: Keratin-10 / genetics, Adult, Adolescent, MESH: Keratin-1 / genetics, Dermatology, MESH: Phenotype, Diagnosis, Differential, 03 medical and health sciences, MESH: Diagnosis, Differential, Predictive Value of Tests, Humans, Genetic Predisposition to Disease, MESH: Adolescent, Hyperkeratosis, Epidermolytic, MESH: Humans, business.industry, MESH: Mosaicism, MESH: Adult, Keratin-10, medicine.disease, MESH: Male, Mutation, MESH: Mutation, business, Keratin-1, MESH: Female
Abstract: International audience; Epidermolytic ichthyosis (EI) is a rare disorder of keratinization belonging to the group of keratinopathic ichthyosis. EI is an autosomal dominant disease due to mutations in the genes encoding keratin 1 (KRT1) or keratin 10 (KRT10) expressed in the suprabasal layers of the epidermis (1). EI is characterized by erythroderma, blistering and erosions at birth, followed by generalized hyperkeratotic and verrucous lesions from early childhood. The lesions are generalized and palmo-plantar keratoderma may be seen (2). EI is a severe disease due to skin aspect, itching and recurrent episodes of skin infections with malodorous skin. Histological examination of skin lesions shows thickening of the stratum corneum, vacuolar degeneration of the epidermal suprabasal layer, and some clumping of tonofilaments in the keratin. Whereas EI is in the form of generalized skin lesions, localized segmental lesions along the Blaschko’s lines have been reported rarely as a consequence of post-zygotic somatic mutations in KRT1 or KRT10. Post-zygotic mosaicism in EI must be distinguished from epidermolytic naevi, a naevoid variant of keratinopathic ichthyosis characterized by localized hyperkeratotic lesions present at birth without an initial phase of blistering (3, 4). Post-zygotic mosaicism in EI usually has a limited distribution. We report here 2 cases of EI with an extensive distribution.
Published: 2016
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28. EFNS review on the role of muscle biopsy in the investigation of myalgia

Author: Tiziana Mongini, J.-M. Burgunder, Laurence A. Bindoff, M. de Visser, Sabrina Sacconi, T. Kyriakides, J. Joseph, J. Schaefer, Corrado Angelini, David Hilton-Jones, Gabriele Siciliano, John Vissing, Institut de Biologie Valrose (IBV), Université Nice Sophia Antipolis (... - 2019) (UNS), and COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA)
Subjects: musculoskeletal diseases, myalgia, Biopsy, Muscle, Myalgia, medicine.medical_specialty, Population, MESH: Myalgia, Muscle hypertrophy, MESH: Biopsy, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, medicine, Humans, education, [SDV.BDD]Life Sciences [q-bio]/Development Biology, Exercise, 030203 arthritis & rheumatology, education.field_of_study, MESH: Humans, Muscle biopsy, medicine.diagnostic_test, business.industry, Myoglobinuria, Muscle weakness, medicine.disease, Dermatology, MESH: Predictive Value of Tests, 3. Good health, Neurology, MESH: Exercise, Physical therapy, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Muscle cramp
Abstract: Background: Myalgia, defined as any pain perceived in muscle, is very common in the general population and a frequent cause for referral to neurologists, rheumatologists and internists in general. It is however only rarely due to primary muscle disease and often referred from ligaments, joints, bones, the peripheral and central nervous system. A muscle biopsy should only be performed if this is likely to be diagnostically useful. At present no 'guidelines' exist. Methods: An EFNS panel of muscle specialists was set to review relevant studies from PubMed dating as far back as 1/1/1990. Only Class IV studies were available and therefore the recommendations arrived at are 'best practice recommendations' based on information harvested from the literature search and expert opinion. Results: Muscle cramps should be recognized while drugs, infections, metabolic/ endocrinological and rheumatological causes of myalgia should be identified from the history and examination and pertinent laboratory tests. A muscle biopsy is more likely to be diagnostically useful if myalgia is exertional and if one or more of the following apply: i) there is myoglobinuria, (ii) there is a second wind phenomenon, (iii) there is muscle weakness, (iv) there is muscle hypertrophy /atrophy, (v) there is hyperCKemia (>2-3× normal), and (vi) there is a myopathic EMG. Conclusions: Patients presenting with myalgia can be recommended to have a biopsy based on careful history and examination and on simple laboratory screening. Click here for the corresponding questions to this CME article. © 2013 EFNS.
Published: 2016
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29. The gamma-glutamyl transpeptidase to platelet ratio (GPR) predicts significant liver fibrosis and cirrhosis in patients with chronic HBV infection in West Africa

Author: Muriel Vray, Shevanthi Nayagam, Robert D. Goldin, Umberto D'Alessandro, Jo Lloyd, Ramou Njie, Yusuke Shimakawa, Penda Suso, Mark Thursz, Vincent Mallet, Makie Taal, Graham S Cooke, Gibril Ndow, Mustapha Khalil, Maud Lemoine, Harr-Freeya Njai, Papa Saliou Mbaye, Medical Research Council Unit The Gambia (MRC), Imperial College London, Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Edward Francis Small Teaching Hospital [Banjul, Gambia] (EFSTH), Ministry of Health and Social Welfare [Banjul, The Gambia] (MOHSW), Hôpital Principal de Dakar, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur [Paris], Université Paris Descartes - Paris 5 (UPD5), The study in The Gambia is part of the PROLIFICA programme funded by the European commission: EC FP7, P34114. The study in Senegal was funded by the ANRS (National Institute of Research on AIDS and Viral Hepatitis), France., The authors thank the MRC laboratories The Gambia unit, the local ministry of health and social welfare for supporting the project, all the study participants, the PROLIFICA team: in particular Ignatius Baldeh, Famara Bojang, Amie Ceesay, Mavis Foster-Nyarko, Debbo Jallow, Abdulie Jatta, Adam Jeng, Sheriff Kolley, Yamundow Jallow Samba, Alagie Sanneh, Bakary, Sanneh, Demba Sonko, Lamin Bojang, Saydiba Tamba and Debbie Garside, the project manager of the PROLIFICA programme. The authors also thank Professor Dominique Valla for his precious recommendations on haemostatic precautions before liver biopsy in the local resource-constrained setting. The authors also thank Dr Philippe Sultanik for his contributions to statistical analysis and Dr Patrick Ingiliz for his constructive comments and suggestions., European Project: 265994,EC:FP7:HEALTH,FP7-AFRICA-2010,PROLIFICA(2011), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Institut Pasteur [Paris] (IP), Imperial College Healthcare NHS Trust- BRC Funding, Commission of the European Communities, and Medical Research Council (MRC)
Subjects: Liver Cirrhosis, Male, Pathology, Cirrhosis, MESH: Biomarkers / blood, Biopsy, Gastroenterology, Severity of Illness Index, MESH: Biopsy, 0302 clinical medicine, Fibrosis, SIMPLE NONINVASIVE INDEX, FIBROSIS, Gamma-glutamyltransferase, MESH: Hepatitis B, Chronic* / complications, MESH: Middle Aged, biology, medicine.diagnostic_test, TRANSIENT ELASTOGRAPHY, gamma-Glutamyltransferase, Hepatitis B, Middle Aged, FIBROTEST, MESH: Liver Cirrhosis* / etiology, MESH: Predictive Value of Tests, 3. Good health, MESH: Biomarkers / analysis, Africa, Western, MESH: Hepatitis B, Chronic* / pathology, Liver, Dimensional Measurement Accuracy, 030220 oncology & carcinogenesis, Predictive value of tests, Liver biopsy, Area Under Curve, HEPATITIS B, 030211 gastroenterology & hepatology, Female, Life Sciences & Biomedicine, CHRONIC HEPATITIS-B, Adult, medicine.medical_specialty, AMINOTRANSFERASE, BIOMARKERS, STIFFNESS MEASUREMENT, MESH: Africa, Western / epidemiology, MESH: Liver / pathology, 03 medical and health sciences, Hepatitis B, Chronic, MESH: gamma-Glutamyltransferase* / blood, Predictive Value of Tests, MESH: Liver Cirrhosis* / diagnosis, Internal medicine, MESH: Severity of Illness Index, medicine, Humans, DIAGNOSTIC-ACCURACY, MESH: Patient Acuity, MESH: Platelet Count / methods, Science & Technology, MESH: Humans, Gastroenterology & Hepatology, business.industry, FibroTest, Platelet Count, Patient Acuity, 1103 Clinical Sciences, MESH: Adult, MESH: Hepatitis B, Chronic* / diagnosis, medicine.disease, MESH: Male, MARKER, MESH: Liver Cirrhosis* / pathology, biology.protein, 1114 Paediatrics and Reproductive Medicine, MESH: Area Under Curve, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, VIRAL-HEPATITIS, MESH: Dimensional Measurement Accuracy, Transient elastography, business, MESH: Female, MESH: gamma-Glutamyltransferase* / analysis
Abstract: International audience; Background: Simple and inexpensive non-invasive fibrosis tests are highly needed but have been poorly studied in sub-Saharan Africa.Methods: Using liver histology as a gold standard, we developed a novel index using routine laboratory tests to predict significant fibrosis in patients with chronic HBV infection in The Gambia, West Africa. We prospectively assessed the diagnostic accuracy of the novel index, Fibroscan, aspartate transaminase-to-platelet ratio index (APRI), and Fib-4 in Gambian patients with CHB (training set) and also in French and Senegalese CHB cohorts (validation sets).Results: Of 135 consecutive treatment-naïve patients with CHB who had liver biopsy, 39% had significant fibrosis (Metavir fibrosis stage ≥F2) and 15% had cirrhosis (F4). In multivariable analysis, gamma-glutamyl transpeptidase (GGT) and platelet count were independent predictors of significant fibrosis. Consequently, GGT-to-platelet ratio (GPR) was developed. In The Gambia, the area under the receiver operating characteristic curve (AUROC) of the GPR was significantly higher than that of APRI and Fib-4 to predict ≥F2, ≥F3 and F4. In Senegal, the AUROC of GPR was significantly better than Fib-4 and APRI for ≥F2 (0.73, 95% CI 0.59 to 0.86) and better than Fib-4 and Fibroscan for ≥F3 (0.93, 0.87 to 0.99). In France, the AUROC of GPR to diagnose ≥F2 (0.72, 95% CI 0.59 to 0.85) and F4 (0.87, 0.76 to 0.98) was equivalent to that of APRI and Fib-4.Conclusions: The GPR is a more accurate routine laboratory marker than APRI and Fib-4 to stage liver fibrosis in patients with CHB in West Africa. The GPR represents a simple and inexpensive alternative to liver biopsy and Fibroscan in sub-Saharan Africa.
Published: 2016
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30. Vascular risk levels affect the predictive value of platelet reactivity for the occurrence of MACE in patients on clopidogrel. Systematic review and meta-analysis of individual patient data

Author: Reny, Jean-Luc, Fontana, Pierre, Hochholzer, Willibald, Neumann, J., ten Berg, Jurriën, Janssen, Paul W, Geisler, Tobias, Gawaz, Meinrad, Marcucci, Rossella, Gori, Anna-Maria, Cuisset, Thomas, Alessi, Marie-Christine, Berdagué, Philippe, Gurbel, Paul A, Yong, Gerald, Angiolillo, Dominick J, Aradi, Dániel, Beigel, Roy, Campo, Gianluca, Combescure, Christophe, Neumann, Franz Josef, Service de médecine interne générale (SMIG), Hôpital Universitaire de Genève = University Hospitals of Geneva (HUG), Fondazione Edmund Mach - Edmund Mach Foundation [Italie] (FEM), Leibniz-Institut für Katalyse (LIKAT Rostock), Universität Rostock-Leibniz Association, Institute of food, Nutrition and Human health, Universitat de Barcelona (UB), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Chimie Moléculaire et des Matériaux d'Orsay (ICMMO), Université Paris-Sud - Paris 11 (UP11)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Geneva University Hospital (HUG), French ministry of health PHRC [15-07], Geneva University Hospitals, Hôpital Universitaire de Genève, Leibniz Association-Universität Rostock, Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)
Subjects: Risk, medicine.medical_specialty, Ticlopidine, Platelet Aggregation, Platelet Function Tests, MESH: Ticlopidine, drug response, 030204 cardiovascular system & hematology, NO, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Internal medicine, Diabetes mellitus, Medicine, Humans, Platelet, 030212 general & internal medicine, cardiovascular diseases, Risk factor, Prospective cohort study, Cardiovascular diseases, Clopidogrel, Drug response, Ischaemic events, Platelets, Cardiovascular Diseases, Age Factors, Hematology, ddc:613, MESH: Platelet Aggregation, ddc:616, MESH: Age Factors, MESH: Humans, MESH: Risk, business.industry, MESH: Cardiovascular Diseases, MESH: Platelet Function Tests, medicine.disease, MESH: Predictive Value of Tests, 3. Good health, Institutional repository, ischaemic events, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Meta-analysis, platelets, business, Mace, medicine.drug
Abstract: SummaryPrior studies have shown an association between high on-clopidogrel platelet reactivity (PR) and the risk of major adverse cardiovascular events (MACE). However, large intervention trials on PR-tailored treatments have been neutral. The role and usefulness of PR with regard to levels of cardiovascular risk are unclear. We undertook a systematic review and meta-analysis of individual patient data on MACE outcomes (acute coronary syndromes (ACS), ischaemic strokes, and vascular deaths) in relation to PR and its interaction with cardiovascular risk levels. PR was determined using ADP-induced light transmission aggregometry with a primary concentration of 20 μM ADP. Thirteen prospective studies totaled 6,478 clopidogrel-treated patients who experienced 421 MACE (6.5 %) during a median follow-up of 12 months. The strength of the association between the risk of MACE and PR increased significantly (p=0.04) with the number of risk factors present (age> 75 years, ACS at inclusion, diabetes, and hypertension). No association was detected in patients with no risk factor (p=0.48). In patients presenting one risk factor, only high-PR was associated with an increased risk of MACE (HR 3.2, p=0.001). In patients presenting ≥ 2 risk factors, the increase of risk started from medium-PR (medium-PR: HR=2.9, p=0.0004; high-PR: HR=3.7, p=0.0003). PR allowed the reclassification of 44 % of the total population to a different risk level for the outcome of MACE, mostly in intermediate or high risk patients. In conclusion, the magnitude of the association between PR and MACE risk is strongly dependent on the level of cardiovascular risk faced by patients on clopidogrel.Supplementary Material to this article is available online at www.thrombosis-online.com.
Published: 2016
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31. Ultra-small superparamagnetic iron oxide enhancement is associated with higher loss of brain tissue structure in clinically isolated syndrome

Author: Jean-Philippe Ranjeva, Gilles Edan, Laurent Pierot, Elise Bannier, Isabelle Berry, Jean Pelletier, Maxime Guye, Jean-Christophe Ferré, Christian Barillot, Adil Maarouf, Bertrand Audoin, Wafaa Zaaraoui, Ayman Tourbah, Arnaud Le Troter, Hôpital Maison Blanche, Centre Hospitalier Universitaire de Reims (CHU Reims), Département de Radiologie [CHU de Rennes], Université de Rennes (UR), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Vision, Action et Gestion d'informations en Santé (VisAGeS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Inria Rennes – Bretagne Atlantique, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-SIGNAUX ET IMAGES NUMÉRIQUES, ROBOTIQUE (IRISA-D5), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Nucléaire - Pierre-Paul Riquet [CHU Toulouse], Pôle imagerie médicale [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Reims Champagne-Ardenne (URCA), Centre d'Exploration Métabolique par Résonance Magnétique [Marseille] (CEMEREM), Hôpital de la Timone [CHU - APHM] (TIMONE), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-CentraleSupélec-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Université de Rennes (UNIV-RENNES)-CentraleSupélec-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-CentraleSupélec, CHU Toulouse [Toulouse], Neurologie, maladies neuro-musculaires [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Neurologie [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de Recherche en Informatique et en Automatique (Inria)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA), Service de Médecine Nucléaire [Toulouse], and Edan, Gilles
Subjects: Male, Pathology, Time Factors, Gadolinium, Axonal loss, Contrast Media, MESH: Nerve Degeneration, 030218 nuclear medicine & medical imaging, MESH: Magnetic Resonance Imaging, 0302 clinical medicine, Medicine, Longitudinal Studies, Prospective Studies, MESH: Dextrans, Magnetite Nanoparticles, MESH: Longitudinal Studies, ComputingMilieux_MISCELLANEOUS, Clinically isolated syndrome, medicine.diagnostic_test, Brain, MESH: Macrophage Activation, Dextrans, Prognosis, Magnetic Resonance Imaging, MESH: Predictive Value of Tests, Neurology, MESH: Young Adult, Disease Progression, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, MESH: Disease Progression, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], France, Infiltration (medical), MRI, Adult, medicine.medical_specialty, MESH: Demyelinating Diseases, chemistry.chemical_element, MESH: Magnetite Nanoparticles, macrophage, MESH: Prognosis, Multiple sclerosis, 03 medical and health sciences, Young Adult, MESH: Brain, In vivo, Predictive Value of Tests, MESH: Contrast Media, Humans, Magnetization transfer, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], MESH: Humans, business.industry, Macrophages, MESH: Time Factors, MESH: Macrophages, Magnetic resonance imaging, MESH: Adult, Macrophage Activation, medicine.disease, USPIO, MESH: Male, MESH: Prospective Studies, MESH: France, chemistry, clinically isolated syndrome, Nerve Degeneration, Neurology (clinical), business, MESH: Female, 030217 neurology & neurosurgery, Demyelinating Diseases
Abstract: Background: Macrophages are important components of inflammatory processes in multiple sclerosis, closely linked to axonal loss, and can now be observed in vivo using ultra-small superparamagnetic iron oxide (USPIO). In the present 1-year longitudinal study, we aimed to determine the prevalence and the impact on tissue injury of macrophage infiltration in patients after the first clinical event of multiple sclerosis. Methods: Thirty-five patients, 32 years mean age, were imaged in a mean of 66 days after their first event using conventional magnetic resonance imaging, gadolinium (Gd) to probe blood–brain barrier integrity, USPIO to study macrophage infiltration and magnetization transfer ratio (MTR) to assess tissue structure integrity. Statistics were performed using two-group repeated-measures ANOVA. Any patient received treatment at baseline. Results: At baseline, patients showed 17 USPIO-positive lesions reflecting infiltration of macrophages present from the onset. This infiltration was associated with local higher loss of tissue structure as emphasized by significant lower MTRnorm values ( p+/Gd+ lesions ( n=16; MTRnormUSPIO+/Gd+=0.78 at baseline, MTRnormUSPIO+/Gd+=0.81 at M12) relative to USPIO-/Gd+ lesions ( n=67; MTRnormUSPIO-/Gd+=0.82 at baseline, MTRnormUSPIO–/Gd+=0.85 at M12). No interaction in MTR values was observed during the 12 months follow-up (lesion type × time). Conclusion: Infiltration of activated macrophages evidenced by USPIO enhancement, is present at the onset of multiple sclerosis and is associated with higher and persistent local loss of tissue structure. Macrophage infiltration affects more tissue structure while tissue recovery during the following year has a similar pattern for USPIO and Gd-enhanced lesions, leading to relative higher persistent local loss of tissue structure in lesions showing USPIO enhancement at baseline.
Published: 2016
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32. A new internet tool to report peritoneal malignancy extent. PeRitOneal MalIgnancy Stage Evaluation (PROMISE) application

Author: François Quenet, Frédéric Marchal, François-Noël Gilly, Laurent Villeneuve, Jean-Marc Guilloit, M. Carretier, S. Carrere, Clarisse Eveno, Julien Fontaine, Faheez Mohamed, Delphine Vaudoyer, S. Isaac, A. Chevallier, A. Dohan, Cécile Brigand, P. Rousset, F. Poizat, Peggy Dartigues, Julio Abba, Frédéric Dumont, Nicolas Pirro, C. Petorin, Frédéric Guyon, G. Lang-Averous, S. Evrard, Gérard Lorimier, Karine Abboud, P. Rat, E. Mery, G. Pourcher, Jack Porcheron, Pablo Ortega-Deballon, M. Messager, Rea Lo Dico, Nicolas Goasguen, Pierre Meeus, R. Tetreau, Houda Ben Rejeb, S. Durand-Fontanier, P. Peyrat, A. Mariani, Dominique Elias, D. Bouzard, D. Geffroy, D. Delroeux, J.M. Bereder, C. de Chaisemartin, Christophe Mariette, R. Kianmanesh, Pierre-Jean Valette, Jean-Jacques Tuech, M. H. Laverrière, B. Lelong, Guillaume Piessen, C. Labbé, Mehdi Karoui, S. Velasco, Guillaume Passot, Diane Goéré, V. Barrau, G. Balague, V. Loi, Olivier Glehen, P. Rousselot, Jean-Marc Regimbeau, Emilie Thibaudeau, Thomas Courvoisier, V. Verriele-Beurrier, Frédéric Bibeau, G. Desolneux, M. Chassang, Marc Pocard, Magali Svrcek, Jérémie H. Lefevre, J. Lacroix, O. Fay, Franck Zinzindohoué, Catherine Arvieux, Naoual Bakrin, Denis Pezet, A. Leroux, Cédric Nadeau, Charles Sabbagh, Romuald Wernert, Bruno Heyd, Pascale Mariani, S. Msika, S. Valmary-Degano, L. Ghouti, A. Thivolet, Clarisse Dromain, R. Kaci, G. Ferron, Pôle Information Médicale Evaluation Recherche (IMER), Hospices Civils de Lyon (HCL), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département de chirurgie, CRLCC Val d'Aurelle - Paul Lamarque, and Département de radiothérapie
Subjects: MESH: Medical Records, medicine.medical_specialty, Scoring application, [SDV.CAN]Life Sciences [q-bio]/Cancer, Medical Records, Peritoneal malignancy, 03 medical and health sciences, Peritoneal Neoplasm, 0302 clinical medicine, MESH: Patient Care Team, Predictive Value of Tests, Medicine, Resectability, MESH: Peritoneal Neoplasms, Humans, Stage (cooking), Peritoneal Neoplasms, Neoplasm Staging, Patient Care Team, Internet, MESH: Humans, business.industry, Medical record, MESH: Peritoneum, Reproducibility of Results, General Medicine, MESH: Neoplasm Staging, Peritoneal cancer index, MESH: Predictive Value of Tests, 3. Good health, Surgery, MESH: Reproducibility of Results, MESH: Internet, Oncology, 030220 oncology & carcinogenesis, Predictive value of tests, Conventional PCI, Peritoneal Cancer Index, 030211 gastroenterology & hepatology, Radiology, Peritoneal diseases, Extent disease, Peritoneum, business, Peritoneal carcinomatosis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Based on the importance of assessing the true extent of peritoneal disease, PeRitOneal MalIgnancy Stage Evaluation (PROMISE) internet application (www.e-promise.org) has been developed to facilitate tabulation and automatically calculate surgically validated peritoneal cancer index (PCI), and other surgically validated scores as Gilly score, simplified peritoneal cancer index (SPCI), Fagotti and Fagotti-modified scores. This application offers computer-assistance to produce simple, quick but precise and standardized pre, intra and postoperative reports of the extent of peritoneal metastases and may help specialized and non-specialized institutions in their current practice but also facilitate research and multicentre studies on peritoneal surface malignancies.
Published: 2016
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33. Temporal deformation pattern in acute and late phases of ST-elevation myocardial infarction: incremental value of longitudinal post-systolic strain to assess myocardial viability

Author: Yves Juillière, Patrick Rossignol, Nicolas Girerd, Erwan Bozec, Emilien Micard, Maxime Benichou, Pierre-Yves Marie, Christine Selton-Suty, Nicolas Sadoul, Damien Mandry, Marine Beaumont, Simon Lemoine, Kevin Duarte, Olivier Huttin, Service de Cardiologie [Institut Lorrain du Cœur et des Vaisseaux], Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Service de Médecine Nucléaire [Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), and Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Time Factors, MESH: Myocardial Contraction, Contrast Media, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, MESH: Observer Variation, MESH: Ventricular Function, Left, Ventricular Function, Left, Strain, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Systolic strain, Cutoff, Myocardial infarction, Prospective Studies, Prospective cohort study, MESH: Aged, Observer Variation, MESH: Stress, Mechanical, MESH: Middle Aged, medicine.diagnostic_test, Left ventricular function, MESH: Magnetic Resonance Imaging, Cine, General Medicine, Middle Aged, Prognosis, MESH: Predictive Value of Tests, Biomechanical Phenomena, MESH: Reproducibility of Results, Echocardiography, Predictive value of tests, Cardiology, Female, France, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, MESH: Myocardium, MESH: Biomechanical Phenomena, Magnetic Resonance Imaging, Cine, MESH: Prognosis, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Cardiac magnetic resonance imaging, St elevation myocardial infarction, Predictive Value of Tests, MESH: Contrast Media, Internal medicine, medicine, Humans, MESH: Tissue Survival, MESH: ST Elevation Myocardial Infarction, Aged, Tissue Survival, MESH: Humans, business.industry, Myocardium, MESH: Time Factors, Reproducibility of Results, medicine.disease, Myocardial Contraction, MESH: Prospective Studies, MESH: Male, MESH: France, Deformation mechanics, ST Elevation Myocardial Infarction, MESH: Echocardiography, Stress, Mechanical, business, MESH: Female
Abstract: International audience; BACKGROUND:Identification of transmural extent and degree of non-viability after ST-segment elevation myocardial infarction (STEMI) is clinically important. The objective of the present study was to assess the regional mechanics and temporal deformation patterns using speckle tracking echocardiography (STE) in acute and later phases of STEMI to predict myocardial damage in these patients.METHODS AND RESULTS:Ninety-eight patients with first STEMI underwent both echocardiography and cardiac magnetic resonance imaging in acute phase and at 6 months follow-up with 2D STE-derived measurements of peak longitudinal strain (PLS), Pre-STretch index (PST) and post-systolic deformation index (PSI). For each segment, late gadolinium enhancement (LGE) was defined as transmural (LGE >66 %) or non-transmural (
Published: 2016
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34. Impact of current cough on health-related quality of life in patients with COPD

Author: Gilles Jebrak, Pascale Nesme-Meyer, Roger Escamilla, Nicolas Roche, Thierry Perez, Isabelle Court-Fortune, Pierre-Régis Burgel, Jean-Louis Paillasseur, Graziella Brinchault-Rabin, Pascal Chanez, Denis Caillaud, Gaëtan Deslée, dormoy, valerian, Hôpital Maison Blanche, Centre Hospitalier Universitaire de Reims (CHU Reims), Plasticité de l'épithélium respiratoire dans les conditions normales et pathologiques - UMR-S 903 (PERPMP), Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims)-Institut National de la Santé et de la Recherche Médicale (INSERM)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de pneumologie [Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance Publique - Hôpitaux de Marseille (APHM), Service de Pneumologie [Saint-Etienne], CHU Saint-Etienne, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire [Rennes], Hôpital Albert Calmette, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), AP-HP - Hôpital Bichat - Claude Bernard [Paris], CHU Clermont-Ferrand, EFFI-STAT, CHU Cochin [AP-HP], CHU Toulouse [Toulouse]-Hôpital Larrey, Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Aix-Marseille Université - Institut universitaire de technologie (IUT AMU), Aix Marseille Université (AMU), Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse]-Hôpital Larrey [Toulouse], and CHU Toulouse [Toulouse]
Subjects: Male, Chronic bronchitis, Time Factors, [SDV]Life Sciences [q-bio], Health Status, MESH: Comorbidity, MESH: Pulmonary Disease, Chronic Obstructive, Comorbidity, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Hospitals, University, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, fluids and secretions, Quality of life, MESH: Sputum, Risk Factors, MESH: Risk Factors, Forced Expiratory Volume, Surveys and Questionnaires, MESH: Cough, 030212 general & internal medicine, Lung, MESH: Health Status, Original Research, MESH: Aged, COPD, Univariate analysis, MESH: Middle Aged, medicine.diagnostic_test, General Medicine, Middle Aged, MESH: Predictive Value of Tests, 3. Good health, multivariate analysis, Cohort, Anxiety, Female, France, medicine.symptom, Spirometry, medicine.medical_specialty, International Journal of Chronic Obstructive Pulmonary Disease, MESH: Forced Expiratory Volume, MESH: Multivariate Analysis, 03 medical and health sciences, MESH: Cross-Sectional Studies, Predictive Value of Tests, Internal medicine, medicine, Humans, MESH: Lung, MESH: Surveys and Questionnaires, Aged, MESH: Hospitals, University, MESH: Humans, business.industry, MESH: Time Factors, sputum, MESH: Quality of Life, dyspnea, questionnaires, medicine.disease, respiratory, MESH: Male, respiratory tract diseases, signs and symptoms, MESH: France, Cross-Sectional Studies, 030228 respiratory system, Cough, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Quality of Life, Sputum, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Spirometry, business, MESH: Female
Abstract: Gaëtan Deslee,1 Pierre-Régis Burgel,2 Roger Escamilla,3 Pascal Chanez,4 Isabelle Court-Fortune,5 Pascale Nesme-Meyer,6 Graziella Brinchault-Rabin,7 Thierry Perez,8 Gilles Jebrak,9 Denis Caillaud,10 Jean-Louis Paillasseur,11 Nicolas Roche2On behalf of the Initiatives BPCO Scientific Committee 1Department of Respiratory Diseases, INSERM UMR 903, Maison Blanche Hospital, University Hospital of Reims, Reims, 2Department of Respiratory Diseases, Cochin Hospital, AP-HP and University Paris Descartes, Sorbonne Paris Cité, Paris, 3Department of Respiratory Diseases, Larrey Hospital, Toulouse, 4Department of Respiratory Diseases, APHM, INSERM U1077, CNRS UMR 7733 Aix Marseille Université, Marseille, 5Department of Respiratory Diseases, University Hospital of St Etienne, 6Department of Respiratory Diseases, La Croix Rousse Hospital, Lyon, 7Department of Respiratory Diseases, Pontchaillou Hospital, University Hospital of Rennes, Rennes, 8Department of Respiratory Diseases, Calmette Hospital, University Hospital of Lille, Lille, 9Department of Respiratory Diseases, Bichat Hospital, AP-HP, Paris, 10Department of Respiratory Diseases, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand, 11EFFI-STAT, Paris,FranceBackground: Cough and sputum production are frequent in chronic obstructive pulmonary disease (COPD). The objective of this study was to examine the relationship between cough and sputum production and health-related quality of life in COPD.Methods: A cross-sectional study was conducted in the French Initiatives COPD cohort and assessed cough and sputum production within the past 7 days using the cough and sputum assessment questionnaire (CASA-Q), health-related quality of life, spirometry, smoking status, dyspnea, exacerbations, anxiety and depression, and comorbidities.Results: One hundred and seventy-eight stable COPD patients were included (age, 62 [56–69]years, 128 male, forced expiratory volume in 1 second [FEV1]: 57 [37–72] % predicted) (median [Q1–Q3]). In univariate analyses, health-related quality of life (Saint George’s respiratory questionnaire total score) was associated with each CASA-Q domain and with chronic bronchitis, exacerbations, dyspnea, FEV1, depression, and anxiety. All four domains introduced separately were independently associated with health-related quality of life. When introduced together in multivariate analyses, only the cough impact domain remained independently associated with health-related quality of life (R2=0.60). With chronic bronchitis (standard definition) instead of the CASA-Q, the R2 was lower (R2=0.54).Conclusion: This study provides evidence that current cough in the previous 7 days is an important determinant of health-related quality of life impairment in stable COPD patients.Keywords: signs and symptoms, respiratory, sputum, questionnaires, dyspnea, multivariate analysis
Published: 2016
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35. Impact of age over 75 years on outcomes after pancreaticoduodenectomy

Author: Pierre Nicolas D'Halluin, Laurent Sulpice, Karim Boudjema, Aude Merdrignac, Bernard Meunier, Yann Harnoy, Michel Rayar, Jean François Bretagne, Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], Service des Maladies de l'Appareil Digestif, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Centre hospitalier Universitaire, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Service des Maladies de l'Appareil Digestif [CHU Rennes]
Subjects: medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, 030230 surgery, Gastroenterology, MESH: Multivariate Analysis, 03 medical and health sciences, 0302 clinical medicine, MESH: Pancreatic Fistula, MESH: Risk Factors, MESH: Postoperative Complications, Internal medicine, medicine, MESH: Hospital Mortality, Mortality, MESH: Age Distribution, MESH: Kaplan-Meier Estimate, MESH: Aged, MESH: Humans, MESH: Middle Aged, Pancreatoduodenectomy, business.industry, MESH: Pancreaticoduodenectomy, Incidence (epidemiology), MESH: Sex Distribution, MESH: Retrospective Studies, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Retrospective cohort study, Pancreaticoduodenectomy, medicine.disease, MESH: Predictive Value of Tests, MESH: Male, 3. Good health, Surgery, Predictive factor, Elderly patients, Increased risk, Pancreatic fistula, 030220 oncology & carcinogenesis, Predictive value of tests, business, MESH: Female
Abstract: International audience; BACKGROUND: The risks associated with pancreaticoduodenectomy (PD) in elderly patients continue to be debated. The aim of our study was to assess the incidence of death and postoperative complications following PD and identify the risk factors in patients >75 y. STUDY DESIGN: All patients who underwent PD between January 2000 and September 2009 were analyzed retrospectively. Patients were divided into two groups according to age (Group 1: patients aged 75 y proved to be predictive factors for mortality (OR 11.04, IC95% [2.57; 47.49], P = 0.001). When compared with Group 1, Group 2 was associated with increased postoperative deaths (24.4% versus 3.66%, P < 0.001) and pancreatic fistulas (26.8% versus 13.2%, P = 0.041), in particular, Grade C fistulas (14.6% versus 4.4%, P = 0.023). In multivariate analysis, only PH proved to be an independent predictive factor for mortality (OR 12.9, IC95% [1.07; 155.5], P = 0.04). CONCLUSIONS: PD in elderly patients aged over 75 y appears to be associated with an increased risk of postoperative death and pancreatic fistula. No single preoperative factor made it possible to predict this risk.
Published: 2012
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36. Localized hypertrophic neuropathy of the sciatic nerve in children: MRI findings

Author: Franck Marin, Bertrand Bruneau, Philippe Violas, Laurent Riffaud, Yves Gandon, Anne Michel, Jean-Yves Gauvrit, Adrien Roux, Catherine Tréguier, Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], CHU Pontchaillou [Rennes], Service de neurochirurgie [Rennes] = Neurosurgery [Rennes], Service de chirurgie pédiatrique [Rennes] = Paediatric / Pediatric surgery [Rennes], Service d'explorations fonctionnelles neurologiques [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes], Vision, Action et Gestion d'informations en Santé (VisAGeS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Inria Rennes – Bretagne Atlantique, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-SIGNAUX ET IMAGES NUMÉRIQUES, ROBOTIQUE (IRISA-D5), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de Recherche en Informatique et en Automatique (Inria)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-CentraleSupélec-Télécom Bretagne-Université de Rennes 1 (UR1), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École normale supérieure - Rennes (ENS Rennes)-Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA), Université de Rennes (UR)-CHU Pontchaillou [Rennes], Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Télécom Bretagne-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), and Gauvrit, Jean-Yves
Subjects: Pathology, intraneural perineuromia, Contrast Media, sciatic nerve, MESH: Magnetic Resonance Imaging, 030218 nuclear medicine & medical imaging, MESH: Aged, 80 and over, 0302 clinical medicine, MESH: Risk Factors, MESH: Carotid Stenosis, Hypertrophic neuropathy, MESH: Child, Medicine, Neuroradiology, Localized hypertrophic neuropathy, MESH: Aged, child, MESH: Middle Aged, MESH: Hypertrophy, Peripheral Nervous System Diseases, Magnetic Resonance Imaging, MESH: Infant, MESH: Predictive Value of Tests, Intraneural perineurioma, MESH: Leg, 3. Good health, MESH: Sciatic Nerve, Child, Preschool, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], MESH: Peripheral Nervous System Diseases, Sciatic nerve, MESH: Hemorrhage, Mri findings, medicine.medical_specialty, MESH: Imaging, Three-Dimensional, MESH: Stroke, MESH: Multivariate Analysis, MESH: Electromyography, 03 medical and health sciences, Imaging, Three-Dimensional, MESH: Contrast Media, Humans, Radiology, Nuclear Medicine and imaging, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Retrospective Studies, Neurological deficit, Leg, MESH: Humans, Electromyography, business.industry, MESH: Child, Preschool, Infant, MESH: Retrospective Studies, Hypertrophy, MESH: Prospective Studies, MESH: Male, eye diseases, nervous system, Pediatrics, Perinatology and Child Health, business, MESH: Female, 030217 neurology & neurosurgery
Abstract: International audience; BACKGROUND: Localized hypertrophic neuropathy (LHN) of the sciatic nerve in children is a rare condition characterized by a painless neurological deficit in the sciatic nerve territory. OBJECTIVE: To demonstrate the role of MRI using a specific protocol and describe the primary findings in LHN. MATERIALS AND METHODS: Imaging in four children (age 2 years to 12 years) is presented. All children presented with lower limb asymmetry. Three had a steppage gait. LHN was confirmed by electrophysiological studies and by MRI of the whole sciatic nerve with a dedicated protocol covering the lumbar spine and the lower limb. RESULTS: There were four direct MRI findings: (1) linear and focal hypertrophy with progressive enlargement of a peripheral nerve or plexus diameter, (2) abnormal hyperintensity of the nerve on T2-weighted images, (3) preserved fascicular configuration, and (4) variable enhancement after intravenous gadolinium administration. In addition there were atrophy and fatty infiltration of innervated muscles. MRI was helpful for determining the extent of lesions and in excluding peripheral nerve compression or tumour. CONCLUSION: MRI of the whole sciatic nerve is the method of choice for diagnosing LHN of the sciatic nerve.
Published: 2012
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37. Circulating ACE is a predictor of weight loss maintenance not only in overweight and obese women, but also in men

Author: Wang, P., Holst, C., Wodzig, W. K. W. H., Andersen, M. R., Astrup, A., Van Baak, M. A., Larsen, T. M., Jebb, S. A., Kafatos, A., Pfeiffer, A. F. H., Martinez, J. A., Handjieva-Darlenska, T., Kunesova, M., Viguerie, N., Langin, D., Saris, W. H. M., Mariman, E. C. M., Diogenes, Consortium, Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism-Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht]-Maastricht University [Maastricht], Institute of Preventive Medicine / Institut for Sygdomsforebyggelse, Copenhagen University Hospital-Frederiksberg Hospital Hovedvejen, Department of Clinical Chemistry, Maastricht University Medical Centre (MUMC), Department of Clinical Biochemistry, Copenhagen University Hospital, Department of Human Nutrition, Faculty of Life Science [Copenhagen], University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), Elsie Widdowson Laboratory, MRC Human Nutrition Research, Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete [Heraklion] (UOC), Department of Clinical Nutrition, German Institute of Human Nutrition, Department of Endocrinology, Diabetes and Nutrition, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Department of Physiology and Nutrition, Universidad de Navarra [Pamplona] (UNAV), Department of Nutrition, Dietetics and Metabolic Diseases, National Multiprofile Transport Hospital, Obesity Management Centre, Institute of Endocrinology, Obesity Research Laboratory, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Department of Human Biology Nutrition and Toxicology Research (Diogenes), Maastricht University [Maastricht]-Institute Maastricht (NUTRIM), Humane Biologie, MUMC+: DA CDL Algemeen (9), RS: NUTRIM - R4 - Gene-environment interaction, RS: NUTRIM - R1 - Metabolic Syndrome, Simon, Marie Francoise, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), MESH: Energy Intake, 030204 cardiovascular system & hematology, Overweight, Weight Gain, 0302 clinical medicine, Weight loss, MESH: Obesity, 2. Zero hunger, [SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, MESH: Diet, Reducing, 0303 health sciences, Nutrition and Dietetics, MESH: Middle Aged, MESH: Sex Distribution, Middle Aged, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, MESH: Predictive Value of Tests, 3. Good health, MESH: Weight Gain, Female, medicine.symptom, Adult, medicine.medical_specialty, Diet, Reducing, Peptidyl-Dipeptidase A, 03 medical and health sciences, MESH: Weight Loss, MESH: Cross-Sectional Studies, Predictive Value of Tests, Internal medicine, Weight Loss, medicine, Humans, Obesity, Sex Distribution, 030304 developmental biology, MESH: Humans, business.industry, MESH: Biological Markers, MESH: Adult, Odds ratio, Anthropometry, Confidence interval, MESH: Male, MESH: Peptidyl-Dipeptidase A, Endocrinology, Cross-Sectional Studies, business, Energy Intake, Weight gain, Body mass index, MESH: Female, Biomarkers
Abstract: BACKGROUND:Circulating angiotensin-converting enzyme (ACE) was identified as a predictor of weight loss maintenance in overweight/obese women of the Diogenes project.OBJECTIVE:To investigate whether ACE acted also as a predictor in men of the Diogenes study and to compare it with that in women.DESIGN:Subjects, who lost >/=8% of body weight induced by low-caloric diet in an 8-week weight loss period, were assigned to weight loss maintenance with dietary intervention for 6 months.SUBJECTS:125 overweight/obese healthy men from eight European countries who completed whole intervention.MEASUREMENTS:Concentrations and activity of serum ACE at baseline and after the 8-week weight loss, in addition to anthropometric and physiological parameters.RESULTS:Serum ACE concentration decreased by 11.3+/-10.6% during the weight loss period in men. A greater reduction is associated with less body weight regain during the maintenance period (r=0.227, P=0.012). ACE change was able to predict a weight regain
Published: 2012
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38. Predictive factors of recurrence and survival of upper tract urothelial carcinomas

Author: Vitaly Margulis, Jay D. Raman, Thomas F. Chromecki, Morgan Rouprêt, Mesut Remzi, Douglas S. Scherr, Shahrokh F. Shariat, Gregory Verhoest, Karim Bensalah, Christian Seitz, Giacomo Novara, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Department of Urology, Cornell University Medical College, Division of Medical Oncology, Penn State College of Medicine, Penn State System-Pennsylvania Commonwealth System of Higher Education (PCSHE)-Penn State System-Pennsylvania Commonwealth System of Higher Education (PCSHE), Medical University Graz, University of Texas Southwestern Medical Center [Dallas]- The University of Texas Health Science Center at Houston (UTHealth), Department of Oncological and Surgical Sciences, Universita degli Studi di Padova, Hospital Barmherzige Brüder, Hospital Weinviertel-Korneuburg-Landesklinikum Korneuburg, Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Pennsylvania Commonwealth System of Higher Education (PCSHE)-Penn State System-Pennsylvania Commonwealth System of Higher Education (PCSHE)-Penn State System, Università degli Studi di Padova = University of Padua (Unipd), De Villemeur, Hervé, Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'urologie et transplantation rénales [CHU Pitié-Salpêtrière], and Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: MESH: Carcinoma, Male, Oncology, predictive factors, Lymphovascular invasion, 030232 urology & nephrology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 0302 clinical medicine, nephro-ureterectomy, Stage (cooking), Lymph node, urothelial carcinoma, MESH: Urologic Surgical Procedures, MESH: Urologic Neoplasms, Standard treatment, Prognosis, MESH: Predictive Value of Tests, 3. Good health, Survival Rate, medicine.anatomical_structure, upper tract, 030220 oncology & carcinogenesis, Predictive value of tests, Urologic Surgical Procedures, Female, MESH: Neoplasm Recurrence, Local, Urologic Neoplasms, medicine.medical_specialty, recurrence, MESH: Survival Rate, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Prognosis, Article, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Predictive Value of Tests, Internal medicine, medicine, Carcinoma, Humans, Clinical significance, Survival rate, MESH: Humans, business.industry, MESH: Urothelium, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, transitional carcinoma, Neoplasm Recurrence, Local, Urothelium, business, MESH: Female
Abstract: International audience; OBJECTIVE: UTUCC is a rare tumor, and most reports on prognostic factors come from small single-center series. The objective of this article was to provide an updated overview of current clinical, pathological and biological prognostic factors of UTUC. METHODS: PubMed was searched for records from 2002 to 2010 using the terms "prognostic factors", "recurrence", "survival", and "upper tract urothelial carcinoma". Among identified citations, papers were selected based on their clinical relevance. RESULTS: Classical clinical factors that influence UTUC prognosis include age, presence of symptoms, hydronephrosis, and interval from diagnosis. Many biomarkers have shown promises to better appraise the natural course of UTUC although none is currently used in clinical practice. Stage, grade, lymph node metastases, lymphovascular invasion, tumor necrosis, and tumor architecture are strong pathological parameters. RNU is the standard treatment of localized UTUC. Both laparoscopic and open approaches seem to offer similar cancer control. Lymph node dissection increases staging accuracy and might confer a survival benefit. CONCLUSION: RNU is the standard treatment for most patients with UTUC. Recent multicenter studies confirmed the prognostic value of classical prognostic parameters. Better survival prediction might be obtained with prognostic systems including clinical data and new biomarkers.
Published: 2011
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39. Diagnostic contributions of cardiac magnetic resonance imaging in patients presenting with elevated troponin, acute chest pain syndrome and unobstructed coronary arteries

Author: Dominique Boulmier, Pierre-Axel Lentz, Marc Bedossa, Hervé Le Breton, Guillaume Leurent, B. Langella, A. Larralde, Claire Fougerou, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Myocardite, MESH: Chi-Square Distribution, Cardiac magnetic resonance, Myocardial Infarction, Contrast Media, MESH: Takotsubo Cardiomyopathy, 030204 cardiovascular system & hematology, Coronary Angiography, Chest pain, Coronary artery disease, 0302 clinical medicine, MESH: Up-Regulation, MESH: Coronary Vessels, MESH: Syndrome, Prospective Studies, 030212 general & internal medicine, Myocardial infarction, MESH: Myocardial Perfusion Imaging, Ejection fraction, biology, medicine.diagnostic_test, MESH: Chest Pain, Syndrome de takotsubo, Myocardial Perfusion Imaging, MESH: Magnetic Resonance Imaging, Cine, Syndrome, General Medicine, Syndrome coronaire aigu, Coronary Vessels, MESH: Predictive Value of Tests, Troponin, Up-Regulation, 3. Good health, MESH: Myocardial Infarction, Myocarditis, MESH: Young Adult, Acute Disease, cardiovascular system, Cardiology, MESH: Acute Disease, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, Acute coronary syndrome, France, Radiology, medicine.symptom, Takotsubo syndrome, Cardiology and Cardiovascular Medicine, Adult, Chest Pain, medicine.medical_specialty, Magnetic Resonance Imaging, Cine, Infarctus du myocarde, MESH: Meglumine, Young Adult, 03 medical and health sciences, Meglumine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Myocarditis, Predictive Value of Tests, Takotsubo Cardiomyopathy, Cardiac magnetic resonance imaging, MESH: Contrast Media, Internal medicine, Organometallic Compounds, medicine, Humans, MESH: Humans, Chi-Square Distribution, business.industry, MESH: Biological Markers, MESH: Adult, MESH: Organometallic Compounds, medicine.disease, MESH: Male, MESH: Prospective Studies, MESH: Coronary Angiography, MESH: France, IRM cardiaque, biology.protein, MESH: Troponin, Myocardial infarction diagnosis, business, human activities, MESH: Female, Biomarkers
Abstract: International audience; AIMS: Myocardial infarction with unobstructed coronary artery disease represents a serious diagnostic challenge. The role of cardiac magnetic resonance in the management of cardiomyopathies is increasing. We examined the diagnostic contributions of cardiac magnetic resonance in patients presenting with acute chest pain syndrome, elevated serum cardiac troponin concentrations and no significant coronary artery stenoses. METHODS: Over a 3-year period, 107 consecutive patients (mean age 43.5 years; 62% men) presented to our institution with acute onset of chest pain, elevated serum troponin concentration and unobstructed coronary arteries, and underwent 3-tesla cardiac magnetic resonance at a mean delay of 6.9 days. A diagnosis was made based on: wall motion abnormalities and pericardial effusion on cine mode; myocardial oedema on T2-weighted imaging; abnormalities on first-pass perfusion imaging; and late gadolinium enhancement on T1-weighted imaging. RESULTS: Cardiac magnetic resonance was normal in 10.3% of patients and contributed a diagnosis in 89.7%, including myocarditis in 59.9%, stress cardiomyopathy (takotsubo syndrome) in 14% and myocardial infarction in 15.8%. Patients with normal cardiac magnetic resonance had a significantly lower mean peak troponin concentration (2.6ng/mL) than patients with diagnostic cardiac magnetic resonance (9.7ng/mL; P=0.01). CONCLUSION: Cardiac magnetic resonance contributed a diagnosis in nearly 90% of patients presenting with acute chest pain, elevated serum troponin and unobstructed coronary arteries.
Published: 2011
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40. Predictors of thrombosis in relatives of patients with venous thromboembolism

Author: Francis Couturaud, Clive Kearon, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Department of Medicine (DM - McMaster), and McMaster University [Hamilton, Ontario]
Subjects: Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Hereditary thrombophilia, 030204 cardiovascular system & hematology, MESH: Venous Thromboembolism, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, MESH: Risk Factors, Humans, Medicine, Family, Genetic Predisposition to Disease, MESH: Thrombosis, cardiovascular diseases, MESH: Family, MESH: Humans, business.industry, MESH: Genetic Predisposition to Disease, Thrombosis, Venous Thromboembolism, equipment and supplies, medicine.disease, MESH: Predictive Value of Tests, 030220 oncology & carcinogenesis, business, Venous thromboembolism, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; PURPOSE OF REVIEW: Hereditary and acquired risk factors contribute to the development of venous thromboembolism (VTE). Relatives of patients who have a hereditary predisposition to thrombosis ('hereditary thrombophilia') will have a heightened risk of VTE if they share the same thrombophilic abnormality. However, if patients do not have a currently recognized thrombophilia it cannot be assumed that their relatives have a normal risk of thrombosis; the patient and their relatives may have a yet to be discovered hereditary abnormality. RECENT FINDINGS: A recent study by our group suggests that the relatives of patients with unprovoked VTE at a young age (e.g. 71 years). This effect occurred independently of whether patients had a currently recognized hereditary thrombophilia. SUMMARY: Relatives of patients with unprovoked VTE have an increased risk of VTE. Testing for thrombophilia in the patients, and in the relatives of the patients who have a thrombophilia, allows the risk of thrombosis in the relatives to be estimated. Thrombosis at a young age appears to be an additional independent risk factor for a heightened risk of thrombosis in patients' relatives.
Published: 2010
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41. Low value of simple echocardiographic indices of ventricular dyssynchrony in predicting the response to cardiac resynchronization therapy

Author: Patricia Reant, John M. Morgan, Kinga Goscinska-Bis, Robert Bowes, Pierre Bordachar, Christophe Leclercq, Sylvain Reuter, Stephane Lafitte, Sandrine Bénard, Ralph-Uwe Mletzko, Jacques Clémenty, Robert M Siegel, Département de cardiologie, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], ELA Medical (Sorin Group), Sorin Group [Clamart], Centre cardio-pneumologique, and Hôpital Pontchaillou
Subjects: Male, medicine.medical_specialty, Cardiac dyssynchrony, Cardiac pacing, medicine.medical_treatment, Cardiac resynchronization therapy, MESH: Cardiac Pacing, Artificial, Nyha class, law.invention, Ventricular Dysfunction, Left, Double-Blind Method, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Randomized controlled trial, Predictive Value of Tests, law, Internal medicine, MESH: Ventricular Dysfunction, Left, medicine, Humans, MESH: Double-Blind Method, cardiovascular diseases, Ventricular dyssynchrony, Aged, Heart Failure, MESH: Aged, Aortic pre-ejection delay, MESH: Humans, MESH: Middle Aged, business.industry, Cardiac Pacing, Artificial, Middle Aged, medicine.disease, MESH: Male, MESH: Predictive Value of Tests, Multicenter study, Echocardiography, Heart failure, Predictive value of tests, MESH: Heart Failure, cardiovascular system, Cardiology, Female, MESH: Echocardiography, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, MESH: Female, Interventricular delay
Abstract: International audience; AIMS: A recent study suggested that no single echocardiographic index of cardiac dyssynchrony can reliably identify candidates for cardiac resynchronization therapy (CRT). We examined the value of three simple echocardiographic indices for predicting the 6-month clinical and echocardiographic responses to CRT. METHODS AND RESULTS: We analysed data from 75 CRT-D system recipients. Standard echocardiography was used to measure aortic pre-ejection delay (APED), interventricular mechanical delay (IVMD), and delayed activation of the left ventricular (LV) infero-lateral wall (OVERLAP). Clinical responders were defined as patients who had an improved status, based on rehospitalization for heart failure, NYHA class, and peak oxygen consumption. Echocardiographic responders had a > or =10% decrease in LV end-systolic volume. During the study, one patient died and five were lost to follow-up. Of the remaining 69 analysable patients, 50 (72.5%) were classed as clinical responders and 41 (59.4%) as echocardiographic responders to CRT. Before CRT implantation, APED, IVMD, and OVERLAP were similar in responders and non-responders. The value of these indices of dyssynchrony as single or combined predictors of the clinical or echocardiographic response to CRT was low, with sensitivities ranging between 4 and 63%, and specificities between 37 and 100%. CONCLUSION: Simple echocardiographic indices of dyssynchrony were poor predictors of response to CRT.
Published: 2010
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42. Self-rated residual symptoms do not predict 1-year recurrence of depression

Author: Guido Bondolfi, D. Marra, Jean-Michel Aubry, Christian Osiek, Nicola Gérard Gervasoni, Gilles Bertschy, Marianne Gex-Fabry, Emmanuel Haffen, Laboratoire de Neurosciences Intégratives et Cliniques - UFC ( NEURO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire de Neurosciences Intégratives et Cliniques - UFC (EA 481) (NEURO), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: Male, Time Factors, Psychometrics, MESH : Recurrence, MESH : Aged, Test validity, ddc:616.89, 0302 clinical medicine, Recurrence, Surveys and Questionnaires, Depressive Disorder, Major/*diagnosis/*epidemiology, MESH : Female, Major depressive episode, Depression (differential diagnoses), MESH: Aged, MESH: Middle Aged, Questionnaires, MESH : Questionnaires, MESH: Follow-Up Studies, Middle Aged, MESH : Adult, MESH: Predictive Value of Tests, Psychiatry and Mental health, Convergent validity, MESH: Young Adult, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Female, medicine.symptom, Psychology, MESH : Depressive Disorder, Major, MESH : Time Factors, Adult, Predictive validity, medicine.medical_specialty, MESH : Male, MESH: Depressive Disorder, Major, MESH : Young Adult, Young Adult, 03 medical and health sciences, Predictive Value of Tests, Rating scale, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH : Predictive Value of Tests, Risk factor, Psychiatry, Aged, Depressive Disorder, Major, MESH: Humans, MESH: Questionnaires, MESH: Time Factors, MESH : Humans, MESH: Adult, MESH : Follow-Up Studies, MESH: Male, MESH: Recurrence, 030227 psychiatry, [ SDV.NEU ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], MESH: Female, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract: BackgroundResidual depressive symptoms are generally documented as a risk factor for recurrence. In the absence of a specific instrument for the assessment of residual symptoms, a new 25-item Depression Residual Symptom Scale (DRSS) was elaborated and tested for recurrence prediction over a 1-year follow-up.Sampling and methodsFifty-nine patients in remission after a major depressive episode (MDE) were recruited in two centres. They were assessed with the DRSS and the Montgomery-Asberg Depression Rating Scale (MADRS) at inclusion and followed for 1 year according to a seminaturalistic design. The DRSS included specific depressive symptoms and subjective symptoms of vulnerability, lack of return to usual self and premorbid level of functioning.ResultsSeverity of residual symptoms was not significantly associated with increased risk of recurrence. However, DRSS score was significantly higher among patients with three or more episodes than one to two episodes. Number of previous episodes and treatment interruption were not identified as significant predictors of recurrence.ConclusionThe proposed instrument is not predictive of depressive recurrence, but is sensitive to increased perception of vulnerability associated with consecutive episodes. Limitations include small sample size, seminaturalistic design (no standardisation of treatment) and content of the instrument.
Published: 2010
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43. Volumetric or time‐based capnography for excluding pulmonary embolism in outpatients?

Author: Erkki Heinonen, Frédéric Thys, Oliver Lope Sanchez, G. Le Gal, Guy Meyer, Arnaud Perrier, F. Verschuren, Marc Philip Righini, Acute Medicine Department, Accidents and Emergency Unit (FV - AMD), Université Catholique de Louvain = Catholic University of Louvain (UCL), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Service de médecine interne générale (SMIG), GE Healthcare Helsinki (EH), GE Healthcare Helsinki, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: MESH: Pulmonary Embolism, Time Factors, Pulmonary Embolism/blood/*diagnosis/metabolism, 030204 cardiovascular system & hematology, MESH: Carbon Dioxide, MESH: Respiratory Dead Space, MESH: Aged, 80 and over, 0302 clinical medicine, Respiratory Dead Space, Outpatients, Prospective Studies, Prospective cohort study, Capnography, ddc:616, Aged, 80 and over, MESH: Aged, Carbon Dioxide/*metabolism, Likelihood Functions, ddc:618, MESH: Middle Aged, medicine.diagnostic_test, Incidence (epidemiology), MESH: Enzyme-Linked Immunosorbent Assay, Hematology, Middle Aged, Point-of-Care Systems, MESH: Predictive Value of Tests, MESH: Point-of-Care Systems, 3. Good health, Pulmonary embolism, Europe, Predictive value of tests, Fibrin Fibrinogen Degradation Products/metabolism, medicine.medical_specialty, Enzyme-Linked Immunosorbent Assay, Sensitivity and Specificity, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, Predictive Value of Tests, Multicenter trial, MESH: Fibrin Fibrinogen Degradation Products, medicine, Humans, Aged, MESH: Humans, Receiver operating characteristic, business.industry, MESH: Time Factors, MESH: Capnography, Carbon Dioxide, MESH: ROC Curve, medicine.disease, MESH: Prospective Studies, MESH: Sensitivity and Specificity, Confidence interval, MESH: Outpatients, Surgery, ROC Curve, 030228 respiratory system, MESH: Likelihood Functions, MESH: Europe, Pulmonary Embolism, Nuclear medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BACKGROUND: Volumetric capnography is technically more demanding but theoretically better than the time-based alveolar deadspace fraction (P(a)CO(2) - EtCO(2))/P(a)CO(2) as a bedside diagnostic tool for excluding pulmonary embolism (PE) in outpatients. OBJECTIVE: We compared both diagnostic accuracy in patients with a suspected PE and positive D-dimer enzyme-linked immunosorbent assay results. PATIENTS AND METHODS: In this clinical multicenter trial with prospective inclusion and 3-month follow-up, alveolar deadspace fraction was compared by receiver operating characteristic (ROC) analysis with other parameters derived from volumetric capnography. RESULTS: Capnography was performed in 239 patients, and 205 tests (86%) were conclusive. The incidence of PE was 33%. The alveolar deadspace fraction accuracy expressed with ROC curve analysis was 0.73 +/- 0.04. The diagnostic performances of parameters from volumetric capnography were not significantly better. Sixteen per cent [95% confidence interval (CI) 12-21%] of patients presented a (P(a)CO(2) - EtCO(2))/P(a)CO(2) ratio under the cut-off value of 0.15, with a low clinical probability. This combination excluded PE, with a sensitivity of 96% (95% CI 89-99%) and a negative likelihood ratio of 0.17 (95% CI 0.09-0.33%). CONCLUSION: Volumetric capnography failed to show superiority to alveolar deadspace fraction measurements [(P(a)CO(2) - EtCO(2))/P(a)CO(2)] for exclusion of PE in outpatients with positive D-dimer test results. Future studies should clarify the safety of excluding PE in patients combining low clinical probability with positive D-dimer results and (P(a)CO(2) - EtCO(2))/P(a)CO(2) ratios below the cut-off value of 0.15.
Published: 2010
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44. Prediction of the warfarin maintenance dose after completion of the 10 mg initiation nomogram: do we really need genotyping?

Author: Marc Carrier, S. Tierney, P. S. Wells, G. Le Gal, H. Majeed, Marc A. Rodger, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Clinical Epidemiology Unit, Ottawa-The Ottawa Hospital, Thrombosis Program, and University of Ottawa [Ottawa]
Subjects: Male, Time Factors, Vitamin K, Administration, Oral, Clinical prediction rule, 030204 cardiovascular system & hematology, MESH: Risk Assessment, MESH: Venous Thromboembolism, MESH: Genotype, 0302 clinical medicine, Risk Factors, MESH: Drug Monitoring, MESH: Risk Factors, Ambulatory Care, Drug Dosage Calculations, heterocyclic compounds, 030212 general & internal medicine, MESH: Warfarin, Prospective cohort study, MESH: Aged, MESH: Middle Aged, Cumulative dose, Maintenance dose, Age Factors, Venous Thromboembolism, Hematology, Middle Aged, MESH: Predictive Value of Tests, MESH: International Normalized Ratio, 3. Good health, MESH: Reproducibility of Results, Phenotype, MESH: Blood Coagulation, MESH: Administration, Oral, Female, Drug Monitoring, MESH: Hemorrhage, medicine.drug, Adult, medicine.medical_specialty, Genotype, MESH: Ambulatory Care, Hemorrhage, MESH: Nomograms, MESH: Anticoagulants, MESH: Drug Administration Schedule, MESH: Phenotype, Risk Assessment, Drug Administration Schedule, 03 medical and health sciences, Therapeutic index, Predictive Value of Tests, Internal medicine, medicine, Humans, International Normalized Ratio, cardiovascular diseases, MESH: Drug Dosage Calculations, Blood Coagulation, Aged, Retrospective Studies, MESH: Age Factors, MESH: Humans, business.industry, Body Weight, MESH: Time Factors, Warfarin, Anticoagulants, Reproducibility of Results, MESH: Vitamin K, MESH: Adult, MESH: Retrospective Studies, Retrospective cohort study, Nomogram, MESH: Male, MESH: Body Weight, Surgery, Nomograms, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; INTRODUCTION: Initiation of warfarin therapy is complicated by its narrow therapeutic index and inter-patient dose-effect variability. A '10-mg nomogram' warfarin initiation protocol permits safe therapeutic anticoagulation in outpatients started on warfarin. We aimed to develop a safe and effective warfarin maintenance dose prediction tool in these patients. METHODS: Baseline potential predictor variables were collected on a retrospective cohort of outpatients initiated on warfarin for venous thromboembolism treatment. The primary outcome was the warfarin maintenance dose, defined as mean warfarin dose over the last 10 days of the first month of warfarin treatment. Univariate and multivariate analyses were performed to determine which baseline variables were warfarin maintenance dose predictors. An independent cohort of patients validated the derived warfarin maintenance dose prediction rule. RESULTS: Patient's age and weight, cumulative dose of warfarin over the first week of induction and international normalized ratio (INR) on days 3, 5 and 8 were statistically significant predictors of the warfarin maintenance dose. Our final prediction rule reads: maintenance dose (in mg) = 2.5 + 10% of the first week cumulative dose - INR value at day 8 + 1.5 if INR was below 2.0 at day 5. In the validation cohort, the predicted dose was strongly correlated with the actual maintenance dose (r = 0.88, P < 0.0001). The mean difference between observed and predicted dose was not clinically significant: -0.1 +/- 1.1 mg. CONCLUSION: In outpatients initiated on warfarin using a '10-mg nomogram', a simple prediction rule can accurately predict warfarin maintenance dose. Prospective studies employing the rule are indicated.
Published: 2010
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45. Prognosis and follow-up of psoriatic arthritis with peripheral joint involvement: Development of recommendations for clinical practice based on published evidence and expert opinion

Author: Alain Cantagrel, Alain Saraux, Thierry Schaeverbeke, Jacques Tebib, Bernard Combe, Carle Paul, Philippe Gaudin, Philippe Goupille, F. Lavie, Daniel Wendling, Emmanuelle Dernis, Carine Salliot, Jean-Francis Maillefert, René-Marc Flipo, Pascal Claudepierre, Xavier Le Loët, CHU Cochin [APHP], Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Lariboisière - Université Paris Diderot - Paris 7 (UP7), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Henri Mondor - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Pellegrin, CHU Bordeaux [Bordeaux] - Groupe hospitalier Pellegrin, Génétique, Immunothérapie, Chimie et Cancer (GICC), Université François Rabelais - Tours - Centre National de la Recherche Scientifique (CNRS), CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF) - CHU Grenoble, CHU Dijon, Centre Hospitalier Universitaire de Dijon (CHU Dijon), Hôpital Lapeyronie, Université Montpellier 1 (UM1) - Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier) - Hôpital Lapeyronie, Service de rhumatologie, Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, CHU Bordeaux [Bordeaux], Service d'immunologie et rhumatologie, Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Rhumatologie, Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Service de rhumatologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Lapeyronie [Montpellier] (CHU), CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Tours-Centre National de la Recherche Scientifique (CNRS), and Cambefort, Jeanne
Subjects: MESH: Inflammation, [SDV]Life Sciences [q-bio], Delphi method, Alternative medicine, MESH: Monitoring, Physiologic, Arthritis, Recommendations, 0302 clinical medicine, MESH: Arthritis, Psoriatic, 030212 general & internal medicine, Practice Patterns, Physicians', MESH: Publishing, Evidence-Based Medicine, Follow-up, MESH: Follow-Up Studies, Prognosis, MESH: Predictive Value of Tests, 3. Good health, [SDV] Life Sciences [q-bio], MESH: Joints, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Psoriatic arthritis, Radiological weapon, Predictive value of tests, MESH: Expert Testimony, medicine.medical_specialty, MEDLINE, MESH: Prognosis, 03 medical and health sciences, Rheumatology, Predictive Value of Tests, medicine, Humans, MESH: Physician's Practice Patterns, Expert Testimony, Monitoring, Physiologic, Inflammation, Publishing, 030203 arthritis & rheumatology, MESH: Humans, business.industry, Arthritis, Psoriatic, Everyday clinical practice, Evidence-based medicine, medicine.disease, Radiography, Physical therapy, Joints, business, MESH: Evidence-Based Medicine, Follow-Up Studies
Abstract: International audience; Objectives: To develop recommendations about prognosis and follow-up of psoriatic arthritis (PsA) with peripheral joint involvement in everyday clinical practice. Methods: The strategy was as following: (a) The choice of five questions, by the scientific committee according to the Delphi method, considered as a basis for the recommendations; (b) the Systematic Literature Research based on Medline, Cochrane and abstracts from the annual meetings of SFR, EULAR and ACR. An expert committee composed with 68 rheumatologists elaborated and validated the recommendations, specifying the strength and the degree of agreement for each of them. Results: The questions selected were: (1) How can articular and cutaneous disease activity of PsA be assessed in usual clinical practice? (2) Which parameters are predictive for functional, radiological and fatal outcome in PsA? (3) Which clinical and biological parameters are useful for the follow-up of PsA? At which frequency? (4) Which X-rays are useful for the follow-up of PsA? At which frequency? (5) How can the response to treatments be assessed in PsA? The literature search identified 1181 abstracts and 123 articles were included and analyzed. Seven recommendations, whose strength ranged from B to D, were drafted and validated by a final vote of the expert committee. Conclusion: Seven recommendations about follow-up of patients with PsA for daily practice were developed. They can be expected to improve clinical practice uniformity and, in the longer term, to optimize the management of patients with PsA. (C) 2009 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.
Published: 2009
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46. Cardiac magnetic resonance demonstrates myocardial oedema in remote tissue early after reperfused myocardial infarction

Author: Jean-Nicolas Dacher, Alain Manrique, Alain Lebon, Edouard Gerbaud, David Bertrand, Geneviève Derumeaux, Alain Cribier, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), GIP Cyceron (Cyceron), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département de cardiologie, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Department of Cardiology, Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service d'imagerie médicale [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Breton, Céline
Subjects: Male, MESH: Angioplasty, Transluminal, Percutaneous Coronary, Time Factors, No-reflow (NR), Myocardial Infarction, No-reflow, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, MESH: Magnetic Resonance Imaging, 0302 clinical medicine, Edema, Medicine, Thrombolytic Therapy, Prospective Studies, Myocardial infarction, Angioplasty, Balloon, Coronary, MESH: Treatment Outcome, MESH: Aged, Edema, Cardiac, MESH: Thrombolytic Therapy, MESH: Middle Aged, Fourier Analysis, medicine.diagnostic_test, General Medicine, Middle Aged, Control subjects, Magnetic Resonance Imaging, MESH: Case-Control Studies, Troponin, MESH: Predictive Value of Tests, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Myocardial Infarction, Treatment Outcome, MESH: No-Reflow Phenomenon, Cardiology, cardiovascular system, Female, Stents, medicine.symptom, Cardiology and Cardiovascular Medicine, TIMI, MRI, IRM, Œdème, Adult, medicine.medical_specialty, MESH: Edema, Cardiac, MESH: Myocardium, Reperfused myocardial infarction, Infarctus du myocarde, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Internal medicine, Image Interpretation, Computer-Assisted, Humans, In patient, cardiovascular diseases, Aged, MESH: Humans, business.industry, Myocardium, MESH: Time Factors, MESH: Biological Markers, Magnetic resonance imaging, MESH: Adult, medicine.disease, MESH: Male, MESH: Prospective Studies, Oedema, Radiography, MESH: Stents, Case-Control Studies, No-Reflow Phenomenon, MESH: Troponin, business, Cardiac magnetic resonance, MESH: Female, MESH: Image Interpretation, Computer-Assisted, Biomarkers, MESH: Fourier Analysis
Abstract: International audience; BACKGROUND: Cardiac magnetic resonance can detect myocardial oedema using myocardial transverse relaxation time (T2)-weighted sequences but quantitative data are lacking in patients evaluated early after acute myocardial infarction. AIM: To assess the spatial distribution of T2 in patients with recent acute myocardial infarction. METHODS: Twenty-four consecutive patients (mean age 60+/-11 years) with acute myocardial infarction (anterior, n=12; inferior, n=12) were evaluated prospectively. T2 was determined using a series of breath-hold T2-weighted segmented half-Fourier turbo-spin echo sequences. No-reflow was defined as the association of early hypoenhancement and delayed enhancement in an akinetic region after a bolus injection of DOTA-Gd (0.2 mmol/kg). RESULTS: No-reflow was present in 13 (54%) patients and absent in 11 (46%) patients. Mean T2 was increased in the infarct region (84.9+/-23.7 ms) compared with in the remote myocardium (62.8+/-10.3 ms, p=0.0001) and in control subjects (55.7+/-4.6 ms, p
Published: 2009
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47. Necrotic core thickness and positive arterial remodeling index: emergent biomechanical factors for evaluating the risk of plaque rupture

Author: Gérard Finet, Roderic I. Pettigrew, Ahmed M. Gharib, Philippe Tracqui, Jacques Ohayon, Gilles Rioufol, Julie Heroux, Melanie Suzanne Kotys, Daniel A. Herzka, Abdalla Elagha, Dynacell, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Department of Hemodynamics and Interventional Cardiology, Institut National de la Santé et de la Recherche Médicale (INSERM), DynaCell, Hôpital Cardiovasculaire Louis Pradel, and Hospices Civils de Lyon (HCL)
Subjects: MESH: Rupture, MESH: Models, Cardiovascular, Pathology, Necrotic core, Physiology, [SDV]Life Sciences [q-bio], MESH: Ultrasonography, Interventional, Coronary Artery Disease, 02 engineering and technology, 030204 cardiovascular system & hematology, MESH: Risk Assessment, Coronary artery disease, 0302 clinical medicine, Fibrosis, Intravascular ultrasound, MESH: Coronary Vessels, MESH: Coronary Artery Disease, Core (anatomy), MESH: Stress, Mechanical, medicine.diagnostic_test, Fibrous cap, Models, Cardiovascular, Plaque rupture, Articles, Coronary Vessels, MESH: Predictive Value of Tests, MESH: Reproducibility of Results, medicine.anatomical_structure, MESH: Fibrosis, Disease Progression, MESH: Disease Progression, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Plaque instability, 0206 medical engineering, Risk Assessment, Necrosis, 03 medical and health sciences, MESH: Computer Simulation, Predictive Value of Tests, Physiology (medical), medicine, Humans, Computer Simulation, Ultrasonography, Interventional, Rupture, MESH: Necrosis, MESH: Humans, business.industry, Reproducibility of Results, medicine.disease, 020601 biomedical engineering, Stress, Mechanical, business
Abstract: Fibrous cap thickness is often considered as diagnostic of the degree of plaque instability. Necrotic core area (Corearea) and the arterial remodeling index (Remodindex), on the other hand, are difficult to use as clinical morphological indexes: literature data show a wide dispersion of Corearea thresholds above which plaque becomes unstable. Although histopathology shows a strong correlation between Corearea and Remodindex, it remains unclear how these interact and affect peak cap stress (Capstress), a known predictor of rupture. The aim of this study was to investigate the change in plaque vulnerability as a function of necrotic core size and plaque morphology. Capstress value was calculated on 5,500 idealized atherosclerotic vessel models that had the original feature of mimicking the positive arterial remodeling process described by Glagov. Twenty-four nonruptured plaques acquired by intravascular ultrasound on patients were used to test the performance of the associated idealized morphological models. Taking advantage of the extensive simulations, we investigated the effects of anatomical plaque features on Capstress. It was found that: 1) at the early stages of positive remodeling, lesions were more prone to rupture, which could explain the progression and growth of clinically silent plaques and 2) in addition to cap thickness, necrotic core thickness, rather than area, was critical in determining plaque stability. This study demonstrates that plaque instability is to be viewed not as a consequence of fibrous cap thickness alone but rather as a combination of cap thickness, necrotic core thickness, and the arterial remodeling index.
Published: 2008
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48. D‐dimer testing is useful to exclude deep vein thrombosis in elderly outpatients

Author: G. Le Gal, Shannon M. Bates, Marc Carrier, P. S. Wells, David R. Anderson, Thrombosis Program, University of Ottawa [Ottawa], Clinical Epidemiology Unit, Ottawa-The Ottawa Hospital, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Department of Medicine, McMaster University [Hamilton, Ontario], Department of Medicine - Halifax (DRA), Dalhousie University [Halifax], Clinical Epidemiology Program (PSW), and The Ottawa Health Research Institute
Subjects: medicine.medical_specialty, MESH: Diagnostic Techniques, Cardiovascular, MESH: Probability, Deep vein, Diagnostic Techniques, Cardiovascular, MESH: Algorithms, Clinical prediction rule, 030204 cardiovascular system & hematology, MESH: Venous Thromboembolism, Diagnosis, Differential, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, MESH: Aged, 80 and over, 0302 clinical medicine, Predictive Value of Tests, MESH: Diagnosis, Differential, Internal medicine, D-dimer, MESH: Fibrin Fibrinogen Degradation Products, medicine, Humans, In patient, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Aged, Probability, Aged, 80 and over, MESH: Aged, MESH: Humans, business.industry, Venous Thromboembolism, Hematology, medicine.disease, Thrombosis, MESH: Predictive Value of Tests, MESH: Prospective Studies, Surgery, Pre- and post-test probability, medicine.anatomical_structure, Predictive value of tests, business, Algorithms, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BACKGROUND: Deep vein thrombosis (DVT) can be safely and reliably excluded in patients with a low clinical probability and a negative D-dimer result but the accuracy and utility of such a strategy is unclear in elderly patients. OBJECTIVES: We sought to compare the performance of the Wells pretest probability (PTP) model and D-dimer testing between patients of different age groups and to examine the utility of the two PTP model classification schemes (low/moderate/high vs. unlikely/likely) in excluding DVT in elderly outpatients. PATIENTS/METHODS: Pooled analysis of databases from three prospective diagnostic studies evaluating consecutive outpatients with suspected DVT. RESULTS: A total of 2696 patients were evaluated. DVT was diagnosed in 400 (15%) patients overall and in 50 out of 325 (15.5%) patients > or = 60 years old. The PTP distribution and the prevalence of DVT in each PTP category were similar among the different age groups. The negative predictive values of a low or unlikely PTP score in combination with a negative D-dimer result were 99% for all groups. A negative D-dimer in combination with a low or unlikely PTP excluded 21.7% and 31% of patients > or = 80 years old, respectively. CONCLUSIONS: The combination of a low or unlikely PTP with a negative D-dimer result can effectively and safely exclude DVT in a significant proportion of elderly outpatients. However, this clinical prediction rule needs to be prospectively validated with different D-dimer assays in this specific population.
Published: 2008
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49. Comparison of the revised Geneva score with the Wells rule for assessing clinical probability of pulmonary embolism

Author: M.V. Huisman, Drahomir Aujesky, E. Kruisman, Marc Philip Righini, J. Spaan, Frederikus A. Klok, M. Nijkeuter, Arnaud Perrier, G. Le Gal, P.-M. Roy, Section of Vascular Disease (LUMC - Vasc Dis), Leiden University Medical Center (LUMC), Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Division of Internal Medicine (DA), Université de Lausanne (UNIL), Service des Urgences (PMR), CHRU - ANGERS, General Internal Medicine (AP), Geneva University Hospital (HUG), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), ACS - Amsterdam Cardiovascular Sciences, Other Research, and Biomedical Engineering and Physics
Subjects: Adult, Male, MESH: Pulmonary Embolism, Pediatrics, medicine.medical_specialty, MESH: Probability, 030204 cardiovascular system & hematology, Single Center, Decision Support Techniques, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, D-dimer, Prevalence, Humans, Medicine, Pulmonary Embolism/diagnosis, 030212 general & internal medicine, Geneva score, MESH: Prevalence, health care economics and organizations, Probability, ddc:616, MESH: Humans, MESH: Middle Aged, Receiver operating characteristic, business.industry, Area under the curve, MESH: Decision Support Techniques, MESH: Adult, Hematology, Middle Aged, MESH: ROC Curve, medicine.disease, MESH: Male, MESH: Predictive Value of Tests, Pulmonary embolism, ROC Curve, Area Under Curve, Predictive value of tests, MESH: Area Under Curve, Female, Pulmonary Embolism, business, MESH: Female, Venous thromboembolism, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BACKGROUND: The revised Geneva score, a standardized clinical decision rule in the diagnosis of pulmonary embolism (PE), was recently developed. The Wells clinical decision is widely used but lacks full standardization, as it includes subjective clinician's judgement. We have compared the performance of the revised Geneva score with the Wells rule, and their usefulness for ruling out PE in combination with D-dimer measurement. METHODS: In 300 consecutive patients, the clinical probability of PE was assessed prospectively by the Wells rule and retrospectively using the revised Geneva score. Patients comprised a random sample from a single center, participating in a large prospective multicenter diagnostic study. The predictive accuracy of both scores was compared by area under the curve (AUC) of receiver operating characteristic (ROC) curves. RESULTS: The overall prevalence of PE was 16%. The prevalence of PE in the low-probability, intermediate-probability and high-probability categories as classified by the revised Geneva score was similar to that of the original derivation set. The performance of the revised Geneva score as measured by the AUC in a ROC analysis did not differ statistically from the Wells rule. After 3 months of follow-up, no patient classified into the low or intermediate clinical probability category by the revised Geneva score and a normal D-dimer result was subsequently diagnosed with acute venous thromboembolism. CONCLUSIONS: This study suggests that the performance of the revised Geneva score is equivalent to that of the Wells rule. In addition, it seems safe to exclude PE in patients by the combination of a low or intermediate clinical probability by the revised Geneva score and a normal D-dimer level. Prospective clinical outcome studies are needed to confirm this latter finding.
Published: 2008
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50. The choledochal ring sign: a specific finding in acute biliary pancreatitis

Author: Philippe Sarliève, Francine Fein, Eric Delabrousse, Bruno Kastler, Sébastien Aubry, Vincent Di Martino, Franck Carbonnel, WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), 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), Agents pathogènes et inflammation - UFC (EA 4266) (API), Service de gastro-entérologie, and Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Subjects: Male, MESH: Chi-Square Distribution, Pancreatic disease, Common Bile Duct Diseases, MESH: Logistic Models, Gastroenterology, 030218 nuclear medicine & medical imaging, MESH: Aged, 80 and over, 0302 clinical medicine, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Radiological and Ultrasound Technology, Common bile duct, General Medicine, Middle Aged, MESH: Predictive Value of Tests, 3. Good health, MESH: Pancreatitis, medicine.anatomical_structure, Biliary tract, Acute abdomen, MESH: Common Bile Duct Diseases, Acute Disease, MESH: Acute Disease, Acute pancreatitis, Female, 030211 gastroenterology & hepatology, Radiology, medicine.symptom, MESH: Tomography, X-Ray Computed, Adult, Diagnostic Imaging, medicine.medical_specialty, Adolescent, Urology, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Aged, Retrospective Studies, MESH: Adolescent, Chi-Square Distribution, MESH: Humans, MESH: Diagnostic Imaging, business.industry, MESH: Retrospective Studies, MESH: Adult, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Hepatology, medicine.disease, MESH: Male, Logistic Models, Pancreatitis, Abdomen, Tomography, X-Ray Computed, business, MESH: Female
Abstract: International audience; We investigated a marked common bile duct wall contrast-enhancement in acute pancreatitis on CT scans as an accurate sign of biliary pancreatitis. Contrast-enhanced CT scans of 80 patients with clinically and biologically confirmed acute pancreatitis were reviewed by two gastrointestinal radiologists without knowledge of the cause of acute pancreatitis. Since this study was retrospective and then did not modify the CT examination routinely performed in acute abdomen, no institutional review board approval and informed consent was requested. A systematic measure of the difference between the CT number of common bile duct wall and the CT number of pancreatic parenchyma was performed. The "choledochal ring" sign, defined by a difference greater than 15 HU was specifically studied and compared to other factors often associated with biliary pancreatitis through univariate and multivariate analyses. Compared to other factors classically associated with acute biliary pancreatitis, the "choledochal ring" sign showed high specificity (100%) and high positive predictive value (100%). In patients with acute pancreatitis, the "choledochal ring" sign is a new and accurate finding of acute biliary pancreatitis on CT scans.
Published: 2007
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