158 results on '"Unité d'Aide Méthodologique"'
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2. Assessment of TNF-α inhibitors in airway involvement of relapsing polychondritis
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Biya, Josette, Dury, Sandra, Perotin, Jeanne-Marie, Launois, Claire, Dewolf, Maxime, Deslée, Gaetan, Lebargy, François, Centre Hospitalier Universitaire de Reims (CHU Reims), Immuno-Régulation dans les Maladies Auto-Immunes Inflammatoires et le Cancer - EA 7509 (IRMAIC), Université de Reims Champagne-Ardenne (URCA), Immunité Adaptative et Fonctionnalité des Barrières Biologiques - EA 4683 (IMAB), Université de Reims Champagne-Ardenne (URCA)-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), 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), dormoy, valerian, 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), Service de Médecine Respiratoire [CHU Reims], Université de Picardie Jules Verne (UPJV), Hôpital Maison Blanche, Unité d'Aide Méthodologique, and Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims)
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[SDV]Life Sciences [q-bio] ,relapsing polychondritis ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,[SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy ,[SDV.IMM.IMM] Life Sciences [q-bio]/Immunology/Immunotherapy ,TNF-a inhibitors ,airways ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,ComputingMilieux_MISCELLANEOUS ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,TNF-α inhibitors - Abstract
International audience; Relapsing polychondritis (RP) is a rare immune-mediated disease affecting cartilaginous structures. Respiratory tract manifestations are frequent and constitute a major cause of morbidity and mortality. The present review of the literature was designed to assess the efficacy of tumor necrosis factor alpha (TNF-a) inhibitors in respiratory tract involvement of RP. A MEDLINE literature search was performed from January 2000 to December 2016 to identify all studies and case reports of anti-TNF-a therapy in RP. Articles published in English or French concerning patients with respiratory tract involvement were eligible. Two authors (JB, FL) independently reviewed and extracted data concerning each patient and 2 personal cases were added. Treatment efficacy was assessed according to systemic and/or respiratory criteria. A total of 28 patients (mean age: 41.6 years; 16 females/12 males) were included in the final analysis. Anti-TNF-a therapy was associated with improved health status and respiratory symptoms in 67.8% and 60.1% of cases, respectively. These results suggest that TNF-a inhibitors could be considered for the treatment of respiratory tract involvement of RP. Abbreviations: CT = computed tomography, FDG/PET = fluorodeoxyglucose positron emission tomography, RP = relapsing polychondritis, TNF-a = tumor necrosis factor alpha.
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- 2019
3. Tumor multifocality with vagus nerve involvement as a phenotypic marker of SDHD mutation in patients with head and neck paragangliomas: A 18 F‐FDOPA PET/CT study
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Pauline Romanet, Ugo Scemama, David Taïeb, Frederic Sebag, Karel Pacak, Arthur Varoquaux, Frederic Castinetti, Anderson Loundou, Nicolas Fakhry, Anne Barlier, Marion Montava, Jean‐Pierre Lavieille, Vincent Amodru, Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d’imagerie médicale [Hôpital Nord - APHM], Hôpital Nord [CHU - APHM], Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel, ORL et Chirurgie cervico-faciale pédiatrique - [Hôpitaux Timone et Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)- Hôpital Nord [CHU - APHM], Laboratoire Parole et Langage (LPL), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche en neurobiologie - neurophysiologie de Marseille (CRN2M), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, 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), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Centre de Recherche en Cancérologie de Marseille (CRCM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, and Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
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Male ,Vagus Nerve Diseases ,Fluorine Radioisotopes ,Heterozygote ,medicine.medical_specialty ,SDHB ,030209 endocrinology & metabolism ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,[SDV.BC.BC]Life Sciences [q-bio]/Cellular Biology/Subcellular Processes [q-bio.SC] ,medicine.disease_cause ,Carotid paraganglioma ,Article ,Neoplasms, Multiple Primary ,03 medical and health sciences ,0302 clinical medicine ,Paraganglioma ,Positron Emission Tomography Computed Tomography ,medicine ,[SDV.MHEP.AHA]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,Humans ,Cranial Nerve Neoplasms ,ComputingMilieux_MISCELLANEOUS ,Retrospective Studies ,Paraganglioma, Extra-Adrenal ,Mutation ,PET-CT ,business.industry ,Age Factors ,Vagus Nerve ,Middle Aged ,medicine.disease ,Phenotype ,Dihydroxyphenylalanine ,3. Good health ,Vagus nerve ,Succinate Dehydrogenase ,Otorhinolaryngology ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Female ,SDHD ,Radiology ,business - Abstract
BACKGROUND: (18)F-FDOPA PET/CT was proved to be a highly sensitive imaging method for detecting head and neck paraganglioma (HNPGL). The primary aim of the study was to evaluate the relationship between tumor characteristics and the SDHx-mutational status in a large series of patients with HNPGL evaluated by (18)F-FDOPA PET/CT. METHODS: A total of 104 patients with HNPGL (65 sporadic/39 SDHx-mutated) were included. RESULTS: In comparison to SDHB/SDC/SDHx-negative cases, patients with SDHD were younger at diagnosis and had a higher rate of multifocal, vagal, and carotid paraganglioma. In patients with SDHD, vagal paraganglia represented the primary site of tumor origin. Multicentric involvement of the vagus nerve alone or in association with other locations was found to be a typical feature of SDHD cases compared to other cases (odds ratio = 59.4). CONCLUSION: The present study shows that tumor multifocality within the vagus nerve is a phenotypic marker of SDHD mutation. This information is essential in the choice of the therapeutic strategy.
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- 2018
4. Prospective comparison of 68Ga-DOTATATE and 18F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases
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Eva Beschmout, Aurélien Archier, Isabelle Morange, Arthur Varoquaux, Anderson Loundou, Anne Barlier, Carole Guerin, Karel Pacak, David Taïeb, Philippe Garrigue, Frederic Sebag, Benjamin Guillet, Marion Montava, Frederic Castinetti, Nicolas Fakhry, Sophie Gabriel, Centre de résonance magnétique biologique et médicale (CRMBM), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Centre Européen de Recherche en Imagerie médicale (CERIMED), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-École Centrale de Marseille (ECM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Centre National de la Recherche Scientifique (CNRS), HOPITAL NORD MARSEILLE - APHM - SERV RADIOPHARM, Service d'ORL, CHU Nord, Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel-Aix Marseille Université (AMU)-Université Gustave Eiffel, Centre Hospitalier Universitaire Conception (CHU Conception), Institute für arbeitsschutz deutschen gesetzlichen unfallversicherung (IFA), Aix Marseille Université (AMU), Centre de recherche en neurobiologie - neurophysiologie de Marseille (CRN2M), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de chirurgie générale et endocrinienne, Hôpital de la Timone [CHU - APHM] (TIMONE), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR)-Aix Marseille Université (AMU)-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), Physiologie, Environnement et Génétique pour l'Animal et les Systèmes d'Elevage [Rennes] (PEGASE), AGROCAMPUS OUEST-Institut National de la Recherche Agronomique (INRA), Centre National de la Recherche Scientifique (CNRS)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-École Centrale de Marseille (ECM)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Service de Radiopharmacie [Hôpital de la Timone- Hôpital Nord - APHM], and Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)- Hôpital Nord [CHU - APHM]
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Adult ,Male ,SDHB ,Adrenal Gland Neoplasms ,[SHS.PSY]Humanities and Social Sciences/Psychology ,030209 endocrinology & metabolism ,Pheochromocytoma ,030218 nuclear medicine & medical imaging ,Paraganglioma ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Positron Emission Tomography Computed Tomography ,Image Processing, Computer-Assisted ,Organometallic Compounds ,Humans ,Medicine ,False Positive Reactions ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Aged ,Aged, 80 and over ,PET-CT ,medicine.diagnostic_test ,biology ,business.industry ,Fibrous dysplasia ,General Medicine ,Middle Aged ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,medicine.disease ,biology.organism_classification ,Quality ,Dihydroxyphenylalanine ,3. Good health ,Pheos ,Positron emission tomography ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,SDHD ,business ,Nuclear medicine - Abstract
International audience; Purpose Pheochromocytomas/paragangliomas (PHEOs/PGLs) overexpress ă somatostatin receptors and recent studies have already shown excellent ă results in the localization of these tumors using Ga-68-labeled ă somatostatin analogs (Ga-68-DOTA-SSA), especially in patients with ă germline succinate dehydrogenase subunit B gene (SDHB) mutations and ă head and neck PGLs (HNPGLs). The value of Ga-68-DOTA-SSA has to be ă established in sporadic cases, including PHEOs. Thus, the aim of this ă study was to compare Ga-68-DOTATATE PET/CT, F-18-FDOPA PET/CT, and ă conventional imaging in patients with various PHEOs/PGLs with a special ă emphasis on sporadic cases, including those located in the adrenal ă gland. ă Design Ga-68-DOTATATE, F-18-FDOPA PET/CT, and conventional imaging ă (contrast-enhanced CT and MRI with MR angiography sequences) were ă prospectively performed in 30 patients (8 with SDHD mutations, 1 with a ă MAX mutation and 21 sporadic cases) with PHEO/PGL at initial diagnosis ă or relapse. ă Results The patient-based sensitivities were 93 % (28/30), 97 % ă (29/30), and 93 % (28/30) for Ga-68-DOTATATE PET/CT, F-18-FDOPA PET/CT, ă and conventional imaging, respectively. The lesion-based sensitivities ă were 93 % (43/46), 89 % (41/46), and 76 % (35/46) for Ga-68-DOTATATE ă PET/CT, F-18-FDOPA PET/CT, and conventional imaging respectively (p = ă 0.042). Ga-68-DOTATATE PET/CT detected a higher number of HNPGLs (30/30) ă than F-18-FDOPA PET/CT (26/30; p = 0.112) and conventional imaging ă (24/30; p = 0.024). Ga-68-DOTATATE PET/CT missed two PHEOs of a few ă millimeters in size and a large recurrent PHEO. One lesion was ă considered false-positive on Ga-68-DOTATATE PET/CT and corresponded to a ă typical focal lesion of fibrous dysplasia on MRI. Among the 11 lesions ă missed by conventional imaging, 7 were detected by conventional imaging ă with knowledge of the PET results (4 HNPGLs, 2 LNs, and 1 recurrent ă PHEO). ă Conclusion Ga-68-DOTATATE PET/CT is the most sensitive tool in the ă detection of HNPGLs, especially SDHD-related tumors, which may be very ă small and fail to concentrate sufficient F-18-FDOPA. The present study ă further expands the use of Ga-68-DOTATATE for all patients with HNPGLs, ă regardless of their genotype. Ga-68-DOTATATE PET/CT may be inferior to ă F-18-FDOPA PET/CT in the detection PHEOs.
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- 2015
5. Managing pain and anxiety during transabdominal chorionic villus sampling. A noninferiority randomized trial of nitrous oxide vs local anesthesia
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Xavier-Côme Donato, Edwin Quarello, Maria Katsogiannou, Marie Raffray, Brigitte Planchet-Barraud, Anderson Loundou, Eric Glowaczower, Marie-Pierre Brechard, Raoul Desbriere, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Saint-Joseph [Marseille], Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, and Service de Gynécologie-Obstétrique, Pôle Parents Enfants,Hôpital Saint-Joseph
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Adult ,Lidocaine ,Visual analogue scale ,Nitrous Oxide ,Chorionic villus sampling ,Pain ,Context (language use) ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,law ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Pregnancy ,medicine ,Humans ,Pain Management ,Local anesthesia ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,Pain Measurement ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,General Medicine ,equipment and supplies ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,Confidence interval ,3. Good health ,Chorionic Villi Sampling ,Anesthesia ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Anxiety ,Female ,medicine.symptom ,business ,medicine.drug ,Anesthesia, Local - Abstract
Introduction Transabdominal chorionic villus sampling (CVS) is an invasive procedure for prenatal diagnosis reported to be associated with anxiety and pain. In this context, the need for analgesia during CVS has been considered useful. Even though several authors have been interested in pain management during amniocentesis, no study has been published on pain reduction during CVS. Our objective was to evaluate pain and anxiety management during transabdominal CVS using nitrous oxide (N2 O) and local anesthesia. Material and methods In a randomized controlled noninferiority trial, self-administered nitrous oxide (N2 O) inhalation (equimolar premix of oxygen and nitrous oxide) was compared with local anesthesia (1% lidocaine) before CVS. Primary outcome was pain and secondary outcome was anxiety, both measured on a visual analog scale 30-60 minutes before, immediately after (5-10 minutes) and 30-60 minutes after CVS. With a statistical power of 90%, type I error of 5% and two-sided test and potential exclusions, a sample size of 96 patients per group was enrolled and randomized. No patient was enrolled before the trial registration date. Results From 13 March 2013 through 10 February 2015, 192 patients (96 per group) were screened and randomized. Most characteristics were similar across groups. Pain in the N2 O group was 2.65 ± 0.22 vs 3.32 ± 0.26 in local anesthesia group [mean ± standard error of mean (SEM)]. Mean anxiety in the N2 O group was 3.17 ± 0.27 vs 5.19 ± 0.30 in the local anesthesia group. Conclusion N2 O was as efficient and even superior to local anesthesia for both pain and anxiety reduction during CVS, as the 95% confidence intervals were both below the prespecified noninferiority margin of 0.8 and below zero.
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- 2018
6. Use of a personalized iterative score to evaluate risk of venous thromboembolism during pregnancy and puerperium
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Florence Bretelle, Caroline Rambeaud, Cécile Chau, Marine Vial, Jennifer Campagna, Anderson Loundou, Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Microbes évolution phylogénie et infections (MEPHI), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)
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medicine.medical_specialty ,Pregnancy Complications, Cardiovascular ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Pregnancy ,Risk Factors ,Prenatal Diagnosis ,medicine ,Odds Ratio ,Humans ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,Retrospective Studies ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,030219 obstetrics & reproductive medicine ,Framingham Risk Score ,Obstetrics ,business.industry ,Heparin ,Age Factors ,Obstetrics and Gynecology ,Anticoagulants ,General Medicine ,Odds ratio ,Puerperal Disorders ,Venous Thromboembolism ,medicine.disease ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,Confidence interval ,3. Good health ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Observational study ,Female ,business ,Risk assessment ,Venous thromboembolism ,Stockings, Compression - Abstract
OBJECTIVE To determine whether a personalized iterative venous thromboembolism (VTE) risk score improved preventive prophylaxis during pregnancy and puerperium. METHODS An observational retrospective comparative study was conducted at single French hospital. Women who gave birth from February 1 to April 30, 2012 (n=557) or from February 1 to April 30, 2015 (n=512) underwent VTE risk assessment. The VTE risk score comprised known risk factors for this condition. RESULTS Use of the VTE risk score at the first consultation increased the likelihood of appropriate treatment (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.2-1.9; P=0.002) and reduced the risk of undertreatment (OR 0.5, 95% CI 0.4-0.7; P
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- 2018
7. Trends in hospitalization rates for psoriasis flares since the introduction of biologics: a time series in France between 2005 and 2015
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N. Oubaya, E. Mahé, Florence Canoui-Poitrine, Emilie Sbidian, Olivier Chosidow, M. Viguier, Marie Aleth Richard, L. Polivka, Carle Paul, Nathalie Beneton, Hervé Bachelez, Marie Beylot-Barry, Jean-Luc Schmutz, Service de Dermatologie [CHU-Necker], Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de référence national des Maladies Génétiques à Expression Cutanée - National Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité d'Aide Méthodologique, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Centre de Recherches en Oncologie biologique et Oncopharmacologie (CRO2), Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de dermatologie, vénéreologie et cancérologie cutanée [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Physiopathologie du cancer du foie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Dermatologie et Allergologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de dermatologie [CH Le Mans], Centre Hospitalier Le Mans (CH Le Mans), Service de Dermatologie - Centre Hospitalier Victor Dupouy, Fédération Hospitalière de France, Hôpital Robert Debré, Centre de Preuves en Dermatologie, Epidemiology in Dermatology and Evaluation in Therapeutics (EpiDermE), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Santé Publique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, EA 7376, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Université de Toulouse (UT)
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Adult ,Male ,medicine.medical_specialty ,Databases, Factual ,Dermatology ,Severity of Illness Index ,Cohort Studies ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Psoriasis ,Inpatient stays ,Severity of illness ,medicine ,Confidence Intervals ,Prevalence ,Humans ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,Aged ,Retrospective Studies ,Series (stratigraphy) ,Biological Products ,Inpatients ,business.industry ,Medical record ,Retrospective cohort study ,Length of Stay ,Middle Aged ,medicine.disease ,Confidence interval ,Hospitalization ,Infectious Diseases ,Time and Motion Studies ,Emergency medicine ,Disease Progression ,Linear Models ,Female ,France ,business ,[SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology ,Cohort study - Abstract
Background In the late 2000s, the introduction of biologics transformed the prognosis for patients with moderate-to-severe psoriasis. We hypothesized that treatment with biologics may associate with a reduction in the hospitalization rate for psoriasis flares. Objective To analyse changes over time in the hospitalization rate for psoriasis flares. Methods We included inpatient stays in any of nine French hospitals between 2005 and 2015 for a psoriasis flare, as documented in the national inpatient database. In two centres, we also analysed data from the individual patients' electronic medical records. Results A total of 3572 stays were included. The introduction of biologics was not associated with a decrease in the number of hospitalizations for a psoriasis flare; on the contrary, we observed a non-significant increase in the number of hospitalizations (13 hospitalizations for psoriasis flares per quarter per 10 000 beds). In the two-centre study, the introduction of biologics was associated with a significant increase in the hospitalization of patients receiving topical treatments only (520 hospitalizations per year per 10 000 beds) and those with a first psoriasis flare. Conclusion The number of hospitalizations for a psoriasis flare tended to increase between 2005 and 2015. The availability of additional treatment options might have increased patient demand and/or broadened the indications in clinical practice.
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- 2018
8. Hereditary multiple exostoses of the ribs as an uncommon cause of pneumothorax
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Dumazet, Antoine, Launois, Claire, Dury, Sandra, Sailhan, Frédéric, Alifano, Marco, Dewolf, Maxime, Lebargy, François, Deslée, Gaetan, Perotin, Jeanne-Marie, Service de Médecine Respiratoire [CHU Reims], 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), Service d'orthopédie [CHU Cochin], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Service de Chirurgie thoracique [CHU Paris Centre], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Centre (CHU Paris Centre), Université de Picardie Jules Verne (UPJV), Unité d'Aide Méthodologique, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Maison Blanche, 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), Immunité Adaptative et Fonctionnalité des Barrières Biologiques - EA 4683 (IMAB), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Centre (CHU Paris Centre), and dormoy, valerian
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[SDV] Life Sciences [q-bio] ,pneumothorax ,[SDV]Life Sciences [q-bio] ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,VATS ,hereditary multiple exostoses ,costal exostosis ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience; Rationale: Hereditary multiple exostoses (HME) is a genetic musculoskeletal condition causing multiple exostoses. Rib location of exostosis can be complicated by thoracic injuries.Patient concerns and diagnoses: We report a case of pneumothorax in a 32-year-old man with a partial left-sided pneumothorax caused by an exostosis of the fourth and fifth ribs.Interventions and outcomes: Clinical and radiological presentations allowed a conservative management. A video-assisted thoracoscopic surgery was performed a few weeks later to avoid any recurrence.Lessons: Rib exostosis represents an unusual cause of pneumothorax. Any local modification of symptoms or size of the exostosis should lead to investigations in regard to chondrosarcoma transformation.
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- 2018
9. Meta-Analysis Reveals the Association Between Male Occupational Exposure to Solvents and Impairment of Semen Parameters
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Virginie Villes, I. Sari-Minodier, Anderson Loundou, Oana Ianos, Marie-Pascale Lehucher-Michel, Jeanne Perrin, Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), Centre Clinico-Biologique d’Assistance Médicale à la Procréation - CECOS [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), 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), Service de Médecine et Santé au Travail - AP-HM - La Timone, Epidémiologie et Sciences Sociales Appliquées à l'Innovation Médicale, Université de la Méditerranée - Aix-Marseille 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Unité d'Aide Méthodologique, and Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille
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Male ,Carbon disulfide ,Physiology ,Ejaculate volume ,Semen ,Aromatic hydrocarbons ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,[SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,[SDV.BDLR.RS]Life Sciences [q-bio]/Reproductive Biology/Sexual reproduction ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Occupational Exposure ,Nerchlorethylene ,Humans ,Medicine ,030212 general & internal medicine ,Glycol ethers ,[SDV.BDD.GAM]Life Sciences [q-bio]/Development Biology/Gametogenesis ,[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health ,030219 obstetrics & reproductive medicine ,Sperm Count ,business.industry ,Public Health, Environmental and Occupational Health ,Sperm ,[SDE.ES]Environmental Sciences/Environmental and Society ,3. Good health ,Semen Analysis ,N-dimethylformamide ,chemistry ,Male fertility ,Strictly standardized mean difference ,Meta-analysis ,Solvents ,Occupational exposure ,[SDV.TOX.ECO]Life Sciences [q-bio]/Toxicology/Ecotoxicology ,Solvent exposure ,business - Abstract
International audience; Objectives: Solvent exposure is among the most common occupational exposures to chemical toxicants; data about the impact of such exposure on semen parameters are contradictory. We conducted the first meta-analysis to evaluate the risk of alteration in semen parameters related to occupational exposure to solvents. Methods: From the PubMed database, we selected studies analyzing the semen of subjects occupationally exposed to solvents, compared with unexposed controls. The meta-analysis was performed on the various semen parameters analyzed in both populations. Results: Seven studies were included in the study. The meta-analysis revealed a significant decrease in ejaculate volume [standardized mean difference (SMD) ¼ À0.35 (À0.63 to À0.07)] and sperm concentration [SMD ¼ À0.36 (À0.64 to À0.08)] in workers exposed to solvents compared with unexposed controls. Conclusion: Our results highlight the importance of preventing reprotoxic risks to male fertility in the workplace.
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- 2018
10. Risk factors for death in septic shock A retrospective cohort study comparing trauma and non-trauma patients
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Coralie Vigne, Karine Baumstarck, Anderson Loundou, Emmanuelle Hammad, Marc Leone, Julie Alingrin, Laurent Zieleskiewicz, François Antonini, Gary Duclos, Sophie Medam, Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Aix Marseille Université (AMU), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, 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 des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), and COMBE, Isabelle
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Adult ,Male ,medicine.medical_specialty ,mouse model ,efficacy ,Observational Study ,030204 cardiovascular system & hematology ,comorbidities ,law.invention ,mosquito-borne diseases ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,law ,death ,Internal medicine ,Humans ,Medicine ,severe trauma ,Retrospective Studies ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,business.industry ,Septic shock ,Mortality rate ,Area under the curve ,030208 emergency & critical care medicine ,Retrospective cohort study ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Shock, Septic ,Intensive care unit ,3. Good health ,age ,Shock (circulatory) ,Cohort ,Wounds and Injuries ,septic shock ,ectoparasiticide ,Female ,France ,medicine.symptom ,Stegomyia albopicta (= Aedes albopictus) ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Research Article - Abstract
International audience; The aim of this study was to compare septic shock directly associated-mortality between severe trauma patients and nontrauma patients to assess the role of comorbidities and age. We conducted a retrospective study in an intensive care unit (ICU) (15 beds) of a university hospital (928 beds). From January 2009 to May 2015, we reviewed 2 anonymized databases including severe trauma patients and nontrauma patients. We selected the patients with a septic shock episode. Among 385 patients (318 nontrauma patients and 67 severe trauma patients), the ICU death rate was 43%. Septic shock was directly responsible for death among 35% of our cohort, representing 123 (39%) nontrauma patients and 10 (15%) trauma patients (P
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- 2017
11. Risk Factor Analysis of Bird Beak Occurrence after Thoracic Endovascular Aortic Repair
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Carine Guivier-Curien, Valérie Deplano, Y.S. Alimi, Olivier Hartung, B. Dona, Anderson Loundou, Mourad Boufi, Olivier Boiron, Institut de Recherche sur les Phénomènes Hors Equilibre (IRPHE), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM), Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel, Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, and Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)
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Adult ,Male ,Traumatic aortic rupture ,Aortic arch ,medicine.medical_specialty ,Adolescent ,Fistula ,medicine.medical_treatment ,Aorta, Thoracic ,030204 cardiovascular system & hematology ,Risk Assessment ,Thoracic aortic aneurysm ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,medicine.artery ,Stent graft ,medicine ,Humans ,Thoracic aorta ,030212 general & internal medicine ,Risk factor ,[PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph] ,Aged ,Retrospective Studies ,Aged, 80 and over ,MESH: Stent graft ,Malapposition ,Anatomy ,Proximal landing zone ,Medicine(all) ,business.industry ,Endovascular Procedures ,Stent ,Middle Aged ,medicine.disease ,Surgery ,Apposition ,Multivariate Analysis ,cardiovascular system ,Female ,Stents ,Tomography, X-Ray Computed ,business ,Cardiology and Cardiovascular Medicine - Abstract
International audience; Objectives: The aim was to analyze the role played by anatomy and stent graft in the incidence of incomplete apposition to aortic arch.Methods: Between 2007 and 2014 data including available and suitable computed tomographic angiography (CIA) imaging of patients who had undergone thoracic endovascular aortic repair were reviewed. The study included 80 patients (65 men, 54 +/- 21 years) treated for traumatic aortic rupture (n = 27), thoracic aortic aneurysm (n = 15), type B aortic dissection (n = 24), penetrating aortic ulcer (n = 5), intramural hematoma (n = 2), aorto-oesophageal fistula (n = 2), and aortic mural thrombus (n = 5). Pre- and post-operative CIA images were analyzed to characterize bird beak in terms of length and angle, and to calculate aortic angulation within a 30 mm range at the proximal deployment zone.Results: Bird beak configuration was detected in 46 patients (57%): mean stent protrusion length was 16 mm (range: 8-29 mm) and mean bird beak angle was 20 degrees (range: 7-40 degrees). The bird beak effect was significantly more frequent after traumatic aortic rupture treatment (p = .05) and in landing zone 2 (p = .01). No influence of either stent graft type or generation, or degree of oversizing was observed (p = .29, p = .28, p = .81 respectively). However, the mean aortic angle of patients with bird beak was higher in the Pro-form group than that in the Zenith TX2 group (62 degrees vs. 48 degrees, p = .13). Multivariate analysis identified the aortic angle of the deployment zone as the unique independent risk factor of malapposition (HR = 1.05, 95% Cl 1-1.10, p = .005). The cutoff value of 51 degrees was found to be predictive of bird beak occurrence with a sensitivity of 58% and a specificity of 85%.Conclusions: Assessment of proximal landing zone morphology to avoid deployment zones generating an aortic angle of over 50 degrees can be recommended to improve aortic curvature apposition with the current available device
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- 2015
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12. Examination of factors in type I endoleak development after thoracic endovascular repair
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Yves S. Alimi, Valérie Deplano, Carine Guivier-Curien, Fatma Aouini, Bianca Dona, Mourad Boufi, Anderson Loundou, Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), Institut de Recherche sur les Phénomènes Hors Equilibre (IRPHE), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel, Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Assistance Publique - Hôpitaux de Marseille (APHM), and Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)
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Male ,Time Factors ,Endoleak ,medicine.medical_treatment ,Aorta, Thoracic ,Kaplan-Meier Estimate ,Risk Factors ,Computed tomography angiography ,Aged, 80 and over ,RISK ,OUTCOMES ,medicine.diagnostic_test ,TEVAR ,Endovascular Procedures ,Hazard ratio ,Middle Aged ,3. Good health ,ARCH ,Treatment Outcome ,Cardiothoracic surgery ,DISEASES ,Female ,Stents ,Radiology ,Cardiology and Cardiovascular Medicine ,STENT-GRAFT REPAIR ,Adult ,Traumatic aortic rupture ,medicine.medical_specialty ,Adolescent ,Aortic Diseases ,Prosthesis Design ,Aortography ,Thoracic aortic aneurysm ,DISSECTIONS ,Blood Vessel Prosthesis Implantation ,Young Adult ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Blood vessel prosthesis ,medicine.artery ,medicine ,AORTIC-ANEURYSMS ,MANAGEMENT ,Humans ,[PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph] ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Aorta ,Chi-Square Distribution ,business.industry ,Stent ,medicine.disease ,Blood Vessel Prosthesis ,Surgery ,Emergencies ,Tomography, X-Ray Computed ,business ,PROXIMAL LANDING ZONE - Abstract
International audience; Objective: The objective of this study was to assess the effects of operative indication, anatomy, and stent graft on type I endoleak occurrence after thoracic endovascular aortic repair.Methods: A retrospective review was conducted of patients admitted for thoracic endovascular aortic repair between 2007 and 2013. All computed tomography angiography imaging was analyzed for the presence of endoleak and measurement of diameters and lengths. Variables studied included underlying disease, emergency, achieved aortic neck length, difference between proximal and distal neck diameters, landing zone 2, and stent graft characteristics (diameter, number, type of device, oversizing degree, and covered aorta length).Results: The study population involved 84 patients (mean age, 56 years; range, 17-94 years) who were treated for thoracic aortic aneurysm (TAA) (n = 29; 34.5%), traumatic aortic rupture (n = 27; 32%), type B aortic dissection (n = 19; 22.5%), intramural hematoma (n = 2; 2%), penetrating aortic ulcer (n = 5; 6%), and aortoesophageal fistula (n = 2; 2%). Of these, 60 patients (71.5%) were treated emergently and 24 (28.5%) electively. Primary type I endoleak was noted in eight patients (9.5%), of which two resolved spontaneously. After a mean follow-up of 32 months (range, 3-76 months), secondary type I endoleak was detected in four patients (4.5%). All of them occurred after emergent TAA treatment. Comparison between emergent and elective groups revealed no significant differences in neck length (19.5 mm vs 26.5 mm; P = .197), oversizing degree (11.1% vs 10.9%; P = .811), or endoleak rates (13.3% vs 8.3%; P = .518). Hemorrhagic shock was not predictive of endoleak (P = .483). Cox regression analysis of the different anatomic and stent graft-related factors revealed short proximal landing zone as the unique independent predictor of type I endoleak (hazard ratio, 0.89; 95% confidence interval, 0.81-0.99; P = .032).Conclusions: Endoleak risk seems not to be increased by an emergency setting. However, the relatively high rate of late endoleak observed after emergent TAA repair advocates for close follow-up, contrary to traumatic aortic rupture. Furthermore, regardless of the pathologic process, a longer proximal landing zone is likely to guarantee early and late success.
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- 2015
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13. Unexplained infertility: live-birth's prognostic factors to determine the ART management
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Blandine Courbiere, Anderson Loundou, Jeanne Perrin, Odile Paulmyer-Lacroix, Alexandra Ohannessian, Audrey Gnisci, Centre Clinico-Biologique d’Assistance Médicale à la Procréation - CECOS [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Laboratoire de Reproduction [Hôpital de la Conception AP-HM] (Centre de Reproduction Assistée), 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), and Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU)
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Adult ,Male ,Infertility ,medicine.medical_specialty ,Pregnancy Rate ,Reproductive Techniques, Assisted ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,media_common.quotation_subject ,Fertility ,Fertilization in Vitro ,Male infertility ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,Insemination, Artificial ,ComputingMilieux_MISCELLANEOUS ,Retrospective Studies ,Unexplained infertility ,media_common ,030219 obstetrics & reproductive medicine ,In vitro fertilisation ,Obstetrics ,business.industry ,Pregnancy Outcome ,Obstetrics and Gynecology ,Prognosis ,medicine.disease ,Time-to-Pregnancy ,Pregnancy rate ,Female ,Live birth ,business ,Live Birth ,030215 immunology - Abstract
BACKGROUND: The purpose of this retrospective observational study was to identify prognostic factors that lead to a live birth (LB) in couples with unexplained infertility in order to define the best assisted-reproductive technique (ART) strategy. METHODS: Prognostic factors of couples with unexplained infertility managed initially with gonadotropin intrauterine inseminations (IUI) at a single university fertility center were analyzed. Infertility was not considered “unexplained” in case of mild male infertility and suspicion of diminished ovarian reserve (FSH>10 IU/L). ART management consisted to start with IUI cycles and then, if failure, to propose in vitro fertilization (IVF). Couples were compared according to the results of IUI cycles in terms of LB. RESULTS: Between January 2011 and July 2015, 133 couples with unexplained infertility were included (320 IUI cycles). The average age of women was 31.6±4.6 years and the average number of IUI per couple was 2.4±1.2. The IUI live birth rate (LBR) was 37.6%, with an average of 2 cycles to obtain a pregnancy. For 63 couples, no pregnancy occurred after IUI cycles. The prognostic factors of the two groups “LB after IUI” vs. “no LB after IUI” were not statistically different. The remaining 20 couples had a spontaneous pregnancy with a LB. Cumulative LBR, including spontaneous and ART pregnancies, was 65.7 %. Of the 63 couples with no LB after IUI, 33.3% dropped-out from infertility treatments before starting IVF. CONCLUSIONS: To avoid couple’s drop-out, we advise to start infertility treatment for unexplained infertility with two IUI before undergoing IVF if IUI failure.
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- 2017
14. Incidence of salivary side effects after radioiodine treatment using a new specifically-designed questionnaire
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Cyrille Chossegros, Sophie Gabriel, Frederic Sebag, David Taïeb, Karine Baumstarck-Barrau, Nicolas Fakhry, Eric Moreddu, Olivier Mundler, Service d'ORL et Chirurgie Cervico-Facial, Hôpital de la Timone [CHU - APHM] (TIMONE), 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), CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Service de Chirurgie Générale et Endocrinienne [La Timone - Marseille], Service de médecine nucléaire [Marseille], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Aix Marseille Université (AMU), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Department of Nuclear Medicine, Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, and Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
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medicine.medical_specialty ,Visual Analog Scale ,[SDV]Life Sciences [q-bio] ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,030209 endocrinology & metabolism ,medicine.disease_cause ,Xerostomia ,Sialadenitis ,Cohort Studies ,Iodine Radioisotopes ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Internal medicine ,medicine ,salivary ,Humans ,Thyroid Neoplasms ,Thyroid cancer ,Thyroid neoplasm ,ComputingMilieux_MISCELLANEOUS ,business.industry ,Incidence (epidemiology) ,medicine.disease ,Dry mouth ,University hospital ,recombinant Human TSH ,3. Good health ,Surgery ,radioiodine ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Thyroid malignancy ,Oral Surgery ,medicine.symptom ,Large group ,business ,thyroid neoplasm ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Sialadenitis is one of the common complications of radioiodine treatment for thyroid malignancy. The aim of this study was to evaluate the prevalence of radioiodine-induced sialadenitis and other side effects by using a self-administered questionnaire. From 1 January 2011 to 31 December 2012 all consecutive patients with a newly-established diagnosis of thyroid cancer who were treated with adjuvant radioiodine at La Timone University Hospital were sent a self-administered questionnaire on salivary complaints that had been specifically designed for this study. A total of 413 patients sent the questionnaire back, of whom 100 (24%) had experienced pain, 116 (28%) discomfort or swelling, and 147 (36%) dry mouth or xerostomia. This survey has highlighted the number of side effects of radioiodine treatment in a large group of patients and corroborates previous observations. Our new self-administered questionnaire may be useful to others for follow-up and research.
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- 2017
15. IMPACT OF C1Q BINDING TO HLA DONOR-SPECIFIC ANTIBODIES ON THE MORTALITY AND THE DEVELOPMENT OF CHRONIC REJECTION (CLAD) IN LUNG TRANSPLANTATION
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Agnès Basire, Martine Reynaud-Gaubert, Anderson Loundou, Julie Di Cristofaro, Pascale Paule, Matthieu Pelardy, Luc Lyonnet, Coralie Frassati, Pascal Thomas, Carine Gomez, Christophe Picard, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Hôpital Nord [CHU - APHM], COMBE, Isabelle, INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, and INSB-INSB-Centre National de la Recherche Scientifique (CNRS)
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[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience; no abstract
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- 2017
16. Antenatal prognostic factor of fetal echogenic bowel
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Fabien Stenard, Pascal de Lagausie, Florence Bretelle, Nicole Philip, Pascale Hoffmann, Anderson Loundou, Pierre Mace, Isabelle Mortier, Jonathan Lopater, Marie Christine Pellissier, Sabine Sigaudy, Claude D'Ercole, M. Capelle, Thierry Merrot, Candice Ronin, Annie Levy, Service de Génétique, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Génétique Médicale et Génomique Fonctionnelle (GMGF), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), Gynépole, Aix Marseille Université (AMU)- Hôpital Nord [CHU - APHM], Babolat VS, Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Département de génétique médicale [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Obstétrique-Gynécologie [Marseille], Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille- Hôpital Nord [CHU - APHM], Biologie du Cancer et de l'Infection (BCI ), Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d’Aide à la Procréation, Département de Génétique et Procréation (CECOS), Hôpital Couple Enfant de Grenoble-CHU de Grenoble, Department of Obstetrics and Gynaecology, University Hospital of Grenoble, La Tronche, France, UMR 6578 : Anthropologie Bio-Culturelle (UAABC), Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique (CNRS), Service de Chirurgie et Radiologie Pédiatrique, Université de la Méditerranée - Aix-Marseille 2, Pédiatrie et oncologie pédiatrique [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), and Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)
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Adult ,Pediatrics ,medicine.medical_specialty ,Intrauterine growth restriction ,Gestational Age ,Ultrasonography, Prenatal ,03 medical and health sciences ,0302 clinical medicine ,Meconium ,Pregnancy ,Risk Factors ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,medicine ,Echogenic Bowel ,Humans ,030212 general & internal medicine ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Infant, Newborn ,Pregnancy Outcome ,Obstetrics and Gynecology ,Gestational age ,Retrospective cohort study ,medicine.disease ,3. Good health ,Reproductive Medicine ,Amniocentesis ,Female ,Trisomy ,business - Abstract
International audience; Objective: The aim of this study was to identify antenatal prognostic factors of neonatal outcomes in cases of fetal echogenic bowel (FEB). Study design: A retrospective study in three tertiary referral centers including fetal echogenic bowel over a 10-year period (from January 2003 to December 2013). The echogenicity of the fetal bowel was graded from 1 to 3, according to Slotnick's definition. Associated echographic findings such as bowel dilations, gallbladder abnormalities, calcifications, extra-abdominal abnormalities, intrauterine growth restriction (IUGR) and a decrease in amniotic fluid volume, if present were also recorded. This was followed by the FEB's sonographic evolution. The sonographic evolution was considered favorable if it was stable or decreasing and unfavorable if the echogenicity of the bowel increased or if additional sonographic findings appeared. Neonates had a pediatric examination in the delivery room and upon discharge from the maternity hospital. An outcome was considered good in the case of on-term delivery of a newborn with normal clinical examination and meconium elimination. Results: Complete pregnancy outcome data were available for 409 pregnancies. 338 newborns had uneventful outcomes (82.6%). Antenatal exploration diagnosed 4 cases of aneuploidy (1 case of trisomy 13, 1 case of trisomy 18 and 2 cases of triploidies), 16 cases of congenital infections, 9 cases of cystic fibrosis and 11 cases of bowel abnormalities. After a multivariate analysis, we discovered the sonographic grade of the echogenic bowel was not a prognostic factor of neonatal outcome. The isolated fetal echogenic bowel had a 6.6-fold increase chance of uneventful outcomes (adjusted odd ratio (aOR) 6.6, 95% CI 3-14.4). Notably, favorable sonographic evolution (aOR 8.1, 95% CI 4.1-16) and late gestational age at the time of the diagnosis (aOR 1.17, 95% CI 1.07-1.27) are independent, good prognostic factors of good neonatal outcomes. None of the 180 fetuses with isolated fetal echogenic bowel and favorable sonographic evolution had adverse outcomes. Among these, 4 cases (0.98%) of aneuploidy, 17 cases (4.2%) of congenital infections and 9 cases (2.2%) of cystic fibroses were also diagnosed. No cases of Down syndrome (DS) were reported. Conclusion: Our study shows that the grade should not be considered a prognostic factor of neonatal outcomes. Our data suggests the need to reevaluate the concept of systematic amniocentesis. Sonographic evolution of fetal bowel is an independent, strong prognostic factor for good neonatal outcomes. It also better defines the FEB prognostic. (C) 2017 Elsevier B.V. All rights reserved.
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- 2017
17. Guideline choice for CTG analysis influences first caesarean decision
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Nadège Vejux, Florence Bretelle, Claude D'Ercole, L. Piechon, Anderson Loundou, Renaud Ledu, Service d'Obstétrique-Gynécologie [Marseille], Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille- Hôpital Nord [CHU - APHM], Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, 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), Gynépole, Aix Marseille Université (AMU)- Hôpital Nord [CHU - APHM], and Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
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Adult ,medicine.medical_specialty ,Cardiotocography ,medicine.medical_treatment ,Clinical Decision-Making ,Decision Making ,Gestational Age ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Humans ,Medicine ,Caesarean section ,Oximetry ,030212 general & internal medicine ,Fetal Monitoring ,10. No inequality ,Retrospective Studies ,Gynecology ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Cesarean Section ,business.industry ,Obstetrics ,Reproducibility of Results ,Obstetrics and Gynecology ,Guideline ,Heart Rate, Fetal ,Hydrogen-Ion Concentration ,Practice Guidelines as Topic ,Pediatrics, Perinatology and Child Health ,Female ,France ,business ,Intrapartum Cardiotocography - Abstract
International audience; Objective: To compare intrapartum cardiotocography (CTG) analysis in case of first caesarean section (CS) for non-reassuring CTG according to international guidelines.Methods: Four ObGyns retrospectively analysed first CS for non-reassuring CTG during labour blind to neonatal outcome. CTG were analysed according to French National College of Obstetricians and Gynaecologists (CNGOF) and to the FIGO guidelines. First, CTG analysis was done without obstetrical context, then secondly, it was given. ObGyns stated if CS was justified or not. Inter-operator ObGyn agreement was analysed.Results: Among 587 CS, 100 women met the inclusion criteria with a first CS for non-reassuring CTG. The overall inter observer agreement was low but fair. ObGyns were significantly more concordant using the FIGO than the CNGOF guidelines (kappa coefficient=0.331 [0.27-0.39] versus 0.209 [0.16-0.26] p
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- 2017
18. Micronodular pattern of organizing pneumonia
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Lebargy, François, Picard, Davy, Hagenburg, Jean, Toubas, Olivier, Perotin, Jeanne-Marie, Sandu, Sebastian, Deslée, Gaetan, Dury, Sandra, Unité d'Aide Méthodologique, Hôpital Robert Debré-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 Maison Blanche, Centre Hospitalier Universitaire de Reims (CHU Reims), Immunité Adaptative et Fonctionnalité des Barrières Biologiques - EA 4683 (IMAB), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), 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)-Centre Hospitalier Universitaire de Reims (CHU Reims)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Reims Champagne-Ardenne (URCA), and dormoy, valerian
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[SDV] Life Sciences [q-bio] ,organizing pneumonia ,[SDV]Life Sciences [q-bio] ,micronodules ,computed tomography ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience; Rationale: Organizing pneumonia (OP) is a clinicopathological entity characterized by granulation tissue plugs in the lumen of small airways, alveolar ducts, and alveoli. OP can be cryptogenic (primary) (COP) or secondary to various lung injuries. Patient concerns: We report the case of a 38-year-old male smoker with COP presenting in the form of diffuse micronodules on computed tomography (CT) scan and describe the clinical, radiological, and functional characteristics of micronodular pattern of organizing pneumonia (MNOP) based on a review of the literature including 14 cases. Patients were younger (36.3 ± 15.5 years) than those with the classical form of OP. The clinical presentation was subacute in all cases with a mean duration of symptoms before admission of 14.5 ± 13.2 days. The radiological pattern was characterized by centrilobular nodules and "bud-in-tree" sign in 86.7% of patients. The diagnosis was based on histological examination of transbronchial (28.6%) or surgical biopsies (71.4%). Diagnosis: An associated condition was identified in 65% of cases and included illicit substance abuse (44.5%), myeloproliferative disease (33.5%), and infections (22%). Outcomes: Steroid therapy was effective in all patients with improvement of symptoms and documented radiologic resolution. No relapse was recorded. Lessons: MNOP should be recognized and distinguished from other diagnoses, mainly infectious bronchiolitis and disseminated tumor, as it requires early specific steroid therapy. Abbreviations: COP = cryptogenic organizing pneumonia, CT = computed tomography, MNOP = micronodular pattern of organizing pneumonia, OP = organizing pneumonia, VATS = video-assisted thoracoscopy.
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- 2017
19. T cell Polarization toward T(H)2/T(FH)2 and T(H)17/T(FH)17 in Patients with IgG4-related Disease
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S. Palat, Nathalie Costedoat-Chalumeau, Alexis Régent, François Maurier, Catherine Farnarier, Anderson Loundou, Jean-Robert Harlé, Julie Graveleau, Bernard Bonotte, Aurélie Grados, Maxime Samson, Mikael Ebbo, Benjamin Terrier, Emmanuelle Bernit, Christelle Piperoglou, Mohamed Hamidou, Nathalie Morel, Nicolas Schleinitz, Frédéric Vély, Matthieu Groh, Sylvain Audia, Amandine Forestier, Hôpital de la Timone [CHU - APHM] (TIMONE), Centre d'Immunologie de Marseille - Luminy (CIML), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Immunologie [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Centre National de la Recherche Scientifique (CNRS), Service des maladies infectieuses et tropicales, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université Paris Descartes - Paris 5 (UPD5), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Immunologie - Immunopathologie - Immunothérapeutique (I3), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de médecine interne et immunologie clinique (SOC 1) [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Laboratory of Translational Immunology [Utrecht, the Netherlands], University Medical Center [Utrecht], Service de médecine interne, Hôpital Sainte-Blandine-Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Centre hospitalier de Saint-Nazaire, Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Médecine interne A et polyclinique médicale [CHU Limoges], CHU Limoges, Aix Marseille Université (AMU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service d'Immunologie [AP-HM], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), 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), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville)-Hôpital Sainte-Blandine, Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (HOTE GREFFON), Université de Franche-Comté (UFC)-Etablissement français du sang [Bourgogne-France-Comté] (EFS [Bourgogne-France-Comté])-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), and Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )
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0301 basic medicine ,medicine.medical_treatment ,T cell ,Immunology ,plasmablasts ,Biology ,CXCR3 ,Peripheral blood mononuclear cell ,Flow cytometry ,03 medical and health sciences ,Interleukin 21 ,T helper cells ,medicine ,Immunology and Allergy ,Cytotoxic T cell ,IgG4-related disease ,B cell ,medicine.diagnostic_test ,3. Good health ,030104 developmental biology ,Cytokine ,medicine.anatomical_structure ,Sjögren’s syndrome ,T follicular helper cells ,[SDV.IMM]Life Sciences [q-bio]/Immunology - Abstract
International audience; IgG4-related disease (IgG4-RD) is a fibro-inflammatory disorder involving virtually every organ with a risk of organ dysfunction. Despite recent studies regarding B cell and T cell compartments, the disease's pathophysiology remains poorly understood. We examined and characterized subsets of circulating lymphocytes in untreated patients with active IgG4-RD. Twenty-eight consecutive patients with biopsy-proven IgG4-RD were included in a prospective, multicentric study. Lymphocyte's subsets were analyzed by flow cytometry, with analysis of T(H)1/T(H)2/T(H)17, T-FH cells, and cytokine release by peripheral blood mononuclear cells. Results were compared to healthy controls and to patients with primary Sjogren's syndrome. Patients with IgG4-RD showed an increase of circulating T regulatory, T(H)2, T(H)17, and CD4(+)CXCR5(+)PD1(+) TFH cell subsets. Accordingly, increased levels of IL-10 and IL-4 were measured in IgG-RD patients. TFH increase was characterized by the specific expansion of T(FH)2 (CCR6(-)CXCR3(-)), and to a lesser extent of (T(FH)17 (CCR6(+)CXCR3(-))) cells. Interestingly, CD4(+)CXCR5(+)PD1(+) TFH cells normalized under treatment. IgG4-RD is characterized by a shift of circulating T cells toward a T(H)2/T(FH)2 and T(H)17/T(FH)17 polarization. This immunological imbalance might be implicated in the disease's pathophysiology. Treatment regimens targeting such T cells warrant further evaluation.
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- 2017
20. Unexplained infertility: live-birth’s prognostic factors to determine the ART management
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Ohannessian, Alexandra, Loundou, Anderson, Gnisci, Audrey, Paulmyer-Lacroix, Odile, Perrin, Jeanne, Courbiere, Blandine, Centre Clinico-Biologique d’Assistance Médicale à la Procréation - CECOS [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, 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), Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), and TASSISTRO, Virginie
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[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health ,[SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,Infertility - Fertilization in vitro - Reproductive techniques ,[SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health ,[SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology ,[SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,assisted - Pregnancy ,[SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology - Abstract
International audience; BACKGROUND: The purpose of this retrospective observational study was to identify prognostic factors that lead to alive birth (LB) in couples with unexplained infertility in order to define the best assisted-reproductive technique (ART)strategy.METHODS: Prognostic factors of couples with unexplained infertility managed initially with gonadotropin intrauterineinseminations (IUI) at a single university fertility center were analyzed. Infertility was not considered “unexplained” incase of mild male infertility and suspicion of diminished ovarian reserve (FSH>10 IU/L). ART management consisted tostart with IUI cycles and then, if failure, to propose in vitro fertilization (IVF). Couples were compared according to theresults of IUI cycles in terms of LB.RESULTS: Between January 2011 and July 2015, 133 couples with unexplained infertility were included (320 IUI cycles).The average age of women was 31.6±4.6 years and the average number of IUI per couple was 2.4±1.2. The IUI livebirth rate (LBR) was 37.6%, with an average of 2 cycles to obtain a pregnancy. For 63 couples, no pregnancy occurredafter IUI cycles. The prognostic factors of the two groups “LB after IUI” vs. “no LB after IUI” were not statistically different.The remaining 20 couples had a spontaneous pregnancy with a LB. Cumulative LBR, including spontaneous andART pregnancies, was 65.7 %. Of the 63 couples with no LB after IUI, 33.3% dropped-out from infertility treatmentsbefore starting IVF.CONCLUSIONS: To avoid couple’s drop-out, we advise to start infertility treatment for unexplained infertility with twoIUI before undergoing IVF if IUI failure.
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- 2017
21. Laparoscopy could be the best approach to treat colorectal cancer in selected patients aged over 80 years: Outcomes from a multicenter study
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Brice Gayet, Jean-Marc Phelip, Xavier Roblin, David Fuks, Léa Clavel, Jack Porcheron, Leslie Rinaldi, Mehdi Ouaissi, Nicolas Williet, Anderson Loundou, Igor Sielezneff, Gabriele Barabino, Centre de Recherches en Oncologie biologique et Oncopharmacologie (CRO2), Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Service d'oncologie digestive et hépato-gastro-entérologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Department of Digestive Surgery, University Medical Hospital, Service d'Hépato-gastroentérologie [CHU Saint-Etienne], CHU Amiens-Picardie, Departement medico-chirurgical de pathologie digestive, Institut Mutualiste de Montsouris (IMM), Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)
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Male ,medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,030230 surgery ,Metastasis ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,10. No inequality ,Laparoscopy ,Survival rate ,Colectomy ,Survival analysis ,ComputingMilieux_MISCELLANEOUS ,Retrospective Studies ,Aged, 80 and over ,Hepatology ,medicine.diagnostic_test ,business.industry ,Age Factors ,Gastroenterology ,Retrospective cohort study ,Length of Stay ,medicine.disease ,Survival Analysis ,3. Good health ,Surgery ,Survival Rate ,Treatment Outcome ,Elective Surgical Procedures ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Female ,France ,Colorectal Neoplasms ,Elective Surgical Procedure ,business - Abstract
The efficacy and safety of treating elderly patients with colorectal cancer (CRC) is of concern. This study aimed to compare the short- and long-term outcomes of elective laparoscopic vs. open surgery to treat CRC in very elderly patients.All patients aged80 years and who had undergone a colectomy for CRC without metastasis between July 2005 and April 2012 were considered for inclusion. Demographic, clinical, operative, and postoperative data, plus overall and disease-free survival rates, were retrospectively collected and compared between two groups of patients that underwent an open procedure (OP group) or laparoscopy (LG).123 patients were enrolled (55 OPG, 68 LG). Median age was similar between the groups (84 vs. 83 years, respectively; NS). Duration of surgery was significantly lower in OPG (170 vs. 200min; p=0.030). Overall mortality at 3 months was 8.3%: it tended to be greater in the OPG (16.5% vs. 1.5%, NS). Morbidity was significantly greater in the OPG compared to the LG (52.7% vs. 27.5%; p=0.021), resulting in significantly longer hospital stay (12 vs. 8 days, respectively; p0.001). Pathological findings were similar between the two groups. Cumulative overall survival rates at 3 and 5 years were significantly greater after laparoscopy (85% and 72%) compared to open surgery (58.2% and 48%, respectively; p0.001).Our study suggests that laparoscopy is safe and could increase overall survival compared to open surgery in elderly patients suffering from CRC.This retrospective study compared the short- and longer-term outcomes of patients aged80 years and undergoing elective laparoscopic or open surgery for CRC between 2005 and 2012.
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- 2017
22. Diagnosis and management of idiopathic pulmonary fibrosis: French practical guidelines
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Jean-François Cordier, Philippe Carré, Romain Kessler, Nicolas Just, Bernard Aguilaniu, Serge Kouzan, François Lebargy, Philippe Delaval, Jacques Cadranel, Benoit Wallaert, Sylvain Marchand-Adam, Bruno Crestani, Dominique Valeyre, Jean-Baptiste Faivre, B. Philippe, Jean-Charles Dalphin, B. Bouquillon, Grégoire Prévot, Françoise Thivolet-Béjui, Martine Reynaud-Gaubert, B. Stach, Dominique Israel-Biet, Gilbert Ferretti, Vincent Cottin, Claire Danel, Department of Pneumology [Lyon], Hospices Civils de Lyon (HCL), Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Avicenne [AP-HP], Service de Pneumologie et Immuno-Allergologie [CHU LIlle], Pole Cardio-vasculaire et pulmonaire [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), CHU Pontchaillou [Rennes], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Strasbourg, CHU Marseille, Clinique du Mail, Opened Mind Health and Associates, Polyclinique Montréal, Partenaires INRAE, Hôpital Albert Calmette, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Cancérologie-Radiothérapie Hôpital Albert MICHALLON (CHU de Grenoble), Université Joseph Fourier - Grenoble 1 (UJF), Centre Hospitalier Victor Provo, Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Hôpital Maison Blanche, Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 (CEPR), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier René Dubos [Pontoise], Hopital Larrey, Physiopathologie et Epidemiologie de l'Insuffisance Respiratoire, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pneumologie A, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Bichat, Département Hospitalo-universtaire FIRE (Fibrosis, Inflammation and Remodeling), LabEx Inflamex, Service de Pneumologie A, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre de compétence des maladies pulmonaires rares, Service des maladies respiratoires, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Avicenne-Jean Verdier-René Muret, Interactions cellulaires tumorales et leur environnement et réponse aux agents anti-cancéreux, Université Pierre et Marie Curie - Paris 6 (UPMC), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Intergroupe Francophone de Cancérologie Thoracique [Paris] (IFCT), Intergroupe Francophone de Cancérologie thoracique, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Pneumologie, Paris, Nouvel Hôpital Civil Strasbourg, Service de chirurgie thoracique, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital nord, HYLAB : Physiologie de l'exercice et interprétation clinique, Department of Physical Education, McGill University = Université McGill [Montréal, Canada], Service d'Anatomie et cytologie pathologique, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Département de radiologie, CHU Grenoble-Hôpital Michallon, Unité d'Aide Méthodologique, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Pathologies Respiratoires : Protéolyse et Aérosolthérapie, Registre Multicentrique à Vocation Nationale des Mésothéliomes Pleuraux (MESONAT), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Hospices Civils de Lyon ( HCL ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Bichat, AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Centre de compétence des maladies pulmonaires rares, Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Avicenne-Jean Verdier-René Muret, Service de Pneumologie et Immuno-Allergologie, Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Service de pneumologie et réanimation [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Intergroupe Francophone de Cancérologie Thoracique [Paris] ( IFCT ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital nord, McGill University-Université de Montréal, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-Hôpital Michallon, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims ( CHU Reims ), Université de Tours-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre national référent cancers rares - mésothéliomes malins pleuraux et tumeurs péritonéales rares ( MESOPATH ), CHU Caen-Hôpital côte de nacre, Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Diagnostic Imaging ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pediatrics ,Consensus ,MEDLINE ,[ SDV.EE.SANT ] Life Sciences [q-bio]/Ecology, environment/Health ,03 medical and health sciences ,Idiopathic pulmonary fibrosis ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Pulmonary Medicine ,medicine ,Humans ,030212 general & internal medicine ,Idiopathic interstitial pneumonia ,Competence (human resources) ,Pulmonologists ,lcsh:RC705-779 ,[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health ,Evidence-Based Medicine ,Modalities ,Executive summary ,business.industry ,lcsh:Diseases of the respiratory system ,Evidence-based medicine ,medicine.disease ,Idiopathic Pulmonary Fibrosis ,3. Good health ,Treatment Outcome ,030228 respiratory system ,Family medicine ,France ,business - Abstract
Initiative that emanated from the French National Reference Centre and the Network of Competence Centres for Rare Lung Diseases; International audience; Idiopathic pulmonary fibrosis (IPF) is the most frequent chronic idiopathic interstitial pneumonia in adults. The management of rare diseases in France has been organised by a national plan for rare diseases, which endorsed a network of expert centres for rare diseases throughout France. This article is an overview of the executive summary of the French guidelines for the management of IPF, an initiative that emanated from the French National Reference Centre and the Network of Regional Competence Centres for Rare Lung Diseases. This review aims at providing pulmonologists with a document that: 1) combines the current available evidence; 2) reviews practical modalities of diagnosis and management of IPF; and 3) is adapted to everyday medical practice. The French practical guidelines result from the combined efforts of a coordination committee, a writing committee and a multidisciplinary review panel, following recommendations from the Haute Autorité de Santé. All recommendations included in this article received at least 90% agreement by the reviewing panel. Herein, we summarise the main conclusions and practical recommendations of the French guidelines.
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- 2014
23. Effect of driving pressure on mortality in ARDS patients during lung ă protective mechanical ventilation in two randomized controlled trials
- Author
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Jean-Marie Forel, Laurent Papazian, Louis Ayzac, Claude Guérin, Jean Reignier, Anderson Loundou, Proseva trials, Laboratoire de Géologie de Lyon - Terre, Planètes, Environnement [Lyon] (LGL-TPE), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-École normale supérieure - Lyon (ENS Lyon), 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), Medical-Surgical Intensive Care Unit, Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Service de réanimation-Détresses Respiratoires et Infections Sévères [Hôpital Nord - APHM] (DRIS), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Service de Réanimation Médicale, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France, parent, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), and Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)
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Male ,ARDS ,medicine.medical_treatment ,[SHS.PSY]Humanities and Social Sciences/Psychology ,Critical Care and Intensive Care Medicine ,law.invention ,Positive-Pressure Respiration ,Prone position ,Lung protective ventilation ,Plateau pressure ,0302 clinical medicine ,Randomized controlled trial ,law ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Hospital Mortality ,Tidal volume ,Aged, 80 and over ,Respiratory Distress Syndrome ,Univariate analysis ,Hazard ratio ,Middle Aged ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,3. Good health ,quality ,Anesthesia ,Driving pressure ,Cardiology ,Female ,Compliance ,Adult ,medicine.medical_specialty ,03 medical and health sciences ,Internal medicine ,Tidal Volume ,medicine ,Humans ,Aged ,Mechanical ventilation ,Proportional hazards model ,business.industry ,Research ,030208 emergency & critical care medicine ,medicine.disease ,Respiration, Artificial ,Neuromuscular blocking agents ,030228 respiratory system ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business - Abstract
Background Driving pressure (ΔPrs) across the respiratory system is suggested as the strongest predictor of hospital mortality in patients with acute respiratory distress syndrome (ARDS). We wonder whether this result is related to the range of tidal volume (VT). Therefore, we investigated ΔPrs in two trials in which strict lung-protective mechanical ventilation was applied in ARDS. Our working hypothesis was that ΔPrs is a risk factor for mortality just like compliance (Crs) or plateau pressure (Pplat,rs) of the respiratory system. Methods We performed secondary analysis of data from 787 ARDS patients enrolled in two independent randomized controlled trials evaluating distinct adjunctive techniques while they were ventilated as in the low VT arm of the ARDSnet trial. For this study, we used VT, positive end-expiratory pressure (PEEP), Pplat,rs, Crs, ΔPrs, and respiratory rate recorded 24 hours after randomization, and compared them between survivors and nonsurvivors at day 90. Patients were followed for 90 days after inclusion. Cox proportional hazard modeling was used for mortality at day 90. If colinearity between ΔPrs, Crs, and Pplat,rs was verified, specific Cox models were used for each of them. Results Both trials enrolled 805 patients of whom 787 had day-1 data available, and 533 of these survived. In the univariate analysis, ΔPrs averaged 13.7 ± 3.7 and 12.8 ± 3.7 cmH2O (P = 0.002) in nonsurvivors and survivors, respectively. Colinearity between ΔPrs, Crs and Pplat,rs, which was expected as these variables are mathematically coupled, was statistically significant. Hazard ratios from the Cox models for day-90 mortality were 1.05 (1.02–1.08) (P = 0.005), 1.05 (1.01–1.08) (P = 0.008) and 0.985 (0.972–0.985) (P = 0.029) for ΔPrs, Pplat,rs and Crs, respectively. PEEP and VT were not associated with death in any model. Conclusions When ventilating patients with low VT, ΔPrs is a risk factor for death in ARDS patients, as is Pplat,rs or Crs. As our data originated from trials from which most ARDS patients were excluded due to strict inclusion and exclusion criteria, these findings must be validated in independent observational studies in patients ventilated with a lung protective strategy. Trial registration Clinicaltrials.gov NCT00299650. Registered 6 March 2006 for the Acurasys trial. Clinicaltrials.gov NCT00527813. Registered 10 September 2007 for the Proseva trial. Electronic supplementary material The online version of this article (doi:10.1186/s13054-016-1556-2) contains supplementary material, which is available to authorized users.
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- 2016
24. Antibody-Dependent NK Cell Activation Is Associated with Late Kidney Allograft Dysfunction and the Complement-Independent Alloreactive Potential of Donor-Specific Antibodies
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Tristan Legris, Christophe Picard, Dilyana Todorova, Luc Lyonnet, Cathy Laporte, Chloe Dumoulin, Corinne Nicolino-Brunet, Laurent Daniel, Anderson Loundou, Sophie Morange, Stanislas Bataille, Henri Vacher Coponat, Valerie Moal, Yvon Berland, Francoise Dignat George, Stephane Burtey, Pascale Paul, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie de l'Endothelium, Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Laboratoire d'anatomie, pathologie, neuropathologie, Hôpital de la Timone [CHU - APHM] (TIMONE), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, CIC - Biotherapie - Marseille, Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Immunologie [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Centre National de la Recherche Scientifique (CNRS), This work was in part supported by translational research grants funded by the Assistance Publique des Hôpitaux de Marseille, Institut National de la Santé et de la Recherche Médicale, L’Institut National Du Cancer (INCa), and Direction Générale de l’Offre de Soins (DGOS) (Acronym FEG CO8-17, ID 2008-A00604-51, AORC MAT, Microangiopathies Thrombotiques, principal investigator: Pr G. Kaplanski). CL was supported by SATT (South East Accelerating Technology Transfer)., Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and DIGNAT-GEORGE, Françoise
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0301 basic medicine ,lcsh:Immunologic diseases. Allergy ,[SDV]Life Sciences [q-bio] ,Immunology ,kidney transplantation ,030230 surgery ,MESH: Anticoagulants ,Antibody mediated rejection ,donor-specific antibodies ,MESH: Venous Thromboembolism ,03 medical and health sciences ,Interleukin 21 ,0302 clinical medicine ,MESH: Risk Factors ,MESH: Cell-Derived Microparticles ,medicine ,Immunology and Allergy ,Cytotoxic T cell ,MESH: Animals ,MESH: Neoplasms ,MESH: Thrombosis ,Kidney transplantation ,Original Research ,Antibody-dependent cell-mediated cytotoxicity ,Lymphokine-activated killer cell ,natural killer cells ,MESH: Humans ,biology ,MESH: Thromboplastin ,natural killer (NK) cells ,medicine.disease ,MESH: Neoplasm Metastasis ,3. Good health ,[SDV] Life Sciences [q-bio] ,Transplantation ,030104 developmental biology ,MESH: Platelet Aggregation Inhibitors ,MESH: Blood Coagulation ,biology.protein ,Interleukin 12 ,antibody-mediated rejection ,MESH: Disease Progression ,Antibody ,MESH: Disease Models, Animal ,lcsh:RC581-607 ,antibody-dependent cellular cytotoxicity - Abstract
International audience; Although kidney transplantation remains the best treatment for end-stage renal failure, it is limited by chronic humoral aggression of the graft vasculature by donor-specific antibodies (DSAs). The complement-independent mechanisms that lead to the antibody-mediated rejection (ABMR) of kidney allografts remain poorly understood. Increasing lines of evidence have revealed the relevance of natural killer (NK) cells as innate immune effectors of antibody-dependent cellular cytotoxicity (ADCC), but few studies have investigated their alloreactive potential in the context of solid organ transplantation. Our study aimed to investigate the potential contribution of the antibody-dependent alloreactive function of NK cells to kidney graft dysfunction. We first conducted an observational study to investigate whether the cytotoxic function of NK cells is associated with chronic allograft dysfunction. The NK-Cellular Humoral Activation Test (NK-CHAT) was designed to evaluate the recipient and antibody-dependent reactivity of NK cells against allogeneic target cells. The release of CD107a/Lamp1(+) cytotoxic granules, resulting from the recognition of rituximab-coated B cells by NK cells, was analyzed in 148 kidney transplant recipients (KTRs, mean graft duration: 6.2 years). Enhanced ADCC responsiveness was associated with reduced graft function and identified as an independent risk factor predicting a decline in the estimated glomerular filtration rate over a 1-year period (hazard ratio: 2.83). In a second approach, we used the NK-CHAT to reveal the cytotoxic potential of circulating alloantibodies in vitro. The level of CD16 engagement resulting from the in vitro recognition of serum-coated allogeneic B cells or splenic cells was further identified as a specific marker of DSA-induced ADCC. The NK-CHAT scoring of sera obtained from 40 patients at the time of transplant biopsy was associated with ABMR diagnosis. Our findings indicate that despite the administration of immunosuppressive treatments, robust ADCC responsiveness can be maintained in some KTRs. Because it evaluates both the Fab recognition of alloantigens and Fc-driven NK cell activation, the NK-CHAT represents a potentially valuable tool for the non-invasive and individualized evaluation of humoral risk during transplantation.
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- 2016
25. Risk Factor Analysis for the Mal-Positioning of Thoracic Aortic Stent ă Grafts
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Anderson Loundou, Valérie Deplano, Y.S. Alimi, B. Dona, Olivier Boiron, Carine Guivier-Curien, Olivier Hartung, Mourad Boufi, Institut de Recherche sur les Phénomènes Hors Equilibre (IRPHE), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM), Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel, Assistance Publique - Hôpitaux de Marseille (APHM), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Unité d'Aide Méthodologique, and Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille
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Male ,Computed Tomography Angiography ,medicine.medical_treatment ,Hemodynamics ,[SHS.PSY]Humanities and Social Sciences/Psychology ,Aorta, Thoracic ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Risk Factors ,Stent graft ,Thoracic aorta ,030212 general & internal medicine ,Aged, 80 and over ,Univariate analysis ,Endovascular Procedures ,Middle Aged ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,quality ,Female ,Stents ,Anatomy ,Cardiology and Cardiovascular Medicine ,Traumatic aortic rupture ,Adult ,medicine.medical_specialty ,Adolescent ,Thoracic aortic aneurysm ,03 medical and health sciences ,Blood Vessel Prosthesis Implantation ,Young Adult ,Mal-positioning ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,medicine.artery ,medicine ,Humans ,Risk factor ,[PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph] ,Aged ,Retrospective Studies ,business.industry ,Stent ,medicine.disease ,Surgery ,Blood Vessel Prosthesis ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Calcification - Abstract
International audience; Objective: The present study aimed at quantifying mal-positioning during ă thoracic endovascular aortic repair and analysing the extent to which ă anatomical factors influence the exact stent graft positioning. ă Methods: A retrospective review was conducted of patients treated ă between 2007 and 2014 with a stent graft for whom proximal landing zones ă (LZ) could be precisely located by anatomical fixed landmarks, that is ă LZ 1, 2, or 3. The study included 66 patients (54 men; mean age 51 ă years, range 17-83 years) treated for traumatic aortic rupture (n = 27), ă type B aortic dissection (n = 21), thoracic aortic aneurysm (n = 8), ă penetrating aortic ulcer (n = 5), intramural hematoma (n = 1), and ă floating aortic thrombus (n = 4). Pharmacologic hemodynamic-control was ă systematically obtained during stent graft deployment. Pre- and ă post-operative computed tomographic angiography was reviewed to quantify ă the distance between planned and achieved LZ and to analyze different ă anatomical factors: iliac diameter, calcification degree, aortic ă angulation at the proximal deployment zone, and tortuosity index (TI). ă Results: Primary endoleak was noted in seven cases (10%): five type I ă (7%) and two type II (3%). Over a mean 35 month follow up (range 3-95 ă months), secondary endoleak was detected in two patients (3%), both ă type I, and stent graft migration was seen in three patients. ă Mal-positioning varied from 2 to 15 mm. A cutoff value of 11 mm was ă identified as an adverse event risk. Univariate analysis showed that TI ă and LZ were significantly associated with mal-positioning (p = .01, p = ă .04 respectively), and that aortic angulation tends to reach ă significance (p = .08). No influence of deployment mechanism (p = .50) ă or stent graft generation (p = .71) or access-related factors was ă observed. Multivariate analysis identified TI as the unique independent ă risk factor of mal-positioning (OR 241, 95% CI 1-6,149, p = .05). A TI ă >1.68 was optimal for inaccurate deployment prediction. ă Conclusion: TI calculation can be useful to anticipate difficulties ă during stent graft deployment and to reduce mal-positioning. (C) 2016 ă European Society for Vascular Surgery. Published by Elsevier Ltd. All ă rights reserved.
- Published
- 2016
26. Validation of the American version of the CareGiver Oncology Quality of ă Life (CarGOQoL) questionnaire
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Philip Symes, Patricia Minaya-Flores, Pascal Auquier, Anderson Loundou, Sarah C. Kaveney, Tarrah Shannon, Karine Baumstarck, Aix Marseille Université (AMU), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), and Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)
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Oncology ,Quality of life ,Adult ,Male ,medicine.medical_specialty ,Psychometrics ,Intraclass correlation ,[SHS.PSY]Humanities and Social Sciences/Psychology ,CarGOQoL ,Linguistic validation ,External validity ,03 medical and health sciences ,Social support ,0302 clinical medicine ,Cronbach's alpha ,Internal medicine ,Neoplasms ,Surveys and Questionnaires ,Validation ,medicine ,Ethnicity ,Humans ,Translations ,030212 general & internal medicine ,Cancer ,Aged ,Questionnaire ,Research ,Public Health, Environmental and Occupational Health ,Reproducibility of Results ,Linguistics ,General Medicine ,Middle Aged ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality ,United States ,Caregivers ,030220 oncology & carcinogenesis ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Metric (unit) ,Psychology ,Factor Analysis, Statistical ,Clinical psychology - Abstract
International audience; Background: The CareGiver Oncology Quality of Life (CarGOQoL) ă questionnaire, a 29-item, multidimensional, self-administered ă questionnaire, was validated using a large French sample. We reported ă the linguistic validation process and the metric validity of the English ă version of CarGOQoL in the United-States. ă Methods: The translation process consisted of 3 consecutive steps: ă forward-backward translation, acceptability testing, and cognitive ă interviews. The psychometric testing was applied to caregivers of ă consecutive patients with representative cancers who were recruited from ă the Regional Cancer Center in northwestern Pennsylvania. All individuals ă completed the CarGOQoL at baseline, day-30, and day-90. Internal ă consistency, reliability, external validity, reproducibility, and ă sensitivity to change were tested. ă Results: The translated version was validated on a total of 87 American ă cancer caregivers. The dimensions of the CarGOQoL generally demonstrated ă a high internal consistency (Cronbach's alpha > 0.70 for all but four ă domain scores). External validity testing revealed that the CarGOQoL ă index score correlated significantly with all SF-36 dimension scores ă except the physical composite score (Pearson's correlation: 0.28-0.70). ă Reproducibility was satisfactory at day-30 (intraclass correlation ă coefficient: 0.46-0.94) and day-90 (0.43-0.92). Four specific dimensions ă of CarGOQoL showed responsiveness: the Psychological well-being, the ă Relationships with health care system, the Social support and the ă Finances. ă Conclusions: The American version of the CarGOQoL constitutes a useful ă instrument to measure QoL in caregivers of cancer patients in the ă United-States.
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- 2016
27. MMPI-2 Profile of French Transsexuals: The Role of Sociodemographic and ă Clinical Factors. A cross-sectional design
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Laurent Boyer, Karine Baumstarck, Mireille Bonierbale, Audrey Gorin-Lazard, Pascal Auquier, Anderson Loundou, Christophe Lançon, Aurélie Maquigneau, Aix Marseille Université (AMU), Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), and Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)
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Adult ,Male ,Gender dysphoria ,medicine.medical_specialty ,Cross-sectional study ,media_common.quotation_subject ,[SHS.PSY]Humanities and Social Sciences/Psychology ,050109 social psychology ,Transgender Persons ,Article ,Hospitals, University ,Young Adult ,03 medical and health sciences ,Psychasthenia ,0302 clinical medicine ,Minnesota Multiphasic Personality Inventory ,MMPI ,medicine ,Humans ,Personality ,0501 psychology and cognitive sciences ,10. No inequality ,Psychiatry ,Demography ,media_common ,Multidisciplinary ,Mental Disorders ,05 social sciences ,Middle Aged ,medicine.disease ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality ,030227 psychiatry ,Transsexual ,Cross-Sectional Studies ,Socioeconomic Factors ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,France ,Personality Assessment Inventory ,Psychology ,Psychopathology - Abstract
International audience; The assessment of co-existing psychological and psychiatric disorders is ă advocated in the Standards of Care for the health of transsexual people. ă This study aimed to determine the psychopathological characteristics of ă transsexuals based on a large sample of French individuals and to ă identify whether these characteristics differed according to the ă individual's sociodemographic or clinical characteristics. The aim of ă this study was to determine the psychopathological characteristics of ă transsexuals from a large sample of French individuals and whether these ă differed by sociodemographic or clinical characteristics. This ă cross-sectional study was conducted in a French public university ă hospital. The inclusion criteria were 18 years or older, diagnosis of ă gender dysphoria, and eligibility for a standardized sex reassignment ă procedure. Personality characteristics were assessed using the Minnesota ă Multiphasic Personality Inventory 2 (MMPI-2). A total of 108 individuals ă provided a valid MMPI-2 between January 2007 and December 2010. The ă final sample had a median age of 31 years and included 54 (50%) ă Female-to-Male individuals. In multivariate models, hormonal therapy ă status was significantly related to the scales of MMPI-2 (Psychasthenia ă and Masculinity/Femininity). Personality assessment can help a ă multidisciplinary gender dysphoria team detect potential ă psychopathological factors of vulnerability.
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- 2016
28. Comparing Three Methods for Dilution Accuracy of Intravenous ă Preparations
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Renaud Vialet, Christine Dosmas, Anderson Loundou, Caroline Rios, Fabrice Michel, Réanimation Pédiatrique et Néonatale, Centre Hospitalier Universitaire Nord, Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Centre de vision numérique (CVN), and Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec
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Serial dilution ,business.industry ,Drug Compounding ,medicine.medical_treatment ,[SHS.PSY]Humanities and Social Sciences/Psychology ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality ,3. Good health ,Dilution ,03 medical and health sciences ,Medical–Surgical Nursing ,0302 clinical medicine ,030202 anesthesiology ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,medicine ,Humans ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,030212 general & internal medicine ,Infusions, Intravenous ,Nuclear medicine ,business ,Saline ,Biomedical engineering - Abstract
International audience; Purpose: Dilutions of intravenous medications may be inaccurate. The ă mixing technique may be a crucial factor. ă Design: Three factors of dilution were tested: volume for dilution ă (large vs small), method for mixing (shaking vs inversion), and number ă of maneuvers (3 times vs 10). ă Methods: Dilutions of glucose in saline solution were made by nurses, ă after a random factorial plan. The judgment criteria were the comparison ă between measured (Cmes) and expected (Cexp) concentration. ă Finding: Cmes (n = 40) ranged from 89.5% to 123.6% of Cexp and was ă more accurate when made with a large volume (98.4% of Cexp vs 106.5%) ă and when mixed by inversion (100.6% of Cexp vs 104.6%). ă Conclusions: Inversion rather than shaking and dilution in a large ă volume is a simple procedure for bedside medication preparation that ă allows better accuracy. The 3 versus 10 mixing procedures resulted in ă the same accuracy, which may be important for these time-consuming ă procedures. These results should be confirmed in clinical situations.
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- 2016
29. A Multidimensional Computerized Adaptive Short-Form Quality of Life ă Questionnaire Developed and Validated for Multiple Sclerosis The ă MusiQoL-MCAT
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Pierre Michel, Karine Baumstarck, Badih Ghattas, Jean Pelletier, Anderson Loundou, Mohamed Boucekine, Pascal Auquier, Laurent Boyer, Génétique du cancer et des maladies neuropsychiatriques (GMFC), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hépato-Gastroentérologie [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Aix Marseille Université (AMU), Institut de Mathématiques de Marseille (I2M), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-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), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Nicolle [Rouen], CHU Rouen, Université Nice Sophia Antipolis (1965 - 2019) (UNS), and COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA)
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[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[SHS.PSY]Humanities and Social Sciences/Psychology ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality - Abstract
International audience; The aim was to develop a multidimensional computerized adaptive ă short-form questionnaire, the MusiQoL-MCAT, from a fixed-length QoL ă questionnaire for multiple sclerosis. ă A total of 1992 patients were enrolled in this international ă cross-sectional study. The development of the MusiQoL-MCAT was based on ă the assessment of between-items MIRT model fit followed by real-data ă simulations. The MCAT algorithm was based on Bayesian maximum a ă posteriori estimation of latent traits and Kullback-Leibler information ă item selection. We examined several simulations based on a fixed number ă of items. Accuracy was assessed using correlations (r) between initial ă IRT scores and MCAT scores. Precision was assessed using the standard ă error measurement (SEM) and the root mean square error (RMSE). ă The multidimensional graded response model was used to estimate item ă parameters and IRT scores. Among the MCAT simulations, the 16-item ă version of the MusiQoL-MCAT was selected because the accuracy and ă precision became stable with 16 items with satisfactory levels (r >= ă 0.9, SEM
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- 2016
30. HLA-E(⁎)01:03 Allele in Lung Transplant Recipients Correlates with Higher Chronic Lung Allograft Dysfunction Occurrence
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Di Cristofaro, Julie, Pelardy, Mathieu, Loundou, Anderson, Basire, Agnès, Gomez, Carine, Chiaroni, Jacques, Thomas, Pascal, Reynaud-Gaubert, Martine, Picard, Christophe, Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Hôpital Nord [CHU - APHM], 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), Vaincre la Mucoviscidose' through Funding 'TP1008.', and Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
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lcsh:Immunologic diseases. Allergy ,Adult ,Graft Rejection ,Male ,Article Subject ,Genotype ,Graft Survival ,Histocompatibility Antigens Class I ,Middle Aged ,Allografts ,Prognosis ,Polymorphism, Single Nucleotide ,Survival Analysis ,Transplant Recipients ,Young Adult ,[SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics ,Gene Frequency ,Clinical Study ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Humans ,Female ,lcsh:RC581-607 ,Alleles ,Lung Transplantation ,Retrospective Studies - Abstract
International audience; Lung transplantation (LTx) is a valid therapeutic option for selected patients with end-stage lung disease. HLA-E seems to play a major role in the immune response to different viral infections and to affect transplantation outcome, in Hematopoietic Stem Cell Transplantation, for example. Two nonsynonymous alleles, HLA-E(⁎)01:01 and HLA-E(⁎)01:03, have functional differences, involving relative peptide affinity, cell surface expression, and potential lytic activity of NK cells. The aim of this retrospective study was to determine the impact of these two alleles for LTx recipients on anti-HLA alloimmunization risk, overall survival, and chronic rejection (CLAD). HLA-E was genotyped in 119 recipients who underwent LTx from 1998 to 2010 in a single transplantation center. In univariate analysis, both HLA-E homozygous states were associated with impaired overall survival compared to heterozygous HLA-E alleles (p = 0.01). In multivariate analysis, HLA-E(⁎)01:03 allele showed increased CLAD occurrence when compared to homozygous HLA-E(⁎)01:01 status (HR: 3.563 (CI 95%, 1.016-12), p = 0.047). HLA-E allele did not affect pathogen infection or the production of de novo DSA. This retrospective study shows an uninvestigated, deleterious association of HLA-E alleles with LTx and requires verification using a larger cohort.
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- 2016
31. Respiratory Conditions Associated with Tracheobronchomegaly (Mounier-Kuhn Syndrome): A Study of Seventeen Cases
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Hervé Dutau, François Lebargy, Levent Dalar, Bénédicte Toublanc, Stéphane Sanchez, Pierre Schmitt, Gérard Chatte, Sandra Dury, Juliette Camuset, Jean-Michel Vergnon, Laurent Cellerin, Gaëtan Deslée, Maxime Sauvage, Stéphane Jouneau, Hôpital Maison Blanche, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Service d’Oncologie Médicale Thoracique et Digestive, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Plasticité de l'épithélium respiratoire dans les conditions normales et pathologiques - UMR-S 903 (PERPMP), 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)-Centre Hospitalier Universitaire de Reims (CHU Reims)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Reims Champagne-Ardenne (URCA), Unité d'Aide Méthodologique, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), 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), and Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA)
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Pulmonary and Respiratory Medicine ,Tracheobronchomegaly ,Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Exacerbation ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,03 medical and health sciences ,0302 clinical medicine ,Bronchoscopy ,medicine ,Humans ,030212 general & internal medicine ,Respiratory system ,Age of Onset ,Respiratory Tract Infections ,Aged ,Retrospective Studies ,Tracheobronchomalacia ,Bronchiectasis ,business.industry ,Reflux ,Stent ,Retrospective cohort study ,Middle Aged ,medicine.disease ,3. Good health ,030228 respiratory system ,Pulmonary Emphysema ,Gastroesophageal Reflux ,Female ,business ,Tomography, X-Ray Computed - Abstract
Background: Mounier-Kuhn syndrome (MKS) is a rare disorder characterized by enlargement of the trachea and main bronchi and associated with recurrent respiratory tract infections. Objective: This multicenter, retrospective study was carried out to describe respiratory conditions associated with tracheobronchomegaly. Methods: Nine institutions involved in the ‘Groupe d'Endoscopie de Langue Française' (GELF) participated in this study. A standard form was used to record patient characteristics, treatments and follow-up from medical charts. Results: Seventeen patients, 53% male, aged 58 ± 18 years at diagnosis were included. Recurrent infections revealed MKS in 88% of cases. Main comorbid conditions were diffuse bronchiectasis in 88% of patients and tracheobronchomalacia in 67% of cases. The exacerbation rate was 1.5 exacerbations/patient/year. The main non-respiratory morbid condition was gastroesophageal reflux disease in 29% of cases. Interventional bronchoscopy was performed in seven patients (41%), consisting of laser (n = 2) and tracheal stenting (n = 5). Complications related to stents were observed in 80% of cases with a mean stent duration of 8 months. Four deaths, including three due to respiratory causes, occurred during follow-up. Conclusions: This is the largest series of MKS reported in the literature, showing that bronchiectasis and tracheobronchomalacia are the main associated morbid conditions that constitute a challenge for treatment.
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- 2016
32. The Prevalence of Mental Disorders Among Children and Adolescents in the Child Welfare System: A Systematic Review and Meta-Analysis
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Guillaume Fond, Laurent Boyer, Anderson Loundou, Marine Alessandrini, Sylvie Tordjman, Pascal Auquier, Guillaume Bronsard, Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), INSERM U955, équipe 15, Service de psychiatrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil]-Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Service Psychiatrie de l'Enfant et de l'Adolescent, CHU Pontchaillou [Rennes]-Centre Hospitalier Guillaume Régnier [Rennes]-CHS (Centre Hospitalier Spécialisé lutte Maladies Mentales), Audition (Psychophysique, Modélisation, Neurosciences) (APMN), Laboratoire des systèmes perceptifs (LSP), Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Département d'Etudes Cognitives - ENS Paris (DEC), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS), Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Réseau de coopération scientifique en santé mentale, Centre National de la Recherche Scientifique (CNRS)-Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS Paris)-École normale supérieure - Paris (ENS Paris)-Centre National de la Recherche Scientifique (CNRS)-Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS Paris)-École normale supérieure - Paris (ENS Paris), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants ( SPMC ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil]-Institut Mondor de Recherche Biomédicale ( IMRB ), Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10, Assistance Publique - Hôpitaux de Marseille ( APHM ) -CHU Marseille, Audition (Psychophysique, Modélisation, Neurosciences) ( APMN ), Laboratoire des systèmes perceptifs, Département d'Etudes Cognitives - ENS Paris ( DEC ), École normale supérieure - Paris ( ENS Paris ) -École normale supérieure - Paris ( ENS Paris ) -Centre National de la Recherche Scientifique ( CNRS ) -Département d'Etudes Cognitives - ENS Paris ( DEC ), École normale supérieure - Paris ( ENS Paris ) -École normale supérieure - Paris ( ENS Paris ) -Centre National de la Recherche Scientifique ( CNRS ), Centre méditérannéen de médecine moléculaire ( C3M ), Université Nice Sophia Antipolis ( UNS ), and Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )
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[ SDV.MHEP.PSM ] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[SHS.PSY]Humanities and Social Sciences/Psychology ,0302 clinical medicine ,Epidemiology ,Prevalence ,[ SHS.ECO ] Humanities and Social Sciences/Economies and finances ,030212 general & internal medicine ,Child ,education.field_of_study ,Mental Disorders ,05 social sciences ,[ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie ,General Medicine ,16. Peace & justice ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality ,Anxiety Disorders ,3. Good health ,Observational Studies as Topic ,Conduct disorder ,Meta-analysis ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Anxiety ,medicine.symptom ,050104 developmental & child psychology ,Research Article ,Conduct Disorder ,medicine.medical_specialty ,Adolescent ,Population ,MEDLINE ,Child Welfare ,[ SHS.PSY ] Humanities and Social Sciences/Psychology ,03 medical and health sciences ,Prevalence of mental disorders ,medicine ,Humans ,0501 psychology and cognitive sciences ,Psychiatry ,education ,Depressive Disorder ,business.industry ,medicine.disease ,Confidence interval ,Attention Deficit Disorder with Hyperactivity ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Meta-Analysis of Observe Studies In Epidemiology - Abstract
Supplemental Digital Content is available in the text, It remains unclear whether children and adolescents in the child welfare system (CWS) exhibit a higher prevalence of mental disorders compared with the general population. The objective of this study was to perform a systematic review and meta-analysis to assess the prevalence of mental disorders in the CWS. All of the epidemiological surveys assessing the prevalence of mental disorders in children and adolescents in the CWS were included. The pooled prevalence was estimated with random effect models. Potential sources of heterogeneity were explored using meta-regression analyses. Eight studies provided prevalence estimates that were obtained from 3104 children and adolescents. Nearly 1 child or adolescent of every 2 (49%; 95% confidence interval (CI) 43–54) was identified as meeting criteria for a current mental disorder. The most common mental disorder was disruptive disorder (27%; 95% CI 20–34), including conduct disorder (20%; 95% CI 13–27) and oppositional defiant disorder (12%; 95% CI 10–14). The prevalence of attention-deficit/hyperactivity disorder was estimated to be 11% (95% CI 6–15). The prevalence estimates of anxiety and depressive disorders were 18% (95% CI 12–24) and 11% (95% CI 7–15). Posttraumatic stress disorder had the lowest prevalence (4%; 95% CI 2–6). High prevalences of mental disorders in the CWS were reported, which highlights the need for the provision of qualified service. The substantial heterogeneity of our findings is indicative of the need for accurate epidemiological data to effectively guide public policy.
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- 2016
33. Reduction of self-perceived discomforts in critically ill patients in ă French intensive care units: study protocol for a cluster-randomized ă controlled trial
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Pascal Auquier, Maité Garrouste-Orgeas, Olivier Mimoz, Julien Amour, Karine Baumstarck, Elie Azoulay, Nathalie Revel, Pierre Kalfon, Isabelle Villard, Tarek Sharshar, Marie-Agnès Geantot, Claude Martin, Anderson Loundou, Hôpital Louis Pasteur [Chartres], Service d'anesthésie réanimation [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Pharmacologie des anti-infectieux (PHAR), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epidémiologie pronostique des cancers et affections graves, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service médical des soins intensifs [CHU Raymond Poincaré], Hôpital Raymond Poincaré [AP-HP], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Aix Marseille Université (AMU), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Modélisations pharmacocinétiques-pharmacodynamiques pour un meilleur usage des anti-infectieux, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP], Hopital Saint Louis Paris, CHU Saint Louis [APHP], AP-HP Hôpital Raymond Poincaré [Garches], and Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)
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Adult ,medicine.medical_specialty ,Endpoint Determination ,Critical Illness ,Psychological intervention ,Medicine (miscellaneous) ,[SHS.PSY]Humanities and Social Sciences/Psychology ,law.invention ,Study Protocol ,03 medical and health sciences ,0302 clinical medicine ,Clinical Protocols ,Randomized controlled trial ,law ,Intervention (counseling) ,Intensive care ,Critical care nursing ,Health care ,Clinical endpoint ,Humans ,Medicine ,Intensive care unit ,Single-Blind Method ,Pharmacology (medical) ,030212 general & internal medicine ,business.industry ,Data Collection ,IPREA ,030208 emergency & critical care medicine ,Discomfort assessment ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality ,Self Concept ,3. Good health ,Critical care ,Intensive Care Units ,Cluster ,Data Interpretation, Statistical ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Emergency medicine ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business - Abstract
International audience; Background: It is now well documented that critically ill patients are ă exposed to stressful conditions and experience discomforts from multiple ă sources. Improved identification of the discomforts of patients in ă intensive care units (ICUs) may have implications for managing their ă care, including consideration of ethical issues, and may assist ă clinicians in choosing the most appropriate interventions. The primary ă objective of this study was to assess the effectiveness of a ă multicomponent program of discomfort reduction in critically ill ă patients. The secondary objectives were to assess the sustainability of ă the impact of the program and the potential seasonality effect. ă Methods/design: We conducted a multicenter, cluster-randomized, ă controlled, single (patient)-blind study involving 34 French adult ICUs. ă The experimental intervention was a 6-month period during which the ă multicomponent program was implemented in the ICU and included the ă following steps: identification of discomforts, immediate feedback to ă the healthcare team, and implementation of targeted interventions. The ă control intervention was a 6-month period during which any program was ă implemented. The primary endpoint was the monthly overall score of ă self-reported discomfort from the French questionnaire on discomforts in ă ICU patients (IPREA). The secondary endpoints were the scores of the ă discomfort items of IPREA. The sample size was 660 individuals to obtain ă 80 % power to detect a 25 % difference in the overall discomfort score ă of IPREA between the two groups (design effect: 2.9). ă Discussion: The results of this cluster-randomized controlled study are ă expected to confirm that a multicomponent program of discomfort ă reduction may be a new strategy in the management of care for critically ă ill patients.
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- 2016
34. Effectiveness of pure argon for renal transplant preservation in a preclinical pig model of heterotopic autotransplantation
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Julia Torrents, Eric Lechevallier, Yves Jammes, Stéphane Berdah, Guy Magalon, Emmanuel Fenouillet, Tristan Legris, Jean Guillaume Steinberg, Matthieu Chalopin, Anderson Loundou, Alice Faure, Laurie Bruzzese, Emmanuelle Garnier, Régis Guieu, Institut des Sciences de la Terre (ISTerre), Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR)-Institut national des sciences de l'Univers (INSU - CNRS)-Institut de recherche pour le développement [IRD] : UR219-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Etudes et recherche (SER / Bpi), Bibliothèque publique d'information, Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Hôpital Nord [CHU - APHM], Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Laboratoire de microbiologie des environnements extrêmophiles (LM2E), Centre National de la Recherche Scientifique (CNRS)-Université de Brest (UBO)-Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER), Service de chirurgie de la main, chirurgie plastique et réparatrice des membres, Assistance Publique - Hôpitaux de Marseille (APHM), Neurobiologie des interactions cellulaires et neurophysiopathologie - NICN (NICN), Centre National de la Recherche Scientifique (CNRS)-Université de la Méditerranée - Aix-Marseille 2, FUI (Fonds Unique Interministeriel) : FRESHORGANS, Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER)-Université de Brest (UBO)-Centre National de la Recherche Scientifique (CNRS), and Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique (CNRS)
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Transplantation, Heterotopic ,Xenon ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Sus scrofa ,030232 urology & nephrology ,Organ preservation ,Diuresis ,Context (language use) ,Disaccharides ,Antioxidants ,General Biochemistry, Genetics and Molecular Biology ,Kidney transplantation ,Electrolytes ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Glutamates ,medicine ,Noble gas ,Animals ,Histidine ,Mannitol ,Argon ,Cold‑storage solution ,Medicine(all) ,Inflammation ,Creatinine ,Biochemistry, Genetics and Molecular Biology(all) ,Research ,Air ,Graft Survival ,Epithelial Cells ,General Medicine ,Cold-storage solution ,medicine.disease ,Ascorbic acid ,Glutathione ,Autotransplantation ,Nephrectomy ,Transplantation ,chemistry ,Ischaemia–reperfusion injury ,Anesthesia ,Models, Animal ,Reperfusion ,Female ,030217 neurology & neurosurgery - Abstract
Background In kidney transplantation, the conditions of organ preservation following removal influence function recovery. Current static preservation procedures are generally based on immersion in a cold-storage solution used under atmospheric air (approximately 78 kPa N2, 21 kPa O2, 1 kPa Ar). Research on static cold-preservation solutions has stalled, and modifying the gas composition of the storage medium for improving preservation was considered. Organoprotective strategies successfully used noble gases and we addressed here the effects of argon and xenon on graft preservation in an established preclinical pig model of autotransplantation. Methods The preservation solution Celsior saturated with pure argon (Argon-Celsior) or xenon (Xenon-Celsior) at atmospheric pressure was tested versus Celsior saturated with atmospheric air (Air-Celsior). The left kidney was removed, and Air-Celsior (n = 8 pigs), Argon-Celsior (n = 8) or Xenon-Celsior (n = 6) was used at 4 °C to flush and store the transplant for 30 h, a duration that induced ischemic injury in our model when Air-Celsior was used. Heterotopic autotransplantation and contralateral nephrectomy were performed. Animals were followed for 21 days. Results The use of Argon-Celsior vs. Air-Celsior: (1) improved function recovery as monitored via creatinine clearance, the fraction of excreted sodium and tubulopathy duration; (2) enabled diuresis recovery 2–3 days earlier; (3) improved survival (7/8 vs. 3/8 pigs survived at postoperative day-21); (4) decreased tubular necrosis, interstitial fibrosis, apoptosis and inflammation, and preserved tissue structures as observed after the natural death/euthanasia; (5) stimulated plasma antioxidant defences during the days following transplantation as shown by monitoring the “reduced ascorbic acid/thiobarbituric acid reactive substances” ratio and Hsp27 expression; (6) limited the inflammatory response as shown by expression of TNF-alpha, IL1-beta and IL6 as observed after the natural death/euthanasia. Conversely, Xenon-Celsior was detrimental, no animal surviving by day-8 in a context where functional recovery, renal tissue properties and the antioxidant and inflammation responses were significantly altered. Thus, the positive effects of argon were not attributable to the noble gases as a group. Conclusions The saturation of Celsior with argon improved early functional recovery, graft quality and survival. Manipulating the gas composition of a preservation medium constitutes therefore a promising approach to improve preservation. Electronic supplementary material The online version of this article (doi:10.1186/s12967-016-0795-y) contains supplementary material, which is available to authorized users.
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- 2016
35. Bilobectomy for lung cancer: contemporary national early morbidity and mortality outcomes
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Anderson Loundou, Françoise Le Pimpec-Barthes, Pascal Thomas, Jacques Jougon, Pierre-Emmanuel Falcoz, Gilbert Massard, Laurent Brouchet, Alain Bernard, Marcel Dahan, Epithor Grp, 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), CHU Strasbourg, Service de chirurgie cardio-vasculaire et thoracique (CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de chirurgie thoracique [AP-HP HEGP, Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), 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 en Communications et en Cybernétique de Nantes ( IRCCyN ), Mines Nantes ( Mines Nantes ) -École Centrale de Nantes ( ECN ) -Ecole Polytechnique de l'Université de Nantes ( Polytech Nantes ), Université de Nantes ( UN ) -Université de Nantes ( UN ) -PRES Université Nantes Angers Le Mans ( UNAM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ), Institut des Maladies Métaboliques et Cardiovasculaires ( I2MC ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, and Assistance Publique - Hôpitaux de Marseille ( APHM ) -CHU Marseille
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Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Operative Time ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Bilobectomy ,Pneumonectomy ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Carcinoma, Non-Small-Cell Lung ,Medicine ,Humans ,Prospective Studies ,Lung cancer ,Aged ,2. Zero hunger ,Performance status ,business.industry ,Thoracic Surgery, Video-Assisted ,General Medicine ,Odds ratio ,Middle Aged ,Pleural Diseases ,medicine.disease ,Confidence interval ,3. Good health ,Surgery ,[ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Treatment Outcome ,Cardiothoracic surgery ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,Female ,Bronchial Fistula ,France ,Cardiology and Cardiovascular Medicine ,business ,Body mass index - Abstract
23rd European Conference on General Thoracic Surgery, Lisbon, PORTUGAL, MAY 31-JUN 03, 2015; International audience; To determine contemporary early outcomes associated with bilobectomy for lung cancer and to identify their predictors using a nationally representative general thoracic surgery database. A total of 1831 patients, who underwent elective bilobectomy for primary lung cancer between 1 January 2004 and 31 December 2013, were selected. Logistic regression analysis was performed on variables for major adverse events. There were 670 upper and 1161 lower bilobectomies. Video-assisted thoracic surgery was seldom performed (2%). Induction therapy and extended resection were performed in 293 (16%) and 279 patients (15.2%), respectively. Operative mortality was 4.8% (upper: 4.5%/lower: 5%; P = 0.62), and significantly higher following extended procedures when compared with standard bilobectomy (4.3 vs 7.5%; P = 0.013). Pulmonary complication rate was 21.1%. Bronchial fistula occurred in 46 patients (2.5%) and pleural space complications in 296 (16.2%). Their respective incidence rates were significantly higher following lower than upper bilobectomy (3.5 vs 0.7%; P < 0.001 and 17.8 vs 13.3%; P = 0.007). At multivariate analysis, extended procedures [odds ratio (OR), 2.3; 95% confidence interval (CI), 1.03-5.31; P = 0.04], ASA scores of 3 or greater (OR, 2.02; 95% CI, 1.33-3.07; P < 0.001) and World Health Organization performance status 2 or greater (OR, 1.47; 95% CI, 1.01-2.13; P = 0.04) were risk predictors of mortality. Female gender (OR, 0.39; 95% CI, 0.19-0.80; P = 0.01), highest body mass index (BMI) values (OR, 0.91; 95% CI, 0.86-0.96; P = 0.001) and recent years of surgery (OR, 0.91; 95% CI, 0.84-0.99; P = 0.02) were protective. Predictors of bronchial fistula were male gender, lowest BMI values, lower bilobectomy and longest operative times. Male gender, lowest BMI values and longest operative times were also predictors of pulmonary complications, together with highest ASA scores and lowest forced expiratory volume in 1 s values. Risks related to lower bilobectomy lie halfway between those reported for lobectomy and pneumonectomy. Additional surgical measures to prevent pleural space complications and bronchial fistula should be encouraged with this operation. In contrast, upper bilobectomy shares more or less the same hazards as lobectomy.
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- 2016
36. Bilobectomy for lung cancer: contemporary national early morbidity and ă mortality outcomes
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Thomas , Pascal A., Falcoz , Pierre-Emmanuel, Bernard , Alain, Le Pimpec-Barthes , Françoise, Jougon , Jacques, Brouchet , Laurent, Massard , Gilbert, Dahan , Marcel, Loundou , Anderson, Grp , EPITHOR, 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), CHU Strasbourg, Service de chirurgie thoracique [AP-HP HEGP, Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse], Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), 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 en Communications et en Cybernétique de Nantes ( IRCCyN ), Mines Nantes ( Mines Nantes ) -École Centrale de Nantes ( ECN ) -Ecole Polytechnique de l'Université de Nantes ( Polytech Nantes ), Université de Nantes ( UN ) -Université de Nantes ( UN ) -PRES Université Nantes Angers Le Mans ( UNAM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ), Institut des Maladies Métaboliques et Cardiovasculaires ( I2MC ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier ( UPS ), and Assistance Publique - Hôpitaux de Marseille ( APHM ) -CHU Marseille
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[ SHS.PSY ] Humanities and Social Sciences/Psychology ,[ SDV.MHEP.PSM ] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[ SHS.ECO ] Humanities and Social Sciences/Economies and finances ,[SHS.PSY]Humanities and Social Sciences/Psychology ,[ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality - Abstract
23rd European Conference on General Thoracic Surgery, Lisbon, PORTUGAL, ă MAY 31-JUN 03, 2015; International audience; To determine contemporary early outcomes associated with bilobectomy for ă lung cancer and to identify their predictors using a nationally ă representative general thoracic surgery database. ă A total of 1831 patients, who underwent elective bilobectomy for primary ă lung cancer between 1 January 2004 and 31 December 2013, were selected. ă Logistic regression analysis was performed on variables for major ă adverse events. ă There were 670 upper and 1161 lower bilobectomies. Video-assisted ă thoracic surgery was seldom performed (2%). Induction therapy and ă extended resection were performed in 293 (16%) and 279 patients ă (15.2%), respectively. Operative mortality was 4.8% (upper: ă 4.5%/lower: 5%; P = 0.62), and significantly higher following extended ă procedures when compared with standard bilobectomy (4.3 vs 7.5%; P = ă 0.013). Pulmonary complication rate was 21.1%. Bronchial fistula ă occurred in 46 patients (2.5%) and pleural space complications in 296 ă (16.2%). Their respective incidence rates were significantly higher ă following lower than upper bilobectomy (3.5 vs 0.7%; P < 0.001 and 17.8 ă vs 13.3%; P = 0.007). At multivariate analysis, extended procedures ă [odds ratio (OR), 2.3; 95% confidence interval (CI), 1.03-5.31; P = ă 0.04], ASA scores of 3 or greater (OR, 2.02; 95% CI, 1.33-3.07; P < ă 0.001) and World Health Organization performance status 2 or greater ă (OR, 1.47; 95% CI, 1.01-2.13; P = 0.04) were risk predictors of ă mortality. Female gender (OR, 0.39; 95% CI, 0.19-0.80; P = 0.01), ă highest body mass index (BMI) values (OR, 0.91; 95% CI, 0.86-0.96; P = ă 0.001) and recent years of surgery (OR, 0.91; 95% CI, 0.84-0.99; P = ă 0.02) were protective. Predictors of bronchial fistula were male gender, ă lowest BMI values, lower bilobectomy and longest operative times. Male ă gender, lowest BMI values and longest operative times were also ă predictors of pulmonary complications, together with highest ASA scores ă and lowest forced expiratory volume in 1 s values. ă Risks related to lower bilobectomy lie halfway between those reported ă for lobectomy and pneumonectomy. Additional surgical measures to prevent ă pleural space complications and bronchial fistula should be encouraged ă with this operation. In contrast, upper bilobectomy shares more or less ă the same hazards as lobectomy.
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- 2016
37. Differential Diagnosis of Meningeal SFT-HPC and Meningioma Which ă Immunohistochemical Markers Should Be Used?
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Dominique Figarella-Branger, Alexandre Vasiljevic, Anderson Loundou, Corinne Bouvier, Nicolas Macagno, Anne Jouvet, Philippe Metellus, Karima Mokthari, Centre de Recherches en Oncologie biologique et Oncopharmacologie (CRO2), Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Hospices Civils de Lyon (HCL), Service de Pathologie, Hospices Civils de Lyon (HCL)-Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Ecosystèmes lagunaires : organisation biologique et fonctionnement (ECOLAG), and Université Montpellier 2 - Sciences et Techniques (UM2)-Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER)-Centre National de la Recherche Scientifique (CNRS)
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0301 basic medicine ,Solitary fibrous tumor ,Pathology ,medicine.medical_specialty ,Biopsy ,CD34 ,[SHS.PSY]Humanities and Social Sciences/Psychology ,Antigens, CD34 ,Biology ,Aldehyde Dehydrogenase 1 Family ,Pathology and Forensic Medicine ,Meningioma ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,medicine ,Biomarkers, Tumor ,Meningeal Neoplasms ,Humans ,Meningeal Neoplasm ,Receptors, AMPA ,Hemangiopericytoma ,Tissue microarray ,integumentary system ,Retinal Dehydrogenase ,medicine.disease ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Immunohistochemistry ,Quality ,3. Good health ,Isoenzymes ,030104 developmental biology ,Tissue Array Analysis ,030220 oncology & carcinogenesis ,Solitary Fibrous Tumors ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,embryonic structures ,Surgery ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Anatomy ,Differential diagnosis ,Neoplasm Grading ,STAT6 Transcription Factor - Abstract
International audience; Meningeal solitary fibrous tumors-hemangiopericytomas (SFT-HPC) and ă meningiomas can be difficult to distinguish on histologic examination. ă STAT6 immunohistochemistry (IHC) is a reliable diagnostic marker of ă SFT-HPCs. Recently, GRIA2 has also been reported to be a diagnostic ă marker of SFT-HPC, although no extensive data are available for ă meningeal SFT-HPCs yet. The aim of this study was to test their ă diagnostic performance in a large cohort of SFT-HPCs and meningiomas. ă IHC analyses for GRIA2 and STAT6 were performed on tissue microarrays ă containing 76 SFT-HPCs and 181 meningiomas. Results were compared with ă previous data with ALDH1 and CD34. Two different anti-STAT6 antibodies ă were tested: SC-20 polyclonal and YE361 monoclonal antibody. Ninety-six ă percent of meningeal SFT-HPCs but no meningioma displayed nuclear STAT6 ă positivity. With SC-20 antibody, concomitant cytoplasmic staining for ă STAT6 was observed in > 50% of all cases, including meningiomas. ă However, using YE361 antibody, cytoplasmic staining was absent, and ă nuclear signal intensity was stronger leading to better interpretation ă of STAT6 IHC. GRIA2 was positive in 84% of SFT-HPCs and in 16% of ă meningiomas. STAT6 had excellent sensitivity (96%) and specificity ă (100%), ALDH1 and GRIA2 had same sensitivity (84%), but ALDH1 and CD34 ă had better specificity than GRIA2 (97% and 96% vs. 84%, ă respectively). For the differential diagnosis of SFT-HPCs versus ă meningiomas, the best diagnostic approach is to perform STAT6, followed ă by ALDH1 and CD34 in the case of uncommon STAT6-negative cases. Because ă of meningioma positivity, GRIA2 seems less useful in this indication.
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- 2016
38. Single- vs double-unit cord blood transplantation for children and young adults with acute leukemia or myelodysplastic syndrome
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Mohamad Mohty, Fanny Rialland, Patrick Lutz, Karine Baumstarck, Anderson Loundou, Sophie Esmiol, Charlotte Jubert, Claire Galambrun, Ibrahim Yakoub-Agha, Mauricette Michallet, Didier Blaise, Cécile Pochon, Anne Sirvent, Jean-Hugues Dalle, Gérard Michel, Claire Oudin, Bénédicte Bruno, Virginie Gandemer, Aude Marie-Cardine, Vanderson Rocha, Mylène Seux, Noel Milpied, Cecile Renard, Pédiatrie et oncologie pédiatrique [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service d'Hématologie pédiatrique, Hôpital de la Timone, Marseille, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Institut Gustave Roussy (IGR), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, 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), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Service de pédiatrie, CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pontchaillou [Rennes], Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Service d’Hématologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'Hématologie Clinique [Nantes], Hôpital Hôtel Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'hématologie pédiatrique, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Stress Cellulaire, Université de la Méditerranée - Aix-Marseille 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Chimie Provence (LCP), Université de Provence - Aix-Marseille 1-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU), Service d'Hématologie [Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d'investigation clinique en cancérologie (CI2C), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Churchill Hospital, Churchill Hospital Oxford Centre for Haematology, Eurocord, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Diderot - Paris 7 (UPD7), France Monacord, Centre Scientifique de Monaco (CSM), Hôpital Robert Debré Paris, Hôpital Robert Debré, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), and Centre National de la Recherche Scientifique (CNRS)-Université de Provence - Aix-Marseille 1-Institut de Chimie du CNRS (INC)
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Male ,Transplantation Conditioning ,[SHS.PSY]Humanities and Social Sciences/Psychology ,Graft vs Host Disease ,Biochemistry ,Gastroenterology ,0302 clinical medicine ,Child ,Acute leukemia ,Leukemia ,Hematology ,Total body irradiation ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality ,3. Good health ,Survival Rate ,surgical procedures, operative ,030220 oncology & carcinogenesis ,Child, Preschool ,Acute Disease ,Female ,Cord Blood Stem Cell Transplantation ,Whole-Body Irradiation ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Immunology ,Disease-Free Survival ,03 medical and health sciences ,Young Adult ,Internal medicine ,medicine ,Humans ,Survival rate ,Antilymphocyte Serum ,business.industry ,Myelodysplastic syndromes ,Cell Biology ,medicine.disease ,Surgery ,Transplantation ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Myelodysplastic Syndromes ,Chronic Disease ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Busulfan ,030215 immunology - Abstract
Transplantation of 2 unrelated cord blood (UCB) units instead of 1 has a been proposed to increase the cell dose. We report a prospective a randomized study, designed to compare single-vs double-UCB a transplantation in children and young adults with acute leukemia in a remission or myelodysplasia. Eligible patients had at least two 4-6 a HLA-identical UCBs with >3x10(7) nucleated cells/kg for the first and a >1.5x10(7) for the second. The primary end point was the 2-year a cumulative incidence of transplantation strategy failure, a composite a end point including transplant-related mortality (TRM), engraftment a failure, and autologous recovery. Randomized patients who did not a proceed to transplantation due to refractory disease were considered a transplantation failures. A total of 151 patients were randomized and a included in the intent-to-treat analysis; 137 were transplanted. a Double-UCB transplantation did not decrease transplantation strategy a failure (23.4% 6 4.9% vs 14.9% +/- 4.2%). Two-year posttransplant a survival, disease-free survival, and TRM were 68.8% +/- 6.0%, 67.6% a +/- 6.0%, and 5.9% +/- 2.9% after single-unit transplantation a compared with 74.8% +/- 5.5%, 68.1% +/- 6.0%, and 11.6% +/- 3.9% a after double-unit transplantation. The final relapse risk did not a significantly differ, but relapses were delayed after double-unit a transplantation. Overall incidences of graft-versus-host disease (GVHD) a were similar, but chronic GVHD was more frequently extensive after a double-UCB transplantation (31.9% +/- 5.7% vs 14.7% +/- 4.3%, a P=.02). In an exploratory subgroup analysis, we found a significantly a lower relapse risk after double-unit transplantation in patients a receiving total body irradiation without antithymocyte globulin (ATG), a whereas the relapse risk was similar in the group treated with busulfan, a cyclophosphamide, and ATG. Single-UCB transplantation with adequate cell a dose remains the standard of care and leads to low TRM. Double-unit a transplantation should be reserved for patients who lack such units. a This trial was registered at www. clinicaltrials. gov as #NCT01067300.
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- 2016
39. Improving access and continuity of care for homeless people: how could ă general practitioners effectively contribute? Results from a mixed study
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Anderson Loundou, Alexandre Daguzan, Gaëtan Gentile, Hubert Balique, Roland Sambuc, Stéphanie Gentile, Dominique Grassineau, Maeva Jego, Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), and ASL Salerno
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Male ,[SHS.PSY]Humanities and Social Sciences/Psychology ,0302 clinical medicine ,PRIMARY CARE ,general practitioners ,Surveys and Questionnaires ,Health care ,Medicine ,030212 general & internal medicine ,Qualitative Research ,Social work ,1. No poverty ,Health services research ,Loneliness ,General Medicine ,Continuity of Patient Care ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality ,homeless people ,3. Good health ,Ill-Housed Persons ,Female ,France ,medicine.symptom ,General practice / Family practice ,0305 other medical science ,Psychosocial ,mixed methods ,Attitude of Health Personnel ,Qualitative property ,03 medical and health sciences ,Nursing ,Humans ,Physician-Patient Relations ,030505 public health ,Primary Health Care ,business.industry ,Research ,Cross-Sectional Studies ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,access to health care ,Observational study ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Qualitative research - Abstract
International audience; Objectives: To analyse the views of general practitioners (GPs) about ă how they can provide care to homeless people (HP) and to explore which ă measures could influence their views. ă Design: Mixed-methods design (qualitative -> quantitative ă (cross-sectional observational) -> qualitative). Qualitative data were ă collected through semistructured interviews and through questionnaires ă with closed questions. Quantitative data were analysed with descriptive ă statistical analyses on SPPS; a content analysis was applied on ă qualitative data. ă Setting: Primary care; views of urban GPs working in a deprived area in ă Marseille were explored by questionnaires and/or semistructured ă interview. ă Participants: 19 GPs involved in HP's healthcare were recruited for ă phase 1 (qualitative); for phase 2 (quantitative), 150 GPs who provide ă routine healthcare ('standard' GPs) were randomised, 144 met the ă inclusion criteria and 105 responded to the questionnaire; for phase 3 ă (qualitative), data were explored on 14 `standard' GPs. ă Results: In the quantitative phase, 79% of the 105 GPs already treated ă HP. Most of the difficulties they encountered while treating HP ă concerned social matters (mean level of perceived difficulties=3.95/5, ă IC 95 (3.74 to 4.17)), lack of medical information (mn=3.78/5, IC 95 ă (3.55 to 4.01)) patient's compliance (mn=3.67/5, IC 95 (3.45 to 3.89)), ă loneliness in practice (mn=3.45/5, IC 95 (3.18 to 3.72)) and time ă required for the doctor (mn=3.25, IC 95 (3 to 3.5)). From qualitative ă analysis we understood that maintaining a stable follow-up was a major ă condition for GPs to contribute effectively to the care of HP. Acting on ă health system organisation, developing a medical and psychosocial ă approach with closer relation with social workers and enhancing the ă collaboration between tailored and non-tailored programmes were also ă other key answers. ă Conclusions: If we adapt the conditions of GPs practice, they could ă contribute to the improvement of HP's health. These results will enable ă the construction of a new model of primary care organisation aiming to ă improve access to healthcare for HP.
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- 2016
40. A Bayesian framework systematic review and meta-analysis of anesthetic ă agents effectiveness/tolerability profile in electroconvulsive therapy ă for major depression
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Laurent Boyer, Jean-Arthur Micoulaud-Franchi, Pascal Auquier, Pierre-Michel Llorca, Djamila Bennabi, Guillaume Fond, Emmanuel Haffen, Anderson Loundou, Christophe Lançon, Lore Brunel, Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Sommeil, Attention et Neuropsychiatrie [Bordeaux] ( SANPSY ), Université de Bordeaux ( UB ) -CHU de Bordeaux Pellegrin [Bordeaux]-Centre National de la Recherche Scientifique ( CNRS ), Services d’explorations fonctionnelles du système nerveux, clinique du sommeil, CHU Bordeaux [Bordeaux], Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille ( APHM ) -CHU Marseille, Pôle de Psychiatrie 'Solaris', Service Pr. Naudin, Centre Hospitalier Universitaire de Sainte-Marguerite, Service de psychiatrie adulte - B, CHU Clermont-Ferrand, Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants ( SPMC ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ), Centre méditérannéen de médecine moléculaire ( C3M ), Université Nice Sophia Antipolis ( UNS ), Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), INSERM U955, équipe 15, Service de psychiatrie, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil]-Institut Mondor de Recherche Biomédicale ( IMRB ), Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10, Sommeil, Attention et Neuropsychiatrie [Bordeaux] (SANPSY), Université de Bordeaux (UB)-CHU de Bordeaux Pellegrin [Bordeaux]-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier-Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil]-Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Sommeil, Addiction et Neuropsychiatrie [Bordeaux] (SANPSY), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre National de la Recherche Scientifique (CNRS)-CHU de Bordeaux Pellegrin [Bordeaux]-Université de Bordeaux (UB)
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medicine.medical_treatment ,[ SDV.MHEP.PSM ] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[SHS.PSY]Humanities and Social Sciences/Psychology ,Article ,03 medical and health sciences ,[ SHS.PSY ] Humanities and Social Sciences/Psychology ,0302 clinical medicine ,Electroconvulsive therapy ,Seizures ,medicine ,Humans ,[ SHS.ECO ] Humanities and Social Sciences/Economies and finances ,Ketamine ,Electroconvulsive Therapy ,Adverse effect ,Depression (differential diagnoses) ,Anesthetics ,Randomized Controlled Trials as Topic ,Depressive Disorder, Major ,Multidisciplinary ,business.industry ,Bayes Theorem ,Electroencephalography ,[ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality ,030227 psychiatry ,3. Good health ,Tolerability ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Methohexital ,Anesthesia ,Meta-analysis ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Propofol ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
International audience; The aim of this study was to assess the efficacy and ă tolerability/acceptability of 6 anesthetic agents in ECT for depressive ă disorders. We systematically reviewed 14 double-blind randomized ă controlled trials (610 participants). Efficacy was measured by the mean ă scores on validated depression scales at 6 ECT (or the nearest score if ă not available), number of responders at the end of treatment and seizure ă duration. The acceptability was measured by the proportion of patients ă who dropped out of the allocated treatment, and the tolerability by the ă number of serious adverse events and post-treatment cognition ă assessment. After excluding the trials responsible for heterogeneity, ă depression scores of patients who were administered methohexital were ă found to be significantly more improved than those who received propofol ă (p = 0.001). On the contrary, those who were administered propofol had ă lower depression scores than those with thiopental at the end of ă treatment (p = 0.002). Compared to propofol, methohexital was found to ă be significantly associated with higher seizure duration (p = 0.018). No ă difference was found for the acceptability profile (all p > 0.05). In ă summary, ketamine and methohexital may be preferred to propofol or ă thiopental in regard of effectiveness in depression scores and increased ă seizure duration. Further studies are warranted to compare ketamine and ă methohexital.
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- 2016
41. Tracheobronchial Involvement of Rosai–Dorfman Disease
- Author
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Boissière, Louis, Patey, Martine, Toubas, Olivier, Vella-Boucaud, Juliette, Perotin-Collard, Jeanne-Marie, Deslée, Gaetan, Lebargy, François, Dury, Sandra, Centre Hospitalier Universitaire de Reims (CHU Reims), Plasticité de l'épithélium respiratoire dans les conditions normales et pathologiques - UMR-S 903 (PERPMP), 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)-Centre Hospitalier Universitaire de Reims (CHU Reims)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Reims Champagne-Ardenne (URCA), Immunité Adaptative et Fonctionnalité des Barrières Biologiques - EA 4683 (IMAB), Université de Reims Champagne-Ardenne (URCA)-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), CHU de Bordeaux Pellegrin [Bordeaux], Laboratoire d’anatomie et cytologie pathologique, Hôpital Robert Debré, CHU de Reims, Service de Médecine Respiratoire [CHU Reims], Hôpital Maison Blanche, 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), Unité d'Aide Méthodologique, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), and dormoy, valerian
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Aged, 80 and over ,[SDV]Life Sciences [q-bio] ,Respiratory Mucosa ,respiratory system ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Radiography ,Trachea ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Humans ,Female ,Clinical Case Report ,Histiocytosis, Sinus ,ComputingMilieux_MISCELLANEOUS ,Research Article - Abstract
International audience; Rosai-Dorfman Disease (RDD) is a rare non-neoplastic entity, also known as sinus histiocytosis with massive lymphadenopathy (SHML), characterized by a benign proliferation of histiocytes in lymph nodes. Localized forms of RDD involving the tracheobronchial tree are very rare. There is no consensus regarding the management of central airway forms and recurrence is frequent. We report the case of an 81-year-old Caucasian woman admitted in 2014 for chronic cough. Her main medical past history included a diagnosis of sinonasal RDD in 1996 with recurrent obstructive rhinosinusitis requiring repeated sinonasal surgery, and a diagnosis of tracheal RDD in 2010 with 2 asymptomatic smooth lesions (5 and 7 mm) on the anterior tracheal wall. Physical examination was normal in 2014. Pulmonary function tests showed an obstructive pattern. Computed tomographic scan revealed a mass arising from the anterior wall of the trachea that projects into the tracheal lumen. Fiberoptic bronchoscopy showed a hypervascular multilobular lesion (2 cm) arising from the anterior tracheal wall and causing 50% obstruction of the tracheal lumen. Mechanical resection with electrocoagulation of the tracheal mass was performed by rigid bronchoscopy with no complication. Histological examination demonstrated tracheal RDD. One year after endotracheal resection, the patient presented no recurrence of cough and the obstructive pattern had resolved. Reports on tracheobronchial involvement are scarce. Symptomatic tracheobronchial obstruction requires mechanical resection by rigid bronchoscopy or surgery. Recurrence is frequent, justifying long-term follow-up
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- 2016
42. Age-related hearing loss in individuals and their caregivers: Effects of coping on the quality of life among the dyads
- Author
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Valérie Aghababian, Sébastien Lazzarotto, Anderson Loundou, Zeinab Hamidou, Tanguy Leroy, Pascal Auquier, Karine Baumstarck, Greps, Laboratoire, Aix Marseille Université (AMU), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), 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), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Aix Marseille Université ( AMU ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -CHU Marseille, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants ( SPMC ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ), Centre de résonance magnétique biologique et médicale ( CRMBM ), and Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Centre National de la Recherche Scientifique ( CNRS )
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Gerontology ,Coping (psychology) ,caregivers ,Hearing loss ,[ SDV.MHEP.PSM ] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,media_common.quotation_subject ,Medicine (miscellaneous) ,[SHS.PSY]Humanities and Social Sciences/Psychology ,Social psychology ,[SHS.PSY] Humanities and Social Sciences/Psychology ,[ SHS.PSY ] Humanities and Social Sciences/Psychology ,03 medical and health sciences ,0302 clinical medicine ,Optimism ,Quality of life ,[ SHS.ECO ] Humanities and Social Sciences/Economies and finances ,Medicine ,030223 otorhinolaryngology ,Pharmacology, Toxicology and Pharmaceutics (miscellaneous) ,age-related hearing impairment ,ComputingMilieux_MISCELLANEOUS ,media_common ,Original Research ,lcsh:R5-920 ,business.industry ,Family caregivers ,Health Policy ,Avoidance coping ,[ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,3. Good health ,coping ,Mood ,Patient Preference and Adherence ,Health ,030220 oncology & carcinogenesis ,dyads ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Quality of Life ,Anxiety ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,emotional status ,medicine.symptom ,lcsh:Medicine (General) ,business ,Social Sciences (miscellaneous) - Abstract
Sébastien Lazzarotto,1,2 Karine Baumstarck,1 Anderson Loundou,1 Zeinab Hamidou,1,3 Valérie Aghababian,1 Tanguy Leroy,1,4 Pascal Auquier1 1EA 3279, Self-Perceived Health Assessment Research Unit, School of Medicine, Aix Marseille Université, 2French Regional Institute for Prevention of Aging, Marseille, 3National Clinical Research Quality of Life in Oncology Platform, Marseille, 4Social Psychology Research Group (GRePS EA 4163), Université Lumière Lyon 2, Bron, France Objectives: Age-related hearing loss (ARHL) impacts the daily living and quality of life (QoL) of affected individuals and the functioning of family caregivers. In the specific context of voluntary medical checkups, we examined sample dyads (ARHL individual and the caregiver) to determine whether QoL of patients and caregivers is influenced by coping strategies implemented either by themselves or their relatives.Methods: This was a cross-sectional study with a descriptive/correlative design performed in a French preventive health center (Regional Institute for Prevention of Aging, Marseille, France) for the beneficiaries of pension funds of private sector employees. The samples included beneficiary–caregiver dyads. The beneficiaries had bilateral (mild to moderately severe) ARHL. Self-reported data were collected as follows: QoL using the World Health Organization Quality of Life questionnaire, coping strategies using the Brief Coping Orientation to Problems Experienced Scale, and anxiety and mood using visual analog scales.Results: The final sample comprised 44 beneficiaries and 44 caregivers. The caregiver was the partner of the beneficiary in 73% of cases. The QoL scores of the social dimension were significantly lower for beneficiaries and caregivers compared with French age- and sex-matched controls. Among beneficiaries and caregivers, coping strategies based on problem solving were the most commonly used strategies. The use of positive thinking strategies was associated with higher QoL scores. The more one member of the dyad used an avoidance coping strategy, the more the other member used a positive thinking strategy.Conclusion: This study emphasizes that QoL of individuals with age-related hearing impairment and their natural caregivers is related to the coping strategies that they use. This finding suggests that targeted interventions should be offered to help individuals who experience emotional difficulties to implement more efficient coping strategies. Keywords: age-related hearing impairment, caregivers, dyads, quality of life, coping, emotional status 
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- 2016
43. HLA-E*01:03 Allele in Lung Transplant Recipients Correlates with ă Higher Chronic Lung Allograft Dysfunction Occurrence
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Julie Di Cristofaro, Mathieu Pelardy, Anderson Loundou, Agnès Basire, Carine Gomez, Jacques Chiaroni, Pascal Thomas, Martine Reynaud-Gaubert, Christophe Picard, Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, and Hôpital Nord [CHU - APHM]
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[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Quality of Life ,[SHS.PSY]Humanities and Social Sciences/Psychology ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance - Abstract
International audience; Lung transplantation (LTx) is a valid therapeutic option for selected ă patients with end-stage lung disease. HLA-E seems to play a major role ă in the immune response to different viral infections and to affect ă transplantation outcome, in Hematopoietic Stem Cell Transplantation, for ă example. Two nonsynonymous alleles, HLA-E*01:01 and HLA-E*01: 03, ă have functional differences, involving relative peptide affinity, cell ă surface expression, and potential lytic activity of NK cells. The aim of ă this retrospective study was to determine the impact of these two ă alleles for LTx recipients on anti-HLA alloimmunization risk, overall ă survival, and chronic rejection (CLAD). HLA-E was genotyped in 119 ă recipients who underwent LTx from 1998 to 2010 in a single ă transplantation center. In univariate analysis, both HLA-E homozygous ă states were associated with impaired overall survival compared to ă heterozygous HLA-E alleles (p = 0.01). In multivariate analysis, ă HLA-E*01:03 allele showed increased CLAD occurrence when compared to ă homozygous HLA-E*01:01 status (HR: 3.563 (CI 95%, 1.016-12), p = ă 0.047). HLA-E allele did not affect pathogen infection or the production ă of de novo DSA. This retrospective study shows an uninvestigated, ă deleterious association of HLA-E alleles with LTx and requires ă verification using a larger cohort.
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- 2016
44. Intra- and interobserver agreement among obstetric experts in court regarding the review of abnormal fetal heart rate tracings and obstetrical management
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Anderson Loundou, Xavier Carcopino, Florence Bretelle, Renaud Le Dû, Laura Sabiani, Claude D'Ercole, Léon Boubli, Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Service d'Obstétrique-Gynécologie [Marseille], Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille- Hôpital Nord [CHU - APHM], 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), Gynépole, Aix Marseille Université (AMU)- Hôpital Nord [CHU - APHM], Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], 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), and INSB-INSB-Centre National de la Recherche Scientifique (CNRS)
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Adult ,Clinical audit ,Pediatrics ,medicine.medical_specialty ,Abnormal fetal heart rate ,Cerebral palsy ,Patient Admission ,Pregnancy ,Intensive Care Units, Neonatal ,medicine ,Humans ,Partogram ,Fetal Monitoring ,Retrospective Studies ,Observer Variation ,Clinical Audit ,business.industry ,Obstetrics ,Malpractice ,Infant, Newborn ,Obstetrics and Gynecology ,Retrospective cohort study ,Heart Rate, Fetal ,Hydrogen-Ion Concentration ,Middle Aged ,Delivery, Obstetric ,Fetal Blood ,medicine.disease ,Respiration, Artificial ,Fetal heart rate ,Apgar Score ,Female ,Apgar score ,France ,[SDE.BE]Environmental Sciences/Biodiversity and Ecology ,business - Abstract
International audience; OBJECTIVE: The objective of the study was to evaluate the intra-and interobserver agreement among obstetric experts in court regarding the retrospective review of abnormal fetal heart rate tracings and obstetrical management of patients with abnormal fetal heart rate during labor. STUDY DESIGN: A total of 22 French obstetric experts in court reviewed 30 cases of term deliveries of singleton pregnancies diagnosed with at least 1 hour of abnormal fetal heart rate, including 10 cases with adverse neonatal outcome. The experts reviewed all cases twice within a 3-month interval, with the first review being blinded to neonatal outcome. For each case reviewed, the experts were provided with the obstetric data and copies of the complete fetal heart rate recording and the partogram. The experts were asked to classify the abnormal fetal heart rate tracing and to express whether they agreed with the obstetrical management performed. When they disagreed, the experts were asked whether they concluded that an error had been made and whether they considered the obstetrical management as the cause of cerebral palsy in children if any. RESULTS: Compared with blinded review, the experts were significantly more likely to agree with the obstetric management performed (P \textless .001) and with the mode of delivery (P \textless .001) when informed about the neonatal outcome and were less likely to conclude that an error had been made (P \textless .001) or to establish a link with potential cerebral palsy (P = .003). The experts' intraobserver agreement for the review of abnormal fetal heart rate tracing and obstetrical management were both mediocre (kappa = 0.46-0.51 and kappa = 0.48-0.53, respectively). The interobserver agreement for the review of abnormal fetal heart rate tracing was low and was not improved by knowledge of the neonatal outcome (kappa = 0.11-0.18). The interobserver agreement for the interpretation of obstetrical management was also low (kappa = 0.08-0.19) but appeared to be improved by knowledge of the neonatal outcome (kappa = 0.15-0.32). CONCLUSION: The intra-and interobserver agreement among obstetric experts in court for the review of abnormal fetal heart rate tracing and the appropriateness of obstetrical care is poor, suggesting a lack of objectivity of obstetrical expertise as currently performed in court.
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- 2015
45. Prognostic Impact of CD133 mRNA Expression in 48 Glioblastoma Patients Treated with Concomitant Radiochemotherapy: A Prospective Patient Cohort at a Single Institution
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Olivier Chinot, Aurelie Tchogandjian, Marylin Barrie, Anderson Loundou, Carole Colin, Isabelle Nanni-Metellus, Dominique Figarella-Branger, Philippe Metellus, L'Houcine Ouafik, Béma Coulibaly, Christine Delfino, Frédéric Fina, Département de Neurochirurgie [CHU Timone], Hôpital de la Timone [CHU - APHM] (TIMONE), Centre de Recherches en Oncologie biologique et Oncopharmacologie (CRO2), Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Transfert d'Oncologie Biologique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Service d'Anatomie Pathologique et de Neuropathologie, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Département de neurooncologie, Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Aix Marseille Université (AMU), and Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)
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Male ,Oncology ,Pathology ,Stem cell marker ,Cohort Studies ,0302 clinical medicine ,Surgical oncology ,Medicine ,AC133 Antigen ,Prospective Studies ,Prospective cohort study ,ComputingMilieux_MISCELLANEOUS ,0303 health sciences ,education.field_of_study ,Brain Neoplasms ,Reverse Transcriptase Polymerase Chain Reaction ,Chemoradiotherapy ,Middle Aged ,3. Good health ,Dacarbazine ,Survival Rate ,Treatment Outcome ,030220 oncology & carcinogenesis ,embryonic structures ,Female ,medicine.drug ,Adult ,medicine.medical_specialty ,Population ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Real-Time Polymerase Chain Reaction ,03 medical and health sciences ,Antigens, CD ,Cancer stem cell ,Internal medicine ,Biomarkers, Tumor ,Temozolomide ,Humans ,RNA, Messenger ,education ,Antineoplastic Agents, Alkylating ,neoplasms ,Survival rate ,Aged ,Glycoproteins ,Neoplasm Staging ,030304 developmental biology ,business.industry ,Surgery ,Glioblastoma ,Peptides ,business ,Follow-Up Studies - Abstract
Cancer stem cells are thought to represent the population of tumorigenic cells responsible for tumor development. The CD133 antigen has been described as a putative stem cell marker in malignant brain tumor that could identify such a tumorigenic population in a subset of glioblastoma. To date, the correlation between CD133 expression in primary glioblastoma and patient prognosis is not clearly established. To address this question we investigated the relationship between CD133 mRNA expression and patient outcome in a glioblastoma patient cohort.The quantitative expression of CD133 stem cell antigen mRNA using real-time QRT-PCR was assessed in a cohort of 48 consecutive primary glioblastoma patients treated by chemoradiation with temozolomide.On multivariate survival analysis, high CD133 mRNA expression was a significant (P = 0.007) prognostic factor for adverse progression-free and overall survival independent of extent of resection (P = 0.012) and MGMT methylation status (P = 0.002). Patient age was also an independent prognosticator of overall survival (P = 0.037). Furthermore, according to the conjoined expression of CD133 mRNA and MGMT status, the patients were categorized into 3 groups with homogenous prognosis.These findings constitute conclusive evidence that the measurement of the mRNA expression of CD133 stem cell antigen actually impacts the survival of GBM patients.
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- 2011
46. How to interpret multidimensional quality of life questionnaires for patients with schizophrenia?
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Pierre Michel, Laurent Boyer, Karine Baumstarck, Christophe Lançon, Anderson Loundou, Badih Ghattas, Pascal Auquier, PSA Peugeot - Citroën (PSA), PSA Peugeot Citroën (PSA), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Institut de Mathématiques de Marseille (I2M), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), 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)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Adult ,Male ,Depression scale ,Global Assessment of Functioning ,Bootstrap analysis ,Quality of life ,Surveys and Questionnaires ,medicine ,Cluster Analysis ,Humans ,Clinical significance ,Cluster analysis ,ComputingMilieux_MISCELLANEOUS ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Positive and Negative Syndrome Scale ,Public Health, Environmental and Occupational Health ,medicine.disease ,humanities ,Cross-Sectional Studies ,Schizophrenia ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Quality of Life ,Female ,Psychology ,Clinical psychology - Abstract
The classification of patients into distinct categories of quality of life (QoL) levels may be useful for clinicians to interpret QoL scores from multidimensional questionnaires. The aim of this study had been to define clusters of QoL levels from a specific multidimensional questionnaire (SQoL18) for patients with schizophrenia by using a new method of interpretable clustering and to test its validity regarding socio-demographic, clinical, and QoL information. In this multicentre cross-sectional study, patients with schizophrenia have been classified using a hierarchical top-down method called clustering using unsupervised binary trees (CUBT). A three-group structure has been employed to define QoL levels as “high”, “moderate”, or “low”. Socio-demographic, clinical, and QoL data have been compared between the three clusters to ensure their clinical relevance. A total of 514 patients have been analysed: 78 are classified as “low”, 265 as “moderate”, and 171 as “high”. The clustering shows satisfactory statistical properties, including reproducibility (using bootstrap analysis) and discriminancy (using factor analysis). The three clusters consistently differentiate patients. As expected, individuals in the “high” QoL level cluster report the lowest scores on the Positive and Negative Syndrome Scale (p = 0.01) and the Calgary Depression Scale (p
- Published
- 2015
47. Plasma Xanthine Oxidase Activity Is Predictive of Cardiovascular Disease in Patients with Chronic Kidney Disease, Independently of Uric Acid Levels
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Noémie Jourde-Chiche, Claire Cerini, Laetitia Dou, Anderson Loundou, Bertrand Gondouin, Yvon Berland, Bertrand Dussol, Sophie Morange, Régis Guieu, Marion Sallée, Stéphane Burtey, Philippe Brunet, Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Physiopathologie de l'Endothelium, Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Assistance Publique - Hôpitaux de Marseille (APHM), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
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Adult ,Male ,medicine.medical_specialty ,Xanthine Oxidase ,Antioxidant ,medicine.medical_treatment ,Kaplan-Meier Estimate ,urologic and male genital diseases ,medicine.disease_cause ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,End stage renal disease ,chemistry.chemical_compound ,Adenosine deaminase ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Predictive Value of Tests ,Renal Dialysis ,Risk Factors ,Internal medicine ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,Renal Insufficiency, Chronic ,Xanthine oxidase ,Aged ,Aged, 80 and over ,Super oxide dismutase ,biology ,business.industry ,Middle Aged ,medicine.disease ,3. Good health ,Uric Acid ,Oxidative Stress ,Endocrinology ,chemistry ,Cardiovascular Diseases ,Purines ,biology.protein ,Uric acid ,Female ,business ,Oxidation-Reduction ,Oxidative stress ,Kidney disease ,Follow-Up Studies - Abstract
Background: Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality. Oxidative stress seems to play a pivotal role in this process, and purine metabolism may be involved in CKD-related oxidative stress. Xanthine oxidase (XO) is an enzyme involved in purine metabolism and is also responsible for the production of reactive oxygen species. Methods: This prospective study aimed to analyze the relation between plasma dosages of molecules involved in redox balance, purine metabolism and cardiovascular events in patients with non-diabetic CKD stages 3-5 or on chronic hemodialysis (HD). CKD (n = 51) and HD (n = 50) patients were compared to matched healthy controls (n = 38) and followed-up for 3 years. Results: Both CKD and HD patients had decreased plasma levels of antioxidants (selenium, zinc, vitamin C). HD patients had decreased levels of the antioxidant enzyme superoxide dismutase and increased levels of oxidation products (ischemia-modified albumin, malondialdehyde [MDA]). The following substrates and enzymes involved in purine metabolism were increased in the HD cohort: adenosine, adenosine deaminase and the pro-oxidant XO. XO activity was negatively correlated with super oxide dismutase and positively with MDA. Interestingly, XO activity was an independent predictor of cardiovascular events in CKD and HD patients, regardless of uric acid levels. Uric acid was not predictive of events. Conclusion: This highlights a possible role of XO itself in CKD-related cardiovascular disease (CVD) and raises the hypothesis that beneficial effects observed with XO inhibitors on CVD in CKD may also be due to the reduction of oxidative stress.
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- 2015
48. Delay of airway epithelial wound repair in COPD is associated with airflow obstruction severity
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Juliette Vella-Boucaud, Gaëtan Deslée, Philippe Birembaut, Anne-Carole Jonvel, Gonzague Delepine, A. Prevost, Damien Adam, Jeanne-Marie Perotin, Sebastian Sandu, François Lebargy, Gérard Berthiot, Christophe Pison, Christelle Coraux, 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), Service de Médecine Respiratoire [CHU Reims], Centre Hospitalier Universitaire de Reims (CHU Reims), Institut Jean Godinot [Reims], UNICANCER, Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF), Centre Hospitalier Universitaire [Grenoble] (CHU), Unité d'Aide Méthodologique, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Dynamique cellulaire et moléculaire de la muqueuse respiratoire, Université de Reims Champagne-Ardenne (URCA)-IFR53-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Maison Blanche, and grant from the University Hospital of Reims (Appel d’Offre Local 2011)
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Male ,Pathology ,Time Factors ,[SDV]Life Sciences [q-bio] ,Gastroenterology ,Severity of Illness Index ,Pulmonary function testing ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Prospective Studies ,Prospective cohort study ,Cells, Cultured ,Cell proliferation ,Aged, 80 and over ,0303 health sciences ,COPD ,respiratory system ,Middle Aged ,Pathophysiology ,3. Good health ,Matrix Metalloproteinase 9 ,Pulmonary Emphysema ,Airway Remodeling ,Cytokines ,Matrix Metalloproteinase 2 ,Female ,Inflammation Mediators ,Wound repair ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Airway epithelium ,Bronchi ,03 medical and health sciences ,Internal medicine ,Severity of illness ,medicine ,Humans ,Bronchial cells ,Bronchiolar cells ,030304 developmental biology ,Aged ,Wound Healing ,business.industry ,Research ,Epithelial Cells ,medicine.disease ,respiratory tract diseases ,030228 respiratory system ,Respiratory epithelium ,business ,Airway ,Wound healing ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Background Airway epithelium integrity is essential to maintain its role of mechanical and functional barrier. Recurrent epithelial injuries require a complex mechanism of repair to restore its integrity. In chronic obstructive pulmonary disease (COPD), an abnormal airway epithelial repair may participate in airway remodeling. The objective was to determine if airway epithelial wound repair of airway epithelium is abnormal in COPD. Methods Patients scheduled for lung resection were prospectively recruited. Demographic, clinical data and pulmonary function tests results were recorded. Emphysema was visually scored and histological remodeling features were noted. Primary bronchial epithelial cells (BEC) were extracted and cultured for wound closure assay. We determined the mean speed of wound closure (MSWC) and cell proliferation index, matrix metalloprotease (MMP)-2, MMP-9 and cytokines levels in supernatants of BEC 18 hours after cell wounding. In a subset of patients, bronchiolar epithelial cells were also cultured for wound closure assay for MSWC analyze. Results 13 COPD and 7 non COPD patients were included. The severity of airflow obstruction and the severity of emphysema were associated with a lower MSWC in BEC (p = 0.01, 95% CI [0.15-0.80]; p = 0.04, 95% CI [−0.77;-0.03] respectively). Cell proliferation index was decreased in COPD patients (19 ± 6% in COPD vs 27 ± 3% in non COPD, p = 0.04). The severity of COPD was associated with a lower level of MMP-2 (7.8 ± 2 105 AU in COPD GOLD D vs 12.8 ± 0.13 105 AU in COPD GOLD A, p = 0.04) and a lower level of IL-4 (p = 0.03, 95% CI [0.09;0.87]). Moreover, higher levels of IL-4 and IL-2 were associated with a higher MSWC (p = 0.01, 95% CI [0.17;0.89] and p = 0.02, 95% CI [0.09;0.87] respectively). Clinical characteristics and smoking history were not associated with MSWC, cell proliferation index or MMP and cytokines levels. Finally, we showed an association of the MSWC of bronchial and corresponding bronchiolar epithelial cells obtained from the same patients (p = 0.02, 95% CI [0.12;0.89]). Conclusion Our results showed an abnormal bronchial epithelial wound closure process in severe COPD. Further studies are needed to elucidate the contribution and the regulation of this mechanism in the complex pathophysiology of COPD. Electronic supplementary material The online version of this article (doi:10.1186/s12931-014-0151-9) contains supplementary material, which is available to authorized users.
- Published
- 2014
49. Humoral immunity after kidney transplantation: impact of two randomized immunosuppressive protocols
- Author
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Yvon Berland, Valérie Moal, Stéphane Burtey, Bertrand Dussol, Henri Vacher-Coponat, Anderson Loundou, Raj Purgus, Tristan Legris, Christophe Picard, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, and Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Azathioprine ,030230 surgery ,Gastroenterology ,Tacrolimus ,Hypogammaglobulinemia ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Kidney transplantation ,Transplantation ,B-Lymphocytes ,biology ,business.industry ,Graft Survival ,Immunosuppression ,General Medicine ,Middle Aged ,Mycophenolic Acid ,medicine.disease ,Kidney Transplantation ,3. Good health ,Immunity, Humoral ,Immunoglobulin A ,stomatognathic diseases ,Treatment Outcome ,Immunoglobulin M ,Immunoglobulin G ,Humoral immunity ,Immunology ,biology.protein ,Cyclosporine ,Drug Therapy, Combination ,Female ,Antibody ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
International audience; BACKGROUND: Controlling alloimmune humoral response is a challenge in transplantation. Few studies have evaluated the impact of maintenance immunosuppression on blood humoral parameters. MATERIAL/METHODS: We performed a post-hoc analysis on 307 kidney transplant recipients included in a prospective randomized trial comparing tacrolimus/mycophenolate mofetil (Tac/MMF) vs. cyclosporine/azathioprine (CsA/AZA), both used with antithymocyte globulin induction and steroids. Humoral parameters were analyzed at D0, D15, and M12. RESULTS: IgG, IgA, and IgM levels decreased significantly as soon as D15 in both groups (-35%, -26%, and -35% respectively, vs. D0). At M12, although peripheral B-cell counts did not differ between the groups, Tac/MMF regimen was associated with lower IgG, IgA, and IgM levels than CsA/AZA (-5.9%, -14.6%, and -34%, respectively). Hypogammaglobulinemia at D15 was not associated with an increased risk of infections during the first year. The proportion of HLA-sensitized patients decreased in the Tac/MMF group (15.9% at D0 and 6.7% at M12, p=0.02) and remained stable in the CsA/AZA group (10.3% at D0 and 8.9% at M12, p=0.5). More patients sensitized at baseline became non-sensitized at M12 with Tac/MMF than with CsA/AZA. CONCLUSIONS: Our results suggest humoral immunosuppression is better with Tac/MMF than with CsA/AZA during the first year of kidney transplantation.
- Published
- 2013
50. Responder and nonresponder patients exhibit different peripheral transcriptional signatures during major depressive episode
- Author
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El Chérif Ibrahim, Aurélie Bergon, Jean Naudin, Raoul Belzeaux, Valérie Jeanjean, Lore Verrier, Catherine Nguyen, Jean Gabert, Anderson Loundou, Béatrice Loriod, Christine Formisano-Tréziny, Jean-Michel Azorin, Karine Baumstarck-Barrau, Laurent Boyer, Valérie Gall, Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre de recherche en neurobiologie - neurophysiologie de Marseille (CRN2M), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Technologies avancées pour le génôme et la clinique (TAGC), Unité de Neurobiologie des canaux Ioniques et de la Synapse (UNIS - Inserm U1072), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Laboratoire de Biochimie et Biologie Moléculaire, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital nord, Ibrahim, El Chérif, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Assistance Publique - Hôpitaux de Marseille (APHM)
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Male ,[SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Interleukin-1beta ,Pharmacology ,Bioinformatics ,Histones ,0302 clinical medicine ,Gene expression ,Longitudinal Studies ,Treatment Failure ,Major depressive episode ,0303 health sciences ,Reverse Transcriptase Polymerase Chain Reaction ,Middle Aged ,Prognosis ,Antidepressive Agents ,3. Good health ,Psychiatry and Mental health ,Treatment Outcome ,Schizophrenia ,[SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN] ,biomarker ,Female ,Original Article ,Psychopharmacology ,medicine.symptom ,Adult ,mood disorder ,Biology ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,[SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN] ,microRNA ,medicine ,Humans ,RNA, Messenger ,Biological Psychiatry ,030304 developmental biology ,Aged ,miRNA ,Depressive Disorder, Major ,antidepressant ,Tumor Necrosis Factor-alpha ,Gene Expression Profiling ,PBMC ,Case-control study ,Membrane Proteins ,medicine.disease ,Gene expression profiling ,MicroRNAs ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Case-Control Studies ,Behavioral medicine ,Thiolester Hydrolases ,transcriptome ,030217 neurology & neurosurgery - Abstract
International audience; To date, it remains impossible to guarantee that short-term treatment given to a patient suffering from a major depressive episode (MDE) will improve long-term efficacy. Objective biological measurements and biomarkers that could help in predicting the clinical evolution of MDE are still warranted. To better understand the reason nearly half of MDE patients respond poorly to current antidepressive treatments, we examined the gene expression profile of peripheral blood samples collected from 16 severe MDE patients and 13 matched controls. Using a naturalistic and longitudinal design, we ascertained mRNA and microRNA (miRNA) expression at baseline, 2 and 8 weeks later. On a genome-wide scale, we detected transcripts with roles in various biological processes as significantly dysregulated between MDE patients and controls, notably those involved in nucleotide binding and chromatin assembly. We also established putative interactions between dysregulated mRNAs and miRNAs that may contribute to MDE physiopathology. We selected a set of mRNA candidates for quantitative reverse transcriptase PCR (RT-qPCR) to validate that the transcriptional signatures observed in responders is different from nonresponders. Furthermore, we identified a combination of four mRNAs (PPT1, TNF, IL1B and HIST1H1E) that could be predictive of treatment response. Altogether, these results highlight the importance of studies investigating the tight relationship between peripheral transcriptional changes and the dynamic clinical progression of MDE patients to provide biomarkers of MDE evolution and prognosis.
- Published
- 2012
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