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1. Associations between the severity of medical and surgical complications and perception of surgeon empathy in esophageal and gastric cancer patients

Author

Gehenne, Lucie, Lelorain, Sophie, Eveno, Clarisse, Piessen, Guillaume, Mariette, Christophe, Glehen, Olivier, d'Journo, Xavier, Mathonnet, Muriel, Regenet, Nicolas, Meunier, Bernard, Baudry, Anne-Sophie, Christophe, Véronique, Adenis, Antoine, Aparicio, Thomas, Assenat, Eric, Barret, Maximilien, Benhaim, Leonor, Benoit, Céline, Bergeat, Damien, Boige, Valérie, Borie, Fréderic, Bouche, Olivier, Bourriez, Damien, Brichon, Pierre-Yves, Brigand, Cécile, Carrere, Nicolas, Cattan, Pierre, Christou, Niki, Coffin, Benoit, Cohen, Romain, Collet, Denis, Conroy, Thierry, Dahan, Laetitia, Deguelte, Sophie, Di Fiore, Fréderic, Dousset, Bertrand, Drouillard, Antoine, Dumont, Frédéric, Elhajbi, Farid, Fabre, Jean Michel, Fabre, Joseph, Gagniere, Johan, Galais, Marie Pierre, Germain, Adeline, Geyl, Sophie, Goere, Diane, Gornet, Jean Marc, Granger, Victoire, Gronnier, Caroline, Guimbaud, Rosine, Hautefeuille, Vincent, Helyon, Morgane, Jougon, Jacques, Lebreton, Gilles, Lefevre, Jérémie, Lepage, Côme, Lievre, Astrid, Marchal, Frédéric, Mathieu, Pierre, Mathysiak, Tamara, Michot, Nicolas, Moszkowicz, David, Moussata, Driffa, Msika, Simon, Neuzillet, Cindy, Ouaissi, Medhi, Paquette, Brice, Paye, François, Penna, Christophe, Père, Guillaume, Perrier, Marine, Peschaud, Frédérique, Pezet, Denis, Phoutthsang, Valérie, Pocard, Marc, Rat, Paul, Regimbeau, Jean Marc, Renaud, Florence, Sabate, Jean-Marc, Souche, Régis, Terrebonne, Eric, Tessier, Williams, Thomas, Pascal Alexandre, Turpin, Anthony, Vaudoyer, Delphine, Vienot, Angélique, Voron, Thibault, You, Benoit, Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 (SCALab), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 (CANTHER), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, 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), Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges], CHU Limoges, Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Pontchaillou [Rennes], Centre hospitalier [Valenciennes, Nord], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de Génétique Moléculaire de Montpellier (IGMM), and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Esophageal Neoplasms, media_common.quotation_subject, education, [SDV.CAN]Life Sciences [q-bio]/Cancer, Empathy, MESH: Perception, Odds, Postoperative complications, MESH: Surgeons, 03 medical and health sciences, 0302 clinical medicine, Stomach Neoplasms, Perception, Internal medicine, Humans, Medicine, 030212 general & internal medicine, Major complication, Retrospective Studies, Cancer, media_common, Multinomial logistic regression, Surgeons, Physician-Patient Relations, MESH: Humans, business.industry, Nursing research, MESH: Retrospective Studies, Cognition, MESH: Stomach Neoplasms, medicine.disease, Patient-physician communication, MESH: Empathy, Oncology, 030220 oncology & carcinogenesis, MESH: Esophageal Neoplasms, MESH: Physician-Patient Relations, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Objective: To assess the impact of global physician empathy and its three subdimensions (establishing rapport, emotional and cognitive processes) on the severity of postoperative complications in a sample of cancer patients.Methods: We retrospectively analyzed data on 256 patients with esogastric cancer from the French national FREGAT database. Empathy and its subdimensions were assessed using the patient-reported CARE scale and the severity of medical and surgical complications was reported with the Clavien-Dindo classification system. The usual covariates were included in multinomial logistic regression analyses.Results: Physician empathy predicted the odds of reporting major complications. When patients perceived high empathy, they were less likely to report major complications compared to no complications (OR = .95, 95% CI = [.91-.99], p = .029). Among the three dimensions, only "establishing rapport" (OR = .84, 95% CI = [.73-.98], p = .019) and the "emotional process" (OR = .85, 95% CI = [.74-.98], p = .022) predicted major complications.Conclusions: Physician empathy is essential before surgery. Further research is needed to understand the mechanisms associating empathy with health outcomes in cancer. Physicians should be trained to establish good rapport with patients, especially in the preoperative period.

Published
2021

2. A clinical decision support tool may help to optimise vedolizumab therapy in Crohn’s disease

Author

Dulai, Parambir S., Amiot, Aurélien, Peyrin-Biroulet, Laurent, Jairaith, Vipul, Serrero, Mélanie, Filippi, Jérome, Singh, Siddharth, Pariente, Benjamin, Loftus, Edward V., Roblin, Xavier, Kane, Sunanda, Buisson, Anthony, Siegel, Corey A., Bouhnik, Yoram, Sandborn, William J., Lasch, Karen, Rosario, Maria, Feagan, Brian G., Bojic, Daniela, Trang-Poisson, Caroline, Shen, Bo, Altwegg, Romain, Sands, Bruce E., Colombel, Jean-Frederic, Carbonnel, Franck, Kochhar, Gursimran, Meserve, Joseph, Barsky, Maria, Boland, Brigid S., Gagniere, Charlotte, Bigard, Marc-André, Zallot, Camille, Grimaud, Jean-Charles, Hebuterne, Xavier, Nachury, Maria, Desreumaux, Pierre, del Tedesco, Emilie, Bommelaer, Gilles, Koliani-Pace, Jenna L., Stefanescu, Carmen, Boureille, Arnaud, Hirten, Robert, Ungaro, Ryan, Vaysse, Thibaud, Bohm, Matthew, Varma, Sashidhar, Fischer, Monika, Hudesman, David, Chang, Shannon, Bourrier, Anne, Seksik, Philippe, Beaugerie, Laurent, Cosnes, Jacques, Sokol, Harry, Landman, Cécilia, Lukin, Dana, Weiss, Aaron, Marteau, Philippe, Dray, Xavier, Nancey, Stephane, Boschetti, Gilles, Laharie, David, Poullenot, Florian, Allez, Matthieu, Gornet, Jean-Marc, Baudry, Clautilde, Savoye, Guillaume, Moreau, Jacques, Vuitton, Lucine, Koch, Stéphane, Viennot, Stéphanie, Aubourg, Alexandre, Picon, Laurence, Pelletier, Anne-Laure, Sickersen, Gaelle, Bouguen, Guillaume, Abitbol, Vered, Chaussade, Stanislas, Nahon, Stéphane, Fumery, Mathurin, Winkfield, Betsy, Brixi-Benmansour, Hedia, Gincul, Rodica, Barberis, Jean-Christophe, Bonaz, Bruno, Michiels, Christophe, Zerbib, Frank, Beauregard, Marie Bourrier, Locher, Christophe, Davin-Couve, Sophie, Poirette, Armelle, Guillem, Laurence, Stetiu-Mocanu, Monica, Philippe, Beau, Beorchia, Sylvain, Al Qaddi, Jawad, Swaminath, Arun, Observ-Ibd, Getaid, Collaboration, Victory Cohorts, Groupe d’Étude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), University of Western Ontario (UWO), Centre Hospitalier Universitaire de Nice (CHU Nice), University of California [San Diego] (UC San Diego), University of California (UC), Mayo Clinic [Rochester], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Dartmouth Hitchcock Medical Center, Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CICECO Department of chemistry and physics, Universidade de Aveiro, Robarts Research Institute [Canada], Centre hospitalier universitaire de Nantes (CHU Nantes), Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Columbia University Irving Medical Center (CUIMC), Icahn School of Medicine at Mount Sinai [New York] (MSSM), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375) (EC2M3), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance Publique - Hôpitaux de Marseille (APHM), Université Côte d'Azur (UCA), Service des Maladies de l'Appareil Digestif et de la Nutrition [CHRU Lille], Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Gastro-entérologie et Hépatologie [CHU Saint-Etienne], Service de neurologie [Le Kremlin Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Indiana University - Purdue University Indianapolis (IUPUI), Indiana University System, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Equipes Traitement de l'Information et Systèmes (ETIS - UMR 8051), Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA)-Centre National de la Recherche Scientifique (CNRS)-CY Cergy Paris Université (CY), Sorbonne Université (SU), Autophagie infection et immunité - Autophagy Infection Immunity (APY), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Bordeaux [Bordeaux], Hôpital Haut-Lévêque [CHU Bordeaux], Hopital Saint-Louis [AP-HP] (AP-HP), Service d'Endocrinologie, Diabétologie, Maladies Métaboliques, Hôpital Avicenne, Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Gastro-Entérologie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Groupe innovation et ciblage cellulaire (GICC), EA 7501 [2018-...] (GICC EA 7501), Université de Tours (UT), Hépato-Gastro-Onco-Entérologie [CHRU de Tours], Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Service d'hépato-gastro-entérologie [Hôpital Saint-Louis, APHP], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Hôpital Cochin [AP-HP], Université Sorbonne Paris Cité (USPC), Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, CHU Amiens-Picardie, Observatory on Efficacy and of Vedolizumab in Patients With Inflammatory Bowel Disease Study Group, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire [Grenoble] (CHU), Service d'Hépato-Gastro-Entérologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Grand Hôpital de l'Est Francilien (GHEF), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Service de gastroentérologie [CHU Saint-Etienne], Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Nicolle [Rouen]-CHU Rouen, and CHU Toulouse [Toulouse]

Subjects
Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Disease, Antibodies, Monoclonal, Humanized, Antiviral Agents, Clinical decision support system, Vedolizumab, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Gastrointestinal Agents, Internal medicine, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Young adult, Optimising Vedolizumab in Crohn's Disease, Crohn's disease, Hepatology, business.industry, Patient Selection, Gastroenterology, Middle Aged, Decision Support Systems, Clinical, medicine.disease, Hepatitis C, Treatment Outcome, Calibration, Original Article, Female, 030211 gastroenterology & hepatology, Observational study, Onset of action, Drug Monitoring, business, Algorithms, medicine.drug, Cohort study
Abstract

International audience; Background A clinical decision support tool (CDST) has been validated for predicting treatment effectiveness of vedolizumab (VDZ) in Crohn's disease. Aim To assess the utility of this CDST for predicting exposure-efficacy and disease outcomes. Methods Using data from three independent datasets (GEMINI, GETAID and VICTORY), we assessed clinical remission rates and measured VDZ exposure, rapidity of onset of action, response to dose optimisation and progression to surgery by CDST-defined response groups (low, intermediate and high). Results A linear relationship existed between CDST-defined groups, measured VDZ exposure, rapidity of onset of action and efficacy in GEMINI through week 52 (P < 0.001 at all time points across three CDST-defined groups). In GETAID, CDST predicted differences in clinical remission at week 14 (AUC = 0.68) and rapidity of onset of action (P = 0.04) between probability groups. The high-probability patients did not benefit from shortening of infusion intervals, and differences in onset of action between the high-intermediate and low-probability groups within GETAID were no longer significant when including low-probability patients who received a week 10 infusion. CDST predicted a twofold increase in surgery risk over 12 months of VDZ therapy among low- to intermediate-probability vs high-probability patients (adjusted HR 2.06, 95% CI 1.33-3.21). Conclusions We further extended the clinical utility of a previously validated VDZ CDST, which accurately predicts at baseline exposure-efficacy relationships and rapidity of onset of action and could be used to help identify patients who would most benefit from interval shortening and those most likely to require surgery while on active therapy.

Published
2019

3. Impact of the Ileal Microbiota on Surgical Site Infections in Crohn's Disease: A Nationwide Prospective Cohort

Author

Julien, Clément, Anakok, Emré, Treton, Xavier, Nachury, Maria, Nancey, Stéphane, Buisson, Anthony, Fumery, Mathurin, Filippi, Jérôme, Maggiori, Léon, Panis, Yves, Zerbib, Philippe, François, Yves, Dubois, Anne, Sabbagh, Charles, Rahili, Amine, Seksik, Philippe, Allez, Matthieu, Lefevre, Jérémie, Cattan, Pierre, Chirica, Mircea, Munoz-Bongrand, Nicolas, Corte, Hélène, Beaupel, Nathan, Catry, Jonathan, Gornet, Jean-Marc, Baudry, Clotilde, Lourenco, Nelson, Maillet, Mariane, Tran-Minh, My-Linh, Chardiny, Victor, Bonnet, Joelle, Chedouba, Leila, Nisard, Andrée, Beaugerie, Laurent, Bourrier, Anne, Nion-Larmurier, Isabelle, Kirchgesner, Julien, Landman, Cécilia, Quevrain, Elodie, Brot, Loic, Chafai, Najim, Parc, Yann, Debove, Clothilde, Svreck, Magali, Vincent, Camille, Guedj, Nathalie, Ferron, Marianne, Bouhnik, Yoram, Corcos, Olivier, Stefanescu, Carmen, Khabil, Sarah, Marteau, Philippe, Dray, Xavier, Chaput, Ulrika, Bommelaer, Gilles, Goutte, Marion, Denizot, Jérémie, Barnich, Nicolas, Coban, Dilek, Desreumaux, Pierre, Pariente, Benjamin, Sommeville, Coralie, Dupas, Jean-Louis, Loreau, Julien, Brazier, Franck, Chatelain, Denis, Attencourt, Christophe, Leconte, Martine, Boschetti, Gilles, Flourié, Bernard, Cotte, Eddy, Charlois, Anne-Laure, Falgon, Peggy, Hadjisavvas, Helena, Moussata, Driffa, Chauvenet, Marion, Boyer, Sarah, Hebuterne, Xavier, Arab, Nadia, Barhoumi, Raja, Hofmann, Paul, Le Corff, Sylvain, Bonnet, Anna, Beyer-Berjot, Laura, Sokol, Harry, Service de Chirurgie viscérale et disgestive, Hôpital Nord [CHU - APHM], Laboratoire de Probabilités, Statistique et Modélisation (LPSM (UMR_8001)), Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Service d'Hépatologie Gastro-entérologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service d'Hépato Gastroenterologie [CHU Amiens-Picardie], CHU Amiens-Picardie, Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Centre Hospitalier Universitaire de Nice (CHU Nice), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie colorectale [Hôpital Beaujon], Hôpital Claude Huriez [Lille], CHU Lille, Service de chirurgie digestive et oncologique [Centre Hôspitalier Lyon Sud], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), CHU Clermont-Ferrand, Chirurgie digestive [CHU Amiens], Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Paris Center for Microbiome Medicine (FHU PaCeMM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Grenoble, Hôpital Lariboisière-Fernand-Widal [APHP], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Servcie Hépato-gastroentérolgie et Nutrition clinique [CHU Nice], Institut Polytechnique de Paris (IP Paris), Communications, Images et Traitement de l'Information (TSP - CITI), Institut Mines-Télécom [Paris] (IMT)-Télécom SudParis (TSP), Traitement de l'Information Pour Images et Communications (TIPIC-SAMOVAR), Services répartis, Architectures, MOdélisation, Validation, Administration des Réseaux (SAMOVAR), Institut Mines-Télécom [Paris] (IMT)-Télécom SudParis (TSP)-Institut Mines-Télécom [Paris] (IMT)-Télécom SudParis (TSP), Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel, MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), and AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Crohn’s disease, Crohn Disease, Ileum, Gastroenterology, Humans, Surgical Wound Infection, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, General Medicine, Gut microbiota, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Prospective Studies, Prediction, Gastrointestinal Microbiome
Abstract

Background and Aims Surgery is performed in 50–70% of Crohn’s disease [CD] patients, and its main risk is surgical site infection [SSI]. The microbiota has been extensively assessed in CD but not as a potential risk factor for septic morbidity. The objective of this study was to assess the impact of the gut microbiota on SSI in CD. Methods We used the multicentric REMIND prospective cohort to identify all patients who experienced SSI after ileocolonic resection for CD, defined as any postoperative local septic complication within 90 days after surgery: wound abscess, intra-abdominal collection, anastomotic leakage or enterocutaneous fistula. The mucosa-associated microbiota of the ileal resection specimen was analysed by 16S gene sequencing in 149 patients. The variable selection and prediction were performed with random forests [R package VSURF] on clinical and microbiotal data. The criterion of performance that we considered was the area under the Receiver Operating Characteristic [ROC] curve [AUC]. Results SSI occurred in 24 patients [16.1%], including 15 patients [10.1%] with major morbidity. There were no significant differences between patients with or without SSI regarding alpha and beta diversity. The top selected variables for the prediction of SSI were all microbiota-related. The maximum AUC [0.796] was obtained with a model including 14 genera, but an AUC of 0.78 had already been obtained with a model including only six genera [Hungatella, Epulopiscium, Fusobacterium, Ruminococcaceae_ucg_009, Actinomyces and Ralstonia]. Conclusion The gut microbiota has the potential to predict SSI after ileocolonic resection for CD. It might play a role in this frequent postoperative complication.

Published
2021

4. Additional file 1 of Gastrointestinal bleeding in critically ill immunocompromised patients

Author

Catano, Jennifer, Sacleux, Sophie Caroline, Gornet, Jean-Marc, Camus, Marine, Bigé, Naike, Saliba, Faouzi, Azoulay, Elie, Dumas, Guillaume, and Zafrani, Lara

Abstract

Additional file 1: Table S1. Immunocompromised patients’ characteristics according to GIB localization. Table S2. Univariate analysis: factors associated with severe gastrointestinal bleeding. Table S3. Univariate analysis: risk factors associated with mortality. Table S4. Factors associated with mortality by multivariate analysis (including the AIM65 score). Table S5. Factors associated with mortality by multivariate analysis (including the FFP/RBC ratio). Figure S1. Case–control analysis: Love plot comparing SMD (standardized Mean Differences) before and after matching.

Published
2021
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5. European Evidence-based Consensus: Inflammatory Bowel Disease and Malignancies

Author

Annese, Vito, Beaugerie, Laurent, Egan, Laurence, Biancone, Livia, Bolling, Claus, Brandts, Christian, Dierickx, Daan, Dummer, Reinhard, Fiorino, Gionata, Gornet, Jean Marc, Higgins, Peter, Katsanos, Konstantinos H., Nissen, Loes, Pellino, Gianluca, Rogler, Gerhard, Scaldaferri, Franco, Szymanska, Edyta, Eliakim, Rami, Bossuyt, P., Bogut, A., Krznaric, Z., Mijandrusic Sincic, B., Bortlik, M., Douda, T., Knudsen, T., Manninen, P., Nieminen, U., Kucharzik, T., Siegmund, B., Koutroubakis, I., Epameinondas, T., Lakatos, P., Waterman, M., Kohn, A., Goll, Null, Kierkus, J., Zagorowicz, E., Diculescu, M. M., Tarabar, D., Drobne, D., Gisbert, J., Strid, H., Pierik, M., Celik, A. F., Irving, P., Marshall, J., Riis, L., Amiot, A., Mantzaris, G., Sinagra, E., Sampietro, G., D'Incà, R., De Ridder, L., Nunesl, P. B., Marin Jimenez, I., Ramirez, V. H., Juillerat, P., Claridge, A., Macdonald, J., Rieder, F., SELVAGGI, Francesco, University of Zurich, Annese, Vito, Bossuyt, Peter, Beaugerie, Laurent, Egan, Laurence, Biancone, Livia, Bolling, Clau, Brandts, Christian, Dierickx, Daan, Dummer, Reinhard, Fiorino, Gionata, Gornet, Jean Marc, Higgins, Peter, Katsanos, Konstantinos H., Nissen, Loe, Pellino, Gianluca, Rogler, Gerhard, Scaldaferri, Franco, Szymanska, Edyta, Eliakim, Rami, Bossuyt, P., Bogut, A., Krznaric, Z., Mijandrusic Sincic, B., Bortlik, M., Douda, T., Knudsen, T., Manninen, P., Nieminen, U., Kucharzik, T., Siegmund, B., Koutroubakis, I., Epameinondas, T., Lakatos, P., Waterman, M., Kohn, A., Goll, Null, Kierkus, J., Zagorowicz, E., Diculescu, M. M., Tarabar, D., Drobne, D., Gisbert, J., Strid, H., Pierik, M., Celik, A. F., Irving, P., Marshall, J., Riis, L., Amiot, A., Mantzaris, G., Sinagra, E., Selvaggi, Francesco, Sampietro, G., D'Incà, R., De Ridder, L., Nunesl, P. B., Marin Jimenez, I., Ramirez, V. H., Juillerat, P., Claridge, A., Macdonald, J., and Rieder, F.

Subjects
medicine.medical_specialty, Evidence-based practice, Prognosi, Alternative medicine, MEDLINE, 610 Medicine & health, Malignancy, Inflammatory bowel disease, Risk Factors, Neoplasms, medicine, Humans, 2715 Gastroenterology, Settore MED/12 - Gastroenterologia, Evidence-Based Medicine, business.industry, Risk Factor, Medicine (all), Inflammatory Bowel Disease, Gastroenterology, 10177 Dermatology Clinic, Cancer, General Medicine, Evidence-based medicine, Inflammatory Bowel Diseases, Prognosis, medicine.disease, Ulcerative colitis, Europe, 10219 Clinic for Gastroenterology and Hepatology, Family medicine, Immunology, Neoplasm, business, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5], Human
Abstract

The global prevalence of cancer is increasing, largely as more patients are living into old age. Therefore, gastroenterologists caring for patients with inflammatory bowel disease [IBD] increasingly are managing patients with cancer, or a previous history of cancer. This often requires joint management with the patient’s oncologist, enabling case-by-case decision-making based on the characteristics and expected evolution of the index cancer. Previously, no European guidelines existed describing the impact of IBD on malignancy. For this reason, the European Crohn’s and Colitis Organisation [ECCO] Guidelines Committee [GuiCom] decided to elaborate a set of Consensus Statements on optimal risk/benefit strategies for treating IBD patients with cancer or a history of cancer. The development of clinical practice guidelines is expensive and time consuming, and it is the Committee’s hope that these statements will facilitate and accelerate future efforts to elaborate formal guidelines, providing useful information on areas for which evidence is lacking and where controlled studies are needed. The strategy used to produce the Consensus Statements involved five steps: 1. Two members of Guicom [VA and RE] identified four main topics that needed to be addressed: a] IBD and solid tumours; b] IBD and skin and haematological malignancies; c] malignancy related to therapy: risk and prevention; and d] management of IBD patients with a history of malignancy. During 2014, calls for participation in the drafting of consensus statements were issued to ECCO members, and selected oncologists known for their expertise and active research in the field were invited to join the Consensus. Participants were selected by the Committee, and four working groups were created, each composed of a chairperson [LE, RE, LB, and VA], two ECCO members including young members [Y-ECCO], and one or two experienced oncologists. The chairmen and their groups elaborated relevant questions on topics dealing with current practice and/or areas …

Published
2015

6. Chimiothérapie des adénocarcinomes avancés de l’intestin grêle : étude AGEO multicentrique

Author

Tougeron David, Aparicio Thomas, Taieb Julien, Malka David, Moulin Valérie, Gauthier Mélanie, Lecomte Thierry, Zaanan Aziz, Locher Christophe, Gornet Jean-Marc, Mitry Emmanuel, Costes Laurent, Afchain Pauline, Bonnetain Franck, and Sobhani Iradj

Subjects
Gynecology, medicine.medical_specialty, business.industry, medicine, General Earth and Planetary Sciences, business, General Environmental Science
Abstract

Les adenocarcinomes de l'intestin grele (AIG) sont des tumeurs rares et de mauvais pronostic a un stade avance. Les donnees publiees concernant l'efficacite de la chimiotherapie palliative sont peu nombreuses. Le but de notre etude etait d'evaluer l'efficacite et la tolerance de differents protocoles « modernes » de chimiotherapie et de comparer l'efficacite des chimiotherapies a base de sels de platine dans le traitement de premiere ligne des AlG avances. Cette etude retrospective multicentrique a inclus 93 patients (sexe masculin: 53 % ; âge median: 56 ans ; site primitif duodenal: 53 %) avec un AIG avance (metastatique: 86 %) traites par LV5FU2 (n = 10), FOLFOX (n = 48), FOLFIRI (n = 19) ou LV5FU2-cisplatine (n = 16). Le taux de toxicite grade 3-4 etait significativement plus frequent dans le groupe de patients traites par LV5FU2-cisplatine (75 %) comparativement aux autres groupes de patients (p = 0,001). Les medianes de survie sans progression (SSP) etaient de 7,7 ; 6,9 ; 6,0 et 4,8 mois (p = 0,16) et les medianes de survie globale (SG) etaient de 13,5 ; 17,8 ; 10,6 et 9,3 mois (p = 0,25) pour les quatre groupes de patients traites par LV5FU2, FOLFOX, FOLFIRI et LV5FU2-cisplatine, respectivement. En analyse multivariee, l'indice de performance OMS a 2 (p < 0,0001) ainsi que des taux eleves d'ACE (p = 0,02) et de CA 19-9 (p = 0,03) avant traitement etaient les seuls facteurs independants significativement associes a un mauvais pronostic. Dans le sous-groupe de patients traites par sels de platine, ceux qui ont recu une chimiotherapie par FOLFOX avaient de meilleures SSP et SG que les patients traites par LV5FU2-cisplatine. En analyse multivariee, le traitement par FOLFOX etait un facteur significatif et independant de survie prolongee en termes de SSP (p < 0,0001) et SG (p = 0,02). Ainsi, cette etude, la plus grande rapportee a ce jour, suggere d'une part que l'indice de performance OMS et les taux d'ACE et CA 19-9 avant traitement sont des facteurs pronostiques independants de survie et, d'autre part que la chimiotherapie par FOLFOX est le traitement de choix en premiere ligne des AIG avances.

Published
2010

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