559 results on '"Saint Luc University Hospital"'
Search Results
2. Study of ADI-PEG 20 in Patients With Relapsed Sensitive or Refractory Small Cell Lung Cancer
- Author
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Memorial Sloan Kettering Cancer Center, Duke University, St. Bartholomew's Hospital, Krankenhaus Nordwest, Saint-Luc University Hospital, National Taiwan University Hospital, National Cheng-Kung University Hospital, Chang Gung Memorial Hospital, Austin Health, and Polaris Group
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- 2022
3. Extraskeletal benefits and risks of calcium, vitamin D and anti-osteoporosis medications
- Author
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Body, J.-J.; Department of Medicine, CHU Brugmann, Universite Libre de Bruxelles, Brussels, Belgium, Bergmann, P.; Department of Radioisotopes, CHU Brugmann, Universite Libre de Bruxelles, Brussels, Belgium, Boonen, S.; Center for Metabolic Bone Diseases, Katholieke University Leuven, Leuven, Belgium, Devogelaer, J.-P.; Department of Rheumatology, Saint Luc University Hospital, Universite Catholique de Louvain, Brussels, Belgium, Gielen, E.; Gerontology and Geriatrics Section, Department of Experimental Medicine, K.U. Leuven, Leuven, Belgium, Goemaere, S.; Department of Rheumatology and Endocrinology, State University of Gent, Gent, Belgium, Kaufman, J.-M.; Department of Endocrinology, State University of Gent, Gent, Belgium, Rozenberg, S.; Department of Gynaecology–Obstetrics, Universite Libre de Bruxelles, Brussels, Belgium, Reginster, J.-Y.; Department of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium, Body, J.-J.; Department of Medicine, CHU Brugmann, Universite Libre de Bruxelles, Brussels, Belgium, Bergmann, P.; Department of Radioisotopes, CHU Brugmann, Universite Libre de Bruxelles, Brussels, Belgium, Boonen, S.; Center for Metabolic Bone Diseases, Katholieke University Leuven, Leuven, Belgium, Devogelaer, J.-P.; Department of Rheumatology, Saint Luc University Hospital, Universite Catholique de Louvain, Brussels, Belgium, Gielen, E.; Gerontology and Geriatrics Section, Department of Experimental Medicine, K.U. Leuven, Leuven, Belgium, Goemaere, S.; Department of Rheumatology and Endocrinology, State University of Gent, Gent, Belgium, Kaufman, J.-M.; Department of Endocrinology, State University of Gent, Gent, Belgium, Rozenberg, S.; Department of Gynaecology–Obstetrics, Universite Libre de Bruxelles, Brussels, Belgium, and Reginster, J.-Y.; Department of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium
- Published
- 2013
4. Making sense of missense variants in TTN-related congenital myopathies
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Anna Sarkozy, Erik-Jan Kamsteeg, Mark Pfuhl, Nicol C. Voermans, Martin Rees, Corrie E. Erasmus, Hülya-Sevcan Daimagüler, Steven A. Moore, Rahul Phadke, Mark R. Holt, Rolf Schröder, Istvan Bodi, Carla Grosmann, Sebahattin Cirak, E. Matthews, Ay Lin Kho, Peter Van den Bergh, Christian Thiel, Shane McKee, Joel Victor Fluss, Roksana Nikoopour, Charu Deshpande, Jens Reimann, Emily C. Oates, Maria Elena Farrugia, Özkan Özdemir, Isabelle Richard, Cristina Domínguez-González, Chaminda Konersman, Ekkehard Wilichowski, Birgit Brandmeier, Atsushi Fukuzawa, Ana Ferreiro, Heinz Jungbluth, Ros Quinlivan, Sandya Tirupathi, Mathias Gautel, Gabriele Dekomien, Cheryl Longman, Miguel A Fernandez-Garcia, Francesco Muntoni, Michael G. Hanna, Elizabeth Wraige, Elke Hobbiebrunken, Sarah Grover, UCL - SSS/IONS - Institute of NeuroScience, UCL - (SLuc) Service de neurologie, UCL - (SLuc) Centre de référence neuromusculaire, King‘s College London, Evelina London Children's Hospital, Guy's Hospital [London], University of Cologne, Children’s University Hospital of Geneva [Switzerland], Queen Elizabeth University Hospital (Glasgow), National Hospital for Neurology and Neurosurgery [London, UK], Great Ormond Street Hospital for Children [London] (GOSH), University College of London [London] (UCL), University of New South Wales [Sydney] (UNSW), Westmead Hospital [Sydney], University Hospital Erlangen [Germany], Universitätsklinikum Erlangen [Erlangen], University of Bonn Medical Centre [Bonn], Radboud university [Nijmegen], Rady Children's Hospital, Belfast City Hospital, Royal Belfast Hospital for Sick Children, University of Iowa [Iowa City], University of Göttingen - Georg-August-Universität Göttingen, Approches génétiques intégrées et nouvelles thérapies pour les maladies rares (INTEGRARE), Université d'Évry-Val-d'Essonne (UEVE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Généthon, Généthon, Saint-Luc University Hospital [Brussels, Belgium], Hospital Universitario 12 de Octubre [Madrid], Université de Paris (UP), Institut de Myologie, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CHU Charles Foix [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), King's College Hospital (KCH), MRC Centre for Neuromuscular Diseases [London, UK], University Hospital Erlangen = Uniklinikum Erlangen, Radboud University [Nijmegen], Radboud University Medical Center [Nijmegen], Gillette Children's Specialty Healthcare [St Paul], Georg-August-University = Georg-August-Universität Göttingen, Ruhr-Universität Bochum [Bochum], Université Paris Cité (UPCité), Unité de Biologie Fonctionnelle et Adaptative (BFA (UMR_8251 / U1133)), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)
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Adult ,Male ,0301 basic medicine ,Weakness ,Adolescent ,Myotonia Congenita ,Mutation, Missense ,Other Research Donders Center for Medical Neuroscience [Radboudumc 0] ,Extraocular muscles ,Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12] ,Pathology and Forensic Medicine ,Young Adult ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Humans ,Medicine ,Missense mutation ,Connectin ,Child ,Myopathy ,Aged ,Muscle contracture ,Genetics ,Phenocopy ,Original Paper ,biology ,business.industry ,Infant ,[SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology ,Middle Aged ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,medicine.disease ,Congenital myopathy ,3. Good health ,030104 developmental biology ,medicine.anatomical_structure ,[SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics ,Child, Preschool ,biology.protein ,Female ,Titin ,Neurology (clinical) ,medicine.symptom ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,030217 neurology & neurosurgery - Abstract
Mutations in the sarcomeric protein titin, encoded byTTN, are emerging as a common cause of myopathies. The diagnosis of aTTN-related myopathy is, however, often not straightforward due to clinico-pathological overlap with other myopathies and the prevalence ofTTNvariants in control populations. Here, we present a combined clinico-pathological, genetic and biophysical approach to the diagnosis ofTTN-related myopathies and the pathogenicity ascertainment ofTTNmissense variants. We identified 30 patients with a primaryTTN-related congenital myopathy (CM) and two truncating variants, or one truncating and one missenseTTNvariant, or homozygous for oneTTNmissense variant. We found that TTN-related myopathies show considerable overlap with other myopathies but are strongly suggested by a combination of certain clinico-pathological features. Presentation was typically at birth with the clinical course characterized by variable progression of weakness, contractures, scoliosis and respiratory symptoms but sparing of extraocular muscles. Cardiac involvement depended on the variant position. Our biophysical analyses demonstrated that missense mutations associated with CMs are strongly destabilizing and exert their effect when expressed on a truncating background or in homozygosity. We hypothesise that destabilizingTTNmissense mutations phenocopy truncating variants and are a key pathogenic feature of recessive titinopathies that might be amenable to therapeutic intervention.
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- 2021
5. Seasonal variations of patients presenting dyspnea to emergency departments in Europe:Results from the EURODEM Study
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Rangé, Gregoire, Saint Etienne, Christophe, Marcollet, Pierre, Chassaing, Stephan, Dequenne, Philippe, Hakim, Radwan, Capsec, Jean, Laure, Christophe, Gautier, Sandra, Albert, Franck, Godillon, Lucile, Stolt, Pelle, Motreff, Pascal, Grammatico-Guillon, Leslie, Karamercan, Mehmet Akif, Dündar, Zerrin Defne, van Meer, Oene, Body, Richard, Harjola, Veli-Pekka, Verschuren, Franck, Christ, Michael, Golea, Adela, Barletta, Cinzia, Garcia-Castrillo, Luis, Altunci, Yusuf Ali, Katirci, Yavuz, Kelly, Anne-Maree, Laribi, Said, Hôpital Louis Pasteur [Chartres], CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Jacques Coeur, Clinique Saint Gatien, Hôpitaux de Chartres [Chartres], Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Maglia Rotta, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Unité d'Épidémiologie des données cliniques [Tours] (EpiDcliC), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Emergency Department (FV - ED), Saint Luc University Hospital, HUS Emergency Medicine and Services, University of Helsinki, and Faculty of Medicine
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Male ,Ambulances ,Comorbidity ,030204 cardiovascular system & hematology ,[SHS]Humanities and Social Sciences ,Cohort Studies ,0302 clinical medicine ,Epidemiology ,Risk-Factors ,Prospective Studies ,Diuretics ,Prospective cohort study ,ComputingMilieux_MISCELLANEOUS ,Aged, 80 and over ,0303 health sciences ,COPD ,education.field_of_study ,Age Factors ,General Medicine ,Middle Aged ,humanities ,ED diagnosis ,Anti-Bacterial Agents ,Bronchodilator Agents ,3. Good health ,Europe ,Hospitalization ,Female ,Seasons ,Emergency Service, Hospital ,medicine.medical_specialty ,emergency department ,Population ,Outcomes ,Article ,Exacerbations ,03 medical and health sciences ,older patient ,Lower respiratory tract infection ,medicine ,Humans ,education ,Aged ,030306 microbiology ,business.industry ,seasonal variations ,Oxygen Inhalation Therapy ,Emergency department ,Pneumonia ,3126 Surgery, anesthesiology, intensive care, radiology ,medicine.disease ,Dyspnea ,Emergency medicine ,Copd ,business - Abstract
Background/aim: To describe seasonal variations in epidemiology, management, and short-term outcomes of patients in Europe presenting to an emergency department (ED) with a main complaint of dyspnea. Materials and methods: An observational prospective cohort study was performed in 66 European EDs which included consecutive patients presenting to EDs with dyspnea as the main complaint during 3 72-h study periods. Data were collected on demographics, comorbidities, chronic treatment, prehospital treatment, mode of arrival of patient to ED, clinical signs at admission, treatment in the ED, ED diagnosis, discharge from ED, and in-hospital outcome. Results: The study included 2524 patients with a median age of 69 (53–80) years old. Of the patients presented, 991 (39.3%) were in autumn, 849 (33.6%) were in spring, and 48 (27.1%) were in winter. The winter population was significantly older (P < 0.001) and had a lower rate of ambulance arrival to ED (P < 0.001). In the winter period, there was a higher rate for lower respiratory tract infection (35.1%), and patients were more hypertensive, more hypoxic, and more hyper/hypothermic compared to other seasons. The ED mortality was about 1% and, in hospital, mortality for admitted patients was 7.4%. Conclusion: The analytic method and the outcome of this study may help to guide the allocation of ED resources more efficiently and to recommend seasonal ED management protocols based on the seasonal trend of dyspneic patients. © TÜBİTAK., Lietuvos Mokslo Taryba: MIP-049/2015, We would like to thank Toine van den Ende and Ans Kluivers for their assistance in collecting data in Europe. The work of Justina Motiejunaite was supported by the Research Council of Lithuania (Grant No. MIP-049/2015), as well as by training grants from the French government, the Embassy of France in Lithuania, and the Erasmus Program. The EuroDEM study protocol and informed consent was received and reviewed by the institutional review board and ethical committee for each country (and/ or institution), and all participants provided informed consent. The EuroDEM study was done under the supervision of the EUSEM Research Committee. Data management in Europe was facilitated by the Jeroen Bosch Hospital., The work of Justina Motiejunaite was supported by the Research Council of Lithuania (Grant No. MIP-049/2015), as well as by training grants from the French government, the Embassy of France in Lithuania, and the Erasmus Program.
- Published
- 2020
6. Get with the guidelines: management of chronic obstructive pulmonary disease in emergency departments in Europe and Australasia is sub-optimal
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Van Meer, Oene, Keijzers, Gerben, Motiejunaite, Justina, Klim, Sharon, Capsec, Jean, Kuan, Win, McNulty, Richard, Tan, Clifford, Cowell, David Lord, Holdgate, Anna, Jain, Nitin, Devillecourt, Tracey, Forrester, Alan, Lee, Kendall, Chalkley, Dane, Gillett, Mark, Lozzi, Lydia, Asha, Stephen, Duffy, Martin, Watkins, Gina, Stone, Richard, Rosengren, David, Thone, Jae, Martin, Shane, Orda, Ulrich, Thom, Ogilvie, Kinnear, Frances, Eley, Rob, Ryan, Alison, Morel, Douglas, May, Christopher, Furyk, Jeremy, Thomson, Graeme, Smith, Simon, Smith, Richard, Maclean, Andrew, Grummisch, Michelle, Meyer, Alistair, Meek, Robert, Rosengarten, Pamela, Chan, Barry, Haythorne, Helen, Archer, Peter, Craig, Simon, Wilson, Kathryn, Knott, Jonathan, Ritchie, Peter, Bryant, Michael, MacDonald, Stephen, Lee, Tom, Mahlangu, Mlungisi, Mountain, David, Rogers, Ian, Otto, Tobias, Stuart, Peter, Bament, Jason, Brown, Michelle, Jones, Peter, Greven‐Garcia, Renee, Scott, Michael, Cheri, Thomas, Nguyen, Mai, Graham, Colin, Wong, Chi‐Pang, Wong, Tai Wai, Leung, Ling‐Pong, Man, Chan Ka, Saiboon, Ismail Mohd, Rahman, Nik Hisamuddin, Lee, Wee Yee, Lee, Francis Chun Yue, Kuan, Win Sen, Russell, SharonKerrie, Kelly, Anne‐Maree, Laribi, Gerbenand Said, Lawoko, Charles, Laribi, Said, Meer, Oene, Harjola, Veli‐Pekka, Golea, Adela, Christ, Michael, Garcia‐Castrillo, Luis, Al Dandachi, Ghanima, Maignan, Maxime, Hermand, DominiqueChristelle, Tessier, Cindy, Roy, Pierre‐Marie, Bucco, Lucie, Barletta, Cinzia, Carbone, Giorgio, Cosentini, Roberto, Truță, Sorana, Hrihorișan, Natalia, Cimpoeșu, Diana, Rotaru, Luciana, Petrică, Alina, Cojocaru, Mariana, Nica, Silvia, Tudoran, Rodica, Vecerdi, Cristina, Puticiu, Monica, Schönberger, Titus, Coolsma, Constant, Baggelaar, Maarten, Fransen, Noortje, Brand, Crispijn, Idzenga, Doutsje, Maas, Maaike, Franssen, Myriam, Mackaij‐Staal, Charlotte, Schutte, Lot, Kubber, Marije, Mignot‐Evers, Lisette, Penninga‐Puister, Ursula, Jansen, Joyce, Kuijten, Jeroen, Bouwhuis, Marna, Body, Richard, Reuben, Adam, Smith, Jason, Ramlakhan, Shammi, Darwent, Melanie, Gagg, James, Keating, Liza, Bongale, Santosh, Hardy, Elaine, Keep, Jeff, Jarman, Heather, Crane, Steven, Lawal, Olakunle, Hassan, Taj, Corfield, Alasdair, Reed, Matthew, Smolarsky, Yvonne, Blaschke, Sabine, Jerrentrup, ClemensAndreas, Hohenstein, Christian, Brünnler, FelixTanja, Ghuysen, Alexandre, Vranckx, Marc, Verschuren, Franck, Karamercan, Mehmet, Ergin, Mehmet, Dundar, Zerrin, Altuncu, Yusuf, Arziman, Ibrahim, Avcil, Mucahit, Katirci, Yavuz, Kokkonen, Liisa, Valli, JukkaJuha, Kiljunen, Minna, Tolonen, Jukka, Kaye, Sanna, Mäkelä, JukkaMikko, Metsäniitty, JukkaJuhani, Vaula, Eija, Duytsche, Nicolas, Garmilla, Pablo, HUS Emergency Medicine and Services, Department of Diagnostics and Therapeutics, University of Helsinki, Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Indian Institute of Technology Kharagpur (IIT Kharagpur), University of Leicester, Smith Watkins Trumpets, Institute for Fiscal Studies, Leibniz Institute for Tropospheric Research (TROPOS), University of California [Santa Barbara] (UCSB), University of California, iThemba Laboratory for Accelerator Based Science, 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), Centre Hospitalier Universitaire [Grenoble] (CHU), Emergency Department (FV - ED), and Saint Luc University Hospital
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Male ,medicine.medical_specialty ,emergency department ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,ACUTE EXACERBATIONS ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,0302 clinical medicine ,Dyspnoea ,Internal Medicine ,medicine ,COPD ,Humans ,Prospective Studies ,030212 general & internal medicine ,PREDICTORS ,Prospective cohort study ,Emergency Treatment ,ComputingMilieux_MISCELLANEOUS ,Aged ,Aged, 80 and over ,Mechanical ventilation ,ASIA ,Australasia ,business.industry ,NEW-ZEALAND DYSPNEA ,Emergency department ,Guideline ,Middle Aged ,medicine.disease ,3. Good health ,Europe ,Respiratory acidosis ,3121 General medicine, internal medicine and other clinical medicine ,Practice Guidelines as Topic ,Emergency medicine ,outcome ,Breathing ,Female ,Observational study ,Emergency Service, Hospital ,business ,management - Abstract
OBJECTIVES: Exacerbations of chronic obstructive pulmonary disease (COPD) are common in emergency departments (ED). Guidelines recommend administration of inhaled bronchodilators, systemic corticosteroids and antibiotics along with non-invasive ventilation (NIV) for patients with respiratory acidosis. We aimed to determine compliance with guideline recommendations for patients with treated for COPD in ED in Europe (EUR) and South East Asia/Australasia (SEA) and to compare management and outcomes. METHODS: In each region, an observational prospective cohort study was performed that included patients presenting to EDs with the main complaint of dyspnoea during three 72-hour periods. This planned sub-study included those with an ED primary discharge diagnosis of COPD. Data were collected on demographics, clinical features, treatment, disposition and in-hospital mortality. We determined overall compliance with guideline recommendations and compared treatments and outcome between regions. RESULTS: 801 patients were included from 122 EDs (66 EUR and 46 SEA). Inhaled bronchodilators were administered to 80.3% of patients, systemic corticosteroids to 59.5%, antibiotics to 44% and 60.6% of patients with pH
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- 2020
7. Treatment and outcome of adult patients with acute asthma in emergency departments in Australasia, South East Asia and Europe: Are guidelines followed? AANZDEM/EuroDEM study
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Cinzia Barletta, Gerben Keijzers, Sharon Klim, Peter A. Jones, Colin A. Graham, Simon Craig, Franck Verschuren, Anna Holdgate, Said Laribi, Oene van Meer, Luis Garcia-Castrillo, Adela Golea, Justina Motiejunaite, Win Sen Kuan, Richard Body, Mehmet Akif Karamercan, Jean Capsec, Anne-Maree Kelly, Veli-Pekka Harjola, Michael Christ, Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), iThemba Laboratory for Accelerator Based Science, Emergency Department (FV - ED), Saint Luc University Hospital, and UCL - SSS/IREC/MEDA - Pôle de médecine aiguë
- Subjects
Adult ,Male ,medicine.medical_specialty ,emergency department ,Adolescent ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Guidelines as Topic ,dyspnoea ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Oxygen therapy ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Asia, Southeastern ,ComputingMilieux_MISCELLANEOUS ,Asthma ,Aged ,Aged, 80 and over ,Australasia ,business.industry ,030208 emergency & critical care medicine ,Interrupted Time Series Analysis ,Emergency department ,Guideline ,asthma ,Middle Aged ,medicine.disease ,Comorbidity ,3. Good health ,Bronchodilator Agents ,Europe ,Outcome and Process Assessment, Health Care ,Treatment Outcome ,Cohort ,Emergency medicine ,Emergency Medicine ,outcome ,Female ,business ,Emergency Service, Hospital ,management ,Cohort study - Abstract
© 2019 Australasian College for Emergency MedicineObjective: Asthma exacerbations are common presentations to ED. Key guideline recommendations for management include administration of inhaled bronchodilators, systemic corticosteroids and titrated oxygen therapy. Our aim was to compare management and outcomes between patients treated for asthma in Europe (EUR) and South East Asia/Australasia (SEA) and compliance with international guidelines. Methods: In each region, prospective, interrupted time series studies were performed including adult (age >18 years) patients presenting to ED with the main complaint of dyspnoea during three 72 h periods. This was a planned sub-study that included those with an ED primary diagnosis of asthma. Data was collected on demographics, clinical features, treatment in ED, diagnosis, disposition and in-hospital outcome. The results of interest were differences in treatment and outcome between EUR and SEA cohorts. Results: Five hundred and eighty-four patients were identified from 112 EDs (66 EUR and 46 SEA). The cohorts had similar demographics and co-morbidity patterns, with 89% of the cohort having a previous diagnosis of asthma. There were no significant differences in treatment between EUR and SEA patients – inhaled beta-agonists were administered in 86% of cases, systemic corticosteroids in 66%, oxygen therapy in 44% and antibiotics in 20%. Two thirds of patients were discharged home from the ED. Conclusion: The data suggests that compliance with guideline-recommended therapy in both regions, particularly corticosteroid administration, is sub-optimal. It also suggests over-use of antibiotics.
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- 2019
8. IL-24 contributes to skin inflammation in Para-Phenylenediamine-induced contact hypersensitivity
- Author
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Rémi Opsomer, Younes Achouri, Astrid Van Belle, Magali de Heusch, Peggy Raynaud, Laure Dumoutier, Guy Warnier, Perrine Cochez, Emilie Hendrickx, Paméla Chéou, Marie Baeck, Jean-Christophe Renauld, Lisa Pointner, Ludwig Institute for Cancer Research, Université Catholique de Louvain = Catholic University of Louvain (UCL), Centre de recherche en Biologie Cellulaire (CRBM), Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Experimental Medicine Unit, Department of Dermatology [Brussels, Belgium], Université Catholique de Louvain = Catholic University of Louvain (UCL)-Saint-Luc University Hospital [Brussels, Belgium], UCL - SSS/DDUV - Institut de Duve, UCL - SSS/DDUV/MEXP - Médecine expérimentale, UCL - SSS/IONS - Institute of NeuroScience, UCL - SSS/IONS/COSY - Systems & cognitive Neuroscience, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, and UCL - (SLuc) Service de dermatologie
- Subjects
0301 basic medicine ,Biopsy ,[SDV]Life Sciences [q-bio] ,lcsh:Medicine ,Acanthosis ,Phenylenediamines ,Interleukin 22 ,Mice ,0302 clinical medicine ,lcsh:Science ,Coloring Agents ,Receptor ,ComputingMilieux_MISCELLANEOUS ,Skin ,Mice, Inbred BALB C ,Multidisciplinary ,medicine.diagnostic_test ,Middle Aged ,3. Good health ,Dermatitis, Allergic Contact ,Cytokines ,medicine.symptom ,Adult ,Inflammation ,[SDV.BC]Life Sciences [q-bio]/Cellular Biology ,Article ,Exocytosis ,03 medical and health sciences ,medicine ,Animals ,Humans ,Allergic contact dermatitis ,Aged ,business.industry ,Interleukins ,lcsh:R ,Receptors, Interleukin ,Immunoglobulin E ,medicine.disease ,Mice, Inbred C57BL ,Disease Models, Animal ,030104 developmental biology ,Immunology ,Leukocyte Common Antigens ,lcsh:Q ,business ,030217 neurology & neurosurgery ,Spongiosis - Abstract
Para-Phenylenediamine (PPD) is an aromatic amine used in hair dyes and in temporary black henna tattoos, which is a frequent cause of allergic contact dermatitis (ACD). ACD is a skin inflammatory reaction characterized by modifications such as spongiosis, exocytosis and acanthosis. The aim of this study is to characterize the expression and the role of IL-20-related cytokines, including IL-19, IL-20, IL-22 and IL-24, in ACD. The expression of IL19, IL20, IL22 and IL24 is increased in affected skin from PPD allergic patients compared with uninvolved skin. In addition, the expression of these cytokines positively correlates with clinical symptoms. To assess their role in ACD, we set up a mouse model of PPD-induced allergic contact dermatitis and we showed that, in contrast to Il22-deficient mice, Il22ra1-, Il20rb- and Il24-deficient mice are partially protected against development of PPD-induced contact hypersensitivity. These mice have decreased ear thickening and less acanthosis compared with WT mice after PPD treatment. In addition, the absence of IL-22R, IL-20R2 or IL-24 affects the recruitment of neutrophils into the skin but not the total IgE production. Taken together, these results demonstrate the implication of IL-24 via the IL-20R type II receptor in the inflammatory process of ACD.
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- 2019
9. Sclerostin antibody reduces long bone fractures in the oim/oim model of osteogenesis imperfecta
- Author
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Daniel Manicourt, Sébastien Lafont, Mickaël Cardinal, Janne Tys, Daniel Chappard, Thomas Roels, Jean-Pierre Devogelaer, Michael S. Ominsky, Guillaume Mabilleau, Catherine Nyssen-Behets, Patrick Ammann, Interactions Sol Plante Atmosphère (UMR ISPA), Institut National de la Recherche Agronomique (INRA)-Ecole Nationale Supérieure des Sciences Agronomiques de Bordeaux-Aquitaine (Bordeaux Sciences Agro), Department of rheumatology, Saint Luc University Hospital, Groupe d'Études Remodelage Osseux et bioMatériaux (GEROM), Université d'Angers (UA), Division of bone diseases, and University Hospital
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0301 basic medicine ,Male ,medicine.medical_specialty ,Bone quality ,Histology ,Physiology ,Endocrinology, Diabetes and Metabolism ,Sclerostin antibody ,[SDV]Life Sciences [q-bio] ,Long bone ,030209 endocrinology & metabolism ,Antibodies ,Oim/Oim ,03 medical and health sciences ,chemistry.chemical_compound ,Osteogenesis Imperfecta Type III ,Fractures, Bone ,Mice ,0302 clinical medicine ,Bone Density ,Internal medicine ,medicine ,Animals ,In patient ,Femur ,Adaptor Proteins, Signal Transducing ,ddc:616 ,biology ,Tibia ,Chemistry ,Biomechanical strength ,medicine.disease ,Survival Analysis ,Biomechanical Phenomena ,Disease Models, Animal ,030104 developmental biology ,medicine.anatomical_structure ,Endocrinology ,Fracture ,Osteogenesis imperfecta ,biology.protein ,Sclerostin ,Female ,Diaphyses ,Antibody - Abstract
International audience; Osteogenesis imperfecta type III (OI) is a serious genetic condition with poor bone quality and a high fracture rate in children. In a previous study, it was shown that a monoclonal antibody neutralizing sclerostin (Scl-Ab) increases strength and vertebral bone mass while reducing the number of axial fractures in oim/oim, a mouse model of OI type III. Here, we analyze the impact of Scl-Ab on long bones in OI mice. After 9 weeks of treatment, Scl-Ab significantly reduced long bone fractures (3.6 ± 0.3 versus 2.1 ± 0.8 per mouse, p
- Published
- 2019
10. Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications
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Cortegiani A, Gregoretti C, Neto A, Hemmes S, Ball L, Canet J, Hiesmayr M, Hollmann M, Mills G, Melo M, Putensen C, Schmid W, Severgnini P, Wrigge H, de Abreu M, Schultz M, Pelosi P, Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Urbanek B, Kahn D, Momeni M, Pospiech A, Lois F, Forget P, Grosu I, Poelaert J, van Mossevelde V, van Malderen M, Dylst D, van Melkebeek J, Beran M, de Hert S, De Baerdemaeker L, Heyse B, Van Limmen J, Wyffels P, Jacobs T, Roels N, De Bruyne A, van de Velde S, Leva B, Damster S, Plichon B, Juros-Zovko M, Djonovic-Omanovic D, Pernar S, Zunic J, Miskovic P, Zilic A, Kvolik S, Ivic D, Azenic-Venzera D, Skiljic S, Vinkovic H, Oputric I, Juricic K, Frkovic V, Kopic J, Mirkovic I, Karanovic N, Carev M, Dropulic N, Saric J, Erceg G, Dvorscak M, Mazul-Sunko B, Pavicic A, Goranovic T, Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, el Kafrawy S, Abdelwahab H, Metwally T, Abdel-Razek A, El-Shaarawy A, Hasan W, Ahmed A, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Krassler J, Merzky S, Uhlig C, Kiss T, Bundy A, Bluth T, Gueldner A, Spieth P, Scharffenberg M, Thiem D, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodorak K, Gkiokas G, Tasoulis M, Sidiropoulou T, Zafeiropoulou F, Florou P, Pandazi A, Tsaousi G, Nouris C, Pourzitaki C, Bystritski D, Pizov R, Eden A, Pesce C, Campanile A, Marrella A, Grasso S, De Michele M, Bona F, Giacoletto G, Sardo E, Sottosanti L, Solca M, Volta C, Spadaro S, Verri M, Ragazzi R, Zoppellari R, Cinnella G, Raimondo P, La Bella D, Mirabella L, D'antini D, Molin A, Brunetti I, Gratarola A, Pellerano G, Sileo R, Pezzatto S, Montagnani L, Pasin L, Landoni G, Zangrillo A, Beretta L, Di Parma A, Tarzia V, Dossi R, Sassone M, Sances D, Tredici S, Spano G, Castellani G, Delunas L, Peradze S, Venturino M, Arpino I, Sher S, Tommasino C, Rapido F, Morelli P, Vargas M, Servillo G, Raineri S, Montalto F, Russotto V, Giarratano A, Baciarello M, Generali M, Cerati G, Leykin Y, Bressan F, Bartolini V, Zamidei L, Brazzi L, Liperi C, Sales G, Pistidda L, Brugnoni E, Musella G, Bacuzzi A, Muhardri D, Gecaj-Gashi A, Sada F, Bytyqi A, Karbonskiene A, Aukstakalniene R, Teberaite Z, Salciute E, Tikuisis R, Miliauskas P, Jurate S, Kontrimaviciute E, Tomkute G, Xuereb J, Bezzina M, Borg F, Wiersma I, Binnekade J, Bos L, Boer C, Duvekot A, in 't Veld B, Werger A, Dennesen P, Severijns C, De Jong J, Hering J, van Beek R, Ivars S, Jammer I, Breidablik A, Hodt K, Fjellanger F, Avalos M, Mellin-Olsen J, Andersson E, Shafi-Kabiri A, Molina R, Wutai S, Morais E, Tareco G, Ferreira D, Amaral J, Castro M, Cadilha S, Appleton S, Parente S, Correia M, Martins D, Monteirosa A, Ricardo A, Rodrigues S, Horhota L, Grintescu I, Mirea L, Corneci D, Negoita S, Dutu M, Garotescu I, Filipescu D, Prodan A, Droc G, Fota R, Popescu M, Tomescu D, Petcu A, Tudoroiu M, Moise A, Guran C, Gherghina I, Costea D, Cindea I, Copotoiu S, Copotoiu R, Barsan V, Tolcser Z, Riciu M, Moldovan S, Veres M, Gritsan A, Kapkan T, Gritsan G, Korolkov O, Kulikov A, Lubnin A, Ovezov A, Prokoshev P, Lugovoy A, Anipchenko N, Babayants A, Komissarova I, Zalina K, Likhvantsev V, Fedorov S, Lazukic A, Pejakovic J, Mihajlovic D, Kusnierikova Z, Zelinkova M, Bruncakova K, Polakovicova L, Sobona V, Novak-Supe B, Pekle-Golez A, Jovanov M, Strazisar B, Markovic-Bozic J, Novak-Jankovic V, Voje M, Grynyuk A, Kostadinov I, Spindler-Vesel A, Moral V, Unzueta M, Puigbo C, Fava J, Moret E, Nunez M, Sendra M, Brunelli A, Rodenas F, Monedero P, Martinez F, Temino M, Simon A, Larriba A, Lisi A, Perez G, Martinez R, Granell M, Vivo J, Ruiz C, Ibanez J, Pastor E, Soro M, Ferrando C, Defez M, Alvares-Santullano C, Perez R, Rico J, Jawad M, Saeed Y, Gillberg L, Bengisun Z, Kazbek B, Coskunfirat N, Boztug N, Sanli S, Yilmaz M, Hadimioglu N, Senturk N, Camci E, Kucukgoncu S, Sungur Z, Sivrikoz N, Ozgen S, Toraman F, Selvi O, Senturk O, Yildiz M, Kuvaki B, Gunenc F, Kucukguclu S, Ozbilgin S, Maral J, Canli S, Arun O, Saltali A, Aydogan E, Akgun F, Sanlikarip C, Karaman F, Mazur A, Vorotyntsev S, Rousseau G, Barrett C, Stancombe L, Shelley B, Scholes H, Limb J, Rafi A, Wayman L, Deane J, Rogerson D, Williams J, Yates S, Rogers E, Pulletz M, Moreton S, Jones S, Venkatesh S, Burton M, Brown L, Goodall C, Rucklidge M, Fuller D, Nadolski M, Kusre S, Lundberg M, Everett L, Nutt H, Zuleika M, Carvalho P, Clements D, Creagh-Brown B, Watt P, Raymode P, Pearse R, Mohr O, Raj A, Creary T, Chishti A, Bell A, Higham C, Cain A, Gibb S, Mowat S, Franklin D, West C, Minto G, Boyd N, Calton E, Walker R, Mackenzie F, Ellison B, Roberts H, Chikungwa M, Jackson C, Donovan A, Foot J, Homan E, Montgomery J, Portch D, Mercer P, Palmer J, Paddle J, Fouracres A, Datson A, Andrew A, Welch L, Rose A, Varma S, Simeson K, Rambhatla M, Susarla J, Marri S, Kodaganallur K, Das A, Algarsamy S, Colley J, Davies S, Szewczyk M, Smith T, Fernandez-Bustamante A, Luzier E, Almagro A, Fernando L, Sulemanji D, Sprung J, Weingarten T, Kor D, Scavonetto F, Tze Y, LAS VEGAS Investigators, PROVE Network, European Soc Anaesthesiology, Cortegiani, A, Gregoretti, C, Neto, A, Hemmes, S, Ball, L, Canet, J, Hiesmayr, M, Hollmann, M, Mills, G, Melo, M, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, Gama de Abreu, M, Schultz, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, Mossevelde, V, van Malderen, M, Dylst, D, Melkebeek, J, Beran, M, Hert, S, Baerdemaeker, L, Heyse, B, Limmen, J, Wyffels, P, Jacobs, T, Roels, N, Bruyne, A, Velde, S, Marina, J, Dejana, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Darija, A, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Saric, J, Erceg, G, Dvorscak, M, Branka, M, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Inga, M, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, Kafrawy, S, Abdelwahab, H, Metwally, T, Ahmed, A, Ahmed Mostafa, E, Hasan, W, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Jaber, S, Prades, A, Krassler, J, Merzky, S, Abreu, M, Uhlig, C, Kiss, T, Bundy, A, Bluth, T, Gueldner, A, Spieth, P, Scharffenberg, M, Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodorak, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, Michele, M, Bona, F, Giacoletto, G, Sardo, E, Sottosanti, L, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Agreta, G, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Binnekade, J, Bos, L, Boer, C, Duvekot, A, Veld, B, Werger, A, Dennesen, P, Severijns, C, Jong, J, Hering, J, Beek, R, Ivars, S, Jammer, I, Breidablik, A, Hodt, K, Fjellanger, F, Avalos, M, Jannicke, M, Andersson, E, Amir, S, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Popescu Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, S, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Barbka, N, Ana, P, Jovanov, M, Strazisar, B, Jasmina, M, Vesna, N, Voje, M, Grynyuk, A, Kostadinov, I, Alenka, S, Moral, V, Unzueta, M, Puigbo, C, Fava, J, Moret, E, Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Martinez, F, Temino, M, Simon, A, Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Vivo, J, Ruiz, C, Andres Ibanez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Cesar Aldecoa, A, Perez, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Bengisun, Z, Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Ben, C, Watt, P, Raymode, P, Pearse, R, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Ana, F, Luzier, E, Almagro, A, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, Acibadem University Dspace, Anesthesiology, Graduate School, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, ACS - Heart failure & arrhythmias, Università degli studi di Palermo - University of Palermo, University of Amsterdam [Amsterdam] (UvA), Hospital Israelita Albert Einstein [São Paulo, Brazil], IRCCS Ospedale Policlinico San Martino [Genoa, Italy], Massachusetts General Hospital [Boston], University Hospital Bonn, University Hospital Carl Gustav Carus [Dresden, Germany], Technische Universität Dresden = Dresden University of Technology (TU Dresden), University Hospital Graz, Johannes Kepler Universität Linz (JKU), Medizinische Universität Wien = Medical University of Vienna, Saint-Luc University Hospital [Brussels, Belgium], Universitair Ziekenhus Brussel (UZ Brussel), Ziekenhuis Oost-Limburg (ZOL), Ghent University Hospital, Hôpital AZ Maria Middelares, Dr. Abdulah Nakas General Hospital, General Hospital Cakovec, General Hospital Karlovac, University Clinical Hospital Osijek, Medical faculty Osijek, University Hospital Rijeka, University of Rijeka, 'Dr. Josip Benčević' General Hospital, Merkur University Hospital, KLINIČKA BOLNICA 'SVETI DUH', Klinička bolnica „Sveti Duh', Medical School, 'Sestre milosrdnice', University Hospital, Medical School, 'Sestre milosrdnice', Faculty of Medicine [Brno] (MED / MUNI), Masaryk University [Brno] (MUNI), University Hospital Hradec Kralove, University Hospital Ostrava, Nemocnice Znojmo, Sahel Teaching Hospital, Kasr Al-Ainy Medical School, Faculty Of Medicine Kasr Al-Ainy Cairo University, Beni Sueif University 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Università degli Studi di Foggia - University of Foggia, Istituto di ricovero e cura a carattere scientifico Azienda Ospedaliera Universitaria 'San Martino' (IRCCS AOU San Martino), University Vita-Salute, Scientific Institute San Raffaele, Milano, European Institute of Oncology [Milan] (ESMO), Ospedale Niguarda Ca' Granda Hospital, Pneumologia Ospedale San Paolo, Università degli Studi di Milano [Milano] (UNIMI), Università degli studi di Napoli Federico II, Policlinico P. Giaccone, Palermo, Azienda Ospedaliero-Universitaria di Parma, Ospedale Santa Maria degli Angeli, Ospedale della Misericordia e Dolce di Prato, University of Sassari, Università degli Studi di Sassari [Sassari] (UNISS), University of Insubria, Varese, District hospital Gjakova, University of Prishtina, Regional Hospital 'Prim.Dr. Daut Mustafa', Hospital of Lithuanian University of Health Sciences Kauno Klinikos [Kaunas, Lithuania], National Cancer Institute (Vilnius), Vilnius University Hospital Santariskiu Clinics, Mater Dei Hospital [Malta], VU University Medical Center [Amsterdam], Haaglanden Medical Center [La Haye, Pays-Bas] (HMC), Dijklander Ziekenhuis, locatie Hoorn, Haukeland University Hospital, University of Bergen (UiB), Førde Sentral Sykehus, Martina Hansens Hospital, Bærum Hospital, Stavanger University Hospital, Hospital Santo Tomás, Hospital do Espírito Santo de Évora (EPE), EPE - Hospital do Espirito Santo de Evora, EPE - Hospital do Espirito de Evora, Centro Hospitalar de Lisboa Central E.P.E, Hospital de S. Francisco Xavier (EPE), Santarem Hospital, Hospital de Santarem, Spitalul Orășenesc, Sf. Ioan Clinical Emergency Hospital, Emergency University Hospital Elias, Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C.C. Iliescu' [Bucharest, Romania], Fundeni Clinical Institute = Institutul Clinic Fundeni [Bucarest, Roumanie], Dr. Professor Dimitrie Gerota Emergency Hospital, Constanta County Emergency Hospital, University of Medicine and Pharmacy of Târgu Mureș, Târgu Mureş Hospital, Krasnoyarsk State Medical University (KrasSMU), Burdenko Neurosurgery Institute (Nmits Neyrokhirurgii Im. Akademika N.n. Burdenko), NN Burdenko Neurosurgical Institute (NNBNI), Moscow Regional Research Clinical Institute (MONICA), City clinical hospital No. 7 of Moscow, Reanimatology Research Institute n.a. Negovskij RAMS, Reanimatology Research Institute n.a. Negovskij RAMS, Moscow, Clinical Center of Vojvodina, National Cancer Institute (Bratislava), Fakultná nemocnica s poliklinikou F. D. 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S., Hemmes, S. N. T., Ball, L., Canet, J., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Melo, M. F. V., Putensen, C., Schmid, W., Severgnini, P., Wrigge, H., Gama de Abreu, M., Schultz, M. J., Pelosi, P., Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Urbanek, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., Mossevelde, V., van Malderen, M. C., Dylst, D., Melkebeek, J. V., Beran, M., Hert, S. D., Baerdemaeker, L. D., Heyse, B., Limmen, J. V., Wyffels, P., Jacobs, T., Roels, N., Bruyne, A. D., Velde, S. V. D., Marina, J. Z., Dejana, D. O., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Darija, A. V., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Saric, J. P., Erceg, G., Dvorscak, M. B., Branka, M. S., Pavicic, A. M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Inga, M. B., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., Kafrawy, S. E., Abdelwahab, H. H., Metwally, T., Ahmed, A. R., Ahmed Mostafa, E. S., Hasan, W. F., Ahmed, A. G., Yassin, H., Magdy, M., Abdelhady, M., Mahran, M., Herodes, E., Kivik, P., Oganjan, J., Aun, A., Sormus, A., Sarapuu, K., Mall, M., Karjagin, J., Futier, E., Petit, A., Gerard, A., Marret, E., Solier, M., Jaber, S., Prades, A., Krassler, J., Merzky, S., Abreu, M. G. D., Uhlig, C., Kiss, T., Bundy, A., Bluth, T., Gueldner, A., Spieth, P., Scharffenberg, M., Thiem, D. T., Koch, T., Treschan, T., Schaefer, M., Bastin, B., Geib, J., Weiss, M., Kienbaum, P., Pannen, B., Gottschalk, A., Konrad, M., Westerheide, D., Schwerdtfeger, B., Simon, P., Reske, A., Nestler, C., Valsamidis, D., Stroumpoulis, K., Antholopoulos, G., Andreou, A., Karapanos, D., Theodorak, K., Gkiokas, G., Tasoulis, M. K., Sidiropoulou, T., Zafeiropoulou, F., Florou, P., Pandazi, A., Tsaousi, G., Nouris, C., Pourzitaki, C., Bystritski, D., Pizov, R., Eden, A., Pesce, C. V., Campanile, A., Marrella, A., Grasso, S., Michele, M. D., Bona, F., Giacoletto, G., Sardo, E., Sottosanti, L. G. V., Solca, M., Volta, C. A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., Bella, D. L., Mirabella, L., D'Antini, D., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Parma, A. L. D., Tarzia, V., Dossi, R., Sassone, M. E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Raineri, S. M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Agreta, G. G., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. J., Hemmes, S., Schultz, M., Hollmann, M., Wiersma, I., Binnekade, J., Bos, L., Boer, C., Duvekot, A., Veld, B. I. '., Werger, A., Dennesen, P., Severijns, C., Jong, J. D., Hering, J., Beek, R. V., Ivars, S., Jammer, I. B., Breidablik, A., Hodt, K. S., Fjellanger, F., Avalos, M. V., Jannicke, M. O., Andersson, E., Amir, S. K., Molina, R., Wutai, S., Morais, E., Tareco, G., Ferreira, D., Amaral, J., Castro, M. D. L. G., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I. M., Mirea, L., Grintescu, I. C., Corneci, D., Negoita, S., Dutu, M., Popescu Garotescu, I., Filipescu, D., Prodan, A. B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A. M., Tudoroiu, M. I., Moise, A., Guran, C. T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S. M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, S. G., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Barbka, N. S., Ana, P. G., Jovanov, M., Strazisar, B., Jasmina, M. B., Vesna, N. J., Voje, M., Grynyuk, A., Kostadinov, I., Alenka, S. V., Moral, V., Unzueta, M. C., Puigbo, C., Fava, J., Moret, E., Nunez, M. R., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Martinez, F. H., Temino, M. J. Y., Simon, A. M., Larriba, A. D. A., Lisi, A., Perez, G., Martinez, R., Granell, M., Vivo, J. T., Ruiz, C. S., Andres Ibanez, J. A. D., Pastor, E., Soro, M., Ferrando, C., Defez, M., Cesar Aldecoa, A. S., Perez, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Bengisun, Z. K., Kazbek, B. K., Coskunfirat, N., Boztug, N., Sanli, S., Yilmaz, M., Hadimioglu, N., Senturk, N. M., Camci, E., Kucukgoncu, S., Sungur, Z., Sivrikoz, N., Ozgen, S. U., Toraman, F., Selvi, O., Senturk, O., Yildiz, M., Kuvaki, B., Gunenc, F., Kucukguclu, S., Ozbilgin, S., Maral, J., Canli, S., Arun, O., Saltali, A., Aydogan, E., Akgun, F. N., Sanlikarip, C., Karaman, F. M., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Ben, C. B., Watt, P., Raymode, P., Pearse, R., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Mills, G., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Ana, F. B., Luzier, E., Almagro, A., Melo, M. V., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Cortegiani A., Gregoretti C., Neto A.S., Hemmes S.N.T., Ball L., Canet J., Hiesmayr M., Hollmann M.W., Mills G.H., Melo M.F.V., Putensen C., Schmid W., Severgnini P., Wrigge H., Gama de Abreu M., Schultz M.J., Pelosi P., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., Mossevelde V., van Malderen M.C., Dylst D., Melkebeek J.V., Beran M., Hert S.D., Baerdemaeker L.D., Heyse B., Limmen J.V., Wyffels P., Jacobs T., Roels N., Bruyne A.D., Velde S.V.D., Marina J.Z., Dejana D.O., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Darija A.V., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Saric J.P., Erceg G., Dvorscak M.B., Branka M.S., Pavicic A.M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Inga M.B., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., Kafrawy S.E., Abdelwahab H.H., Metwally T., Ahmed A.R., Ahmed Mostafa E.S., Hasan W.F., Ahmed A.G., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Jaber S., Prades A., Krassler J., Merzky S., Abreu M.G.D., Uhlig C., Kiss T., Bundy A., Bluth T., Gueldner A., Spieth P., Scharffenberg M., Thiem D.T., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodorak K., Gkiokas G., Tasoulis M.K., Sidiropoulou T., Zafeiropoulou F., Florou P., Pandazi A., Tsaousi G., Nouris C., Pourzitaki C., Bystritski D., Pizov R., Eden A., Pesce C.V., Campanile A., Marrella A., Grasso S., Michele M.D., Bona F., Giacoletto G., Sardo E., Sottosanti L.G.V., Solca M., Volta C.A., Spadaro S., Verri M., Ragazzi R., Zoppellari R., Cinnella G., Raimondo P., Bella D.L., Mirabella L., D'antini D., Molin A., Brunetti I., Gratarola A., Pellerano G., Sileo R., Pezzatto S., Montagnani L., Pasin L., Landoni G., Zangrillo A., Beretta L., Parma A.L.D., Tarzia V., Dossi R., Sassone M.E., Sances D., Tredici S., Spano G., Castellani G., Delunas L., Peradze S., Venturino M., Arpino I., Sher S., Tommasino C., Rapido F., Morelli P., Vargas M., Servillo G., Raineri S.M., Montalto F., Russotto V., Giarratano A., Baciarello M., Generali M., Cerati G., Leykin Y., Bressan F., Bartolini V., Zamidei L., Brazzi L., Liperi C., Sales G., Pistidda L., Brugnoni E., Musella G., Bacuzzi A., Muhardri D., Agreta G.G., Sada F., Bytyqi A., Karbonskiene A., Aukstakalniene R., Teberaite Z., Salciute E., Tikuisis R., Miliauskas P., Jurate S., Kontrimaviciute E., Tomkute G., Xuereb J., Bezzina M., Borg F.J., Hemmes S., Schultz M., Hollmann M., Wiersma I., Binnekade J., Bos L., Boer C., Duvekot A., Veld B.I.'., Werger A., Dennesen P., Severijns C., Jong J.D., Hering J., Beek R.V., Ivars S., Jammer I.B., Breidablik A., Hodt K.S., Fjellanger F., Avalos M.V., Jannicke M.O., Andersson E., Amir S.K., Molina R., Wutai S., Morais E., Tareco G., Ferreira D., Amaral J., Castro M.D.L.G., Cadilha S., Appleton S., Parente S., Correia M., Martins D., Monteirosa A., Ricardo A., Rodrigues S., Horhota L., Grintescu I.M., Mirea L., Grintescu I.C., Corneci D., Negoita S., Dutu M., Popescu Garotescu I., Filipescu D., Prodan A.B., Droc G., Fota R., Popescu M., Tomescu D., Petcu A.M., Tudoroiu M.I., Moise A., Guran C.T., Gherghina I., Costea D., Cindea I., Copotoiu S.M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan S.G., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Barbka N.S., Ana P.G., Jovanov M., Strazisar B., Jasmina M.B., Vesna N.J., Voje M., Grynyuk A., Kostadinov I., Alenka S.V., Moral V., Unzueta M.C., Puigbo C., Fava J., Moret E., Nunez M.R., Sendra M., Brunelli A., Rodenas F., Monedero P., Martinez F.H., Temino M.J.Y., Simon A.M., Larriba A.D.A., Lisi A., Perez G., Martinez R., Granell M., Vivo J.T., Ruiz C.S., Andres Ibanez J.A.D., Pastor E., Soro M., Ferrando C., Defez M., Cesar Aldecoa A.S., Perez R., Rico J., Jawad M., Saeed Y., Gillberg L., Bengisun Z.K., Kazbek B.K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N.M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S.U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F.N., Sanlikarip C., Karaman F.M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Ben C.B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Ana F.B., Luzier E., Almagro A., Melo M.V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., Tze Y., Hemmes, Snt, Hollmann, Mw, Mills, Gh, Melo, Mfv, Schultz, Mj, on behalf of the LAS VEGAS Investigators the PROVE Network and the Clinical Trial Network of the European Society of, Anaesthesiology, Maltepe Üniversitesi, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - (SLuc) Service d'anesthésiologie, and Selçuk Üniversitesi
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Lung Diseases ,Postoperative Complications/epidemiology ,Male ,Internationality ,Intraoperative Complication ,medicine.medical_treatment ,Settore MED/41 - Anestesiologia ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Lung Disease ,Cohort Studies ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Anesteziologija i reanimatologija ,0302 clinical medicine ,030202 anesthesiology ,Risk Factors ,patient safety ,Medicine ,General anaesthesia ,postoperative complication ,Prospective Studies ,intraoperative complications ,Statistics & numerical data ,Prospective cohort study ,Incidence (epidemiology) ,Incidence ,general anaesthesia, intraoperative complications, patient safety, postoperative complications, pulmonary ,Middle Aged ,Operative ,3. Good health ,Surgical Procedures, Operative ,Female ,general anaesthesia ,postoperative complications ,pulmonary ,Cohort study ,Human ,Adult ,medicine.medical_specialty ,Lung Diseases/epidemiology ,[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery ,NO ,03 medical and health sciences ,Intraoperative Complications/epidemiology ,After-Hours Care ,Humans ,MED/41 - ANESTESIOLOGIA ,Adverse effect ,Aged ,Mechanical ventilation ,Surgical Procedures ,business.industry ,Risk Factor ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Anesthesiology and Reanimatology ,intraoperative complication ,Surgery ,After-Hours Care/statistics & numerical data ,Anesthesiology and Pain Medicine ,Clinical trial ,MESH: After-hours Care / statistics & numerical data ,Lung diseases / epidemiology ,Surgical procedures, operative ,Prospective Studie ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Cohort Studie ,business - Abstract
WOS: 000458513600019, PubMed: 30770054, Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs). Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during 'daytime' when induction of anaesthesia was between 8: 00 AM and 7: 59 PM, and as 'night-time' when induction was between 8: 00 PM and 7: 59 AM. Results: Of 9861 included patients, 555 (5.6%) underwent surgery during night-time. The proportion of patients who developed intraoperative AEs was higher during night-time surgery in unmatched (43.6% vs 34.1%; P, NIHeNHLBI [1R34HL123438]; European Society of Anaesthesiology, The LAS VEGAS study was co-funded and endorsed by the European Society of Anaesthesiology, which had no role in the study design nor data analysis and interpretation. MFVM was supported by NIHeNHLBI (1R34HL123438).
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- 2019
11. Epidemiology of patients presenting with dyspnea to emergency departments in Europe and the Asia-Pacific region
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Mehmet Akif Karamercan, Jean Capsec, Peter A. Jones, Luis Garcia-Castrillo, Colin A. Graham, Leslie Grammatico-Guillon, Simon Craig, Win Sen Kuan, Veli-Pekka Harjola, Oene van Meer, Gerben Keijzers, Sharon Klim, Richard Body, Franck Verschuren, Anne-Maree Kelly, Justina Motiejunaite, Adela Golea, Michael Christ, Cinzia Barletta, Said Laribi, Anna Holdgate, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service des urgences, HUS Emergency Medicine and Services, Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), iThemba Laboratory for Accelerator Based Science, University of Helsinki, Emergency Department (FV - ED), Saint Luc University Hospital, Unité d'Épidémiologie des données cliniques [Tours] (EpiDcliC), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)
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Male ,Internationality ,Exacerbation ,[SDV]Life Sciences [q-bio] ,Comorbidity ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Cohort Studies ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Epidemiology ,Prevalence ,Hospital Mortality ,Prospective Studies ,Prospective cohort study ,ComputingMilieux_MISCELLANEOUS ,Aged, 80 and over ,education.field_of_study ,COPD ,OUTCOMES ,STATEMENT ,Mortality rate ,Middle Aged ,3. Good health ,Europe ,Emergency Medicine ,outcome ,epidemiology ,Female ,Emergency Service, Hospital ,management ,Cohort study ,medicine.medical_specialty ,Asia ,emergency department ,Population ,ACUTE HEART-FAILURE ,Pacific Islands ,03 medical and health sciences ,Age Distribution ,medicine ,Humans ,Sex Distribution ,education ,Aged ,Heart Failure ,business.industry ,030208 emergency & critical care medicine ,Emergency department ,Pneumonia ,medicine.disease ,3126 Surgery, anesthesiology, intensive care, radiology ,Asthma ,respiratory tract diseases ,Dyspnea ,Emergency medicine ,business - Abstract
Objective The primary objective of this study was to describe the epidemiology and management of dyspneic patients presenting to emergency departments (EDs) in an international patient population. Our secondary objective was to compare the EURODEM and AANZDEM patient populations. Patients and methods An observational prospective cohort study was carried out in Europe and the Asia-Pacific region. The study included consecutive patients presenting to EDs with dyspnea as the main complaint. Data were collected on demographics, comorbidities, chronic treatment, clinical signs and investigations, treatment in the ED, diagnosis, and disposition from ED. Results A total of 5569 patients were included in the study. The most common ED diagnoses were lower respiratory tract infection (LRTI) (24.9%), heart failure (HF) (17.3%), chronic obstructive pulmonary disease (COPD) exacerbation (15.8%), and asthma (10.5%) in the overall population. There were more LRTI, HF, and COPD exacerbations in the EURODEM population, whereas asthma was more frequent in the AANZDEM population. ICU admission rates were 5.5%. ED mortality was 0.6%. The overall in-hospital mortality was 5.0%. In-hospital mortality rates were 8.7% for LRTI, 7.6% for HF, and 5.6% for COPD patients. Conclusion Dyspnea as a symptom in the ED has high ward and ICU admission rates. A variety of causes of dyspnea were observed in this study, with chronic diseases accounting for a major proportion.
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- 2019
12. Effect of Pressure Support Ventilation on Carboxyhemoglobin Toxicokinetic after Acute Carbon Monoxide Intoxication: a Swine Model
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Frédéric Thys, Giuseppe Liistro, A Penaloza, Philippe Hantson, N. Delvau, I. K. Delattre, P. Gianello, Pierre-Marie Roy, Emergency Department (FV - ED), Saint Luc University Hospital, Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), and Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
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Male ,genetic structures ,Swine ,Health, Toxicology and Mutagenesis ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Pressure support ventilation ,Pilot Projects ,Carbon monoxide intoxication ,030204 cardiovascular system & hematology ,Toxicology ,03 medical and health sciences ,chemistry.chemical_compound ,Carbon Monoxide Poisoning ,0302 clinical medicine ,Primary outcome ,Oxygen therapy ,medicine ,Toxicokinetics ,Animals ,Continuous positive airway pressure ,Prospective Studies ,Carbon monoxide ,Continuous Positive Airway Pressure ,business.industry ,030208 emergency & critical care medicine ,Respiration, Artificial ,Positive pressure ventilation ,Toxicokinetic ,3. Good health ,Oxygen ,Carboxyhemoglobin (COHb) ,Treatment Outcome ,chemistry ,Carboxyhemoglobin ,Anesthesia ,Original Article ,Continuous positive airway pressure (CPAP) ,business ,Half-Life ,circulatory and respiratory physiology - Abstract
INTRODUCTION: In an experimental study on carbon monoxide (CO) exposure in swine, we aimed to compare the influence of oxygen therapy using a non-rebreathing mask (NRM) to continuous positive airway pressure (CPAP) and two pressure support ventilation (PSV) devices on the decrease of the terminal elimination half-life of carboxyhemoglobin (COHb t(1/2)). This was the primary outcome. METHODS: Eight spontaneously breathing pigs were sedated by propofol and exposed to 940 ppm CO several times (n = 25) to obtain COHb levels of 30%. CPAPb (high flow open system, CPAP Boussignac® [7.5 cmH(2)O]), PSV-Vy (open system, Vylife Boussignac®), and PSV-Leg (closed system, Legendair® [inspiratory/expiratory airway pressure 12/4 cmH(2)O]) devices were used in a randomized order and compared to NRM (O(2) at 15 l min(−1)) and atmospheric air (AA). The primary outcome was COHb t(1/2). Multiple comparisons were performed using Dunn’s tests. RESULTS: Median FiO(2) and minute ventilation were significantly higher in the PSV-Leg group than the NRM group (p
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- 2018
13. Treatment of chronic spontaneous urticaria: Immunomodulatory approaches
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Laurence de Montjoye, Marie Baeck, Anne Herman, Jean-François Nicolas, Cheval, Christelle, Department of Dermatology [Brussels, Belgium], Université Catholique de Louvain = Catholic University of Louvain (UCL)-Saint-Luc University Hospital [Brussels, Belgium], Institute of Experimental and Clinical Research [Brussels, Belgium] (Pole of Pneumology, ENT and Dermatology), Université Catholique de Louvain = Catholic University of Louvain (UCL), Immunologie de l'allergie cutanée et vaccination – Immunology of skin allergy and vaccination, 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), Département d'allergie et d'immunologie clinique [CHU Lyon Sud], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de dermatologie, 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), and 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)
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Urticaria ,[SDV.IMM] Life Sciences [q-bio]/Immunology ,medicine.medical_treatment ,Immunology ,Complex disease ,Disease ,030207 dermatology & venereal diseases ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine ,B-lymphocytes ,Humans ,Immunology and Allergy ,T-lymphocytes ,Autoantibodies ,[SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,business.industry ,Autoantibody ,Chronic spontaneous urticaria ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,Pathophysiology ,Basophils ,3. Good health ,Treatment ,030228 respiratory system ,chemistry ,Chronic Disease ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Histamine H1 Antagonists ,Mast cells ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Antihistamine ,[SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,business ,Histamine - Abstract
International audience; This paper summarizes and reviews the mechanisms of action and data concerning efficacy of recommended treatments as well as other treatments that have been tested, independently of the outcomes, in the management of chronic spontaneous urticaria. Due to the central role of mast cells, basophils and histamine in the pathophysiology of this disease, H1-antihistamines remain the first-line treatment. However, current knowledge about this complex disease, also recognizes an important role for T lymphocytes, B lymphocytes, and autoantibodies. Implications of these others mediators thus provide further targets for treatment. Indeed, agents previously used to treat other autoimmune and inflammatory diseases, have demonstrated efficacy in chronic spontaneous urticaria and are therefore potential therapeutic alternatives for antihistamine unresponsive patients.
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- 2018
14. Can We Identify Patients with High Risk of Osteoarthritis Progression Who Will Respond to Treatment? A Focus on Biomarkers and Frailty
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Andrea Laslop, Eleonora Tajana Messi, Pieter D’Hooghe, René Rizzoli, Olivier Bruyère, S. Reiter-Niesert, Francis Berenbaum, Nigel K Arden, Gabriel Herrero-Beaumont, Jean-Pierre Devogelaer, Cécile Clerc, Johanne Martel-Pelletier, Giuseppe Mautone, Yannis Tsouderos, Jean-Pierre Pelletier, Cyrus Cooper, Lucio C. Rovati, Marc C. Hochberg, Stefania Maggi, Maria Luisa Brandi, Jean-Yves Reginster, F Petit-Dop, Elaine M. Dennison, Véronique Leblanc, Jaime Branco, Eric Abadie, John A. Kanis, Pascal Richette, NIHR Musculoskeletal BRU, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford [Oxford], ARUK Sports, Exercise and Osteoarthisis Centre of Excellence, Oxford, UFR Médicale, Université Paris Diderot - Paris 7 (UPD7), Fédération de rhumatologie, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), MRC Epidemiology Resource Centre, University of Southampton, Department of public health, Université de Liège, Division of cardiology, Hôpital Ambroise Paré [AP-HP], CEDOC - Department of Rheumatology, Centro de Estudos de Doenças Crónicas (CEDOC), NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA)-Universidade Nova de Lisboa = NOVA University Lisbon (NOVA)-NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA)-Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), CHLO, EPE, Hospital De Egas Moniz, Department of internal medicine, Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), 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), Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoires Genevrier Antibes, Department of rheumatology, Saint Luc University Hospital, Division of rheumatology and clinical immunology, University of Maryland [Baltimore County] (UMBC), University of Maryland System-University of Maryland System, Department of orthopaedics and sport medicine, Aspetar Hospital, Doha, Qatar, Bone and Joint Research Unit, Fundacion Jimenez Diaz [Madrid] (FJD), WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield [Sheffield], Scientific Office, Austrian Agency for Health and Food Safety (AGES), Expansciences laboratoires, Courbevoie, Aging Program, National research council, Padua, Italy, Institut Biochimique SA (IBSA), Osteoarthritis Research Unit, Université de Montréal (UdeM)-Hopital Notre-Dame, Institut de Recherches Internationales Servier (IRIS), Laboratoire Servier, Federal Institute of Drugs and Medical Devices [Bonn], Service of Bone Diseases, Department of Rehabilitation and Geriatrics, Geneva University Hospital and Geneva University, Clinical Research Unit, Rottapharm/Madaus, University of Oxford, Università degli Studi di Firenze = University of Florence (UniFI), CHU Pitié-Salpêtrière [AP-HP], NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), Service de Rhumatologie [CHU Pitié Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Administateur, HAL Sorbonne Université
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medicine.medical_specialty ,Osteoporosis ,MEDLINE ,Osteoarthritis ,Disease ,Bioinformatics ,Pharmacotherapy ,Predictive Value of Tests ,Risk Factors ,medicine ,Humans ,Pharmacology (medical) ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,business.industry ,medicine.disease ,Magnetic Resonance Imaging ,3. Good health ,Current Opinion ,Potential biomarkers ,Predictive value of tests ,ddc:618.97 ,Physical therapy ,Disease Progression ,Personalized medicine ,Geriatrics and Gerontology ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Biomarkers - Abstract
Funding: This meeting was founded by the European Society for Clinical and Economics Aspect of Osteoporosis and Osteoarthritis, a not for profit organization from Belgium. Osteoarthritis (OA), a disease affecting different patient phenotypes, appears as an optimal candidate for personalized healthcare. The aim of the discussions of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group was to explore the value of markers of different sources in defining different phenotypes of patients with OA. The ESCEO organized a series of meetings to explore the possibility of identifying patients who would most benefit from treatment for OA, on the basis of recent data and expert opinion. In the first meeting, patient phenotypes were identified according to the number of affected joints, biomechanical factors, and the presence of lesions in the subchondral bone. In the second meeting, summarized in the present article, the working group explored other markers involved in OA. Profiles of patients may be defined according to their level of pain, functional limitation, and presence of coexistent chronic conditions including frailty status. A considerable amount of data suggests that magnetic resonance imaging may also assist in delineating different phenotypes of patients with OA. Among multiple biochemical biomarkers identified, none is sufficiently validated and recognized to identify patients who should be treated. Considerable efforts are also being made to identify genetic and epigenetic factors involved in OA, but results are still limited. The many potential biomarkers that could be used as potential stratifiers are promising, but more research is needed to characterize and qualify the existing biomarkers and to identify new candidates. publishersversion published
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- 2015
15. Assessing clinical probability of pulmonary embolism: prospective validation of the simplified Geneva score
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Khaled Mostaguir, Marc Philip Righini, G. Le Gal, Helia Robert-Ebadi, F. Verschuren, Kare M, Menno V. Huisman, H.R. Büller, Philippe Girard, Farès Moustafa, Marcel M. C. Hovens, Pieter W. Kamphuisen, Cardiovascular Centre (CVC), Vascular Ageing Programme (VAP), Emergency Department (FV - ED), Saint Luc University Hospital, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Other departments, ACS - Amsterdam Cardiovascular Sciences, Vascular Medicine, ACS - Pulmonary hypertension & thrombosis, ACS - Atherosclerosis & ischemic syndromes, Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), and Calvez, Ghislaine
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Male ,pulmonary embolism ,diagnosis ,[SDV]Life Sciences [q-bio] ,D-DIMER ,Clinical prediction rule ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Risk Factors ,Prevalence ,Routine clinical practice ,Prospective Studies ,030212 general & internal medicine ,Geneva score ,health care economics and organizations ,ComputingMilieux_MISCELLANEOUS ,Event (probability theory) ,ddc:616 ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,DECISION RULES ,age-adjusted D-dimer cut-off ,Hematology ,Middle Aged ,Prognosis ,EMERGENCY ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,3. Good health ,Pulmonary embolism ,[SDV] Life Sciences [q-bio] ,Europe ,Pre- and post-test probability ,Female ,TRIAL ,medicine.medical_specialty ,Clinical Decision-Making ,Suspected pulmonary embolism ,Decision Support Techniques ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,diagnostic tests ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Predictive Value of Tests ,Internal medicine ,D-dimer ,medicine ,MANAGEMENT ,Humans ,PREDICTION RULES ,METAANALYSIS ,Aged ,Retrospective Studies ,business.industry ,Reproducibility of Results ,medicine.disease ,Surgery ,MODEL ,clinical prediction rules ,business ,Biomarkers ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Essentials The simplified Geneva score allows easier pretest probability assessment of pulmonary embolism (PE). We prospectively validated this score in the ADJUST-PE management outcome study. The study shows that it is safe to manage patients with suspected PE according to this score. The simplified Geneva score is now ready for use in routine clinical practice. SummaryBackground Pretest probability assessment by a clinical prediction rule (CPR) is an important step in the management of patients with suspected pulmonary embolism (PE). A limitation to the use of CPRs is that their constitutive variables and corresponding number of points are difficult to memorize. A simplified version of the Geneva score (i.e. attributing one point to each variable) has been proposed but never been prospectively validated. Aims Prospective validation of the simplified Geneva score (SGS) and comparison with the previous version of the Geneva score (GS). Methods In the ADJUST-PE study, which had the primary aim of validating the age-adjusted D-dimer cut-off, the SGS was prospectively used to determine the pretest probability in a subsample of 1621 study patients. Results Overall, PE was confirmed in 294 (18.1%) patients. Using the SGS, 608 (37.5%), 980 (60.5%) and 33 (2%) were classified as having a low, intermediate and high clinical probability. Corresponding prevalences of PE were 9.7%, 22.4% and 45.5%; 490 (30.1%) patients with low or intermediate probability had a D-dimer level below 500 μg L−1 and 653 (41.1%) had a negative D-dimer test according to the age-adjusted cut-off. Using the GS, the figures were 491(30.9%) and 650 (40.9%). None of the patients considered as not having PE based on a low or intermediate SGS and negative D-dimer had a recurrent thromboembolic event during the 3-month follow-up. Conclusions The use of SGS has similar efficiency and safety to the GS in excluding PE in association with the D-dimer test.
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- 2017
16. Correlates of Social Exclusion in Social Anxiety Disorder: An fMRI study
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Laurence Dricot, Alexandre Heeren, Joël Billieux, Pierre Maurage, Delphine Grynberg, Pierre Philippot, Philippe de Timary, Institut de recherche en sciences psychologiques (IPSY), Université Catholique de Louvain (UCL), Harvard University [Cambridge], Institute of Neuroscience [Bruxelles], University of Luxembourg [Luxembourg], Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193 (SCALab), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Saint Luc University Hospital (ULC), Saint Luc Hospital, Université Catholique de Louvain = Catholic University of Louvain (UCL), Cliniques Universitaires Saint-Luc [Bruxelles], UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de psychiatrie adulte, UCL - SSH/IPSY - Psychological Sciences Research Institute, Harvard University, Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 (SCALab), Université de Lille, CNRS, CHU Lille, Institut de recherche en sciences psychologiques [IPSY], and Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 [SCALab]
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Adult ,medicine.medical_specialty ,Science ,media_common.quotation_subject ,Population ,Traitement & psychologie clinique [H13] [Sciences sociales & comportementales, psychologie] ,Treatment & clinical psychology [H13] [Social & behavioral sciences, psychology] ,behavioral disciplines and activities ,Article ,050105 experimental psychology ,Young Adult ,[SCCO]Cognitive science ,03 medical and health sciences ,0302 clinical medicine ,Social neuroscience ,mental disorders ,medicine ,Humans ,0501 psychology and cognitive sciences ,education ,Psychiatry ,media_common ,education.field_of_study ,Neural correlates of consciousness ,Multidisciplinary ,05 social sciences ,Social anxiety ,Brain ,Phobia, Social ,Cognition ,Magnetic Resonance Imaging ,Psychological Distance ,Feeling ,Medicine ,Female ,[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Social exclusion ,Brain level ,Psychology ,psychological phenomena and processes ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Cognitive models posit that social anxiety disorder (SAD) is maintained by biased information-processing vis-à-vis threat of social exclusion. However, uncertainty still abounds regarding the very nature of this sensitivity to social exclusion in SAD. Especially, brain alterations related to social exclusion have not been explored in SAD. Our primary purpose was thus to determine both the self-report and neural correlates of social exclusion in this population. 23 patients with SAD and 23 matched nonanxious controls played a virtual game (“Cyberball”) during fMRI recording. Participants were first included by other players, then excluded, and finally re-included. At the behavioral level, patients with SAD exhibited significantly higher levels of social exclusion feelings than nonanxious controls. At the brain level, patients with SAD exhibited significantly higher activation within the left inferior frontal gyrus relative to nonanxious controls during the re-inclusion phase. Moreover, self-report of social exclusion correlates with the activity of this cluster among individuals qualifying for SAD diagnosis. Our pattern of findings lends strong support to the notion that SAD may be better portrayed by a poor ability to recover following social exclusion than during social exclusion per se. These findings value social neuroscience as an innovative procedure to gain new insight into the underlying mechanisms of SAD.
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- 2017
17. Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study
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Morgan Jaffrelot, Marije Ten Wolde, Renée A. Douma, Menno V. Huisman, Paul L. den Exter, Olivier Thierry Rutschmann, Farès Moustafa, Pierre-Marie Roy, Josien van Es, Alessandra Principe, Pieter Willem Kamphuisen, A Trinh-Duc, Marc Philip Righini, Olivier Sanchez, Marco J. J. H. Grootenboers, Marc Durian, Y. Whitney Cheung, Guy Meyer, Catherine Le Gall, Franck Verschuren, Grégoire Le Gal, Klaas W Van Kralingen, Petra M. G. Erkens, Henri Bounameaux, Anja A. van Houten, Alexandre Ghuysen, Germa Hazelaar, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Department of Vascular Medicine (AMSTERDAM - DVM), Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA)-University of Amsterdam [Amsterdam] (UvA), Department of Thrombosis and Hemostasis (LEIDEN - DTH), Leiden University Medical Center (LUMC), Service des Urgences (PMR), CHRU - ANGERS, Emergency Department (FV - ED), Saint Luc University Hospital, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service des Urgences (MG), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service d'Accueil des Urgences (AGEN - SAU), Centre Hospitalier d'Agen, Service d'Accueil des Urgences (ARGENTEUIL - SAU), CH Argenteuil, Département des Urgences, CHU Clermont-Ferrand, Service des Urgences (CHPM - SU), CH Morlaix, Department of Internal Medicine (ROTTERDAM - Med Int), Maasstad Hospital, Department of Vascular Medicine (DVM - AMC), Department of General Practice (CAPHRI), Maastricht University [Maastricht], Department of Vascular Medicine (DVM - Groningen), University Medical Center Groningen [Groningen] (UMCG), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cardiovascular Centre (CVC), Vascular Ageing Programme (VAP), Vascular Medicine, Other departments, 01 Internal and external specialisms, Family Medicine, RS: CAPHRI School for Public Health and Primary Care, Biochemie, RS: CAPHRI - Clinical epidemiology, and Hematology
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Male ,MESH: Pulmonary Embolism ,REVISED GENEVA SCORE ,[SDV]Life Sciences [q-bio] ,030204 cardiovascular system & hematology ,Gastroenterology ,MESH: Venous Thromboembolism ,0302 clinical medicine ,Reference Values ,Outpatients ,EXCLUSION ,Prevalence ,Cutoff ,Prospective Studies ,030212 general & internal medicine ,Geneva score ,Prospective cohort study ,ELDERLY-PATIENTS ,ddc:616 ,MESH: Aged ,MESH: Angiography ,MESH: Risk ,Respiratory disease ,Age Factors ,Angiography ,MESH: Reference Values ,General Medicine ,EMERGENCY ,Thrombosis ,3. Good health ,Pulmonary embolism ,Europe ,MESH: Emergency Service, Hospital ,Acute Disease ,MESH: Diagnostic Errors ,MESH: Acute Disease ,Female ,Emergency Service, Hospital ,Risk ,medicine.medical_specialty ,MESH: Probability ,Age adjustment ,Sensitivity and Specificity ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,Internal medicine ,D-dimer ,medicine ,MANAGEMENT ,MESH: Fibrin Fibrinogen Degradation Products ,Humans ,COMPUTED-TOMOGRAPHY ,Diagnostic Errors ,MESH: Prevalence ,Aged ,Probability ,MESH: Age Factors ,VENOUS THROMBOEMBOLISM ,MESH: Humans ,business.industry ,DIAGNOSTIC STRATEGIES ,medicine.disease ,MESH: Male ,MESH: Prospective Studies ,MESH: Sensitivity and Specificity ,Surgery ,CLINICAL PROBABILITY ,MESH: Outpatients ,THROMBOSIS ,MESH: Europe ,Pulmonary Embolism ,business ,MESH: Female - Abstract
International audience; IMPORTANCE: D-dimer measurement is an important step in the diagnostic strategy of clinically suspected acute pulmonary embolism (PE), but its clinical usefulness is limited in elderly patients. OBJECTIVE: To prospectively validate whether an age-adjusted D-dimer cutoff, defined as age × 10 in patients 50 years or older, is associated with an increased diagnostic yield of D-dimer in elderly patients with suspected PE. DESIGN, SETTINGS, AND PATIENTS: A multicenter, multinational, prospective management outcome study in 19 centers in Belgium, France, the Netherlands, and Switzerland between January 1, 2010, and February 28, 2013. INTERVENTIONS: All consecutive outpatients who presented to the emergency department with clinically suspected PE were assessed by a sequential diagnostic strategy based on the clinical probability assessed using either the simplified, revised Geneva score or the 2-level Wells score for PE; highly sensitive D-dimer measurement; and computed tomography pulmonary angiography (CTPA). Patients with a D-dimer value between the conventional cutoff of 500 µg/L and their age-adjusted cutoff did not undergo CTPA and were left untreated and formally followed-up for a 3-month period. MAIN OUTCOMES AND MEASURES: The primary outcome was the failure rate of the diagnostic strategy, defined as adjudicated thromboembolic events during the 3-month follow-up period among patients not treated with anticoagulants on the basis of a negative age-adjusted D-dimer cutoff result. RESULTS: Of the 3346 patients with suspected PE included, the prevalence of PE was 19%. Among the 2898 patients with a nonhigh or an unlikely clinical probability, 817 patients (28.2%) had a D-dimer level lower than 500 µg/L (95% CI, 26.6%-29.9%) and 337 patients (11.6%) had a D-dimer between 500 µg/L and their age-adjusted cutoff (95% CI, 10.5%-12.9%). The 3-month failure rate in patients with a D-dimer level higher than 500 µg/L but below the age-adjusted cutoff was 1 of 331 patients (0.3% [95% CI, 0.1%-1.7%]). Among the 766 patients 75 years or older, of whom 673 had a nonhigh clinical probability, using the age-adjusted cutoff instead of the 500 µg/L cutoff increased the proportion of patients in whom PE could be excluded on the basis of D-dimer from 43 of 673 patients (6.4% [95% CI, 4.8%-8.5%) to 200 of 673 patients (29.7% [95% CI, 26.4%-33.3%), without any additional false-negative findings. CONCLUSIONS AND RELEVANCE: Compared with a fixed D-dimer cutoff of 500 µg/L, the combination of pretest clinical probability assessment with age-adjusted D-dimer cutoff was associated with a larger number of patients in whom PE could be considered ruled out with a low likelihood of subsequent clinical venous thromboembolism. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01134068.
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- 2014
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18. Diagnosis of pulmonary embolism by multidetector CT alone or combined with venous ultrasonography of the leg: a randomised non-inferiority trial
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Dominique Mottier, Guy Meyer, Jacques Cornuz, Michel Nonent, Pierre-Alexandre Alois Poletti, Henri Bounameaux, Olivier Sanchez, Grégoire Le Gal, Marc Philip Righini, Arnaud Perrier, Cédric Petit Le Manach, Frédéric Thys, Thomas V. Perneger, Drahomir Aujesky, Olivier Thierry Rutschmann, Franck Verschuren, Pierre-Marie Roy, Marie-Pierre Revel, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Internal Medicine (DIM -CHUV), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Centre de Recherche Clinique (CRC Angers), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service des Urgences (PMR), CHRU - ANGERS, Emergency Department (FV - ED), Saint Luc University Hospital, Division of General Internal Medicine, Université de Lausanne (UNIL), Département de radiologie [Brest] (DR - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille, Emergency Radiology Service, HUG (HUG), Université de Genève (UNIGE), 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), Division of Clinical Epidemiology (DCE), Geneva University Hospital (HUG), Service de médecine interne générale (SMIG), Hôpital Universitaire de Genève = University Hospitals of Geneva (HUG), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Lausanne = University of Lausanne (UNIL), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), and Université de Genève = University of Geneva (UNIGE)
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Male ,MESH: Pulmonary Embolism ,Pulmonary Embolism/diagnosis/etiology/ultrasonography ,030204 cardiovascular system & hematology ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,Risk Factors ,MESH: Risk Factors ,law ,030212 general & internal medicine ,Geneva score ,Ultrasonography ,Venous Thrombosis ,MESH: Middle Aged ,Respiratory disease ,MESH: Enzyme-Linked Immunosorbent Assay ,General Medicine ,Middle Aged ,Thrombosis ,3. Good health ,Pulmonary embolism ,medicine.anatomical_structure ,Female ,Venous Thrombosis/complications ,Radiology ,MESH: Tomography, X-Ray Computed ,Fibrin Fibrinogen Degradation Products/metabolism ,medicine.medical_specialty ,MESH: Probability ,Enzyme-Linked Immunosorbent Assay ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,MESH: Fibrin Fibrinogen Degradation Products ,medicine ,Humans ,ddc:610 ,Vein ,Contraindication ,Probability ,MESH: Humans ,business.industry ,medicine.disease ,MESH: Male ,Surgery ,Clinical trial ,MESH: Venous Thrombosis ,Pulmonary Embolism ,Tomography, X-Ray Computed ,business ,MESH: Female ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; BACKGROUND: Multislice CT (MSCT) combined with D-dimer measurement can safely exclude pulmonary embolism in patients with a low or intermediate clinical probability of this disease. We compared this combination with a strategy in which both a negative venous ultrasonography of the leg and MSCT were needed to exclude pulmonary embolism. METHODS: We included 1819 consecutive outpatients with clinically suspected pulmonary embolism in a multicentre non-inferiority randomised controlled trial comparing two strategies: clinical probability assessment and either D-dimer measurement and MSCT (DD-CT strategy [n=903]) or D-dimer measurement, venous compression ultrasonography of the leg, and MSCT (DD-US-CT strategy [n=916]). Randomisation was by computer-generated blocks with stratification according to centre. Patients with a high clinical probability according to the revised Geneva score and a negative work-up for pulmonary embolism were further investigated in both groups. The primary outcome was the 3-month thromboembolic risk in patients who were left untreated on the basis of the exclusion of pulmonary embolism by diagnostic strategy. Clinicians assessing outcome were blinded to group assignment. Analysis was per protocol. This study is registered with ClinicalTrials.gov, number NCT00117169. FINDINGS: The prevalence of pulmonary embolism was 20.6% in both groups (189 cases in DD-US-CT group and 186 in DD-CT group). We analysed 855 patients in the DD-US-CT group and 838 in the DD-CT group per protocol. The 3-month thromboembolic risk was 0.3% (95% CI 0.1-1.1) in the DD-US-CT group and 0.3% (0.1-1.2) in the DD-CT group (difference 0.0% [-0.9 to 0.8]). In the DD-US-CT group, ultrasonography showed a deep-venous thrombosis in 53 (9% [7-12]) of 574 patients, and thus MSCT was not undertaken. INTERPRETATION: The strategy combining D-dimer and MSCT is as safe as the strategy using D-dimer followed by venous compression ultrasonography of the leg and MSCT for exclusion of pulmonary embolism. An ultrasound could be of use in patients with a contraindication to CT.
- Published
- 2008
19. The Simplified Pulmonary Embolism Severity Index (PESI): validation of a clinical prognostic model for pulmonary embolism
- Author
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Marc Philip Righini, G. Le Gal, Drahomir Aujesky, Guy Meyer, P.-M. Roy, F. Verschuren, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Centre de Recherche Clinique (CRC Angers), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), 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), Department of Emergency Medicine, Saint Luc University Hospital, Division of General Internal Medicine, Université de Lausanne (UNIL), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
MESH: Pulmonary Embolism ,medicine.medical_specialty ,Validation study ,Index (economics) ,MEDLINE ,030204 cardiovascular system & hematology ,Severity of Illness Index ,MESH: Prognosis ,03 medical and health sciences ,0302 clinical medicine ,Pulmonary Embolism/pathology ,MESH: Severity of Illness Index ,Severity of illness ,medicine ,Humans ,030212 general & internal medicine ,MESH: Models, Theoretical ,ComputingMilieux_MISCELLANEOUS ,ddc:616 ,MESH: Humans ,business.industry ,Hematology ,Models, Theoretical ,Prognosis ,medicine.disease ,Pulmonary embolism ,Surgery ,Emergency medicine ,Prognostic model ,Pulmonary Embolism ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience
- Published
- 2011
20. Fibrinolysis for patients with intermediate-risk pulmonary embolism
- Author
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Sebastian Schellong, Mustapha Sebbane, Thierry Danays, Samuel Z. Goldhaber, Guy Meyer, Irene M. Lang, Cecilia Becattini, Eric Vicaut, Francis Couturaud, Christian Kupatt, Bożena Sobkowicz, Adam Torbicki, Claudia Dellas, Franck Verschuren, Erich Bluhmki, Hélène Bouvaist, Abstr Act, Nicolas Meneveau, Branislav Stefanovic, Benjamin Brenner, Annette Geibel, Piotr Pruszczyk, Mareike Lankeit, Jan Beyer-Westendorf, Ana Franca, Nils Kucher, Klaus Empen, David Jiménez, Matija Kozak, Nazzareno Galiè, Holger Thiele, Antoniu Petris, Giancarlo Agnelli, Gerard Pacouret, Aldo Salvi, Stavros Konstantinides, Matteo Rugolotto, Massimiliano Palazzini, Hôpital Européen Georges Pompidou [APHP] ( HEGP ), GIRC Thrombose, Service de Statistiques, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, BOEHRINGER INGELHEIM, Boehringer Ingelheim, Internal and Cardiovascular Medicine - Stroke Unit ( PERUGIA - ICM-SU ), Università degli Studi di Perugia ( UNIPG ), Carl Gustav Carus University ( DRESDEN - CGCU ), Technische Universität Dresden ( TUD ), Service de Cardiologie, CHU Grenoble, Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Centre d'Investigation Clinique ( CIC - Brest ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Département de Médecine Interne et Pneumologie [Brest] ( DMIP - Brest ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Department of Cardiology, University of Freiburg [Freiburg], Cardiovascular Division ( SZG ), Brigham and Women's Hospital [Boston], Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) ( PCVP / CARDIO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université de Franche-Comté ( UFC ) -Université Bourgogne Franche-Comté [COMUE] ( UBFC ), Service de Cardiologie A ( TOURS - Cardiologie A ), CHRU Tours, Dresden-Friedrichstadt Hospital ( DRESDEN-FRIEDRICHSTADT HOSPITAL ), Dresden-Friedrichstadt Hospital, Département de Médecine d'Urgence, Hôpital Lapeyronie, Cologne Center for Genomics (CCG), University of Cologne, Emergency Department ( FV - ED ), Saint Luc University Hospital, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Internal and Cardiovascular Medicine - Stroke Unit (PERUGIA - ICM-SU), Università degli Studi di Perugia (UNIPG), Carl Gustav Carus University (DRESDEN - CGCU), Technische Universität Dresden = Dresden University of Technology (TU Dresden), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Cardiovascular Division (SZG), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) (PCVP / CARDIO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de Cardiologie A (TOURS - Cardiologie A), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Dresden-Friedrichstadt Hospital (DRESDEN-FRIEDRICHSTADT HOSPITAL), Emergency Department (FV - ED), HEGP ( SPRM ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( PCVP / CARDIO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Guy Meyer, Eric Vicaut, Thierry Danay, Giancarlo Agnelli, Cecilia Becattini, Jan Beyer-Westendorf, Erich Bluhmki, Helene Bouvaist, Benjamin Brenner, Francis Couturaud, Claudia Della, Klaus Empen, Ana Franca, Nazzareno Galiè, Annette Geibel, Samuel Z. Goldhaber, David Jimenez, Matija Kozak, Christian Kupatt, Nils Kucher, Irene M. Lang, Mareike Lankeit, Nicolas Meneveau, Gerard Pacouret, Massimiliano Palazzini, Antoniu Petri, Piotr Pruszczyk, Matteo Rugolotto, Aldo Salvi, Sebastian Schellong, Mustapha Sebbane, Bozena Sobkowicz, Branislav S. Stefanovic, Holger Thiele, Adam Torbicki, Franck Verschuren, and Stavros V. Konstantinides
- Subjects
MESH: Pulmonary Embolism ,Male ,MESH: Heparin ,MESH : Stroke ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Ventricular Dysfunction, Right ,MESH : Aged ,MESH : Ventricular Dysfunction, Right ,law.invention ,MESH : Tissue Plasminogen Activator ,MESH: Aged, 80 and over ,Randomized controlled trial ,MESH: Risk Factors ,law ,Risk Factors ,MESH: Tissue Plasminogen Activator ,MESH: Fibrinolytic Agents ,MESH: Double-Blind Method ,MESH : Female ,Stroke ,MESH: Ventricular Dysfunction, Right ,MESH: Treatment Outcome ,MESH: Aged ,Aged, 80 and over ,MESH: Middle Aged ,Age Factors ,General Medicine ,Middle Aged ,MESH : Risk Factors ,Troponin ,3. Good health ,Pulmonary embolism ,Treatment Outcome ,Anesthesia ,Tissue Plasminogen Activator ,MESH : Pulmonary Embolism ,Drug Therapy, Combination ,Female ,MESH: Hemorrhage ,medicine.drug ,medicine.medical_specialty ,Randomization ,MESH : Male ,Tenecteplase ,610 Medicine & health ,Hemorrhage ,MESH : Treatment Outcome ,MESH : Hemorrhage ,Placebo ,MESH: Stroke ,Double-Blind Method ,Fibrinolytic Agents ,Fibrinolysis ,medicine ,Fibrinolysi ,MESH : Double-Blind Method ,Humans ,Decompensation ,MESH : Middle Aged ,MESH : Aged, 80 and over ,Aged ,MESH: Age Factors ,MESH: Humans ,[ SDV ] Life Sciences [q-bio] ,business.industry ,Heparin ,MESH : Drug Therapy, Combination ,MESH : Humans ,MESH : Fibrinolytic Agents ,medicine.disease ,MESH: Male ,Surgery ,MESH: Drug Therapy, Combination ,MESH : Troponin ,MESH : Heparin ,MESH: Troponin ,MESH : Age Factors ,business ,Pulmonary Embolism ,MESH: Female - Abstract
International audience; BACKGROUND: The role of fibrinolytic therapy in patients with intermediate-risk pulmonary embolism is controversial. METHODS: In a randomized, double-blind trial, we compared tenecteplase plus heparin with placebo plus heparin in normotensive patients with intermediate-risk pulmonary embolism. Eligible patients had right ventricular dysfunction on echocardiography or computed tomography, as well as myocardial injury as indicated by a positive test for cardiac troponin I or troponin T. The primary outcome was death or hemodynamic decompensation (or collapse) within 7 days after randomization. The main safety outcomes were major extracranial bleeding and ischemic or hemorrhagic stroke within 7 days after randomization. RESULTS: Of 1006 patients who underwent randomization, 1005 were included in the intention-to-treat analysis. Death or hemodynamic decompensation occurred in 13 of 506 patients (2.6%) in the tenecteplase group as compared with 28 of 499 (5.6%) in the placebo group (odds ratio, 0.44; 95% confidence interval, 0.23 to 0.87; P=0.02). Between randomization and day 7, a total of 6 patients (1.2%) in the tenecteplase group and 9 (1.8%) in the placebo group died (P=0.42). Extracranial bleeding occurred in 32 patients (6.3%) in the tenecteplase group and 6 patients (1.2%) in the placebo group (P
- Published
- 2014
21. The prognostic value of pro-B-Type natriuretic peptide in acute pulmonary embolism
- Author
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Mathieu Bonnet, Marie-Odile Benoit, Franck Verschuren, Nicolas Meneveau, Guy Meyer, Damien Gruson, Marc Philip Righini, Olivier Sanchez, Francis Couturaud, Francis Zech, Pierre-Marie Roy, Emergency Department (FV - ED), Saint Luc University Hospital, Service de Biochimie (HEGP - Biochimie), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département d'Endocrinologie et Nutrition (LOUVAIN - Endocrino), Université Catholique de Louvain = Catholic University of Louvain (UCL), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) (PCVP / CARDIO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service des Urgences (PMR), CHRU - ANGERS, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, 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), Emergency Department ( FV - ED ), Service de Biochimie ( HEGP - Biochimie ), Assistance publique - Hôpitaux de Paris (AP-HP), Département d'Endocrinologie et Nutrition ( LOUVAIN - Endocrino ), Université Catholique de Louvain ( UCL ), Département de Médecine Interne et Pneumologie [Brest] ( DMIP - Brest ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( PCVP / CARDIO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Service des Urgences ( PMR ), Service d'angiologie et d'hémostase ( MR ), HEGP ( SPRM ), and Hôpital Européen Georges Pompidou [APHP] ( HEGP )
- Subjects
Male ,MESH: Pulmonary Embolism ,[SDV]Life Sciences [q-bio] ,MESH : Aged ,030204 cardiovascular system & hematology ,Cohort Studies ,0302 clinical medicine ,Natriuretic Peptide, Brain ,Natriuretic peptide ,Medicine ,MESH : Female ,030212 general & internal medicine ,MESH: Natriuretic Peptide, Brain ,MESH: Cohort Studies ,ddc:616 ,MESH: Aged ,MESH : Prognosis ,MESH: Middle Aged ,Cardiogenic shock ,MESH : Acute Disease ,Hematology ,Middle Aged ,Prognosis ,3. Good health ,Pulmonary embolism ,Acute Disease ,MESH : Pulmonary Embolism ,Cardiology ,MESH: Acute Disease ,Female ,hormones, hormone substitutes, and hormone antagonists ,Cohort study ,MESH : Natriuretic Peptide, Brain ,medicine.medical_specialty ,medicine.drug_class ,MESH : Male ,MESH : Cohort Studies ,MESH: Prognosis ,03 medical and health sciences ,Internal medicine ,Humans ,In patient ,Clinical significance ,MESH : Middle Aged ,cardiovascular diseases ,Aged ,MESH: Humans ,Receiver operating characteristic ,[ SDV ] Life Sciences [q-bio] ,business.industry ,MESH : Humans ,MESH: ROC Curve ,medicine.disease ,MESH: Male ,Surgery ,ROC Curve ,Pulmonary Embolism ,business ,Venous thromboembolism ,MESH: Female ,MESH : ROC Curve - Abstract
International audience; AIMS: To assess the clinical performance of pro-B-type natriuretic peptide 1-108 (proBNP) for the prognosis of acute pulmonary embolism. METHODS: This study was ancillary to a recently published multicentre study including 570 patients with acute pulmonary embolism. ProBNP values were analysed using a new sandwich immunoassay proBNP1-108, Bioplex2200 (Bio-Rade Laboratories). Data was compared with BNP and N-terminal (NT) proBNP values. Adverse outcomes at 30 days were defined as death, secondary cardiogenic shock, or recurrent venous thromboembolism. RESULTS: ProBNP values were analysed in 549 patients, with 39 (7.1%) presenting adverse outcomes. All three natriuretic peptides were significantly elevated in these 39 patients compared with the group without adverse outcomes (BNP: p < 0.001; NT-proBNP: p < 0.001; proBNP: 0.044), with median proBNP values being 605 pg/ml (113-1437) and 109 pg/ml (30-444), respectively. Multivariate analyses revealed that proBNP significantly depended on patient age (p < 0.001) and renal failure (p=0.001), with proBNP values increasing with both factors. The areas under the receiver operating curve were 0.74 (95% CI 0.69-0.79) for BNP, 0.76 (95% CI 0.72-0.80) for NT-proBNP, and 0.70 (95% CI 0.65-0.75) for proBNP, meaning that the performance of proBNP was significantly lower than that of the two other peptides (p = 0.017). CONCLUSION: ProBNP, BNP, and NT-proBNP values were significantly increased in patients with adverse outcomes after acute pulmonary embolism. However, the prognostic performance of proBNP for predicting adverse versus favourable outcomes was lower than that of the other natriuretic peptides, thus limiting the clinical relevance of proBNP as a prognostic marker in pulmonary embolism.
- Published
- 2013
22. Prognostic value of the Geneva prediction rule in patients with pulmonary embolism
- Author
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Arnaud Perrier, Drahomir Aujesky, Olivier Sanchez, Franck Verschuren, Marc Philip Righini, Henri Bounameaux, Grégoire Le Gal, L. Bertoletti, Pierre-Marie Roy, Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Saint Etienne, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Department of Internal Medicine (DIM -CHUV), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service des Urgences (PMR), CHRU - ANGERS, Emergency Department (FV - ED), Saint Luc University Hospital, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Department of Internal Medicine (AP), and Geneva University Hospital (HUG)
- Subjects
Male ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Clinical prediction rule ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Multicenter trial ,Medicine ,Humans ,In patient ,030212 general & internal medicine ,Geneva score ,Aged ,Probability ,ddc:616 ,Aged, 80 and over ,business.industry ,Mortality rate ,Hematology ,Odds ratio ,Middle Aged ,medicine.disease ,Prognosis ,Confidence interval ,3. Good health ,Surgery ,Pulmonary embolism ,ddc:618.97 ,Female ,business ,Pulmonary Embolism ,Follow-Up Studies - Abstract
International audience; BACKGROUND: Assessment of pre-test probability of pulmonary embolism (PE) and prognostic stratification are two widely recommended steps in the management of patients with suspected PE. Some items of the Geneva prediction rule may have a prognostic value. We analyzed whether the initial probability assessed by the Geneva rule was associated with the outcome of patients with PE. METHODS: In a post-hoc analysis of a multicenter trial including 1,693 patients with suspected PE, the all-cause death or readmission rates during the 3-month follow-up of patients with confirmed PE were analyzed. PE probability group was prospectively assessed by the revised Geneva score (RGS). Similar analyses were made with the a posteriori-calculated simplified Geneva score (SGS). RESULTS: PE was confirmed in 357 patients and 21 (5.9%) died during the 3-month follow-up. The mortality rate differed significantly with the initial RGS group, as with the SGS group. For the RGS, the mortality increased from 0% (95% Confidence Interval: [0-5.4%]) in the low-probability group to 14.3% (95% CI: [6.3-28.2%]) in the high-probability group, and for the SGS, from 0% (95% CI: [0-5.4%] to 17.9% (95% CI: [7.4-36%]). Readmission occurred in 58 out of the 352 patients with complete information on readmission (16.5%). No significant change of readmission rate was found among the RGS or SGS groups. CONCLUSIONS: Returning to the initial PE probability evaluation may help clinicians predict 3-month mortality in patients with confirmed PE. (ClinicalTrials.gov: NCT00117169).
- Published
- 2013
23. Echocardiography and PESI have independent prognostic role in pulmonary embolism
- Author
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Sanchez, Olivier, Trinquart, Ludovic, Planquette, Benjamin, Couturaud, Francis, Verschuren, Franck, Caille, Vincent, Meneveau, Nicolas, Pacouret, Gérard, Roy, Pierre-Marie, Righini, Marc, Perrier, Arnaud, Bertoletti, Laurent, Parent, Florence, Lorut, Christine, Meyer, Guy, 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), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Emergency Department (FV - ED), Saint Luc University Hospital, Service des Urgences (PMR), CHRU - ANGERS, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Department of Internal Medicine (AP), Geneva University Hospital (HUG), Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Service de pneumologie [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre chirurgical Marie Lannelongue, Service de Pneumologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel Dieu, AP-HP - Hôpital Antoine Béclère [Clamart], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Subjects
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; We analysed a cohort of patients with normotensive pulmonary embolism (PE) in order to assess whether combining echocardiography and biomarkers with the pulmonary embolism severity index (PESI) improves the risk-stratification in comparison to the PESI alone.The PESI was calculated in normotensive patients with PE who also underwent echocardiography and assays of troponin and brain natriuretic peptide. Thirty-day adverse outcome was defined as death, recurrent PE or shock.529 patients were included, 25 (4.7%; 95% confidence interval (CI), 3.2% to 6.9%) had at least one outcome event. The proportion of patients with adverse events increased from 2.1% in PESI class I-II to 8.4% in PESI class III-IV, and to 14.3% in PESI class V (P
- Published
- 2012
24. Performance of age-adjusted D-dimer cut-off to rule out pulmonary embolism
- Author
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Frédéric Thys, G. Le Gal, Jeffrey A. Kline, N. Delvau, Franck Verschuren, S. Quentin-Georget, Andrea Penaloza, P.-M. Roy, Emergency Department (FV - ED), Saint Luc University Hospital, Service des Urgences (PMR), CHRU - ANGERS, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Acute Medicine Department, Accidents and Emergency Unit (FV - AMD), and Université Catholique de Louvain = Catholic University of Louvain (UCL)
- Subjects
Male ,medicine.medical_specialty ,Age adjustment ,MEDLINE ,030204 cardiovascular system & hematology ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Older patients ,Internal medicine ,D-dimer ,medicine ,Humans ,030212 general & internal medicine ,Prospective cohort study ,Aged ,business.industry ,Age Factors ,Hematology ,Middle Aged ,medicine.disease ,3. Good health ,Surgery ,Pulmonary embolism ,Female ,business ,Pulmonary Embolism ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Summary: Background: Age-adjusted D-dimer cut-off has recently been proposed to increase D-dimer usefulness in older patients suspected of pulmonary embolism (PE). Objective: We externally validated this age-adjusted D-dimer cut-off using different D-dimer assays in a multicenter sample of emergency department patients. Methods: Secondary analysis of three prospectively collected databases (two European, one American) of patients suspected of having PE. D-dimer performance for ruling out PE was assessed by calculating negative likelihood ratio (nLR) for D-dimer with age-adjusted D-dimer cut-off ( 75 years: NTT halved from 8.1 to 3.6. The proportion of patients over 75 years with normal D-dimer was doubled (27.9% vs. 12.3%). Conclusions: Our study shows that age-adjusted D-dimer had low nLR, allowing its use as a rule-out PE strategy in non-high pretest clinical probability patients, as well as using Vidas(®) , Liatest(®) or MDA(®) assays. This age-adjusted cut-off increased clinical usefulness of D-dimer in older patients. A large prospective study is required to confirm these results.
- Published
- 2012
25. Prognostic value of the Geneva prediction rule in patients in whom pulmonary embolism is ruled out
- Author
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Bertoletti, L, Le Gal, G, Aujesky, D, Roy, P-M, Sanchez, Oliver Lope, Verschuren, F, Bounameaux, Henri, Perrier, Arnaud, Righini, Marc Philip, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Division of General Internal Medicine (DGIM), Bern University Hospital, Service des Urgences (PMR), CHRU - ANGERS, Department of Pneumology and Intensive Care Unit (DPICU), Université Paris Descartes - Paris 5 (UPD5), Emergency Department (FV - ED), Saint Luc University Hospital, Department of Internal Medicine (AP), Geneva University Hospital (HUG), Université de Brest (UBO)-Université de Brest (UBO), Service d'angiologie et d'hémostase ( MR ), Groupe de recherche sur la thrombose ( GRT (EA 3065) ), Université Jean Monnet [Saint-Étienne] ( UJM ), Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Centre d'Investigation Clinique ( CIC - Brest ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Division of General Internal Medicine ( DGIM ), Service des Urgences ( PMR ), Department of Pneumology and Intensive Care Unit ( DPICU ), Université Paris Descartes - Paris 5 ( UPD5 ), Emergency Department ( FV - ED ), Department of Internal Medicine ( AP ), and Geneva University Hospital ( HUG )
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MESH: Pulmonary Embolism ,Male ,MESH : Aged ,MESH: Epidemiologic Methods ,France/epidemiology ,Switzerland/epidemiology ,MESH: Belgium ,Belgium ,Neoplasms ,MESH : Cardiovascular Diseases ,MESH : Female ,MESH: Neoplasms ,Cardiovascular Diseases/mortality ,ddc:616 ,MESH: Aged ,MESH : Prognosis ,MESH: Middle Aged ,MESH : Adult ,Middle Aged ,Prognosis ,Cardiovascular Diseases ,MESH : Pulmonary Embolism ,Female ,Neoplasms/mortality ,France ,MESH : Belgium ,Respiratory Insufficiency ,MESH : Decision Support Techniques ,Switzerland ,Adult ,MESH : Switzerland ,Respiratory Insufficiency/mortality ,MESH : Male ,MESH: Switzerland ,Patient Readmission ,MESH : Epidemiologic Methods ,MESH: Prognosis ,Decision Support Techniques ,[ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology ,MESH: Patient Readmission ,Humans ,Pulmonary Embolism/diagnosis ,MESH : Middle Aged ,MESH : France ,Belgium/epidemiology ,MESH : Patient Readmission ,Aged ,MESH: Humans ,MESH : Humans ,MESH: Cardiovascular Diseases ,MESH: Decision Support Techniques ,MESH: Adult ,MESH : Respiratory Insufficiency ,MESH : Neoplasms ,MESH: Male ,MESH: France ,Patient Readmission/statistics & numerical data ,Epidemiologic Methods ,Pulmonary Embolism ,MESH: Female ,MESH: Respiratory Insufficiency ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; OBJECTIVES: The prognosis of patients in whom pulmonary embolism (PE) is suspected but ruled out is poorly understood. We evaluated whether the initial assessment of clinical probability of PE could help to predict the prognosis for these patients. DESIGN: Retrospective analysis of data obtained during a prospective multicentre management study. SETTING: Six general and teaching hospitals in Belgium, France and Switzerland. SUBJECTS: In 1334 patients in whom PE was ruled out, 3-month mortality data were available (hospital readmission status was unknown for three patients) and clinical probability was evaluated with the revised Geneva score (RGS). MAIN OUTCOME MEASURES: Three-month mortality and readmission rates. RESULTS: Three-month mortality and readmissions rates were 3% and 19%, respectively and differed significantly depending on the RGS-determined PE probability group (P
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- 2011
26. Total ankle arthroplasty in France
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Christian Leonardi, Thibaut Lemrijse, Jean-Alain Colombier, Eric Toullec, Michel Bonnin, Fabrice Gaudot, Thierry Judet, Olivier Jarde, Jean-Luc Besse, Joseph Asencio, Michel Maestro, Laboratoire de Biomécanique et Mécanique des Chocs, Université de Lyon-Institut National de Recherche sur les Transports et leur Sécurité ( INRETS ), Nouvelle clinique de l' union, Nouvelle clinique de l'Union, Médecin orthopédiste, Centre Orthopédique Santy Lyon, Centre Orthopédique Santy - Lyon, AP-HP Hôpital Raymond Poincaré [Garches], Département d'orthopédie, Hôpital Nord-Amiens, IM2s Concep, Saint-Luc University Hospital, Cliniques Universitaires Saint-Luc [Bruxelles], Hôpital du Tondu, Hôpital du Tondu- Bordeaux, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche sur les Transports et leur Sécurité (INRETS), Hôpital Raymond Poincaré [AP-HP], and CHU Amiens-Picardie
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Male ,Joint Prosthesis ,medicine.medical_treatment ,CHEVILLE ,MARCHE A PIED ,Prosthesis ,Postoperative Complications ,0302 clinical medicine ,Surveys and Questionnaires ,RADIOGRAPHIE ,Medicine ,Orthopedics and Sports Medicine ,[ PHYS.MECA.BIOM ] Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph] ,030222 orthopedics ,PROTHESE ,Total ankle arthroplasty ,Middle Aged ,Biomechanical Phenomena ,Prosthesis Failure ,3. Good health ,Treatment Outcome ,medicine.anatomical_structure ,Radiological weapon ,Female ,France ,ETUDE CLINIQUE ,Adult ,Reoperation ,medicine.medical_specialty ,SF-36 ,Arthrodesis ,Ankle replacement ,[ SDV.EE.SANT ] Life Sciences [q-bio]/Ecology, environment/Health ,03 medical and health sciences ,Humans ,Arthroplasty, Replacement ,[PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph] ,Aged ,[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health ,business.industry ,Retrospective cohort study ,030229 sport sciences ,Arthroplasty ,Surgery ,POSTURE ,ENQUETE ,Ankle ,business ,Ankle Joint - Abstract
Summary Objectives After more than 10 years’ experience in France, the French Foot Surgery Association ( Association francaise de chirurgie du pied [AFCP]) presents an update on mobile-bearing ankle prostheses, based on a multicenter study. Meta-analysis – Biomechanics – Assessment and indications A preliminary comparative meta-analysis of the literature studies on ankle and prosthesis biomechanics, reviews validated indications and contra-indications, and details clinical and radiological outcomes assessment protocols. Professional survey Sixty-three surgeons (95% AFCP members) answered a professional online survey, by email or regular post: 70% performed total ankle replacement (TAR), 39% of them at least two per year and 16% more than 10 per year, resulting in 317 TARs per year or 50% of the French activity and 312 arthrodeses per year or 17% of the French activity – which gave the survey considerable power. In 2004–2005, 46% of the TARs implanted were AES ® , 38% Salto ® and 9% Hintegra ® . Gait analysis following TAR This study included two series of patients (15 in Brussels and six in Paris) with laboratory gait analysis preoperatively and at 6 months’ and 1 year's FU. Following TAR, speed, cadence and strides increased and mean total work approximated normal values. These two independent studies quantified the advantages of TAR over arthrodesis. Multicenter study This retrospective study had a minimum follow-up of 1 year. Results were not distinguished between the four types of prosthesis (approved by the French Healthcare Agency [HAS]) involved. Inclusion criteria for operators were: AFCP membership, and experience of more than 20 prostheses of a given type. Twelve out of 15 centers responded and undertook to include continuous series. Data were centralized on a dedicated anonymous online site. Five hundred and ninety-two TARs (388 Salto ® , 173 AES ® , 22 Hintegra ® , nine Star ® ) in 555 patients (mean age, 56.4 years; range 17–84 yrs) were included. Indications were post-traumatic arthritis (48%), arthritis associated with laxity (15%), inflammatory arthropathy (20%), primitive arthritis (9%), prosthetic revision (2%), and miscellaneous (5%). Sixty-one percent of operations included associated procedures: 208 Achilles lengthenings, 45 subtalar arthrodeses, nine calcaneal osteotomies and 45 lateral ligament reconstructions. Complications comprised 53 malleolar fractures, and 39 cutaneous and seven infections (9%). At a mean 37 months’ FU, 87.5% of patients were satisfied or very satisfied; mean functional score was 82.1/100; radiographic mobility, 23.2°; and total SF 36 score (on the Short Form Health Survey), 66. X-ray found stable anchorage in 98% of cases, cysts in 15%, and calcification in 4%. Revision for failure Overall cumulated survivorship was 88% at 71 months: 22 patients underwent arthrodesis (61% satisfied), and 10 implant replacement (50% satisfied). Conclusion This multioperator, multi-implant series of 592 patients confirmed literature data. Prospective follow-up of the cohorts managed in these expert centers is essential, in order to make available long-term data.
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- 2010
27. Complete venous ultrasound in outpatients with suspected pulmonary embolism
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Righini, Marc, Le Gal, Grégoire, Aujesky, D., Roy, Pierre-Marie, Sanchez, Olivier, Verschuren, F., Bressollette, Luc, Meyer, Guy, Perrier, Arnaud, Bounameaux, Henri, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Department of Internal Medicine (DIM -CHUV), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Service des Urgences (PMR), CHRU - ANGERS, 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), Emergency Department (FV - ED), Saint Luc University Hospital, Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Department of Internal Medicine (AP), Geneva University Hospital (HUG), and Calvez, Ghislaine
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[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,ComputingMilieux_MISCELLANEOUS ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience
- Published
- 2009
28. Cardiac biomarkers for risk stratification in non-massive pulmonary embolism: a multicenter prospective study
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Jean-Charles Sanchez, Nicolas Vuilleumier, Natacha Turck, G. Le Gal, Arnaud Perrier, Thomas V. Perneger, Noury Mensi, Denis F. Hochstrasser, Marc Philip Righini, F. Verschuren, Henri Bounameaux, Division of Laboratory Medicine (DLM), Geneva University Hospital (HUG), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Emergency Department (FV - ED), Saint Luc University Hospital, Service de médecine interne générale (SMIG), Hôpital Universitaire de Genève, Service d'angiologie et d'hémostase (MR), Biomedical Proteomic Research Group (BPRG), University Medical Centre of Geneva, Biomedical Proteomics Research Group (BPRG), Centre médical universitaire, and Division of Clinical Epidemiology (DCE)
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MESH: Pulmonary Embolism ,030204 cardiovascular system & hematology ,Chest pain ,MESH: Risk Assessment ,Gastroenterology ,0302 clinical medicine ,Natriuretic Peptide, Brain ,Odds Ratio ,030212 general & internal medicine ,MESH: Natriuretic Peptide, Brain ,Prospective Studies ,Prospective cohort study ,MESH: Peptide Fragments ,ddc:616 ,Univariate analysis ,MESH: Middle Aged ,Area under the curve ,Hematology ,Middle Aged ,Prognosis ,Troponin/blood ,Troponin ,MESH: Predictive Value of Tests ,3. Good health ,Pulmonary embolism ,MESH: Young Adult ,Predictive value of tests ,Biological Markers ,Female ,medicine.symptom ,Adult ,medicine.medical_specialty ,Adolescent ,Fibrin Fibrinogen Degradation Products/analysis ,Fatty Acid-Binding Proteins ,MESH: Fatty Acid-Binding Proteins ,Risk Assessment ,MESH: Prognosis ,Fibrin Fibrinogen Degradation Products ,Pulmonary Embolism/*diagnosis ,03 medical and health sciences ,Young Adult ,Predictive Value of Tests ,Internal medicine ,medicine ,MESH: Fibrin Fibrinogen Degradation Products ,Humans ,ddc:576 ,ddc:613 ,MESH: Adolescent ,MESH: Humans ,business.industry ,MESH: Biological Markers ,MESH: Adult ,Odds ratio ,medicine.disease ,Peptide Fragments ,Confidence interval ,MESH: Prospective Studies ,MESH: Odds Ratio ,Surgery ,MESH: Troponin ,Natriuretic Peptide, Brain/blood ,Pulmonary Embolism ,business ,Peptide Fragments/blood ,MESH: Female ,Biomarkers ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Fatty Acid-Binding Proteins/blood - Abstract
International audience; BACKGROUND: Troponins (cTnI and cTnT), N-terminal pro-Brain Natriuretic Peptide (NT-proBNP), myoglobin, heart-type fatty acid-binding protein (H-FABP) and fibrin D-Dimer are emergent candidates for risk stratification in pulmonary embolism (PE). OBJECTIVE: To compare the respective prognostic values of biomarker with non-massive PE to predict an adverse outcome at 3 months. PATIENTS/METHODS: One hundred and forty-six consecutive patients with non-massive PE were included in this multicenter prospective study. The combined outcome consisted of intensive care monitoring on admission, death or hospitalization attributable to either a PE-related complication [defined by PE/deep vein thrombosis (DVT) relapse or major bleeding under anticoagulation] or to dyspnoea with or without chest pain during follow-up. RESULTS: The outcome was met in 12% of patients. In univariate analysis, a NT-proBNP level above 300 pg/ml was the strongest predictor of unfavorable outcome with an odds ratio (OR) of 15.8 [95% confidence interval (CI): 2.05-122). ORs for the other variables were: 8.0 for D-dimer >2000 ng/ml (95% CI: 1.1-64), 4.7 for H-FABP >6 ng/ml (95% CI:1.5-14.8), 3.5 for cTnI >0.09 ng/ml (95% CI:1.2-9.7), 3.4 for myoglobin >70 ng/ml (95% CI:0.9-12.2). Receiver operating curve (ROC) analysis indicated that NT-proBNP was the best predictor [area under the curve (AUC) 0.84; 95%CI: 0.76-0.92; P < 0.0001] with a negative predictive value of 100% (95% CI: 91-100) at 300 pg/ml. At that cut-off, the true negative rate for NT-proBNP was 40%. In multivariate analysis, NT-proBNP was the only significant independent predictors. CONCLUSIONS: NT-proBNP appears to be a good risk stratification marker in identifying low-risk patients with non-massive PE who could be treated in an outpatient setting.
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- 2009
29. Complete venous ultrasound in outpatients with suspected pulmonary embolism
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P.-M. Roy, F. Verschuren, Guy Meyer, Luc Bressollette, Oliver Lope Sanchez, Henri Bounameaux, Arnaud Perrier, G. Le Gal, Drahomir Aujesky, Michel P. Kossovsky, Marc Philip Righini, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Internal Medicine (DIM -CHUV), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Service des Urgences (PMR), CHRU - ANGERS, 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), Emergency Department (ED - SLUH), Saint Luc University Hospital, and Service de médecine interne générale (SMIG)
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MESH: Pulmonary Embolism ,Venous Thrombosis/diagnosis/ultrasonography ,Deep vein ,030204 cardiovascular system & hematology ,Likelihood ratios in diagnostic testing ,0302 clinical medicine ,MESH: Aged, 80 and over ,Outpatients ,030212 general & internal medicine ,Tomography ,Ultrasonography ,Venous Thrombosis ,MESH: Aged ,ddc:616 ,Aged, 80 and over ,MESH: Middle Aged ,MESH: Tomography ,Hematology ,Middle Aged ,Thrombosis ,3. Good health ,Pulmonary embolism ,medicine.anatomical_structure ,Radiology ,Lower limbs venous ultrasonography ,medicine.medical_specialty ,Fibrin Fibrinogen Degradation Products/analysis ,Sensitivity and Specificity ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,Pulmonary Embolism/diagnosis/ultrasonography ,D-dimer ,medicine ,MESH: Fibrin Fibrinogen Degradation Products ,Humans ,False Positive Reactions ,Vein ,Aged ,MESH: Humans ,MESH: False Positive Reactions ,business.industry ,medicine.disease ,Confidence interval ,MESH: Sensitivity and Specificity ,MESH: Outpatients ,MESH: Venous Thrombosis ,Pulmonary Embolism ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,MESH: Ultrasonography - Abstract
International audience; BACKGROUND: Compression ultrasonography (US) confined to the proximal veins is usually performed to detect deep vein thrombosis (DVT) in patients with suspected pulmonary embolism (PE). Recent studies suggested a limited yield of proximal US when multislice computed tomography (MSCT) was used. OBJECTIVES: To assess whether performing an additional distal vein US would increase the diagnostic yield of the test. Patients and methods: Data of 855 consecutive outpatients included in a multicenter randomized controlled trial were analyzed. Patients were investigated by a sequential diagnostic strategy including clinical probability assessment, D-dimer measurement, proximal US and MSCT. Proximal US was completed by an examination of the distal veins, the result of which was not disclosed to the physician in charge of the patient. RESULTS: US was positive in 21% of patients, of whom 10% (53/541) had proximal DVT and 11% (59/541) isolated distal DVT. Of the 59 patients with distal DVT, 21 (36%) had no PE on MSCT. Twenty of those 21 patients were not given anticoagulant therapy and had an uneventful follow-up. The diagnostic performance of distal US for the diagnosis of PE was as follows: sensitivity 22% [95% confidence interval (CI) 17-29]; specificity 94% (95% CI 91-96); positive likelihood ratio 3.9 (95% CI 2.4-6.4). CONCLUSIONS: In patients with suspected PE, distal US has limited diagnostic performance, and its additional use only modestly increases the yield of US. Moreover, it carries a high false-positive rate, impeding the use of distal US as a confirmatory test for PE.
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- 2009
30. Prospective validation of the Pulmonary Embolism Severity Index. A clinical prognostic model for pulmonary embolism
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Pierre-Marie Roy, Grégoire Le Gal, Drahomir Aujesky, Michael J. Fine, Jacques Donzé, Arnaud Perrier, Olivier Sanchez, Franck Verschuren, Marc Philip Righini, Jacques Cornuz, Guy Meyer, Calvez, Ghislaine, Department of Internal Medicine (DIM -CHUV), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Clinique (CRC Angers), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), 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), Emergency Department (FV - ED), Saint Luc University Hospital, Service de médecine interne générale (SMIG), Hôpital Universitaire de Genève, and Service d'angiologie et d'hémostase (MR)
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MESH: Pulmonary Embolism ,Male ,Time Factors ,MESH: Hospitalization ,MESH: Risk Assessment ,Severity of Illness Index ,MESH: Aged, 80 and over ,MESH: Risk Factors ,Risk Factors ,Ambulatory Care ,Medicine ,Prospective Studies ,ddc:616 ,MESH: Aged ,Aged, 80 and over ,MESH: Middle Aged ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,Hematology ,Middle Aged ,Prognosis ,MESH: Predictive Value of Tests ,Pulmonary embolism ,MESH: Reproducibility of Results ,Europe ,Hospitalization ,Female ,Prognostic variable ,medicine.medical_specialty ,MESH: Ambulatory Care ,Risk Assessment ,Sensitivity and Specificity ,MESH: Prognosis ,Europe/epidemiology ,Discriminatory power ,Ambulatory care ,Predictive Value of Tests ,MESH: Severity of Illness Index ,Internal medicine ,Humans ,In patient ,Aged ,MESH: Humans ,Receiver operating characteristic ,business.industry ,MESH: Time Factors ,Pulmonary Embolism/*diagnosis/etiology/mortality/therapy ,Reproducibility of Results ,MESH: ROC Curve ,medicine.disease ,MESH: Prospective Studies ,MESH: Sensitivity and Specificity ,MESH: Male ,Confidence interval ,Surgery ,ROC Curve ,Prognostic model ,MESH: Europe ,business ,Pulmonary Embolism ,MESH: Female ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
SummaryPractice guidelines recommend outpatient care for selected patients with non-massive pulmonary embolism (PE), but fail to specify how these low-risk patients should be identified. Using data from U.S. patients, we previously derived the Pulmonary Embolism Severity Index (PESI), a prediction rule that risk stratifies patients with PE. We sought to validate the PESI in a European patient cohort. We prospectively validated the PESI in patients with PE diagnosed at six emergency departments in three European countries. We used baseline data for the rule’s 11 prognostic variables to stratify patients into five risk classes (I-V) of increasing probability of mortality. The outcome was overall mortality at 90 days after presentation.To assess the accuracy of the PESI to predict mortality, we estimated the sensitivity, specificity, and predictive values for low- (risk classes I/II) versus higher- risk patients (risk classes III-V), and the discriminatory power using the area under the receiver operating characteristic (ROC) curve. Among 357 patients with PE, overall mortality was 5.9%, ranging from 0% in class I to 17.9% in class V. The 186 (52%) low-risk patients had an overall mortality of 1.1% (95% confidence interval [CI]: 0.1–3.8%) compared to 11.1% (95% CI: 6.8–16.8%) in the 171 (48%) higher- risk patients. The PESI had a high sensitivity (91%,95% CI: 71–97%) and a negative predictive value (99%, 95% CI: 96–100%) for predicting mortality. The area under the ROC curve was 0.78 (95% CI:0.70–0.86). The PESI reliably identifies patients with PE who are at low risk of death and who are potential candidates for outpatient care. The PESI may help physicians make more rational decisions about hospitalization for patients with PE.
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- 2008
31. Future needs for continuing innovation in hemophilia: improving outcomes for individuals of all severities, including women and those in resource-constrained regions.
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Blatný J, Astermark J, Catarino C, Dolan G, Fijnvandraat K, Hermans C, Holstein K, Jiménez-Yuste V, Klamroth R, Lavin M, Lenting PJ, Lobet S, Mancuso ME, Motwani J, O'Donnell JS, and Königs C
- Abstract
Over recent decades, management of people with hemophilia (PwH) has been greatly improved by scientific advances that have resulted in a rich and varied therapeutic landscape. Nevertheless, treatment limitations continue to drive innovation, and emerging options have the potential to realize further improvement. We advocate four general principles to optimize benefits from innovation: individualizing the treatment approach, targeting 'normal,' making the most of available resources, and considering treatment affordability. Ultimately, all PwH-men and women, of all ages and severities, and worldwide-should have access to treatment that fully prevents bleeding, while allowing personal, social, family, and professional lives of choice. Clearly, we are not there yet, but developing goals/milestones based on the principles we describe may help to achieve this., Competing Interests: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JB has received consultation and/or speaker’s fees from NovoNordisk, Roche, Sobi, Takeda, and CSL Behring. JA has received research grants from Sobi, CSL Behring, Takeda/Shire, and Bayer, and speaker’s fees and consultancy for Octapharma, Novo Nordisk, Pfizer, Bayer, Sobi, CSL Behring, Takeda/Shire, BioMarin, Uniqure, and Spark Therapeutics. CC has received payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events, and support for attending meetings and/or travel from Sobi, Bayer, Roche, and Novo Nordisk, and has also participated in data safety monitoring boards or advisory boards for Sobi, Bayer, Roche, and Novo Nordisk. GD has received consulting fees from Pfizer, Biomarin, CSL, Roche, and Sobi, and payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from Pfizer, Spark Therapeutics, CSL, Bayer, Takeda, Roche, Chugai, and Sobi. KF has received unrestricted research grants from CSL Behring, Sobi, and Novo Nordisk, as well as consultancy fees from Hoffman-La Roche, Sanofi, Sobi, and Novo Nordisk, with all fees paid to her institution. CH has received research funding from Bayer, BioMarin, CSL Behring, Novo Nordisk, Pfizer, Shire/Takeda, and Sobi, as well as honoraria/speaker’s bureau fees from Bayer, CAF-DCF, CSL Behring, Hoffmann-La Roche, LFB, Novo Nordisk, Octapharma, Pfizer, Shire/Takeda, Sobi, and UniQure. KH has received grants for research or clinical studies (paid to her institution) from Bayer, CSL Behring, Novo Nordisk, Pfizer, Regeneron, Sanofi, and Sobi, as well honoraria or consultancy fees from Bayer, Biomarin, Biotest, CSL Behring, LFB, Novo Nordisk, Pfizer, Roche, Sobi, and Takeda. VJ-Y has received reimbursement for attending symposia/congresses and/or honoraria for speaking and/or honoraria for consulting, and/or funds for research from Takeda, Bayer, BioMarin, CSL Behring, Grifols, Novo Nordisk, Sobi, Roche, Octapharma, and Pfizer. RK has received consultancy fees and honoraria for lectures and advisory boards from Bayer, Biomarin, CSL Behring, Novo Nordisk, Grifols, Octapharma, Pfizer, Roche/Chugai, Sanofi, Sobi, and Takeda. ML has served on an advisory board for CSL Behring, as a consultant for Sobi, CSL Behring, Takeda, and Band Therapeutics, and has received research funding from Takeda and speaker fees from Sobi and Takeda. PJL has received research support to his institute from Sobi, Sanofi, BioMarin, and Roche. SL has acted as a paid consultant to Faust Pharmaceuticals Inc. MEM has acted as a paid speaker/consultant/advisor for Bayer, Biomarin, CSL Behring, Kedrion, LFB, Octapharma, Novo Nordisk, Pfizer, Roche, Sanofi, Sobi, and Takeda. JM has received honoraria and/or educational support from Sobi, Roche, Bayer, and CSL. JSO’D declares no conflicts of interest beyond the support for this manuscript from Sobi. CK has received funding from BFSH, Bayer, CSL Behring, Florio, MSD, Novo Nordisk, Roche/Chugai, Sobi/Sanofi, and Takeda for presentations and/or scientific advice, and his institution has received research funding from Bayer, Biotest, CSL Behring, Intersero, Novo Nordisk, Pfizer, Roche/Chugai, Sobi/Sanofi, and Takeda., (© The Author(s), 2024.)
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- 2024
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32. Amygdala atrophies in specific subnuclei in preclinical Alzheimer's disease.
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Salman Y, Gérard T, Huyghe L, Colmant L, Quenon L, Malotaux V, Ivanoiu A, Lhommel R, Dricot L, and Hanseeuw BJ
- Abstract
Introduction: Magnetic resonance imaging (MRI) segmentation algorithms make it possible to study detailed medial temporal lobe (MTL) substructures as hippocampal subfields and amygdala subnuclei, offering opportunities to develop biomarkers for preclinical Alzheimer's disease (AD)., Methods: We identified the MTL substructures significantly associated with tau-positron emission tomography (PET) signal in 581 non-demented individuals from the Alzheimer's Disease Neuroimaging Initiative (ADNI-3). We confirmed our results in our UCLouvain cohort including 110 non-demented individuals by comparing volumes between individuals with different visual Braak's stages and clinical diagnosis., Results: Four amygdala subnuclei (cortical, central, medial, and accessory basal) were associated with tau in amyloid beta-positive (Aβ+) clinically normal (CN) individuals, while the global amygdala and hippocampal volumes were not. Using UCLouvain data, we observed that both Braak I-II and Aβ+ CN individuals had smaller volumes in these subnuclei, while no significant difference was observed in the global structure volumes or other subfields., Conclusion: Measuring specific amygdala subnuclei, early atrophy may serve as a marker of temporal tauopathy in preclinical AD, identifying individuals at risk of progression., Highlights: Amygdala atrophy is not homogeneous in preclinical Alzheimer's disease (AD). Tau pathology is associated with atrophy of specific amygdala subnuclei, specifically, the central, medial, cortical, and accessory basal subnuclei. Hippocampal and amygdala volume is not associated with tau in preclinical AD. Hippocampus and CA1-3 volume is reduced in preclinical AD, regardless of tau., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
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- 2024
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33. Correction: Free access via computational cloud to deep learning-based EEG assessment in neonatal hypoxic-ischemic encephalopathy: revolutionary opportunities to overcome health disparities.
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Dilena R and Cilio MR
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- 2024
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34. Subthalamic DBS does not restore deficits in corticospinal suppression during movement preparation in Parkinson's disease.
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Wilhelm E, Derosiere G, Quoilin C, Cakiroglu I, Paço S, Raftopoulos C, Nuttin B, and Duque J
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- Humans, Male, Female, Middle Aged, Aged, Transcranial Magnetic Stimulation methods, Reaction Time physiology, Parkinson Disease physiopathology, Parkinson Disease therapy, Deep Brain Stimulation methods, Subthalamic Nucleus physiopathology, Pyramidal Tracts physiopathology, Evoked Potentials, Motor physiology, Movement physiology, Motor Cortex physiopathology, Motor Cortex physiology
- Abstract
Objective: Parkinson's disease (PD) patients exhibit changes in mechanisms underlying movement preparation, particularly the suppression of corticospinal excitability - termed "preparatory suppression" - which is thought to facilitate movement execution in healthy individuals. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) being an attractive treatment for advanced PD, we aimed to study the potential contribution of this nucleus to PD-related changes in such corticospinal dynamics., Methods: On two consecutive days, we applied single-pulse transcranial magnetic stimulation to the primary motor cortex of 20 advanced PD patients treated with bilateral STN-DBS (ON vs. OFF), as well as 20 healthy control subjects. Motor-evoked potentials (MEPs) were elicited at rest or during movement preparation in an instructed-delay choice reaction time task including left- or right-hand responses. Preparatory suppression was assessed by expressing MEPs during movement preparation relative to rest., Results: PD patients exhibited a deficit in preparatory suppression when it was probed on the responding hand side, particularly when this corresponded to their most-affected hand, regardless of their STN-DBS status., Conclusions: Advanced PD patients displayed a reduction in preparatory suppression which was not restored by STN-DBS., Significance: The current findings confirm that PD patients lack preparatory suppression, as previously reported. Yet, the fact that this deficit was not responsive to STN-DBS calls for future studies on the neural source of this regulatory mechanism during movement preparation., (Copyright © 2024. Published by Elsevier B.V.)
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- 2024
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35. Free access via computational cloud to deep learning-based EEG assessment in neonatal hypoxic-ischemic encephalopathy: revolutionary opportunities to overcome health disparities.
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Dilena R and Cilio MR
- Abstract
In this issue of Pediatric Research, Kota et al. evaluate a novel monitoring visual trend using deep-learning - Brain State of the Newborn (BSN)- based EEG as a bedside marker for severity of the encephalopathy in 46 neonates with hypoxic-ischemic encephalopathy (HIE) compared with healthy infants. Early BSN distinguished between normal and abnormal outcome, and correlated with the Total Sarnat Score., (© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)
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- 2024
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36. Injectable chitosan hydrogel effectively controls lesion growth in a venous malformation murine model.
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Nguyen HL, Holderbaum Do Amaral R, Lerouge S, De Roo AK, Zehtabi F, Vikkula M, and Soulez G
- Abstract
Purpose: The purpose of this study was to evaluate the safety and efficacy of intralesional injection of chitosan hydrogel (CH) combined with sodium tetradecyl sulfate (STS) to sclerose and embolize venous malformations (VMs) by comparison with 3% STS foam and placebo in a mouse model., Materials and Methods: Subcutaneous VMs were created by injecting HUVEC_TIE2-L914F cells, mixed with matrigel, into the back of athymic mice (Day [D] 0). After VM-like lesions were established at D10, 70 lesions were randomly assigned to one of six treatment groups (untreated, saline, 3% STS-foam, CH, 1% STS-CH, 3% STS-CH). For 3% STS-foam, the standard Tessari technique was performed. VMs were regularly evaluated every 2-3 days to measure lesion size until the time of collection at D30 (primary endpoint). At D30, VM lesions including the matrigel plugs were culled and evaluated by histological analysis to assess vessel size, chitosan distribution and endothelial expression. One-way analysis of variance (ANOVA) test was performed to compare quantitative variables with normal distribution, otherwise Kruskal-Wallis test followed by pairwise comparisons by a Wilcoxon rank sum test was performed., Results: All VMs were successfully punctured and injected. Six VMs injected with 3% STS-CH showed early skin ulceration with an extrusion of the matrigel plug and were excluded from final analysis. In the remaining 64 VMs, skin ulceration occurred on 26 plugs, resulting in the loss of three 3% STS-foam and one 1% STS-CH plugs. Both chitosan formulations effectively controlled growth of VMs by the end of follow-up compared to untreated or 3% STS-foam groups (P < 0.05). Vessel sizes were smaller with both CH formulations compared to untreated and saline groups (P < 0.05). Additionally, there were smaller vascular channels within the 1% STS-CH group compared to the 3% STS-foam group (P < 0.05)., Conclusion: Chitosan's ability to control the growth of VMs suggests a promising therapeutic effect that outperforms the gold standard (STS-foam) on several variables., Competing Interests: Declaration of competing interest Gilles Soulez and Sophie Lerouge have patented the STS-CH hydrogel (A sclerosing and embolizing gel, US publication number: 8840867 B2, 23 Sept. 2014, Patent Appl. CA 2704,971, May 2010. Licensed to Cook Medical). They also act as consultants for Cook Medical., (Copyright © 2024 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)
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- 2024
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37. Hip Dysplasia in a Context of Blue Rubber Bleb Nevus Syndrome, 5-years Follow-up after Hip Arthroplasty.
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Popescu D, Chalon T, Boon LM, Docquier PL, and Cauter MV
- Abstract
Introduction: Blue rubber bleb nevus syndrome (BRBNS) is a rare congenital vascular disorder that affects the venous system. Lesions are multiple and involved not only the skin and subcutaneous tissue but also muscles, joints and organs such as the gastrointestinal tract. At present, little is known regarding its potential orthopedic complications., Case Report: We present a unique case of a patient with BRBNS displaying both intra-articular and extra-articular severe venous malformation (VM) of the hip. This extensive VM caused severe deformities in bone growth, mainly affecting the proximal femur, and impacted the muscular development of the gluteus medius and gluteus maximus. Its intra-articular extension, along with repeated secondary hemarthrosis, led to cartilaginous destruction. Consequently, the patient presented with significant coxa valga and developed acetabular dysplasia and subluxation of femoral head, during growth. In order to restore hip function and alleviate pain, the patient underwent a total hip arthroplasty (THA) at the age of 18., Discussion: The dysplastic changes in the hip joint observed in this case are attributed to the deleterious effects of VMs and coxa valga on joint anatomy and biomechanics. VMs induce recurrent hemarthrosis, leading to cartilage destruction and hip instability. Additionally, coxa valga alters hip biomechanics, exacerbating joint instability and accelerating wear. Surgical intervention with THA aimed to restore joint stability and function, although challenges arose due to anatomical complexities and limited prosthetic options., Conclusion: This is the first reported case of hip dysplasia associated with BRBNS. This case shows the involvement of vascular malformation in the development of hip dysplasia leading to total hip arthroplasty. The surgical planning and technique must take the specificity of this pathology into account to get the best result possible for the patient. This case illustrates the importance of a multidisciplinary approach to treat patients with this specific syndrome and adds valuable information to the limited literature on orthopedic complications in BRBNS., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)
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- 2024
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38. Incidence, survival, and mortality of cancer in children and young adolescents in Belgium and the Netherlands in 2004-2015: A comparative population-based study.
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Peirelinck H, Schulpen M, Hoogendijk R, Van Damme A, Pieters R, Henau K, Van Damme N, and Karim-Kos HE
- Subjects
- Humans, Belgium epidemiology, Adolescent, Netherlands epidemiology, Child, Child, Preschool, Infant, Male, Incidence, Female, Infant, Newborn, Survival Rate, Neuroblastoma epidemiology, Neuroblastoma mortality, Neoplasms epidemiology, Neoplasms mortality, Registries
- Abstract
International comparisons of cancer surveillance measures may provide insight into inequalities in registration practices, etiological factors, and treatment strategies. This study aimed to compare incidence, survival, and mortality of cancer in children and young adolescents between Belgium and the Netherlands. All children (0-14 years) and young adolescents (15-17 years) diagnosed with cancer between 2004 and 2015 were selected from the population-based cancer registries of Belgium (N = 4739) and the Netherlands (N = 7322). Differences in incidence and mortality were expressed as standardized rate ratios (SRR; BE/NL). Five-year observed survival was calculated using the Kaplan-Meier method. During 2004-2015, the overall cancer incidence among children and young adolescents was similar in both countries. Incidence of neuroblastoma was significantly higher in Belgian children (2010-2015: SRR = 1.3, 95% CI 1.0-1.6). Five-year survival of all malignant cancers was comparable in 2010-2015, exceeding 80% in both age groups. Remarkable differences in survival existed in children for malignant central nervous system (CNS) tumors in 2004-2009 (BE = 62%, NL = 45%), for acute myeloid leukemia (BE = 68%, NL = 78%) and rhabdomyosarcomas (BE = 60%, NL = 79%) in 2010-2015, and for neuroblastoma in both periods (2004-2009: BE = 76%, NL = 64%; 2010-2015: BE = 82%, NL = 64%). Overall cancer mortality in children decreased by approximately 3 percent-points annually in both countries, but was slightly lower in Belgium in 2004-2009 (SRR = 0.9, 95% CI 0.7-1.0). Despite differences for specific cancer types, overall cancer incidence, survival, and mortality were comparable between Dutch and Belgian children and young adolescents in 2010-2015. Variability in screening, diagnosis, and registration practices probably explains the observed differences in incidence and survival of neuroblastoma and malignant CNS tumors., (© 2024 UICC.)
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- 2024
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39. Ultra-Long factor VIII: a major step forward toward a hemophilia-free mind.
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Hermans C and Pierce GF
- Subjects
- Humans, von Willebrand Factor metabolism, Half-Life, Coagulants pharmacokinetics, Coagulants therapeutic use, Coagulants administration & dosage, Immunoglobulin Fc Fragments, Treatment Outcome, Hemostasis drug effects, Infusions, Intravenous, Blood Coagulation drug effects, Animals, Recombinant Fusion Proteins therapeutic use, Recombinant Fusion Proteins pharmacokinetics, Recombinant Fusion Proteins administration & dosage, Hemophilia A blood, Hemophilia A drug therapy, Factor VIII pharmacokinetics, Factor VIII administration & dosage, Factor VIII therapeutic use
- Abstract
A remarkable step forward in the treatment of hemophilia A has recently been achieved with the development of an Ultra-Long modified factor (F)VIII. Leveraging expertise gained with fusion to immunoglobulin Fc fragments, disconnecting FVIII from endogenous von Willebrand factor (via a D'-D3 fragment), and benefiting from the pharmacokinetic prolongation provided by the addition of hydrophilic polypeptides, efanesoctocog alfa opens a new era in the treatment of hemophilia A. The term Ultra-Long FVIII has been proposed to designate it and differentiate it from extended half-life FVIII. The level of FVIII correction within the normal range for several days provided by this molecule should allow an increasing number of patients to free themselves from the physical and psychological constraints of hemophilia A. Certainly, the burden of weekly intravenous infusions persists but is compensated by a correction of hemostasis whose amplitude and duration remain unmatched by other therapeutic options currently available., Competing Interests: Declaration of competing interests This manuscript reflects the positions of the authors. C.H. has received consulting fees for his contribution to advisory boards from Sanofi and Sobi. G.F.P. has received an honorarium for participating in a Sanofi symposium., (Copyright © 2024 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved.)
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- 2024
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40. Erroneous Compensation for Long-Latency Feedback Delays as Origin of Essential Tremor.
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Blondiaux F, Colmant L, Lebrun L, Hanseeuw B, and Crevecoeur F
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- Humans, Male, Female, Middle Aged, Aged, Adult, Psychomotor Performance physiology, Electromyography, Movement physiology, Essential Tremor physiopathology, Reaction Time physiology
- Abstract
Essential tremor (ET), a movement disorder characterized by involuntary oscillations of the limbs during movement, remains to date not well understood. It has been recently suggested that the tremor originates from impaired delay compensation, affecting movement representation and online control. Here we tested this hypothesis directly with 24 ET patients (14 female; 10 male) and 28 neurologically intact (NI) human volunteers (17 female; 11 male) in an upper limb postural perturbation task. After maintaining their hand in a visual target, participants experienced perturbations of unpredictable direction and magnitude and were instructed to counter the perturbation and steer their hand back to the starting position. In comparison with NI volunteers, ET patients' early muscular responses (short and long-latency responses, 20-50 and 50-100 ms, respectively) were preserved or even slightly increased. However, they exhibited perturbation-dependent deficits when stopping and stabilizing their hand in the final target supporting the hypothesis that the tremor was generated by the feedback controller. We show in a computational model that errors in delay compensation accumulating over time produced the same small increase in initial feedback response followed by oscillations that scaled with the perturbation magnitude as observed in ET population. Our experimental results therefore validate the computational hypothesis that inaccurate delay compensation in long-latency pathways could be the origin of the tremor., Competing Interests: The authors declare no competing financial interests., (Copyright © 2024 the authors.)
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- 2024
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41. Biological variation of thrombin generation on ST Genesia.
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van Dievoet MA, Morimont L, Bouvy C, Gruson D, Stephenne X, and Douxfils J
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- Humans, Male, Female, Thrombin metabolism, Thrombin biosynthesis
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- 2024
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42. Six country vignettes: Strengthening radiotherapy and theranostics.
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Mikhail-Lette M, Cordero L, Lievens Y, Al-Ibraheem A, Urbain JL, Chera B, Muylle K, Vaandering A, Rosa AA, Cerci JJ, Sathekge M, Minjgee M, Nansalmaa E, Erdenechimeg S, Ruiz RL, Scott A, Paez D, Giammarile F, Veduta A, Minoshima E, Vichare S, and Abdel-Wahab M
- Subjects
- Humans, South Africa, Jordan, Brazil, Costa Rica, Precision Medicine, Radiotherapy, Theranostic Nanomedicine, Neoplasms radiotherapy
- Abstract
Background: For cancer patient populations worldwide, the synchronous scale-up of diagnostics and treatments yields meaningful gains in survival and quality of life. Among advanced cancer therapies, radiotherapy (RT) and theranostics are key to achieving practical, high-quality, and personalized precision medicine - targeting disease manifestations of individual patients and broad populations, alike. Aiming to learn from one another across different world regions, the six country vignettes presented here depict both challenges and victories in de novo establishment or improvement of RT and theranostics infrastructure., Methods: The International Atomic Energy Agency (IAEA) convened global RT and theranostics experts from diverse world regions and contexts to identify relevant challenges and report progress in their own six countries: Belgium, Brazil, Costa Rica, Jordan, Mongolia, and South Africa. These accounts are collated, compared, and contrasted herein., Results: Common challenges persist which could be more strategically assessed and addressed. A quantifiable discrepancy entails personnel. The estimated radiation oncologists (ROs), nuclear medicine physicians (NMPs), and medical physicists (MPs for RT and nuclear medicine) per million inhabitants in the six collective countries respectively range between 2.69-38.00 ROs, 1.00-26.00 NMPs, and 0.30-3.45 MPs (Table 1), reflecting country-to-country inequities which largely match World Bank country-income stratifications., Conclusion: Established goals for RT and nuclear medicine advancement worldwide have proven elusive. The pace of progress could be hastened by enhanced approaches such as more sustainably phased implementation; better multinational networking to share lessons learned; routine quality and safety audits; as well as capacity building employing innovative, resource-sparing, cutting-edge technologic approaches. Bodies such as ministries of health, professional societies, and the IAEA shall serve critical roles in convening and coordinating more innovative RT and theranostics translational research, including expanding nuanced global database metrics to inform, reach, and potentiate milestones most meaningfully., Policy Summary: Aligned with WHO 25×25 NCDs target; WHA70.12 and WHA76.5 resolutions., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)
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- 2024
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43. Targeted treatment in complex lymphatic anomaly: a case of synergistic efficacy of trametinib and sirolimus.
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Seront E, Froidure A, Revencu N, Dekeuleneer V, Clapuyt P, Dumitriu D, Vikkula M, and Boon LM
- Subjects
- Humans, Lymphatic Abnormalities drug therapy, Lymphatic Abnormalities pathology, Pyridones therapeutic use, Pyrimidinones therapeutic use, Sirolimus therapeutic use
- Abstract
Repurposing anticancer drugs to vascular malformations has significantly improved patient outcomes. Complex Lymphatic Anomalies (CLA) are part of the spectrum of lymphatic malformations (LMs) that share similar oncogenic mutations to cancer. We report the case of a young patient with highly symptomatic CLA who was initially treated with sirolimus, due to the frequent involvement of the PI3K-AKT-mTOR pathway in CLA pathogenesis. Despite an initial reduction in symptoms, sirolimus progressively lost its effectiveness. After an unsuccessful attempt with trametinib alone, sirolimus was added to trametinib and resulted in a significant, rapid and sustained improvement in symptoms. This suggests that, contrary to current dogmas, combination therapy using sub-therapeutic doses targeting both the PI3K and RAS pathways retains efficacy without generating the toxicity known for combination therapies, and is beneficial in the management of CLAs and potentially other vascular anomalies., (© 2024. The Author(s).)
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- 2024
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44. Has Propranolol Eradicated the Need for Surgery in the Management of Infantile Hemangioma?
- Author
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Coulie J, Dekeuleneer V, Gerdom A, Roggen M, Bataille AC, Moniotte S, Coyette M, De Roo AK, and Boon LM
- Abstract
Background: To assess the impact of propranolol as the first-line treatment of infantile hemangioma (IH) on the need for surgery in the management of IH., Methods: Retrospective study of 420 patients, with IH, referred to our multidisciplinary center between January 2005 and August 2014. Clinical data including sex, age at first consultation and at treatment initiation, location, size, number, aspect, and complication of IH, as well as the type of treatment were collected. Statistical analyses were conducted considering each patient and each tumor independently., Results: A total of 625 IH(420 patients (P))were reviewed, 113 patients had more than one IH (26.91%). Median age at first consultation was 7 months old. Overall, 243 patients were treated (57.86%) using either surgery (n=128 P/141 IH), propranolol (n=79 P/89 IH), corticosteroids (n=51 P/56 IH), and/or laser (n=34 P /36 IH). Propranolol was effective in all but 2 infants with IH. Seven patients (n=7/79 P; 8.86%) initially treated with propranolol, still required surgery, in contrast to 18 patients (n=18/51 P; 35.29%) initially treated with corticosteroids, and 103 patients (n=103/290 P; 35.51%) with no medical treatment. Since the availability of propranolol, patients were less likely to undergo surgery (48 P versus 80 P; P-Value < 0.001). This demonstrated that the use of propranolol reduced the need for surgery (P-Value < 0.001 with an OR of 0.177: CI 95% 0.079-0.396)., Conclusion: Propranolol has dramatically reduced the need for surgery, regarding indications and number of patients. Surgical correction remains important for sequelae management, non-responders or strawberry-like IH., Competing Interests: Conflict of interest: Laurence M. Boon discloses the following interactions with the medical industry: (1) clinical trial support for VASE: Pfizer [slow-flow vascular anomalies (rapamycin)]; (2) clinical trial support for TRAMAV: Novartis [fast-flow vascular anomalies (trametinib)]; and (4) clinical advisory board: Pierre Fabre [infantile hemangiomas (beta-blockers)]. All other authors have no conflict of interest related to the content of this article., (Copyright © 2024 by the American Society of Plastic Surgeons.)
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- 2024
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45. Emicizumab as first-line therapy in acquired hemophilia A.
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Iarossi M and Hermans C
- Abstract
Acquired hemophilia A (AHA) is a rare autoimmune disease resulting from the development of autoantibodies directed against endogenous factor (F)VIII, leading to bleeding manifestations that can be life-threatening. The current standard hemostatic treatment involves the use of bypassing agents that circumvent FVIII (recombinant activated FVII, activated prothrombin complex concentrate, and recombinant porcine FVIII) that must be administered intravenously and possess a short half-life. These limitations and the risk of potentially fatal bleeding complications justify the early initiation of immunosuppressive treatment (IST) aimed at promptly eradicating the autoantibodies. IST is not without side effects, sometimes severe and possibly fatal, especially in persons with AHA who are generally older and have multiple comorbidities. Emicizumab, a bispecific antibody that mimics the action of FVIII, has emerged as an effective hemostatic therapy among persons with congenital hemophilia, whether complicated by the presence of anti-FVIII antibodies or not. Numerous arguments from recent clinical experiences suggest positioning emicizumab as a first-line treatment for AHA. This strategy has the potential to reduce bleeding complications and, importantly, the side effects associated with IST, which can be delayed and tailored to each patient., (© 2024 The Author(s).)
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- 2024
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46. Low-dose emicizumab for more equitable access to prophylaxis in resource limited countries.
- Author
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Mannucci PM and Hermans C
- Subjects
- Humans, Developing Countries, Health Services Accessibility, Antibodies, Bispecific therapeutic use, Antibodies, Monoclonal, Humanized therapeutic use, Hemophilia A drug therapy
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- 2024
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47. Serum Neurofilament Light and Postoperative Delirium in Cardiac Surgery: A Preplanned Secondary Analysis of a Prospective Observational Study.
- Author
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Khalifa C, Robert A, Cappe M, Lemaire G, Tircoveanu R, Dehon V, Ivanoiu A, Piérard S, de Kerchove L, Jacobs Sariyar A, Teunissen CE, and Momeni M
- Subjects
- Humans, Intermediate Filaments, Postoperative Complications etiology, Risk Factors, Prospective Studies, Cardiac Surgical Procedures adverse effects, Cognitive Dysfunction etiology, Delirium diagnosis, Delirium etiology, Emergence Delirium etiology
- Abstract
Background: Impaired cognition is a major predisposing factor for postoperative delirium, but it is not systematically assessed. Anesthesia and surgery may cause postoperative delirium by affecting brain integrity. Neurofilament light in serum reflects axonal injury. Studies evaluating the perioperative course of neurofilament light in cardiac surgery have shown conflicting results. The authors hypothesized that postoperative serum neurofilament light values would be higher in delirious patients, and that baseline concentrations would be correlated with patients' cognitive status and would identify patients at risk of postoperative delirium., Methods: This preplanned secondary analysis included 220 patients undergoing elective cardiac surgery with cardiopulmonary bypass. A preoperative cognitive z score was calculated after a neuropsychological evaluation. Quantification of serum neurofilament light was performed by the Simoa (Quanterix, USA) technique before anesthesia, 2 h after surgery, on postoperative days 1, 2, and 5. Postoperative delirium was assessed using the Confusion Assessment Method for Intensive Care Unit, the Confusion Assessment Method, and a chart review., Results: A total of 65 of 220 (29.5%) patients developed postoperative delirium. Delirious patients were older (median [25th percentile, 75th percentile], 74 [64, 79] vs. 67 [59, 74] yr; P < 0.001) and had lower cognitive z scores (-0.52 ± 1.14 vs. 0.21 ± 0.84; P < 0.001). Postoperative neurofilament light concentrations increased in all patients up to day 5, but did not predict delirium when preoperative concentrations were considered. Baseline neurofilament light values were significantly higher in patients who experienced delirium. They were influenced by age, cognitive z score, renal function, and history of diabetes mellitus. Baselines values were significantly correlated with cognitive z scores (r, 0.49; P < 0.001) and were independently associated with delirium whenever the patient's cognitive status was not considered (hazard ratio, 3.34 [95% CI, 1.07 to 10.4])., Conclusions: Cardiac surgery is associated with axonal injury, because neurofilament light concentrations increased postoperatively in all patients. However, only baseline neurofilament light values predicted postoperative delirium. Baseline concentrations were correlated with poorer cognitive scores, and they independently predicted postoperative delirium whenever patient's cognitive status was undetermined., (Copyright © 2024 American Society of Anesthesiologists. All Rights Reserved.)
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- 2024
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48. Use of neonatal lung ultrasound in European neonatal units: a survey by the European Society of Paediatric Research.
- Author
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Alonso-Ojembarrena A, Ehrhardt H, Cetinkaya M, Lavizzari A, Szczapa T, Sartorius V, Rocha G, Sindelar R, Wald M, Heiring C, Soukka H, Danhaive O, Roehr CC, Cucerea M, Calkovska A, Dimitriou G, Barzilay B, Klingenberg C, Schulzke S, Plavka R, Tameliene R, O'Donnell CPF, and van Kaam AH
- Abstract
Objective: Regarding the use of lung ultrasound (LU) in neonatal intensive care units (NICUs) across Europe, to assess how widely it is used, for what indications and how its implementation might be improved., Design and Intervention: International online survey., Results: Replies were received from 560 NICUs in 24 countries between January and May 2023. LU uptake varied considerably (20%-98% of NICUs) between countries. In 428 units (76%), LU was used for clinical indications, while 34 units (6%) only used it for research purposes. One-third of units had <2 years of experience, and only 71 units (13%) had >5 years of experience. LU was mainly performed by neonatologists. LU was most frequently used to diagnose respiratory diseases (68%), to evaluate an infant experiencing acute clinical deterioration (53%) and to guide surfactant treatment (39%). The main pathologies diagnosed by LU were pleural effusion, pneumothorax, transient tachypnoea of the newborn and respiratory distress syndrome. The main barriers for implementation were lack of experience with technical aspects and/or image interpretation. Most units indicated that specific courses and an international guideline on neonatal LU could promote uptake of this technique., Conclusions: Although LU has been adopted in neonatal care in most European countries, the uptake is highly variable. The main indications are diagnosis of lung disease, evaluation of acute clinical deterioration and guidance of surfactant. Implementation may be improved by developing courses and publishing an international guideline., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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49. Women and girls with inherited bleeding disorders: Focus on haemophilia carriers and heavy menstrual bleeding.
- Author
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Hermans C, Johnsen JM, and Curry N
- Subjects
- Male, Female, Humans, Hemorrhage genetics, Hemophilia A complications, Hemophilia A diagnosis, Hemophilia A genetics, Menorrhagia etiology, Menorrhagia genetics
- Abstract
Raising awareness and improving recognition, accurate classification, and enhanced access to new treatments represent current key challenges for carriers of haemophilia. Women and girls carrying genes for haemophilia often experience significant bleeding and/or low factor levels. The bleeding associated with female haemophilia is frequently overlooked, has a weak correlation with factor levels, and manifests differently than in males, with heavy menstrual bleeding being a predominant symptom. Recent changes in terminology now allow the diagnosis of haemophilia in females with low factor levels and differentiate between symptomatic and asymptomatic carriers of the gene. Observations from real-world experiences and limited clinical trial data have highlighted the positive impact of various new haemophilia treatments for women and girls with clotting factor deficiencies. There is an urgent need for initiatives that increase their access to these treatments and encourage well-designed clinical trials focusing on female-specific outcomes. In women with inherited bleeding disorders, early recognition and optimal management of heavy menstrual bleeding are crucial. However, treatment options and guidance from high-quality clinical trials are currently insufficient. Menstrual health assessment should be a regular part of monitoring women and girls with inherited bleeding disorders throughout their lives, emphasizing the importance of gathering data to improve future management., (© 2024 John Wiley & Sons Ltd.)
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- 2024
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50. Unveiling the Uncertainties: Opioid-free Anesthesia and the Road Ahead.
- Author
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Ladha KS and Lavand'homme P
- Subjects
- Humans, Analgesics, Opioid, Pain, Postoperative, Anesthesia, Anesthesiology
- Published
- 2024
- Full Text
- View/download PDF
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