37 results on '"P. Forget"'
Search Results
2. Feasibility and Preliminary Effects of a Telerehabilitation Program for People Living With HIV: A Pilot Randomized Study.
- Author
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Piraux, Elise, Reychler, Gregory, Forget, Patrice, Yombi, Jean-Cyr, and Caty, Gilles
- Abstract
We investigated feasibility and preliminary effects of telerehabilitation for people living with HIV (PLWH) and taking antiretroviral therapy. We randomized 25 PLWH to either an endurance and resistance training exercise (ERTE) group or a control group. Endurance and resistance training exercise sessions occurred in a public fitness center, with online guidance and weekly telephone advice. The primary outcome was feasibility (recruitment and retention rates and safety). Secondary outcomes were assessed at baseline and 6 weeks according to the three International Classification of Functioning, Disability, and Health domains. Nine patients completed the ERTE program. Recruitment and retention rates were 93% and 69%, respectively. No adverse events occurred. After 6 weeks, percentage change in D-dimer was lower in the ERTE group, but not significantly after the Bonferroni correction. Other parameters were not different between the groups. Therefore, telerehabilitation is feasible in PLWH taking antiretroviral therapy; however, the performance of the program is still questioned, and future research is warranted. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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3. Adoptive T-cell therapy using autologous tumor-infiltrating lymphocytes for metastatic melanoma: current status and future outlook.
- Author
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Wu, Richard, Forget, Marie-Andrée, Chacon, Jessica, Bernatchez, Chantale, Haymaker, Cara, Chen, Jie Qing, Hwu, Patrick, and Radvanyi, Laszlo G
- Abstract
Immunotherapy using autologous T cells has emerged to be a powerful treatment option for patients with metastatic melanoma. These include the adoptive transfer of autologous tumor-infiltrating lymphocytes (TILs), T cells transduced with high-affinity T cell receptors against major tumor antigens, and T cells transduced with chimeric antigen receptors composed of hybrid immunoglobulin light chains with endodomains of T-cell signaling molecules. Among these and other options for T-cell therapy, TILs together with high-dose interleukin 2 have had the longest clinical history with multiple clinical trials in centers across the world consistently demonstrating durable clinical response rates near 50% or more. A distinct advantage of TIL therapy making it still the T-cell therapy of choice is the broad nature of the T-cell recognition against both defined and undefined tumors antigens against all possible major histocompatibility complex, rather than the single specificity and limited major histocompatibility complex coverage of the newer T cell receptors and chimeric antigen receptor transduction technologies. In the past decade, significant inroads have been made in defining the phenotypes of T cells in TIL-mediating tumor regression. CD8+ T cells are emerging to be critical, although the exact subset of CD8+ T cells exhibiting the highest clinical activity in terms of memory and effector markers is still controversial. We present a model in which both effector-memory and more differentiated effector T cells ultimately may need to cooperate to mediate long-term tumor control in responding patients. Although TIL therapy has shown great potential to treat metastatic melanoma, a number of issues have emerged that need to be addressed to bring it more into the mainstream of melanoma care. First, we have a reached the point where a pivotal phase II or phase III trial is needed in an attempt to gain regulatory approval of TILs as standard of care. Second, improvements in how we expand TILs for therapy are needed that minimize the time the T cells are in culture and improve the memory and effector characteristics of the T cells for longer persistence and enhanced anti-tumor activity in vivo. Third, there is a critical need to identify surrogate and predictive biomarkers to better select suitable patients for TIL therapy to improve response rate and duration. Overall, the outlook for TIL therapy for melanoma is very bright. We predict that TILs will indeed emerge to become an approved treatment in the upcoming years through pivotal clinical trials. Moreover, new approaches combining TILs with targeted signaling pathway drugs, such as mutant B-RAF inhibitors, and synergistic immunomodulatory interventions enhancing T-cell costimulation and preventing negative regulation should further increase therapeutic efficacy and durable complete response rates. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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4. Using Activity Diaries to Measure Children's and Adolescents' Compliance With Activity Restrictions After Mild Traumatic Brain Injury.
- Author
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Gagnon, Isabelle, Swaine, Bonnie, and Forget, Robert
- Abstract
Purpose: To examine the extent to which children and adolescents with a mild traumatic brain injury (MTBI) comply with the activity restrictions received upon discharge from a pediatric trauma center. Participants: Thirty-four children with MTBI (aged 8-16 years) and 34 control children matched for age, sex, and premorbid level of physical activity. Main Measure: Activity diary documenting the exact level of activity during 3 consecutive days during the 1st, 4th, and 12th week post-MTBI (corresponding time intervals for controls) and the Physical Activity Questionnaire. Results: Fifteen pairs of children (MTBI + control) completed the diaries for all 3 assessment times (77% participation rate among consecutive admissions and 44% compliance rate with diary completion). Although some children engaged in activities before the end of the 4-week restriction period, the majority of the children followed the recommendations they received. Children with MTBI maintained a lower level of energy expenditure at the 1- and 4-week evaluations than did the noninjured children, but not at the 12-week evaluation. Conclusion: Children with MTBI usually comply with the activity restrictions they receive upon discharge from the hospital. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
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5. Visuomotor Response Time in Children With a Mild Traumatic Brain Injury.
- Author
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Gagnon, Isabelle, Swaine, Bonnie, Friedman, Debbie, and Forget, Robert
- Abstract
Objective: Compare the visuomotor response times of children after a mild traumatic brain injury (mTBI) with those of noninjured children matched for ape, sex. and premorbid level of physical activity. Design: Prospective cohort study. Setting: Pediatric trauma center Participants: Thirty-eight children aged 7 to 16 years in each group. Children with mTBI had a mean Glasgow Coma Scale score of 14.8 and were considered normal on a neurological assessment carried out at the time of hospital discharge. Noninjured children were friends of those with mTBI Intervention: Assessments of response time were conducted at 1,4, and 12 weeks after mTBI and at corresponding time intervals for the control children. Main Outcome Measures: The response speed subtest of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP); reaction and movement time for upper and lower extremities, for simple, choice, and reversed choice response time paradigms. Results: Over the assessment period, children with mTBI performed worse than the control group only on the response speed subtest of the HOTMP The mTBI children however tended to have slower movement times 1 week postinjury for the reversed choice response time paradigm for the lower extremities. Conclusions: Some children with mTBI may have some problems in response time persisting until 12 weeks postinjury. Further research is required to better identify and understand the severity of these problems and determine their impact, if any. on participation in physical activities. [ABSTRACT FROM AUTHOR]
- Published
- 2004
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6. Balance Findings in a Child before and after a Mild Head Injury.
- Author
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Gagnon, Isabelle, Friedman, Debbie, Swaine, Bonnie, and Forget, Robert
- Abstract
Objective: This case study reviews the preinjury and postinjury balance performance of an 11-year-old child who sustained a mild head injury. Design: A prospective design was used to document balance 5 days before injury and 1, 4, and 12 weeks after injury. Outcome Measures: The assessments used were the balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency, the Pediatric Clinical Test of Sensory Interaction for Balance, and the Postural Stress Test. Results: One week after the trauma, balance deficits were observed in the three tests. The deficits improved 4 weeks after the injury, and performance remained stable over the following 2 months for two of the evaluations except for the Postural Stress Test performance, which failed to improve in the 3-month period after trauma. Conclusions: The good recovery of balance skills observed over the first month after injury seems to validate the current activity restrictions imposed on children after a mild head injury. However, the persistence of poor performance in the area of reactions to external perturbations indicates that some deficits may persist beyond what is expected with this population. Key words: balance, mild head injuries. [ABSTRACT FROM AUTHOR]
- Published
- 2001
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7. Patients' perspective on the chronic pain classification in the 11th revision of the International Classification of Diseases (ICD-11): results from an international web-based survey.
- Author
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Korwisi B, Hay G, Forget P, Ryan D, Treede RD, Rief W, and Barke A
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- Humans, Male, Female, Middle Aged, Adult, Aged, Young Adult, Surveys and Questionnaires, Adolescent, Chronic Pain psychology, Chronic Pain classification, Chronic Pain diagnosis, Internet, International Classification of Diseases
- Abstract
Abstract: The 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11) aims at improving the lives of persons with the lived experience of chronic pain by providing clearly defined and clinically useful diagnoses that can reduce stigma, facilitate communication, and improve access to pain management, among others. The aim of this study was to assess the perspective of people with chronic pain on these diagnoses. An international web-based survey was distributed among persons with the lived experience of chronic pain. After having seen an information video, participants rated the diagnoses on 8 endorsement scales (eg, diagnostic fit, stigma) that ranged from -5 to +5 with 0 representing the neutral point of no expected change. Overall ratings and differences between participants with chronic primary pain (CPP) and chronic secondary pain (CSP) were analyzed. N = 690 participants were included in the data analysis. The ratings on all endorsement scales were significantly higher than the neutral point of 0. The highest ratings were obtained for "openness" (2.95 ± 1.93) and "overall opinion" (1.87 ± 1.98). Participants with CPP and CSP did not differ in their ratings; however, those with CSP indicated an improved diagnostic fit of the new diagnoses, whereas participants with CPP rated the diagnostic fit of the new diagnoses similar to the fit of their current diagnoses. These results show that persons with the lived experience of chronic pain accept and endorse the new diagnoses. This endorsement is an important indicator of the diagnoses' clinical utility and can contribute to implementation and advocacy., (Copyright © 2024 International Association for the Study of Pain.)
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- 2024
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8. Method of Anesthesia and Perioperative Risk Factors, Maternal Anesthesia Complications, and Neonatal Mortality Following Cesarean Delivery in Africa: A Substudy of a 7-Day Prospective Observational Cohort Study.
- Author
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Gerber C, Bishop DG, Dyer RA, Maswime S, Rodseth RN, van Dyk D, Kluyts HL, Mbwele B, Tumukunde JT, Madzimbamuto FD, Elkhogia AM, Ndonga AK, Ngumi ZWW, Omigbodun AO, Amanor-Boadu SD, Zoumenou E, Basenero A, Munlemvo DM, Coulibaly Y, Ndayisaba G, Antwi-Kusi A, Gobin V, Forget P, Rakotoarison S, Samateh AL, Mehyaoui R, Patel-Mujajati U, Sani CM, Madiba TE, Pearse RM, and Biccard BM
- Subjects
- Humans, Female, Pregnancy, Prospective Studies, Risk Factors, Adult, Infant, Newborn, Africa epidemiology, Maternal Mortality trends, Anesthesia, Spinal adverse effects, Anesthesia, Spinal mortality, Infant, Young Adult, Cohort Studies, Cesarean Section adverse effects, Cesarean Section mortality, Anesthesia, Obstetrical adverse effects, Anesthesia, Obstetrical mortality, Infant Mortality trends, Anesthesia, General adverse effects, Anesthesia, General mortality
- Abstract
Background: The African Surgical Outcomes Study (ASOS) found that maternal mortality following cesarean delivery in Africa is 50 times higher than in high-income countries, and associated with obstetric hemorrhage and anesthesia complications. Mothers who died were more likely to receive general anesthesia (GA). The associations between GA versus spinal anesthesia (SA) and preoperative risk factors, maternal anesthesia complications, and neonatal outcomes following cesarean delivery in Africa are unknown., Methods: This is a secondary explanatory analysis of 3792 patients undergoing cesarean delivery in ASOS, a prospective observational cohort study, across 22 African countries. The primary aim was to estimate the association between preoperative risk factors and the outcome of the method of anesthesia delivered. Secondary aims were to estimate the association between the method of anesthesia and the outcomes (1) maternal intraoperative hypotension, (2) severe maternal anesthesia complications, and (3) neonatal mortality. Generalized linear mixed models adjusting for obstetric gravidity and gestation, American Society of Anesthesiologists (ASA) category, urgency of surgery, maternal comorbidities, fetal distress, and level of anesthesia provider were used., Results: Of 3709 patients, SA was performed in 2968 (80%) and GA in 741 (20%). Preoperative factors independently associated with GA for cesarean delivery were gestational age (adjusted odds ratio [aOR], 1.093; 95% confidence interval [CI], 1.052-1.135), ASA categories III (aOR, 11.84; 95% CI, 2.93-46.31) and IV (aOR, 11.48; 95% CI, 2.93-44.93), eclampsia (aOR, 3.92; 95% CI, 2.18-7.06), placental abruption (aOR, 6.23; 95% CI, 3.36-11.54), and ruptured uterus (aOR, 3.61; 95% CI, 1.36-9.63). SA was administered to 48 of 94 (51.1%) patients with eclampsia, 12 of 28 (42.9%) with cardiac disease, 14 of 19 (73.7%) with preoperative sepsis, 48 of 76 (63.2%) with antepartum hemorrhage, 30 of 55 (54.5%) with placenta previa, 33 of 78 (42.3%) with placental abruption, and 12 of 29 (41.4%) with a ruptured uterus. The composite maternal outcome "all anesthesia complications" was more frequent in GA than SA (9/741 [1.2%] vs 3/2968 [0.1%], P < .001). The unadjusted neonatal mortality was higher with GA than SA (65/662 [9.8%] vs 73/2669 [2.7%], P < .001). The adjusted analyses demonstrated no association between method of anesthesia and (1) intraoperative maternal hypotension and (2) neonatal mortality., Conclusions: Analysis of patients undergoing anesthesia for cesarean delivery in Africa indicated patients more likely to receive GA. Anesthesia complications and neonatal mortality were more frequent following GA. SA was often administered to high-risk patients, including those with eclampsia or obstetric hemorrhage. Training in the principles of selection of method of anesthesia, and the skills of safe GA and neonatal resuscitation, is recommended., Competing Interests: Conflicts of Interest: See Disclosures at the end of the article., (Copyright © 2024 International Anesthesia Research Society.)
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- 2024
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9. Systemic Hypertension and Postoperative Symptomatic Spinal Epidural Hematoma: A Scoping Review.
- Author
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Robinson L, Forget P, and Nesvadba D
- Abstract
Postoperative symptomatic spinal epidural hematoma (PSSEH) is a serious complication of spinal surgery that is associated with significant morbidity. Studies suggest that hypertension is a risk factor for the development of PSSEH. The aim of this review was to evaluate the literature reporting associations between hypertension and PSSEH. A comprehensive literature search was conducted using the MEDLINE/PubMed, Embase, and Cochrane Library databases to identify studies that investigated PSSEH and reported data on preoperative hypertension status and/or perioperative blood pressure (BP). Eighteen studies were identified for inclusion in the review. Observational data suggested that uncontrolled/untreated preoperative hypertension, extubation-related increases in systolic BP, and elevated postoperative systolic BP were associated with an increased risk of PSSEH. The overall quality of evidence was low because of the retrospective nature of the studies, heterogeneity, and lack of precision in reporting. Despite the limitations of the current evidence, our findings could be important in establishing preoperative BP targets for elective spine surgery and inform perioperative clinical decision-making, while allowing consideration of risk factors for PSSEH. Well-controlled studies are required to investigate further the relationship between BP and PSSEH., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
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10. Postoperative Outcomes Associated With Procedural Sedation Conducted by Physician and Nonphysician Anesthesia Providers: Findings From the Prospective, Observational African Surgical Outcomes Study.
- Author
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van der Merwe F, Vickery NJ, Kluyts HL, Yang D, Han Y, Munlemvo DM, Ashebir DZ, Mbwele B, Forget P, Basenero A, Youssouf C, Antwi-Kusi A, Ndonga AK, Ngumi ZWW, Elkhogia A, Omigbodun AO, Tumukunde J, Madzimbamuto FD, Gobin V, Mehyaoui R, Samateh AL, du Toit L, Madiba TE, Pearse RM, and Biccard BM
- Subjects
- Adult, Humans, Postoperative Complications epidemiology, Postoperative Complications etiology, Prospective Studies, Treatment Outcome, Anesthesia adverse effects, Physicians
- Abstract
Background: There is an unmet need for essential surgical services in Africa. Limited anesthesia services are a contributing factor. Nonphysician anesthesia providers are utilized to assist with providing anesthesia and procedural sedation to make essential surgeries available. There is a paucity of data on outcomes following procedural sedation for surgery in Africa. We investigated the postoperative outcomes following procedural sedation by nonphysicians and physicians in Africa. We hypothesized that the level of training of the sedation provider may be associated with the incidence of severe postoperative complications and death., Methods: A secondary analysis of a prospective cohort of inhospital adult surgical patients representing 25 African countries was performed. The primary outcome was a collapsed composite of inhospital severe postoperative complications and death. We assessed the association between receiving procedural sedation conducted by a nonphysician (versus physician) and the composite outcome using logistic regression. We used the inverse probability of treatment weighting propensity score method to adjust for potential confounding variables including patient age, hemoglobin level, American Society of Anesthesiologists (ASA) physiological status, diabetes mellitus, urgency of surgery, severity of surgery, indication for surgery, surgical discipline, seniority of the surgical team, hospital level of specialization, and hospital funding system using public or private funding. All patients who only received procedural sedation for surgery were included., Results: Three hundred thirty-six patients met the inclusion criteria, of which 98 (29.2%) received sedation from a nonphysician provider. The incidence of severe postoperative complications and death was 10 of 98 (10.2%) in the nonphysician group and 5 of 238 (2.1%) in the physician group. The estimated association between procedural sedation conducted by a nonphysician provider and inhospital outcomes was an 8-fold increase in the odds of severe complications and/or death, with an odds ratio (95% confidence interval [CI]) of 8.3 (2.7-25.6)., Conclusions: The modest number of observations in this secondary data analysis suggests that shifting the task of procedural sedation from physicians to nonphysicians to increase access to care may be associated with severe postoperative complications and death in Africa. Research focusing on identifying factors contributing to adverse outcomes associated with procedural sedation is necessary to make this practice safer., Competing Interests: Conflicts of Interest: See Disclosures at the end of the article., (Copyright © 2021 International Anesthesia Research Society.)
- Published
- 2022
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11. Prescribing and deprescribing opioids.
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Forget P
- Subjects
- Analgesics, Opioid adverse effects, Deprescriptions
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- 2022
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12. Opioid-free Anesthesia: Comment.
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Forget P, Mulier J, Lavand'homme P, De Baerdemaeker L, Pelosi P, and de Boer HD
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- Analgesics, Opioid adverse effects, Humans, Pain, Postoperative, Anesthesia, Anesthesiology
- Published
- 2021
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13. Perspectives on pain registries.
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Macfarlane GJ, Forget P, Price C, Meissner W, and Zaslansky R
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- Humans, Registries, Pain epidemiology
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- 2021
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14. Propofol for Induction and Maintenance of Anesthesia in Patients With Brugada Syndrome: A Single-Center, 25-Year, Retrospective Cohort Analysis.
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Flamée P, Viaene K, Tosi M, Nogueira Carvalho H, de Asmundis C, Forget P, and Poelaert J
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- Adult, Aged, Aged, 80 and over, Anesthetics, Intravenous adverse effects, Brugada Syndrome physiopathology, Cohort Studies, Female, Humans, Male, Middle Aged, Propofol adverse effects, Retrospective Studies, Time Factors, Young Adult, Anesthetics, Intravenous administration & dosage, Anesthetics, Intravenous blood, Brugada Syndrome blood, Brugada Syndrome surgery, Propofol administration & dosage, Propofol blood
- Abstract
Background: Propofol administration in patients with Brugada syndrome (BrS) is still a matter of debate. Despite lacking evidence for its feared arrhythmogenicity, up to date, expert cardiologists recommend avoiding propofol. The main aim of this study is to assess the occurrence of malignant arrhythmias or defibrillations in patients with BrS, during and 30 days after propofol administration. The secondary aim is to investigate the occurrence of adverse events during propofol administration and hospitalization, as the 30-day readmission and 30-day mortality rate., Methods: We performed a retrospective cohort study on patients with BrS who received propofol anytime from January 1, 1996 to September 30, 2020. Anesthesia was induced by propofol in both groups. In the total intravenous anesthesia (TIVA) group, anesthesia was maintained by propofol, while in the BOLUS group, volatile anesthesia was provided. The individual anesthetic charts and the full electronic medical records up to 30 postprocedural days were scrutinized., Results: One hundred thirty-five BrS patients who underwent a total of 304 procedures were analyzed. The TIVA group included 27 patients for 33 procedures, and the BOLUS group included 108 patients for 271 procedures. In the TIVA group, the median time of propofol infusion was 60 minutes (interquartile range [IQR] = 30-180). The estimated plasma or effect-site concentration ranged between 1.0 and 6.0 µg·mL-1 for target-controlled infusion (TCI). The infusion rate for manually driven TIVA varied between 0.8 and 10.0 mg·kg-1·h-1. In the BOLUS group, the mean propofol dose per kilogram total body weight was 2.4 ± 0.9 mg·kg-1. No malignant arrhythmias or defibrillations were registered in both groups. The estimated 95% confidence interval (CI) of the risk for malignant arrhythmias in the BOLUS and TIVA groups was 0-0.011 and 0-0.091, respectively., Conclusions: The analysis of 304 anesthetic procedures in BrS patients, who received propofol, either as a TIVA or as a bolus during induction of volatile-based anesthesia, revealed no evidence of malignant arrhythmias or defibrillations. The present data do not support an increased risk with propofol-based TIVA compared to propofol-induced volatile anesthesia. Prospective studies are needed to investigate the electrophysiologic effects of propofol in BrS patents., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 International Anesthesia Research Society.)
- Published
- 2021
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15. Multimodal Analgesia for Spine Surgery: Does the Intraoperative Opioid Dose Matter?
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Forget P and Cata JP
- Subjects
- Analgesics, Opioid adverse effects, Double-Blind Method, Humans, Analgesia, Ketamine
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- 2021
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16. Methotrexate-induced Acute Myelopathy in a Teenager With High-risk Acute Lymphoblastic Leukemia.
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Geurten C, Forget P, Leroy P, Barrea C, and Hoyoux C
- Subjects
- Adolescent, Female, Humans, Ataxia chemically induced, Ataxia rehabilitation, Hypesthesia chemically induced, Hypesthesia rehabilitation, Methotrexate administration & dosage, Methotrexate adverse effects, Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy
- Abstract
Acute lymphoblastic leukemia (ALL) is one of the most frequent malignancies in childhood whose long-term survival has increased up to 80% thanks to modern therapy enhancements. Nevertheless, methotrexate (MTX) remains a mainstay of ALL therapy, but also represents one of the major causes of neurotoxicity in patients with ALL. MTX-induced toxicity occurs in about 9% of patients treated for ALL. It usually affects deep white matter region leading to leukoencephalopathy, which has varying clinical manifestations ranging from acute neurologic disturbances to seizures or chronic permanent encephalopathy. Here we describe a 13-year-old girl affected with ALL who developed lower limbs hypesthesia and static ataxia due to transverse myelopathy after intrathec administration of MTX therapy. A high-dose corticotherapy combined to vitamin supplementation and rehabilitation was tested. Neurological evolution was characterized by slow and partial recovery.
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- 2020
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17. One-year Results of a Factorial Randomized Trial of Aspirin versus Placebo and Clonidine versus Placebo in Patients Having Noncardiac Surgery.
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Sessler DI, Conen D, Leslie K, Yusuf S, Popova E, Graham M, Kurz A, Villar JC, Mrkobrada M, Sigamani A, Biccard BM, Meyhoff CS, Parlow JL, Guyatt G, Xavier D, Chan MTV, Kumar PA, Forget P, Malaga G, Fleischmann E, Amir M, Torres D, Wang CY, Paniagua P, Berwanger O, Srinathan S, Landoni G, Manach YL, Whitlock R, Lamy A, Balasubramanian K, Gilron I, Turan A, Pettit S, and Devereaux PJ
- Subjects
- Aged, Analgesics adverse effects, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Aspirin adverse effects, Clonidine adverse effects, Female, Follow-Up Studies, Humans, Internationality, Male, Middle Aged, Myocardial Infarction diagnosis, Myocardial Infarction epidemiology, Myocardial Infarction prevention & control, Perioperative Care adverse effects, Postoperative Complications epidemiology, Postoperative Complications prevention & control, Time Factors, Analgesics administration & dosage, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Aspirin administration & dosage, Clonidine administration & dosage, Perioperative Care methods, Postoperative Complications diagnosis
- Abstract
Background: The authors previously reported that perioperative aspirin and/or clonidine does not prevent a composite of death or myocardial infarction 30 days after noncardiac surgery. Moreover, aspirin increased the risk of major bleeding and clonidine caused hypotension and bradycardia. Whether these complications produce harm at 1 yr remains unknown., Methods: The authors randomized 10,010 patients with or at risk of atherosclerosis and scheduled for noncardiac surgery in a 1:1:1:1 ratio to clonidine/aspirin, clonidine/aspirin placebo, clonidine placebo/aspirin, or clonidine placebo/aspirin placebo. Patients started taking aspirin or placebo just before surgery; those not previously taking aspirin continued daily for 30 days, and those taking aspirin previously continued for 7 days. Patients were also randomly assigned to receive clonidine or placebo just before surgery, with the study drug continued for 72 h., Results: Neither aspirin nor clonidine had a significant effect on the primary 1-yr outcome, a composite of death or nonfatal myocardial infarction, with a 1-yr hazard ratio for aspirin of 1.00 (95% CI, 0.89 to 1.12; P = 0.948; 586 patients [11.8%] vs. 589 patients [11.8%]) and a hazard ratio for clonidine of 1.07 (95% CI, 0.96 to 1.20; P = 0.218; 608 patients [12.1%] vs. 567 patients [11.3%]), with effect on death or nonfatal infarction. Reduction in death and nonfatal myocardial infarction from aspirin in patients who previously had percutaneous coronary intervention at 30 days persisted at 1 yr. Specifically, the hazard ratio was 0.58 (95% CI, 0.35 to 0.95) in those with previous percutaneous coronary intervention and 1.03 (95% CI, 0.91to 1.16) in those without (interaction P = 0.033). There was no significant effect of either drug on death, cardiovascular complications, cancer, or chronic incisional pain at 1 yr (all P > 0.1)., Conclusions: Neither perioperative aspirin nor clonidine have significant long-term effects after noncardiac surgery. Perioperative aspirin in patients with previous percutaneous coronary intervention showed persistent benefit at 1 yr, a plausible sub-group effect.
- Published
- 2020
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18. Electrocardiographic Effects of Propofol versus Etomidate in Patients with Brugada Syndrome.
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Flamée P, Varnavas V, Dewals W, Carvalho H, Cools W, Bhutia JT, Beckers S, Umbrain V, Verborgh C, Forget P, Chierchia GB, Brugada P, Poelaert J, and de Asmundis C
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Anesthesia, General adverse effects, Double-Blind Method, Female, Humans, Male, Middle Aged, Prospective Studies, Young Adult, Anesthesia, General methods, Anesthetics, Intravenous adverse effects, Brugada Syndrome physiopathology, Electrocardiography drug effects, Etomidate adverse effects, Propofol adverse effects
- Abstract
Background: Brugada Syndrome is an inherited arrhythmogenic disease, characterized by the typical coved type ST-segment elevation in the right precordial leads from V1 through V3. The BrugadaDrugs.org Advisory Board recommends avoiding administration of propofol in patients with Brugada Syndrome. Since prospective studies are lacking, it was the purpose of this study to assess the electrocardiographic effects of propofol and etomidate on the ST- and QRS-segments. In this trial, it was hypothesized that administration of propofol or etomidate in bolus for induction of anesthesia, in patients with Brugada Syndrome, do not clinically affect the ST- and QRS-segments and do not induce arrhythmias., Methods: In this prospective, double-blinded trial, 98 patients with established Brugada syndrome were randomized to receive propofol (2 to 3 mg/kg) or etomidate (0.2 to 0.3 mg/kg) for induction of anesthesia. The primary endpoints were the changes of the ST- and QRS-segment, and the occurrence of new arrhythmias upon induction of anesthesia., Results: The analysis included 80 patients: 43 were administered propofol and 37 etomidate. None of the patients had a ST elevation greater than or equal to 0.2 mV, one in each group had a ST elevation of 0.15 mV. An ST depression up to -0.15mV was observed eleven times with propofol and five with etomidate. A QRS-prolongation of 25% upon induction was seen in one patient with propofol and three with etomidate. This trial failed to establish any evidence to suggest that changes in either group differed, with most percentiles being zero (median [25th, 75th], 0 [0, 0] vs. 0 [0, 0]). Finally, no new arrhythmias occurred perioperatively in both groups., Conclusions: In this trial, there does not appear to be a significant difference in electrocardiographic changes in patients with Brugada syndrome when propofol versus etomidate were administered for induction of anesthesia. This study did not investigate electrocardiographic changes related to propofol used as an infusion for maintenance of anesthesia, so future studies would be warranted before conclusions about safety of propofol infusions in patients with Brugada syndrome can be determined.
- Published
- 2020
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19. (Non) Pharmacological Modalities in Acute Procedural Pain.
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Najafi N, Forget P, and Poelaert J
- Subjects
- Child, Humans, Pain, Pain Management, Pain, Procedural
- Published
- 2019
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20. Neutrophil-to-Lymphocyte Ratio Predicts Death in Acute-on-Chronic Liver Failure Patients Admitted to the Intensive Care Unit: A Retrospective Cohort Study.
- Author
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Moreau N, Wittebole X, Fleury Y, Forget P, Laterre PF, and Castanares-Zapatero D
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- Acute-On-Chronic Liver Failure metabolism, Aged, Female, Humans, Intensive Care Units statistics & numerical data, Male, Middle Aged, Retrospective Studies, Acute-On-Chronic Liver Failure immunology, Acute-On-Chronic Liver Failure mortality, Lymphocytes cytology, Neutrophils cytology
- Abstract
The neutrophil-to-lymphocyte ratio (NLR) is an inflammation score recognized as associated with outcome. Although inflammation has been shown to correlate with the development of acute-on-chronic liver failure (ACLF), we sought to investigate the role of NLR in predicting 90-day mortality in cirrhotic patients experiencing ACLF. We performed a retrospective cohort study involving a total of 108 consecutive cirrhotic patients admitted in the intensive care unit (ICU). NLR, clinical and biological data were recorded. Of the total, 75 patients had ACLF. The 90-day mortality rate was 53%. ACLF patients displayed higher NLR values in comparison with cirrhotic patients without ACLF throughout the ICU stay. NLR proved more elevated in nonsurvivors ACLF patients, with mortality correlating with increasing quartiles of NLR. On multivariable Cox regression analysis, NLR was found to be a predictor of mortality along with the Sequential Organ Failure Assessment (SOFA) score and mechanical ventilation requirement. The model for end-stage liver disease (MELD) score was not predictive of 90-days mortality. Performance analysis revealed an area under curve of 0.71 [95% confidence interval: 0.59-0.82] regarding NLR capacity to predict 90-days mortality. When including NLR, SOFA score, and mechanical ventilation requirement into the final model, the area under curve was significantly higher (0.81 [95% confidence interval: 0.72-0.91]).These findings suggest that NLR is associated with mortality in ACLF patients admitted to the ICU. Combining NLR, SOFA score, and the need for mechanical ventilation could be a useful prognostic tool to identify ACLF patients at a higher risk of mortality.
- Published
- 2018
- Full Text
- View/download PDF
21. Shifting to Translational Research on Postoperative Pain and Its Chronification.
- Author
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Forget P and Deumens R
- Subjects
- Animals, Female, Humans, Male, Cathepsin G biosynthesis, Chronic Pain metabolism, Pain, Postoperative metabolism
- Published
- 2015
- Full Text
- View/download PDF
22. A case of osteosarcoma in a patient with pycnodysostosis.
- Author
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Cortisse N, Forget P, Dresse MF, Florkin B, Mascard E, Guinebretière JM, Brugières L, and Hoyoux C
- Subjects
- Adult, Humans, Male, Femoral Neoplasms etiology, Osteosarcoma etiology, Pycnodysostosis complications
- Abstract
Pycnodysostosis is a rare sclerosing bone dystrophy. The main clinical features are short stature and oral and maxillofacial abnormalities such as a large head, a small and underdeveloped face with prominent nose and eyes, irregular dentition, small hands and feet with dystrophic nails, and trunk deformities such as scoliosis. The differential diagnosis is established with other skeletal dysplasias such as osteopetrosis, cleidocranial dysplasia, and idiopathic acro-osteolysis. Since its first description in 1962 by Maroteaux and Lamy, about 100 cases have been published, some of these with uncommon features. We describe the case of a 22-year-old European man with pycnodysostosis who developed a chondroblastic osteosarcoma of the right femur. No case of bone cancer in this sclerosing bone disease had been described so far.
- Published
- 2012
- Full Text
- View/download PDF
23. Endpoint selection and unreported analgesic use may render oncologic studies inconclusive.
- Author
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Forget P, Leonard D, Kartheuser A, and De Kock M
- Subjects
- Analgesia, Epidural, Analgesics therapeutic use, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Humans, Neoplasm Recurrence, Local prevention & control, Analgesics pharmacology, Endpoint Determination, Medical Oncology
- Published
- 2011
- Full Text
- View/download PDF
24. Goal-directed fluid management based on the pulse oximeter-derived pleth variability index reduces lactate levels and improves fluid management.
- Author
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Forget P, Lois F, and de Kock M
- Subjects
- Aged, Digestive System Surgical Procedures adverse effects, Digestive System Surgical Procedures methods, Disease Management, Female, Humans, Male, Middle Aged, Pilot Projects, Plethysmography methods, Postoperative Complications blood, Postoperative Complications etiology, Postoperative Complications prevention & control, Fluid Therapy methods, Goals, Lactic Acid blood, Monitoring, Intraoperative methods, Oximetry methods
- Abstract
Background: Dynamic variables predict fluid responsiveness and may improve fluid management during surgery. We investigated whether displaying the variability in the pulse oximeter plethysmogram (pleth variability index; PVI) would guide intraoperative fluid management and improve circulation as assessed by lactate levels., Methods: Eighty-two patients scheduled for major abdominal surgery were randomized into 2 groups to compare intraoperative PVI-directed fluid management (PVI group) versus standard care (control group). After the induction of general anesthesia, the PVI group received a 500-mL crystalloid bolus and a crystalloid infusion of 2 mL · kg(-1) · h(-1). Colloids of 250 mL were administered if the PVI was >13% Vasoactive drug support was given to maintain the mean arterial blood pressure above 65 mm Hg. In the control group, an infusion of 500 mL of crystalloids was followed by fluid management on the basis of fluid challenges and their effects on mean arterial blood and central venous pressure. Perioperative lactate levels, hemodynamic data, and postoperative complications were recorded prospectively., Results: Intraoperative crystalloids and total volume infused were significantly lower in the goal-directed PVI group. Lactate levels were significantly lower in the PVI group during surgery and 48 hours after surgery (P < 0.05)., Conclusions: PVI-based goal-directed fluid management reduced the volume of intraoperative fluid infused and reduced intraoperative and postoperative lactate levels.
- Published
- 2010
- Full Text
- View/download PDF
25. Do intraoperative analgesics influence breast cancer recurrence after mastectomy? A retrospective analysis.
- Author
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Forget P, Vandenhende J, Berliere M, Machiels JP, Nussbaum B, Legrand C, and De Kock M
- Subjects
- Adult, Aged, Analgesics, Opioid adverse effects, Analgesics, Opioid therapeutic use, Analysis of Variance, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Breast Neoplasms pathology, Data Collection, Disease-Free Survival, Endpoint Determination, Female, Humans, Kaplan-Meier Estimate, Ketorolac therapeutic use, Lymph Nodes pathology, Lymphatic Metastasis pathology, Mastectomy, Middle Aged, Neoplasm Metastasis, Neoplasm Recurrence, Local, Pain, Postoperative drug therapy, Regression Analysis, Retrospective Studies, Analgesics therapeutic use, Breast Neoplasms epidemiology, Breast Neoplasms surgery, Intraoperative Care
- Abstract
Background: Whether intraoperative analgesics have an impact on postoperative cancer recurrence is unknown. Some investigations suggest that the opioids could favor relapse and that regional analgesia and nonsteroidal antiinflammatory drugs could improve cancer prognosis. We retrospectively reviewed our series of breast cancer surgery patients., Methods: This retrospective study included 327 consecutive women who underwent mastectomy with axillary dissection for breast cancer. The main objective was to compare the incidence of cancer recurrence among patients who received different analgesics during surgery., Results: Perioperative characteristics, cancer prognostic factors, and the length of surgery were comparable regardless of the analgesics administered. Univariate and multivariate analyses showed a lower cancer recurrence rate when ketorolac was given before surgery (P = 0.019). Other analgesics (sufentanil, ketamine, and clonidine) were not associated with a significant reduction in cancer recurrence rates in our series., Conclusion: This retrospective analysis suggests that intraoperative administration of ketorolac decreases the risk of breast cancer relapse compared with other analgesícs.
- Published
- 2010
- Full Text
- View/download PDF
26. Pediatric gastric lymphoma: a rare entity.
- Author
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Jacquemart C, Guidi O, Etienne I, Delrez R, Forget P, Dresse MF, Depas G, de Leval L, and Hoyoux C
- Subjects
- Adolescent, Burkitt Lymphoma drug therapy, Fluorodeoxyglucose F18, Helicobacter Infections diagnosis, Helicobacter Infections drug therapy, Helicobacter pylori isolation & purification, Humans, Male, Positron-Emission Tomography, Radiopharmaceuticals, Stomach Neoplasms drug therapy, Burkitt Lymphoma pathology, Stomach Neoplasms pathology
- Abstract
Primary gastric lymphoma is a rare event in childhood. We describe a 13-year-old boy with gastric Burkitt-like lymphoma localized in the fundus. Symptoms mimicking gastritis-epigastric pain, hypochromic anemia, anorexia, and weight loss had been present for a few months before diagnosis. No Helicobacter pylori infection was shown at diagnosis. Biopsies obtained by ultrasound gastroscopy proved the diagnosis; F-fluorodeoxyglucose-positron emission tomography detected an isolated large gastric hypermetabolic mass. According to the international FAB/LMB 96 trial, the patient was treated with chemotherapy alone and is in first complete remission 2(1/2) years after diagnosis.
- Published
- 2008
- Full Text
- View/download PDF
27. Influence of respiratory system impedance on volume and pressure delivered at the Y piece in ventilated infants.
- Author
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Nève V, Leclerc F, Noizet O, Vernoux S, Leteurtre S, Forget P, Sadik A, and Riou Y
- Subjects
- Electric Impedance, Female, Humans, Infant, Male, Manometry, Positive-Pressure Respiration methods, Prospective Studies, Airway Resistance physiology, Intubation, Intratracheal, Lung Compliance physiology, Positive-Pressure Respiration instrumentation, Tidal Volume
- Abstract
Objectives: Tidal volume (VT) delivered to infants' airways are overestimated and pressure underestimated when measured in the ventilator and not at the Y piece. This study aimed at evaluating the influence of respiratory system impedance on expiratory VT (VTE) and pressure measurement difference., Design: Prospective observational study., Setting: Pediatric intensive care unit at a university hospital., Patients: Data were collected between February 2000 and October 2001 for 30 infants (range, 1-23 months) ventilated in the pressure-controlled or volume-controlled mode., Interventions: Measurements of VTE, pressure obtained at the same time at the Y piece and on the ventilator Servo 300, were collected in ventilated infants. Respiratory system impedance was calculated from data obtained at the Y piece. Circuit compliance was measured in vitro. VTEs were corrected for compressible volume., Measurements and Results: VTEs were overestimated by the Servo 300 in the pressure-controlled and volume-controlled modes (from 5% to 62% of the value displayed on Servo 300). Maximal inspiratory pressures were underestimated by the Servo 300 in the pressure-controlled mode (difference from -2 to +19 cm H(2)O). Measurement difference increased with increasing respiratory system impedance. Ventilator VTE corrected for circuit compliance did not offer a sufficiently accurate estimation of VTE at the Y piece., Conclusions: VT and pressure measurements must be performed at the Y piece, especially in infants with increased respiratory system impedance (i.e., decreased respiratory system compliance or increased resistance). Correcting VTE for circuit compliance cannot replace measurement of VT at the Y piece.
- Published
- 2003
- Full Text
- View/download PDF
28. Fecal polyamine concentration in children with and without nutrient malabsorption.
- Author
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Forget P, Sinaasappel M, Bouquet J, Deutz NE, and Smeets C
- Subjects
- Adolescent, Cadaverine analysis, Child, Child, Preschool, Chromatography, High Pressure Liquid, Female, Humans, Infant, Lipids analysis, Male, Putrescine analysis, Feces chemistry, Malabsorption Syndromes metabolism, Polyamines analysis
- Abstract
Background: Fermentation products of malabsorbed nutrients are thought to be responsible for intestinal adaptation following small bowel resection in rats. It has been suggested that either short-chain fatty acids or polyamines (mainly putrescine and cadaverine) could be the fermentation products involved. There are no data available on fecal polyamine content in humans. The present study compared the fecal polyamine concentrations in children with and without malabsorption., Methods: Sixteen (8 girls, 8 boys) malabsorption patients (cystic fibrosis: 13, short bowel syndrome: 2, biliary atresia: 1) with a mean age of 8 years were compared to 17 (9 girls, 8 boys) sick children without malabsorption (mean age 5.7 years). Three-day fecal collections were performed and analyzed for fat and polyamine concentrations. High-performance liquid chromatography (HPLC) was used for the measurement of polyamine concentrations., Results: Mean and SEM for fecal fat excretion was 13.4 +/- 2.5 g/day and 1.5 +/- 0.3 g/day in the malabsorption and control group respectively. Median fecal cadaverine and putrescine concentrations were 3723 mumol.kg-1 feces and 4737 mumol.kg-1 feces for the malabsorption group and 114 mumol.kg-1 feces and 306 mumol.kg-1 feces for the control group (p < 0.007 and < 0.00001 respectively). No significant differences were found for fecal spermine and spermidine concentrations between the two groups., Conclusions: Children with malabsorption show very high fecal putrescine and cadaverine concentrations. Our results support the hypothesis that fecal polyamines could be important.
- Published
- 1997
- Full Text
- View/download PDF
29. Authors' reply to acid steatocrit.
- Author
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Tran M, Forget P, and Van den Neucker A
- Subjects
- Humans, Hydrogen-Ion Concentration, Feces chemistry, Lipids analysis
- Published
- 1997
- Full Text
- View/download PDF
30. Improved steatocrit results obtained by acidification of fecal homogenates are due to improved fat extraction.
- Author
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Tran M, Forget P, Van den Neucker A, and van Kreel B
- Subjects
- Centrifugation, Female, Humans, Hydrogen-Ion Concentration, Infant, Newborn, Lipids isolation & purification, Male, Microscopy, Perchlorates, Celiac Disease diagnosis, Feces chemistry, Infant, Premature, Diseases diagnosis, Lipids analysis
- Abstract
Conflicting results have been reported on the value of the steatocrit as a screening test for steatorrhea. We recently modified the test procedure by fecal acidification with the hope of improving fat extraction and consequently the sensitivity of the test. The aim of the present study was to ascertain whether or not fecal acidification led to improved fat extraction by comparing the fat content of both fatty and solid layers obtained by centrifugation of 12 acidified (acid steatocrit) and unacidified (classical steatocrit) steatorrheal stool samples. The fat content of fatty and solid layers was evaluated using the semiquantitative (+ = 1, +2 = 2, +3 = 3) scoring system described by Drummey for the interpretation of the Sudan microscopic method for fecal fat. The fatty layers sum of scores for the 12 samples examined was 31 and 16 for the acid and classical steatocrit, respectively. The solid layers sum of scores for the 12 samples was 13 and 24 for the acid and classical steatocrit, respectively. Fat extraction from stool samples was significantly improved after fecal sample acidification (p < 0.005). Acid steatocrit results agreed better with chemically measured fecal fat than classical steatocrit results. We conclude that fecal acidification, by improving fat extraction, increases the reliability of the steatocrit method for the detection of steatorrhea.
- Published
- 1996
- Full Text
- View/download PDF
31. The acid steatocrit: a much improved method.
- Author
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Tran M, Forget P, Van den Neucker A, Strik J, van Kreel B, and Kuijten R
- Subjects
- Child, Child, Preschool, Cystic Fibrosis physiopathology, Female, Humans, Hydrogen-Ion Concentration, Infant, Male, Methods, Celiac Disease diagnosis, Feces chemistry, Lipids analysis
- Abstract
The steatocrit method has recently been introduced as a simple screening test for steatorrhea. As it seemed likely that separation of fecal homogenate by centrifugation into a lipid phase, a watery phase, and a solid phase would be pH-dependent, we evaluated the effect of fecal acidification on steatocrit results. We also compared classical and acid steatocrit results in healthy children and in patients with cystic fibrosis and studied the relationship between two steatocrit methods and fecal fat content as measured by a reference chemical method. Steatocrit results increased with the degree of fecal acidification, and maximal results were obtained at the lowest fecal pH values. Means and SEM for classical and acid steatocrit values were 1.1 +/- 0.4% (classical) versus 3.8 +/- 1% (acid) in controls (n = 6) and 5.4 +/- 1.9% (classical) versus 26.9 +/- 4.3% (acid) in cystic fibrosis patients (n = 9). The correlations between fecal fat content measured chemically and steatocrit results were 0.18 (p = 0.35) and 0.81 (p < 0.0001) for classical and acid steatocrit, respectively. We conclude that acidification of fecal homogenates leads to a marked improvement in the steatocrit method.
- Published
- 1994
- Full Text
- View/download PDF
32. Permeability of the small intestine to [51Cr]EDTA in children with acute gastroenteritis or eczema.
- Author
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Forget P, Sodoyez-Goffaux F, and Zappitelli A
- Subjects
- Acute Disease, Adult, Child, Child, Preschool, Chromium Radioisotopes, Edetic Acid, Female, Humans, Infant, Male, Cell Membrane Permeability, Eczema metabolism, Gastroenteritis metabolism, Intestine, Small metabolism
- Abstract
Increased gut permeability to macromolecules is thought to be an important factor in the development of food hypersensitivity. The latter can develop in the course of acute gastroenteritis and could play a role in infantile eczema. We studied gut permeability in 10 normal adults, 11 control children, 7 children with acute gastroenteritis, and 8 patients with infantile eczema, making use of [51Cr]EDTA as probe molecule. [51Cr]EDTA was given orally (50-100 microCi); 24-h urinary excretion of [51Cr]EDTA was measured and expressed as a percentage of the oral dose. Mean and standard error were 2.35 +/- 0.24, 2.51 +/- 0.21, 9.96 +/- 3.44, and 10.90 +/- 2.05 in normal adults, control children, and gastroenteritis and eczema patients, respectively. Differences between controls and either gastroenteritis (p less than 0.001) or eczema (p less than 0.001) patients are significant. Our results support the hypothesis that increased gut permeability could play a role in food hypersensitivity.
- Published
- 1985
- Full Text
- View/download PDF
33. Lactase insufficiency revisited.
- Author
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Forget P, Lombet J, Grandfils C, Dandrifosse G, and Geubelle F
- Subjects
- Adolescent, Child, Child, Preschool, Female, Gastrointestinal Diseases diagnosis, Humans, Hydrogen, Infant, Intestine, Small enzymology, Intestine, Small pathology, Lactose, Lactose Intolerance enzymology, Male, Respiration, Respiratory Tract Diseases diagnosis, Sucrase metabolism, alpha-Glucosidases metabolism, Galactosidases deficiency, Lactose Intolerance diagnosis, beta-Galactosidase deficiency
- Abstract
The definition of "insufficient" small bowel lactase activity varies greatly among authors. The present study is aimed at redefining lactase insufficiency by comparing intestinal lactase activity and results of the lactose breath hydrogen test. Primary "insufficient" lactase activity was considered to be present when a child with a normal small bowel histology showed lactose malabsorption as measured by the lactose breath hydrogen test. The lactase activity of 22 "normal" children ranged from 0.77 to 4.57 U/g wet weight, while five children showed primary lactase insufficiency as defined above. Small bowel lactase activity in the latter patients was less than 0.74 U/g wet weight. Sucrase and maltase activities were similar in both groups of patients. We conclude that children with a normal small bowel histology should be considered to have primary lactase insufficiency when small bowel lactase activity is below 0.75 U/g wet weight.
- Published
- 1985
- Full Text
- View/download PDF
34. Usefulness of random fecal alpha 1-antitrypsin and chymotrypsin determinations in children.
- Author
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Mbonda E, Forget P, Saye Z, and Leclercq-Foucart J
- Subjects
- Adolescent, Child, Child, Preschool, Crohn Disease enzymology, Diarrhea enzymology, Female, Gastroenteritis enzymology, Humans, Male, Chymotrypsin analysis, Cystic Fibrosis diagnosis, Feces enzymology, alpha 1-Antitrypsin analysis
- Abstract
Random fecal chymotrypsin activity and fecal alpha 1-antitrypsin (FA-1-AT) concentrations were determined in 11 children with cystic fibrosis, 5 children with Crohn's disease, 9 children with chronic aspecific diarrhea, 85 children with acute gastroenteritis, and 54 control children. Cystic fibrosis patients showed only very low fecal chymotrypsin values that did not overlap with values obtained in patients with either acute or chronic diarrhea. When compared with our control group, a significant increase of FA-1-AT concentrations was found only in children with Crohn's disease. Normal values were found in all patients with either chronic aspecific diarrhea or cystic fibrosis, while 12 of 85 children with acute gastroenteritis showed FA-1-AT concentrations above the 95th percentile of control children. We conclude that diarrhea (either acute or chronic) does not significantly decrease the clinical usefulness of fecal chymotrypsin activity measurements in the diagnosis of pancreatic insufficiency, while acute (gastroenteritis) but not chronic (chronic aspecific diarrhea, cystic fibrosis) diarrhea can give rise to protein losing and FA-1-AT concentrations similar to those found in Crohn's disease.
- Published
- 1989
- Full Text
- View/download PDF
35. Intestinal permeability to [51Cr]EDTA in children with cystic fibrosis.
- Author
-
Leclercq-Foucart J, Forget P, Sodoyez-Goffaux F, and Zappitelli A
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Edetic Acid urine, Female, Humans, Male, Permeability, Chromium Radioisotopes urine, Cystic Fibrosis physiopathology, Intestinal Absorption
- Abstract
Intestinal permeability was investigated in 14 children with cystic fibrosis making use of [51Cr]EDTA as probe molecule. Ten normal young adults and 11 children served as controls. After oral administration of [51Cr]EDTA, 24 h urine was collected. Urinary radioactivity was calculated and results expressed as percentage of oral dose excreted in 24 h urine. Mean and SEM were as follows: 2.51 +/- 0.21, 2.35 +/- 0.24, and 13.19 +/- 1.72 for control children, normal adults, and cystic fibrosis patients, respectively. The permeability differences between cystic fibrosis patients and either control children or control adults are significant (p less than 0.001).
- Published
- 1986
- Full Text
- View/download PDF
36. Diamine oxidase in serum and small intestinal biopsy tissue in childhood celiac disease.
- Author
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Forget P, Grandfils C, Van Cutsem JL, and Dandrifosse G
- Subjects
- Amine Oxidase (Copper-Containing) metabolism, Celiac Disease blood, Child, Child, Preschool, Disaccharidases metabolism, Female, Humans, Infant, Male, Amine Oxidase (Copper-Containing) blood, Celiac Disease enzymology, Duodenum enzymology, Intestinal Mucosa enzymology
- Abstract
Diamine oxidase (DAO) activities were measured in small intestinal biopsies and in serum from control children and children with florid celiac disease. Mucosal DAO activities were found to be significantly higher in control children when compared with children with celiac disease (mean +/- SEM: 486 +/- 39 versus 121 +/- 22.1 nmol h-1 g-1 wet weight, p less than 0.001). Similarly, serum DAO activities were significantly higher in control children when compared with children with celiac disease (mean +/- SEM: 39 +/- 12 versus 13.6 +/- 2 pmol h-1 ml-1 serum, p less than 0.002). The lower serum activities associated with low mucosal values support the hypothesis that serum DAO activity reflects small bowel integrity.
- Published
- 1986
- Full Text
- View/download PDF
37. Evolution of some biochemical characteristics of the intestinal mucosa during the first postnatal weeks in C57 mice. Effects of thyroxine and putrescine.
- Author
-
Etienne-Poncin A, Dandrifosse G, Forget P, and Lepoint A
- Subjects
- Amine Oxidase (Copper-Containing) metabolism, Animals, Child, Humans, Intestinal Mucosa analysis, Intestinal Mucosa drug effects, Mice, Mitotic Index, Polyamines analysis, Sucrase metabolism, alpha-Glucosidases metabolism, beta-Galactosidase metabolism, Animals, Newborn growth & development, Intestinal Mucosa growth & development, Mice, Inbred C57BL growth & development, Putrescine pharmacology, Thyroxine pharmacology
- Abstract
In C57 mice, during the third week after birth, there is a rapid conversion of the intestinal epithelium from fetal to mature adult status. Some characteristics (lactase, maltase, diamine oxidase, and sucrase activity; putrescine, spermine and spermidine concentrations; mitotic index) have been analyzed for the proximal, middle, and distal parts of the intestine in mice of different ages: 8, 15, 19, and 60 days. The most important observations recorded were as follows: (a) sucrase- and maltase-specific activities as well as spermine and spermidine contents increased abruptly on the 19th postnatal day and then decreased; (b) decrease of lactase and diamine oxidase-specific activity was recorded between the 15th and 19th postnatal days, (c) later, diamine oxidase-specific activity increased, whereas putrescine content decreased in the proximal part of the intestine; and (d) mitotic index was not significantly different when estimated for the crypts on days 11 and 19. No similar variations of these biochemical parameters were observed over a period of 3 days when mice were injected with thyroxine on the 8th day or when mice received putrescine per os on the 9th day, as explained in the text. Only a slight but significant variation in sucrase- or maltase-specific activity with thyroxine and a variation of the lactase or DAO-specific activity of the distal part of the intestine with putrescine were recorded.
- Published
- 1989
- Full Text
- View/download PDF
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