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36 results on '"Département de l'Information Médicale"'

1. Efficacy of Intradiscal Injection of BM-MSC in Subjects With Chronic Low Back Pain (LBP) Due to Lumbar Degenerative Disc Disease (DDD) Unresponsive (RESPINE)

Author: Interdisziplinäres Zentrum Klinische Studien (IZKS), European Clinical Research Infrastructure Network, Département de l'information médicale, CHU de Montpellier, Centre National de la Recherche Scientifique, France, Université Montpellier, Univercell-Biosolutions S.A.S, National University of Ireland, Galway, Ireland, University of Valladolid, Citospin, Rennes University Hospital, APHP, Campus Bio-Medico University, BG Klinikum Bergmannstrost, Halle, Germany, Nantes University Hospital, Institut de Terapia Regenerativa Tissular, and University of Navarra
Published: 2023

2. Mild sporadic primary hyperparathyroidism: high rate of multiglandular disease is associated with lower surgical cure rate

Author: Emmanuelle Trebouet, Matthieu Wargny, Karine Renaudin, Eric Mirallié, Lucy Chaillous, Catherine Ansquer, Françoise Kraeber-Bodéré, Christophe Leux, C. Caillard, Sahar Bannani, Service d'Endocrinologie [Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Clinique de Chirurgie Digestive et Endocrinienne [CHU Nantes], Département de l'Information Médicale [CHU Nantes], Nuclear Oncology (CRCINA-ÉQUIPE 13), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Médecine Nucléaire [Nantes], Hôpital Laennec, Service d’Anatomie et Cytologie Pathologiques [CHU Nantes], Bernardo, Elizabeth, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)
Subjects: Adult, Male, Technetium Tc 99m Sestamibi, Multiglandular disease, Sestamibi scan, Parathyroidectomy, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Mild primary hyperparathyroidism, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, MIBI scintigraphy, 030230 surgery, Scintigraphy, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Humans, education, Aged, Retrospective Studies, Aged, 80 and over, Tomography, Emission-Computed, Single-Photon, Neck ultrasound, education.field_of_study, medicine.diagnostic_test, business.industry, Middle Aged, Vascular surgery, Hyperparathyroidism, Primary, medicine.disease, Normocalcemic form, 3. Good health, Cardiac surgery, Treatment Outcome, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Female, Surgery, Radiopharmaceuticals, Tomography, X-Ray Computed, business, Primary hyperparathyroidism, Abdominal surgery
Abstract: International audience; BACKGROUND:Mild primary hyperparathyroidism (serum calcium ≤ 2.85 mmol/L) is the most representative form of pHPT nowadays. The aim of this study was to evaluate its subtypes and the multiglandular disease (MGD) rate as it may lower the sensitivity of preoperative parathyroid scintigraphy and the surgical cure rate.METHODS:We retrospectively included patients with mild pHPT who underwent parathyroid dual-tracer scintigraphy with 99mTc-MIBI SPECT/CT and surgery between January 2013 and December 2015. Cure was defined as normalization of serum calcium (or PTH in the normocalcemic form) at 6 months. MGD was defined by either two abnormal resected glands or persistent disease after resection of at least one abnormal gland.RESULTS:We included 121 patients. Median preoperative serum calcium was 2.68 mmol/L and median PTH was 83.4 pg/mL. A total of 141 glands were resected (95 adenomas, 33 hyperplasias). The subtypes were 57% classic, 32.2% normohormonal, and 10.7% normocalcemic. MGD occurred in 23.5% of patients divided as 13%, 30%, and 64% respectively (p = 0.0011). The surgical cure rate was 85.2%. The normocalcemic form had lower cure rate than the normohormonal (45% vs 84%, p = 0.018) and classic forms (45% vs 93%, p = 0.0006). MIBI scintigraphy identified at least one abnormal lesion, later confirmed by the pathologist in 90/98 patients, making the sensitivity per patient 91.8% (95% CI 84.1-96.2%).CONCLUSIONS:MGD is strongly associated with mild pHPT, especially the normocalcemic form where it accounts for 64% of cases. Bilateral neck exploration should be performed in this population to improve the cure rate, even if the scintigraphy shows a single focus.
Published: 2019
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3. Progression of disease within 2 years (POD24) is a clinically relevant endpoint to identify high-risk follicular lymphoma patients in real life

Author: Amandine Le Bourgeois, Patrice Chevallier, Philippe Moreau, Christophe Leux, Benoit Tessoulin, Steven Le Gouill, Thierry Guillaume, Beatrice Mahe, Clara Sortais, Cyrille Touzeau, Thomas Gastinne, Anne Moreau, Anne Lok, Alice Garnier, Pierre Peterlin, Viviane Dubruille, Nicolas Blin, Céline Bossard, Bernardo, Elizabeth, Département d'Hématologie Clinique [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Regulation of Bcl2 and p53 Networks in Multiple Myeloma and Mantle Cell Lymphoma (CRCINA-ÉQUIPE 10), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Service d’Anatomopathologie [CHU Nantes], Immunobiology of Human αβ and γδ T Cells and Immunotherapeutic Applications (CRCINA-ÉQUIPE 1), Integrative Oncogenomics of Multiple Myeloma Pathogenesis and Progression (CRCINA-ÉQUIPE 11), Département de l'Information Médicale [CHU Nantes], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)
Subjects: Male, Oncology, Time Factors, Follicular lymphoma, Cohort Studies, 0302 clinical medicine, Recurrence, Risk Factors, Prednisone, Antineoplastic Combined Chemotherapy Protocols, Lymphoma, Follicular, Aged, 80 and over, Hematology, General Medicine, Middle Aged, Prognosis, 3. Good health, Treatment Outcome, Vincristine, 030220 oncology & carcinogenesis, Cohort, Disease Progression, Female, Rituximab, France, medicine.drug, Adult, medicine.medical_specialty, Cyclophosphamide, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Predictive Value of Tests, Internal medicine, Biomarkers, Tumor, medicine, Humans, Aged, Retrospective Studies, business.industry, medicine.disease, Survival Analysis, Lymphoma, Clinical trial, Doxorubicin, Neoplasm Grading, business, 030215 immunology
Abstract: International audience; Follicular lymphoma (FL) is an indolent non-Hodgkin's lymphoma with heterogeneous outcomes. Progression or relapse of FL within 2 years (so-called POD24) after diagnosis is associated with a poor outcome for patients treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, prednisone) in clinical trials. POD24 needs further validation before it can be used as a relevant endpoint to assess treatment efficacy. In the present retrospective monocentric study, we investigated the predictive value of POD24 in a cohort of grade 1, 2, or 3a FL patients treated in our institution (Nantes Medical University, France) and registered in our local database. We investigated the nature of treatment lines, patients' outcomes, and the prognostic value of POD24. Between 2007 and 2016, 317 patients were included. After first-line therapy, 60 patients relapsed within 2 years (POD24-pos cohort), and 254 patients did not relapse within 2 years (PO24-neg cohort). Thirty-three patients died, and 34 patients had an aggressive transformation. The median follow-up is 59.9 months (1.6-395.5). The median PFS is 59.9 months. Overall survival (OS) at 1 year, 3 years, and 5 years is 98.4% [97.0-99.8], 95.1% [92.6-97.6], and 92.5% [89.3-95.9], respectively. The 5-year OS was statistically lower for POD24-pos patients (82% [71.9-93.5]) than for POD24-neg patients (93.3% [88.98-97.8]) (p = 10-5). In multivariate analyses, transformation was predictive of OS, and PS (≥ 1) was predictive of POD24. POD24 is predictive of a worse OS and may be recommended as a relevant endpoint in clinical trials and in real life in particular for patients with advanced disease.
Published: 2020
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4. 2019 ARIA Care pathways for allergen immunotherapy

Author: Bousquet, J. and Pfaar, O. and Togias, A. and Schünemann, H.J. and Ansotegui, I. and Papadopoulos, N.G. and Tsiligianni, I. and Agache, I. and Anto, J.M. and Bachert, C. and Bedbrook, A. and Bergmann, K.-C. and Bosnic-Anticevich, S. and Bosse, I. and Brozek, J. and Calderon, M.A. and Canonica, G.W. and Caraballo, L. and Cardona, V. and Casale, T. and Cecchi, L. and Chu, D. and Costa, E. and Cruz, A.A. and Czarlewski, W. and Durham, S.R. and Du Toit, G. and Dykewicz, M. and Ebisawa, M. and Fauquert, J.L. and Fernandez-Rivas, M. and Fokkens, W.J. and Fonseca, J. and Fontaine, J.-F. and Gerth van Wijk, R. and Haahtela, T. and Halken, S. and Hellings, P.W. and Ierodiakonou, D. and Iinuma, T. and Ivancevich, J.C. and Jacobsen, L. and Jutel, M. and Kaidashev, I. and Khaitov, M. and Kalayci, O. and Kleine Tebbe, J. and Klimek, L. and Kowalski, M.L. and Kuna, P. and Kvedariene, V. and La Grutta, S. and Larenas-Linemann, D. and Lau, S. and Laune, D. and Le, L. and Lodrup Carlsen, K. and Lourenço, O. and Malling, H.-J. and Marien, G. and Menditto, E. and Mercier, G. and Mullol, J. and Muraro, A. and O’Hehir, R. and Okamoto, Y. and Pajno, G.B. and Park, H.-S. and Panzner, P. and Passalacqua, G. and Pham-Thi, N. and Roberts, G. and Pawankar, R. and Rolland, C. and Rosario, N. and Ryan, D. and Samolinski, B. and Sanchez-Borges, M. and Scadding, G. and Shamji, M.H. and Sheikh, A. and Sturm, G.J. and Todo Bom, A. and Toppila-Salmi, S. and Valentin-Rostan, M. and Valiulis, A. and Valovirta, E. and Ventura, M.-T. and Wahn, U. and Walker, S. and Wallace, D. and Waserman, S. and Yorgancioglu, A. and Zuberbier, T. and the ARIA Working Group, MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France, INSERM U 1168, VIMA : Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France, Euforea, Brussels, Belgium, Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany, Department of Dermatology and Allergy, Berlin Institute of Health, Comprehensive Allergy Center, Berlin, Germany, Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany, Division of Allergy, Immunology, and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, United States, Department of Health Research Methods, Evidence and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, ON, Canada, Hospital Quirónsalud Bizkaia, Bilbao, Spain, Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, United Kingdom, Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital 'P&A Kyriakou', University of Athens, Athens, Greece, Department of Social Medicine, Faculty of Medicine, University of Crete and International Primary Care Respiratory Group, Crete, Greece, Faculty of Medicine, Transylvania University, Brasov, Romania, Centre for Research in Environmental Epidemiology (CREAL), ISGlobAL, Barcelona, Spain, IMIM (Hospital del Mar Research Institute), Barcelona, Spain, Universitat Pompeu Fabra (UPF), Barcelona, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain, ENT Department, Upper Airways Research Laboratory, Ghent University Hospital, Ghent, Belgium, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Comprehensive Allergy Centre, Member of GA2LEN, Humboldt-Uniersität zu Berlin, Berlin, Germany, Woolcock Institute of Medical Research, Woolcock Emphysema Centre and Local Health District, University of Sydney, Glebe, NSW, Australia, Allergist, La Rochelle, France, Imperial College London - National Heart and Lung Institute, Royal Brompton Hospital NHS, London, United Kingdom, Personalized Medicine Clinic Asthma & Allergy, Humanitas Research Hospital, Humanitas University, Milan, Italy, Institute for Immunological Research, University of Cartagena, Campus de Zaragocilla, Cartagena, Colombia, Foundation for the Development of Medical and Biological Sciences (Fundemeb), Cartagena, Colombia, Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL Research Network, Barcelona, Spain, Division of Allergy/Immunology, University of South Florida, Tampa, FL, United States, SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy, UCIBIO, REQUIMTE, Faculty of Pharmacy, and Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), University of Porto, Porto, Portugal, ProAR – Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil, WHO GARD Planning Group, Salvador, Brazil, Medical Consulting Czarlewski, Levallois, France, Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom, Guy's and st Thomas' NHS Trust, Kings College London, London, United Kingdom, Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, United States, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan, Unité de pneumo-allergologie de l'enfant, pôle pédiatrique, CHU de Clermont-Ferrand-Estaing, Clermont-Ferrand, France, Allergy Department, IdISSC, Hospital Clinico San Carlos, Madrid, Spain, Department of Otorhinolaryngology, Academic Medical Centres, Amsterdam, Netherlands, CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto, Porto, Portugal, Medida, Lda, Porto, Portugal, Allergist, Reims, France, Department of Internal Medicine, Section of Allergology, Erasmus MC, Rotterdam, Netherlands, Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland, Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark, Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands, Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan, Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina, Allergy Learning and Consulting, Copenhagen, Denmark, Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland, Ukrainian Medical Stomatological Academy, Poltava, Ukraine, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular immunology, National Research Center, Moscow, Russian Federation, Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey, Allergy & Asthma Center Westend, Berlin, Germany, Center for Rhinology and Allergology, Wiesbaden, Germany, Department of Immunology and Allergy, Healthy Ageing Research Center, Medical University of Lodz, Lodz, Poland, Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden, Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland, Department of Pathology, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania, Faculty of Medicine, Institute of Clinical medicine, Clinic of Chest diseases and Allergology, Vilnius University, Vilnius, Lithuania, Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council (CNR), Palermo, Italy, Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico, Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin, Berlin, Germany, KYomed INNOV, Montpellier, France, University of Medicine and Pharmacy, Hochiminh City, Viet Nam, Department of Paediatrics, Oslo University Hospital, Oslo, Norway, Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway, Faculty of Health Sciences and CICS – UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal, Danish Allergy Centre, University of Copenhagen, Copenhagen, Denmark, CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy, Département de l’Information Médicale, Unité Médico-Economie, University Hospital, Montpellier, France, Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain, Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia, Department of Pediatrics, Allergy Unit, University of Messina, Messina, Italy, Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea, Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic, Allergy and Respiratory Diseases, Ospedale Policlino San Martino -University of Genoa, Genoa, Italy, Allergy Department, Pasteur Institute, Paris, France, David Hide Centre, St Mary's Hospital, Isle of Wight and University of Southampton, Southampton, United Kingdom, Department of Pediatrics, Nippon Medical School, Tokyo, Japan, Association Asthme et Allergie, Paris, France, Hospital de Clinicas, University of Parana, Parana, Brazil, Allergy and Respiratory Research Group, Medical School, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland, Allergy and Clinical Immunology Department, Centro Medico-Docente La Trinidad, Caracas, Venezuela, The Royal National TNE Hospital, University College London, London, United Kingdom, Immunomodulation and Tolerance Group, Imperial College London, London, United Kingdom, Allergy and Clinical Immunology, Imperial College London, London, United Kingdom, The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom, Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria, Outpatient Allergy Clinic Reumannplatz, Vienna, Austria, Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal, Allergist, Montevideo, Uruguay, Clinic of Children's Diseases, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania, Department of Public Health, Institute of Health Sciences, Vilnius, Lithuania, European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium, Department of Lung Diseases and Clinical Immunology, Terveystalo Allergy Clinic, University of Turku, Turku, Finland, Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy, Pediatric Department, Charité, Berlin, Germany, Asthma UK, London, United Kingdom, Nova Southeastern University, Fort Lauderdale, FL, United States, Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada, and Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
Abstract: Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including healthcare professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow-up of patients. © 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
Published: 2019

5. Hospital production cost of transcranial direct current stimulation (tDCS) in the treatment of depression

Author: Solène Schirr-Bonnais, Nicolas Mauduit, Olivier Sellal, Cécile Dert, François Etcheverrigaray, Anne Pichot, Anne Sauvaget, Samuel Bulteau, Christophe Leux, Agathe Tostivint, Johann Clouet, Valéry-Pierre Riche, Clémence Cabelguen, Département d'addictologie et de psychiatrie de liaison [CHU de Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Motricité, interaction, performance EA 4334 (MIP), Le Mans Université (UM)-Université de Nantes - UFR des Sciences et Techniques des Activités Physiques et Sportives (UFR STAPS), Université de Nantes (UN)-Université de Nantes (UN), Pharmacie [CHD Vendée], Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon, Département Partenariat et Innovation [CHU Nantes] (Cellule d'innovation), Centre hospitalier universitaire de Nantes (CHU Nantes)-Direction des Affaires Médicales et de la Recherche [CHU Nantes] (DAMR), Regenerative Medicine and Skeleton research lab (RMeS), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), UFR d’Odontologie [CHU Hôtel Dieu, Nantes], Université de Nantes (UN), Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, PHU 11 Pharmacie [CHU Nantes] (Pharmacie Centrale), Département de l'Information Médicale [CHU Nantes], MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, This work has been supported by a grant from the FrenchHealth Ministry for the DISCO study PRME-2017-0097., Motricité, interactions, performance EA 4334 / Movement - Interactions - Performance (MIP), Université de Nantes - UFR des Sciences et Techniques des Activités Physiques et Sportives (UFR STAPS), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Le Mans Université (UM), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes - UFR Odontologie, Jehan, Frederic, Le Mans Université (UM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR des Sciences et Techniques des Activités Physiques et Sportives (UFR STAPS), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Regenerative Medicine and Skeleton (RMeS), École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques
Subjects: Cost, medicine.medical_treatment, Cost accounting, Transcranial Direct Current Stimulation, 050105 experimental psychology, TDCS, 03 medical and health sciences, 0302 clinical medicine, Health Economics, Multidisciplinary approach, Physiology (medical), Medicine, Humans, 0501 psychology and cognitive sciences, Operations management, Economics, Hospital, Neurostimulation, Health policy, Depression (differential diagnoses), health care economics and organizations, Psychiatry, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Health economics, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Transcranial direct-current stimulation, business.industry, Depression, Health Policy, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, 05 social sciences, Usability, General Medicine, Hospitals, 3. Good health, Treatment Outcome, Neurology, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Neurology (clinical), France, business, 030217 neurology & neurosurgery
Abstract: Summary Objectives Due to its ease of use, tolerance, and cost of acquisition, transcranial direct current stimulation (tDCS) could constitute a credible therapeutic option for non-resistant depression in primary care, when combined with drug management. This indication has yet to receive official recognition in France. The objective of this study is to evaluate the production cost of tDCS for the treatment of depression in hospitals, under realistic conditions. Methods The methodology adopted is based on cost accounting and was validated by a multidisciplinary working group. It includes equipment, staff, and structural costs to obtain the most realistic estimate possible. We first estimated the cost of producing a tDCS session, based on our annual activity objective, and then estimated the cost of a 15-session treatment program. This was followed up with a sensitivity analysis applying appropriate parameters. Results The hospital production cost of a tDCS depression treatment program for a single patient was estimated at €1555.60 euros: €99 in equipment costs, €1076.95 in staff costs, and €379.65 in structural costs. Conclusion This cost analysis should make it possible to draw up pricing proposals in compliance with regulations and health policy choices and to develop health-economic studies. This would ultimately lead to official recognition of tDCS treatment for depression in France and pave the way for studying various scenarios of coverage by the French national health insurance system.
Published: 2018
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6. Dyspnea in patients receiving noninvasive ventilation for acute respiratory failure: prevalence, risk factors and prognostic impact – a prospective observational study

Author: Matthieu Resche-Rigon, Laurence Dangers, Alexandre Demoule, Ferhat Meziani, Thomas Similowski, Sébastien Perbet, Achille Kouatchet, Elie Azoulay, Claire Montlahuc, Samir Jaber, Neurophysiologie Respiratoire Expérimentale et Clinique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Pitié-Salpêtrière [APHP], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Urgences médicales, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), PRES Université Nantes Angers Le Mans (UNAM), Service d'anesthésie et de réanimation B, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Mitochondries, stress oxydant et protection musculaire (Strasbourg), Mitochondrie, stress oxydant et protection musculaire (MSP), Université de Strasbourg (UNISTRA)-Université de Strasbourg (UNISTRA), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), CHU Clermont-Ferrand, Département de l'information médicale et de la biostatistique [AP-HP Hôpital Saint-Louis], AP-HP Hôpital Saint-Louis, Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7), Equipe 2 : ECSTRA - Epidémiologie Clinique, STatistique, pour la Recherche en Santé (CRESS - U1153), Université Paris Diderot - Paris 7 (UPD7)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Université Paris-Sorbonne (UP4), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), and Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)
Subjects: Pulmonary and Respiratory Medicine, Mechanical ventilation, medicine.medical_specialty, Respiratory rate, business.industry, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Odds ratio, Intensive care unit, 3. Good health, law.invention, respiratory tract diseases, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Interquartile range, law, Emergency medicine, Severity of illness, medicine, 030212 general & internal medicine, Prospective cohort study, business, ComputingMilieux_MISCELLANEOUS, Cohort study
Abstract: Dyspnoea is a frequent and intense symptom in intubated patients, but little attention has been paid to dyspnoea during noninvasive mechanical ventilation in the intensive care unit (ICU).The objectives of this study were to quantify the prevalence, intensity and prognostic impact of dyspnoea in patients receiving noninvasive ventilation (NIV) for acute respiratory failure (ARF) based on secondary analysis of a prospective observational cohort study in patients who received ventilatory support for ARF in 54 ICUs in France and Belgium. Dyspnoea was measured by a modified Borg scale.Among the 426 patients included, the median (interquartile range) dyspnoea score was 4 (3-5) on admission and 3 (2-4) after the first NIV session (p=0.001). Dyspnoea intensity ≥4 after the first NIV session was associated with the Sequential Organ Failure Assessment Score (odds ratio (OR) 1.12, p=0.001), respiratory rate (OR 1.03, p=0.032), anxiety (OR 1.92, p=0.006), leaks (OR 2.5, p=0.002) and arterial carbon dioxide tension (OR 0.98, p=0.025). Dyspnoea intensity ≥4 was independently associated with NIV failure (OR 2.41, p=0.001) and mortality (OR 2.11, p=0.009), but not with higher post-ICU burden and altered quality of life.Dyspnoea is frequent and intense in patients receiving NIV for ARF and is associated with a higher risk of NIV failure and poorer outcome.
Published: 2018
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7. Apports de l’analyse contextuelle des données non structurées des dossiers médicaux dans une étude rétrospective de parcours de soins en hémato-oncologie à Montpellier, France

Author: C. Duflos, G. Mercier, G. Cartron, T. Kanouni, Département de l'Information Médicale, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital La Colombière, Département Hématologie biologique [CHRU Montpellier], Pôle Biologie-Pathologie [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and Unité de recherche médico-économique - CHU Montpellier
Subjects: 03 medical and health sciences, 030505 public health, 0302 clinical medicine, Coordination hémato-oncologie, Epidemiology, Public Health, Environmental and Occupational Health, Parcours de soins, [SDV.CAN]Life Sciences [q-bio]/Cancer, 030212 general & internal medicine, 0305 other medical science, Analyse contextuelle, Données non structurées, [SHS]Humanities and Social Sciences
Abstract: International audience; L’accompagnement des parcours de soins des patients d’hématolo-oncologie, au CHU de Montpellier, est réalisé par des infirmières de coordination. Une étude en cours vise à évaluer la charge de coordination en fonction du traitement et des caractéristiques cliniques et sociales du patient. Deux informations majeures sont présentes dans les transmissions des infirmières : l’isolement social et la survenue de prise d’antibiotiques en intercure. Ces transmissions ne sont pas structurées. Nous rapportons notre utilisation d’un logiciel permettant l’analyse contextuelle des transmissions, et la génération automatique de variables binaires à partir de ces transmissions non structurées.Méthodes : tous les patients d’hématologie ayant un dossier de coordination ont été inclus. L’analyse contextuelle et la génération de deux variables binaires a été réalisé au moyen de SAS Contextual Analysis® : « isolement », « antibiotique ». Un échantillon des dossiers a ensuite été relu par les auteurs, pour évaluer la validité de la variable « isolement ».Résultats : au total, 476 dossiers de patients, contenant 34 788 transmissions d’intercure, ont été analysés. La variable « antibiotique » a été construite en utilisant la classification ATC et la procédure de repérage des fautes de frappe du logiciel ; 672 prises d’antibiotiques ont été retrouvées. La variable « isolement » a été construite en définissant les concepts de famille proche et de vie en couple. Parmi les 476 patients, 250 avaient une information sur l’isolement, dont 37 patients identifiés comme isolés (test positif). La relecture de ces dossiers confirmait l’isolement chez 28 patients (76 %). Parmi les dossiers identifiés comme non isolés, l’absence d’isolement a été confirmée dans 98 des 100 dossiers tirés au sort.Discussion/conclusion : l'analyse contextuelle permet une analyse rapide et détaillée des données non structurées des transmissions infirmières. Le logiciel utilisé nécessite un apprentissage dont le premier plateau est rapidement atteint. Ce logiciel pourrait donc permettre de faciliter le travail des chercheurs. Cependant, l’extrapolabilité des règles de génération automatique de variables n’a pas été évaluée.
Published: 2018
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8. Determinants of long-term outcome in ICU survivors: results from the FROG-ICU study

Author: Morgane Michel, Jean-Marie Launay, Jacques Duranteau, Marc Leone, Alexandre Mebazaa, Bernard Cholley, Philippe Montravers, Jean-Yves Lefrant, Qin Lu, Matthieu Legrand, Charles Damoisel, Xavier Monnet, Matthieu Resche-Rigon, Bertrand Guidet, Karine Chevreul, Elie Azoulay, Isabelle Rennuit, Mervyn Singer, Nicolas Bréchot, Heikel Oueslati, Samir Jaber, Pierre-François Laterre, Diane Friedman, Romain Sonneville, Sebastien Pili-Floury, Nicolas Deye, Eric Vicaut, Etienne Gayat, Antoine Vieillard-Baron, Alain Cariou, Antoine Tesniere, Département d'Anesthésie Réanimation SMUR [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Espaces, Nature et Culture (ENeC), Université Paris-Sorbonne (UP4)-Centre National de la Recherche Scientifique (CNRS), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service de réanimation medico-chirurgicale [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC), Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Unité de Soins Intensifs [Saint-Louis], Hôpital Raymond Poincaré [AP-HP], Service d'Anesthésie Réanimation, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Bichat - Claude Bernard, Département d'Anesthésie Réanimation [CHU Bichat-Claude-Bernard], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Service d'anesthésie et soins intensifs [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service d'anesthésie et réanimation, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Université Catholique de Louvain = Catholic University of Louvain (UCL), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Département de la Recherche Clinique et du Développement [AP-HP Hôtel Dieu] (DRCD-URC Eco), Unité de Recherche Clinique en Economie de la Santé d'Ile-de-France, Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Hôtel-Dieu [Paris], Psychiatrie et Neurologie personnalisées [AP-HP Hôpital Henri-Mondor] (DHU PePsy), Hôpital Henri Mondor, Service de RadioBiologie et d'Epidémiologie (IRSN/DRPH/SRBE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Service d'Anesthésie-Réanimation [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service d'Anesthésie et Soins Intensifs, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Université Paris Diderot - Paris 7 (UPD7), Unité de Recherche Clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Fernand-Widal, Département de l'information médicale et de la biostatistique [AP-HP Hôpital Saint-Louis], Hopital Saint-Louis [AP-HP] (AP-HP), Hôpital Ambroise Paré [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Neurologie [CHU Pitié-Salpêtrière], IFR70-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Radiobiologie et épidémiologie (DRPH/SRBE), UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), COMBE, Isabelle, and Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris]
Subjects: Male, Time Factors, Outcome Assessment, health care facilities, manpower, and services, 030204 cardiovascular system & hematology, Cardiovascular, Critical Care and Intensive Care Medicine, Medical and Health Sciences, law.invention, Cohort Studies, 0302 clinical medicine, Belgium, law, Outcome Assessment, Health Care, Odds Ratio, Medicine, Vasoconstrictor Agents, Hospital Mortality, Prospective Studies, Survivors, Prospective cohort study, education.field_of_study, Respiration, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Score, Middle Aged, Intensive care unit, 3. Good health, Hospitalization, Intensive Care Units, Heart Disease, Artificial, Female, Patient Safety, France, Cohort study, medicine.medical_specialty, Critical Illness, Population, Post-intensive care syndrome, 03 medical and health sciences, Long-term survival, Clinical Research, Intensive care, Humans, education, Aged, business.industry, Research, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Odds ratio, Length of Stay, medicine.disease, Comorbidity, Emergency & Critical Care Medicine, Respiration, Artificial, Health Care, Good Health and Well Being, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Emergency medicine, Discharge, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Biomarkers
Abstract: Background Intensive care unit (ICU) survivors have reduced long-term survival compared to the general population. Identifying parameters at ICU discharge that are associated with poor long-term outcomes may prove useful in targeting an at-risk population. The main objective of the study was to identify clinical and biological determinants of death in the year following ICU discharge. Methods FROG-ICU was a prospective, observational, multicenter cohort study of ICU survivors followed 1 year after discharge, including 21 medical, surgical or mixed ICUs in France and Belgium. All consecutive patients admitted to intensive care with a requirement for invasive mechanical ventilation and/or vasoactive drug support for more than 24 h following ICU admission and discharged from ICU were included. The main outcome measure was all-cause mortality at 1 year after ICU discharge. Clinical and biological parameters on ICU discharge were measured, including the circulating cardiovascular biomarkers N-terminal pro-B type natriuretic peptide, high-sensitive troponin I, bioactive-adrenomedullin and soluble-ST2. Socioeconomic status was assessed using a validated deprivation index (FDep). Results Of 1570 patients discharged alive from the ICU, 333 (21%) died over the following year. Multivariable analysis identified age, comorbidity, red blood cell transfusion, ICU length of stay and abnormalities in common clinical factors at the time of ICU discharge (low systolic blood pressure, temperature, total protein, platelet and white cell count) as independent factors associated with 1-year mortality. Elevated biomarkers of cardiac and vascular failure independently associated with 1-year death when they are added to multivariable model, with an almost 3-fold increase in the risk of death when combined (adjusted odds ratio 2.84 (95% confidence interval 1.73–4.65), p
Published: 2018
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9. Clinical features and prognosis of paraquat poisoning in French Guiana

Author: Elenga, Narcisse, Merlin, Caroline, Le Guern, Rémi, Kom-Tchameni, Rémi, Ducrot, Yves-Marie, Pradier, Maxime, Ntab, Balthazar, Dinh-Van, Kim-Anh, Sobesky, Milko, Mathieu, Daniel, Dueymes, Jean-Marc, Egmann, Gérald, Kallel, Hathem, Mathieu-Nolf, Monique, Service de Pédiatrie [Cayenne, Guyanne Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut de Microbiologie [CHRU Lille], Pôle de Biologie Pathologie Génétique [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Département des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de Tourcoing, Centre Hospitalier de l'Ouest Guyanais (CHOG), CHOG-Centre Hospitalier de l'Ouest Guyanais, Centre médico-chirurgical de Kourou [Guyane française], Département de l'information médicale, Centre Hospitalier de Cayenne, Intensive Care Unit and Hyperbaric Center, Lille University Hospital, F-59037, Lille, CH Cayenne, and Centres antipoison et de toxicovigilance (CAPTV Lille)
Subjects: [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2018
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10. Neurodevelopmental outcome at 2 years for preterm children born at 22 to 34 weeks’ gestation in France in 2011: EPIPAGE-2 cohort study

Author: Pierrat, Véronique, Marchand-Martin, Laetitia, Arnaud, Catherine, Kaminski, Monique, Resche-Rigon, Matthieu, Lebeaux, Cécile, Bodeau-Livinec, Florence, Morgan, Andrei S., Goffinet, François, Marret, Stéphane, Ancel, Pierre-Yves, Rozé, Jean-Christophe, Flamant, Cyril, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Centre Hospitalier Universitaire de Lille (CHU de Lille), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de l'information médicale et de la biostatistique [AP-HP Hôpital Saint-Louis], AP-HP Hôpital Saint-Louis, Département Méthodes quantitatives en santé publique (METIS), École des Hautes Études en Santé Publique [EHESP] (EHESP), DHU Risques Et Grossesse, Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Service de pédiatrie néonatale et réanimation - neuropédiatrie [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), CIC - Mère Enfant Necker Cochin Paris Centre (CIC 1419), CHU Cochin [AP-HP]-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), This project has been funded with support from the following organisations: The French Institute of Public Health Research/Institute of Public Health and its partners: the French Health Ministry, the National Institute of Health and Medical Research (INSERM), the National Institute of Cancer, and the National Solidarity Fund for Autonomy (CNSA), The National Research Agency through the French EQUIPEX program of investments in the future (reference ANR-11-EQPX-0038), the PREMUP Foundation, Fondation de France (reference 00050329), and Fondation pour la Recherche Médicale (reference SPF20160936356)., ANR-11-EQPX-0038/11-EQPX-0038,RE-CO-NAI,Plateforme de REcherche sur les COhortes d'enfants suivis depuis la NAIssance(2011), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de pédiatrie néonatale et réanimation - neuropédiatrie [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), ANR-11-EQPX-0038,RE-CO-NAI,Plateforme de REcherche sur les COhortes d'enfants suivis depuis la NAIssance(2011), pierrat, veronique, Equipements d'excellence - Plateforme de REcherche sur les COhortes d'enfants suivis depuis la NAIssance - - RE-CO-NAI2011 - ANR-11-EQPX-0038 - EQPX - VALID, Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique ( CRESS - U1153 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Lille ( CHU de Lille ), Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Département Méthodes quantitatives en santé publique ( METIS ), École des Hautes Études en Santé Publique [EHESP] ( EHESP ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Assistance publique - Hôpitaux de Paris (AP-HP), CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Hôpital Charles Nicolle [Rouen], Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques ( GPMCND ), Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institute for Research and Innovation in Biomedicine ( IRIB ), CIC - Mère Enfant Necker Cochin Paris Centre ( CIC 1419 ), CHU Cochin [AP-HP]-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), ANR-11-EQPX-0038/11-EQPX-0038,RE-CO-NAI,Plateforme de REcherche sur les COhortes d'enfants suivis depuis la NAIssance ( 2011 ), CHU Lille, Université de Lille, Hôpital Jeanne de Flandre [Lille], Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité [CRESS (U1153 / UMR_A_1125 / UMR_S_1153)], Université Toulouse III - Paul Sabatier [UT3], and Hôpital Saint-Louis
Subjects: Male, Pediatrics, Developmental Disabilities, [ SDV.MHEP.PED ] Life Sciences [q-bio]/Human health and pathology/Pediatrics, Infant, Premature, Diseases, Blindness, Population based cohort, Corrected Age, 0302 clinical medicine, 030202 anesthesiology, Outcome Assessment, Health Care, MESH: Blindness/epidemiology, Blindness/etiology, Cerebral Palsy/epidemiology, Cerebral Palsy/etiology, Child, Preschool, Developmental Disabilities/epidemiology, Developmental Disabilities/etiology, Female, Follow-Up Studies, France/epidemiology, Gestational Age, Hearing Loss/epidemiology, Hearing Loss/etiology, Humans, Infant, Extremely Premature, Infant, Premature, Diseases/epidemiology, Infant, Premature, Diseases/mortality, Infant, Premature, Diseases/physiopathology, Outcome Assessment (Health Care), Prospective Studies, Survivors, 030212 general & internal medicine, Prospective cohort study, education.field_of_study, 030219 obstetrics & reproductive medicine, Gestational age, Gross Motor Function Classification System, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, 3. Good health, Gestation, France, Cohort study, medicine.medical_specialty, Pédiatrie, Population, Cerebral palsy, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, 030225 pediatrics, medicine, education, Hearing Loss, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, business.industry, Cerebral Palsy, Research, medicine.disease, Confidence interval, MESH : Blindness/epidemiology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; Objectives To describe neurodevelopmental outcomes at 2 years corrected age for children born alive at 22-26, 27-31, and 32-34 weeks' gestation in 2011, and to evaluate changes since 1997.Design Population based cohort studies, EPIPAGE and EPIPAGE-2.Setting France.Participants 5567 neonates born alive in 2011 at 22-34 completed weeks' gestation, with 4199 survivors at 2 years corrected age included in follow-up. Comparison of outcomes reported for 3334 (1997) and 2418 (2011) neonates born alive in the nine regions participating in both studies.Main outcome measures Survival; cerebral palsy (2000 European consensus definition); scores below threshold on the neurodevelopmental Ages and Stages Questionnaire (ASQ; at least one of five domains below threshold) if completed between 22 and 26 months corrected age, in children without cerebral palsy, blindness, or deafness; and survival without severe or moderate neuromotor or sensory disabilities (cerebral palsy with Gross Motor Function Classification System levels 2-5, unilateral or bilateral blindness or deafness). Results are given as percentage of outcome measures with 95% confidence intervals.Results Among 5170 liveborn neonates with parental consent, survival at 2 years corrected age was 51.7% (95% confidence interval 48.6% to 54.7%) at 22-26 weeks' gestation, 93.1% (92.1% to 94.0%) at 27-31 weeks' gestation, and 98.6% (97.8% to 99.2%) at 32-34 weeks' gestation. Only one infant born at 22-23 weeks survived. Data on cerebral palsy were available for 3599 infants (81.0% of the eligible population). The overall rate of cerebral palsy at 24-26, 27-31, and 32-34 weeks' gestation was 6.9% (4.7% to 9.6%), 4.3% (3.5% to 5.2%), and 1.0% (0.5% to 1.9%), respectively. Responses to the ASQ were analysed for 2506 children (56.4% of the eligible population). The proportion of children with an ASQ result below threshold at 24-26, 27-31, and 32-34 weeks' gestation were 50.2% (44.5% to 55.8%), 40.7% (38.3% to 43.2%), and 36.2% (32.4% to 40.1%), respectively. Survival without severe or moderate neuromotor or sensory disabilities among live births increased between 1997 and 2011, from 45.5% (39.2% to 51.8%) to 62.3% (57.1% to 67.5%) at 25-26 weeks' gestation, but no change was observed at 22-24 weeks' gestation. At 32-34 weeks' gestation, there was a non-statistically significant increase in survival without severe or moderate neuromotor or sensory disabilities (P=0.61), but the proportion of survivors with cerebral palsy declined (P=0.01).Conclusions In this large cohort of preterm infants, rates of survival and survival without severe or moderate neuromotor or sensory disabilities have increased during the past two decades, but these children remain at high risk of developmental delay.
Published: 2017
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11. Effects of a short-term Interval Aerobic Training Programme with active Recovery bouts (IATP-R) on cognitive and mental health, functional performance and quality of life: A randomised controlled trial in sedentary seniors

Author: Georges Kaltenbach, François Lefebvre, Pierre Olivier Lang, Walid Bouaziz, Pierre-Marie Leprêtre, Bernard Geny, Thomas Vogel, Elise Schmitt, Mitochondrie, stress oxydant et protection musculaire (MSP), Université de Strasbourg (UNISTRA), Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Pôle de Gériatrie [CHU Strasbourg], CHU Strasbourg, Département de l'Information Médicale [CHU Strasbourg], Centre Hospitalier Universitaire de Strasbourg (CHU de Strasbourg ), Adaptations Physiologiques à l'Exercice et Réadaptation à l'effort - UR UPJV 3300 (APERE), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Unité de Réadaptation Cardiovasculaire [CH Corbie], Centre Hospitalier de Corbie (CH Corbie), Centre Mémoire Ressources et Recherche [Strasbourg] (CMRR Strasbourg), Département des Explorations Fonctionnelles [CHU Strasbourg], Health and Wellbeing Academy [Cambridge, UK], Anglia Ruskin University (ARU), Geriatric and Rehabilitation Geriatric Division [CHU Lausanne] (UNIV Lausanne), Lausanne University Hospital [Switzerland]-Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), This study was supported by the Department of Clinical Research and Innovation of the University Hospitals of Strasbourg (France)., Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV)-Lausanne University Hospital, Dupuis, Christine, and CHU Amiens-Picardie-Université de Picardie Jules Verne (UPJV)
Subjects: Male, medicine.medical_specialty, Time Factors, Paced Auditory Serial Addition Test, Health Status, Trail Making Test, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, Cognition, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Randomized controlled trial, Quality of life, law, Humans, Medicine, Aerobic exercise, Prospective Studies, 030212 general & internal medicine, Aged, Sedentary lifestyle, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, medicine.diagnostic_test, business.industry, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, General Medicine, Physical Functional Performance, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Mental Health, Quality of Life, Physical therapy, Anxiety, Female, Sedentary Behavior, medicine.symptom, business, Ventilatory threshold, human activities, Physical Conditioning, Human
Abstract: BACKGROUND: Interval aerobic training programme with active recovery bouts (IATP-R) has shown to improve tolerance to IATP among seniors. However, data concerning its benefits for seniors' health are still limited. PURPOSE: The purpose of this study was to examine the effects of IATP-R on seniors' health status. METHODS: Sedentary volunteers (n = 60, aged ≥70 years) were randomly assigned to either IATP-R or maintained sedentary lifestyle for 9.5 weeks. IATP-R consisted of 30-minute cycling (6 × 4 minutes at first ventilatory threshold (VT1 ) intensity + 1 minute at 40% of VT1 ) twice a week. Cognitive and functional performances were assessed with the Trail Making Test (TMT-A; TMT-B); Paced Auditory Serial Addition Test (PASAT); Timed Up and Go (TUG) test; 6-Minute Walk Test (6-MWT); one-leg balance test; and the Short Physical Performance Battery (SPPB) tests, respectively. QoL and anxiety/depression status were measured by the Short Form-12 and the Goldberg's Scale, respectively. All participants were assessed at baseline and 9.5 weeks later. RESULTS: Compared to controls, IATP-R improved cognitive functions (TMT-A: +1.5% vs -21.5%; TMT-B: +0.9% vs -13.3%; PASAT: +1.4% vs -14.6%; semantic fluency: -1.1% vs +11.7%), functional performance (TUG: +5.4% vs -16.5%; 6-MWT: -3.2% vs +11.5%; SPPB: -3.2% vs +14.6%; One-leg balance: -16.3% vs +25.0%); QoL (physical health: -13.3% vs +23.1%; mental health: -7.1% vs +8.2%); and depressive symptoms (+26.3% vs -42.8%). Significant impacts were measured neither on letter modality of fluency tasks nor on anxiety score. CONCLUSION: These data showed that IATP-R is an effective training programme to improve functional and cognitive performances, mental health and well-being in sedentary seniors. Trial registration ClinicalTrials.gov NCT02263573. Registered October 1, 2014.
Published: 2018
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12. Hospitalisation pour insuffisance cardiaque aiguë : le parcours intra-hospitalier prédit le risque de réhospitalisation pour insuffisance cardiaque aiguë à un an

Author: D. Logeart, C. Ségouin, Claire Duflos, Gregoire Mercier, P. Troude, Département de l'Information Médicale, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Unité de recherche médico-économique - CHU Montpellier
Subjects: Insuffisance cardiaque, 03 medical and health sciences, [SHS.STAT]Humanities and Social Sciences/Methods and statistics, 030505 public health, 0302 clinical medicine, Organisation, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Epidemiology, Réhospitalisation, Public Health, Environmental and Occupational Health, Parcours hôpital, 030212 general & internal medicine, 0305 other medical science
Abstract: International audience; Chez les patients avec insuffisance cardiaque aiguë (ICA), les facteurs pronostiques de mortalité bien connus sont cliniques. La Haute Autorité de santé (HAS) met aussi l’accent sur les facteurs organisationnels modifiables, qui pourraient être d’autres facteurs pronostiques. Notre objectif est d’évaluer le lien entre les facteurs organisationnels lors d’une hospitalisation pour ICA et le risque de réhospitalisation.Méthodes : cette étude rétrospective sur dossiers et sur PMSI a inclus les patients âgés de plus de 65 ans, hospitalisés pour ICA à Lariboisière en 2013. Les variables de parcours étaient : unités fréquentées, durée de séjour, modes d’entrée et de sortie, réalisation de procédures diagnostiques, traitement de sortie. Des groupes homogènes de parcours ont été construits, et le lien avec le taux de réhospitalisations à un mois et à un an, pour ICA ou toutes causes, a été modélisé par un modèle binomial négatif avec offset, incluant le groupe et les variables cliniques classiques (ACFA, BPCO, diabète, HTA, insuffisance rénale, présentation clinique de l’ICA, sexe, tabac, FEVG, âge).Résultats : le parcours a pu être analysé chez 207 patients, parmi les 223 initialement inclus. Cinq groupes ont été retrouvés : trois groupes classiques des filières USIC, cardiologie, et médecine/gériatrie, un groupe avec un parcours dit chaotique, et un groupe de patients décédés. Le groupe est prédictif du nombre de réhospitalisations pour ICA à un an (p = 0,0015) : le groupe chaotique augmente le risque (p = 0,0054), le groupe cardiologie a une tendance à la réduction du risque (p = 0,0675). Le groupe n’est pas associé aux autres critères de jugement.Discussion/conclusion : le parcours intrahospitalier est lié au risque de réhospitalisation, indépendamment des variables cliniques. Ce résultat devrait être confirmé, puis suivi d’une recherche des mécanismes en cause dans la génération de ces parcours chaotiques et de leurs conséquences.
Published: 2018
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13. Serum procalcitonin and C-reactive protein concentrations to distinguish mildly infected from non-infected diabetic foot ulcers: a pilot study

Author: Pierre Corbeau, Jean-Philippe Lavigne, Nathalie Jourdan, Christophe Combescure, M. Rodier, A. Jeandrot, Albert Sotto, J.-L. Richard, S. Finge, Laboratoire de bactériologie, virologie et parasitologie, Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service des maladies de la nutrition et de diabétologie, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Département de l'information médicale, Service des maladies métaboliques et endocriniennes, Service d'immunologie, Systèmes de sécrétion de type IV et virulence bactérienne, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Lavigne, Jean-Philippe
Subjects: medicine.medical_specialty, Pathology, biology, business.industry, Endocrinology, Diabetes and Metabolism, C-reactive protein, Virulence, medicine.disease, Gastroenterology, Diabetic foot, Article, digestive system diseases, Procalcitonin, Diabetic foot ulcer, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Predictive value of tests, Internal medicine, Diabetes mellitus, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal Medicine, Normal flora, medicine, biology.protein, business
Abstract: International audience; AIMS/HYPOTHESIS: Infection of diabetic foot ulcers is common; at early stages it is difficult to differentiate between non-infected ulcers (or those colonised with normal flora) and ulcers infected with virulent bacteria that lead to deterioration. This pilot study aimed to assess the diagnostic accuracy of inflammatory markers as an aid to making this distinction. METHODS: We included 93 diabetic patients who had an episode of foot ulcer and had not received antibiotics during the 6 months preceding the study. Ulcers were classified as infected or uninfected, according to the Infectious Diseases Society of America-International Working Group on the Diabetic Foot classification. Diabetic patients without ulcers (n = 102) served as controls. C-reactive protein (CRP), orosomucoid, haptoglobin and procalcitonin were measured together with white blood cell and neutrophil counts. The diagnostic performance of each marker, in combination (using logistic regression) or alone, was assessed. RESULTS: As a single marker, CRP was the most informative for differentiating grade 1 from grade 2 ulcers (sensitivity 0.727, specificity 1.000, positive predictive value 1.000, negative predictive value 0.793) with an optimal cut-off value of 17 mg/l. In contrast, white blood cell and neutrophil counts were not predictive. The most relevant combination derived from the logistic regression was the association of CRP and procalcitonin (AUC 0.947), which resulted in a significantly more effective determination of ulcer grades, as shown by comparing receiver operating characteristic curves. CONCLUSIONS/INTERPRETATION: Measurement of only two inflammatory markers, CRP and procalcitonin, might be of value for distinguishing between infected and non-infected foot ulcers in subgroups of diabetic patients, to help ensure the appropriate allocation of antibiotic treatment. Nevertheless, external validation of the diagnostic value of procalcitonin and CRP in diabetic foot ulcers is needed before routine use can be recommended.
Published: 2007
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14. Diagnosing pelvic osteomyelitis beneath pressure ulcers in spinal cord injured patients: a prospective study

Author: A.-S. Brunel, B. Lamy, C. Cyteval, H. Perrochia, L. Téot, R. Masson, H. Bertet, A. Bourdon, D. Morquin, J. Reynes, V. Le Moing, Isabelle Alméras, Aurélie Du Thanh, Anthony Gélis, Claire Reynaud, Hélène Rouays, Chloé Trial, Sergio Fliueraru, Christian Herlin, Jean-Philippe Lavigne, Christophe Delfour, Marie-Pierre Baron, Pierre Viala, Thibaut Mura, Philippe Géraud, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hydrosciences Montpellier (HSM), Institut national des sciences de l'Univers (INSU - CNRS)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université de Montpellier (UM), Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Euromov (EuroMov), CHU Montpellier, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Département de l'Information Médicale, and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie
Subjects: 0301 basic medicine, Microbiology (medical), Adult, Male, medicine.medical_specialty, Histology, 030106 microbiology, Comorbidity, medicine.disease_cause, 030207 dermatology & venereal diseases, 03 medical and health sciences, pressure ulcers, 0302 clinical medicine, Anti-Infective Agents, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Risk Factors, Biopsy, medicine, Humans, Prospective Studies, Prospective cohort study, Pelvic Bones, Pelvis, Spinal Cord Injuries, Aged, Pressure Ulcer, biology, medicine.diagnostic_test, Streptococcus, business.industry, Osteomyelitis, microbiology, General Medicine, Middle Aged, biology.organism_classification, medicine.disease, Magnetic Resonance Imaging, Peptostreptococcus, 3. Good health, Surgery, medicine.anatomical_structure, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Staphylococcus aureus, Female, business, Biomarkers
Abstract: International audience; There is no consensus on a diagnostic strategy for osteomyelitis underlying pressure ulcers. We conducted a prospective study to assess the accuracy of multiple bone biopsies and imaging to diagnose pelvic osteomyelitis. Patients with clinically suspected osteomyelitis beneath pelvic pressure ulcers were enrolled. Bone magnetic resonance imaging (MRI) and surgical bone biopsies (three or more for microbiology and one for histology per ulcer) were performed. Bacterial osteomyelitis diagnosis relied upon the association of positive histology and microbiology (at least one positive culture for non-commensal microorganisms or three or more for commensal microorganisms of the skin). From 2011 to 2014, 34 patients with 44 pressure ulcers were included. Bacterial osteomyelitis was diagnosed for 28 (82.3%) patients and 35 (79.5%) ulcers according to the composite criterion. Discrepancy was observed between histology and microbiology for 5 (11.4%) ulcers. Most common isolates were Staphylococcus aureus (77.1%), Peptostreptococcus (48.6%) and Bacteroides (40%), cultured in three or more samples in 42.9% of ulcers for S. aureus and ≥20% for anaerobes. Only 2.8% of ulcers had three or more positive specimens with coagulase-negative staphylococci, group B Streptococcus, and nil with enterococci and Pseudomonas aeruginosa. Staphylococcus aureus, Proteus and group milleri Streptococcus were recovered from one sample in 22.8%, 11.4% and 11.4% of ulcers, respectively. Agreement was poor between biopsies and MRI (κ 0.2). Sensitivity of MRI was 94.3% and specificity was 22.2%. The diagnosis of pelvic osteomyelitis relies on multiple surgical bone biopsies with microbiological and histological analyses. At least three bone samples allows the detection of pathogens and exclusion of contaminants. MRI is not routinely useful for diagnosis.
Published: 2015
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15. Effects of vitamin C, vitamin E, zinc gluconate, and selenomethionine supplementation on muscle function and oxidative stress biomarkers in patients with facioscapulohumeral dystrophy: A double-blind randomized controlled clinical trial

Author: Koen B.E. Böcker, Fabien Pillard, Audrey Jaussent, Gilles Carnac, Marie-Christine Picot, Emilie Passerieux, Jacques Mercier, Joël Pincemail, Fares Gouzi, Dalila Laoudj-Chenivesse, Gérald Hugon, Theo Verrips, Maurice Hayot, Jean-Olivier Defraigne, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Unité de biostatistiques et épidémiologie, Service d'exploration de la fonction respiratoire et de médecine du sport, CHU Toulouse [Toulouse], Département de l'Information Médicale, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, The Alan Turing Institute, Centre Hospitalier Universitaire de Liège (CHU-Liège), Utrecht University [Utrecht], and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, Antioxidant, medicine.medical_treatment, Administration, Oral, Pilot Projects, Ascorbic Acid, Walking, medicine.disease_cause, Biochemistry, Antioxidants, Physical performance, 0302 clinical medicine, Vitamin E, Facioscapulohumeral muscular dystrophy, Selenomethionine, Gait, ComputingMilieux_MISCELLANEOUS, 0303 health sciences, Chemistry, Autosomal dominant trait, Middle Aged, Muscular Dystrophy, Facioscapulohumeral, 3. Good health, Radical oxygen species, Female, Muscle Contraction, Adult, medicine.medical_specialty, Gluconates, Facioscapulohumeral muscular dystrophy (FSHD), 03 medical and health sciences, Atrophy, Double-Blind Method, Physiology (medical), Internal medicine, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Muscle, Skeletal, 030304 developmental biology, Vitamin C, medicine.disease, Ascorbic acid, Endocrinology, Oxidative stress, Dietary Supplements, Physical Endurance, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, 030217 neurology & neurosurgery
Abstract: Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant disease characterized by progressive weakness and atrophy of specific skeletal muscles. As growing evidence suggests that oxidative stress may contribute to FSHD pathology, antioxidants that might modulate or delay oxidative insults could help in maintaining FSHD muscle function. Our primary objective was to test whether oral administration of vitamin C, vitamin E, zinc gluconate, and selenomethionine could improve the physical performance of patients with FSHD. Adult patients with FSHD (n=53) were enrolled at Montpellier University Hospital (France) in a randomized, double-blind, placebo-controlled pilot clinical trial. Patients were randomly assigned to receive 500 mg vitamin C, 400mg vitamin E, 25mg zinc gluconate and 200 μg selenomethionine (n=26), or matching placebo (n=27) once a day for 17 weeks. Primary outcomes were changes in the two-minute walking test (2-MWT), maximal voluntary contraction, and endurance limit time of the dominant and nondominant quadriceps (MVCQD, MVCQND, TlimQD, and TlimQND, respectively) after 17 weeks of treatment. Secondary outcomes were changes in the antioxidant status and oxidative stress markers. Although 2-MWT, MVCQ, and TlimQ were all significantly improved in the supplemented group at the end of the treatment compared to baseline, only MVCQ and TlimQ variations were significantly different between groups (MVCQD: P=0.011; MVCQND: P=0.004; TlimQD: P=0.028; TlimQND: P=0.011). Similarly, the vitamin C (P
Published: 2015
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16. Short- and long-term outcomes of HIV-infected patients admitted to the intensive care unit: impact of antiretroviral therapy and immunovirological status

Author: T. Mura, Alain Makinson, Olivier Jonquet, Jacques Reynes, David Morquin, Kada Klouche, Vincent Le Moing, Philippe Corne, Département d'anesthésie-réanimation[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Département de l'Information Médicale, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Centre d'Investigation Clinique, CHU Saint-Eloi-Institut National de la Santé et de la Recherche Médicale (INSERM)-Clinical Investigation Center 1001, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Clinical Investigation Center 1001, and BMC, Ed.
Subjects: Pediatrics, medicine.medical_specialty, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Population, Critical Care and Intensive Care Medicine, Prognostic factors, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Intensive care, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Medicine, 030212 general & internal medicine, Mortality, education, education.field_of_study, Intensive care units, business.industry, Human immunodeficiency virus, Research, Hazard ratio, Retrospective cohort study, Odds ratio, Intensive care unit, 3. Good health, Antiretroviral therapy, Acquired immunodeficiency syndrome, Critical care, 030228 respiratory system, SAPS II, business, Viral load
Abstract: International audience; BackgroundThe purpose of this study was to assess the short- and long-term outcomes of HIV-infected patients admitted to intensive care units (ICU) according to immunovirological status at admission and highly active antiretroviral therapy (HAART) use in ICU.MethodsRetrospective study of 98 HIV-infected patients hospitalized between 1997 and 2008 in two medical ICU in Montpellier, France. The primary outcome was mortality in ICU. The secondary end point was probability of survival in the year following ICU admission.ResultsEighty-two (83.6%) admissions in ICU were related to HIV infection and 45% of patients had received HAART before admission. Sixty-two patients (63.3%) were discharged from ICU, and 34 (34.7%) were alive at 1 year. Plasma HIV RNA viral load (VL) and CD4+ cell count separately were not associated with outcome. Independent predictors of ICU mortality were the use of vasopressive agents (odds ratio (OR), 3.779; 95% confidence interval (CI), 1.11-12.861; p = 0.0334) and SAPS II score (OR, 1.04; 95% CI, 1.003-1.077; p = 0.0319), whereas introducing or continuing HAART in ICU was protective (OR, 0.278; 95% CI, 0.082-0.939; p = 0.0393). Factors independently associated with 1-year mortality were immunovirological status with high VL (>3 log10/ml) and low CD4 (ConclusionsIn a population of HIV-infected patients admitted to ICU, short- and long-term outcomes are related to acute illness severity and immunovirological status at admission. Complementary studies are necessary to identify HIV-infected patients who benefit from HAART use in ICU according to immunovirological status and the reasons of ICU admission.
Published: 2012
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17. Mineralocorticoid Modulation of Cardiac Ryanodine Receptor Activity Is Associated With Downregulation of FK506-Binding Proteins

Author: Romain Perrier, Héctor H. Valdivia, Yannis Sainte-Marie, Ana María Gómez, Ćline Latouche, Frederic Jaisser, Spyros Zissimopoulos, Sylvain Richard, Xinsheng Zhu, Marie Christine Picot, Jean-Pierre Benitah, F. Anthony Lai, Emeline Perrier, Angélica Rueda, Roxane Schaub, Laetitia Pereira, Physiopathologie cardiovasculaire, Université Montpellier 1 (UM1)-IFR3, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM), Gènes et pression artérielle (INSERM U772), Collège de France (CdF (institution))-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Wales Heart Research Institute, School of Medicine [Cardiff], Cardiff University-Institute of Medical Genetics [Cardiff]-Cardiff University-Institute of Medical Genetics [Cardiff], Department of Physiology, University of Wisconsin Medical School, Département de l'Information Médicale, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, A05071FS/APV05030FSA, strep eurepe CT 2005 N°018802, CONTICA, Gomez, Ana Maria, Université Montpellier 1 ( UM1 ) -IFR3-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Gènes et pression artérielle ( Inserm U772 ), Collège de France ( CdF ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Cardiff University School of Medicine, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, and ANR : A05071FS/APV05030FSA,A05071FS/APV05030FSA
Subjects: Male, Patch-Clamp Techniques, MESH : Arrhythmias, Cardiac, MESH: Myocytes, Cardiac, 030204 cardiovascular system & hematology, MESH: Down-Regulation, MESH : Receptors, Mineralocorticoid, MESH: Ryanodine Receptor Calcium Release Channel, MESH : Down-Regulation, Mice, chemistry.chemical_compound, MESH : Calcium Signaling, 0302 clinical medicine, Mineralocorticoid receptor, MESH: Receptors, Mineralocorticoid, Myocytes, Cardiac, MESH: Animals, MESH : Patch-Clamp Techniques, Aldosterone, Cells, Cultured, MESH : Ryanodine Receptor Calcium Release Channel, Calcium signaling, 0303 health sciences, MESH : Rats, Ryanodine receptor, TOR Serine-Threonine Kinases, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Mice, Transgenic, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Sarcoplasmic Reticulum, MESH: Arrhythmias, Cardiac, cardiovascular system, MESH: Sarcoplasmic Reticulum, MESH : Sarcoplasmic Reticulum, Cardiology and Cardiovascular Medicine, MESH: Cells, Cultured, RM, medicine.medical_specialty, MESH: Rats, medicine.drug_class, MESH: Mice, Transgenic, MESH : Male, MESH : Myocytes, Cardiac, Down-Regulation, Mice, Transgenic, MESH : Protein Kinases, MESH : Rats, Wistar, MESH : Tacrolimus Binding Proteins, MESH: Calcium Signaling, Tacrolimus Binding Proteins, 03 medical and health sciences, Downregulation and upregulation, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Mineralocorticoids, Physiology (medical), Internal medicine, MESH : Cells, Cultured, MESH : Mice, MESH: Patch-Clamp Techniques, medicine, Animals, Humans, Calcium Signaling, Patch clamp, Rats, Wistar, MESH: Protein Kinases, MESH: Mice, 030304 developmental biology, MESH: Tacrolimus Binding Proteins, Heart Failure, MESH: Humans, MESH : Aldosterone, business.industry, MESH : Humans, MESH: Aldosterone, Arrhythmias, Cardiac, Ryanodine Receptor Calcium Release Channel, MESH: Rats, Wistar, medicine.disease, R1, MESH : Mineralocorticoids, MESH: Male, Rats, Receptors, Mineralocorticoid, Endocrinology, chemistry, MESH: Mineralocorticoids, Mineralocorticoid, Heart failure, MESH: Heart Failure, MESH : Animals, MESH : Heart Failure, business, Protein Kinases
Abstract: Background— The mineralocorticoid pathway is involved in cardiac arrhythmias associated with heart failure through mechanisms that are incompletely understood. Defective regulation of the cardiac ryanodine receptor (RyR) is an important cause of the initiation of arrhythmias. Here, we examined whether the aldosterone pathway might modulate RyR function. Methods and Results— Using the whole-cell patch clamp method, we observed an increase in the occurrence of delayed afterdepolarizations during action potential recordings in isolated adult rat ventricular myocytes exposed for 48 hours to aldosterone 100 nmol/L, in freshly isolated myocytes from transgenic mice with human mineralocorticoid receptor expression in the heart, and in wild-type littermates treated with aldosterone. Sarcoplasmic reticulum Ca 2+ load and RyR expression were not altered; however, RyR activity, visualized in situ by confocal microscopy, was increased in all cells, as evidenced by an increased occurrence and redistribution to long-lasting and broader populations of spontaneous Ca 2+ sparks. These changes were associated with downregulation of FK506-binding proteins (FKBP12 and 12.6), regulatory proteins of the RyR macromolecular complex. Conclusions— We suggest that in addition to modulation of Ca 2+ influx, overstimulation of the cardiac mineralocorticoid pathway in the heart might be a major upstream factor for aberrant Ca 2+ release during diastole, which contributes to cardiac arrhythmia in heart failure.
Published: 2009
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18. In-vitro and in-vivo evidence of dose-dependent decrease of uropathogenic Escherichia coli virulence after consumption of commercial Vaccinium macrocarpon (cranberry) capsules

Author: Gisèle Bourg, Jean-Philippe Lavigne, Henri Botto, Albert Sotto, Christophe Combescure, Lavigne, Jean-Philippe, Systèmes de sécrétion de type IV et virulence bactérienne, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de l'information médicale, Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service d'urologie, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Foch [Suresnes]
Subjects: Microbiology (medical), Adult, Capsules, Urine, Biology, medicine.disease_cause, Placebo, beta-Lactams, Bacterial Adhesion, beta-Lactam Resistance, Article, Microbiology, Cell Line, food, Double-Blind Method, In vivo, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, medicine, Escherichia coli, Vaccinium macrocarpon, Animals, Humans, Caenorhabditis elegans, food.beverage, Escherichia coli Infections, Cross-Over Studies, Dose-Response Relationship, Drug, CRANBERRY JUICE, cranberry, Epithelial Cells, General Medicine, therapy, urinary tract infection, Crossover study, Dose–response relationship, Infectious Diseases, Treatment Outcome, Adherence, Urinary Tract Infections, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female
Abstract: International audience; This study evaluated the antibacterial efficacy of the consumption of cranberry capsules vs. placebo in the urine of healthy volunteers. A first double-blind, randomised, crossover trial involved eight volunteers who had followed three regimens, with or without cranberry, with a wash-out period of at least 6 days between each regimen. Twelve hours after consumption of cranberry or placebo hard capsules, the first urine of the morning was collected. Different Escherichia coli strains were cultured in the urine samples. Urinary antibacterial adhesion activity was measured in vitro using the human T24 epithelial cell-line, and in vivo using the Caenorhabditis elegans killing model. With the in-vitro model, 108 mg of cranberry induced a significant reduction in bacterial adherence to T24 cells as compared with placebo (p
Published: 2008
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19. Miniaturized oligonucleotide arrays: a new tool for discriminating colonization from infection due to Staphylococcus aureus in diabetic foot ulcers

Author: Sotto, Albert, Richard, Jean-Louis, Jourdan, Nathalie, Combescure, Christophe, Bouziges, Nicole, Lavigne, Jean-Philippe, Lavigne, Jean-Philippe, Systèmes de sécrétion de type IV et virulence bactérienne, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies de la nutrition et de diabétologie, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service des maladies métaboliques et endocriniennes, Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Département de l'information médicale, and Laboratoire de bactériologie
Subjects: [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, digestive system diseases
Abstract: OBJECTIVE: We sought to evaluate the use of oligonucleotide arrays to discriminate colonization from infection due to Staphylococcus aureus in diabetic foot ulcers. RESEARCH DESIGN AND METHODS: We included diabetic patients hospitalized in a diabetic foot department for an episode of foot ulcer. Only patients who had no antibiotic treatment during the previous 6 months were included. At admission, ulcers were classified on clinical examination, according to the Infectious Diseases Society of America system. Seventy-two patients with a culture positive only for S. aureus as the sole pathogen were included. In individuals with a grade 1 ulcer, a second wound bacterial specimen was obtained 1 month later. Using oligonucleotide arrays, S. aureus resistance and virulence genes were compared between grade 1 and grades 2-4 ulcers. RESULTS: S. aureus was initially isolated from 22 grade 1 and 50 grade 2-4 ulcers: 35 were methicillin resistant and 37 methicillin sensitive. In 20 grade 1 ulcers (92%), no virulence genes were identified, whereas these genes were present in all but 1 grade 2-4 ulcers. During follow-up, the two grade 1 ulcers that were infected with strains carrying virulence genes rapidly deteriorated; the array technology showed unchanged genotype profiles. On the contrary, two grade 1 ulcers healed: the genotype profiles were different from those at inclusion but without appearance of virulence genes. CONCLUSIONS: The DNA array appears as a promising technique and is easy to perform. Our observational study suggests that it might help distinguish colonized grade 1 from infected grade 2 wounds, predict ulcer outcome, and contribute to a more adequate use of antibiotics.
Published: 2007
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20. Reference values for vastus lateralis fiber size and type in healthy subjects over 40 years old. A systematic review and meta-analysis

Author: Jacques Mercier, Maurice Hayot, Pascal Pomiès, C. Prefaut, Nicolas Molinari, Jonathan Maury, Fares Gouzi, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU de Montpellier, Département de l'Information Médicale, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital La Colombière, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: 2. Zero hunger, 0303 health sciences, medicine.medical_specialty, Physiology, business.industry, Healthy subjects, Fiber size, 030204 cardiovascular system & hematology, medicine.disease, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Atrophy, Chronic disease, Physiology (medical), Reference values, Internal medicine, medicine, Physical therapy, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], 10. No inequality, business, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology, Skeletal muscle atrophy
Abstract: Skeletal muscle atrophy is a major systemic impairment in chronic diseases. Yet its determinants have been hard to identify because a clear research definition has not been agreed upon. The reduction in muscle fiber cross-sectional area (CSA) is a widely acknowledged marker of muscle atrophy, but no reference values for the muscle fiber CSA at the age of the onset of chronic disease have ever been published. Thus, we aimed to systematically review the studies providing data on fiber CSA and fiber type proportion in the vastus lateralis of the quadriceps of healthy subjects (age >40 yr) and then to pool and analyze the data from the selected studies to determine reference values for fiber CSA. We followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and identified 19 studies, including 423 subjects that matched the inclusion criteria. On the basis of fiber type and gender, the mean fiber CSA and the lower limits of normal (LLNs) were (%type I*60) + 1,743 μm2 and (%type I*60) − 718 μm2, respectively, for men; and (%type I*70) + 139 μm2 and (%type I*70) − 1,485 μm2, respectively, for women. There was no significant heterogeneity among subgroups of fiber type and gender. The pooled type I fiber proportion was 50.3% (LLN = 32.9%). In multivariate analysis, fiber CSA was significantly correlated with V̇o2 peak ( r = 190.92; P = 0.03), and type I fiber proportion was correlated with age ( r = −0.024; P = 0.005), body mass index ( r = 0.096; P = 0.005), and V̇o2 peak ( r = −0.053; P = 0.005). Our metaanalysis of a homogeneous set of studies is the first to provide valuable LLNs for fiber CSA according to fiber type and gender. This analysis will be improved by prospective assessment in well-characterized healthy subjects.
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21. Clinical outcomes of COVID-19 in patients with sickle cell disease in French Guiana.

Author: Elenga N, Ntab B, Mafema Missindu J, Thomas Boizan N, and Abassi A
Abstract: Objectives: French Guiana also suffered concrete epidemiological consequences of the SARS-CoV2 epidemic. These regions are home to a large number of sickle cell patients who are at risk of developing severe forms of COVID-19. This study aimed to describe the characteristics and prognosis of patients with sickle disease infected with SARS-CoV2 during the first and second epidemic waves of 2020 in French Guiana., Design: We conducted a multicenter, retrospective cohort study that included sickle cell patients followed up in French Guiana., Results: Among the 79 patients infected with SARS-CoV2, there were 26 children <18 years. Forty-two patients were hospitalized and 37 were outpatients. Respiratory illness (38 %), vaso-occlusive crises (18 %), and acute chest syndrome (8 %) were the main causes of hospitalization. There were two cases of pulmonary embolism and one case of deep limb thrombosis. Seven patients were transferred to the ICU. Of these, three received mechanical ventilation, and two died. The deceased patients had the SS phenotype (a 16-year-old boy and a 32-year-old man), both of whom exhibited severe pneumonitis complicated by COVID-19., Conclusion: Despite the two deaths, the overall outcome was favorable., Competing Interests: The authors declare that they have no competing interests., (© 2024 The Authors.)
Published: 2024
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22. Changes in Lean Tissue Mass, Fat Mass, Biological Parameters and Resting Energy Expenditure over 24 Months Following Sleeve Gastrectomy.

Author: Maïmoun L, Aouinti S, Puech M, Lefebvre P, Deloze M, de Santa Barbara P, Renard E, Christol JP, Myzia J, Picot MC, Mariano-Goulart D, and Nocca D
Subjects: Humans, Female, Male, Longitudinal Studies, Energy Metabolism, Gastrectomy, Obesity surgery, Body Composition
Abstract: Sleeve gastrectomy (SG) induces weight loss but its effects on body composition (BC) are less well known. The aims of this longitudinal study were to analyse the BC changes from the acute phase up to weight stabilization following SG. Variations in the biological parameters related to glucose, lipids, inflammation, and resting energy expenditure (REE) were concomitantly analysed. Fat mass (FM), lean tissue mass (LTM), and visceral adipose tissue (VAT) were determined by dual-energy X-ray absorptiometry in 83 obese patients (75.9% women) before SG and 1, 12 and 24 months later. After 1 month, LTM and FM losses were comparable, whereas at 12 months the loss of FM exceeded that of LTM. Over this period, VAT also decreased significantly, biological parameters became normalized, and REE was reduced. For most of the BC, biological and metabolic parameters, no substantial variation was demonstrated beyond 12 months. In summary, SG induced a modification in BC changes during the first 12 months following SG. Although the significant LTM loss was not associated with an increase in sarcopenia prevalence, the preservation of LTM might have limited the reduction in REE, which is a longer-term weight-regain criterion.
Published: 2023
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23. Opioid misuse in community pharmacy patients with chronic non-cancer pain.

Author: Philip C, Roy S, Eiden C, Soler M, Georgin F, Müller A, Picot MC, Donnadieu-Rigole H, and Peyriere H
Subjects: Adult, Analgesics, Opioid adverse effects, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Morphine, Chronic Pain drug therapy, Opioid-Related Disorders drug therapy, Opioid-Related Disorders epidemiology, Pharmacies
Abstract: Aims: Community pharmacists could contribute to identify people misusing prescription opioids, which may be associated with hospitalizations, substance use disorders and death. This study investigated prescription opioid misuse in community pharmacy patients and the factors potentially associated with high Prescription Opioid Misuse Index (POMI) scores., Methods: In this cross-sectional study, pharmacy students asked patients with opioid prescriptions to fill in a questionnaire (including the POMI) in community pharmacies in a French region, in April 2019. Eligible patients were adults with chronic non-cancer pain who consented to participate., Results: In total, 414 patients (62.4% women; mean age: 58.00 years ± 16.00) were included. The prescribed opioids were mainly weak opioids (73.2%; paracetamol/tramadol: 35%). Strong opioids (32.6%) included oxycodone (11.95%), fentanyl (9%) and morphine (9%). The median morphine milligram equivalent (MME) was 40 mg/day (IQR 25-75 : 20-80). The POMI score (0 to 6) was ≥4 in 16% of patients who were younger (P < .01), more urban (P = .03), with higher pain visual analogue scale (VAS) score (P < .01) and MME (P < .01), and treated more frequently with strong opioids (P = .04). In multivariate analysis, age (OR for 10y : 0.68 (95% CI: 0.56-0.82, P < .0001)), VAS (OR 2units : 1.78 (95% CI: 1.26-2.40, P = .0008)), and MME (>100 mg, OR: 2.65 (95% CI: 1.14-4.41, P = .0194)) were significantly associated with POMI scores ≥4., Conclusions: The high proportion of patients with high POMI scores underlines the interest of prescription opioid misuse screening in community pharmacies, in order to help these patients and refer them to pain specialists, if needed., (© 2021 British Pharmacological Society.)
Published: 2022
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24. Efficacy of cognitive behavioral therapy on aggressive behavior in children with attention deficit hyperactivity disorder and emotion dysregulation: study protocol of a randomized controlled trial.

Author: Vacher C, Romo L, Dereure M, Soler M, Picot MC, and Purper-Ouakil D
Subjects: Adolescent, Child, Emotions, Humans, Parenting, Parents, Quality of Life, Randomized Controlled Trials as Topic, Treatment Outcome, Attention Deficit Disorder with Hyperactivity diagnosis, Attention Deficit Disorder with Hyperactivity therapy, Cognitive Behavioral Therapy
Abstract: Background: Attention deficit hyperactivity disorder (ADHD) is frequently associated with emotional dysregulation (ED). ED is characterized by excessive and inappropriate emotional reactions compared to social norms, uncontrolled and rapid shifts in emotion, and attention focused on emotional stimuli. Few studies have evaluated non-pharmacological interventions to improve ED in children with ADHD. The current randomized controlled trial assesses the efficacy of a cognitive behavioral therapy (CBT) intervention compared with a theater-based intervention (TBI) in children with ADHD and ED., Methods: Sixty-eight 7- to 13-year-old children with ADHD and ED will be recruited and randomly assigned to the CBT or TBI group. CBT aims to reduce ED by teaching anger management strategies. TBI seeks to reduce ED by improving emotion understanding and expression through mimics and movement. In both groups, children participate in 15 1-h sessions, and parents participate in 8 sessions of a parent management program. The primary outcome measure is the change in the "Aggression" sub-score of the Child Behavior Checklist (CBCL). Secondary outcome measures include overall impairment (Children's Global Assessment Scale, Strengths and Difficulties Questionnaire), personality profile (Hierarchical Personality Inventory for Children), executive function (Behavioral Rating Inventory of Executive Function), quality of life (Kidscreen-27), parental stress (Parenting Stress Index, 4th edition), parental depression (Beck Depression Inventory-II), and impact of child disorders on the quality of the family life (Parental Quality of Life and Developmental Disorder)., Discussion: Children with ADHD and ED are at risk of functional impairment and poor outcomes and have specific therapeutic needs. This randomized controlled trial wants to assess non-pharmacological treatment options for this population., Trial Registration: Clinicaltrials.gov. NCT03176108 . Registered on June 5, 2017., (© 2022. The Author(s).)
Published: 2022
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25. Maternal HLA Ib Polymorphisms in Pregnancy Allo-Immunization.

Author: Persson G, Picard C, Marin G, Isgaard C, Stæhr CS, Molinari N, Chiaroni J, Lebech M, Hviid TVF, and Di Cristofaro J
Subjects: Adolescent, Adult, Alleles, Female, Gene Dosage, Gene Frequency, Genetic Association Studies, Genotype, Humans, Immunization, Immunoglobulin G immunology, Phenotype, Pregnancy, Young Adult, HLA-DQ Antigens genetics, HLA-DQ Antigens immunology, Isoantibodies immunology, Polymorphism, Genetic
Abstract: During pregnancy the formation of alloreactive anti-human leukocyte antigen (HLA) antibodies are a major cause of acute rejection in organ transplantation and of adverse effects in blood transfusion. The purpose of the study was to identify maternal HLA class Ib genetic factors associated with anti-HLA allo-immunization in pregnancy and the degree of tolerance estimated by IgG4 expression. In total, 86 primiparous women with singleton pregnancies were included in the study. Maternal blood samples and umbilical cord samples were collected at delivery. Clinical data were obtained. Maternal blood serum was screened for HLA class I and II antibodies, identification of Donor Specific Antibody (DSA), activation of complement measured by C1q and IgG4 concentrations. Mothers were genotyped for HLA class Ib ( HLA-E, -F and -G ). Anti-HLA class I and II antibodies were identified in 24% of the women. The maternal HLA-E*01:06 allele was significantly associated with a higher fraction of anti-HLA I immunization (20.0% vs. 4.8%, p = 0.048). The maternal HLA-G 3'-untranslated region UTR4-HLA-G*01:01:01:05 haplotype and the HLA-F*01:03:01 allele were significantly associated with a low anti-HLA I C1q activation (16.7% vs . 57.1%, p = 0.028; 16.7% vs. 50.0%, p = 0.046; respectively). Both HLA‑G and HLA - F*01:03:01 showed significantly higher levels of IgG4 compared with the other haplotypes. The results support an association of certain HLA class Ib alleles with allo-immunization during pregnancy. Further studies are needed to elucidate the roles of HLA-E*01:06, HLA-F*01:03 and HLA‑G UTR4 in reducing the risk for allo-immunization., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Persson, Picard, Marin, Isgaard, Stæhr, Molinari, Chiaroni, Lebech, Hviid and Di Cristofaro.)
Published: 2021
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26. Adult T-cell leukemia/lymphoma incidence rate in French Guiana: a prospective cohort of women infected with HTLV-1.

Author: Ramassamy JL, Tortevoye P, Ntab B, Seve B, Carles G, Gaquière D, Madec Y, Fontanet A, and Gessain A
Subjects: Adolescent, Adult, Female, French Guiana epidemiology, Humans, Incidence, Japan, Pregnancy, Prospective Studies, Human T-lymphotropic virus 1, Leukemia-Lymphoma, Adult T-Cell diagnosis, Leukemia-Lymphoma, Adult T-Cell epidemiology
Abstract: Adult T-cell leukemia/lymphoma (ATL) is an aggressive malignancy caused by the human T-cell leukemia virus type 1 (HTLV-1). The incidence of ATL among HTLV-1 carriers remains largely unknown in endemic countries other than Japan as very few prospective studies have been performed. We assessed the ATL incidence rate among HTLV-1 infected women in a prospective cohort in French Guiana. This is the first prospective study to assess the ATL incidence rate in an area of South America where HTLV-1 prevalence is high. Patients were enrolled between 1991 and 2005, and follow-up continued until April 2018. In the general hospital in Saint-Laurent-du-Maroni, 307 pregnant women were diagnosed with HTLV-1 infection, and 268 of them were observed for a median of 16.7 years. During follow-up, 9 ATL incident cases occurred resulting in an ATL incidence rate of 2.03 per 1000 HTLV-1 carrier-years (95% confidence interval, 0.93-3.85 per 1000 HTLV-1 carrier-years). The median age at diagnosis was 47.4 years, and median survival from diagnosis was low at 3.5 months. The ATL incidence rate was elevated for a study population consisting mostly of young people, which could either be a general feature in South America or could be specific to the Noir Marron population that constituted most of the cohort., (© 2020 by The American Society of Hematology.)
Published: 2020
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27. The Reference Site Collaborative Network of the European Innovation Partnership on Active and Healthy Ageing.

Author: Bousquet J, Illario M, Farrell J, Batey N, Carriazo AM, Malva J, Hajjam J, Colgan E, Guldemond N, Perälä-Heape M, Onorato GL, Bedbrook A, Leonardini L, Stroetman V, Birov S, Abreu C, Abrunhosa A, Agrimi A, Alalääkkölä T, Allegretti N, Alonso-Trujillo F, Álvarez-Benito M, Angioli S, Apóstolo J, Armitage G, Arnavielhe S, Baena-ParejoI M, Bamidis PD, Balenović A, Barbolini M, Baroni I, Blain H, Bernard PL, Bersani M, Berti E, Bogatyrchuk L, Bourret R, Brehm J, Brussino L, Buhr D, Bultje D, Cabeza E, Cano A, De Capitani C, Carantoña E, Cardoso A, Coll Clavero JI, Combe B, Conforti D, Coppola L, Corti F, Coscioni E, Costa E, Crooks G, Cunha A, Daien C, Dantas, Darpón Sierra J, Davoli M, Dedeu Baraldes A, De Luca V, De Nardi L, Di Ciano M, Dozet A, Ekinci B, Erve S, Espinoza Almendro JM, Fait A, Fensli R, Fernandez Nocelo S, Gálvez-Daza P, Gámez-Payá J, García Sáez M, Garcia Sanchez I, Gemicioğlu B, Goetzke W, Goossens E, Geurdens M, Gütter Z, Hansen H, Hartman S, Hegendörfer G, Heikka H, Henderson D, Héran D, Hirvonen S, Iaccarino G, Jansson N, Kallasvaara H, Kalyoncu F, Kirchmayer U, Kokko JA, Korpelainen J, Kostka T, Kuna P, Lajarín Ortega T, Lama CM, Laune D, Lauri D, Ledroit V, Levato G, Lewis L, Liotta G, Lundgren L, Lupiañez-Villanueva F, Mc Garry P, Maggio M, Manuel de Keenoy E, Martinez C, Martínez-Domene M, Martínez-Lozano Aranaga B, Massimilliano M, Maurizio A, Mayora O, Melle C, Mendez-Zorilla A, Mengon H, Mercier G, Mercier J, Meyer I, Millet Pi-Figueras A, Mitsias P, Molloy DW, Monti R, Moro ML, Muranko H, Nalin M, Nobili A, Noguès M, O'Caoimh R, Pais S, Papini D, Parkkila P, Pattichis C, Pavlickova A, Peiponen A, Pereira S, Pépin JL, Piera Jiménez J, Portheine P, Potel L, Pozzi AC, Quiñonez P, Ramirez Lauritsen X, Ramos MJ, Rännäli-Kontturi A, Risino A, Robalo-Cordeiro C, Rolla G, Roller R, Romano M, Romano V, Ruiz-Fernández J, Saccavini C, Sachinopoulou A, Sánchez Rubio MJ, Santos L, Scalvini S, Scopetani E, Smedberg D, Solana-Lara R, Sołtysik B, Sorlini M, Stericker S, Stramba Badiale M, Taillieu I, Tervahauta M, Teixeira A, Tikanmäki H, Todo-Bom A, Tooley A, Tuulonen A, Tziraki C, Ussai S, Van der Veen S, Venchiarutti A, Verdoy-Berastegi D, Verissimo M, Visconti L, Vollenbroek-Hutten M, Weinzerl K, Wozniak L, Yorgancıoğlu A, Zavagli V, and Zurkuhlen AJ
Abstract: Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) have been recognised by the European Commission in 2016 for their commitment to excellence in investing and scaling up innovative solutions for active and healthy ageing. The Reference Site Collaborative Network (RSCN) brings together the EIP on AHA Reference Sites awarded by the European Commission, and Candidate Reference Sites into a single forum. The overarching goals are to promote cooperation, share and transfer good practice and solutions in the development and scaling up of health and care strategies, policies and service delivery models, while at the same time supporting the action groups in their work. The RSCN aspires to be recognized by the EU Commission as the principal forum and authority representing all EIP on AHA Reference Sites. The RSCN will contribute to achieve the goals of the EIP on AHA by improving health and care outcomes for citizens across Europe, and the development of sustainable economic growth and the creation of jobs.
Published: 2019

28. Clinical features and prognosis of paraquat poisoning in French Guiana: A review of 62 cases.

Author: Elenga N, Merlin C, Le Guern R, Kom-Tchameni R, Ducrot YM, Pradier M, Ntab B, Dinh-Van KA, Sobesky M, Mathieu D, Dueymes JM, Egmann G, Kallel H, and Mathieu-Nolf M
Subjects: Adolescent, Adult, Aged, Charcoal administration & dosage, Child, Child, Preschool, Dose-Response Relationship, Drug, Drug Overdose mortality, Female, French Guiana, Humans, Incidence, Infant, Length of Stay statistics & numerical data, Male, Middle Aged, Prognosis, Retrospective Studies, Suicide, Attempted statistics & numerical data, Survival Rate, Young Adult, Drug Overdose diagnosis, Drug Overdose therapy, Paraquat poisoning
Abstract: Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates. Because of its high toxicity, the European Union withdrew it from its market in 2007. The aim of this study is to analyze all cases of paraquat poisoning hospitalized in French Guiana in order to assess their incidence and main characteristics.Medical records of all paraquat intoxicated patients hospitalized from 2008 until 2015 were reviewed in this retrospective study.Demographics, clinical presentation, and laboratory data were evaluated.A total of 62 cases were reviewed. The incidence of paraquat poisoning was 3.8/100,000 inhabitants/year. There were 44 adults and 18 children younger than 16 years of age. The median ages were 31 years [18.08-75.25] in adults and 13.4 years [0.75-15.08] in children, respectively. The median duration of hospitalization was longer in children [15.5 days (1-24)] than in adults [2 days (1-30)], P < .01. The majority of cases was due to self-poisoning (84%).Children had ingested a lower quantity of paraquat [48.8 mg/kg (10-571.1)] than adults [595.8 mg/kg (6-3636.4), P = .03]. There were more deaths among adults (65%) than in children (22%), P = .004. The severity and outcome was determined primarily by the amount of paraquat ingested.In conclusion, French Guiana has the largest cohort of paraquat poisonings in the European Union. The major factor affecting the prognosis of patients was the ingested amount of paraquat. The administration of activated charcoal or Pemba, in situ, within the first hour after ingestion of paraquat is essential.
Published: 2018
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29. Molecular, clinical and neuropsychological study in 31 patients with Kabuki syndrome and KMT2D mutations.

Author: Lehman N, Mazery AC, Visier A, Baumann C, Lachesnais D, Capri Y, Toutain A, Odent S, Mikaty M, Goizet C, Taupiac E, Jacquemont ML, Sanchez E, Schaefer E, Gatinois V, Faivre L, Minot D, Kayirangwa H, Sang KLQ, Boddaert N, Bayard S, Lacombe D, Moutton S, Touitou I, Rio M, Amiel J, Lyonnet S, Sanlaville D, Picot MC, and Geneviève D
Subjects: Adolescent, Alleles, Child, DNA Mutational Analysis, Female, Gene Order, Genetic Loci, Humans, Intelligence, Male, Neuropsychological Tests, Abnormalities, Multiple diagnosis, Abnormalities, Multiple genetics, DNA-Binding Proteins genetics, Face abnormalities, Genetic Association Studies, Hematologic Diseases diagnosis, Hematologic Diseases genetics, Mutation, Neoplasm Proteins genetics, Phenotype, Vestibular Diseases diagnosis, Vestibular Diseases genetics
Abstract: Kabuki syndrome (KS-OMIM 147920) is a rare developmental disease characterized by the association of multiple congenital anomalies and intellectual disability. This study aimed to investigate intellectual performance in children with KS and link the performance to several clinical features and molecular data. We recruited 31 children with KMT2D mutations who were 6 to 16 years old. They all completed the Weschler Intelligence Scale for Children, fourth edition. We calculated all indexes: the Full Scale Intellectual Quotient (FSIQ), Verbal Comprehension Index (VCI), Perceptive Reasoning Index (PRI), Processing Speed Index (PSI), and Working Memory Index (WMI). In addition, molecular data and several clinical symptoms were studied. FSIQ and VCI scores were 10 points lower for patients with a truncating mutation than other types of mutations. In addition, scores for FSIQ, VCI and PRI were lower for children with visual impairment than normal vision. We also identified a discrepancy in indexes characterized by high WMI and VCI and low PRI and PSI. We emphasize the importance of early identification and intensive care of visual disorders in patients with KS and recommend individual assessment of intellectual profile., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Published: 2017
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30. Treatment tolerance and patient-reported outcomes favor online hemodiafiltration compared to high-flux hemodialysis in the elderly.

Author: Morena M, Jaussent A, Chalabi L, Leray-Moragues H, Chenine L, Debure A, Thibaudin D, Azzouz L, Patrier L, Maurice F, Nicoud P, Durand C, Seigneuric B, Dupuy AM, Picot MC, Cristol JP, and Canaud B
Subjects: Age Factors, Aged, Aged, 80 and over, Female, France, Geriatric Assessment, Hemodiafiltration adverse effects, Hemodiafiltration mortality, Hospitalization, Humans, Kaplan-Meier Estimate, Kidney Diseases diagnosis, Kidney Diseases mortality, Kidney Diseases physiopathology, Male, Prospective Studies, Quality of Life, Renal Dialysis adverse effects, Renal Dialysis mortality, Time Factors, Treatment Outcome, Hemodiafiltration methods, Kidney physiopathology, Kidney Diseases therapy, Renal Dialysis methods
Abstract: Large cohort studies suggest that high convective volumes associated with online hemodiafiltration may reduce the risk of mortality/morbidity compared to optimal high-flux hemodialysis. By contrast, intradialytic tolerance is not well studied. The aim of the FRENCHIE (French Convective versus Hemodialysis in Elderly) study was to compare high-flux hemodialysis and online hemodiafiltration in terms of intradialytic tolerance. In this prospective, open-label randomized controlled trial, 381 elderly chronic hemodialysis patients (over age 65) were randomly assigned in a one-to-one ratio to either high-flux hemodialysis or online hemodiafiltration. The primary outcome was intradialytic tolerance (day 30-day 120). Secondary outcomes included health-related quality of life, cardiovascular risk biomarkers, morbidity, and mortality. During the observational period for intradialytic tolerance, 85% and 84% of patients in high-flux hemodialysis and online hemodiafiltration arms, respectively, experienced at least one adverse event without significant difference between groups. As exploratory analysis, intradialytic tolerance was also studied, considering the sessions as a statistical unit according to treatment actually received. Over a total of 11,981 sessions, 2,935 were complicated by the occurrence of at least one adverse event, with a significantly lower occurrence in online hemodiafiltration with fewer episodes of intradialytic symptomatic hypotension and muscle cramps. By contrast, health-related quality of life, morbidity, and mortality were not different in both groups. An improvement in the control of metabolic bone disease biomarkers and β2-microglobulin level without change in serum albumin concentration was observed with online hemodiafiltration. Thus, overall outcomes favor online hemodiafiltration over high-flux hemodialysis in the elderly., (Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)
Published: 2017
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31. Low Osteoporosis Treatment Initiation Rate in Women after Distal Forearm or Proximal Humerus Fracture: A Healthcare Database Nested Cohort Study.

Author: Viprey M, Caillet P, Canat G, Jaglal S, Haesebaert J, Chapurlat R, and Schott AM
Subjects: Female, Humans, Middle Aged, Osteoporosis complications, Radius Fractures complications, Shoulder Fractures complications, Database Management Systems, Osteoporosis therapy, Radius Fractures therapy, Shoulder Fractures therapy
Abstract: Treatment initiation rates following fragility fractures have often been reported to be low and in recent years numerous programs have been implemented worldwide to increase them. This study aimed at describing osteoporosis (OP) treatment initiation in a representative sample of women who were hospitalized for a distal forearm fracture (DFF) or proximal humerus fracture (PHF) in 2009-2011 in France. The data source was a nationwide sample of 600,000 individuals, extracted from the French National Insurance Healthcare System database. All women aged 50 years and older who were hospitalized for a DFF or PHF between 2009 and 2011 and who had not received any OP treatment in the preceding 12 months were included in a retrospective cohort study. OP treatments initiated during the year following the fracture were analyzed. From 2009 to 2011, 729 women were hospitalized for a DFF or a PHF and 284 were on OP treatment at the time of the fracture occurrence. Among the 445 women who had no prevalent OP treatment, 131 (29.4%) received supplementation treatment only (vitamin D and/or calcium) and 42 (9.4%) received a pharmacologic OP treatment in the year following their fracture. Pharmacological OP treatments included bisphosphonates (n = 21), strontium ranelate (n = 14), hormone replacement therapy (n = 4), or raloxifene (n = 3). General practitioners prescribed 75% of initial OP treatments. Despite the guidelines published in 2006 and the numerous initiatives to promote post-fracture OP treatment, OP treatment initiation rate in women who were hospitalized for a fragility fracture remained low in 2009-2011 in France.
Published: 2015
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32. Is generalization of exhaled CO assessment in primary care helpful for early diagnosis of COPD?

Author: Molinari N, Abou-Badra M, Marin G, Ky CL, Amador N, Gamez AS, Vachier I, and Bourdin A
Subjects: Adult, Aged, Area Under Curve, Breath Tests, Early Diagnosis, Female, Humans, Male, Mass Screening, Middle Aged, ROC Curve, Carbon Monoxide analysis, Patient Acceptance of Health Care, Primary Health Care, Pulmonary Disease, Chronic Obstructive diagnosis, Smoking
Abstract: Background: COPD is largely under-diagnosed and once diagnosed usually at a late stage. Early diagnosis is thoroughly recommended but most attempts failed as the disease is marginally known and screening marginally accepted. It is a rare cause of concern in primary care and spirometry is not very common. Exhaled carbon monoxide (eCO) is a 5-seconds easy-to-use device dedicated to monitor cigarette smoke consumption. We aimed to assess whether systematic eCO measurement in primary care is a useful tool to improve acceptance for early COPD diagnosis., Methods: This was a two-center randomized controlled trial enrolling 410 patients between March and May, 2013. Whatever was the reason of attendance to the clinic, all adults were proposed to measure eCO during randomly chosen days and outcomes were compared between the two different groups of patients (performing and not performing eCO). Primary outcome was the rates of acceptance for COPD screening., Results: Rate of acceptance for COPD screening was 28% in the eCO group and 26% in the other (P = 0.575). These rates increased to 48 and 51% in smokers (current and former). eCO significantly increased the rate of clinics during which a debate on smoking was initiated (42 vs. 24%, P = 0.001). eCO at 2.5 ppm was the discriminative concentration for identifying active smokers (ROC curve AUC: 0.935). Smoking was the only independent risk factor associated with acceptance for early COPD screening (OR = 364.6 (82.5-901.5) and OR = 78.5 (18.7-330.0) in current and former smokers, respectively) while eCO measurement was not., Conclusions: Early COPD diagnosis is a minor cause of concern in primary care. Systematic eCO assessment failed to improve acceptance for early COPD screening.
Published: 2015
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33. Mortality attributable to nosocomial infection: a cohort of patients with and without nosocomial infection in a French university hospital.

Author: Fabbro-Peray P, Sotto A, Defez C, Cazaban M, Molinari L, Pinède M, Mahamat A, and Daures JP
Subjects: Adult, Aged, Aged, 80 and over, Cohort Studies, Cross Infection epidemiology, Female, France epidemiology, Humans, Incidence, Length of Stay, Logistic Models, Male, Middle Aged, Prospective Studies, Risk Factors, Cross Infection mortality, Hospital Mortality, Hospitals, University
Abstract: Objective: To assess nosocomial infection (NI) as a risk factor for death and to estimate the population-attributable risk of death from NI., Design: A prospective cohort study of patients with and without NI., Setting: Nimes University Hospital, Nimes, France., Patients: Patients were recruited from May 7, 2001, to January 10, 2003. Patients in acute care and long-term care units who had NI were enrolled, and patients without NI were randomly selected and matched with patients with NI for age, sex, type of care (acute care vs. long-term care) and length of stay in hospital at study inclusion., Outcome Measures: Vital status within 60 days after study inclusion was assessed. We used conditional logistic regression to estimate the relative death risk from NI after adjusting for comorbidities, severity of the underlying disease, and all other confounding factors. The adjusted population-attributable risk was assessed using the Mantel-Haenszel method., Results: We recruited 1,914 patients with NI and 5,172 patients without NI. The median age of the patients with NI was 73 years; 1,045 (54.6%) were female. NI was associated with death within 60 days (adjusted odds ratio, 1.7 [95% confidence interval {CI}, 1.4-;2.2]; P<.001). The adjusted population-attributable risk of death for all sites of infection was 1.7% (95% CI, 1.4-2.1). If we consider the NI incidence to be 3%-6% in French hospitals, the population-attributable risk of death from NI would range from 2.1% (95% CI, 1.7%-2.5%) to 4.0% (95% CI, 3.3%-4.9%)., Conclusion: In this study, NI appeared to have a significant impact on mortality. Multicenter studies will be needed to confirm these results.
Published: 2007
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34. Evolution of fluoroquinolone resistance among Escherichia coli urinary tract isolates from a French university hospital: application of the dynamic regression model.

Author: Mahamat A, Lavigne JP, Fabbro-Peray P, Kinowski JM, Daurès JP, and Sotto A
Subjects: Ciprofloxacin pharmacology, Escherichia coli isolation & purification, Escherichia coli Infections microbiology, Forecasting, France, Hospitals, University, Humans, Ofloxacin pharmacology, Regression Analysis, Time Factors, Urinary Tract Infections microbiology, Anti-Infective Agents pharmacology, Drug Resistance, Bacterial, Escherichia coli drug effects, Fluoroquinolones pharmacology
Abstract: Escherichia coli urinary tract isolates were collected in 1997-2003 from Nimes University Hospital in order to investigate long-term trends in antibiotic resistance and to explore the relationship between antibiotic use and the emergence of resistance. Time-series analysis (ARIMA models) and dynamic regression models were used to investigate relationships between antibiotic use and resistance to ofloxacin and ciprofloxacin. Significant increases were seen in the frequency of ofloxacin (8.9 to 16.7%) and ciprofloxacin resistance (6.2 to 10.1%) (p < 0.001). Using multivariate dynamic regression analysis, it was found that an increased use of one defined daily dose (DDD)/1000 patient-days for ofloxacin, ciprofloxacin and norfloxacin induced average increases of 0.81%, 0.65% and 0.53% in E. coli ofloxacin resistance (p < 0.01), with average delays of 4, 4 and 6 months, respectively. An increase of 1 DDD/1000 patient-days of ciprofloxacin, ofloxacin and norfloxacin use induced increases of 0.73%, 0.82% and 0.63% in E. coli ciprofloxacin resistance (p < 0.01), with average delays of 4, 4 and 5 months, respectively. The use of nalidixic acid was not associated significantly with an increase in resistance to fluoroquinolones by multivariate analysis.
Published: 2005
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35. Environmental risk factors for non-Hodgkin's lymphoma: a population-based case-control study in Languedoc-Roussillon, France.

Author: Fabbro-Peray P, Daures JP, and Rossi JF
Subjects: Adult, Aged, Case-Control Studies, Confounding Factors, Epidemiologic, Female, France epidemiology, Humans, Logistic Models, Lymphoma, Non-Hodgkin chemically induced, Male, Middle Aged, Multivariate Analysis, Occupational Diseases chemically induced, Odds Ratio, Risk Factors, Smoking adverse effects, Surveys and Questionnaires, Electromagnetic Fields adverse effects, Environmental Exposure adverse effects, Lymphoma, Non-Hodgkin epidemiology, Lymphoma, Non-Hodgkin etiology, Occupational Diseases epidemiology, Occupational Diseases etiology
Abstract: Objective: To investigate the occupational and environmental risk factors related to non-Hodgkin's lymphoma (NHL)., Methods: A case-control study was performed during the 1992-1996 period in Languedoc-Roussillon, southern France. Four hundred and forty-five cases of histologically diagnosed NHL were declared. One thousand and twenty-five randomly selected population controls were interviewed about their medical histories; occupational exposures, such as chemicals, pesticides, and electromagnetic radiation; and toxic habits., Results: The following factors were independently and significantly related to NHL as a result of the multivariate analysis: a previous hematopoietic malignancy (ORa = 11.5, 95% CI 2.4-55.4), a history of hives (ORa = 1.7, 95% CI 1.2-2.2), benzene exposure > 810 days (ORa = 4.6, 95% CI 1.1-19.2), daily welding (ORa = 2.5, 95% CI 1.2-5.0), and activity of radio operator (ORa = 3.1, 95% CI 1.4-6.6). To be an agricultural professional seemed slightly related to NHL in reference to non-professionals (ORa = 1.5, 95% CI 1.0-2.1). All of these results have also been adjusted for age, gender, education level, and urban setting., Conclusions: As some of the reported associations were based on a very small proportion of exposed subjects, further investigations are necessary to confirm our results. However, the findings suggest that factors related to altered immune functions such as a history of hematopoietic malignancy, history of hives, occupational exposure to benzene, or being an agricultural professional might increase the risk of NHL. Currently, underlying mechanisms for these associations are still unclear, and further investigations focused on interactions between immunity alterations and different chemicals would be of great interest.
Published: 2001
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36. Bladder cancer and black tobacco cigarette smoking. Some results from a French case-control study.

Author: Momas I, Daures JP, Festy B, Bontoux J, and Gremy F
Subjects: Aged, Analysis of Variance, Carcinoma etiology, Case-Control Studies, Confidence Intervals, France epidemiology, Humans, Incidence, Interviews as Topic, Male, Middle Aged, Odds Ratio, Random Allocation, Retrospective Studies, Risk Factors, Smoking adverse effects, Surveys and Questionnaires, Urinary Bladder Neoplasms etiology, Carcinoma epidemiology, Smoking epidemiology, Urinary Bladder Neoplasms epidemiology
Abstract: A retrospective study was planned in the Hérault (Mediterranean) region of France where bladder cancer mortality and incidence rates are high. In the present paper, variations in bladder cancer risk according to various smoking-related variables, in particular time of exposure and type of tobacco, are examined. This case-control study with 219 male incident cases and 794 male population controls randomized from electoral rolls was carried out in 1987-89. Trained interviewers obtained information on demographics, dietary habits (coffee, alcohol, artificial sweeteners, vegetables, spices, etc.), occupational exposures and detailed history of tobacco smoking (average number of cigarettes per day, number of years of smoking, age at which they began and/or quitted smoking, use of filter-tip and type of tobacco). The odds ratio (OR) for cigarette smokers versus non-smokers was greater than 5. Results for number of cigarettes daily, duration of smoking and lifetime smoking showed a highly significant dose-response relationship, which was confirmed when these variables were treated as continuous in a logistic regression model. Eighty-eight percent of the smokers used black tobacco. Quitting smoking did not result in a significant reduction in bladder cancer risk. Higher risks were associated with starting to smoke at an early age (OR before age 13 versus after age 21 = 3.42; 95% CI 1.07-10.9) and with black tobacco smoking (OR black versus blond = 1.63; 95% CI 0.73-3.64). Results suggest that black tobacco may be more harmful than blond tobacco and may have an early non-reversible role in bladder carcinogenesis.
Published: 1994
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