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9 results on '"Céline Giraud"'

1. Nutritional Status Deterioration Occurs Frequently During Children’s ICU Stay*

Author

Fleur Cour-Andlauer, Elodie Gervet, Lyvonne N Tume, Bénédicte Gaillard-Le Roux, Carole Ford-Chessel, Etienne Javouhey, Florent Baudin, Tiphanie Ginhoux, Céline Giraud, and Frédéric V. Valla

Subjects
Male, Pediatrics, medicine.medical_specialty, Critical Illness, medicine.medical_treatment, Psychological intervention, Nutritional Status, 030204 cardiovascular system & hematology, Standard score, Intensive Care Units, Pediatric, Critical Care and Intensive Care Medicine, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Weight loss, Weight Loss, medicine, Humans, Prospective Studies, Child, Prospective cohort study, Rehabilitation, business.industry, Malnutrition, Infant, Newborn, Infant, 030208 emergency & critical care medicine, Length of Stay, medicine.disease, Failure to Thrive, Nutrition Assessment, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Observational study, medicine.symptom, business, Body mass index
Abstract

OBJECTIVES: Malnutrition and faltering growth at PICU admission have been related to suboptimal outcomes. However, little is known about nutritional status deterioration during PICU stay, as critical illness is characterized by a profound and complex metabolism shift, which affects energy requirements and protein turnover. We aim to describe faltering growth occurrence during PICU stay. DESIGN: Single-center prospective observational study. SETTING: Twenty-three-bed general PICU, Lyon, France. PATIENTS: All critically ill children 0-18 years old with length of stay longer than 5 days were included (September 2013-December 2015). INTERVENTIONS: Weight and height/length were measured at admission, and weight was monitored during PICU stay, in order to calculate body mass index for age z score. Faltering growth was defined as body mass index z score decline over PICU stay. Children admitted during the first year of the study and who presented with faltering growth were followed after PICU discharge for 3 months. MEASUREMENTS AND MAIN RESULTS: We analyzed 579 admissions. Of them, 10.2% presented a body mass index z score decline greater than 1 SD and 27.8% greater than 0.5. Admission severity risk scores and prolonged PICU stay accounted for 4% of the variability in nutritional status deterioration. Follow-up of post-PICU discharge nutritional status showed recovery within 3 months in most patients. CONCLUSIONS: Nutritional deterioration is frequent and often intense in critically ill children with length of stay greater than 5 days. Future research should focus on how targeted nutritional therapies can minimize PICU faltering growth and improve post-PICU rehabilitation.

Published
2019

2. Effect and safety of morphine use in acute anterior ST-segment elevation myocardial infarction

Author

Mickael Bonin, Nathan Mewton, Francois Roubille, Olivier Morel, Guillaume Cayla, Denis Angoulvant, Meyer Elbaz, Marc J. Claeys, David Garcia‐Dorado, Céline Giraud, Gilles Rioufol, Claire Jossan, Michel Ovize, Patrice Guerin, Eric Bonnefoy‐Cudraz, Nicolas Delarche, Pierre Coste, Gerald Vanzetto, Marc Metge, Jean‐François Aupetit, Bernard Jouve, Pascal Motreff, Christophe Tron, Jean‐Noel Labeque, Philippe Gabriel Steg, Yves Cottin, Grégoire Range, Jérome Clerc, Patrick Coussement, Fabrice Prunier, Frédéric Moulin, Olivier Roth, Loïc Belle, Philippe Dubois, Paul Barragan, Martine Gilard, Christophe Piot, Patrice Colin, Fabien De Poli, Marie‐Claude Morice, Omar Ider, Jean‐Luc Dubois‐Randé, Thierry Unterseeh, Hervé Le Breton, Thierry Béard, Didier Blanchard, Gilles Grollier, Vincent Malquarti, Patrick Staat, Arnaud Sudre, Eskil Elmer, Magnus J. Hansson, Cyrille Bergerot, Inesse Boussaha, Geneviève Derumeaux, CIRCUS Study Investigators, Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon (HCL), 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), Université de Strasbourg (UNISTRA), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université de Tours, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Universiteit Antwerpen [Antwerpen], Vall d'Hebron University Hospital [Barcelona], Cardioprotection, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours (UT), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Universiteit Antwerpen = University of Antwerpen [Antwerpen], MORNET, Dominique, 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, Time Factors, Databases, Factual, Narcotic Antagonists, medicine.medical_treatment, 030204 cardiovascular system & hematology, Coronary Angiography, Anterior ST segment elevation, Chest pain, clinical, 0302 clinical medicine, Recurrence, Risk Factors, Clinical Studies, Coronary Heart Disease, 030212 general & internal medicine, Myocardial infarction, Stroke, Randomized Controlled Trials as Topic, Original Research, Quality and Outcomes, Cardiogenic shock, morphine, Middle Aged, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, pharmaceutical safety, Treatment Outcome, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Cardiology, Administration, Intravenous, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Shock, Cardiogenic, Risk Assessment, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, ST‐segment elevation myocardial infarction, Humans, Angina, Unstable, Anterior Wall Myocardial Infarction, Aged, Heart Failure, Pharmacology, Unstable angina, business.industry, percutaneous coronary intervention, Percutaneous coronary intervention, medicine.disease, Heart failure, opioid, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, ST Elevation Myocardial Infarction, Human medicine, business, Acute Coronary Syndromes
Abstract

Background Morphine is commonly used to treat chest pain during myocardial infarction, but its effect on cardiovascular outcome has never been directly evaluated. The aim of this study was to examine the effect and safety of morphine in patients with acute anterior ST ‐segment elevation myocardial infarction followed up for 1 year. Methods and Results We used the database of the CIRCUS (Does Cyclosporine Improve Outcome in ST Elevation Myocardial Infarction Patients) trial, which included 969 patients with anterior ST ‐segment elevation myocardial infarction, admitted for primary percutaneous coronary intervention. Two groups were defined according to use of morphine preceding coronary angiography. The composite primary outcome was the combined incidence of major adverse cardiovascular events, including cardiovascular death, heart failure, cardiogenic shock, myocardial infarction, unstable angina, and stroke during 1 year. A total of 554 (57.1%) patients received morphine at first medical contact. Both groups, with and without morphine treatment, were comparable with respect to demographic and periprocedural characteristics. There was no significant difference in major adverse cardiovascular events between patients who received morphine compared with those who did not (26.2% versus 22.0%, respectively; P =0.15). The all‐cause mortality was 5.3% in the morphine group versus 5.8% in the no‐morphine group ( P =0.89). There was no difference between groups in infarct size as assessed by the creatine kinase peak after primary percutaneous coronary intervention (4023±118 versus 3903±149 IU/L; P =0.52). Conclusions In anterior ST ‐segment elevation myocardial infarction patients treated by primary percutaneous coronary intervention, morphine was used in half of patients during initial management and was not associated with a significant increase in major adverse cardiovascular events at 1 year.

Published
2018

3. Measles virus infection of human keratinocytes: Possible link between measles and atopic dermatitis

Author

Geraldine Gourru-Lesimple, Sophie Grande, Cyrille Mathieu, Louis Marie Bloyet, Cindy G. Boer, Catherine Goujon, Katarzyna Tomczak, Céline Giraud, Catherine Cornu, Jean François Jégou, Branka Horvat, Vanessa Guillaume-Vasselin, Thomas Thevenet, Immunobiologie des infections virales – Immunobiology of Viral Infections (IbIV), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Inflammation, Tissus épithéliaux et Cytokines (LITEC), Université de Poitiers, EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacologie Clinique, hospices civils de Lyon, Département d'allergie et d'immunologie clinique [CHU Lyon Sud], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
0301 basic medicine, Keratinocytes, Male, Biopsy, Dermatitis, Biochemistry, 0302 clinical medicine, Multiplicity of infection, Chlorocebus aethiops, Medicine, Prospective Studies, Skin, biology, Vaccination, Atopic dermatitis, Middle Aged, CC, Rash, 3. Good health, Chemokines, CC, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Cytokines, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, medicine.symptom, Chemokines, Adult, Thymic stromal lymphopoietin, Dermatology, Measles, Atopic, Dermatitis, Atopic, Cell Line, Cercopithecus aethiops, Measles virus, 03 medical and health sciences, Thymic Stromal Lymphopoietin, Double-Blind Method, Humans, Animals, Immune response, Molecular Biology, Vero Cells, business.industry, Chemokine CCL26, biology.organism_classification, medicine.disease, Virology, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 030104 developmental biology, Immune System, Immunology, Measles vaccine, business, 030215 immunology
Abstract

International audience; BACKGROUND: Measles virus (MV) infection is marked with a skin rash in the acute phase of the disease, which pathogenesis remains poorly understood. Moreover, the association between measles and progression of skin diseases, such as atopic dermatitis (AD), is still elusive. OBJECTIVE: We have thus analysed the susceptibility of human keratinocytes to MV infection and explore the potential relationship between MV vaccination and the pathogenesis the AD. METHODS: We performed immunovirological characterisation of MV infection in human keratinocytes and then tested the effect of live attenuated measles vaccine on the progression of AD in adult patients, in a prospective, double-blind study. RESULTS: We showed that both human primary keratinocytes and the keratinocyte cell line HaCaT express MV receptors and could be infected by MV. The infection significantly modulated the expression of several keratinocyte-produced cytokines, known to be implicated in the pathogenesis of inflammatory allergic diseases, including AD. We then analysed the relationship between exposure to MV by vaccination and the progression of AD in 20 adults during six weeks. We found a significant decrease in CCL26 and thymic stromal lymphopoietin (TSLP) mRNA in biopsies from acute lesions of vaccinated patients, suggesting MV-induced modulation of skin cytokine expression. Clinical analysis revealed a transient improvement of SCORAD index in vaccinated compared to placebo-treated patients, two weeks after vaccination. CONCLUSIONS: Altogether, these results clearly demonstrate that keratinocytes are susceptible to MV infection, which could consequently modulate their cytokine production, resulting with a beneficial effect in the progression of AD. This study provides thus a proof of concept for the vaccination therapy in AD and may open new avenues for the development of novel strategies in the treatment of this allergic disease.

Published
2017

4. Can we identify response markers to antihypertensive drugs? First results from the IDEAL Trial

Author

Giampiero Bricca, G Leftheriotis, J.-M. Boivin, Yves Zerbib, Theodora Bejan-Angoulvant, François Gueyffier, A. Mercier, Céline Giraud, Sylvie Erpeldinger, Fabien Subtil, Jean-Philippe Baguet, J P Gagnol, Jean-Pierre Fauvel, and Delphine Maucort-Boulch

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Population, Angiotensin-Converting Enzyme Inhibitors, 030204 cardiovascular system & hematology, Pharmacology, Placebo, Age and sex, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Double-Blind Method, Internal medicine, Internal Medicine, Perindopril, Humans, Medicine, Arterial Pressure, 030212 general & internal medicine, Diuretics, education, Antihypertensive Agents, Aged, education.field_of_study, Cross-Over Studies, business.industry, Patient Selection, Indapamide, Age Factors, Mean age, Middle Aged, Crossover study, 3. Good health, Treatment Outcome, Blood pressure, Hypertension, Female, France, business, circulatory and respiratory physiology, medicine.drug
Abstract

Current antihypertensive strategies do not take into account that individual characteristics may influence the magnitude of blood pressure (BP) reduction. Guidelines promote trial-and-error approaches with many different drugs. We conducted the Identification of the Determinants of the Efficacy of Arterial blood pressure Lowering drugs (IDEAL) Trial to identify factors associated with BP responses to perindopril and indapamide. IDEAL was a cross-over, double-blind, placebo-controlled trial, involving four 4-week periods: indapamide, perindopril and two placebo. Eligible patients were untreated, hypertensive and aged 25-70 years. The main outcome was systolic BP (SBP) response to drugs. The 112 participants with good compliance had a mean age of 52. One in every three participants was a woman. In middle-aged women, the SBP reduction from drugs was -11.5 mm Hg (indapamide) and -8.3 mm Hg (perindopril). In men, the response was significantly smaller: -4.8 mm Hg (indapamide) and -4.3 (perindopril) (P for sex differences 0.001 and 0.015, respectively). SBP response to perindopril decreased by 2 mm Hg every 10 years of age in both sexes (P=0.01). The response to indapamide increased by 3 mm Hg every 10 years of age gradient in women (P=0.02). Age and sex were important determinants of BP response for antihypertensive drugs in the IDEAL population. This should be taken into account when choosing drugs a priori.

Published
2014

5. Référentiel ECRIN pour la conformité aux bonnes pratiques de gestion des données des essais cliniques multinationaux

Author

Carine Coffre, Boulkedid Rym, Christine Binquet, Amélie Le Gouge, Alain Leizorovicz, Céline Giraud, Catherine Cornu, Isabelle Vaugier, Alexandra Félin, Thibault Mura, Nadine Juge, Frédéric Barbot, Hugues Chevassus, François Gueyffier, Anne Donche, CIC 1407, Hospices Civils de Lyon (HCL), Hôpital Louis Pradel [CHU - HCL], Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Robert Debré, 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], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'Investigation Clinique 1426 (CIC 1426), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Centre d’Investigation Clinique 1429 [Garches] (CIC 1429), Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CIC Tours, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris]-Université Paris Diderot - Paris 7 (UPD7), CIC1429 Garches, Institut National de la Santé et de la Recherche Médicale (INSERM)- AP-HP Hôpital Raymond Poincaré [Garches], CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Eloi, Neuropsychiatrie : recherche épidémiologique et clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon ( HCL ), Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), Hôpital Bretonneau-Université de Tours-CHRU Tours-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables ( Inserm U1123 - ECEVE ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AP-HP Hôpital universitaire Robert-Debré [Paris], Centre d'Investigation Clinique 1426 ( CIC 1426 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AP-HP Hôpital universitaire Robert-Debré [Paris], Institut National de la Santé et de la Recherche Médicale ( INSERM ) - AP-HP Hôpital Raymond Poincaré [Garches], Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] ( Pôle S2R ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques ( CIC-EC ), Université de Bourgogne ( UB ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -CHU Saint-Eloi-Institut National de la Santé et de la Recherche Médicale ( INSERM )

Subjects
Gestion de données, 020205 medical informatics, Études cliniques institutionnelles, [ SDV.SP.PHARMA ] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, 02 engineering and technology, Quality reference, Référentiel qualité, Information technology, Data management, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Academic studies, 0202 electrical engineering, electronic engineering, information engineering, Systèmes d’information, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Pharmacology (medical), 030212 general & internal medicine
Abstract

Resume Contexte Les etudes cliniques generent une quantite croissante de donnees, mais il n’y a pas de standard de qualite suffisamment pratique, realiste et en acces libre pour leur traitement par les structures academiques. European Clinical Research Infrastructures Network (ECRIN) a publie un referentiel pour la certification de centres de gestion de donnees. Nous publions une version francaise du referentiel. Methodes Un groupe d’experts a produit ce referentiel par consensus, revise apres son utilisation lors d’audits pilotes pour la certification ECRIN. Resultats Le referentiel comporte 21 listes de 5 a 10 exigences, divisees en trois groupes : technologies de l’information, gestion de donnees (data management [DM]) et « generalites ». Conclusions Ce referentiel offre une description claire des bonnes pratiques en informatique et en DM. Initialement cree pour servir de referentiel de certification des centres de gestion de donnees ECRIN, il peut etre utile a de nombreuses structures academiques developpant ce type d’activites.

Published
2016

6. Pre-PCI angiographic TIMI flow in the culprit coronary artery influences infarct size and microvascular obstruction in STEMI patients

Author

Meyer Elbaz, Patrice Guerin, Nathan Mewton, Bernard Jouve, Céline Giraud, Michel Ovize, Olivier Morel, Nicolas Delarche, Thien Tri Cung, Fabrice Prunier, Guillaume Cayla, Pierre Croisille, Gérald Vanzetto, Pierre Coste, Mathieu Schaaf, Ingrid Sanchez, François Roubille, Olivier Roth, Didier Revel, Christophe Piot, Denis Angoulvant, Eric Bonnefoy-Cudraz, Gilles Rioufol, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), RMN et optique : De la mesure au biomarqueur, Hospices Civils de Lyon (HCL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), 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, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Embolism, Myocardial Infarction, 030204 cardiovascular system & hematology, Coronary Angiography, Culprit, 03 medical and health sciences, Coronary circulation, Percutaneous Coronary Intervention, 0302 clinical medicine, Coronary Circulation, Internal medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, ComputingMilieux_MISCELLANEOUS, Aged, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Middle Aged, medicine.disease, Coronary Vessels, medicine.anatomical_structure, surgical procedures, operative, Coronary occlusion, Microvessels, Preoperative Period, Conventional PCI, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, human activities, TIMI, Artery
Abstract

International audience; OBJECTIVE: The influence of initial-thrombolysis in myocardial infarction (i-TIMI) coronary flow in the culprit coronary artery on myocardial infarct and microvascular obstruction (MVO) size is unclear. We assessed the impact on infarct size of i-TIMI flow in the culprit coronary artery, as well as on MVO incidence and size, by contrast-enhanced cardiac magnetic resonance (ce-CMR). METHODS: In a prospective, multicenter study, pre-percutaneous coronary intervention (PCI) coronary occlusion was defined by an i-TIMI flow \textless/=1, and patency was defined by an i-TIMI flow \textgreater/=2. Infarct size, as well as MVO presence and size, were measured on ce-CMR 72h after admission. RESULTS: A total of 140 patients presenting with ST-elevated myocardial infarction referred for primary PCI were included. There was no significant difference in final post-PCI TIMI flow between the groups (2.95+/-0.02 vs. 2.97+/-0.02, respectively; p=0.44). In the i-TIMI flow \textless/=1 group, infarct size was significantly larger (32+/-17g vs. 21+/-17g, respectively; p=0.002), MVO was significantly more frequent (74% vs. 53%, respectively; p=0.012), and MVO size was significantly larger [1.3 IQR (0; 7.1) vs. 0 IQR (0; 1.6)], compared to in the i-TIMI \textgreater/=2 patient group. CONCLUSION: Initial angiographic TIMI flow in the culprit coronary artery prior to any PCI predicted final infarct size and MVO size: the better was the i-TIMI flow, the smaller were the infarct and MVO size.

Published
2016

7. Influence of cardiovascular risk factors on infarct size and interaction with mechanical ischaemic postconditioning in ST-elevation myocardial infarction

Author

Céline Giraud, Michel Ovize, François Roubille, Denis Angoulvant, Nathan Mewton, Olivier Lairez, Theodora Bejan-Angoulvant, Gilles Rioufol, Inesse Boussaha, Christophe Piot, Sophie Pichot, Meyer Elbaz, 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), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Génomique Fonctionnelle (IGF), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Arbitrary unit, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Coronary Artery Disease, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, Medicine, 030212 general & internal medicine, Myocardial infarction, 10. No inequality, ComputingMilieux_MISCELLANEOUS, business.industry, Percutaneous coronary intervention, medicine.disease, Infarct size, Obesity, 3. Good health, Surgery, Cardiology, Population study, Cardiology and Cardiovascular Medicine, business, Dyslipidemia
Abstract

International audience; OBJECTIVE: Previous studies have shown that mechanical postconditioning (PostC) significantly reduces infarct size (IS) in patients with acute myocardial infarction. Our objective was to assess the influence of traditional cardiovascular (CV) risk factors on IS and their interaction with ischaemic PostC in patients with acute ST-elevation myocardial infarction (STEMI). METHODS: The study population was constituted from the clinical database pooling of four previously published PostC prospective, multicentre, randomised, open-label controlled trials with identical inclusion criteria. Patients with STEMI, presenting within 12 h of symptoms onset referred for percutaneous coronary intervention, were included. Mechanical ischaemic PostC was performed by four repeated cycles of inflation-deflation of the angioplasty balloon within 1 min of reflow, while the control group underwent no intervention. IS was assessed by measuring total creatine kinase release over 72 h. RESULTS: 173 patients, aged 58+/-12 years, 76% males, 48% anterior infarct were included (82 in the PostC group, 91 in the control group). IS was significantly reduced in the PostC compared to the control group (71.7+/-41.6 vs 88.2+/-54.5x10(3) arbitrary units; p=0.027). After adjustment for abnormally contracting segments, older patients had smaller IS and smokers had larger IS. Gender, diabetes, hypertension, dyslipidemia and obesity did not have any significant effect on IS. Multivariate regression analysis showed that none of the traditional risk factors had a significant impact on the cardioprotective effect of mechanical ischaemic PostC. CONCLUSIONS: The present analysis suggests that the cardioprotective effect of mechanical PostC is not influenced by traditional CV risk factors that are prevalent in patients with STEMI.

Published
2015

8. The IDEAL Study : Towards Personalized Drug Treatment of Hypertension

Author

Theodora Bejan-Angoulvant, Jean-Philippe Baguet, Sylvie Erpeldinger, Jean-Marc Boivin, Alain Mercier, Georges Leftheriotis, Jean-Pierre Gagnol, Jean-Pierre Fauvel, Céline Giraud, Giampiero Bricca, François Gueyffier, Yishi Li, Calin Pop, Salam Farhat, Alain Richet, Yves Zerbib, Marie-France Le Goaziou, Rojee Neguib, Marie Flori, Pierre Lantelme, Denis Angoulvant, Pierrette Darchy, Stéphane Laurent, Faiez Zannad, Patrick Rossignol, Anne-Françoise Cailleux, Christian Libersa, Atul Pathak, Jean-Michel Halimi, Jacques Amar, Xavier Jeunemaitre, Michel Azizi, Florent Boutitie, Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), and Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Genetic Markers, Male, Quality Control, Drug, medicine.medical_specialty, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Angiotensin-Converting Enzyme Inhibitors, 030204 cardiovascular system & hematology, Pharmacology, Placebo, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Internal medicine, Regression toward the mean, medicine, Humans, Arterial Pressure, Pharmacology (medical), 030212 general & internal medicine, Precision Medicine, Family history, Diuretics, Antihypertensive Agents, media_common, Cross-Over Studies, biology, business.industry, Angiotensin-converting enzyme, Middle Aged, medicine.disease, 3. Good health, Treatment Outcome, Blood pressure, Data Interpretation, Statistical, Pathophysiology of hypertension, Hypertension, biology.protein, Female, business, Pharmacogenetics
Abstract

Objective To identify markers (phenotypic, genetic, or environmental) of blood pressure (BP) response profiles to angiotensin converting enzyme inhibitors (ACEIs) and diuretics. Methods IDEAL was a crossover (two active and two wash out phases), double-blind, placebo-controlled trial. Eligible patients were untreated hypertensive, aged 25 to 70. After two visits, patients were randomized to one of four sequences. The main outcome was BP differences between the active treatment and placebo. Results One hundred and twenty-four patients were randomised: mean age 53, men 65%, family history of hypertension 60%. Average BP fall at each visit before randomisation was about 2% of the initial level reflecting both a regression to the mean and a placebo effect. Conclusion The results are expected to improve knowledge in drug’s mechanisms of action and pathophysiology of hypertension, and to help in personalizing treatment. The estimation of BP responses to each drug in standardized conditions provided a benefit to each participant.

Published
2012

9. Thyroglobulin measurement in fine-needle aspirates of lymph nodes in patients with differentiated thyroid cancer: a simple definition of the threshold value, with emphasis on potential pitfalls of the method

Author

Françoise Borson-Chazot, Véronique Lapras, Karim Chikh, Christian Paulin, Catherine Cornu, Cécile Nozières, Marie-Laure Denier, Myriam Decaussin-Petrucci, Anne Charrié, Jean-Louis Peix, Jean-Christophe Lifante, Claire Bournaud, Céline Giraud, Jacques Orgiazzi, Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), and Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Male, Pathology, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Clinical Biochemistry, Biopsy, Fine-Needle, 030209 endocrinology & metabolism, Sensitivity and Specificity, Thyroglobulin, Thyroid carcinoma, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, medicine, Biomarkers, Tumor, Humans, Thyroid Neoplasms, skin and connective tissue diseases, neoplasms, Lymph node, Thyroid cancer, False Negative Reactions, Thyroglobulin Measurement, medicine.diagnostic_test, Receiver operating characteristic, business.industry, Biochemistry (medical), Thyroidectomy, General Medicine, Middle Aged, medicine.disease, 3. Good health, body regions, surgical procedures, operative, Fine-needle aspiration, medicine.anatomical_structure, ROC Curve, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Female, Lymph Nodes, business, Nuclear medicine
Abstract

Background: Thyroglobulin measurements in fine-needle aspirate (FNA-Tg) is an accurate method for the diagnosis of lymph node metastasis in differentiated thyroid carcinoma. The goal of this study is to determine the most appropriate diagnostic threshold value for FNA-Tg. Methods: Ultrasound-guided fine-needle aspiration-cytology (FNA-C) and FNA-Tg were performed on suspicious lymph nodes in 114 consecutive patients with thyroid cancer prior to thyroidectomy (n=13) or during follow-up (n=93), and in 16 control subjects. Functional sensitivity of the thyroglobulin assay was 0.7 ng/mL. Sensitivity and specificity of FNA-Tg and FNA-C were determined for different cut-off values within a range of 0.69–1.34 nanogram/punction (ng/p) using receiver operating characteristic curve analysis. Results: The FNA-Tg cut-off value of 0.93 ng/p offers the best diagnostic performances: 94.2% sensitivity, 97.8% specificity. FNA-C showed 100% specificity in diagnostic samples, but low sensitivity of 71% due primarily to inadequate samples. Combining FNA-C and FNA-Tg resulted in 98% sensitivity and 100% specificity. Conclusions: A unique threshold of 0.93 ng/p gives high sensitivity and specificity, even in non-thyroidectomized patients. However, since false negative results may be observed in poorly differentiated thyroid cancer, FNA-C should remain combined to FNA-Tg. Clin Chem Lab Med 2010;48:1171–7.

Published
2010

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