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

1. 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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2. Effects of Interval Aerobic Training Program with Recovery bouts on cardiorespiratory and endurance fitness in seniors

Author

Elise Schmitt, Evelyne Lonsdorfer, Romain Remetter, Pierre Olivier Lang, Walid Bouaziz, Bernard Geny, Georges Kaltenbach, François Lefebvre, Pierre-Marie Leprêtre, Thomas Vogel, Dupuis, Christine, 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 ), Département des Explorations Fonctionnelles [CHU 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), Health and Wellbeing Academy [Cambridge, UK], Anglia Ruskin University (ARU), Montchoisi Clinic [Lausanne, Switzerland], This study was funded by the Department of Clinical Research and Innovation of the University Hospitals of Strasbourg., and CHU Amiens-Picardie-Université de Picardie Jules Verne (UPJV)

Subjects
Male, medicine.medical_specialty, Walk Test, Physical Therapy, Sports Therapy and Rehabilitation, endurance performance, seniors, 03 medical and health sciences, Oxygen Consumption, sedentary, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Heart Rate, Heart rate, medicine, Humans, Aerobic exercise, Orthopedics and Sports Medicine, Prospective Studies, 030212 general & internal medicine, Adverse effect, Exercise, interval training, older adults, Aged, Sedentary lifestyle, Aged, 80 and over, cardiorespiratory fitness, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, business.industry, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Cardiorespiratory fitness, 030229 sport sciences, Interim analysis, Oxygen uptake, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, aerobic capacity, Physical Endurance, Physical therapy, Female, Sedentary Behavior, Ventilatory threshold, business, human activities
Abstract

International audience; Interval aerobic training programs (IATP) improve cardiorespiratory and endurance parameters. They are, however, unsuitable to seniors as frequently associated with occurrence of exhaustion and muscle pain. The purpose of this study was to measure the benefits of an IATP designed with recovery bouts (IATP-R) in terms of cardiorespiratory and endurance parameters and its acceptability among seniors (≥70 years). Sedentary healthy volunteers were randomly assigned either to IATP-R or sedentary lifestyle. All participants performed an incremental cycle exercise and 6-minute walk test (6-MWT) at baseline and 9.5 weeks later. The first ventilatory threshold (VT1 ); maximal tolerated power (MTP); peak of oxygen uptake (VO2peak ); maximal heart rate (HRmax ); and distance walked at 6-MWT were thus measured. IATP-R consisted of 19 sessions of 30-minute (6 × 4-min at VT1 + 1-minute at 40% of VT1 ) cycling exercise over 9.5 weeks. With an adherence rate of 94.7% without any significant adverse events, 9.5 weeks of IATP-R, compared to controls, enhanced endurance (VT1 : +18.3 vs -4.6%; HR at baseline VT1 : -5.9 vs +0.2%) and cardiorespiratory parameters (VO2peak : +14.1 vs -2.7%; HRmax : +1.6 vs -1.7%; MTP: +19.2 vs -2.3%). The walk distance at the 6-MWT was also significantly lengthened (+11.6 vs. -3.1%). While these findings resulted from an interim analysis planned when 30 volunteers were enrolled in both groups, IATP-R appeared as effective, safe, and applicable among sedentary healthy seniors. These characteristics are decisive for exercise training prescription and adherence.

Published
2018
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3. Severe leptospirosis in Morocco: comparative data from the Amazonian area

Author

Loïc Epelboin, Emilie Mosnier, Magalie Demar, Roxane Schaub, Félix Djossou, Mathieu Nacher, Stéphanie Houcke, Anne Jolivet, Erwann Fontaine, Paul Le Turnier, Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université de Guyane (UG), Département de l'Information Médicale, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service de médecine interne et maladies tropicales, and CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André

Subjects
medicine.medical_specialty, business.industry, [SDV]Life Sciences [q-bio], Amazonian, Pain medicine, 030231 tropical medicine, Critical Care and Intensive Care Medicine, medicine.disease, Leptospirosis, Morocco, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Environmental protection, Anesthesiology, Emergency medicine, medicine, Humans, 030212 general & internal medicine, business, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience

Published
2017
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4. 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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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. 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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10. 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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11. 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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12. 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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13. 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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14. 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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15. 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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16. Cost of lung cancer: a methodological review

Author

Alain Vergnenegre, Bruno Housset, Laurent Molinier, Alain Grand, Jean-Pierre Daurès, Christophe Combescure, Cristos Chouaïd, Didier Fabre, 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), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Pneumologie et de Pathologie Professionnelle, CHI Créteil, Service de Pathologie respiratoire et allergologie [CHU Limoges], CHU Limoges, L Molinier, C Combescure, C Chouaïd, JP Daurès, B Housset, Fabre D, Grand A, and A SCHILLER

Subjects
medicine.medical_specialty, Lung Neoplasms, Total cost, MESH: Health Care Costs, Disease, macromolecular substances, Health administration, 03 medical and health sciences, Indirect costs, 0302 clinical medicine, Resource (project management), Cost of Illness, Carcinoma, Non-Small-Cell Lung, Credibility, parasitic diseases, Humans, Medicine, Carcinoma, Small Cell, health care economics and organizations, Pharmacology, Actuarial science, Health economics, MESH: Humans, business.industry, 030503 health policy & services, Health Policy, fungi, Public Health, Environmental and Occupational Health, MESH: Carcinoma, Small Cell, Health Care Costs, MESH: Cost of Illness, 3. Good health, Surgery, MESH: Lung Neoplasms, 030220 oncology & carcinogenesis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, Strengths and weaknesses, MESH: Carcinoma, Non-Small-Cell Lung
Abstract

International audience; Cost of illness (COI) studies estimate the overall economic burden of a specific disease, rather than simply treatment-related costs. While having been criticised for not allowing resource prioritisation, COI studies can provide useful guidance, so long as they adhere to accepted methodology. The aim of this review is to analyse the methods used to evaluate the cost of lung cancer. Because of the increasing incidence and high direct and indirect costs of lung cancer, it is an important disease in terms of economic implications, and therefore provides a relevant example with which to review COI study methodologies. First, the key points of the methodology relating to COI studies were identified. COI studies relating to lung cancer were then reviewed, focussing on an analysis of the different methods used and an identification of the strengths and weaknesses of each approach. The COI studies that were analysed confirmed that lung cancer is a costly illness, and that hospitalisation and treatments account for a large part of direct costs, while indirect costs represent a large part of the total costs. The review also showed that COI studies adopted significantly different approaches to estimate the costs of lung cancer, reflecting a lack of consensus on the methodology of COI studies in this area. Hence, to increase the credibility of COI studies, closer agreement among researchers on methodological principles would be desirable.

Published
2006
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17. 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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