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1. Risk of Severe Bacterial Infection in People Living Human Immunodeficiency Virus Infection in the Combined Antiretroviral Therapy Era

Author

Murielle Mary-Krause, Sébastien Gallien, Martin Siguier, Dominique Costagliola, Hugues Melliez, Patricia Enel, Patrizia Carrieri, Juliette Pavie, Xavier Duval, Pierre Tattevin, Marguerite Guiguet, Claudine Duvivier, Anaenza Freire-Maresca, Sophie Abgrall, Dupuis, Christine, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Département des Maladies Infectieuses [CH Tourcoing] (Hôpital Gustave Dron), Centre Hospitalier Gustave Dron [Tourcoing]-Centre Hospitalier de Tourcoing, Hôpital de la Région de Saint-Omer [Helfaut], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Service de médecine interne, immunologie clinique [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de santé publique et information médicale [Hôpital de la Conception - APHM], Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Service d'Immunologie Clinique et Maladies Infectieuses [AP-HP Hôpital H. Mondor-A. Chenevier, Paris], Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-AP-HP Hôpital A. Chenevier [Créteil], Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Médical de l'Institut Pasteur (CMIP), Institut Pasteur [Paris] (IP), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Service d'Immunologie Clinique [Hôpital Européen Georges Pompidou - APHP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de maladies infectieuses et tropicales [Saint-Louis], 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)-Université Paris Cité (UPCité), Service de médecine interne [CHU Ambroise Paré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], France Recherche Nord&Sud Sida-hiv Hépatites, Institut National de la Santé et de la Recherche Médicale, French Ministry of Health, Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Antoine Béclère [Clamart], Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Hôpital Henri Mondor-AP-HP Hôpital A. Chenevier [Créteil], Institut Pasteur [Paris], Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Université de Paris (UP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Centre Médical de l'Institut Pasteur, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Pasteur [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Service des maladies infectieuses et réanimation médicale [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou

Subjects
Male, 0301 basic medicine, Databases, Factual, Neutrophils, [SDV]Life Sciences [q-bio], HIV Infections, Comorbidity, Leukocyte Count, Liver disease, 0302 clinical medicine, Risk Factors, Immunology and Allergy, Prospective Studies, 030212 general & internal medicine, diabetes, Incidence, Incidence (epidemiology), Hazard ratio, Bacterial Infections, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Alcoholism, Infectious Diseases, Anti-Retroviral Agents, Drug Therapy, Combination, Female, France, liver disease, Adult, medicine.medical_specialty, Neutropenia, Malignancy, Risk Assessment, AIDS-defining malignancy, End Stage Liver Disease, 03 medical and health sciences, Internal medicine, Diabetes mellitus, Diabetes Mellitus, medicine, Humans, Renal Insufficiency, Chronic, Aged, business.industry, HIV, medicine.disease, Confidence interval, 030104 developmental biology, HIV-1, business, chronic kidney disease, Kidney disease
Abstract

BackgroundSevere bacterial infections are the first cause of morbidity in people with human immunodeficiency virus (PWH). We aimed to assess their incidence and to analyze their determinants.MethodsWe studied human immunodeficiency virus (HIV)-1-infected individuals aged at least 15 years and prospectively followed between 2006 and 2015 in the French Hospital Database on HIV. The Andersen and Gill model was used to calculate the adjusted hazard ratios (HRs), focusing on heavy alcohol use and neutrophil function-altering comorbidities.ResultsOf 25 795 participants, 1414 developed 1883 severe bacterial infections. Between 2006 and 2009 and 2013 and 2015, the incidence fell from 13.2 (95% confidence interval [CI], 12.3–14.1) to 7.1 (95% CI, 6.3–7.8) per 1000 person-years. Heavy alcohol use was associated with an increased risk of severe bacterial infection (HR = 1.3, 95% CI = 1.1–1.7 for 40–80 g/day and HR = 1.6, 95% CI = 1.2–2.1 for >80 g/day), as were diabetes, chronic kidney disease, and end-stage liver disease (HR = 1.2, 95% CI = 1.0–1.4 when 1 comorbidity; HR = 2.3, 95% CI = 1.6–3.4 when more than 1 comorbidity), and nonacquired immune deficiency syndrome-defining malignancy (HR = 2.0; 95% CI, 1.6–2.4).ConclusionsHeavy alcohol use was associated with an increased risk of severe bacterial infection, as were neutrophil function-altering comorbidities. Controlled-drinking approaches should be promoted and comorbidity management should be strengthened in PWH.

Published
2020
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2. Unilateral recurrent laryngeal nerve palsy post-thyroidectomy: Looking for hyperventilation syndrome

Author

Laurent Boyer, Françoise Zerah-Lancner, Jean-François Papon, André Coste, E. Bequignon, H. Dang, 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), Cytosquelette et développement (CD), Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), AP-HP Hôpital A. Chenevier [Créteil], Hôpital Henri Mondor, Centre Hospitalier Intercommunal de Créteil (CHIC), Biomécanique & Appareil Respiratoire (BAR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), and CCSD, Accord Elsevier

Subjects
Adult, Male, Hyperventilation syndrome, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Unilateral vocal fold paralysis, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Swallowing, Hyperventilation, medicine, Recurrent laryngeal nerve, Humans, Prospective Studies, 030223 otorhinolaryngology, Aged, Palsy, Lung, Hypocapnia, Recurrent Laryngeal Nerve palsy, business.industry, Thyroidectomy, Syndrome, Middle Aged, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Dyspnea, medicine.anatomical_structure, Otorhinolaryngology, 030220 oncology & carcinogenesis, Anesthesia, Arterial blood, Female, Surgery, Blood Gas Analysis, medicine.symptom, business, Vocal Cord Paralysis, Alkalosis, Respiratory
Abstract

International audience; Aims: Unilateral Recurrent Laryngeal Nerve (RLN) palsy is responsible for dysphonia and difficulties in swallowing. The role of unilateral RLN palsy on dyspnea is not fully elucidated. Our hypothesis is that air leak could be responsible for development of hyperventilation syndrome (HVS).Objective: The objective of this study was to determine in patients with unilateral RLN palsy if dyspnea could be associated with HVS.Material and methods: Over a 12-month period, all patients with permanent unilateral RLN palsy after thyroidectomy complaining from the onset of unexplained dyspnea were tested. Measurement of Nijmegen score, an hyperventilation test, an arterial blood gas, lung function and cardiac tests were performed. The diagnosis of HVS was defined if at least two criteria were present among: Nijmegen score>23; reproduction of at least 2 usual symptoms during hyperventilation test; an expirated pressure of CO2 (EpCO2)

Published
2019
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3. « Paralysie récurrentielle unilatérale après thyroïdectomie : savoir rechercher un syndrome d’hyperventilation »

Author

Laurent Boyer, F. Zerah-Lancner, André Coste, J.-F. Papon, H. Dang, E. Bequignon, 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), Cytosquelette et développement (CD), Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), AP-HP Hôpital A. Chenevier [Créteil], CHI Créteil, Hôpital Henri Mondor, Biomécanique & Appareil Respiratoire (BAR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), and CCSD, Accord Elsevier

Subjects
03 medical and health sciences, [SPI]Engineering Sciences [physics], 0302 clinical medicine, 030228 respiratory system, Otorhinolaryngology, [SPI] Engineering Sciences [physics], Surgery, 030223 otorhinolaryngology, 3. Good health
Abstract

International audience; La paralysie unilatérale du nerf récurrent peut être responsable d’une dysphonie et de troubles de la déglutition. La physiopathologie de l’apparition d’une dyspnée induite par une paralysie récurrentielle unilatérale n’est pas complètement élucidée. Notre hypothèse est que la fuite d’air au niveau glottique pourrait être responsable du développement d’un syndrome d’hyperventilation (SHV).ObjectifL’objectif de cette étude était de déterminer, chez les patients atteints de paralysie récurrentielle unilatérale, si la dyspnée pouvait être associée au SHV.Matériel et méthodesSur une période de 12 mois, tous les patients atteints de paralysie récurrentielle unilatérale permanente (> 6 mois) après thyroïdectomie se plaignant de l’apparition d’une dyspnée inexpliquée ont été explorés. Les tests suivants ont été réalisés : score de Nijmegen, test d’hyperventilation provoquée, gazométrie artérielle, épreuves fonctionnelles respiratoires et tests cardiaques. Le diagnostic de SHV a été posé si au moins deux critères étaient présents parmi les suivants : score de Nijmegen > 23 ; reproduction d’au moins 2 symptômes habituels lors du test d’hyperventilation ; pression télé-expiratoire en CO2 (PetCO2) < 30 mmHg ou < 90 % de la PetCO2 initiale après une période de récupération de 5 min à la suite d’une hyperventilation volontaire de 3 min.RésultatsDix patients sur 366 opérés d’une thyroïdectomie pour une maladie bénigne présentaient une paralysie récurrentielle unilatérale permanente et une dyspnée. Parmi les 10 patients inclus, chez 8 le diagnostic de SHV a été retenu lors du test d’hyperventilation provoquée sans dysfonctionnement cardiaque/pulmonaire.ConclusionEn résumé, cette étude est en faveur de l’implication du SHV dans la dyspnée associée à la paralysie récurrentielle unilatérale.

Published
2019
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4. Seminal Plasma Exposures Strengthen Vaccine Responses in the Female Reproductive Tract Mucosae

Author

Romain, Marlin, Marie-Thérèse, Nugeyre, Nicolas, Tchitchek, Matteo, Parenti, Cécile, Lefebvre, Hakim, Hocini, Fahd, Benjelloun, Claude, Cannou, Silvia, Nozza, Nathalie, Dereuddre-Bosquet, Yves, Levy, Françoise, Barré-Sinoussi, Gabriella, Scarlatti, Roger, Le Grand, Elisabeth, Menu, Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Mucosal Immunity and Sexually Transmitted Infection Control (MISTIC), Institut Pasteur [Paris] (IP), Vaccine Research Institute [Créteil, France] (VRI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Infectious Diseases Models for Innovative Therapies (IDMIT), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, 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), Infectious Diseases Department [Milan, Italy], IRCCS San Raffaele Scientific Institute [Milan, Italie], Service d'Immunologie Clinique et Maladies Infectieuses [AP-HP Hôpital H. Mondor-A. Chenevier, Paris], Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-AP-HP Hôpital A. Chenevier [Créteil], Division International, Viral Evolution and Transmission Unit [Milan, Italy], San Raffaele Scientific Institute, Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), NT held a fellowship from the ANRS (France Recherche Nord & Sud Sida-HIV Hépatites). FB held fellowships from the ANRS, Sidaction and Institut Carnot-Pasteur, Microbes & Santé. This work was supported by the Programme Investissement d’Avenir (PIA) managed by the ANR under reference ANR-11-INBS0008, funding the Infectious Disease Models and Innovative Therapies (IDMIT, Fontenay-aux-Roses, France) infrastructure, the ANR-10-EQPX-02-01, funding the FlowCyTech facility (IDMIT, Fontenay-aux-Roses, France) and the ANR-10-LABX77-01 funding the Vaccine Research Institute (VRI)., We thank Drs. Anne-Sophie Beignon, Mireille Centlivre, and the Bmuc division members for scientific discussions. Alex Edelman & Associates for critical editing of the manuscript. Transgene for providing the wild type MVA strain and ANRS/INSERM and the Vaccine Research Institute the MVA-HIV-B vaccine. Andrea Galli for preparation of SP pool. Rahima Yousfi for technical assistance. Dr. Véronique Avettand-Fenoel for HIV-1 viral load quantification. Dr. Bernard Verrier for providing the p24 HIV-1 antigen and all members of the IDMIT infrastructure for their excellent expertise and outstanding contribution, ANR-11-INBS-0008,IDMIT,Infrastructure nationale pour la modélisation des maladies infectieuses humaines(2011), ANR-10-EQPX-0002,FlowCyTech,Plateforme de phénotypage en Mass cytométrie pour l'analyse multiparamétrique de biomarqueurs complexes de l'efficacité de nouvelles stratégies thérapeutiques ou vaccinales(2010), ANR-10-LABX-0077,VRI,Initiative for the creation of a Vaccine Research Institute(2010), Institut Pasteur [Paris], Vaccine Research Institute (VRI), Centre d'Immunologie et de Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre d'Immunologie et des Maladies Infectieuses (CIMI), MENU, Elisabeth, Infrastructures - Infrastructure nationale pour la modélisation des maladies infectieuses humaines - - IDMIT2011 - ANR-11-INBS-0008 - INBS - VALID, Equipements d'excellence - Plateforme de phénotypage en Mass cytométrie pour l'analyse multiparamétrique de biomarqueurs complexes de l'efficacité de nouvelles stratégies thérapeutiques ou vaccinales - - FlowCyTech2010 - ANR-10-EQPX-0002 - EQPX - VALID, and Laboratoires d'excellence - Initiative for the creation of a Vaccine Research Institute - - VRI2010 - ANR-10-LABX-0077 - LABX - VALID

Subjects
Adult, Male, [SDV.IMM] Life Sciences [q-bio]/Immunology, Immunology, HIV Infections, Vaccinia virus, Cervix Uteri, female reproductive tract (FRT), Antibodies, Viral, [SDV.IMM.II]Life Sciences [q-bio]/Immunology/Innate immunity, [SDV.IMM.VAC] Life Sciences [q-bio]/Immunology/Vaccinology, Semen, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, vaccine, Animals, Humans, [SDV.IMM.II] Life Sciences [q-bio]/Immunology/Innate immunity, mucosa, Original Research, Mucous Membrane, Uterus, Viral Vaccines, Middle Aged, Macaca fascicularis, [SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology, Immunoglobulin G, [SDV.IMM.IA] Life Sciences [q-bio]/Immunology/Adaptive immunology, Vagina, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, seminal plasma, HIV-1, Cytokines, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology
Abstract

International audience; HIV-1 sexual transmission occurs mainly via mucosal semen exposures. In the female reproductive tract (FRT), seminal plasma (SP) induces physiological modifications, including inflammation. An effective HIV-1 vaccine should elicit mucosal immunity, however, modifications of vaccine responses by the local environment remain to be characterized. Using a modified vaccinia virus Ankara (MVA) as a vaccine model, we characterized the impact of HIV-1 + SP intravaginal exposure on the local immune responses of non-human primates. Multiple HIV-1 + SP exposures did not impact the anti-MVA antibody responses. However, SP exposures revealed an anti-MVA responses mediated by CD4 + T cells, which was not observed in the control group. Furthermore, the frequency and the quality of specific anti-MVA CD8 + T cell responses increased in the FRT exposed to SP. Multi-parameter approaches clearly identified the cervix as the most impacted compartment in the FRT. SP exposures induced a local cell recruitment of antigen presenting cells, especially CD11c + cells, and CD8 + T cell recruitment in the FRT draining lymph nodes. CD11c + cell recruitment was associated with upregulation of inflammation-related gene expression after SP exposures in the cervix. We thus highlight the fact that physiological conditions, such as SP exposures, should be taken into consideration to test and to improve vaccine efficacy against HIV-1 and other sexually transmitted infections.

Published
2019
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5. The Fami-life study: protocol of a prospective observational multicenter mixed study of psychological consequences of grieving relatives in French palliative care units on behalf of the family research in palliative care (F.R.I.P.C research network)

Author

Véronique Michonneau-Gandon, Laure Copel, Virginie Verliac, Dominique Gracia, Gaelle Ranchou, Willeme Kaczmarek, Emmanuel De Larivière, Maité Garrouste-Orgeas, Adrien Evin, Virginie Guastella, Catherine Verlaine, Frédéric Guirimand, Jean-François Timsit, Alaa Mhalla, Florent Bienfait, Licia Touzet, Guillaume Bouquet, Marie Sonrier, Laurence Birkui de Francqueville, Ségolène Perruchio, Cécile Flahault, Anne Vanbésien, Sébastien Bailly, Carmen Mathias, Virginie Fossez-Diaz, Edith Poulain, Stéphane Ruckly, Véronique Marché, Cécile Poupardin, Dominique Michel, Bruno Richard, Salvy-Córdoba, Nathalie, Epidémiologie pronostique des cancers et affections graves, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Psychopathologie et Processus de Santé (LPPS - EA 4057), Université Paris Descartes - Paris 5 (UPD5), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de recherche Versailles Saint-Quentin Institutions Publiques (VIP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CH de Troyes, Centre Hospitalier [Douai, Nord], Centre Hospitalier de la Dracénie [Draguignan], Centre Hospitalier Compiègne-Noyon, Centre Hospitalier Tourcoing, Groupe Hospitalier Diaconesses Croix Saint-Simon, Groupe hospitalier de la région de Mulhouse Sud-Alsace (GHRMSA), Hopital de Salon d eProvence, AP-HP Hôpital A. Chenevier [Créteil], Centre Hospitalier Intercommunal Castres-Mazamet, Service d'Hépato-Gastroentérologie, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hopital de Périgueux (CH Périgueux), Hopital de Périgueux, Centre de Soins Palliatifs [CHU Clermont-Ferrand] (CSP), CHU Louise Michel [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Informatique et Distribution (ID-IMAG), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-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), INSERM U823, équipe 11 (Epidémiologie des cancers et des affections graves), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-Hôpital Michallon, CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)

Subjects
medicine.medical_specialty, Palliative care, media_common.quotation_subject, lcsh:Special situations and conditions, [SDV.NEU.PC] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, [SDV.CAN]Life Sciences [q-bio]/Cancer, Anxiety, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Clinical Protocols, [SDV.CAN] Life Sciences [q-bio]/Cancer, Surveys and Questionnaires, Humans, Medicine, Family, Prospective Studies, 030212 general & internal medicine, Psychiatry, Depression (differential diagnoses), media_common, Interpretative phenomenological analysis, [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, business.industry, Minimal clinically important difference, Incidence (epidemiology), lcsh:RC952-1245, Post-traumatic, General Medicine, Stress disorders, Relatives, 3. Good health, 030220 oncology & carcinogenesis, Grief, Observational study, France, medicine.symptom, business
Abstract

Background Grieving relatives can suffer from numerous consequences like anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, and prolonged grief. This study aims to assess the psychological consequences of grieving relatives after patients’ death in French palliative care units and their needs for support. Methods This is a prospective observational multicenter mixed study. Relatives of adult patients with a neoplasia expected to be hospitalized more than 72 h in a palliative care unit for end-of-life issues will be included within 48 h after patient admission. End-of-life issues are defined by the physician at patient admission. Relatives who are not able to have a phone call at 6-months are excluded. The primary outcome is the incidence of prolonged grief reaction defined by an ICG (Inventory Complicate Grief) > 25 (0 best-76 worst) at 6 months after patient’ death. Prespecified secondary outcomes are the risk factors of prolonged grief, anxiety and depression symptoms between day 3 and day 5 and at 6 months after patients’ death based on an Hospital Anxiety and Depression score (range 0–42) > 8 for each subscale (minimal clinically important difference: 2.5), post-traumatic stress disorder symptoms 6 months after patient’ death based on the Impact of Events Scale questionnaire (0 best-88 worst) score > 22, experience of relatives during palliative care based on the Fami-Life questionnaire, specifically built for the study. Between 6 and 12 months after the patient’s death, a phone interview with relatives with prolonged grief reactions will be planned by a psychologist to understand the complex system of grief. It will be analyzed with the Interpretative Phenomenological Analysis. We planned to enroll 500 patients and their close relatives assuming a 25% prolonged grief rate and a 6-month follow-up available in 60% of relatives. Discussion This study will be the first to report the psychological consequences of French relatives after a loss of a loved one in palliative care units. Evaluating relatives’ experiences can provide instrumental insights for means of improving support for relatives and evaluation of bereavement programs. Trial registration NCT03748225 registered on 11/19/2018. Recruiting patients.

Published
2019
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6. No Positive Association between Vitamin D Level and Immune Responses to Hepatitis B and Streptococcus pneumoniae Vaccination in HIV-Infected Adults

Author

Alex Assuied, Rodolphe Thiébaut, Yves Levy, Jean-Claude Souberbielle, Jean-Paul Viard, Fabrice Carrat, Laura Richert, Odile Launay, Geneviève Chêne, Centre de Diagnostic et de Thérapeutique, Hôpital de l’Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Vaccine Research Institute (VRI), CHU Necker - Enfants Malades [AP-HP], CHU Bordeaux [Bordeaux], Statistics In System biology and Translational Medicine (SISTM), Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)- Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CIC Cochin Pasteur (CIC 1417), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5)-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM), Vaccine Research Institute [Créteil, France] (VRI), HAL UPMC, Gestionnaire, Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes - Faculté de Médecine ( UPD5 Médecine ), Université Paris Descartes - Paris 5 ( UPD5 ), Institut de Santé Publique, d'Epidémiologie et de Développement ( ISPED ), INSERM U955, équipe 16, Vaccine Research Institute ( VRI ), Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Institut Mondor de Recherche Biomédicale ( IMRB ), Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10, Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service d'Immunologie Clinique et Maladies Infectieuses [AP-HP Hôpital H. Mondor-A. Chenevier, Paris], Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -AP-HP Hôpital Henri Mondor (Créteil)-AP-HP Hôpital A. Chenevier [Créteil], Statistics In System biology and Translational Medicine ( SISTM ), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique ( Inria ) -Institut National de Recherche en Informatique et en Automatique ( Inria ), 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 ), CHU Saint-Antoine [APHP], CIC Cochin Pasteur ( CIC 1417 ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP]-Hôtel-Dieu-Université Paris Descartes - Paris 5 ( UPD5 ) -Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale ( INSERM ), F-CRIN, I-REIVAC, and Institut National de la Santé et de la Recherche Médicale ( INSERM )

Subjects
0301 basic medicine, Male, Physiology, Gastroenterology and hepatology, Antibody Response, Organic chemistry, lcsh:Medicine, medicine.disease_cause, Biochemistry, Hepatitis, Pneumococcal Vaccines, 0302 clinical medicine, Immune Physiology, Medicine and Health Sciences, Medicine, Public and Occupational Health, 030212 general & internal medicine, Vitamin D, lcsh:Science, Immune Response, Vaccines, Multidisciplinary, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Immune System Proteins, biology, Vitamins, Hepatitis B, Middle Aged, Vaccination and Immunization, 3. Good health, Vaccination, Physical sciences, Titer, Chemistry, Infectious hepatitis, Streptococcus pneumoniae, Nutritional deficiencies, Infectious diseases, Female, Antibody, Research Article, Adult, medicine.medical_specialty, Immunology, Viral diseases, Antibodies, 03 medical and health sciences, Chemical compounds, Immune system, Internal medicine, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Organic compounds, Vitamin D and neurology, Humans, Hepatitis B Vaccines, Hepatitis B Antibodies, Liver diseases, Nutrition, Vitamin D deficiency, business.industry, lcsh:R, Biology and Life Sciences, Proteins, medicine.disease, Confidence interval, 030104 developmental biology, Immunoglobulin G, biology.protein, lcsh:Q, Preventive Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; ObjectiveTo assess whether higher 25-hydroxyvitamin D (25OHD) levels are associated with subsequent better immune responses to hepatitis B and Streptococcus pneumoniae vaccination in HIV-infected patients.Methods25OHD was measured on stored baseline plasma samples from two randomized vaccine trials in HIV-infected adults: the ANRS HB03 VIHVAC B trial and an immunological sub-study of the ANRS 114-PNEUMOVAC trial. In ANRS HB03 VIHVAC B, participants received three or four doses of recombinant HBV vaccine strategies. Anti-HBs IgG titers were measured four weeks after the last injection. Associations between baseline 25OHD levels and ordered IgG response categories were analyzed in multivariable proportional odds models. In the ANRS 114-PNEUMOVAC sub-study, two strategies of pneumococcal vaccination were tested, cellular immune responses were measured at repeated time points, and IgG responses four weeks after the last vaccine injection. Exploratory statistical analyses were performed on this sub-study data set.ResultsThree hundred and thirty-nine ANRS HB03 VIHVAC B and 25 ANRS 114-PNEUMOVAC sub-study participants were included in the analyses. Median age in each of the two studies was 43 years, 68% were male, and 77–92% on antiretroviral treatment. Median 25OHD level was 18 ng/mL (IQR: 12–25) and 24 ng/mL (IQR: 13–32) in the two trial populations, respectively. In the multivariable model, there was no significant association between baseline 25OHD level and vaccine responses in ANRS HB03 VIHVAC B (proportional odds ratio 0.83 per 10 ng/mL 25OHD increase; 95% confidence interval 0.65–1.07, p = 0.14). Exploratory analyses of ANRS 114-PNEUMOVAC showed consistent results.ConclusionThis study does not support a positive association between 25OHD and immune responses to hepatitis B or pneumococcal vaccination in HIV-infected patients.

Published
2016
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7. Rituximab for prevention of delayed hemolytic transfusion reaction in sickle cell disease

Author

Marc Michel, Dora Bachir, Frédéric Galactéros, F. Noizat-Pirenne, Philippe Chadebech, Jean-Claude Lecron, Anne Plonquet, Philippe Bierling, Etablissement Français du Sang [Île-de-France Mondor], Centre de référence des cytopénies auto-immunes [CHU Mondor] (CeReCAI), CHU Henri Mondor, Unité des Maladies Génétiques du Globule Rouge [CHU Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de médecine interne [Mondor], Service d'Immunologie Clinique et Maladies Infectieuses [AP-HP Hôpital H. Mondor-A. Chenevier, Paris], Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-AP-HP Hôpital A. Chenevier [Créteil], Laboratoire Cytokines et Inflammation, Université de Poitiers, and CHADEBECH, Philippe

Subjects
Adult, Erythrocytes, Exacerbation, Cell, Disease, [SDV.BC.BC]Life Sciences [q-bio]/Cellular Biology/Subcellular Processes [q-bio.SC], Anemia, Sickle Cell, 030204 cardiovascular system & hematology, [SDV.BC.IC] Life Sciences [q-bio]/Cellular Biology/Cell Behavior [q-bio.CB], Hemolysis, 03 medical and health sciences, Antibodies, Monoclonal, Murine-Derived, 0302 clinical medicine, Second line, Hemoglobin drop, hemic and lymphatic diseases, [SDV.BC.IC]Life Sciences [q-bio]/Cellular Biology/Cell Behavior [q-bio.CB], [SDV.BC.BC] Life Sciences [q-bio]/Cellular Biology/Subcellular Processes [q-bio.SC], Medicine, Humans, Immunologic Factors, Autoantibodies, B-Lymphocytes, business.industry, Antibodies, Monoclonal, Hematology, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, medicine.disease, 3. Good health, Delayed hemolytic transfusion reaction, medicine.anatomical_structure, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunology, Rituximab, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Anemia, Hemolytic, Autoimmune, [SDV.IMM.IMM] Life Sciences [q-bio]/Immunology/Immunotherapy, business, Complication, Erythrocyte Transfusion, 030215 immunology, medicine.drug
Abstract

International audience; Delayed hemolytic transfusion reaction (DHTR), a life-threatening transfusion complication in sickle cell disease (SCD), is characterized by a marked hemoglobin drop with destruction of both transfused and autologous red blood cells (RBCs) and exacerbation of SCD symptoms. One mechanism of RBCs destruction is auto-antibody production secondary to transfusion. As rituximab specifically targets circulating B cells, we thought that it could be beneficial in preventing this immune-mediated transfusion complication. We report the case of a SCD patient who previously experienced DHTR with auto-antibodies and who needed a new transfusion. DHTR recurrence was successfully prevented by rituximab administration prior transfusion, supporting the safe use of rituximab to prevent DHTR in SCD patients as a second line approach when other measures failed.

Published
2007
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