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1. Mapping of the myxomatous mitral valve: The three-dimensional extension of mitral annular disjunction in surgically repaired mitral prolapse

Author

Raoul Biondi, Sophie Ribeyrolles, Christelle Diakov, Nicolas Amabile, Gabriella Ricciardi, Nizar Khelil, Alain Berrebi, and Konstantinos Zannis

Subjects
3D transesophageal echocardiography, mitral annular disjunction, mitral regurgitation, mitral valve prolapse, mitral repair, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

ObjectivesThis study aimed to describe the heterogeneous extension of mitral annular disjunction (MAD) and assess the hypotesis that different phenotypes of disjunction are not associated with increased surgical challenges.BackgroundMitral regurgitation (MR) is the most common end-stage scenario of degenerative mitral valve disease (DMVD). Few data exist on the three-dimensional extension and geometry of MAD, as well as for its role in valvular dynamic and coaptation.MethodsA total of 85 consecutive subjects, who underwent elective mitral valve repair (MVR) for MMVD at our Institution between November 2019 and October 2021, were studied retrospectively. The extension and geometry of MAD was assessed using the digitally stored volumetric datasets of real-time 3D transesophageal echocardiography (TEE). Annular phenotypes and surgical repair techniques were analyzed.ResultsMitral annular disjunction was diagnosed in 50 out of 85 patients (59%) with Barlow disease (BD). A detailed analysis of MAD extension was conducted on 33 patients. Two pattern of disjunction were identified: a bimodal shape was highlighted in 21 patients, while a more uniform distribution of the disjuncted annulus was observed in 12 patients. The bimodal pattern was characterized by lower disjunction distance (DD) at the 140°–220° arch (3.6 ± 2.2 mm), while a more regular DD was measured in the remaining patients. All patients successfully underwent MVR. Triangular leaflet resection was performed in 58% of the cases, neochordae implantation in 9%, and notably a 27% received an isolated annuloplasty.ConclusionRather than a binary feature, MAD should be taken into account in its complex and heterogeneous morphology, where two major phenotypes can be identified. Despite its anatomical complexity, MAD was not associated with an increased surgical challenge; conversely a peculiar subgroup of patient was successfully treated with an isolated annuloplasty.

Published
2022
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2. Ecocardiografía transesofágica intraoperatoria posreparación mitral

Author

Laura Vidal-Bonet, Pere Pericas, and Alain Berrebi

Subjects
Mitral repair, Intraoperative transesophageal, Intraoperative echocardiography, Medicine, Surgery, RD1-811
Abstract

Resumen: La ecocardiografía transesofágica intraoperatoria se ha convertido en un aliado indispensable para el cirujano cardiaco, especialmente en la cirugía de reparación mitral. La evaluación de la insuficiencia mitral residual debe realizarse en todos los casos de reparación mitral, una vez optimizadas las condiciones de presión y contractilidad ventricular tras la salida de circulación extracorpórea, y debe valorar la presencia y severidad de la insuficiencia mitral residual, el mecanismo y la localización de la misma y las posibles complicaciones asociadas. Este artículo trata de revisar las peculiaridades de esta técnica, los puntos claves de la valoración del resultado quirúrgico, así como su importancia en la toma de decisiones. Abstract: Intraoperative transesophageal echocardiography has become an indispensable ally for the cardiac surgeon, especially in mitral repair surgery. The evaluation of residual mitral regurgitation should be carried out in all cases of mitral repair, once the conditions of pressure and ventricular contractility have been optimized after the cardiopulmonary bypass, and should assess the presence and severity of residual mitral regurgitation, the mechanism and its location and possible associated complications. This article tries to review the peculiarities of this technique, the key points in the assessment of the surgical result, as well as its importance in decision-making.

Published
2022
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3. Transcatheter Mitral Valve-In-Valve Implantation

Author

Sophie Ribeyrolles, MD, Christelle Diakov, MD, Aurélie Veugeois, MD, Alain Berrebi, MD, and Christophe Caussin, MD

Subjects
echocardiography, mitral valve, pregnancy, valve replacement, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

A pregnant woman presented with symptomatic bioprosthetic mitral valve stenosis. We discuss the difficulties of decision making in this particular situation where two lives are at stake, the fetus’s and the mother’s, questioning whether transcatheter mitral valve-in-valve implantation can be an effective and safe option for this challenging condition. (Level of Difficulty: Advanced.)

Published
2020
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4. PERPHERAL BLOOD CELL MITOCHONDRIAL DYSFUNCTION IN MYELODYSPLASTIC SYNDROMECAN BE IMPROVED BY A COMBINATION OF COENZYME Q10 AND CARNITINE

Author

Kalman Filanovsky, Michal Haran, Vita Mirkin, Andrei Braester, Olga Shevetz, Anfisa Stanevsky, Erica Sigler, Ekaterina Votinov, Yehudit Zalzman-Amir, Alain Berrebi, Atan Gross, and Lev Shvidel

Subjects
myelodysplastic syndrome, mitochondria, oxidative phosphorylation, coenzyme Q10, seahorse XF analyzer., Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Structural mitochondrial abnormalities as well as genetic aberrations in mitochondrial proteins have been known in Myelodysplastic syndrome (MDS) , yet there is currently little data regarding the metabolic properties and energy production of MDS cells. In the current study we used state-of-the-art methods to assess OXPHOS in peripheral blood cells obtained from MDS patients and healthy controls We then assessed the effect of food supplements- Coenzyme Q10 and carnitine on mitochondrial function and hematological response .We show here for the first time that in low risk MDS there is a significant impairment of mitochondrial respiration in peripheral blood cells and this can be improved with food supplements. We also show that such myelodysplastic syndrome, mitochondria, oxidative phosphorylation, coenzyme Q10, seahorse XF analyzer. supplements lead to improvement in cytopenia's and quality of life.

Published
2020
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5. A Y-chromosome portrait of the population of Jerba (Tunisia) to elucidate its complex demographic history

Author

Franz Manni, Pascal Leonardi, Étienne Patin, Alain Berrebi, Houssein Khodjet el Khil, Karl Skorecki, Dror Rosengarten, Hassan Rouba, Evelyne Heyer, and Marc Fellous

Subjects
Unique Event Polymorphisms (UEPs), Y-chromosome, History of Civilization, CB3-482
Abstract

The Island of Jerba has a long demographic history that is related to its central position in the Mediterranean Sea. The island was in contact with different civilizations and its population is heterogeneous (Arabs, Berbers, black Africans and Jews). We sampled 127 males (Jewish sample N = 32; Berber sample N = 46; Arab sample N = 47) in order to identify the Y-chromosome variability of the population according to 10 Unique Event Polymorphisms (UEPs): SRY-2627; SRY-10831a; SRY-4064; 92R7; Tat; YAP; M2; LLY22g; M9; 12f2q. We also sampled the Black group living in Jerba but typing ambiguities forced us to exclude it from further analyses. The results suggest a very low degree of genetic differentiation between Jerban Arabs and Berbers, who can be considered genetically, as belonging to the same group. In contrast, pairwise FST measures show that the genetic distances between the Jewish sample and the other ethnic groups are the highest in the island. This datum implies a low level of gene flow between the different communities that reside in Jerba, with the exception of Arabs and Berbers. Since geographic isolation plays no role, the different allelic profiles of the three ethnic groups are related to their different geographic origins, which are likely to have been maintained by the cultural differences existing between Arabs, Berbers and Jews. By comparing the observed haplogroup profiles with 19 reference populations located around the Mediterranean basin, we confirm a North African origin for the Berber and Arab sample and a Middle Eastern ancestral population for Jerban Jews.

Published
1999
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7. Human cytomegalovirus infection elicits new decidual natural killer cell effector functions.

Author

Johan Siewiera, Hicham El Costa, Julie Tabiasco, Alain Berrebi, Géraldine Cartron, Philippe Le Bouteiller, and Nabila Jabrane-Ferrat

Subjects
Immunologic diseases. Allergy, RC581-607, Biology (General), QH301-705.5
Abstract

During the first trimester of pregnancy the uterus is massively infiltrated by decidual natural killer cells (dNK). These cells are not killers, but they rather provide a microenvironment that is propitious to healthy placentation. Human cytomegalovirus (HCMV) is the most common cause of intrauterine viral infections and a known cause of severe birth defects or fetal death. The rate of HCMV congenital infection is often low in the first trimester of pregnancy. The mechanisms controlling HCMV spreading during pregnancy are not yet fully revealed, but evidence indicating that the innate immune system plays a role in controlling HCMV infection in healthy adults exists. In this study, we investigated whether dNK cells could be involved in controlling viral spreading and in protecting the fetus against congenital HCMV infection. We found that freshly isolated dNK cells acquire major functional and phenotypic changes when they are exposed to HCMV-infected decidual autologous fibroblasts. Functional studies revealed that dNK cells, which are mainly cytokines and chemokines producers during normal pregnancy, become cytotoxic effectors upon their exposure to HCMV-infected autologous decidual fibroblasts. Both the NKG2D and the CD94/NKG2C or 2E activating receptors are involved in the acquired cytotoxic function. Moreover, we demonstrate that CD56(pos) dNK cells are able to infiltrate HCMV-infected trophoblast organ culture ex-vivo and to co-localize with infected cells in situ in HCMV-infected placenta. Taken together, our results present the first evidence suggesting the involvement of dNK cells in controlling HCMV intrauterine infection and provide insights into the mechanisms through which these cells may operate to limit the spreading of viral infection to fetal tissues.

Published
2013
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12. Supplementary Figure 5 from Redox Modulation of Adjacent Thiols in VLA-4 by AS101 Converts Myeloid Leukemia Cells from a Drug-Resistant to Drug-Sensitive State

Author

Benjamin Sredni, Yona Kalechman, Dan L. Longo, Michael Albeck, Alon Silberman, Elad Noy, Maor H. Pauker, Alain Berrebi, Itai Skornick, and Adi Layani-Bazar

Abstract

PDF file - 1086K, Fig. S5: Knocking out VLA-4 in mouse myelomonocytic leukemia cells or human AML leukemic cells induces drug sensitivity which is not further enhanced by AS101.

Published
2023

13. Supplementary Figure 6 from Redox Modulation of Adjacent Thiols in VLA-4 by AS101 Converts Myeloid Leukemia Cells from a Drug-Resistant to Drug-Sensitive State

Author

Benjamin Sredni, Yona Kalechman, Dan L. Longo, Michael Albeck, Alon Silberman, Elad Noy, Maor H. Pauker, Alain Berrebi, Itai Skornick, and Adi Layani-Bazar

Abstract

PDF file - 981K, Fig. S6: Inhibition of pAkt mediates AS101's activity involving chemotherapy-induced AML cell death as tested by subG1 accumulation.

Published
2023

14. Data from Redox Modulation of Adjacent Thiols in VLA-4 by AS101 Converts Myeloid Leukemia Cells from a Drug-Resistant to Drug-Sensitive State

Author

Benjamin Sredni, Yona Kalechman, Dan L. Longo, Michael Albeck, Alon Silberman, Elad Noy, Maor H. Pauker, Alain Berrebi, Itai Skornick, and Adi Layani-Bazar

Abstract

Interaction between the integrin VLA-4 on acute myelogenous leukemia (AML) cells with stromal fibronectin is a decisive factor in chemotherapeutic resistance. In this study, we provide a rationale for a drug repositioning strategy to blunt integrin activation in AML cells and restore their sensitivity to chemotherapy. Specifically, we demonstrate that the nontoxic tellurium compound AS101, currently being evaluated in clinical trials, can abrogate the acquired resistance of AML. Mechanistic investigations revealed that AS101 caused redox inactivation of adjacent thiols in the exofacial domain of VLA-4 after its ligation to stromal fibronectin. This effect triggered cytoskeletal conformational changes that decreased PI3K/Akt/Bcl2 signaling, an obligatory step in chemosensitization by AS101. In a mouse xenograft of AML derived from patient leukemic cells with high VLA-4 expression and activity, we demonstrated that AS101 abrogated drug resistance and prolonged survival in mice receiving chemotherapy. Decreased integrin activity was confirmed on AML cells in vivo. The chemosensitizing activity of AS101 persisted in hosts with defective adaptive and innate immunity, consistent with evidence that integrin deactivation was not mediated by heightening immune attack. Our findings provide a mechanistic rationale to reposition the experimental clinical agent, AS101, to degrade VLA-4–mediated chemoresistance and improve clinical responses in patients with AML. Cancer Res; 74(11); 3092–103. ©2014 AACR.

Published
2023

16. Supplementary Figure 3 from Redox Modulation of Adjacent Thiols in VLA-4 by AS101 Converts Myeloid Leukemia Cells from a Drug-Resistant to Drug-Sensitive State

Author

Benjamin Sredni, Yona Kalechman, Dan L. Longo, Michael Albeck, Alon Silberman, Elad Noy, Maor H. Pauker, Alain Berrebi, Itai Skornick, and Adi Layani-Bazar

Abstract

PDF file - 718K, Fig. S3: The VLA-4 integrin activity on AML cells can be directly affected by AS101 by redox rearrangements of vicinal thiols within the cysteine-rich domain of the integrin resulting in physiologic consequences.

Published
2023

18. Grading mitral regurgitation using 4D flow CMR: Comparison to transthoracic echocardiography

Author

Sophie Ribeyrolles, Jean‐Luc Monin, Adela Rohnean, Christelle Diakov, Christophe Caussin, Sebastien Monnot, Alain Berrebi, and Jean‐François Paul

Subjects
Magnetic Resonance Spectroscopy, Echocardiography, Humans, Magnetic Resonance Imaging, Cine, Mitral Valve Insufficiency, Reproducibility of Results, Radiology, Nuclear Medicine and imaging, Prospective Studies, Cardiology and Cardiovascular Medicine, Severity of Illness Index
Abstract

To determine the 4D Flow Cardiac Magnetic Resonance (CMR) thresholds that achieve the best agreement with transthoracic echocardiography (TTE) for grading mitral regurgitation (MR).We conducted a single-center prospective study of patients evaluated for chronic primary MR in 2016-2020. MR was evaluated blindly by TTE and 4D Flow CMR, respectively by two cardiologists and two radiologists with decades of experience. MR was graded with both methods as mild, moderate, or severe. 4D Flow CMR measurements included MR regurgitant volume per beat (RV) and mitral anterograde flow per beat (MF). RF was obtained as the ratio RV/MF. Additionally, MF was compared to left ventricular stroke volume (LVSV) by cine-CMR.We included 33 patients in the initial cohort and 33 in the validation cohort. Inter-observer agreement was excellent for 4D Flow CMR ICC = .94 (95% CI, .86-.97, p 0.0001). Using recommended TTE thresholds (30 ml, 60 ml, 30%, 50%), agreement was moderate for RV and RF. The best agreement between 4D Flow CMR and TTE was obtained with CMR thresholds of 20 and 40 ml for RV (κ = .93; 95% CI, .8-1) and 20% and 37% for RF (κ = .90; 95% CI, .7-.9). In the validation cohort, agreement between TTE and 4D Flow CMR was good with the optimal thresholds (κ = .78; 95% CI, .61-.94).We propose CMR thresholds that provide a good agreement between TTE and CMR for grading MR. Further studies are needed to fully validate 4D-Flow CMR accuracy for primary MR quantification.

Published
2022

19. Bicuspidization of a unicuspid valve using sliding plasty of a rudimentary right coronary cusp

Author

Nathanael Shraer, Alain Berrebi, Raoul Biondi, and Emmanuel Lansac

Subjects
Adult, Pulmonary and Respiratory Medicine, Aortic Valve, Aortic Valve Insufficiency, Humans, Mitral Valve, Surgery, Tricuspid Valve, General Medicine, Cardiac Surgical Procedures, Cardiology and Cardiovascular Medicine
Abstract

Unicuspid aortic valve repair relies on the principles of bicuspidization by creating a neo-commissure at 180° from the existing commissure, with pericardial patch interposition. We report a case of a 26-year-old patient with cor triatriatum and a severely regurgitating unicuspid valve. The left atrium membrane was resected. Aortic valve repair was performed creating a neo-commissure using a sliding plasty of the rudimentary right coronary cusp and patch reconstruction of the anterior part of the non-coronary cusp, protected by external subvalvular annuloplasty and hemi-root remodelling. We detail a repair technique of a partial autologous reconstruction approach for bicuspidization.

Published
2022

20. Assessment of tricuspid annulus: anatomic and echocardiographic correlation

Author

Marta Sitges, Víctor M. Parra, Guillermina Fita, José L. Pomar, Alain Berrebi, and Irene Rovira

Subjects
medicine.medical_specialty, Regurgitation (circulation), 030204 cardiovascular system & hematology, Transoesophageal echocardiography, 03 medical and health sciences, 0302 clinical medicine, Tricuspid Valve Insufficiency, Predictive Value of Tests, Tricuspid annulus, Humans, Medicine, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, 030212 general & internal medicine, Cardiac imaging, Tricuspid valve, business.industry, Limits of agreement, Infant, Newborn, Ethics committee, medicine.anatomical_structure, Echocardiography, cardiovascular system, Tricuspid Valve, Radiology, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal
Abstract

Tricuspid regurgitation is associated with a poor outcome and its quantification remains a challenge. Tricuspid annulus dilatation is one of the parameters that influences clinical decision-making. The aim of this study was to compare the use of 2D transoesophageal echocardiography with surgical assessment for the measurement of the tricuspid annulus. Sixty-one cardiac patients (median age 64 years) were included in the study. Echocardiographic tricuspid annulus measurements were obtained from four chamber and transgastric short axis views and compared with the surgical measurements of this valve. The study was approved by the Ethics Committee of our institution. The tricuspid annulus measurements were obtained from the four chamber and the short axis views in 57 and 49 patients, respectively, while surgical measurement was performed in all 61 patients. Bland–Altman analysis of 49 tricuspid annulus-matched dimensions of the short axis view and surgical values showed a mean bias of 0.223 mm/m2, with limits of agreement of −5.86 to 6.31 mm/m2. Echocardiographic measurements of the tricuspid annulus dimension were accurate (90% sensitivity and 90% specificity for a four chamber view cut-off value ≥ 24.5 mm/m2, and 89% sensitivity and 97% specificity for a short axis view cut-off value ≥ 37.6 mm/m2, P

Published
2021

22. Aortic valve fenestration: respect it or fix it?

Author

Nathanael Shraer, Pouya Youssefi, Jean-Luc Monin, Alain Berrebi, Leila Mankoubi, Milena Noghin, Mathieu Debauchez, and Emmanuel Lansac

Subjects
Reoperation, Pulmonary and Respiratory Medicine, Treatment Outcome, Aortic Valve, Aortic Valve Insufficiency, Humans, Surgery, General Medicine, Cardiology and Cardiovascular Medicine, Cardiac Valve Annuloplasty, Respect
Abstract

OBJECTIVES We investigated whether aortic valve fenestrations (respected or fixed) represent a factor associated with recurrent aortic insufficiency or reoperation after repair. METHODS Between 2003 and 2019, patients who underwent aortic valve repair were included. Aortic insufficiency phenotypes were root aneurysm (repair: root remodelling + annuloplasty), ascending aorta aneurysm (repair: tubular aortic replacement + annuloplasty) and isolated regurgitation (repair: single/double annuloplasty). Fenestrations were either respected or fixed according to their features. RESULTS A total of 618 patients (out of 798 operated on; 77.4%) had their valve repaired, with 167 cases of fenestrations (128 were respected, 39 fixed—32 with a patch, 6 with running suture and 1 with both). After conducting propensity score matching between no-fenestration (n = 167) and fenestration groups (n = 167), respectively, we noted the following: survival [90.3% (n = 7 deaths) vs 95.8% (n = 4)], cumulative incidence of reoperation [6.7% (n = 7) vs 5.2% (n = 4)], aortic insufficiency grade ≥ 3 [6.4% (n = 6) vs 4.4% (n = 4)] and grade ≥ 2 [28.9% (n = 28) vs 37.1% (n = 35)] were similar at 9 years [P = 0.94; median follow-up: 2.2, interquartile range: (0.8, 5.8)], whether fenestration was respected (P = 0.55) or fixed (P = 0.6, at 6 years). Standardization of the surgical approach (consisting of double annuloplasty in isolated regurgitation phenotype and expansible subvalvular annuloplasty with effective height assessment with remodelling repair for root aneurysm phenotype) reduced the risk of reoperation (era before standardization: hazard ratio: 5.4, 95% confidence interval: 1.9–15.7, P = 0.002). CONCLUSIONS Fenestration, respected or fixed, is not a factor associated with reoperation or recurrence of significant aortic insufficiency after valve repair if the surgical approach is standardized.

Published
2022

23. Transcatheter Mitral Valve-In-Valve Implantation

Author

Christelle Diakov, Christophe Caussin, Aurélie Veugeois, Sophie Ribeyrolles, and Alain Berrebi

Subjects
0301 basic medicine, mitral valve, medicine.medical_specialty, medicine.medical_treatment, education, 030105 genetics & heredity, 03 medical and health sciences, 0302 clinical medicine, Mitral valve stenosis, Valve replacement, Internal medicine, Mitral valve, medicine, Diseases of the circulatory (Cardiovascular) system, echocardiography, MVS, mitral valve stenosis, Peripartum Cardiovascular Disease Mini-Focus Issue, Pregnancy, business.industry, TMVI, transcatheter mitral valve implantation, BPMV, bioprosthetic mitral valve, medicine.disease, humanities, medicine.anatomical_structure, TTE, transthoracic echocardiography, RC666-701, Cardiology, Case Report: Clinical Case, pregnancy, VKA, vitamin K antagonists, valve replacement, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery
Abstract

A pregnant woman presented with symptomatic bioprosthetic mitral valve stenosis. We discuss the difficulties of decision making in this particular situation where two lives are at stake, the fetus’s and the mother’s, questioning whether transcatheter mitral valve-in-valve implantation can be an effective and safe option for this challenging condition. (Level of Difficulty: Advanced.), Graphical abstract, A pregnant woman presented with symptomatic bioprosthetic mitral valve stenosis…

Published
2020

24. Aortic valve repair using pericardial patch standardized with external ring annuloplasty

Author

Pichoy Danial, Alexander Moiroux-Sahraoui, Mathieu Debauchez, Jean-Luc Monin, Alain Berrebi, Nathanael Shraer, and Emmanuel Lansac

Subjects
Cohort Studies, Reoperation, Pulmonary and Respiratory Medicine, Treatment Outcome, Aortic Valve, Aortic Valve Insufficiency, Humans, Surgery, General Medicine, Cardiology and Cardiovascular Medicine, Cardiac Valve Annuloplasty, Aged
Abstract

OBJECTIVES This study was undertaken to analyse outcomes of aortic valve repair using additional material and compare the results to those of cusp repair without the use of the pericardial patch. METHODS All consecutive patients aged over 16 who underwent aortic valve repair with external ring annuloplasty for isolated aortic insufficiency, aortic insufficiency and tubular aortic aneurysm or aortic root aneurysm between May 2003 and November 2019 were included in a cohort study. Data were collected and analysed from the AVIATOR registry (AorticValve repair InternATiOnal Registry). Propensity score framework analysis (inverse probability of treatment weighting) was used to compare outcomes of the groups while controlling for confounders. RESULTS During the 16-year study period, 618 patients underwent aortic valve repair. Eight-year survival rate was 92% in the patch group and 90.2% in the no patch group without significant differences [P = 0.957 inverse probability of treatment weighting (IPTW) weighted]. Early valve-related reoperation was more frequent in the patch group as compared to the no patch group (6% vs 1%, P < 0.001 IPTW weighted), the freedom from aortic valve-related reintervention and from structural valve deterioration at 8 years was not significantly different between the patch and no patch groups (93.7% vs 94%, P = 0.968 IPTW weighted; and 99.3% vs 96.7%, P = 0.964 IPTW weighted). CONCLUSIONS Although a higher rate of early reintervention was observed, aortic valve repair using the pericardial patch, in a standardized approach using external annuloplasty, with effective coaptation height of at least 9 mm, was not associated with an increase in mid-term aortic valve-related reoperation or structural valve deterioration as compared to valve repair without the pericardial patch.

Published
2022

25. Contemporary Management of Severe Symptomatic Aortic Stenosis

Author

Marc Eugène, Piotr Duchnowski, Bernard Prendergast, Olaf Wendler, Cécile Laroche, Jean-Luc Monin, Yannick Jobic, Bogdan A. Popescu, Jeroen J. Bax, Alec Vahanian, Bernard Iung, Jeroen Bax, Michele De Bonis, Victoria Delgado, Michael Haude, Gerhard Hindricks, Aldo P. Maggioni, Luc Pierard, Susanna Price, Raphael Rosenhek, Frank Ruschitzka, Stephan Windecker, Souad Mekhaldi, Katell Lemaitre, Sébastien Authier, Magdy Abdelhamid, Astrid Apor, Gani Bajraktari, Branko Beleslin, Alexander Bogachev-Prokophiev, Daniela Cassar Demarco, Agnes Pasquet, Sait Mesut Dogan, Andrejs Erglis, Arturo Evangelista, Artan Goda, Nikolaj Ihlemann, Huseyin Ince, Andreas Katsaros, Katerina Linhartova, Julia Mascherbauer, Erkin Mirrakhimov, Vaida Mizariene, Shelley Rahman-Haley, Regina Ribeiras, Fuad Samadov, Antti Saraste, Iveta Simkova, Elizabeta Srbinovska Kostovska, Lidia Tomkiewicz-Pajak, Christophe Tribouilloy, Eliverta Zera, Mimoza Metalla, Ervina Shirka, Elona Dado, Loreta Bica, Jorida Aleksi, Gerti Knuti, Lidra Gjyli, Rudina Pjeci, Eritinka Shuperka, Erviola Lleshi, Joana Rustemaj, Marsjon Qordja, Mirald Gina, Senada Husi, Daniel Basic, Regina Steringer-Mascherbauer, Charlotte Huber, Christian Ebner, Elisabeth Sigmund, Andrea Ploechl, Thomas Sturmberger, Veronica Eder, Tanja Koppler, Maria Heger, Andreas Kammerlander, Franz Duca, Christina Binder, Matthias Koschutnik, Leonard Perschy, Lisa Puskas, Chen-Yu Ho, Farid Aliyev, Vugar Guluzada, Galib Imanov, Firdovsi Ibrahimov, Abbasali Abbasaliyev, Tahir Ahmedov, Fargana Muslumova, Jamil Babayev, Yasmin Rustamova, Tofig Jahangirov, Rauf Samadov, Muxtar Museyibov, Elnur Isayev, Oktay Musayev, Shahin Xalilov, Saleh Huseynov, Madina Yuzbashova, Vuqar Zamanov, Vusal Mammadov, Gery Van Camp, Martin Penicka, Hedwig Batjoens, Philippe Debonnaire, Daniel Dendooven, Sebastien Knecht, Mattias Duytschaever, Yves Vandekerckhove, Luc Missault, Luc Muyldermans, René Tavernier, Tineke De Grande, Patrick Coussement, Joyce DeTroyer, Katrien Derycker, Kelly De Jaegher, Antoine Bondue, Christophe Beauloye, Céline Goffinet, Daniela Corina Mirica, Frédéric Vanden Eynden, Philippe Van de Borne, Béatrice Van Frachen, David Vancraeynest, Jean Louis Vanoverschelde, Sophie Pierard, Mihaela Malanca, Florence Sinnaeve, Séverine Tahon, Marie De Clippel, Frederic Gayet, Jacques Loiseau, Nico Van de Veire, Veronique Moerman, Anne-Marie Willems, Bernard Cosyns, Steven Droogmans, Andreea Motoc, Dirk Kerkhove, Daniele Plein, Bram Roosens, Caroline Weytjens, Patrizio Lancellotti, Elena Raluca Dulgheru, Ilona Parenicova, Helena Bedanova, Frantisek Tousek, Stepanka Sindelarova, Julia Canadyova, Milos Taborsky, Jiri Ostransky, null Ivona simkova, Marek Vicha, Libor Jelinek, Irena Opavska, Miroslav Homza, Miriam Kvrayola, Radim Brat, Dan Mrozek, Eva Lichnerova, Iveta Docekalova, Marta Zarybnicka, Marketa Peskova, Patrik Roucka, Vlasta Stastna, Dagmar Jungwirtova Vondrackova, Alfred Hornig, Matus Niznansky, Marian Branny, Alexandra Vodzinska, Miloslav Dorda, Libor Snkouril, Krystyna Kluz, Jana Kypusova, Radka Nezvalova, Niels Thue Olsen, Hosam Hasan Ali, Salma Taha, Mohamed Hassan, Ahmed Afifi, Hamza Kabil, Amr Mady, Hany Ebaid, Yasser Ahmed, Mohammad Nour, Islam Talaat, CairoMaiy El Sayed, Ahmad Elsayed Mostafa, CairoYasser Sadek, CairoSherif Eltobgi, Sameh Bakhoum, Ramy Doss, Mahmoud Sheashea, Abd Allah Elasry, Ahmed Fouad, Mahmoud Baraka, Sameh Samir, Alaa Roshdy, Yasmin AbdelRazek, Mostafa M. Abd Rabou, Ahmed Abobakr, Moemen Moaaz, Mohamed Mokhtar, Mohamed Ashry, Khaled Elkhashab, Haytham Soliman Ghareeb, Mostafa Kamal, Gomaa AbdelRazek, GizaNabil Farag, Giza:Ahmed Elbarbary, Evette Wahib, Ghada Kazamel, Diaa Kamal, Mahmoud Tantawy, Adel Alansary, Mohammed Yahia, Raouf Mahmoud, Tamer El Banna, Mohamed Atef, Gamela Nasr, Salah Ahmed, Ehab E. El Hefny, Islam Saifelyazal, Mostafa Abd El Ghany, Abd El Rahman El Hadary, Ahmed Khairy, Jyri Lommi, Mika Laine, Minna Kylmala, Katja Kankanen, Anu Turpeinen, Juha Hartikainen, Lari Kujanen, Juhani Airaksinen, Tuija Vasankari, Catherine Szymanski, Yohann Bohbot, Mesut Gun, Justine Rousseaux, Loic Biere, Victor Mateus, Martin Audonnet, Jérémy Rautureau, Charles Cornet, Emmanuel Sorbets, BourgesKarine Mear, Adi Issa, Florent Le Ven, Marie-Claire Pouliquen, Martine Gilard, Alice Ohanessian, Ali Farhat, Alina Vlase, Fkhar Said, Caroline Lasgi, Carlos Sanchez, Romain Breil, Marc Peignon, Jean-Philippe Elkaim, Virginie Jan-Blin, Sylvain Ropars BertrandM'Ban, Hélène Bardet, Samuel Sawadogo, Aurélie Muschoot, Dieudonné Tchatchoua, Simon Elhadad, Aline Maubert, Tahar Lazizi, Kais Ourghi, Philippe Bonnet, Clarisse Menager-Gangloff, Sofiene Gafsi, Djidjiga Mansouri, Victor Aboyans, Julien Magne, Elie Martins, Sarah Karm, Dania Mohty, Guillaume Briday, Amandine David, Sylvestre Marechaux, Caroline Le Goffic, Camille Binda, Aymeric Menet, Francois Delelis, Anne Ringlé, Anne-Laure Castel, Ludovic Appert, Domitille Tristram, Camille Trouillet, Yasmine Nacer, Lucas Ngoy, MarseilleGilbert Habib, Franck Thuny, Julie Haentjens, Jennifer Cautela, Cécile Lavoute, Floriane Robin, Pauline Armangau, Ugo Vergeylen, Khalil Sanhadji, Nessim Hamed Abdallah, Hassan Kerzazi, Mariana Perianu, François Plurien, Chaker Oueslati, Mathieu Debauchez, Zannis Konstantinos, Alain Berrebi, Alain Dibie, Emmanuel Lansac, Aurélie Veugeois, Christelle Diakov, Christophe Caussin, Daniel Czitrom, Suzanna Salvi, Nicolas Amabile, Patrice Dervanian, Stéphanie Lejeune, Imane Bagdadi, Yemmi Mokrane, Gilles Rouault, Jerome Abalea, Marion Leledy, Patrice Horen, Erwan Donal, Christian Bosseau, Elise Paven, Elena Galli, Edouard Collette, Jean-Marie Urien, Valentin Bridonneau, Renaud Gervais, Fabrice Bauer, Houzefa Chopra, Arthur Charbonnier, David Attias, Nesrine Dahouathi, Moukda Khounlaboud, Magalie Daudin, Christophe Thebault, Cécile Hamon, Philippe Couffon, Catherine Bellot, Maelle Vomscheid, Anne Bernard, Fanny Dion, Djedjiga Naudin, Mohammed Mouzouri, Mathilde Rudelin, Alain Berenfeld, Thibault Vanzwaelmen, Tarik Alloui, Marija Gjerakaroska Radovikj, Slavica Jordanova, Werner Scholtz, Eva Liberda-Knoke, Melanie Wiemer, Andreas Mugge, Georg Nickenig, Jan-Malte Sinning, Alexander Sedaghat, Matthias Heintzen, Jan Ballof, Daniel Frenk, Rainer Hambrecht, Harm Wienbergen, Annemarie Seidel, Rico Osteresch, Kirsten Kramer, Janna Ziemann, Ramona Schulze, Wolfgang Fehske, Clarissa Eifler, Bahram Wafaisade, Andreas Kuhn, Sören Fischer, Lutz Lichtenberg, Mareike Brunold, Judith Simons, Doris Balling, Thomas Buck, Bjoern Plicht, Wolfgang Schols, Henning Ebelt, Marwan Chamieh, Jelena Anacker, Tienush Rassaf, Alexander Janosi, Alexander Lind, Julia Lortz, Peter Lüdike, Philipp Kahlert, Harald Rittger, Gabriele Eichinger, Britta Kuhls, Stephan B. Felix, Kristin Lehnert, Ann-Louise Pedersen, Marcus Dorr, Klaus Empen, Sabine Kaczmarek, Mathias Busch, Mohammed Baly, Fikret Er, Erkan Duman, Linda Gabriel, Christof Weinbrenner, Johann Bauersachs, Julian Wider, Tibor Kempf, Michael Bohm, Paul-Christian Schulze, C. Tudor Poerner, Sven Möbius-Winkler, Karsten Lenk, Kerstin Heitkamp, Marcus Franz, Sabine Krauspe, Burghard Schumacher, Volker Windmuller, Sarah Kurwitz, Holger Thiele, Thomas Kurz, Roza Meyer-Saraei, Ibrahim Akin, Christian Fastner, Dirk Lossnitzer, Ursula Hoffmann, Martin Borggrefe, Stefan Baumann, Brigitte Kircher, Claudia Foellinger, Heike Dietz, Bernhard Schieffer, Feraydoon Niroomand, Harald Mudra, Lars Maier, Daniele Camboni, Christoph Birner, Kurt Debl, Michael Paulus, Benedikt Seither, Nour Eddine El Mokhtari, Alper Oner, Evren Caglayan, Mohammed Sherif, Seyrani Yucel, Florian Custodis, Robert Schwinger, Marc Vorpahl, Melchior Seyfarth, Ina Nover, Till Koehler, Sarah Christiani, David Calvo Sanchez, Barbel Schanze, Holger Sigusch, Athir Salman, Jane Hancock, John Chambers, Camelia Demetrescue, Claire Prendergast, Miles Dalby, Robert Smith, Paula Rogers, Cheryl Riley, Dimitris Tousoulis, Ioannis Kanakakis, Konstantinos Spargias, Konstantinos Lampropoulos, Tolis Panagiotis, Athanasios Koutsoukis, Lampros Michalis, Ioannis Goudevenos, Vasileios Bellos, Michail Papafaklis, Lampros Lakkas, George Hahalis, Athanasios Makris, Haralampos Karvounis, Vasileios Kamperidis, Vlasis Ninios, Vasileios Sachpekidis, Pavlos Rouskas, Leonidas Poulimenos, Georgios Charalampidis, Eftihia Hamodraka, Athanasios Manolis, Robert Gabor Kiss, Tunde Borsanyi, Zoltan Jarai, Andras Zsary, Elektra Bartha, Annamaria Kosztin, Alexandra Doronina, Attila Kovacs, Barabas Janos Imre, Chun Chao, Kalman Benke, Istvan Karoczkai, Kati Keltai, Zsolt Förchécz, Zoltán Pozsonyi, Zsigmond Jenei, Adam Patthy, Laszlo Sallai, Zsuzsanna Majoros, Tamás Pál, Jusztina Bencze, Ildiko Sagi, Andrea Molnar, Anita Kurczina, Gabor Kolodzey, Istvan Edes, Valeria Szatmari, Zsuzsanna Zajacz, Attila Cziraki, Adam Nemeth, Reka Faludi, Laszlone Vegh, Eva Jebelovszki, Geza Karoly Lupkovics, Zsofia Kovacs, Andras Horvath, Gezim Berisha, Pranvera Ibrahimi, Luan Percuku, Rano Arapova, Elmira Laahunova, Kseniia Neronova, Zarema Zhakypova, Gulira Naizabekova, Gulnazik Muratova, Iveta Sime, Nikolajs Sorokins, Ginta Kamzola, Irina Cgojeva-Sproge, Gita Rancane, Ramune Valentinaviciene, Laima Rudiene, Rasa Raugaliene, Aiste Bardzilauske, Regina Jonkaitiene, Jurate Petrauskaite, Monika Bieseviciene, Raimonda Verseckaite, Ruta Zvirblyte, Danute Kalibatiene, Greta Radauskaite, Gabija Janaviciute-Matuzeviciene, Dovile Jancauskaite, Deimile Balkute, Juste Maneikyte, Ingrida Mileryte, Monika Vaisvilaite, Lina Gedvilaite, Mykolas Biliukas, Vaiva Karpaviciene, Robert George Xuereb, Elton Pllaha, Roxana Djaberi, Klaudiusz Komor, Agnieszka Gorgon-Komor, Beata Loranc, Jaroslaw Myszor, Katarzyna Mizia-Stec, Adrianna Berger-Kucza, Magdalena Mizia, Mateusz Polak, Piotr Bogacki, Piotr Podolec, Monika Komar, Ewa Sedziwy, Dorota Sliwiak, Bartosz Sobien, Beata Rog, Marta Hlawaty, Urszula Gancarczyk, Natasza Libiszewska, Danuta Sorysz, Andrzej Gackowski, Malgorzata Cieply, Agnieszka Misiuda, Franciszek Racibor, Anna Nytko, Kazimierz Widenka, Maciej Kolowca, Janusz Bak, Andrzej Curzytek, Mateusz Regulski, Malgorzata Kamela, Mateusz Wisniowski, Tomasz Hryniewiecki, Piotr Szymanski, Monika Rozewicz, Maciej Grabowski, Andrzej Budaj, Beata Zaborska, Ewa Pilichowska-Paskiet, Malgorzata Sikora-Frac, Tomasz Slomski, Isabel Joao, Ines Cruz, Hélder Pereira, Rita Cale, Ana Marques, Ana Rita Pereira, Carlos Morais, Antonio Freitas, David Roque, Nuno Antunes, Antonio Costeira Pereira, Catarina Vieira, Nuno Salome, Juliana Martins, Isabel Campos, Goncalo Cardoso, Claudia Silva, Afonso Oliveira, Mariana Goncalves, Rui Martins, Nuno Quintal, Bruno Mendes, Joseline Silva, Joao Ferreira, James Milner, Patricia Alves, Vera Marinho, Paula Gago, Jose Amado, Joao Bispo, Dina Bento, Inocencia Machado, Margarida Oliveira, Lucy Calvo, Pedro von Hate, Bebiana Faria, Ana Galrinho, Luisa Branco, Antonio Goncalves, Tiago Mendonca, Mafalda Selas, Filipe Macedo, Carla Sousa, Sofia Cabral, Filomena Oliveira, Maria Trepa, Marta Fontes-Oliveira, Alzira Nunes, Paulo Araújo, Vasco Gama Ribeiro, Joao Almeida, Alberto Rodrigues, Pedro Braga, Sonia Dias, Sofia Carvalho, Catarina Ferreira, Alberto Ferreira, Pedro Mateus, Miguel Moz, Silvia Leao, Renato Margato, Ilidio Moreira, Jose Guimanaes, Joana Ribeiro, Fernando Goncalves, Jose Cabral, Ines Almeida, Luisa Goncalves, Mariana Tarusi, Calin Pop, Claudia Matei, Diana Tint, Sanziana Barbulescu, Sorin Micu, Ioana Pop, Costica Baba, Doina Dimulescu, Maria Dorobantu, Carmen Ginghina, Roxana Onut, Andreea Popescu, Brandusa Zamfirescu, Raluca Aflorii, Mihaela Popescu, Liviu Ghilencea, Andreeea Rachieru, Monica Stoian, Nicoleta Oprescu, Silvia Iancovici, Iona Petre, Anca Doina Mateescu, Andreea Calin, Simona Botezatu, Roxana Enache, Monica Rosca, Daniela Ciuperca, Evelyn Babalac, Ruxandra Beyer, Laura Cadis, Raluca Rancea, Raluca Tomoaia, Adela Rosianu, Emese Kovacs, Constantin Militaru, Alina Craciun, Oana Mirea, Mihaela Florescu, Lucica Grigorica, Daniela Dragusin, Luiza Nechita, Mihai Marinescu, Teodor Chiscaneanu, Lucia Botezatu, Costela Corciova, Antoniu Octavian Petris, Catalina Arsenescu-Georgescu, Delia Salaru, Dan Mihai Alexandrescu, Carmjen Plesoianu, Ana Tanasa, Ovidiu Mitu, Irina Iuliana Costache, Ionut Tudorancea, Catalin Usurelu, Gabriela Eminovici, Ioan Manitiu, Oana Stoia, Adriana Mitre, Dan-Octavian Nistor, Anca Maier, Silvia Lupu, Mihaela Opris, Adina Ionac, Irina Popescu, Simina Crisan, Cristian Mornos, Flavia Goanta, Liana Gruescu, Oana Voinescu, Madalina Petcu, Ramona Cozlac, Elena Damrina, Liliya Khilova, Irina Ryazantseva, Dmitry Kozmin, Maria Kiseleva, Marina Goncharova, Kamila Kitalaeva, Victoria Demetskay, Artem Verevetinov, Mikhail Fomenko, Elena Skripkina, Viktor Tsoi, Georgii Antipov, Yuri Schneider, Denis Yazikov, Marina Makarova, Aleksei Cherkes, Natalya Ermakova, Aleksandr Medvedev, Anastasia Sarosek, Mikhail Isayan, Tatyana Voronova, Oleg Kulumbegov, Alina Tuchina, Sergei Stefanov, Margarita Klimova, Konstantin Smolyaninov, Zhargalma Dandarova, Victoriya Magamet, Natalia Spiropulos, Sergey Boldyrev, Kirill Barbukhatty, Dmitrii Buyankov, Vladimir Yurin, Yuriy Gross, Maksim Boronin, Mariya Mikhaleva, Mariya Shablovskaya, Alex Zotov, Daniil Borisov, Vasily Tereshchenko, Ekaterina Zubova, A. Kuzmin, Ivan Tarasenko, Alishir Gamzaev, Natalya Borovkova, Tatyana Koroleva, Svetlana Botova, Ilya Pochinka, Vera Dunaeva, Victoria Teplitskaya, Elena I. Semenova, Olga V. Korabel'Nikova, Denis S. Simonov, Elena Denisenko, Natalia Harina, Natalia Yarohno, Svetlana Alekseeva, Julia Abydenkova, Lyubov Shabalkina, Olga Mayorova, Valeriy Tsechanovich, Igor Medvedev, Michail Lepilin, PenzaEvgenii Nemchenko, Vadim Karnahin, Vasilya Safina, Yaroslav Slastin, Venera Gilfanova, Roman Gorbunov, Ramis Jakubov, Aigul Fazylova, Mansur Poteev, Laysan Vazetdinova, Indira Tarasova, Rishat Irgaliyev, Olga Moiseeva, Mikhail Gordeev, Olga Irtyuga, Raisa Moiseeva, Nina Ostanina, Dmitry Zverev, Patimat Murtazalieva, Dmitry Kuznetsov, Mariya Skurativa, Larisa Polyaeva, Kirill Mihaiilov, Biljana Obrenovic-Kircanski, Svetozar Putnik, Dragan Simic, Milan Petrovic, Natasa Markovic Nikolic, Ljiljana Jovovic, Dimitra Kalimanovska Ostric, Milan Brajovic, Milica Dekleva Manojlovic, Vladimir Novakovic, Danijela Zamaklar-Trifunovic, Bojana Orbovic, Olga Petrovic, Marija Boricic-Kostic, Kristina Andjelkovic, Marko Milanov, Maja Despotovic-Nikolic, Sreten Budisavljevic, Sanja Veljkovic, Nataša Cvetinovic, Daniijela Lepojevic, Aleksandra Todorovic, Aleksandra Nikolic, Branislava Borzanovic, Ljiljana Trkulja, Slobodan Tomic, Milan Vukovic, Jelica Milosavljevic, Mirjana Milanovic, Vladan Stakic, Aleksandra Cvetkovic, Suzana Milutinovic, Olivera Bozic, Miodrag Miladinovic, Zoran Nikolic, Dinka Despotovic, Dimitrije Jovanovic, Anastazija Stojsic-Milosavljevic, Aleksandra Ilic, Mirjana Sladojevic, Stamenko Susak, Srdjan Maletin, Salvo Pavlovic, Vladimir Kuzmanovic, Nikola Ivanovic, Jovana Dejanovic, Dusan Ruzicic, Dragana Drajic, Danijel Cvetanovic, Marija Mirkovic, Jon Omoran, Roman Margoczy, Katarina Sedminova, Adriana Reptova, Eva Baranova, Tatiana Valkovicova, Gabriel Valocik, Marian Kurecko, Marianna Vachalcova, Alzbeta Kollarova, Martin Studencan, Daniel Alusik, Marek Kozlej, Jana Macakova, Sergio Moral, Merce Cladellas, Daniele Luiso, Alicia Calvo, Jordi Palet, Juli Carballo, Gisela Teixido Tura, Giuliana Maldonado, Laura Gutierrez, Teresa Gonzalez-Alujas, Rodriguez Palomares Jose Fernando, Nicolas Villalva, Ma Jose Molina-Mora, Ramon Rubio Paton, Juan Jose Martinez Diaz, Pablo Ramos Ruiz, Alfonso Valle, Ana Rodriguez, Edgardo Alania, Emilio Galcera, Julia Seller, Gonzalo de la Morena Valenzuela, Daniel Saura Espin, Dolores Espinosa Garcia, Maria Jose Oliva Sandoval, Josefa Gonzalez, Miguel Garcia Navarro, Maria Teresa Perez-Martinez, Jose Ramon Ortega Trujillo, Irene Menduina Gallego, Daniel San Roman, Eliu David Perez Nogales, Olga Medina, Rodolfo Antonio Montiel Quintero, Pablo Felipe Bujanda Morun, Marta Lopez Perez, Jimmy Plasencia Huaripata, Juan Jose Morales Gonzalez, Veronica Quevedo Nelson, Jose Luis Zamorano, Ariana Gonzalez Gomez, Alfonso Fraile, Maria Teresa Alberca, Joaquin Alonso Martin, Covadonga Fernandez-Golfin, Javier Ramos, Sergio Hernandez Jimenez, Cristina Mitroi, Pedro L. Sanchez Fernandez, Elena Diaz-Pelaez, Beatriz Garde, Luis Caballero, Fermin Martinez Garcia, Francisco Cambronero, Noelia Castro, Antonio Castro, Alejandro De La Rosa, Pastora Gallego, Irene Mendez, David Villagomez Villegas, Manuel Gonzalez Correa, Roman Calvo, Francisco Florian, Rafael Paya, Esther Esteban, Francisco Buendia, Andrés Cubillos, Carmen Fernandez, Juan Pablo Cárdenas, José Leandro Pérez-Boscá, Joan Vano, Joaquina Belchi, Cristina Iglesia-Carreno, Francisco Calvo Iglesias, Aida Escudero-Gonzalez, Sergio Zapateria-Lucea, Juan Sterling Duarte, Lara Perez-Davila, Rafael Cobas-Paz, Rosario Besada-Montenegro, Maribel Fontao-Romeo, Elena Lopez-Rodriguez, Emilio Paredes-Galan, Berenice Caneiro-Queija, Alba Guitian Gonzalez, Abdi Bozkurt, Serafettin Demir, Durmus Unlu, Caglar Emre Cagliyan, Muslum Firat Ikikardes, Mustafa Tangalay, Osman Kuloglu, Necla Ozer, Ugur Canpolat, Melek Didem Kemaloglu, Abdullah Orhan Demirtas, Didar Elif Akgün, Eyup Avci, Gokay Taylan, Mustafa Adem Yilmaztepe, Fatih Mehmet Ucar, Servet Altay, Muhammet Gurdogan, Naile Eris Gudul, Mujdat Aktas, Mutlu Buyuklu, Husnu Degirmenci, Mehmet Salih Turan, Kadir Ugur Mert, Gurbet Ozge Mert, Muhammet Dural, Sukru Arslan, Nurten Sayar, Batur Kanar, Beste Ozben Sadic, Ahmet Anil Sahin, Ahmet Buyuk, Onur Kilicarslan, Cem Bostan, Tarik Yildirim, Seda Elcim Yildirim, Kahraman Cosansu, Perihan Varim, Ersin Ilguz, Recep Demirbag, Asuman Yesilay, Abdullah Cirit, Eyyup Tusun, Emre Erkus, Muhammet Rasit Sayin, Zeynep Kazaz, Selim Kul, Turgut Karabag, Belma Kalayci, Clinical sciences, Cardio-vascular diseases, and Cardiology

Subjects
Male, medicine.medical_specialty, Multivariate analysis, Clinical Decision-Making, Risk Assessment, Severity of Illness Index, decision making, surgery, Risk Factors, Internal medicine, Intervention (counseling), medicine, Clinical endpoint, Humans, 03.02. Klinikai orvostan, guidelines, Symptomatic aortic stenosis, Aged, Retrospective Studies, Aged, 80 and over, business.industry, valvular heart disease, Disease Management, aortic stenosis, Aortic Valve Stenosis, Odds ratio, medicine.disease, Europe, Stenosis, Treatment Outcome, Echocardiography, Aortic Valve, Charlson comorbidity index, transcatheter aortic valve replacement, Female, Morbidity, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, surgical aortic valve replacement
Abstract

BACKGROUND There were gaps between guidelines and practice when surgery was the only treatment for aortic stenosis (AS). OBJECTIVES This study analyzed the decision to intervene in patients with severe AS in the EORP VHD (EURObservational Research Programme Valvular Heart Disease) II survey. METHODS Among 2,152 patients with severe AS, 1,271 patients with high-gradient AS who were symptomatic fulfilled a Class I recommendation for intervention according to the 2012 European Society of Cardiology guidelines; the primary end point was the decision for intervention. RESULTS A decision not to intervene was taken in 262 patients (20.6%). In multivariate analysis, the decision not to intervene was associated with older age (odds ratio [OR]: 1.34 per 10-year increase; 95% CI: 1.11 to 1.61; P = 0.002), New York Heart Association functional classes I and II versus III (OR: 1.63; 95% CI: 1.16 to 2.30; P = 0.005), higher age adjusted Charlson comorbidity index (OR: 1.09 per 1-point increase; 95% CI: 1.01 to 1.17; P = 0.03), and a lower transaortic mean gradient (OR: 0.81 per 10-mm Hg decrease; 95% CI: 0.71 to 0.92; P < 0.001). During the study period, 346 patients (40.2%, median age 84 years, median EuroSCORE II [European System for Cardiac Operative Risk Evaluation II] 3.1%) underwent transcatheter intervention and 515 (59.8%, median age 69 years, median EuroSCORE II 1.5%) underwent surgery. A decision not to intervene versus intervention was associated with lower 6-month survival (87.4%; 95% CI: 82.0 to 91.3 vs 94.6%; 95% CI: 92.8 to 95.9; P < 0.001). CONCLUSIONS A decision not to intervene was taken in 1 in 5 patients with severe symptomatic AS despite a Class I recommendation for intervention and the decision was particularly associated with older age and combined comorbidities. Transcatheter intervention was extensively used in octogenarians. (J Am Coll Cardiol 2021;78:2131-2143) (c) 2021 by the American College of Cardiology Foundation.

Published
2021

26. Aortic valve repair versus mechanical valve replacement for root aneurysm: the CAVIAAR multicentric study

Author

Emmanuel Lansac, Isabelle Di Centa, Pichoy Danial, Olivier Bouchot, Eric Arnaud-Crozat, Rachid Hacini, Fabien Doguet, Roland Demaria, Jean Philippe Verhoye, Jerome Jouan, Didier Chatel, Stephane Lopez, Thierry Folliguet, Pascal Leprince, Thierry Langanay, Christian Latremouille, Georges Fayad, Jean Philippe Fleury, Jean Luc Monin, Leila Mankoubi, Milena Noghin, Alain Berrebi, Sarah Pousset, Aline Laubriet-Jazayeri, Alexandre Lafourcade, Estelle Marcault, Michel Kindo, Laurent Payot, Eric Bergoend, Cecile Jourdain Hoffart, Mathieu Debauchez, and Florence Tubach

Subjects
Pulmonary and Respiratory Medicine, Reoperation, Heart Valve Prosthesis Implantation, Aortic Valve Insufficiency, General Medicine, Middle Aged, Cardiac Valve Annuloplasty, Aortic Aneurysm, Treatment Outcome, Aortic Valve, Quality of Life, Humans, Surgery, Prospective Studies, Cardiology and Cardiovascular Medicine, Retrospective Studies
Abstract

OBJECTIVES Despite growing evidence that aortic valve repair improves long-term patient outcomes and quality of life, aortic valves are mostly replaced. We evaluate the effect of aortic valve repair versus replacement in patients with dystrophic aortic root aneurysm up to 4 years. METHODS The multicentric CAVIAAR (Conservation Aortique Valvulaire dans les Insuffisances Aortiques et les Anévrismes de la Racine aortique) prospective cohort study enrolled 261 patients: 130 underwent standardized aortic valve repair (REPAIR) consisting of remodelling root repair with expansible aortic ring annuloplasty, and 131 received mechanical composite valve and graft replacement (REPLACE). Primary outcome was a composite criterion of mortality, reoperation, thromboembolic or major bleeding events, endocarditis or operating site infections, pacemaker implantation and heart failure, analysed with propensity score-weighted Cox model analysis. Secondary outcomes included major adverse valve-related events and components of primary outcome. RESULTS The mean age was 56.1 years, and valve was bicuspid in 115 patients (44.7%). Up to 4 years, REPAIR did not significantly differ from REPLACE in terms of primary outcome [Hazard Ratio (HR) 0.66 (0.39; 1.12)] but showed significantly less valve-related deaths (HR 0.09 [0.02; 0.34]) and major bleeding events (HR 0.37 [0.16; 0.85]) without an increased risk of valve-related reoperation (HR 2.10 [0.64; 6.96]). When accounting for the occurrence of multiple events in a single patient, the REPAIR group had half the occurrence of major adverse valve-related events (HR 0.51 [0.31; 0.86]). CONCLUSIONS Although the primary outcome did not significantly differ between the REPAIR and REPLACE groups, the trend is in favour of REPAIR by a significant reduction of valve-related deaths and major bleeding events. Long-term follow-up beyond 4 years is needed to confirm these findings.

Published
2021

27. Aortic Valve Surgery in Nonelderly Patients: Insights Gained From AVIATOR

Author

Jean-François Fuzellier, Christophe de Meester, Rémi Houel, Florence Tubach, Georges Fayad, Maciej Matuszewski, Eric Arnaud-Crozat, Svenja Rauch, Jean-François Obadia, Adrian Kolesar, Matteo Pettinari, Bardia Arabkhani, Jos A. Bekkers, Fabrizio Ceresa, Andrea Mangini, Dave R. Koolbergen, Daniel Czytrom, František Sabol, Thomas J van Brakel, Ignacio Bibiloni, Pallav Shah, Rosina Ziller, Alain Leguerrier, Marek Jasiński, Gianclaudio Mecozzi, Mihail Svetkin, Taoufik Benkacem, Jaroslav Hlubocky, Hans-Joachim Schäfers, Vincent Doisy, Jean-Luc Monin, Christine Leon, Carlo Antona, Jan Vojacek, Munir Boodhwani, Francesco Patane, Andrey Slautin, Gebrine Elkhoury, Rubina Rosa, Yutaka Okita, Ismail El-Hamamsy, Wenke Goossens, Alain Berrebi, Paolo Ferrero, Jan Nijs, Fabien Doguet, Mauro Masat, Monica Contino, Edward P. Chen, Gregorio Rábago, Stéphane Lopez, Duke E. Cameron, Johannes Steindl, José Aramendi, Eric Bergoend, Maurice Enriquez-Sarano, Jean-Louis Vanoverschelde, Bart Meuris, Virginia Alvarez-Asiain, Robert Novotny, Davor Barić, Michael A. Borger, Tomas Toporcer, Ruggero De Paulis, Leila Mankoubi, J. M. Marnette, Christelle Diakov, Amaia Melero, Said Soliman, Michael Tousch, Ryan E. Accord, Philippe Pibarot, Mikita Karalko, Vladislav Aminov, Agnes Pasquet, Serban Stoica, David Messika Zeitoun, Olivier Bouchot, Bernard Albat, Jérôme Jouan, Savica Gjorgijevska, Klaartje Van den Bossche, Igor Rudez, J. Kluin, Laurent de Guillaume Jondeau, Didier Chatel, Pascal Leprince, Sarah Pousset, Rafael Sadaba, Veerle Van Mossevelde, Evi Schepmans, Johanna J.M. Takkenberg, Carlos Porras, Herbert Gutermann, Isabelle Di Centa, Aude Boignard, Joseph E. Bavaria, Pierre-Emmanuel Noly, Yves Glock, Corinne Coulon, Bart Loeys, Rita K. Milewski, Christian Dinges, Marien Lenoir, Francesco Grigioni, Alejandro Crespo, Patrick Moeller, Frederiek de Heer, Mohamad Bashir, Milean Noghin, Fadoua Kaddouri, Takashi Kunihara, Isaac Wenger, Ilaria Chirichilli, Claudia Romagnoni, Diana Aicher, Arturo Evangelista Masip, Daniel Unić, Emmanuel Lansac, Fabrice Wautot, Peter Verbrugghe, Laurent de Kerchove, Pouya Youssefi, Josip Varvodić, Robert J.M. Klautz, Patrick Yiu, Frank Theisohn, Pavel Zacek, Guy Fernandez, Takeshi Miyairi, Thierry Bourguignon, Cardiothoracic Surgery, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, and UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique

Subjects
Aortic valve, Time Factors, Nonelderly patients, medicine.medical_treatment, Heart Valve Diseases, AVIATOR, Aortic valve surgery, Adult, Age Factors, Aortic Valve, Bioprosthesis, Evidence-Based Medicine, Heart Valve Prosthesis, Life Expectancy, Middle Aged, Prosthesis Failure, Recovery of Function, Registries, Risk Factors, Treatment Outcome, Heart Valve Prosthesis Implantation, Transcatheter Aortic Valve Replacement, 030204 cardiovascular system & hematology, 0302 clinical medicine, Aortic valve repair, Quality of life, Expectancy theory, education.field_of_study, Ross procedure, General Medicine, medicine.anatomical_structure, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Population, 03 medical and health sciences, medicine, Humans, education, business.industry, Mechanical Aortic Valve, Surgery, Settore MED/23, 030228 respiratory system, Life expectancy, business
Abstract

Aortic valve surgery in non-elderly patients represents a very challenging patient population. The younger the patient is at the point of aortic valve intervention, the longer their anticipated life expectancy will be, with longer exposure to valve-related complications and risk for re-operation. Although the latest international guidelines recommend aortic valve repair in patients with aortic valve insufficiency, what we see in the real world is that the vast majority of these aortic valves are replaced. However, current prosthetic valves has now been shown to lead to significant loss of life expectancy for non-elderly patients up to 50% for patients in their 40s undergoing mechanical aortic valve replacement. Bioprostheses carry an even worse long-term survival, with higher rates of re-intervention. The promise of trans-catheter valve-in-valve technology is accentuating the trend of bioprosthetic implantation in younger patients, without yet the appropriate evidence. In contrast, aortic valve repair has shown excellent outcomes in terms of quality of life, freedom from re-operation and freedom from major adverse valve-related events with similar life expectancy to general population as it is also found for the Ross procedure, the only available living valve substitute. We are at a time when the paradigm of aortic valve surgery needs to change for the better. To better serve our patients, we must acquire high quality real-world evidence from multiple centers globally - this is the vision of the AVIATOR registry and our common responsibility.

Published
2019

28. Primary Mitral Regurgitation

Author

Eric Brochet and Alain Berrebi

Subjects
medicine.medical_specialty, Mitral regurgitation, Primary (chemistry), business.industry, Internal medicine, medicine, Cardiology, business
Published
2020

29. AZF : Du prix Nobel de Fritz Haber à l'explosion de l'usine de Toulouse

Author

Alain Berrebi and Alain Berrebi

Abstract

Breslau, 1868, Fritz Haber voit le jour près de la grande synagogue de la Cigogne Blanche dans le quartier Juif de la ville. Chimiste de génie il met au point la synthèse de l'ammoniac, permet la production industrielle d'engrais azotés et prévient la famine pour plusieurs milliards d'être humain. Avant la découverte de Fritz Haber, les engrais azotés nécessitaient de prélever le guano sud-américain et le salpêtre du Chili dont les réserves s'épuisent à vue d'œil. Il reçoit, pour cette découverte et prouesse technologique, le Prix Nobel de Chimie en 1919. Mais Haber se sert également de ses connaissances en chimie pour mettre au point les gaz de combat pendant la Première Guerre Mondiale. Toulouse, le 21 septembre 2001 à 10h17, l'explosion de 300 à 400 kilos de nitrate d'ammonium de l'usine AZF fait 31 morts, plus de 2.500 blessés et des dégâts considérables aux alentours. Quel rapport entre Fritz Haber et la catastrophe d'AZF? C'est ce que propose de vous faire découvrir cet ouvrage qui relate une histoire étonnante et dramatique à la fois.À PROPOS DE L'AUTEURAlain Berrébi a été médecin hospitalier à Toulouse. Il est l'auteur de plusieurs ouvrages dont les « Maladies rares et grossesse » aux éditions Flammarion, « Les grandes épidémies et pandémies de l'Histoire » aux éditions Sydney Laurent et « La Murène ou Marcus Eliezer Bloch » aux éditions Edilivre.

Published
2023

30. Root repair with aortic ring annuloplasty using the standard approach

Author

Daniel Czytrom, Leila Mankoubi, Alain Berrebi, Milena Noghin, Pavel Zacek, Emmanuel Lansac, Mathieu Debauchez, Jean Luc Monin, and Pouya Youssefi

Subjects
medicine.medical_specialty, Aortic Valve Insufficiency, Hemodynamics, 030204 cardiovascular system & hematology, Cardiac Valve Annuloplasty, 03 medical and health sciences, 0302 clinical medicine, Aortic valve repair, Aortic ring, Risk Factors, medicine.artery, Internal medicine, Ascending aorta, medicine, Humans, Cardiac skeleton, Prosthetic valve, Heart Valve Prosthesis Implantation, Aorta, business.industry, Sinotubular Junction, General Medicine, Recovery of Function, Aortic Aneurysm, Treatment Outcome, 030228 respiratory system, Aortic Valve, Heart Valve Prosthesis, cardiovascular system, Cardiology, Quality of Life, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract

Standardization of aortic valve repair techniques with use of a calibrated annuloplasty have led to improved long-term outcomes in dystrophic aortic insufficiency. It can also improve dissemination of techniques and rates of aortic valve repair. Dystrophic aortic insufficiency can be found in three aortic phenotypes: dilated aortic root, dilated ascending aorta and isolated aortic insufficiency. The aortic annulus is invariably dilated above 25 mm in the vast majority of cases of aortic insufficiency, regardless of whether the aorta is dilated or not. A dilated annulus is a risk factor for late failure of aortic valve repair if not addressed at the time of surgery. We perform a calibrated annuloplasty at both sub- and supra-valvular levels in order to restore the ratio of sinotubular junction and annulus. Current evidence shows aortic valve repair reduces valve-related mortality compared to prosthetic valve replacement, with an improved quality of life.

Published
2020

31. Standardization of bicuspid valve repair with aortic annuloplasty provides similar results to tricuspid aortic valve repair

Author

Milena Noghin, N. Khelil, M Debauchez, Leila Mankoubi, C Le Breton, Jean-Luc Monin, Alain Berrebi, E. Lansac, and Nicolas Amabile

Subjects
medicine.medical_specialty, Aortic valve repair, business.industry, Bicuspid valve, Internal medicine, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Background Bicuspid aortic valves (BAV) represent the main cause of severe dystrophic aortic insufficiency in young patients and are mostly replaced with high rates of valve-related events and altered quality of life in case of mechanical prosthesis. Valve repair is now recommended for root aneurysm and tricuspid aortic valves (TAV) when feasible. However, concerns remain regarding the long-term durability of BAV repair, compared to TAV. Purpose Our objective is to compare the long-term results of repair between TAV and BAV, in consecutive patients operated on with a standardized approach according to each phenotype of the dystrophic ascending aorta. Methods Data were prospectively collected into the multicenter international AVIATOR registry (AorticValve repair InternATiOnal Registry). Between 2003 and 2019, according to ascending aorta phenotypes, 226 patients with BAV and 309 patients with TAV underwent either isolated valve repair with external ring annuloplasty (26,2%), or root remodeling with external ring (59,4%), or a supra-coronary graft with external ring (14,4%). Results Cusp repair was performed in 95,1% patients in the BAV group and in 63,8% in the TAV group. The 30-day operative mortality was 0,93% (n=5). Mean follow-up was 5,5±4,4 years. The actuarial survival rate at 12 years was 93,2% in the BAV group and 87,8% in the TAV group (p=0,14). Freedom from reoperation at 12 years was similar between groups being 94,9% for bicuspid and 93,2% for tricuspid (p=0,75). Freedom from major adverse valve-related events at 12 years was 82,8% and 82,9% in BAV and TAV groups respectively (p=0,17). At 12 years, freedom from AI ≥Grade 2 or ≥Grade 3 was 68,7% and 94,3% for BAV and 76,5% and 94,7% for TAV group, with no significant difference (respectively p=0,16 and p=0,92). Conclusion Aortic valve repair with a standardized approach adapted to the aorta phenotype provides excellent long-term results with a low rate of valve-related events. Similar results were achieved between BAV and TAV patients. freedom from reoperation for BAV and TAV Funding Acknowledgement Type of funding source: None

Published
2020

32. Multiple reoperations on the aortic valve: outcomes and implications for future potential valve-in-valve strategy†

Author

Jean-Noël Fabiani, Alain Berrebi, Paul Achouh, Alain Carpentier, Yashutosh Joshi, Philippe Menasché, Jérôme Jouan, and Christian Latremouille

Subjects
Male, Reoperation, Pulmonary and Respiratory Medicine, Aortic valve, medicine.medical_specialty, Percutaneous, medicine.medical_treatment, Heart Valve Diseases, 030204 cardiovascular system & hematology, Preoperative care, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, medicine, Humans, Endocarditis, Aged, Retrospective Studies, Bioprosthesis, Heart Valve Prosthesis Implantation, business.industry, Mitral valve replacement, Retrospective cohort study, General Medicine, Odds ratio, Middle Aged, medicine.disease, Surgery, Treatment Outcome, medicine.anatomical_structure, 030228 respiratory system, Aortic Valve, Heart Valve Prosthesis, Concomitant, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Objectives Surgical mortality and long-term outcomes are important considerations when determining strategies for multiple reoperations on the aortic valve (AV). With the rise of percutaneous valve-in-valve, we sought to evaluate the current outcomes of conventional surgery for AV reoperation, focusing first on the effect of the number of previous AV interventions with a subsequent analysis of the risk factors for adverse outcomes. Methods From January 2007 to December 2016, 316 consecutive patients underwent an open redo operation (replacement) on their AV at a single centre. It was the first AV reintervention in 263 patients (Group 1), second in 42 patients (Group 2) and third or more in 11 patients (Group 3). Results There were 230 men and 86 women, with a median age of 58 (Q1-Q3: 46-70) years. Structural valve deterioration (SVD) of the bioprosthesis (n = 136, 44%), endocarditis (n = 57, 18%) and prosthetic valve dehiscence (n = 41, 13%) were the most common reasons for reintervention. Overall, in-hospital mortality was 7.3%: 7.2% in Group 1, 4.76% in Group 2 and 18.2% in Group 3 (P = 0.233) and ranged from 3.7% for SVD to 14.0% when endocarditis was the reason for reintervention. Higher preoperative New York Heart Association (NYHA) class (III/IV) [odds ratio (OR) 15.9, P = 0.011], injury during re-entry (OR 16.9, P = 0.015), endocarditis (OR 3.7, P = 0.038) and concomitant mitral valve replacement (OR 5.6, P = 0.006) were independent risk factors for in-hospital mortality. Survival at 8 years was 79.0 ± 3.0% for the entire cohort and 88.4 ± 3.2% for re-replacement after SVD. Conclusions Multiple AV reoperations carry an acceptable risk of early postoperative mortality, particularly for isolated valve replacements of SVD.

Published
2017

33. Noninvasive Coronary Flow Reserve Predicts Response to Exercise in Asymptomatic Severe Aortic Stenosis

Author

F. Elmkies, Jerome Clerc, Daniel Czitrom, Alain Berrebi, Patrick Meimoun, Sonia Martis, and Jean Christophe Seghezzi

Subjects
Male, medicine.medical_specialty, 030204 cardiovascular system & hematology, Anterior Descending Coronary Artery, Severity of Illness Index, Asymptomatic, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Coronary Circulation, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, 030212 general & internal medicine, Exertion, Aged, Exercise Tolerance, Ejection fraction, Receiver operating characteristic, business.industry, Coronary flow reserve, Aortic Valve Stenosis, Middle Aged, medicine.disease, Coronary Vessels, Echocardiography, Doppler, Color, Stenosis, Asymptomatic Diseases, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Blood Flow Velocity, Echocardiography, Stress, Follow-Up Studies
Abstract

In patients with asymptomatic aortic stenosis (AS), exercise stress echocardiography (ESE) provides additional prognostic information beyond baseline. The coronary flow velocity reserve (CFVR) is impaired in AS, but its link with exertion is unknown in this setting. The aim of this study was to test the hypothesis that CFVR could predict exercise capacity and abnormal exercise test results in AS.Noninvasive CFVR and symptom-limited semisupine ESE were prospectively performed the same day in 43 patients with asymptomatic isolated severe AS (mean age, 68.5 ± 11 years; 26% women; mean aortic valve area, 0.8 ± 0.16 cmResting, hyperemic left anterior descending coronary artery flow velocity and CFVR (2.45 ± 0.8 vs 2.4 ± 0.8) were similar between the group unable to perform ESE and the ESE group (P = NS for all). Compared with patients with normal results on ESE, those with abnormal results on ESE (n = 22) were older, had higher E/e' ratios, had higher resting left anterior descending coronary artery flow velocities (39 ± 12 vs 31 ± 8 cm/sec), and had lower CFVR (2.01 ± 0.3 vs 2.85 ± 0.7; P .01 for all). Furthermore, CFVR was significantly correlated with age, changes in transvalvular pressure gradient and left ventricular ejection fraction with exercise, workload (in watts), and exercise duration (P .05 for all). After adjusting for other variables, CFVR remained independently correlated with exercise duration, workload, and abnormal results on ESE (P .01 for all). On receiver operating characteristic curve analysis, CFVR 2.3 was the best cutoff to predict abnormal results on ESE (area under the curve = 0.88 ± 0.06, P .01).In patients with asymptomatic severe AS, noninvasive CFVR is correlated with exercise duration and workload, and low CFVR predicts abnormal results on ESE with good accuracy.

Published
2017

34. Clinical Trial Principles and Endpoint Definitions for Paravalvular Leaks in Surgical Prosthesis

Author

Stephen R. Ramee, E. Marc Jolicoeur, Alain Berrebi, Patrick T. O'Gara, Chad Kliger, Gino Gerosa, Carlos E. Ruiz, Greg Fontana, Martin B. Leon, Zoltan G. Turi, Patrick Nataf, Vladimir Jelnin, Josep Rodés-Cabau, Rakesh M. Suri, Julie A. Swain, Paul Sorajja, Jonathon Leipsic, E. Murat Tuzcu, José Luis Zamorano, Rebecca T. Hahn, Francesco Maisano, Neil J. Weissman, Reda Ibrahim, Charanjit S. Rihal, Itzhak Kronzon, Philippe Pibarot, Hasan Jilaihawi, Jeffrey S. Borer, Xavier Millán, Patrick W. Serruys, Donald E. Cutlip, University of Zurich, and Ruiz, Carlos E

Subjects
Research design, Cardiac Catheterization, medicine.medical_specialty, Standardization, Endpoint Determination, medicine.medical_treatment, Concordance, Aortic Valve Insufficiency, MEDLINE, 610 Medicine & health, 030204 cardiovascular system & hematology, Risk Assessment, Severity of Illness Index, Prosthesis, 2705 Cardiology and Cardiovascular Medicine, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, Disease severity, Severity of illness, Outcome Assessment, Health Care, medicine, Clinical endpoint, Humans, 030212 general & internal medicine, Intensive care medicine, closure devices, Statement (computer science), Clinical Trials as Topic, Sutures, business.industry, regurgitation, 10020 Clinic for Cardiac Surgery, Surgery, Clinical trial, Echocardiography, Research Design, transcatheter, Aortic Valve, Heart Valve Prosthesis, Cardiology and Cardiovascular Medicine, business, Vascular Closure Devices
Abstract

The VARC (Valve Academic Research Consortium) for transcatheter aortic valve replacement set the standard for selecting appropriate clinical endpoints reflecting safety and effectiveness of transcatheter devices, and defining single and composite clinical endpoints for clinical trials. No such standardization exists for circumferentially sutured surgical valve paravalvular leak (PVL) closure. This document seeks to provide core principles, appropriate clinical endpoints, and endpoint definitions to be used in clinical trials of PVL closure devices. The PVL Academic Research Consortium met to review evidence and make recommendations for assessment of disease severity, data collection, and updated endpoint definitions. A 5-class grading scheme to evaluate PVL was developed in concordance with VARC recommendations. Unresolved issues in the field are outlined. The current PVL Academic Research Consortium provides recommendations for assessment of disease severity, data collection, and endpoint definitions. Future research in the field is warranted.

Published
2017

35. Développement d'une approche intégrative modélisatrice pour évaluer l'exposition interne foetale humaine à un contaminant, appliquée au bisphénol A au titre de molécule modèle

Author

Gayrard-Troy, Véronique V., Glenn Gauderat, Marlène Lacroix, Alain Berrebi, Daniel Zalko, Laurent Debrauwer, Catherine Viguié, Nicole Picard-Hagen, ToxAlim (ToxAlim), Institut National de la Recherche Agronomique (INRA)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Gynécologie‑Obstétrique, Hôpital Paule de Viguier, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], CHU Toulouse [Toulouse], and Centre hospitalier universitaire de Toulouse - CHU Toulouse

Subjects
[SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2019

36. Systematic echocardiographic assessment of aortic regurgitation-what should the surgeon know for aortic valve repair?

Author

Jean-Luc Monin, Emmanuel Lansac, and Alain Berrebi

Subjects
Aortic valve, Aorta, medicine.medical_specialty, Keynote Lecture Series, business.industry, General surgery, Regurgitation (circulation), 030204 cardiovascular system & hematology, medicine.disease, Clinical Practice, 03 medical and health sciences, 0302 clinical medicine, Aortic valve repair, medicine.anatomical_structure, Aneurysm, 030228 respiratory system, medicine.artery, Heart team, medicine, Materials Chemistry, Surgery, Cardiology and Cardiovascular Medicine, business, Surgical treatment
Abstract

Aortic valve (AV) repair is the preferred surgical treatment in young patients with aortic regurgitation (AR) and/or proximal aorta aneurysm, as noted in the recent European Society of Cardiology (ESC) guidelines. However, this surgical option is still underused in clinical practice. This emphasizes the need to build a heart team dedicated to AV repair with expert surgeons and echocardiographers. Surgical techniques are now standardized in their approaches to enhance the reproducibility and expansion of AV repair. The objective of this keynote is to also demonstrate the need for a standardized pre-pump intra-operative echocardiography protocol to fulfill surgeon’s needs in providing a road map and predicting techniques to be used for an effective and durable repair.

Published
2019

37. Incidence of Profound Hypogammaglobulinemia and Infection Rate in Lymphoma Patients Following the Combination of Chemotherapy and Rituximab

Author

Erica Sigler, Alain Berrebi, Lev Shvidel, Kalman Filanovsky, and Edward B. Miller

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Adolescent, Lymphoma, medicine.medical_treatment, Infections, Gastroenterology, Cohort Studies, Hypogammaglobulinemia, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Agammaglobulinemia, immune system diseases, hemic and lymphatic diseases, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Drug Discovery, medicine, Humans, Pharmacology (medical), Clinical significance, Young adult, Aged, Retrospective Studies, Aged, 80 and over, 030201 allergy, Chemotherapy, business.industry, Incidence, Incidence (epidemiology), General Medicine, Middle Aged, medicine.disease, Fludarabine, 030228 respiratory system, Oncology, Case-Control Studies, Immunology, Female, Rituximab, business, Follow-Up Studies, medicine.drug
Abstract

Background The Anti-CD20 monoclonal antibody Rituximab suppresses B-lymphocytes and may induce hypogammaglobulinemia in treated patients. The incidence and clinical significance of rituximab induced hypogammaglobulinemia in lymphoma patients is underestimated. Methods We retrospectively analyzed the rates of hypogammaglobulinemia, infection and infection-related mortality in 136 lymphoma patients who were treated with a combination of chemotherapy and rituximab. Results Rituximab given in more than 8 doses (OR 6.05, 95% CI: 1.24-29.5), relative hypogammaglobulinemia at time of lymphoma diagnosis (OR 4.2, 95% CI: 1.26-14.1) and the combination of fludarabine with rituximab (OR 3.4, 95% CI: 1.24-9.47) were factors significantly associated with prolonged (more than 6 months) hypogammaglobulinemia. The combination of fludarabine and rituximab (OR 6.4, 95% CI: 1.49-27.0) and secondarily prolonged hypogammaglobulinemia (OR 4.5, 95% CI: 1.19-18.5) were found to be predictive factors for severe infections and infection-related mortality. Conclusion These data suggest the importance of following serum immunoglobulin levels before and after combination immuno-chemotherapy, particularly in patients with recurrent infections or relapsed/refractory disease.

Published
2016

38. Pitting new treatments for chronic lymphocytic leukemia against old ones: how do they fare?

Author

Lev Shvidel and Alain Berrebi

Subjects
Bendamustine, Oncology, medicine.medical_specialty, Chronic lymphocytic leukemia, Antineoplastic Agents, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, hemic and lymphatic diseases, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Transplantation, Homologous, Cyclophosphamide, Chlorambucil, business.industry, Hematology, Prognosis, medicine.disease, Leukemia, Lymphocytic, Chronic, B-Cell, Surgery, Fludarabine, Regimen, chemistry, 030220 oncology & carcinogenesis, Ibrutinib, Rituximab, Immunotherapy, Neoplasm Recurrence, Local, business, Idelalisib, Immunosuppressive Agents, Vidarabine, Stem Cell Transplantation, 030215 immunology, medicine.drug
Abstract

Significant progress has been made in the treatment of chronic lymphocytic leukemia (CLL) patients during the last two decades. In this review we present a personal case study for discussion on contemporary management in CLL. Presently immunochemotherapy using fludarabine, cyclophosphamide, and rituximab (FCR) is the standard upfront regimen for physically fit patients requiring treatment. Patients older than 65 years can be treated with modified doses of FCR, bendamustine, or chlorambucil combined with anti-CD20 antibody. This treatment can be repeated at relapse when the duration of response is over 2 years. Patients at high risk (with 17p deletion or early relapse) need alternative treatment with novel agents, e.g. ibrutinib or idelalisib. However, the optimal use of the novel agents in terms of duration, combinations, and long-term adverse effects is unknown. In selected eligible patients at high risk, allogeneic transplantation should be considered. Clinical trials in all stages of treatment are encouraged.

Published
2015

39. PERPHERAL BLOOD CELL MITOCHONDRIAL DYSFUNCTION IN MYELODYSPLASTIC SYNDROMECAN BE IMPROVED BY A COMBINATION OF COENZYME Q10 AND CARNITINE

Author

Erica Sigler, Olga Shevetz, Kalman Filanovsky, Atan Gross, Andrei Braester, Vita Mirkin, Yehudit Zaltsman-Amir, Anfisa Stanevsky, Alain Berrebi, Ekaterina Votinov, Lev Shvidel, and Michal Haran

Subjects
0301 basic medicine, Coenzyme Q10, Cytopenia, business.industry, Hematology, Oxidative phosphorylation, Mitochondrion, Pharmacology, medicine.disease, Peripheral blood, 03 medical and health sciences, chemistry.chemical_compound, 030104 developmental biology, 0302 clinical medicine, Infectious Diseases, chemistry, hemic and lymphatic diseases, 030220 oncology & carcinogenesis, medicine, Peripheral blood cell, Carnitine, business, Mitochondrial protein, medicine.drug
Abstract

Structural mitochondrial abnormalities as well as genetic aberrations in mitochondrial proteins have been known in Myelodysplastic syndrome (MDS) , yet there is currently little data regarding the metabolic properties and energy production of MDS cells. In the current study we used state-of-the-art methods to assess OXPHOS in peripheral blood cells obtained from MDS patients and healthy controls We then assessed the effect of food supplements- Coenzyme Q10 and carnitine on mitochondrial function and hematological response .We show here for the first time that in low risk MDS there is a significant impairment of mitochondrial respiration in peripheral blood cells and this can be improved with food supplements. We also show that such myelodysplastic syndrome, mitochondria, oxidative phosphorylation, coenzyme Q10, seahorse XF analyzer. supplements lead to improvement in cytopenia's and quality of life.

Published
2020

40. Aortic valve repair—'Pearls and Pitfalls'

Author

Leila Mankoubi, Daniel Czytrom, Mathieu Debauchez, Emmanuel Lansac, Jean Luc Monin, Christelle Diakov, Pavel Zacek, Alain Berrebi, Milena Noghin, and Pouya Youssefi

Subjects
medicine.medical_specialty, Aortic valve repair, business.industry, medicine, business, Surgery
Published
2020

41. Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial

Author

Laurent Mandelbrot, François Kieffer, Rémi Sitta, Hélène Laurichesse-Delmas, Norbert Winer, Louis Mesnard, Alain Berrebi, Gwenaëlle Le Bouar, Jean-Paul Bory, Anne-Gaëlle Cordier, Yves Ville, Franck Perrotin, Jean-Marie Jouannic, Florence Biquard, Claude d’Ercole, Véronique Houfflin-Debarge, Isabelle Villena, Rodolphe Thiébaut, Denis Pons, C. Nourrisson, Rose-Anne Lavergne, Judith Fillaux, Corinne Assouline, Florence Robert-Gangneux, Coralie L’Ollivier, Florence Bretelle, Béatrice Guidicelli, Patricia Garcia, Anne-Gaelle Cordier, Alexandra Benachi, Christelle Vauloup-Fellous, Emmanuelle Letamendia, Marie-Elisabeth Bougnoux, Nathalie Van Langendonck, Jérôme Potin, Pierre Marty, Christelle Pomarès, Cynthia Trastour, Anne Sophie Deleplancque, Jean-Marc Costa, Marie-Thérèse Chève, Jean-Yves Col, Bernard Cimon, Y. Sterkers, Laurence Lachaud, Gilles Burlet, Martine Maréchaud, Estelle Perraud, Anne-Gaelle Grébille, Morgane Valentin, Sandrine Houzé, Sophie Omnès, Yvon Chitrit, Christine Boissinot, Hélène Yéra, Olivia Anselem, Vassilis Tsatsaris, Marie-Victoire Sénat, Florent Fuchs, Adela Angoulvant, Charles Muszynski, Anne Totet, Catherine Noël, Laurent Bidat, Tiphaine Barjat, Pierre Flori, Hervé Pelloux, Marie-Pierre Brenier-Pinchart, Catherine Thong-Vanh, Corinne Floch, Lionel Carbillon, Eric Lachassine, Aude Ricbourg, Luc Paris, Marc Dommergues, Thierry Rousseau, Frederic Dalle, Marie Laure Dardé, Véronique Aubard, Camille Olivier, Eric Verspyk, Loic Favennec, Service de gynécologie obstétrique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Nord Val de Seine, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de Puériculture et de Périnatalogie, Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Physiopathologie des Adaptations Nutritionnelles (PhAN), Institut National de la Recherche Agronomique (INRA)-Université de Nantes (UN), Gynécologie‑Obstétrique, Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Université Paris Descartes - Paris 5 (UPD5), CHU Necker - Enfants Malades [AP-HP], Centre Hospitalier Universitaire de Reims (CHU Reims), CHRU Tours, Hôpital Bretonneau, Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie-Obstétrique [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Service de gynécologie-obstétrique, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Epidémiosurveillance de protozooses à transmission alimentaire et vectorielle (ESCAPE), Université de Reims Champagne-Ardenne (URCA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Université de Bordeaux (UB), Centre de recherche sur la Paléobiodiversité et les Paléoenvironnements (CR2P), Muséum national d'Histoire naturelle (MNHN)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Microorganismes : Génome et Environnement (LMGE), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS), Centre de Physiopathologie Toulouse Purpan (CPTP), 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)-Centre National de la Recherche Scientifique (CNRS), Service de Parasitologie et Mycologie, CHU Toulouse [Toulouse]-Institut Fédératif de Biologie (IFB) - Hôpital Purpan, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance Publique - Hôpitaux de Marseille (APHM), Gynépole, Aix Marseille Université (AMU)- Hôpital Nord [CHU - APHM], Service de gynécologie-obstétrique, médecine de la reproduction [Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Division of Pediatrics and Neonatal Critical Care, FAME Department, South Paris, University Hospitals, 'A.Beclere' Medical Center-APHP, Service de Parasitologie-Mycologie-Médecine Tropicale, CHRU Bretonneau, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Anofel Cryptosporidium National Network, Institut de signalisation, biologie du développement et cancer (ISBDC), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Laboratoire de Biologie Moléculaire, Hôpital américain, Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP), Université d'Angers (UA), Biologie, Génétique et Pathologie des Pathogènes Eucaryotes (MIVEGEC-BioGEPPE), Pathogènes, Environnement, Santé Humaine (EPATH), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), laboratoire parasitologie, CHU Bichat Paris, Ministère de la santé, Hôpital Louis Mourier - AP-HP [Colombes], Service de parasitologie-mycologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Service de Gynécologie et Obstétrique [Cochin], Hôpital Cochin [AP-HP], Physiopathologie et Pharmacotoxicologie Placentaire Humaine (U1139), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie-Obstétrique [Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Service de gynécologie-obstétrique et médecine de la reproduction, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Biomécanique et Bioingénierie (BMBI), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), Departments of Medical Parasitology and Mycology, Centre Hospitalier René Dubos [Pontoise], Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP), Université Jean Monnet [Saint-Étienne] (UJM), Laboratoire de parasitologie-mycologie, CHU Grenoble, Epigenetique, Pathologie et Developpement (UMR_S_741), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Parasitologie - Mycologie [CHU Pitié-Salpétrière], CHU Pitié-Salpêtrière [AP-HP], Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [CHU Pitié-Salpêtrière], Centre Max Weber (CMW), École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-Université Jean Monnet [Saint-Étienne] (UJM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Interactions Muqueuses Agents Transmissibles (LIMA), Université de Bourgogne (UB), Service de Gynécologie-Obstétrique [CHU Limoges], CHU Limoges, CHU Tenon [AP-HP], Appareil Digestif Environnement Nutrition (ADEN ), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), 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)-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), 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), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Bordeaux [Bordeaux], CHU Clermont-Ferrand, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional d'Orléans (CHRO), AP-HP - Hôpital Antoine Béclère [Clamart], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), PRES Université Nantes Angers Le Mans (UNAM), CHU Lille, Université de Reims Champagne-Ardenne (URCA), Hôpital Maison Blanche, 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), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Nantes (UN)-Institut National de la Recherche Agronomique (INRA), Hôpital Paule de Viguier, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Reims Champagne-Ardenne (URCA), Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Université Nice Sophia Antipolis (... - 2019) (UNS), Centre National de la Recherche Scientifique (CNRS)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Service de parasitologie - mycologie [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service Gynécologie [CHU Toulouse], Pôle Femme-Mère-Couple [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Parasitologie et Mycologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Jean Monnet - Saint-Étienne (UJM), École normale supérieure de Lyon (ENS de Lyon)-Université Lumière - Lyon 2 (UL2)-Université Jean Monnet - Saint-Étienne (UJM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hopital Louis Mourier - AP-HP [Colombes]-Hôpitaux Universitaires Paris Nord Val de Seine, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle de Gynécologie-Obstétrique et Reproduction Humaine, CHU Clermont-Ferrand-Université de Clermont-Ferrand, Physiologie des Adaptations Nutritionnelles [UMR_A1280] (PhAN), Centre de Physiopathologie Toulouse Purpan ex IFR 30 et IFR 150 (CPTP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), Centre de recherche Médecine, Science, Santé et Société (CERMES), Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Gynécologie et Obstétrique [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Hôpital Sud, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Antoine Béclère, Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Trousseau [APHP], Groupe d'Etude des Interactions Hôte-Parasite (GEIHP), Institut de Recherche pour le Développement (IRD [France-Sud])-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Hopital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre, Université Paris 13 (UP13)-Hôpital Jean Verdier [Bondy], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service de Gynécologie et Obstétrique [Groupe Hospitalier Pitié-Salpêtrière], CHU Pitié-Salpêtrière [APHP], and CHU Tenon [APHP]

Subjects
0301 basic medicine, Adult, medicine.medical_specialty, 030106 microbiology, Antiprotozoal Agents, Sulfadiazine, [SDV.MP.PRO]Life Sciences [q-bio]/Microbiology and Parasitology/Protistology, Toxoplasmosis, Congenital, law.invention, 03 medical and health sciences, Folinic acid, pyrimethamine-sulfadiazine, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Humans, 030212 general & internal medicine, Seroconversion, Pregnancy Complications, Infectious, ComputingMilieux_MISCELLANEOUS, spiramycin, prenatal diagnosis, tolerance, business.industry, Spiramycin, Obstetrics and Gynecology, Prenatal Care, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Toxoplasmosis, Infectious Disease Transmission, Vertical, 3. Good health, SISTM, Pyrimethamine, Treatment Outcome, Chemoprophylaxis, Drug Therapy, Combination, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, pregnancy, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug, toxoplasmosis
Abstract

International audience; Background - The efficacy of prophylaxis to prevent prenatal toxoplasmosis transmission is controversial, without any previous randomized clinical trial. In France, spiramycin is usually prescribed for maternal seroconversions. A more potent pyrimethamine + sulfadiazine regimen is used to treat congenital toxoplasmosis and is offered in some countries as prophylaxis. Objective - We sought to compare the efficacy and tolerance of pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission. Study design - This was a randomized, open-label trial in 36 French centers, comparing pyrimethamine (50 mg qd) + sulfadiazine (1 g tid) with folinic acid vs spiramycin (1 g tid) following toxoplasmosis seroconversion. Results - In all, 143 women were randomized from November 2010 through January 2014. An amniocentesis was later performed in 131 cases, with a positive Toxoplasma gondii polymerase chain reaction in 7/67 (10.4%) in the pyrimethamine + sulfadiazine group vs 13/64 (20.3%) in the spiramycin group. Cerebral ultrasound anomalies appeared in 0/73 fetuses in the pyrimethamine + sulfadiazine group, vs 6/70 in the spiramycin group (P = .01). Two of these pregnancies were terminated. Transmission rates, excluding 18 children with undefined status, were 12/65 in the pyrimethamine + sulfadiazine group (18.5%), vs 18/60 in the spiramycin group (30%, P = .147), equivalent to an odds ratio of 0.53 (95% confidence interval, 0.23-1.22) and which after adjustment tended to be stronger (P = .03 for interaction) when treatment started within 3 weeks of seroconversion (95% confidence interval, 0.00-1.63). Two women had severe rashes, both with pyrimethamine + sulfadiazine. Conclusion - There was a trend toward lower transmission with pyrimethamine + sulfadiazine, but it did not reach statistical significance, possibly for lack of statistical power because enrollment was discontinued. There were also no fetal cerebral toxoplasmosis lesions in the pyrimethamine + sulfadiazine group. These promising results encourage further research on chemoprophylaxis to prevent congenital toxoplasmosis.

Published
2018

42. Acute steroid myopathy: a highly overlooked entity

Author

Michal Haran, Amichai Schattner, A Mate, N. Kozak, Lev Shvidel, and Alain Berrebi

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, medicine.drug_class, 03 medical and health sciences, 0302 clinical medicine, Muscular Diseases, medicine, Humans, In patient, 030212 general & internal medicine, Respiratory system, Myopathy, Glucocorticoids, Aged, Proximal limb muscle weakness, Aged, 80 and over, Muscle Weakness, Critically ill, business.industry, General Medicine, Distal limb, Acute Disease, Corticosteroid, medicine.symptom, business, 030217 neurology & neurosurgery, Steroid Myopathy
Abstract

Background Myopathy in patients being treated with corticosteroids is known primarily among chronically treated patients or in critically ill and mechanically ventilated patients receiving corticosteroids, often in high doses. Aim To highlight the entity of acute, early onset corticosteroid-treatment-associated myopathy and its characteristics. Design and methods Reporting our experience with four patients and reviewing all published reports of myopathy developing ≤14 days of initiating corticosteroid-treatment. Results Acute corticosteroid myopathy (ASM) exists, though the syndrome appears to be rare. It is characterized by unpredictability and heterogeneity, sometimes developing within 1-3 days, after a single dose, which may not be high and administered by varied routes. Proximal limb muscle weakness is the most common form, but distal limb, bulbar and respiratory muscles may be involved. Steroid cessation often leads to improvement/resolution, but irreversibility may occur. Conclusions A high index of suspicion for the possibility of ASM is necessary to ensure drug discontinuation and recovery. This is particularly true since the entity is not widely recognized and its symptoms are often erroneously interpreted as due to the patient's underlying disease.

Published
2018

43. Perfluoroalkyl acid (PFAA) levels and profiles in breast milk, maternal and cord serum of French women and their newborns

Author

Jean-Philippe Antignac, Bruno Le Bizec, Charles Pollono, Ronan Cariou, Ami Yamada, Alain Berrebi, Jean-Charles Leblanc, Sophie Durand, Bruno Veyrand, Philippe Marchand, Daniel Zalko, LUNAM Université [Nantes Angers Le Mans], Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), CHU Toulouse [Toulouse], Métabolisme et Xénobiotiques (ToxAlim-MeX), ToxAlim (ToxAlim), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Recherche Agronomique (INRA)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Recherche Agronomique (INRA), Laboratoire d'étude des Résidus et Contaminants dans les Aliments (LABERCA), and Institut National de la Recherche Agronomique (INRA)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)

Subjects
Perfluorooctanesulfonic acid, Physiology, Breast milk, Perfluorononanoic acid, Toxicology, chemistry.chemical_compound, Pregnancy, CORD SERUM, Biomonitoring, Animals, Humans, Endocrine disruptors, lcsh:Environmental sciences, General Environmental Science, lcsh:GE1-350, Fluorocarbons, Milk, Human, Perinatal Exposure, Chemistry, Profiling, Infant, Newborn, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Fetal Blood, Perinatal exposure, 3. Good health, Breast Feeding, Perfluoroalkyl substances, Alkanesulfonic Acids, Maternal Exposure, Perfluorooctanoic acid, Female, France, [SDV.TOX.ECO]Life Sciences [q-bio]/Toxicology/Ecotoxicology, Caprylates, Perinatal period, Environmental Monitoring
Abstract

One major concern regarding perfluoroalkyl acids (PFAAs) is their potential role in onset of health troubles consecutive to early exposure during the perinatal period. In the present work, the internal exposure levels of 18 targeted PFAAs were determined in ca. 100 mother–newborn pairs recruited in France between 2010 and 2013. In serum, the cumulated concentrations of the 7 most frequently detected compounds were 5.70 ng/mL and 2.83 ng/mL (median values) in maternal and cord serum, respectively. Perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexylesulfonic acid (PFHxS) and perfluorononanoic acid (PFNA) contributed to around 90% of the total PFAAs contamination, with concentration levels and contamination profiles in accordance with other published work in Europe. Levels measured in breast milk were far lower (20 to 150 fold) than those determined in serum. Associations between the different monitored substances as well as between levels determined in the different investigated biological matrices mostly do not appear statistically significant. The estimated materno-foetal transfer would be thus substance-dependant, mainly driven by the physico-chemical properties of the different PFAAs (nature of polar group and length of alkylated side chain). We conclude that trans-placental passage and breastfeeding are both significant routes of human exposure to PFAAs. Keywords: Perfluoroalkyl substances, Endocrine disruptors, Perinatal exposure, Biomonitoring, Profiling

Published
2015

44. 3D transesophageal echocardiography: A new imaging tool for assessment of mitral regurgitation and for guiding percutaneous edge-to-edge mitral valve repair

Author

Giovanni Pedrazzini, Gabriele Casso, Tiziano Moccetti, Francesco Faletra, Giorgio Cautilli, Alain Berrebi, Tiziano Cassina, Joseph F. Malouf, Vera Lucia Paiocchi, Laura Anna Leo, University of Zurich, and Faletra, Francesco F

Subjects
Cardiac Catheterization, medicine.medical_specialty, Percutaneous, medicine.medical_treatment, Echocardiography, Three-Dimensional, 610 Medicine & health, 030204 cardiovascular system & hematology, Effective Regurgitant Orifice Area, Severity of Illness Index, 11171 Cardiocentro Ticino, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, Mitral valve, medicine, Humans, Fluoroscopy, 030212 general & internal medicine, Cardiac Surgical Procedures, Mitral valve repair, Mitral regurgitation, Vena contracta, medicine.diagnostic_test, business.industry, Hemodynamics, Mitral Valve Insufficiency, medicine.disease, Echocardiography, Doppler, Color, Treatment Outcome, medicine.anatomical_structure, Cardiology, Mitral Valve, Radiology, Cardiology and Cardiovascular Medicine, Mitral valve regurgitation, business, human activities, Echocardiography, Transesophageal
Abstract

Real time three dimensional transesophageal echocardiography (3D TEE) is probably the most powerful and convincing imaging method for understanding the complicated multiform morphology and for evaluating geometry, dynamics and function of degenerative and functional mitral valve (MV) regurgitation. Moreover, color Doppler 3D TEE has been valuable to identify the location of the regurgitant orifice and the severity of the mitral regurgitation. 3D TEE has been shown to be of enormous value in helping surgeons to perform MV repair. In addition, due to its ability to show a "panoramic" view of the "theater" where the procedure takes place, it has become an indispensable companion of 2D TEE during percutaneous edge-to-edge repair. A novel hybrid imaging modality where echocardiography is merged with fluoroscopy, may in the future further improve guidance of this and other complex percutaneous transcatheter interventions.

Published
2017

45. Temporal Trends in Transcatheter Aortic Valve Replacement in France

Author

Vincent Auffret, Thierry Lefevre, Eric Van Belle, Hélène Eltchaninoff, Bernard Iung, René Koning, Pascal Motreff, Pascal Leprince, Jean Philippe Verhoye, Thibaut Manigold, Geraud Souteyrand, Dominique Boulmier, Patrick Joly, Frédéric Pinaud, Dominique Himbert, Jean Philippe Collet, Gilles Rioufol, Said Ghostine, Olivier Bar, Alain Dibie, Didier Champagnac, Lionel Leroux, Frédéric Collet, Emmanuel Teiger, Olivier Darremont, Thierry Folliguet, Florence Leclercq, Thibault Lhermusier, Patrick Olhmann, Bruno Huret, Luc Lorgis, Laurent Drogoul, Bernard Bertrand, Christian Spaulding, Laurent Quilliet, Thomas Cuisset, Maxence Delomez, Farzin Beygui, Jean-Philippe Claudel, Alain Hepp, Arnaud Jegou, Antoine Gommeaux, Anfani Mirode, Luc Christiaens, Charles Christophe, Claude Cassat, Damien Metz, Lionel Mangin, Karl Isaaz, Laurent Jacquemin, Philippe Guyon, Christophe Pouillot, Serge Makowski, Vincent Bataille, Josep Rodés-Cabau, Martine Gilard, Hervé Le Breton, Herve Le Breton, Marc Laskar, Bernard Chevalier, Philippe Garot, Thomas Hovasse, Patrick Donzeau Gouge, Arnaud Farge, Mauro Romano, Bertrand Cormier, Erik Bouvier, Jean-Jacques Bauchart, Jean-Christophe Bodart, Cédric Delhaye, David Houpe, Robert Lallemant, Fabrice Leroy, Arnaud Sudre, Francis Juthier, Mohamed Koussa, Thomas Modine, Natacha Rousse, Jean-Luc Auffray, Marjorie Richardson, Jacques Berland, Mathieu Godin, Jean-Paul Bessou, Vincent Letocart, Jean-Christian Roussel, Philippe Jaafar, Nicolas Combaret, Nicolas D’Ostrevy, Andréa Innorta, Guillaume Clerfond, Charles Vorilhon, Marc Bedossa, Guillaume Leurent, Amedeo Anselmi, Majid Harmouche, Jean-Philippe Verhoye, Erwan Donal, Jacques Bille, Rémi Houel, Bertrand Vilette, Wissam Abi Khalil, Stéphane Delepine, Olivier Fouquet, Frédéric Rouleau, Jérémie Abtan, Marina Urena, Soleiman Alkhoder, Walid Ghodbane, Dimitri Arangalage, Eric Brochet, Coppelia Goublaire, Olivier Barthelemy, Rémi Choussat, Jean-Philippe Collet, Guillaume Lebreton, Chiro Mastrioanni, Richard Isnard, Raphael Dauphin, Olivier Dubreuil, Guy Durand De Gevigney, Gérard Finet, Brahim Harbaoui, Sylvain Ranc, Fadi Farhat, Olivier Jegaden, Jean-François Obadia, Matteo Pozzi, Saïd Ghostine, Philippe Brenot, Sahbi Fradi, Alexandre Azmoun, Philippe Deleuze, Martin Kloeckner, Didier Blanchard, Christophe Barbey, Stephan Chassaing, Didier Chatel, Olivier Le Page, Arnaud Tauran, Didier Bruere, Laurent Bodson, Yvon Meurisse, Aurélien Seemann, Nicolas Amabile, Christophe Caussin, Simon Elhaddad, Luc Drieu, Alice Ohanessian, François Philippe, Aurélie Veugeois, Matthieu Debauchez, Konstantinos Zannis, Daniel Czitrom, Chrystelle Diakov, François Raoux, Yves Lienhart, Patrick Staat, Oualid Zouaghi, Vincent Doisy, Jean Philippe Frieh, Fabrice Wautot, Julie Dementhon, Olivier Garrier, Fadi Jamal, Pierre Yves Leroux, Frédéric Casassus, Benjamin Seguy, Laurent Barandon, Louis Labrousse, Julien Peltan, Claire Cornolle, Marina Dijos, Stéphane Lafitte, Gilles Bayet, Claude Charmasson, Alain Vaillant, Jacques Vicat, Marie Paule Giacomoni, Eric Bergoend, Céline Zerbib, Jean Louis Leymarie, Philippe Clerc, Emmanuel Choukroun, Nicolas Elia, Jean-Philippe Grimaud, Jean-Philippe Guibaud, Stéphane Wroblewski, Eric Abergel, Emmanuel Bogino, Christophe Chauvel, Patrick Dehant, Marc Simon, Michel Angioi, Julien Lemoine, Simon Lemoine, Batric Popovic, Pablo Maureira, Olivier Huttin, Christine Selton Suty, Guillaume Cayla, Delphine Delseny, Gilles Levy, Jean Christophe Macia, Eric Maupas, Christophe Piot, François Rivalland, Gabriel Robert, Laurent Schmutz, Frédéric Targosz, Bernard Albat, Arnaud Dubar, Nicolas Durrleman, Thomas Gandet, Emmanuel Munos, Stéphane Cade, Frédéric Cransac, Frédéric Bouisset, Etienne Grunenwald, Bertrand Marcheix, Pauline Fournier, Olivier Morel, Patrick Ohlmann, Michel Kindo, Minh Tam Hoang, Hélène Petit, Hafida Samet, Anne Trinh, Guillaume Lecoq, Jean François Morelle, Pascal Richard, Thierry Derieux, Emmanuel Monier, Cédric Joret, Olivier Bouchot, Jean Christophe Eicher, Pierre Meyer, Stéphane Lopez, Michel Tapia, Jacques Teboul, Jean-Pierre Elbeze, Alain Mihoubi, Gérald Vanzetto, Olivier Wittenberg, Vincent Bach, Cécile Martin, Carole Sauier, Charlotte Casset, Philippe Castellant, Eric Bezon, Jean-Noel Choplain, Ahmed Kallifa, Bahaa Nasr, Yannick Jobic, Antoine Lafont, Jean-Yves Pagny, Ramzi Abi Akar, Jean-Noël Fabiani, Rachid Zegdi, Alain Berrebi, Tania Puscas, Bernard Desveaux, Fabrice Ivanes, Christophe Saint Etienne, Thierry Bourguignon, Blandine Aupy, Romain Perault, Jean-Louis Bonnet, Marc Lambert, Dominique Grisoli, Nicolas Jaussaud, Erwan Salaun, Amine Laghzaoui, Christine Savoye, Mathieu Bignon, Vincent Roule, Rémy Sabatier, Calin Ivascau, Vladimir Saplacan, Eric Saloux, Damien Bouchayer, Guillaume Tremeau, Camille Diab, Joel Lapeze, Franck Pelissier, Thomas Sassard, Catherine Matz, Nicolas Monsarrat, Ivan Carel, Franck Sibellas, Alain Curtil, Grégoire Dambrin, Xavier Favereau, Gabriel Ghorayeb, Laurent Guesnier, Wassim Khoury, Christophe Kucharski, Bruno Pouzet, Claude Vaislic, Riadh Cheikh-Khelifa, Loïc Hilpert, Philippe Maribas, Gery Hannebicque, Philippe Hochart, Marc Paris, Max Pecheux, Olivier Fabre, Laurent Leborgne, Marcel Peltier, Faouzi Trojette, Doron Carmi, Christophe Tribouilloy, Jean Mergy, Pierre Corbi, Pascale Raud Raynier, Sylvain Carillo, Arnaud Hueber, Fédéric Moulin, Georges Pinelli, Nicole Darodes, Francis Pesteil, Chadi Aludaat, Frédéric Torossian, Loïc Belle, Nicolas Chavanis, Chrystelle Akret, Alexis Cerisier, Jean Pierre Favre, Jean François Fuzellier, Romain Pierrard, Olivier Roth, Jean Yves Wiedemann, Nicolas Bischoff, Georghe Gavra, Nicolas Bourrely, Franck Digne, Mohammed Najjari, Victor Stratiev, Nicolas Bonnet, Patrick Mesnildrey, David Attias, Julien Dreyfus, Daniel Karila Cohen, Thierry Laperche, Julien Nahum, Aliocha Scheuble, Geoffrey Rambaud, Eric Brauberger, Michel Ah Hot, Philippe Allouch, Fabrice Beverelli, Julien Rosencher, Stéphane Aubert, Jean Michel Grinda, Thierry Waldman, Service de cardiologie et maladies vasculaires, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle ( MIVEGEC ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche pour le Développement ( IRD [France-Sud] ), Service de cardiologie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), CHU Gabriel Montpied ( CHU ), CHU Clermont-Ferrand, Institut Pascal - Clermont Auvergne ( IP ), Sigma CLERMONT ( Sigma CLERMONT ) -Université Clermont Auvergne ( UCA ) -Centre National de la Recherche Scientifique ( CNRS ), Service de chirurgie cardiaque et thoracique [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de chirurgie cardio-vasculaire et thoracique, CHU Angers, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition ( ICAN ), CHU Pitié-Salpêtrière [APHP]-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Université Pierre et Marie Curie - Paris 6 ( UPMC ), Adaptation cardiovasculaire à l'ischemie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale ( INSERM ), 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 ), Service de cardiologie [Toulouse], Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Cochin [AP-HP], Nutrition, obésité et risque thrombotique ( NORT ), Institut National de la Recherche Agronomique ( INRA ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), CHU de Poitiers, Epidémiologie et Biostatistique, Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps [Toulouse], Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Optimisation des régulations physiologiques ( ORPHY (EA 4324) ), Université de Brest ( UBO ) -Institut Brestois du Numérique et des Mathématiques ( IBNM ), Université de Brest ( UBO ) -Université de Brest ( UBO ), Institut de Chimie de la Matière Condensée de Bordeaux ( ICMCB ), Université de Bordeaux ( UB ) -Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Institut national de recherches archéologiques préventives ( Inrap ), Hémostase et pathologie cardiovasculaire, EA2693-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lille, Droit et Santé, Belgian Institute for Space Aeronomy / Institut d'Aéronomie Spatiale de Belgique ( BIRA-IASB ), ONERA - The French Aerospace Lab ( Toulouse ), ONERA, Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Institut de cardiologie [CHU Pitié-Salpêtrière], Service de Chirurgie Thoracique et Cardiovasculaire [CHU Pitié-Salpêtrière], Cardioprotection, Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Cardiovasculaire, métabolisme, diabétologie et nutrition ( CarMeN ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hospices Civils de Lyon ( HCL ) -Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Institut National de la Recherche Agronomique ( INRA ), Carnegie Mellon University [Pittsburgh] ( CMU ), Hôpital nord, St Etienne, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Clinique du Tonkin, Unité de recherche Phytopharmacie et Médiateurs Chimiques ( UPMC ), Institut National de la Recherche Agronomique ( INRA ), Département de cardiologie, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Centre des Sciences des Littératures en Langue Française ( CSLF ), Université Paris Nanterre ( UPN ), Service de Cardiologie [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Laboratoire de Chimie Physique - Matière et Rayonnement ( LCPMR ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire d'Informatique Fondamentale de Lille ( LIFL ), Université de Lille, Sciences et Technologies-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Université de Lille, Sciences Humaines et Sociales-Centre National de la Recherche Scientifique ( CNRS ), Défaillance Cardiovasculaire Aiguë et Chronique ( DCAC ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lorraine ( UL ), Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Institut des Maladies Métaboliques et Cardiovasculaires ( I2MC ), Université Paul Sabatier - Toulouse 3 ( UPS ) -Hôpital de Rangueil-Institut National de la Santé et de la Recherche Médicale ( INSERM ), École de sages-femmes René Rouchy ( ESF Angers ), Université d'Angers ( UA ) -CHU Angers, Laboratoire de Génie Civil et d'Ingénierie Environnementale ( LGCIE ), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Institut National des Sciences Appliquées ( INSA ), Agriculture and Agri-Food [Ottawa] ( AAFC ), Centre d'études et de recherche sur les contentieux - EA 3164 ( CERC ), Université de Toulon ( UTLN ), Radiopharmaceutiques biocliniques, Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Clinique de chirurgie cardiaque, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble, Unité Mixte de Recherches sur les Herbivores ( UMR 1213 Herbivores ), VetAgro Sup ( VAS ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Recherche Agronomique ( INRA ), Université Grenoble Alpes - UFR Médecine ( UGA UFRM ), Université Grenoble Alpes ( UGA ), Développement artériel, Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de recherche en économie et management ( CREM ), Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Centre National de la Recherche Scientifique ( CNRS ), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Récepteurs nucléaires, maladies cardiovasculaires et diabète ( EGID ), Université de Lille, Droit et Santé-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut Pasteur de Lille, Réseau International des Instituts Pasteur ( RIIP ) -Réseau International des Instituts Pasteur ( RIIP ) -Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Edwards Lifesciences Medtronic Lead-Up Medicines Company French Cardiology Federation (Federation Francaise de Cardiologie) Eli Lilly WebMD Biosensor ACIST Abbott Biosensors Terumo Daichii-Sankyo Boston Scientific St. Jude Medical Bristol-Myers Squibb Bayer AstraZeneca French Ministry of Health Abiomed Zoll Medpass Cordis Servier, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pitié-Salpêtrière [APHP], Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), Institut Pasteur de Lille, and Réseau International des Instituts Pasteur ( RIIP ) -Réseau International des Instituts Pasteur ( RIIP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille )

Subjects
Aortic valve, medicine.medical_specialty, medicine.medical_treatment, national registry, 030204 cardiovascular system & hematology, outcomes, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, Cardiac tamponade, Medicine, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aortic dissection, business.industry, Mortality rate, transfemoral, EuroSCORE, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine.disease, pacemaker, 3. Good health, Surgery, Stenosis, Catheter, medicine.anatomical_structure, Cardiology and Cardiovascular Medicine, business
Abstract

Background - Transcatheter aortic valve replacement (TAVR) is standard therapy for patients with severe aortic stenosis who are at high surgical risk. However, national data regarding procedural characteristics and clinical outcomes over time are limited. Objectives - The aim of this study was to assess nationwide performance trends and clinical outcomes of TAVR during a 6-year period. Methods - TAVRs performed in 48 centers across France between January 2013 and December 2015 were prospectively included in the FRANCE TAVI (French Transcatheter Aortic Valve Implantation) registry. Findings were further compared with those reported from the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry, which captured all TAVRs performed from January 2010 to January 2012 across 34 centers. Results - A total of 12,804 patients from FRANCE TAVI and 4,165 patients from FRANCE 2 were included in this analysis. The median age of patients was 84.6 years, and 49.7% were men. FRANCE TAVI participants were older but at lower surgical risk (median logistic European System for Cardiac Operative Risk Evaluation [EuroSCORE]: 15.0% vs. 18.4%; p < 0.001). More than 80% of patients in FRANCE TAVI underwent transfemoral TAVR. Transesophageal echocardiography guidance decreased from 60.7% to 32.3% of cases, whereas more recent procedures were increasingly performed in hybrid operating rooms (15.8% vs. 35.7%). Rates of Valve Academic Research Consortium-defined device success increased from 95.3% in FRANCE 2 to 96.8% in FRANCE TAVI (p < 0.001). In-hospital and 30-day mortality rates were 4.4% and 5.4%, respectively, in FRANCE TAVI compared with 8.2% and 10.1%, respectively, in FRANCE 2 (p

Published
2017

46. [THE ROLE OF THE PLANT ARTEMISIA IN SURVIVAL AND INDUCTION OF APOPTOSIS OF B CELLS IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL)]

Author

Vita, Mirkin, Alain, Berrebi, Igor, Rakhman, Michal, Haran, and Lev, Shvidel

Subjects
B-Lymphocytes, Artemisia, Plant Extracts, Humans, Apoptosis, Israel, Leukemia, Lymphocytic, Chronic, B-Cell, Cells, Cultured
Abstract

The cytotoxic effect of plants such as green tea and turmeric (curcumin) on B chronic lymphocytic leukemia (CLL) cells has been established. The plant Artemisia has been used in China for anti-cancer and anti-malaria applications. In Israel, Artemisia absinthium ("the Chiba") is used to release abdominal pain. In attempts to evaluate the cytotoxic effect of this plant in CLL cells, we prepared a decoction of Artemisia leaves and after filtration used it as an inducer of apoptosis of B CLL cells.CLL cells were collected from 7 patients in different stages of the disease. Apoptosis was measured using an annexin based flow cytometry assay.First a viability test showed that 100μl/106 cells was the most effective dilution for killing up to 70% cells after 48 hours of incubation. In these conditions Artemisia induced approximately 75% apoptosis in comparison to 32% in the cultures without Artemisia.We concluded that decoction of Artemisia absinthium is a potent inducer of in vitro apoptosis of CLL cells. Our results provide a laboratory basis for further clinical application.

Published
2017

47. A phase I-II clinical trial of the anti-CD74 monoclonal antibody milatuzumab in frail patients with refractory chronic lymphocytic leukaemia: A patient based approach

Author

Orly Mordich, Ayelet Marom, Nurith Harpaz, Idit Shachar, Marina Shtreiter, Vita Mirkin, Shulamit Greenberg, Rosa Ruchlemer, Lev Shvidel, Mordechai Shtalrid, Olga Shevetz, Inbal Binsky-Ehrenreich, Yair Herishanu, Alain Berrebi, Liora Valinsky, Michal Haran, Orna Amram, and Andrei Braester

Subjects
0301 basic medicine, Oncology, Male, medicine.medical_specialty, CD74, medicine.drug_class, Frail Elderly, Phases of clinical research, Monoclonal antibody, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Antineoplastic Agents, Immunological, Refractory, Internal medicine, Patient-Centered Care, medicine, Humans, Aged, Aged, 80 and over, Lymphocytic leukaemia, Performance status, business.industry, Histocompatibility Antigens Class II, Hematology, Leukemia, Lymphocytic, Chronic, B-Cell, Milatuzumab, Clinical trial, Antigens, Differentiation, B-Lymphocyte, 030104 developmental biology, chemistry, 030220 oncology & carcinogenesis, Physical therapy, Quality of Life, Female, business
Published
2017

48. Position paper for the evaluation and management of oral status in patients with valvular disease: Groupe de Travail Valvulopathies de la Societe Francaise de Cardiologie, Societe Frangaise de Chinirgie Orale, Societe Frangaise de Parodontologie et d'Implantologie Orale, Societe Frangaise d'Endodontie et Societe de Pathologie Infectieuse de Langue Frangaise

Author

Philippe Lesclous, Sarah Millot, Marie-Laure Colombier, Philippe Tramba, Bernard Iung, Emmanuel Lansac, Clement Messeca, Mathieu Ballanger, Jean Luc Charrier, Christophe Tribouilloy, Xavier Duval, Fabien Doguet, Loredana Radoï, Stéphane Simon, Alain Berrebi, Gilbert Habib, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'ingénierie osteo-articulaire et dentaire (LIOAD), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes - UFR Odontologie, Université de Nantes (UN), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), 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), Université de Nantes (UN)-Université de Nantes (UN), Université Paris Descartes - Faculté de Chirurgie Dentaire (UPD5 Odontologie), Université Paris Descartes - Paris 5 (UPD5), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Oral medicine and oral surgery department, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Laboratoire Hospitalier et Universitaire Parasitologie Mycologie, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Gynécologie‑Obstétrique, Hôpital Paule de Viguier, Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Cardiologie [Amiens], CHU Amiens-Picardie, Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), CIC Hôpital Bichat, AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine, DHU FIRE Centre de compétence des maladies pulmonaires rares, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine-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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Nantes - UFR Odontologie (UFR Odonto), École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), 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), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Gynécologie [CHU Toulouse], Pôle Femme-Mère-Couple [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), AP-HP - Hôpital Bichat - Claude Bernard [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, General surgery, valvular heart disease, Implant failure, Physical examination, 030206 dentistry, General Medicine, Disease, 030204 cardiovascular system & hematology, medicine.disease, 3. Good health, Surgery, 03 medical and health sciences, 0302 clinical medicine, Acute Endocarditis, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Infective endocarditis, medicine, Endocarditis, Antibiotic prophylaxis, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; Oral health is of particular importance in patients with heart valve diseases because of the risk of infective endocarditis. Recommendations for antibiotic prophylaxis before dental procedures have been restricted, but the modalities of oral evaluation and dental care are not detailed in guidelines. Therefore, a multidisciplinary working group reviewed the literature to propose detailed approaches for the evaluation and management of buccodental status in patients with valvular disease. Simple questions asked by a non-dental specialist may draw attention to buccodental diseases. Besides clinical examination, recent imaging techniques are highly sensitive for the detection of inflammatory bone destruction directly related to oral or dental infection foci. The management of buccodental disease before cardiac valvular surgery should be adapted to the timing of the intervention. Simple therapeutic principles can be applied even before urgent intervention. Restorative dentistry and endodontic and periodontal therapy can be performed before elective valvular intervention and during the follow-up of patients at high risk of endocarditis. The detection and treatment of buccodental foci of infection should follow specific rules in patients who present with acute endocarditis. Implant placement is no longer contraindicated in patients at intermediate risk of endocarditis, and can also be performed in selected high-risk patients. The decision for implant placement should follow an analysis of general and local factors increasing the risk of implant failure. The surgical and prosthetic procedures should be performed in optimal safety conditions. It is therefore now possible to safely decrease the number of contraindicated dental procedures in patients at risk of endocarditis. (C) 2017 Elsevier Masson SAS. All rights reserved.

Published
2017

50. Infection par le VIH et grossesse : nouvelles recommandations 2013 du groupe d’experts français

Author

R. Tubiana, V. Boyer, Albert Faye, Laurent Mandelbrot, François Dabis, C. Taeron, C. Rouzioux, L. Bujan, Sophie Matheron, P. Morlat, M. Partisani, Josiane Warszawski, P. Faucher, Stéphane Blanche, and Alain Berrebi

Subjects
Pregnancy, Pediatrics, medicine.medical_specialty, Combination therapy, business.industry, Breastfeeding, Obstetrics and Gynecology, Gestational age, General Medicine, medicine.disease, Zidovudine, Reproductive Medicine, Maternity and Midwifery, Medicine, business, Adverse effect, Viral load, Premature rupture of membranes, medicine.drug
Abstract

With effective antiretroviral therapy, the risk of mother to child transmission (MTCT) is now under 1%. The 2013 French guidelines emphasize early antiretroviral lifelong antiretroviral therapy. Thus, the current trend for women living with HIV is to take antiretroviral therapy before, during and after their pregnancies. A major issue today is the choice of antiretroviral drugs, to maximize the benefits and minimize the risks of fetal exposure. This requires interdisciplinary care. The use of effective therapies permits gradual but profound changes in obstetric practice. When maternal plasma viral load is controlled ( 400 copies/mL or in case of complications such as preterm delivery, bleeding or chorio-amnionitis during labor. In case of premature rupture of membranes before 34 weeks, a multidisciplinary decision should be made, based on gestational age and control of maternal viral load; if the woman is under antiretroviral therapy and especially if her viral load is undetectable, steroids and antibiotics should be offered and pregnancy can be continued except in case of signs or symptoms of chorio-amnionitis. Breastfeeding is not recommended in women living with HIV in France, as in industrialized countries. Prophylaxis in the newborn is usually zidovudine for 1 month. In case of significant exposure to HIV perinatally, in particular when, maternal viral load is>1000 copies/mL, prophylactic combination therapy is recommended. Monitoring of the child is necessary to determine whether or not it is free of HIV infection and to monitor possible adverse effects of perinatal exposure to antiretroviral drugs.

Published
2014

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