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1. Assessment of Spontaneous Retinal Arterial Pulsations in Acute Central Retinal Vein Occlusions

Author

Nicolas Arej, Vivien Vasseur, Elyse Jabbour, Anthony Manassero, Céline Giraud, Sébastien Bruneau, Yannick Le Mer, and Martine Mauget-Faÿsse

Subjects
Ophthalmology, RE1-994
Abstract

Central retinal vein occlusion (CRVO) is a common retinal disease. Recent works mentioned spontaneous retinal arterial pulsations (SRAPs) as a feature of some CRVOs. This is a retrospective study on patients presenting with CRVO who were followed up for at least 6 months. The objective was to identify SRAP in the acute phase of the disease and determine their relationship with patients’ characteristics and visual prognosis. A 10-second infrared film centered on the optic disc was recorded within a month of the onset of symptoms, and SRAPs were detected in two-thirds of the cases. Patients with SRAP were significantly younger than those without SRAP. Mean central macular thickness was significantly higher in the absence of SRAP, which was translated into a more severe macular edema; however, this difference faded with time. BCVA tended to be higher in the presence of SRAP at the 6-month follow-up when adjusted to baseline. This study demonstrates that SRAPs are a frequent finding, easily detected by infrared fundus video recording, and associated with a younger age and lesser macular edema.

Published
2020
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2. Effect and Safety of Morphine Use in Acute Anterior ST‐Segment Elevation Myocardial Infarction

Author

Mickael Bonin, Nathan Mewton, Francois Roubille, Olivier Morel, Guillaume Cayla, Denis Angoulvant, Meyer Elbaz, Marc J. Claeys, David Garcia‐Dorado, Céline Giraud, Gilles Rioufol, Claire Jossan, Michel Ovize, and Patrice Guerin

Subjects
clinical, morphine, opioid, percutaneous coronary intervention, pharmaceutical safety, ST‐segment elevation myocardial infarction, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

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

Published
2018
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4. Nutritional Status Deterioration Occurs Frequently During Children’s ICU Stay*

Author

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

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

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

Published
2019

5. Assessment of Spontaneous Retinal Arterial Pulsations in Acute Central Retinal Vein Occlusions

Author

Nicolas Arej, Sébastien Bruneau, Martine Mauget-Faÿsse, Yannick Le Mer, Anthony Manassero, Vivien Vasseur, Elyse Jabbour, and Céline Giraud

Subjects
medicine.medical_specialty, Younger age, Central retinal vein, Article Subject, genetic structures, business.industry, Retrospective cohort study, Retinal, RE1-994, medicine.disease, eye diseases, Ophthalmology, chemistry.chemical_compound, medicine.anatomical_structure, Central retinal vein occlusion, chemistry, Fundus (uterus), medicine, Clinical Study, sense organs, business, Macular edema, Optic disc
Abstract

Central retinal vein occlusion (CRVO) is a common retinal disease. Recent works mentioned spontaneous retinal arterial pulsations (SRAPs) as a feature of some CRVOs. This is a retrospective study on patients presenting with CRVO who were followed up for at least 6 months. The objective was to identify SRAP in the acute phase of the disease and determine their relationship with patients’ characteristics and visual prognosis. A 10-second infrared film centered on the optic disc was recorded within a month of the onset of symptoms, and SRAPs were detected in two-thirds of the cases. Patients with SRAP were significantly younger than those without SRAP. Mean central macular thickness was significantly higher in the absence of SRAP, which was translated into a more severe macular edema; however, this difference faded with time. BCVA tended to be higher in the presence of SRAP at the 6-month follow-up when adjusted to baseline. This study demonstrates that SRAPs are a frequent finding, easily detected by infrared fundus video recording, and associated with a younger age and lesser macular edema.

Published
2019

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

Author

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

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

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

Published
2017

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

Author

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

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

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

Published
2014

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

Author

Carine Coffre, Boulkedid Rym, Christine Binquet, Amélie Le Gouge, Alain Leizorovicz, Céline Giraud, Catherine Cornu, Isabelle Vaugier, Alexandra Félin, Thibault Mura, Nadine Juge, Frédéric Barbot, Hugues Chevassus, François Gueyffier, Anne Donche, CIC 1407, Hospices Civils de Lyon (HCL), Hôpital Louis Pradel [CHU - HCL], Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Robert Debré, Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'Investigation Clinique 1426 (CIC 1426), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Centre d’Investigation Clinique 1429 [Garches] (CIC 1429), Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CIC Tours, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris]-Université Paris Diderot - Paris 7 (UPD7), CIC1429 Garches, Institut National de la Santé et de la Recherche Médicale (INSERM)- AP-HP Hôpital Raymond Poincaré [Garches], CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Eloi, Neuropsychiatrie : recherche épidémiologique et clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon ( HCL ), Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), Hôpital Bretonneau-Université de Tours-CHRU Tours-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables ( Inserm U1123 - ECEVE ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AP-HP Hôpital universitaire Robert-Debré [Paris], Centre d'Investigation Clinique 1426 ( CIC 1426 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AP-HP Hôpital universitaire Robert-Debré [Paris], Institut National de la Santé et de la Recherche Médicale ( INSERM ) - AP-HP Hôpital Raymond Poincaré [Garches], Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] ( Pôle S2R ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques ( CIC-EC ), Université de Bourgogne ( UB ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -CHU Saint-Eloi-Institut National de la Santé et de la Recherche Médicale ( INSERM )

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

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

Published
2016

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

Author

Meyer Elbaz, Patrice Guerin, Nathan Mewton, Bernard Jouve, Céline Giraud, Michel Ovize, Olivier Morel, Nicolas Delarche, Thien Tri Cung, Fabrice Prunier, Guillaume Cayla, Pierre Croisille, Gérald Vanzetto, Pierre Coste, Mathieu Schaaf, Ingrid Sanchez, François Roubille, Olivier Roth, Didier Revel, Christophe Piot, Denis Angoulvant, Eric Bonnefoy-Cudraz, Gilles Rioufol, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), RMN et optique : De la mesure au biomarqueur, Hospices Civils de Lyon (HCL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Embolism, Myocardial Infarction, 030204 cardiovascular system & hematology, Coronary Angiography, Culprit, 03 medical and health sciences, Coronary circulation, Percutaneous Coronary Intervention, 0302 clinical medicine, Coronary Circulation, Internal medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, ComputingMilieux_MISCELLANEOUS, Aged, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Middle Aged, medicine.disease, Coronary Vessels, medicine.anatomical_structure, surgical procedures, operative, Coronary occlusion, Microvessels, Preoperative Period, Conventional PCI, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, human activities, TIMI, Artery
Abstract

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

Published
2016

12. Existe-t-il un intérêt à poursuivre les frottis de dépistage du cancer du col utérin après 65 ans ? Ètude rétrospective sur 53 644 femmes

Author

P. Mathevet, Raphaël Meyer, Anne-Lise Lemay, Céline Giraud, Xavier Guy, and Marie Flori

Subjects
Gynecology, Cancer Research, medicine.medical_specialty, Oncology, business.industry, medicine, Radiology, Nuclear Medicine and imaging, Hematology, General Medicine, business
Abstract

Resume Contexte Un tiers des cancers du col uterin est decouvert apres 65 ans. Or, les recommandations francaises, concernant le depistage du cancer du col, sont d’exclure du depistage les femmes apres 65 ans ayant eu au moins deux frottis normaux consecutifs. Objectif Etudier la frequence des lesions cytologiques chez les femmes âgees de plus de 65 ans dont le rythme de suivi cytologique anterieur avait ete normal et suffisant, afin de determiner s’il existe un interet de poursuivre les frottis de depistage apres 65 ans. Patientes et methodes Etude retrospective multicentrique a partir des donnees de trois laboratoires de cytopathologie de la region Rhone-Alpes. Etude d’une population de 53 644 femmes de plus de 65 ans chez qui un frottis a ete realise entre 2004 et 2008. Resultats Des lesions precancereuses et cancereuses du col sont decouvertes apres 65 ans malgre un suivi anterieur suffisant. Le taux de frottis pathologique pour ce groupe de femmes est de 14,2 ‰ et il est de 1,4 ‰ pour les frottis evocateurs de cancer. Conclusion Il existe un interet a poursuivre les frottis de depistage apres 65 ans. Cette approche semble raisonnable tant du point de vue medical qu’economique.

Published
2012

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

Author

Céline Giraud, Michel Ovize, François Roubille, Denis Angoulvant, Nathan Mewton, Olivier Lairez, Theodora Bejan-Angoulvant, Gilles Rioufol, Inesse Boussaha, Christophe Piot, Sophie Pichot, Meyer Elbaz, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Génomique Fonctionnelle (IGF), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

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

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

Published
2015

14. Cataracte

Author

Franck Fajnkuchen, Kamel Achebouche, Céline Giraud, Jean-Franc¸ois Girmens, Sylvia Nghiem-Buffet, Gilles Chaine, and Isabelle Nataf-Herzhaft

Published
2006

16. [Is there a benefit to continue pap smear screening for cervical cancer after 65 years of age? A retrospective study on 53,644 women]

Author

Raphaël, Meyer, Anne-Lise, Lemay, Xavier, Guy, Céline, Giraud, Patrice, Mathevet, and Marie, Flori

Subjects
Aged, 80 and over, Vaginal Smears, Age Factors, Humans, Uterine Cervical Neoplasms, Female, France, Precancerous Conditions, Aged, Papanicolaou Test, Retrospective Studies
Abstract

One third of cervical cancers are discovered after age 65. French guidelines allow women to cease having cervical pap smears at age 65, providing they have had a minimum of two consecutive negative smears.To study the frequency of pathological smears in the group of women aged over 65 with a normal and sufficient cytological follow-up, according to the guidelines. To analyze the smear results and the former follow-up of this population to determine whether there is an interest to continue the smear screening after age 65.This is a retrospective multicenter study based on collecting data from three pathology laboratories of the region Rhone-Alpes. We study a population of women 65 and older with smears that have been made between 2004 and 2008.Precancerous lesions and cervical cancer can be discovered after age 65 despite an adequate former follow-up. The rate of these women for having a pathological smear is 14,2‰, including 1,2‰ with cytological abnormalities in favour of cancer.These results show that there is interest to continue the smear tests after age 65 at least, while considering medical and financial issues of a reasonable screening strategy.

Published
2012

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

Author

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

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

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

Published
2012

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

Author

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

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

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

Published
2010

19. Decreased venous tortuosity associated with resolution of macular edema after intravitreal injection of triamcinolone

Author

Alain Gaudric, José Sahel, Jean-François Girmens, Valérie Krivosic, Michel Paques, and Céline Giraud

Subjects
Adult, Male, medicine.medical_specialty, Triamcinolone acetonide, Visual Acuity, Triamcinolone Acetonide, Macular Edema, Injections, Venous tortuosity, Ophthalmology, medicine, Humans, Fluorescein Angiography, Macular edema, Glucocorticoids, Intraocular Pressure, business.industry, Resolution (electron density), General Medicine, Middle Aged, medicine.disease, Retinal Vein, Vitreous Body, Female, business, medicine.drug
Published
2005

21. Evolution of Neuroimaging Findings in Severe COVID-19 Patients with Initial Neurological Impairment: An Observational Study

Author

François Lersy, Caroline Bund, Mathieu Anheim, Mary Mondino, Vincent Noblet, Shirley Lazzara, Clelie Phillipps, Olivier Collange, Walid Oulehri, Paul-Michel Mertes, Julie Helms, Hamid Merdji, Maleka Schenck, Francis Schneider, Julien Pottecher, Céline Giraudeau, Agathe Chammas, François-Daniel Ardellier, Seyyid Baloglu, Khalid Ambarki, Izzie Jacques Namer, and Stéphane Kremer

Subjects
COVID-19, neuroimaging, follow-up, Microbiology, QR1-502
Abstract

Background and Objectives: Cerebral complications related to the COVID-19 were documented by brain MRIs during the acute phase. The purpose of the present study was to describe the evolution of these neuroimaging findings (MRI and FDG-PET/CT) and describe the neurocognitive outcomes of these patients. Methods: During the first wave of the COVID-19 outbreak between 1 March and 31 May 2020, 112 consecutive COVID-19 patients with neurologic manifestations underwent a brain MRI at Strasbourg University hospitals. After recovery, during follow-up, of these 112 patients, 31 (initially hospitalized in intensive care units) underwent additional imaging studies (at least one brain MRI). Results: Twenty-three men (74%) and eight women (26%) with a mean age of 61 years (range: 18–79) were included. Leptomeningeal enhancement, diffuse brain microhemorrhages, acute ischemic strokes, suspicion of cerebral vasculitis, and acute inflammatory demyelinating lesions were described on the initial brain MRIs. During follow-up, the evolution of the leptomeningeal enhancement was discordant, and the cerebral microhemorrhages were stable. We observed normalization of the vessel walls in all patients suspected of cerebral vasculitis. Four patients (13%) demonstrated new complications during follow-up (ischemic strokes, hypoglossal neuritis, marked increase in the white matter FLAIR hyperintensities with presumed vascular origin, and one suspected case of cerebral vasculitis). Concerning the grey matter volumetry, we observed a loss of volume of 3.2% during an average period of approximately five months. During follow-up, the more frequent FDG-PET/CT findings were hypometabolism in temporal and insular regions. Conclusion: A minority of initially severe COVID-19 patients demonstrated new complications on their brain MRIs during follow-up after recovery.

Published
2022
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22. Investigation of PolyVinyl Chloride Plastisol Tissue-Mimicking Phantoms for MR- and Ultrasound-Elastography

Author

Simon Chatelin, Elodie Breton, Ajeethan Arulrajah, Céline Giraudeau, Benoit Wach, Laurence Meylheuc, and Jonathan Vappou

Subjects
tissue modeling, phantom, elasticity imaging, indentation, magnetic resonance imaging, ultrasound imaging, Physics, QC1-999
Abstract

Objective: Realistic tissue-mimicking phantoms are essential for the development, the investigation and the calibration of medical imaging techniques and protocols. Because it requires taking both mechanical and imaging properties into account, the development of robust, calibrated phantoms is a major challenge in elastography. Soft polyvinyl chloride gels in a liquid plasticizer (plastisol or PVCP) have been proposed as soft tissue-mimicking phantoms (TMP) for elasticity imaging. PVCP phantoms are relatively low-cost and can be easily stored over long time periods without any specific requirements. In this work, the preparation of a PVCP gel phantom for both MR and ultrasound-elastography is proposed and its acoustic, NMR and mechanical properties are studied.Materials and methods: The acoustic and magnetic resonance imaging properties of PVCP are measured for different mass ratios between ultrasound speckle particles and PVCP solution, and between resin and plasticizer. The linear mechanical properties of plastisol samples are then investigated over time using not only indentation tests, but also MR and ultrasound-elastography clinical protocols. These properties are compared to typical values reported for biological soft tissues and to the values found in the literature for PVCP gels.Results and conclusions: After a period of two weeks, the mechanical properties of the plastisol samples measured with indentation testing are stable for at least the following 4 weeks (end of follow-up period 43 days after gelation-fusion). Neither the mechanical nor the NMR properties of plastisol gels were found to be affected by the addition of cellulose as acoustic speckle. Mechanical properties of the proposed gels were successfully characterized by clinical, commercially-available MR Elastography and sonoelastography protocols. PVCP with a mass ratio of ultrasound speckle particles of 0.6%–0.8% and a mass ratio between resin and plasticizer between 50 and 70% appears as a good TMP candidate that can be used with both MR and ultrasound-based elastography methods.

Published
2020
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23. Validation of MRI for Volumetric Quantification of Atelectasis in the Perioperative Period: An Experimental Study in Swine

Author

Eric Noll, Mickael Ohana, Maryse Hengen, Elliott Bennett-Guerrero, Michele Diana, Celine Giraudeau, Julien Pottecher, Nicolas Meyer, and Pierre Diemunsch

Subjects
lung imaging, perioperative medicine, postoperative pulmonary complications, lung physiopathology, alveolar recruitment, Physiology, QP1-981
Abstract

Background: Impairment of pulmonary aeration is a frequent postoperative complication that is associated with adverse outcome. Diagnosis and quantification of impaired pulmonary aeration by CT scan is limited due to concern for exposure to ionizing radiation. Magnetic resonance imaging (MRI) represents a potential radiation-free alternative for this use. We undertook an experimental study to validate the use of MRI to quantify pulmonary aeration impairment.Methods: Ten large white pigs were studied before intubation, after intubation, 2 h after non-protective mechanical ventilation and after intra-tracheal negative pressure suction to induce atelectasis. A lung CT scan immediately followed by a lung MRI were performed at all four time points. On the 40 CT images lung volumes corresponding to non-aerated, poorly aerated, normally aerated, and overinflated voxels were measured based on their radiodensity. Similarly, on the 40 MRI images lung volumes corresponding to non-aerated and aerated voxels were measured based on their signal intensity. The correlation between non-aerated lung by MRI vs., CT scans, and with PaO2/FiO2 measured at each of the four time points was assessed with the Pearson’ correlation coefficient, bias and limits of agreement.Results: Pearson correlation coefficient, bias and limits of agreements between the CT non-aerated lung volumes and MRI abnormal lung volumes were 0.88, -16 ml, and (-108, 77), respectively. Pearson correlation coefficient between PaO2/FiO2 and abnormal lung volumes measured with MRI was -0.60.Conclusion: In a preclinical swine model, quantitative measurements of pulmonary atelectasis by MRI-imaging are well correlated with the gold standard, i.e., densitometric scan CT measurements.

Published
2019
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