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1. Physiological comparison of breathing patterns with neurally adjusted ventilatory assist (NAVA) and pressure-support ventilation to improve NAVA settings

Author: Didier Pradon, Nicolas Terzi, Henri Meric, Frédéric Lofaso, Pascale Calabrese, Michèle Lejaille, Groupe de Recherche Clinique et Technologique sur le Handicap (GRCTH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de physiologie et d'explorations fonctionnelles [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Physiologie cardio-Respiratoire Expérimentale Théorique et Appliquée (TIMC-IMAG-PRETA), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), INSERM U955, équipe 13, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Groupe de Recherche Clinique et Technologique sur le Handicap (GRCTH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM)-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)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Caen Normandie (UNICAEN), Normandie Université (NU), Mobilités : Attention, Orientation et Chronobiologie (COMETE), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Soins Intensifs [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), and Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-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 Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-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, Pulmonary and Respiratory Medicine, Physiology, medicine.medical_treatment, Diaphragm, Diaphragmatic breathing, Pressure support ventilation, 030204 cardiovascular system & hematology, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Breathing pattern, Respiratory Rate, Pressure, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Neurally adjusted ventilatory assist, Humans, Medicine, Lung volumes, Interactive Ventilatory Support, Lung, Tidal volume, Mechanical ventilation, business.industry, Respiration, General Neuroscience, Middle Aged, Respiration, Artificial, Plethysmography, Inhalation, 030228 respiratory system, Anesthesia, Breathing, Female, Lung Volume Measurements, business
Abstract: International audience; : Neurally adjusted ventilator assist (NAVA) assists spontaneous breathing in proportion to diaphragmatic electrical activity (EAdi). Here, we evaluate the effects of various levels of NAVA and PSV on the breathing pattern and, thereby, on [Formula: see text] homeostasis in 10 healthy volunteers. For each ventilation mode, four levels of support (delivered pressure 0 i.e. baseline, 5, 8, and 10cmH2O) were tested in random order. EAdi, flow, and airway pressure were recorded. Optoelectronic plethysmography was used to study lung volume distribution. During both PSV and NAVA, EAdi decreased with the level of assistance (P
Published: 2014

2. Les urgences infectieuses en urologie

Author: E, Seizilles de Mazancourt, M, Vallée, A, Sotto, C, Le Goux, A, Dihn, A, Therby, R, Boissier, P H, Savoie, J A, Long, F, Bruyere, Hospices Civils de Lyon (HCL), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Virulence bactérienne et maladies infectieuses (VBMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service d'urologie [CH René Dubos Pontoise], Centre Hospitalier René Dubos [Pontoise], CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier de Versailles André Mignot (CHV), Aix Marseille Université (AMU), Assistance Publique - Hôpitaux de Marseille (APHM), Hopital d'instruction des armées Sainte-Anne [Toulon] (HIA), Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Service d'urologie [Tours], and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau
Subjects: Male, Pyélonéphrite, Urology, MESH: Urinary Tract Infections, Urgence, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Infection urinaire, MESH: Emergencies, MESH: Anti-Bacterial Agents, Humans, MESH: Ecosystem, Infections urinaires associées aux soins, Ecosystem, Aged, Infection urinaire masculine, MESH: Aged, Bacterial prostatitis, Urinary tract infection, MESH: Humans, Pyelonephritis, Candidurie, MESH: Urology, MESH: Male, Anti-Bacterial Agents, Urosepsis, Sepsis urinaire, Health related urinary infection, Urinary Tract Infections, Emergency, Candiduria, Emergencies
Abstract: International audience; Objective: To report the nature, diagnosis and therapeutic strategy of infectious emergencies in urology.Material and methods: Bibliographic research from Pubmed, Embase, and Google scholar in July 2021. A synthesis of the guidelines of national infectious diseases societies.Results: Urosepsis and complicated urinary tract infection have a standardized definition. Diagnosis and therapeutic strategy are presented for upper tract urinary infection, male urinary infection, healthcare associated urinary infection, symptomatic canduria and urinary infections of the elderly. Appropriate antibiotherapy should be tailored to the degree of severity, bacterial ecosystem, patient characteristics et localization of the infection.Conclusion: Urinary infections can be critical and require immediate care. Knowledge of the guidelines and of appropriate diagnosis and therapeutics strategy improve care which should be rapidly applied, and collegial.; ObjectifRapporter la nature, les stratégies diagnostiques et thérapeutiques des urgences infectieuses en urologie.Matériel et méthodeRecherche bibliographique à partir de Pubmed, Embase et Google Scholar en juillet 2021. Synthèse des recommandations nationales du comité d’infectiologie de l’AFU (CIAFU) et de la Société de Pathologies Infectieuses de Langue Française (SPILF).RésultatsL’urosepsis et sepsis urinaire grave répondent à des critères diagnostiques stricts. La prise en charge infectieuse diagnostique et thérapeutique des pyélonéphrites graves, infections urinaires masculines graves, infections urinaires associées aux soins, candiduries symptomatiques et infections urinaires chez la personne âgée sont décrites. L’antibiothérapie doit être adaptée à la gravité, l’écologie bactérienne, aux particularités du patient et au site d’infection.ConclusionLes infections urinaires peuvent être graves et nécessitent une prise en charge en urgence. La connaissance des recommandations et des stratégies diagnostiques et thérapeutiques adaptées aux diverses présentations permet une optimisation de la prise en charge qui doit être la plus rapide possible, et collégiale.
Published: 2021

3. Factors Associated With a Higher Score of Burnout in a Population of 860 French Psychiatrists

Author: Nuss, Philippe, Tessier, Cedric, Masson, Marc, Fossati, Philippe, Gaillard, Raphaël, Lapidus, Nathanaël, Gourion, David, Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Psychiatrie adultes [CHU Saint-Antoine], CHU Saint-Antoine [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), CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Sainte Anne [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Ecole des Hautes Etudes Commerciales (HEC Paris), and HAL-SU, Gestionnaire
Subjects: [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Published: 2020

4. Long-term use of pitolisant to treat patients with narcolepsy: Harmony III Study

Author: Leu-Semenescu, Smaranda, Lecomte, Isabelle, Scart-Grès, Catherine, Lecomte, Jeanne-Marie, Schwartz, Jean-Charles, Arnulf, Isabelle, Bastuji, Hélène, Dauvilliers, Yves, Vieccherini, Marie Françoise, Pépin, Jean Louis, Quera Salva, Maria Antonia, Stoll, Anne Thibault, Szakacs, Zoltan, Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-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), Service des Pathologies du sommeil [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Bioprojet, Bioprojet-Biotech, Intégration centrale de la douleur chez l'homme, 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), CIC CHU Lyon (inserm), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hypoxie : Physiopathologie Respiratoire et Cardiovasculaire (HP2 ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Strasbourg, State Health Center [Budapest, Hungary], Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), HARMONY III study group: Isabelle Arnulf, Hélène Bastuji, Yves Dauvilliers, Marie Françoise Vieccherini, Jean Louis Pepin, Maria Antonia Quera Salva, Anne Thibault Stoll, Zoltan Szakacs, SALAS, Danielle, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-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)-Centre National de la Recherche Scientifique (CNRS), Service de Pathologies du sommeil [CHU Pitié-Salpêtrière], Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Salvy-Córdoba, Nathalie
Subjects: Male, Cataplexy, Excessive daytime sleepiness, narcolepsy, Anxiety, chemistry.chemical_compound, [SCCO]Cognitive science, 0302 clinical medicine, Piperidines, Sleep Initiation and Maintenance Disorders, pitolisant, 0303 health sciences, Depression, cataplexy, Epworth Sleepiness Scale, excessive daytime sleepiness, Headache, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, 3. Good health, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, Treatment Outcome, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], medicine.symptom, Sleep paralysis, Histamine H3 Antagonists, Adult, medicine.medical_specialty, Pitolisant, Nausea, Neurological Disorders, 03 medical and health sciences, Physiology (medical), Internal medicine, medicine, Humans, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Adverse effect, 030304 developmental biology, business.industry, [SCCO] Cognitive science, medicine.disease, chemistry, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Central Nervous System Stimulants, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), business, 030217 neurology & neurosurgery, Narcolepsy
Abstract: Study ObjectivesTo asses the long-term safety and efficacy of pitolisant, an histamine H3-receptor antagonist, on narcolepsy.MethodsThis open-label, single-arm, pragmatic study, recruited adult patients with narcolepsy and Epworth Sleepiness Scale (ESS) score ≥12. After a titration period, patients were treated for up to 1 year with oral pitolisant once-a-day at up to 40 mg. Concomitant stimulants and anti-cataplectic agents were allowed. The primary endpoint was safety; secondary endpoints included ESS, cataplexy, and other diary parameters.ResultsPatients (n = 102, 75 with cataplexy) received pitolisant, for the first time in 73 of them. Sixty-eight patients (51 with cataplexy) completed the 12-month treatment. Common treatment-emergent adverse events were headache (11.8% of patients), insomnia (8.8%), weight gain (7.8%), anxiety (6.9%), depressive symptoms (4.9%), and nausea (4.9%). Seven patients had a serious adverse effect, unrelated to pitolisant except for a possibly related miscarriage. One-third of patients stopped pitolisant, mostly (19.6%) for insufficient benefit. ESS score decreased by 4.6 ± 0.6. Two-thirds of patients completing the treatment were responders (ESS ≤ 10 or ESS decrease ≥ 3), and one third had normalized ESS (≤10). Complete and partial cataplexy, hallucinations, sleep paralysis, and sleep attacks were reduced by 76%, 65%, 54%, 63%, and 27%, respectively. Pitolisant as monotherapy (43% of patients) was better tolerated and more efficacious on ESS than on add-on, but efficacy was maintained in this last case.ConclusionsLong-term safety and efficacy of pitolisant on daytime sleepiness, cataplexy, hallucinations, and sleep paralysis is confirmed.
Published: 2019

5. Outcome of acute mesenteric ischemia in the intensive care unit: a retrospective, multicenter study of 780 cases

Author: Mourad Boufi, Eric Kipnis, Oriane Martinez, Alexandra Piton, Djillali Annane, Nicolas Bruder, Olivier Baldesi, Didier Demory, Matthieu Legrand, Jean-Michel Constantin, Claude Martin, Bernard Allaouchiche, Florent Wallet, Karim Asehnoune, Olivier Mimoz, Karine Baumstarck, Baptiste Hengy, Jean-Yves Lefrant, Charlotte Arbelot, Laurence Delapierre, Alexandre Ouattara, Bruno Levy, Carole Ichai, Simon Bourcier, Fanny Klasen, Elisa Richter, Thomas Rimmelé, Kamel Toufik, Carole Bechis, Marc Leone, Sigismond Lasocki, Emilie Friou, Pascal Augustin, Jugurtha Aliane, Olivier Collange, Etienne Brasdefer, Marie-Charlotte Vogler, Samir Jaber, Eric Peytel, Pierre-Marie Bertrand, 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, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Service d’anesthésie et de réanimation, Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Service d’Anesthésie-Réanimation II Bordeaux, Services de soins intensifs, CHU Strasbourg, Département d’Anesthésie Réanimation Chirurgicale, CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'anesthésie et réanimation chirurgicale [Nantes], Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de réanimation, CHU Saint-Antoine [AP-HP], Service de Réanimation Polyvalente, Centre Hospitalier Henri Duffaut (Avignon), Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Sektion Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinikum Ulm - University Hospital of Ulm, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Lille (CHU de Lille), Pôle d'Anesthésie Réanimation, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pharmacologie des anti-infectieux (PHAR), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Agressions vasculaires et réponses tissulaires, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Intensive Care Unit, Cannes general hospital, Cannes, Réanimation Polyvalente, Hôpital de la Timone [CHU - APHM] (TIMONE), Unité médicale de soins intensifs, Department of Medical Intensive Care and Hyperbaric Medicine, 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), Service de Réanimation Médicale [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service d’Anesthésiologie et Réanimation [H.I.A Laveran, Marseille], Hôpital d'instruction des armées Laveran [Marseille], Pôle Anesthésie Réanimation [CHU de Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Département d’Anesthésie et de Réanimation, Medical-surgical Intensive Care Unit, Service d’anesthésie réanimation, Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), CHU Clermont-Ferrand, CHU Marseille, 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 Universitaire de Nîmes (CHU Nîmes), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Surgical Critical Care Unit, Department of Anesthesiology and Critical Care, Département d'anesthésie et de soins intensifs, and MORNET, Dominique
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], health care facilities, manpower, and services, Recursive partitioning, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Anesthesiology, Severity of illness, medicine, Risk factor, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, business.industry, Mortality rate, 030208 emergency & critical care medicine, Retrospective cohort study, medicine.disease, Intensive care unit, 3. Good health, [SDV] Life Sciences [q-bio], Mesenteric ischemia, Emergency medicine, business
Abstract: In the intensive care unit (ICU), the outcomes of patients with acute mesenteric ischemia (AMI) are poorly documented. This study aimed to determine the risk factors for death in ICU patients with AMI. A retrospective, observational, non-interventional, multicenter study was conducted in 43 ICUs of 38 public institutions in France. From January 2008 to December 2013, all adult patients with a diagnosis of AMI during their hospitalization in ICU were included in a database. The diagnosis was confirmed by at least one of three procedures (computed tomography scan, gastrointestinal endoscopy, or upon surgery). To determine factors associated with ICU death, we established a logistic regression model. Recursive partitioning analysis was applied to construct a decision tree regarding risk factors and their interactions most critical to determining outcomes. The death rate of the 780 included patients was 58 %. Being older, having a higher sequential organ failure assessment (SOFA) severity score at diagnosis, and a plasma lactate concentration over 2.7 mmol/l at diagnosis were independent risk factors of ICU mortality. In contrast, having a prior history of peripheral vascular disease or an initial surgical treatment were independent protective factors against ICU mortality. Using age and SOFA severity score, we established an ICU mortality score at diagnosis based on the cutoffs provided by recursive partitioning analysis. Probability of survival was statistically different (p
Published: 2015

6. Lamins and nesprin-1 mediate inside-out mechanical coupling in muscle cell precursors through FHOD1

Author: Schwartz, Christine, Fischer, Martina, Mamchaoui, Kamel, Bigot, Anne, Lok, Thevy, Verdier, Claude, Duperray, Alain, Michel, Richard, Holt, Ian, Voit, Thomas, Quijano-Roy, Suzanna, Bonne, Gisèle, Coirault, Catherine, Centre de recherche en myologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Interdisciplinaire de Physique [Saint Martin d’Hères] (LIPhy), Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Institut Albert Bonniot, RJAH Orthopaedic NHS Trust, CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), HAL UPMC, Gestionnaire, Centre de recherche en Myologie – U974 SU-INSERM, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Subjects: Fetal Proteins, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Science, Formins, Nuclear Proteins, Cell Differentiation, Nerve Tissue Proteins, macromolecular substances, Lamin Type A, R1, Article, Myoblasts, Cytoskeletal Proteins, Mutation, Medicine, Humans, Cells, Cultured, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; LINC complexes are crucial for the response of muscle cell precursors to the rigidity of their environment, but the mechanisms explaining this behaviour are not known. Here we show that pathogenic mutations in LMNA or SYNE-1 responsible for severe muscle dystrophies reduced the ability of human muscle cell precursors to adapt to substrates of different stiffness. Plated on muscle-like stiffness matrix, mutant cells exhibited contractile stress fibre accumulation, increased focal adhesions, and higher traction force than controls. Inhibition of Rho-associated kinase (ROCK) prevented cytoskeletal defects, while inhibiting myosin light chain kinase or phosphorylation of focal adhesion kinase was ineffective. Depletion or inactivation of a ROCK-dependent regulator of actin remodelling, the formin FHOD1, largely rescued morphology in mutant cells. The functional integrity of lamin and nesprin-1 is thus required to modulate the FHOD1 activity and the inside-out mechanical coupling that tunes the cell internal stiffness to match that of its soft, physiological-like environment.
Published: 2017

7. Somatosensory evoked potentials in the assessment of peripheral neuropathies: Commented results of a survey among French-speaking practitioners and recommendations for practice

Author: J. M. Zola, Tarik Nordine, Francine Mesrati, Jean-Michel Guerit, Louise Tyvaert, Guillemette Fayet, Julien Cassereau, Emmanuel Fournier, Philippe Convers, Sandrine Benaderette, Jean-Pascal Lefaucheur, Martine Gavaret, Yann Péréon, Gaël Nicolas, Eric Azabou, Philippe Petiot, Agnès Trébuchon, François Mauguière, Elsa Krim, Nathalie André-Obadia, Véronique Mutschler, Christophe Vial, H. Salhi, Jean Pouget, Julie Zyss, Julien Praline, V. Pautot, Dominique Guehl, Philippe Merle, S. Attarian, Jérôme Franques, Arnaud Delval, Jean-Christophe Antoine, Nathalie Kubis, Arnaud Lacour, J. D'anglejean, Samar S. Ayache, Régine Morizot-Koutlidis, Pierre Lozeron, Marie-Christine Durand, J.-P. Camdessanché, Olivier Etard, Hospices Civils de Lyon (HCL), Centre de recherche en neurosciences de Lyon (CRNL), 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), Bases de données et traitement des langues naturelles (BDTLN), Laboratoire d'Informatique Fondamentale et Appliquée de Tours (LIFAT), Université de Tours-Institut National des Sciences Appliquées - Centre Val de Loire (INSA CVL), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Université de Tours-Institut National des Sciences Appliquées - Centre Val de Loire (INSA CVL), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Génétique Médicale et Génomique Fonctionnelle (GMGF), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de physiologie et d'explorations fonctionnelles [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe de Recherche Clinique et Technologique sur le Handicap (GRCTH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de neurologie [Angers], Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Troubles cognitifs vasculaires et dégénératifs, Université de Lille, Sciences et Technologies, Cognitions Humaine et ARTificielle (CHART), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Université Paris Nanterre (UPN)-Université Paris 8 Vincennes-Saint-Denis (UP8)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Service des Explorations Fonctionnelles Neurologiques [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Institut National de l'Environnement Industriel et des Risques (INERIS), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Epilepsies, Lesions Cerebrales et Systemes Neuraux de la Cognition, Université de la Méditerranée - Aix-Marseille 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurophysiologie Clinique, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Institut des Maladies Neurodégénératives [Bordeaux] (IMN), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Service de neurologie, CHG Pau, Service de Neurologie, Hôpital Roger Salengro, Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie [Strasbourg], CHU Strasbourg-Hopital Civil, Institut Jean-Pierre Bourgin (IJPB), Institut National de la Recherche Agronomique (INRA)-AgroParisTech, Service des Explorations Fonctionnelles - Centre de Référence des Maladies Neuromusculaires Rares, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire de l'Hôtel Dieu (CHU Hôtel Dieu), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Hôpital de la Timone [CHU - APHM] (TIMONE), Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire des systèmes électriques et de télécommande (LABSET), Université de Saâd Dahlab [Blida] (USDB ), Hôpital neurologique, France Telecom, Centre National d'Etudes de Télécommunications, Laboratoire de Bagneux (CNET Bagneux), CNET, AstroParticule et Cosmologie (APC (UMR_7164)), Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), Service de physiologie et d'explorations fonctionnelles, AP-HP Hôpital Raymond Poincaré [Garches]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP Hôpital Raymond Poincaré [Garches]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris 8 Vincennes-Saint-Denis (UP8)-École pratique des hautes études (EPHE)-Université Paris Nanterre (UPN)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Franche-Comté (UFC), Imagerie et cerveau, PSL Research University (PSL)-PSL Research University (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université de Tours-Institut National des Sciences Appliquées - Centre Val de Loire (INSA CVL), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Observatoire de Paris, PSL Research University (PSL)-PSL Research University (PSL)-Université Paris Diderot - Paris 7 (UPD7), Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), 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), Université de Tours (UT)-Institut National des Sciences Appliquées - Centre Val de Loire (INSA CVL), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Université de Tours (UT)-Institut National des Sciences Appliquées - Centre Val de Loire (INSA CVL), Université Paris 8 Vincennes-Saint-Denis (UP8)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Nanterre (UPN)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Département de neurologie [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Saâd Dahlab Blida 1 (UB1), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hospices Civils de Lyon ( HCL ), Centre de recherche en neurosciences de Lyon ( CRNL ), 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 ), Bases de données et traitement des langues naturelles ( BDTLN ), Laboratoire d'Informatique de l'Université de Tours ( LI ), Université de Tours-Polytech'Tours-Université de Tours-Polytech'Tours, Génétique Médicale et Génomique Fonctionnelle ( GMGF ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ) -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 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches], Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Groupe de Recherche Clinique et Technologique sur le Handicap ( GRCTH ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ), Université d'Angers ( UA ) -CHU Angers, Cognitions Humaine et ARTificielle ( CHART ), Université Paris 8 Vincennes-Saint-Denis ( UP8 ) -École pratique des hautes études ( EPHE ) -Université Paris Nanterre ( UPN ), laboratoire d'Explorations Fonctionnelles Neurologiques ( EFN ), Institut National de l'Environnement Industriel et des Risques ( INERIS ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Centre de résonance magnétique biologique et médicale ( CRMBM ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Centre National de la Recherche Scientifique ( CNRS ), Université de la Méditerranée - Aix-Marseille 2-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Institut des Maladies Neurodégénératives [Bordeaux] ( IMN ), Université de Bordeaux ( UB ) -Centre National de la Recherche Scientifique ( CNRS ), Angiogenese et recherche translationnelle ( CART U965 ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut Jean-Pierre Bourgin ( IJPB ), Institut National de la Recherche Agronomique ( INRA ) -AgroParisTech, Centre Hospitalier Universitaire de Nantes, Centre Hospitalier Universitaire de l'Hôtel Dieu ( CHU Hôtel Dieu ), Hospices Civils de Lyon ( HCL ) -Hôpital de la Croix-Rousse [CHU - HCL], Hôpital de la Timone [CHU - APHM] ( TIMONE ), Université de Tours-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire des systèmes électriques et de télécommande ( LABSET ), Université de Blida, France Telecom, Centre National d'Etudes de Télécommunications, Laboratoire de Bagneux ( CNET Bagneux ), AstroParticule et Cosmologie ( APC - UMR 7164 ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National de Physique Nucléaire et de Physique des Particules du CNRS ( IN2P3 ) -Observatoire de Paris-Université Paris Diderot - Paris 7 ( UPD7 ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ), Université Paris 8 Vincennes-Saint-Denis (UP8)-École pratique des hautes études (EPHE), and Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
Subjects: medicine.medical_specialty, Neural Conduction, Context (language use), Somatosensory system, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Evoked Potentials, Somatosensory, Surveys and Questionnaires, Physiology (medical), medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Protocol (science), business.industry, Peripheral Nervous System Diseases, General Medicine, medicine.disease, Electric Stimulation, Peripheral, Clinical Practice, Peripheral neuropathy, Neurology, Somatosensory evoked potential, [ SDV.NEU ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Practice Guidelines as Topic, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], France, Neurology (clinical), business, Neuroscience, 030217 neurology & neurosurgery
Abstract: Summary Background Somatosensory evoked potentials (SSEPs) are increasingly performed for the assessment of peripheral neuropathies, but no practical guidelines have yet been established in this specific application. Study aim To determine the relevant indication criteria and optimal technical parameters for SSEP recording in peripheral neuropathy investigation. Methods A survey was conducted among the French-speaking practitioners with experience of SSEP recording in the context of peripheral neuropathies. The results of the survey were analyzed and discussed to provide recommendations for practice. Results SSEPs appear to be a second-line test when electroneuromyographic investigation is not sufficiently conclusive, providing complementary and valuable information on central and proximal peripheral conduction in the somatosensory pathways. Conclusions Guidelines for a standardized recording protocol, including the various parameters to be measured, are proposed. Clinical relevance We hope that these proposals will help to recognize the value of this technique in peripheral neuropathy assessment in clinical practice.
Published: 2015

8. Energy Cost of Obstacle Crossing in Stroke Patients

Author: Djamel Bensmail, Raphael Zory, Didier Pradon, Nicolas Roche, Jean Slawinski, Centre de Recherche sur le Sport et le Mouvement (CeRSM), Université Paris Nanterre (UPN), Groupe de Recherche Clinique et Technologique sur le Handicap (GRCTH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de physiologie et d'explorations fonctionnelles [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Plateforme nouvelles technologies, Hôpital Raymond Poincaré [AP-HP], Service de médecine physique et de réadaptation, Laboratoire de Mécanique, Modélisation et Procédés Propres (M2P2), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), and Centre National de la Recherche Scientifique (CNRS)-École Centrale de Marseille (ECM)-Aix Marseille Université (AMU)
Subjects: Adult, Male, medicine.medical_specialty, Obstacle crossing, Stroke patient, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Energetic cost, Physical Therapy, Sports Therapy and Rehabilitation, Hemiplegia, Walking, Analyse du Mouvement en Biomécanique Physiologie et Imagerie, Physical medicine and rehabilitation, Oxygen Consumption, Reference Values, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph], Stroke, business.industry, Rehabilitation, Stroke Rehabilitation, medicine.disease, Gait, Gas analyzer, nervous system diseases, Preferred walking speed, Oxygen, ergometry, Energy cost, Physical therapy, Female, business, Energy Metabolism, Pulmonary Ventilation, human activities
Abstract: OBJECTIVE: The purpose of this study was to analyze the effects of clearing and skirting obstacles during the gait on the energetic cost of walking (ECW) of patients with chronic hemiplegia. The hypothesis was that hemiplegia would have a greatest increase in the ECW than in the healthy group. DESIGN: Fifteen healthy subjects and 17 patients with chronic hemiplegia completed two 6-min walking sessions: one with obstacles and the other without obstacles. During both sessions, the patients were equipped with a portable gas analyzer to measure oxygen uptake (V˙o2). Gait velocity and ECW were calculated. RESULTS: In both groups, gait velocity was lower in the with-obstacles condition and the ECW was significantly higher. V˙o2 was greater in the with-obstacles condition for the healthy group, whereas it remained unchanged for the group with hemiplegia. CONCLUSIONS: Results demonstrated that the addition of obstacles during gait increased the ECW and decreased mean walking speed in both the healthy subjects and the patients with hemiplegia. More interestingly, the authors found differences in adaptation strategies between the healthy subjects and the patients with hemiplegia. During the with-obstacles condition, the oxygen uptakes of the healthy subjects increased and mean walking speed decreased, whereas, in the subjects with hemiplegia, only mean walking speed decreased. CONCLUSIONS: Results demonstrated that the addition of obstacles during gait increased the ECW and decreased mean walking speed in both the healthy subjects and the patients with hemiplegia. More interestingly, the authors found differences in adaptation strategies between the healthy subjects and the patients with hemiplegia. During the with-obstacles condition, the oxygen uptakes of the healthy subjects increased and mean walking speed decreased, whereas, in the subjects with hemiplegia, only mean walking speed decreased.
Published: 2014

9. The Biomechanical Effect of Arm Mass on Long Jump Performance: A Case Study of a Paralympic Upper Limb Amputee

Author: Alice Mazure-Bonnefoy, Raphael Zory, Didier Pradon, Jean Slawinski, Giuseppe Rabita, Emilie Hutin, Groupe de Recherche Clinique et Technologique sur le Handicap (GRCTH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de physiologie et d'explorations fonctionnelles [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Hôpital Cantonal de Genève, Institut national du sport, de l'expertise et de la performance (INSEP), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre de Recherche sur le Sport et le Mouvement (CeRSM), and Université Paris Nanterre (UPN)
Subjects: Adult, Male, medicine.medical_specialty, Computer science, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, medicine.medical_treatment, Movement, Artificial Limbs, Kinematics, Analyse du Mouvement en Biomécanique Physiologie et Imagerie, Health Professions (miscellaneous), Prosthesis, biomechanics, Physical medicine and rehabilitation, Forearm, Amputees, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Force platform, [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph], Added mass, Rehabilitation, Biomechanics, Jumper, Biomechanical Phenomena, medicine.anatomical_structure, long jump, Athletes, Jump, Physical therapy, Arm
Abstract: Epub 2013 Aug 28; BACKGROUND: The role of arm motion during the long jump has been well studied. The aim of this study was to quantify the effect of forearm mass on impulse and the kinematics of the flight phase in an upper limb amputee.CASE DESCRIPTION AND METHODS: A world-record paralympic long jumper carried out jumps in three conditions: wearing his usual forearm prosthesis and with 0.3 and 0.4 kg added mass. A motion capture system including force plates was used to record the jump.FINDINGS AND OUTCOME: At take-off, the addition of 0.4 kg to the prosthesis decreased the vertical velocity of the centre of mass but increased horizontal velocity. These modifications were associated with an increase in landing distance and an improvement of the synchronization between arms.CONCLUSION: Increasing forearm mass appears to improve long jump performance. Further studies need to evaluate the optimal prosthetic mass for both training and competition.CLINICAL RELEVANCE: This biomechanical analysis of the long jump highlighted the effects of changing prosthesis mass on performance. This methodological approach may be useful in the context of sport and performance research.
Published: 2014

10. Chronic pseudo-angina left precordial chest pain caused by a thoracic meningioma

Author: Laurence Kocher, Vincent Kumako, Colette Berger, Eric Azabou, Pierre-Marie Gonnaud, Mahmoud Al Moussawi, Nathalie André-Obadia, Service de physiologie et d'explorations fonctionnelles [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe de Recherche Clinique et Technologique sur le Handicap (GRCTH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de Consultations et d'Explorations Fonctionnelles Neurologiques, Hospices Civils de Lyon (HCL), and Azabou, Eric
Subjects: medicine.medical_specialty, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Case Report, 030204 cardiovascular system & hematology, Chest pain, Angina, 03 medical and health sciences, Magnetic resonance imaging, 0302 clinical medicine, Internal medicine, medicine, otorhinolaryngologic diseases, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], 030212 general & internal medicine, Herniated disk, business.industry, Pseudo-angina pain, Heartburn, Tietze syndrome, medicine.disease, 3. Good health, Pulmonary embolism, Pneumothorax, Pleurisy, Cardiology, medicine.symptom, Meningioma, business, Cardiology and Cardiovascular Medicine, Cardiac
Abstract: Left precordial chest pain (LPCP) evokes above all angina. Eliminating a cardiac origin is then always the first priority. When cardiac causes are eliminated, non-cardiac causes are sought in order to avoid leaving patients with undiagnosed or undifferentiated chest pain. There is a myriad of non-cardiac causes ranging from heartburn, panic attacks, pleurisy, pulmonary embolism, pneumothorax, Tietze syndrome, bruises and fractures of the ribs, to spine meningioma, neuroma, herniated disk and impairment of the nerve roots. Although clinical presentation and characteristics of the pain are usually helpful in diagnosing the cause, conducting magnetic resonance imaging of the spine may be of a high utility in some situations. Here we report a case of chronic angina-like LPCP, caused by a thoracic meningioma.
Published: 2013

11. Transcranial direct-current stimulation reduced the excitability of diaphragmatic corticospinal pathways whatever the polarity used

Author: Eric Azabou, Michel Petitjean, Bernard Bussel, Tarek Sharshar, Frédéric Lofaso, Nicolas Roche, Service de physiologie et d'explorations fonctionnelles [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Service de Médecine Aiguë Spécialisée, Groupe de Recherche Clinique et Technologique sur le Handicap (GRCTH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine physique et de réadaptation, and Azabou, Eric
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, Anodal tdcs, Physiology, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], medicine.medical_treatment, Diaphragm, Pyramidal Tracts, Diaphragmatic breathing, Stimulation, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Neuromodulation, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, 030304 developmental biology, 0303 health sciences, Transcranial direct-current stimulation, General Neuroscience, Motor Cortex, Evoked Potentials, Motor, Transcranial Magnetic Stimulation, Diaphragm (structural system), Transcranial magnetic stimulation, medicine.anatomical_structure, corticospinal pathways, neuromodulation, motor evoked potentials, Psychology, Neuroscience, 030217 neurology & neurosurgery, Motor cortex
Abstract: International audience; We investigated effects of transcranial direct-current stimulation (tDCS) on the diaphragmatic corticospinal pathways in healthy human. Anodal, cathodal, and sham tDCS were randomly applied upon the left diaphragmatic motor cortex in twelve healthy right-handed men. Corticospinal pathways excitability was assessed by means of transcranial magnetic stimulation (TMS) elicited motor-evoked-potential (MEP). For each tDCS condition, MEPs were recorded before (Pre) tDCS then after 10 min (Post1, at tDCS discontinuation in the anodal and cathodal sessions) and 20 min (Post2). As result, both anodal and cathodal tDCS significantly decreased MEP amplitude of the right hemidiaphragm at both Post1 and Post2, versus Pre. MEP amplitude was unchanged versus Pre during the sham condition. The effects of cathodal and anodal tDCS applied to the diaphragm motor cortex differ from those observed during tDCS of the limb motor cortex. These differences may be related to specific characteristics of the diaphragmatic corticospinal pathways as well as to the diaphragm's functional peculiarities compared with the limb muscles.
Published: 2013

12. Optimal parameters of transcranial electrical stimulation for intraoperative monitoring of motor evoked potentials of the tibialis anterior muscle during pediatric scoliosis surgery

Author: Jay L. Shils, Frédéric Lofaso, C. Fischer, François Mauguière, Eric Azabou, Nathalie André-Obadia, V. Manel, C. Peiffer, Groupe de Recherche Clinique et Technologique sur le Handicap (GRCTH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de physiologie et d'explorations fonctionnelles [CHU Raymond-Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Service epilepsie sommeil et explorations fonctionnelles neuropédiatriques (HFME), Hospices Civils de Lyon (HCL)-Université de Lyon, Service de neurologie fonctionnelle et d'épileptologie, Hospices Civils de Lyon (HCL)-Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Intraoperative monitoring, Lahey clinic, and Azabou, Eric
Subjects: Male, medicine.medical_specialty, Adolescent, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Stimulation parameters, NOP, Pyramidal Tracts, Scoliosis, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Tibialis anterior muscle, 030202 anesthesiology, Intraoperative neurophysiologic monitoring, Physiology (medical), Monitoring, Intraoperative, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, General anaesthesia, Motor evoked potential, Scoliosis surgery, Child, Muscle, Skeletal, Children, Rachis, business.industry, General Medicine, medicine.disease, Spinal cord, Evoked Potentials, Motor, Transcranial Magnetic Stimulation, Surgery, Electrophysiology, medicine.anatomical_structure, Neurology, Anesthesia, Corticospinal tract, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: International audience; OBJECTIVE: Transcranial electric stimulation elicited muscle motor evoked potentials (TESmMEPs) is one of the best methods for corticospinal tract's function monitoring during spine and spinal cord surgeries. A train of multipulse electric stimulation is required for eliciting TESmMEPs under general anaesthesia. Here, we investigated the best stimulation parameters for eliciting and recording tibialis anterior's TESmMEPs during paediatric scoliosis surgery. PATIENTS AND METHODS: Numbers of pulses (NOP), inter-stimulus intervals (ISI) and current intensities allowing the best size tibialis anterior muscle's TESmMEPs under general anaesthesia, were tested and collected during 77 paediatric scoliosis surgery monitoring procedures in our hospital. Individual pulse duration was kept at 0.5 ms and stimulating electrodes were positioned at C1 and C2 (International 10-20-EEG-System) during all the tests. RESULTS: The NOP used for eliciting the best tibialis anterior TESmMEPs response was 5, 6, and 7 respectively in 21 (27%), 47 (61%) and 9 (12%) out of the 77 patients. The ISI was 2, 3 and 4 ms respectively in 13 (17%), 55 (71%) and 9 (12%) of them. The current intensity used varied from 300 to 700 V (mean: 448±136 V). CONCLUSION: Most patients had 6 as best NOP (61%) and 3 ms as best ISI (71%). These findings support that a NOP of 6 and an ISI of 3 ms should be preferentially used as optimal stimulation settings for intraoperative tibialis anterior muscle's TESmMEPs eliciting and recording during paediatric scoliosis surgery.
Published: 2013

13. Patient-controlled positive end-expiratory pressure with neuromuscular disease: effect on speech in patients with tracheostomy and mechanical ventilation support.: Speech and Mechanical Ventilation

Author: Garguilo, Marine, Leroux, Karl, Lejaille, Michèle, Pascal, Sophie, Orlikowski, David, Lofaso, Frédéric, Prigent, Hélène, Guellaen, Georges, Groupe de Recherche Clinique et Technologique sur le Handicap (GRCTH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), ADEP Assistance, ADEP assistance, CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine physique et de réadaptation, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Service de réanimation médicale[Poincaré], Service de physiologie et d'explorations fonctionnelles [CHU Raymond-Poincaré], Physiopathologie et Thérapeutiques Respiratoires, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10, and Marine Garguilo received a grant from the Institut Garches and the Axa fund for research. The study was supported by the Association d'Entraide des Polios et Handicapés (ADEP assistance).
Subjects: speech, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, tracheostomy, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, neuromuscular, respiratory system, mechanical ventilation, respiratory tract diseases, positive end-expiratory pressure
Abstract: International audience; OBJECTIVE: Communication is a major issue for patients with tracheostomy who are supported by mechanical ventilation. The use of positive end-expiratory pressure (PEEP) may restore speech during expiration; however, the optimal PEEP level for speech may vary individually. We aimed to improve speech quality with an individually adjusted PEEP level delivered under the patient's control to ensure optimal respiratory comfort. METHODS: Optimal PEEP level (PEEPeff), defined as the PEEP level that allows complete expiration through the upper airways, was determined for 12 patients with neuromuscular disease who are supported by mechanical ventilation. Speech and respiratory parameters were studied without PEEP, with PEEPeff, and for an intermediate PEEP level. Flow and airway pressure were measured. Microphone speech recordings were subjected to both quantitative and qualitative assessments of speech, including an intelligibility score, a perceptual score, and an evaluation of prosody determined by two speech therapists blinded to PEEP condition. RESULTS: Text reading time, phonation flow, use of the respiratory cycle for phonation, and speech comfort significantly improved with increasing PEEP, whereas qualitative parameters remained unchanged. This resulted mostly from the increase of the expiratory volume through the upper airways available for speech for all patients combined, with a rise in respiratory rate for nine patients. Respiratory comfort remained stable despite high levels of PEEPeff (median, 10.0 cm H2O; interquartile range, 9.5-12.0 cm H2O). CONCLUSIONS: Patient-controlled PEEP allowed for the use of high levels of PEEP with good respiratory tolerance and significant improvement in speech (enabling phonation during the entire respiratory cycle in most patients). The device studied could be implemented in home ventilators to improve speech and, therefore, autonomy of patients with tracheostomy. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01479959; URL: clinicaltrials.gov.
Published: 2013

14. Early-onset ventilator-associated pneumonia in adults randomized clinical trial: comparison of 8 versus 15 days of antibiotic treatment

Author: C. Charpentier, Djillali Annane, Mariette Mercier, Thibault Desmettre, Christophe Faisy, Antoine Roch, Joel Cousson, Gilles Capellier, Samuel Limat, Laurent Papazian, Hélène Mockly, Gilles Blasco, CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Médecine Générale et Soins Intensifs, Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches], Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre National de la Recherche Scientifique ( CNRS ), 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 ), Service de Réanimation des Détresses Respiratoires et Infections Sévères, Assistance Publique - Hôpitaux de Marseille ( APHM ), Service de soins intensifs, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ) -Université Bourgogne Franche-Comté [COMUE] ( UBFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Université de Franche-Comté ( UFC ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Raymond Poincaré [AP-HP], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), 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), Assistance Publique - Hôpitaux de Marseille (APHM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP Hôpital Raymond Poincaré [Garches]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP Hôpital Raymond Poincaré [Garches], Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC), Laboratoire Chrono-environnement (UMR 6249) (LCE), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), and Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO)
Subjects: Male, Critical Care and Emergency Medicine, Pulmonology, MESH : Aged, MESH : Prospective Studies, MESH: Pneumonia, Ventilator-Associated, MESH : Pneumonia, Ventilator-Associated, MESH : Drug Resistance, Bacterial, MESH : Intensive Care, law.invention, 0302 clinical medicine, Antibiotics, Odds Ratio, Clinical endpoint, Prospective Studies, lcsh:Science, MESH : Intubation, MESH: Treatment Outcome, Cross Infection, MESH: Middle Aged, Death rates, Drug Information, Pneumonia, Ventilator-Associated, 3. Good health, Cohort, Medicine, MESH : Intensive Care Units, MESH : Bronchoalveolar Lavage, MESH : Cross Infection, Cohort study, medicine.medical_specialty, MESH : Drug Administration Schedule, MESH : Cohort Studies, MESH: Drug Administration Schedule, Drug Administration Schedule, 03 medical and health sciences, Sepsis, MESH: Anti-Bacterial Agents, Multicenter trial, Drug Resistance, Bacterial, Humans, Clinical Trials, MESH : Middle Aged, MESH: Intensive Care, Aged, MESH: Humans, [ SDV ] Life Sciences [q-bio], lcsh:R, MESH : Humans, MESH: Adult, Pneumonia, medicine.disease, 030228 respiratory system, Bacterial Pneumonia, lcsh:Q, Bacterial pathogens, Intubation, MESH: Female, Bacterial Diseases, Time Factors, Nosocomial Infections, [SDV]Life Sciences [q-bio], Enterococcus infections, lcsh:Medicine, Bronchoalveolar Lavage, Cohort Studies, Randomized controlled trial, law, MESH : Female, 030212 general & internal medicine, MESH : Anti-Bacterial Agents, Prospective cohort study, MESH: Cohort Studies, MESH: Aged, Intensive care units, Multidisciplinary, MESH: Bronchoalveolar Lavage, Ventilatory Support, Middle Aged, MESH : Adult, Anti-Bacterial Agents, Infectious Diseases, Treatment Outcome, Female, Research Article, MESH : Time Factors, Adult, Drugs and Devices, Critical Care, Clinical Research Design, Secondary infection, MESH : Male, MESH : Treatment Outcome, Respiratory Failure, Internal medicine, MESH: Drug Resistance, Bacterial, medicine, MESH: Intubation, business.industry, MESH: Time Factors, Respiratory infections, MESH: Cross Infection, MESH: Male, MESH: Odds Ratio, MESH: Prospective Studies, Surgery, MESH: Intensive Care Units, MESH : Odds Ratio, business
Abstract: Purpose The optimal treatment duration for ventilator-associated pneumonia is based on one study dealing with late-onset of the condition. Shortening the length of antibiotic treatment remains a major prevention factor for the emergence of multiresistant bacteria. Objective To demonstrate that 2 different antibiotic treatment durations (8 versus 15 days) are equivalent in terms of clinical cure for early-onset ventilator-associated pneumonia. Methods Randomized, prospective, open, multicenter trial carried out from 1998 to 2002. Measurements The primary endpoint was the clinical cure rate at day 21. The mortality rate was evaluated on days 21 and 90. Results 225 patients were included in 13 centers. 191 (84.9%) patients were cured: 92 out of 109 (84.4%) in the 15 day cohort and 99 out of 116 (85.3%) in the 8 day cohort (difference = 0.9%, odds ratio = 0.929). 95% two-sided confidence intervals for difference and odds ratio were [−8.4% to 10.3%] and [0.448 to 1.928] respectively. Taking into account the limits of equivalence (10% for difference and 2.25 for odds ratio), the objective of demonstrative equivalence between the 2 treatment durations was fulfilled. Although the rate of secondary infection was greater in the 8 day than the 15 day cohort, the number of days of antibiotic treatment remained lower in the 8 day cohort. There was no difference in mortality rate between the 2 groups on days 21 and 90. Conclusion Our results suggest that an 8-day course of antibiotic therapy is safe for early-onset ventilator-associated pneumonia in intubated patients. Trial Registration ClinicalTrials.gov NCT01559753
Published: 2012

15. Robust Virtual Keyboard for Brain-Computer Interface (ROBIK): An Halfway Update on the Project

Author: Sabine Filipe, G. Charvet, Louis Mayaud, Remi Schoettel, Djillali Annane, Marco Congedo, Institute of Biomedical Engineering (IBME), University of Oxford, GIPSA - Vision and Brain Signal Processing (GIPSA-VIBS), Département Images et Signal (GIPSA-DIS), Grenoble Images Parole Signal Automatique (GIPSA-lab), Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Stendhal - Grenoble 3-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Stendhal - Grenoble 3-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Grenoble Images Parole Signal Automatique (GIPSA-lab), Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Stendhal - Grenoble 3-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Stendhal - Grenoble 3-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS), Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information (CEA-LETI), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Dixi Microtechniques (DIXI), DIXI, CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Raymond Poincaré [AP-HP], Congedo, Marco, University of Oxford [Oxford], Université Stendhal - Grenoble 3-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Stendhal - Grenoble 3-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Grenoble Images Parole Signal Automatique (GIPSA-lab), and Université Stendhal - Grenoble 3-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Stendhal - Grenoble 3-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)
Subjects: Brain-Computer Interface, Computer science, Headset, 0206 medical engineering, Population, 02 engineering and technology, computer.software_genre, Personalization, law.invention, 03 medical and health sciences, 0302 clinical medicine, Software, law, Robustness (computer science), RoBIK, education, Brain–computer interface, Virtual keyboard, education.field_of_study, Signal processing, business.industry, [SCCO.NEUR]Cognitive science/Neuroscience, [SCCO.NEUR] Cognitive science/Neuroscience, 020601 biomedical engineering, Operating system, business, computer, 030217 neurology & neurosurgery, Computer hardware
Abstract: Introduction The principle of a Brain-Computer Interface or BCI is to control a device through the extraction and interpretation of signal features from electroencephalograms (EEG) collected either from the surface of the scalp or through invasive measurements. This late idea of communication technique (Vidal 1973), offers the advantage of bypassing the need for muscle activity in the control chain and is therefore presented as a promising alternative to restore communication and control in severely disabled patients (Wolpow, et al. 2002). However, the lack of robustness and ergonomics of both available software and EEG measurement techniques have delayed the transfer of this technology to patients bedsides. Materials and methods The French Research Agency has funded a 3-year project gathering national leaders in microelectronics (CEA-Leti), EEG signal processing (Gipsa-Lab) and clinical management of severely disabled people (Raymond Poincar hospital). The aim of the project is the development and the clinical validation of a BrainComputer Interface prototype for communication. As an initial step, a survey was carried out to assess patients’ and users (family and caretakers) needs, which were translated into specifications, on the basis of which software and hardware were developed. Results The survey (n=45) highlighted the need for easy-to-setup systems (installation time i 15min), which stresses the importance of mechanical comfort and customization of application. The development of signal processing techniques has led to improvements of the P3Speller paradigm. A first prototype of a 32-channel EEG recording system is under development. To ease the EEG measurements and reduce installation time, the system has a reduced size. It includes the analog amplification and digital conversion of 32 channels sampled at 1 kHz, as well as the wireless data transmission to a computer. First in vivo validations were performed on small animals. This system will be optimized and connected to a headset specifically designed to provide a comfortable and handy interface with dry electrodes. Discussion The present project will still run for one and a half years, ending with its clinical validation in a population of severely disabled patients, which will compare performances of the system with existing assistive technologies. At this stage, the proposed system yields very promising results, and outperforms the current state-of-theart. If such a system is shown to perform better than current users assistive technology, it could reach the commercial availability for severely disabled patients within the next 5 years.
Published: 2011

16. Design, conduct, and analysis of a multicenter, pharmacogenomic, biomarker study in matched patients with severe sepsis treated with or without drotrecogin Alfa (activated)

Author: Anthony C. Gordon, Jonathan E. Sevransky, Frank Stüber, James A. Russell, Patrick J. Heagerty, Mauricio Neira, Alexandra D. J. Mancini, Djillali Annane, Hugh Wellman, Lorraine B. Ware, Jean Paul Mira, CIT-IT Garches, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Médecine Générale et Soins Intensifs, Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches], Université Paris Descartes - Paris 5 ( UPD5 ), Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Section of Anaesthetics, Pain Medicine, and Intensive Care, Imperial College London-Charing Cross Hospital, MICU, John Hopkins BMC, Inselspital Bern, Biostatistics, University of Washington [Seattle], Sirius Genomics, Sirius Genomics Inc, Critical Care Research Laboratories, St. Paul's Hospital-The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research-University of British Columbia ( UBC ), BMC, Ed., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Raymond Poincaré [AP-HP], Université Paris Descartes - Paris 5 (UPD5), Vanderbilt University School of Medicine [Nashville], and St. Paul's Hospital-The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research-University of British Columbia (UBC)
Subjects: medicine.medical_specialty, Propensity score, Survival, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Predictive marker, 030204 cardiovascular system & hematology, Pharmacogenomics biomarker, Critical Care and Intensive Care Medicine, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Drotrecogin alfa activated (DAA), Anesthesiology, Internal medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Medicine, 030212 general & internal medicine, Intensive care medicine, Drotrecogin alfa (activated), APACHE II, [ SDV.MHEP.PHY ] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], business.industry, Drotrecogin alfa, Research, Treatment selection, medicine.disease, Severe sepsis, 3. Good health, Activated protein C, Propensity score matching, Biomarker (medicine), Genome wide association study, business, medicine.drug, Companion diagnostic
Abstract: Background A genomic biomarker identifying patients likely to benefit from drotrecogin alfa (activated) (DAA) may be clinically useful as a companion diagnostic. This trial was designed to validate biomarkers (improved response polymorphisms (IRPs)). Each IRP (A and B) contains two single nucleotide polymorphisms that were associated with a differential DAA treatment effect. Methods DAA is typically given to younger patients with greater disease severity; therefore, a well-matched control group is critical to this multicenter, retrospective, controlled, outcome-blinded, genotype-blinded trial. Within each center, DAA-treated patients will be matched to controls treated within 24 months of each other taking into account age, APACHE II, cardiovascular, respiratory, renal, and hematologic dysfunction, mechanical ventilation status, medical/surgical status, and infection site. A propensity score will estimate the probability that a patient would have received DAA given their baseline characteristics. Two-phase data transfer will ensure unbiased selection of matched controls. The first transfer will be for eligibility and matching data and the second transfer for outcomes and genotypic data. The primary analysis will compare the effect of DAA in IRP + and IRP − groups on in-hospital mortality through day 28. Discussion A design-based approach matching DAA-free to DAA-treated patients in a multicenter study of patients who have severe sepsis and high risk of death will directly compare control to DAA-treated groups for mortality by genotype. Results, which should be available in 2012, may help to identify the group of patients who would benefit from DAA and may provide a model for future investigation of sepsis therapies.
Published: 2012

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16 results on '"CIT-IT Garches"'

1. Physiological comparison of breathing patterns with neurally adjusted ventilatory assist (NAVA) and pressure-support ventilation to improve NAVA settings

2. Les urgences infectieuses en urologie

3. Factors Associated With a Higher Score of Burnout in a Population of 860 French Psychiatrists

4. Long-term use of pitolisant to treat patients with narcolepsy: Harmony III Study

5. Outcome of acute mesenteric ischemia in the intensive care unit: a retrospective, multicenter study of 780 cases

6. Lamins and nesprin-1 mediate inside-out mechanical coupling in muscle cell precursors through FHOD1

7. Somatosensory evoked potentials in the assessment of peripheral neuropathies: Commented results of a survey among French-speaking practitioners and recommendations for practice

8. Energy Cost of Obstacle Crossing in Stroke Patients

9. The Biomechanical Effect of Arm Mass on Long Jump Performance: A Case Study of a Paralympic Upper Limb Amputee

10. Chronic pseudo-angina left precordial chest pain caused by a thoracic meningioma

11. Transcranial direct-current stimulation reduced the excitability of diaphragmatic corticospinal pathways whatever the polarity used

12. Optimal parameters of transcranial electrical stimulation for intraoperative monitoring of motor evoked potentials of the tibialis anterior muscle during pediatric scoliosis surgery

13. Patient-controlled positive end-expiratory pressure with neuromuscular disease: effect on speech in patients with tracheostomy and mechanical ventilation support.: Speech and Mechanical Ventilation

14. Early-onset ventilator-associated pneumonia in adults randomized clinical trial: comparison of 8 versus 15 days of antibiotic treatment

15. Robust Virtual Keyboard for Brain-Computer Interface (ROBIK): An Halfway Update on the Project

16. Design, conduct, and analysis of a multicenter, pharmacogenomic, biomarker study in matched patients with severe sepsis treated with or without drotrecogin Alfa (activated)

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