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1. Tetanus-induced rhythmic seizures mimicking the clinical and electroencephalographic presentation of status epilepticus

Author: Hippolyte Lequain, Aurelie Richard-Mornas, Laurent Argaud, Auguste Dargent, Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Lyon, VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), Hôpital Edouard Herriot [CHU - HCL], and CarMeN, laboratoire
Subjects: Tetanus, Epilepsy, Infectious diseases, Electroencephalography, General Medicine, Adult intensive care, Epilepsy and seizures, Substance Withdrawal Syndrome, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Alcoholism, Status Epilepticus, Seizures, Emergency medicine, Humans, Female, Anticonvulsants, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract: We describe the case of a woman in her 60s admitted to the intensive care unit after a first generalised tonic-clonic seizure in the context of alcohol withdrawal. She was placed under invasive mechanical ventilation due to persistence of coma despite antiepileptic treatment. Despite continuous sedation with propofol, the frequency and intensity of seizure increased. Seizures were very similar to epileptic tonic-clonic seizures and were recorded with video and electroencephalogram (EEG). A diagnosis of tetanus was considered after a scalp wound was discovered. The patient’s husband revealed that a trismus had appeared a few days before hospital admission after a head trauma. EEG showed a pattern of diffuse spikes, which disappeared after a cisatracurium bolus. The diagnosis of tetanus was later confirmed by cultures from wound samples. Therefore, severe tetanus can mimic both the clinical and EEG features of status epilepticus and could be added to the differential diagnosis of epilepsy.
Published: 2024

2. What should European nephrology do with the new CKD-EPI equation?

Author: Gansevoort, Ron T., Anders, Hans-Joachim, Cozzolino, Mario, Fliser, Danilo, Fouque, Denis, Ortiz, Alberto, Soler, María José, Wanner, Christoph, Universitat Autònoma de Barcelona, University Medical Center Groningen [Groningen] (UMCG), Klinikum der Universität [München], Università degli Studi di Milano = University of Milan (UNIMI), Saarland University [Saarbrücken], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Fundacion Jimenez Diaz [Madrid] (FJD), Universidad Autónoma de Madrid (UAM), Vall d’Hebron Research Institute (VHIR), Vall d'Hebron University Hospital [Barcelona], Universitat Autònoma de Barcelona (UAB), University Hospital of Würzburg, CarMeN, laboratoire, Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Institut Català de la Salut, [Gansevoort RT] Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. [Anders HJ] Renal Division, Hospital of the Ludwig Maximilans University, Munich, Germany. [Cozzolino M] Department of Health Sciences, University of Milan, Renal Division, ASST Santi Paolo e Carlo, Milan, Italy. [Fliser D] Department of Internal Medicine IV, Renal and Hypertensive Disease, University Medical Center, Homburg, Saar, Germany. [Fouque D] Department of Nephrology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Benite, University of Lyon, France. [Ortiz A] Department of Nephrology, IIS-Fundacion Jimenez Diaz- UAM, Madrid, Spain. Department of Medicine, Universidad Autonoma de Madrid, Madrid, Spain. [Soler MJ] Servei de Nefrologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Wanner C] Department of Internal Medicine I and Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany, and Vall d'Hebron Barcelona Hospital Campus
Subjects: Settore MED/14 - Nefrologia, Transplantation, Sang - Anàlisi, enfermedades urogenitales masculinas::enfermedades urológicas::enfermedades renales::insuficiencia renal::insuficiencia renal crónica [ENFERMEDADES], Otros calificadores::/diagnóstico [Otros calificadores], Glomèruls renals, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Nephrology, Insuficiència renal crònica - Prognosi, Other subheadings::/diagnosis [Other subheadings], diagnóstico::técnicas y procedimientos diagnósticos::técnicas diagnósticas urológicas::pruebas de función renal::tasa de filtración glomerular [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Renal Insufficiency::Renal Insufficiency, Chronic [DISEASES], [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Urological::Kidney Function Tests::Glomerular Filtration Rate [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT]
Abstract: Nephrology; CKD-EPI equation Nefrologia; Equació CKD-EPI Nefrología; Ecuación CKD-EPI
Published: 2023

3. Exosomal lipids from membrane organization to biomarkers: Focus on an endolysosomal-specific lipid

Author: Françoise Hullin-Matsuda, Pascal Colosetti, Maxence Rabia, Céline Luquain-Costaz, Isabelle Delton, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Laboratoire d'automatique, de génie des procédés et de génie pharmaceutique (LAGEPP), Université de Lyon-Université de Lyon-École Supérieure de Chimie Physique Électronique de Lyon (CPE)-Centre National de la Recherche Scientifique (CNRS), and CarMeN, laboratoire
Subjects: bis(monoacylglycero)phosphate, Proteins, Cell Communication, Lipid trafficking, General Medicine, Extracellular vesicles, Exosomes, Lipids, Biochemistry, Docosahexaenoic acid, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Cholesterol, interest, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Biomarkers
Abstract: The term extracellular vesicles (EVs) has been recommended to describe various membrane-bound vesicles secreted by most living cells and found in various biological fluids. They gained growing interest as mediators of cell-cell communication and for their roles in different patho-physiological processes. In addition, they were recently considered as disease biomarkers and new drug delivery systems. However, it is still difficult to link a biological function to a specific EV population among the heterogenous EV mixture secreted in the extracellular space due to limitations of optimal isolation methods. EV classification according to their size as small (\textless200 nm) and large (\textgreater200 nm) vesicles is also completed by the identification of selected proteins, nucleic acids and lipids. In this review, we summarized briefly knowledge about the composition and role of EV lipids that received less attention compared to their protein and nucleic acid content. Lipids are not only essential structural components of EVs, but can give important information on their biogenesis. Especially, we discussed our recent data showing the utility of bis(monoacylglycero)phosphate (BMP), a specific endolysosomal lipid marker, that could sign the endosomal origin of small EVs, classically named as exosomes.
Published: 2022

4. Fat Graft Retention: Adipose Tissue, Adipose-Derived Stem Cells, and Aging

Author: Trotzier, C., Sequeira, I., Auxenfans, C., Mojallal, A. A., CarMeN, laboratoire, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), L'Oréal Recherche France (L'Oréal Recherche), L'OREAL, Queen Mary University of London (QMUL), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Banque de tissus et de cellules [CHU - HCL] (Hôpital Edouard Herriot), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Hôpital de la Croix-Rousse [CHU - HCL], and Université de Lyon
Subjects: [SDV.BA] Life Sciences [q-bio]/Animal biology, [SDV.BA]Life Sciences [q-bio]/Animal biology, Surgery
Abstract: Over the past 30 years, there has been a dramatic increase in the use of autologous fat grafting for soft-tissue augmentation and to improve facial skin quality. Several studies have highlighted the impact of aging on adipose tissue, leading to a decrease of adipose tissue volume and preadipocytes proliferation and increase of fibrosis. Recently, there has been a rising interest in adipose tissue components, including Adipose-derived Stem/Stromal Cells (ASCs) due to their regenerative potential, including inflammation, fibrosis and vascularization modulation. Due to their differentiation potential and paracrine function, ASC has been largely used for fat grafting procedures as they are described to be a key component in fat graft survival. However, many parameters as surgical procedures of adipose tissue biology could change clinical outcomes. Variation on fat grafting methods lead to numerous inconsistent clinical outcomes. Donor-to-donor variation could also be imputed to ASCs, tissue inflammatory state or tissue origin. In this review, we aim to analyze (1) the parameters involved on the graft survival, and (2) the effect of aging on adipose tissue components, especially ASCs, that could lead to a decrease of skin regeneration and fat graft retention.
Published: 2022

5. Advanced hybrid closed loop therapy versus conventional treatment in adults with type 1 diabetes (ADAPT): a randomised controlled study

Author: Pratik Choudhary, Ralf Kolassa, Winfried Keuthage, Jens Kroeger, Charles Thivolet, Mark Evans, Roseline Ré, Simona de Portu, Linda Vorrink, John Shin, Aklilu Habteab, Javier Castañeda, Julien da Silva, Ohad Cohen, King‘s College London, NHS Foundation Trust [London], The Royal Marsden, University of Leicester, Diabetologische Schwerpunktpraxis [Bergheim, Germany] (DS), Schwerpunktpraxis für Diabetes und Ernährungsmedizin [Münster, Germany] (SDE), Zentrum für Diabetologie Bergedorf [Hamburg, Germany] (ZDB), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), MRC Epidemiology Unit [Cambridge, UK] (Wellcome Trust-MRC Institute of Metabolic Science), University of Cambridge [UK] (CAM)-Addenbrooke’s Hospital [Cambridge, UK]-Wellcome Trust-MRC Institute of Metabolic Science (IMS), Medtronic Diabetes, International Trading Sàrl [Tolochenaz, Switzerland ] (MDITS), Medtronic [Northridge, CA, USA] (Mt), Medtronic Bakken Research Center BV, Institut de Ciencies del Cosmos (ICCUB), Universitat de Barcelona (UB), ADAPT study Group, and CarMeN, laboratoire
Subjects: Adult, Blood Glucose, Glycated Hemoglobin, Blood Glucose Self-Monitoring, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, Diabetic Ketoacidosis, [SDV] Life Sciences [q-bio], Diabetes Mellitus, Type 1, Treatment Outcome, Endocrinology, Internal Medicine, Humans, Hypoglycemic Agents, Insulin, Prospective Studies
Abstract: International audience; BACKGROUND: Adults with type 1 diabetes who are treated with multiple daily injections of insulin plus intermittently scanned continuous glucose monitoring (isCGM) can have suboptimal glucose control. We aimed to assess the efficacy of an advanced hybrid closed loop (AHCL) system compared with such therapy in this population. METHODS: The Advanced Hybrid Closed Loop Study in Adult Population with Type 1 Diabetes (ADAPT) trial is a prospective, multicentre, open-label, randomised controlled trial that involved 14 centres in three European countries (France, Germany, and the UK). We enrolled patients who were at least 18 years of age, had a type 1 diabetes duration of at least 2 years, HbA(1c) of at least 8% (64 mmol/mol), and were using multiple daily injections of insulin plus isCGM (cohort A) or real time continuous glucose monitoring (cohort B) for at least 3 months. Here, only results for cohort A are reported. Participants were randomly allocated 1:1 to AHCL therapy or continuation of multiple daily injections of insulin plus continuous glucose monitoring for 6 months with an investigator-blinded block randomisation procedure. Participants and treating clinicians could not be masked to the arm assignment. The primary endpoint was the between-group difference in mean HbA(1c) change from baseline to 6 months in the intention-to-treat population using AHCL therapy and those using multiple daily injections of insulin plus isCGM. The primary endpoint was analysed using a repeated measures random-effects model with the study arm and period as factors. Safety endpoints included the number of device deficiencies, severe hypoglycaemic events, diabetic ketoacidosis, and serious adverse events. This study is registered with ClinicalTrials.gov, NCT04235504. FINDINGS: Between July 13, 2020, and March 12, 2021, 105 people were screened and 82 randomly assigned to treatment (41 in each arm). At 6 months, mean HbA(1c) had decreased by 1·54% (SD 0·73), from 9·00% to 7·32% in the AHCL group and 0·20% (0·80) in the multiple daily injections of insulin plus isCGM from 9·07% to 8·91% (model-based difference -1·42%, 95% CI -1·74 to -1·10; p\textless0·0001). No diabetic ketoacidosis, severe hypoglycaemia, or serious adverse events related to study devices occurred in either group; two severe hypoglycaemic events occurred in the run-in phase. 15 device-related non-serious adverse events occurred in the AHCL group, compared with three in the multiple daily injections of insulin plus isCGM group. Two serious adverse events occurred (one in each group), these were breast cancer (in one patient in the AHCL group) and intravitreous haemorrhage (in one patient in the multiple daily injections of insulin plus isCGM group). INTERPRETATION: In people with type 1 diabetes using multiple daily injections of insulin plus isCGM and with HbA(1c) of at least 8%, the use of AHCL confers benefits in terms of glycaemic control beyond those that can be achieved with multiple daily injections of insulin plus isCGM. These data support wider access to AHCL in people with type 1 diabetes not at target glucose levels. FUNDING: Medtronic International Trading Sàrl.
Published: 2022

6. Protein-bound uremic toxins: putative modulators of calcineurin inhibitor exposure

Author: Carmen Lab, KOPPE Laetitia, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), and CarMeN, laboratoire
Subjects: [SDV] Life Sciences [q-bio], Transplantation, Nephrology, [SDV]Life Sciences [q-bio], Calcineurin Inhibitors, Humans, Uremic Toxins, Kidney Transplantation, Indican, Uremia
Abstract: International audience; No abstract available
Published: 2022

7. Calcium homeostasis and hyperparathyroidism: Nephrologic and endocrinologic points of view

Author: Lemoine, S., Figueres, L., Bacchetta, J., Frey, S., Dubourg, L., Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Filières Maladies Rares ORKID et ERK-Net, Centre de Référence des Maladies Rares du Métabolisme du Phosphore et du Calcium and Filière de Santé Maladies Rares (OSCAR), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre hospitalier universitaire de Nantes (CHU Nantes), Physiopathologie, diagnostic et traitements des maladies osseuses / Pathophysiology, Diagnosis & Treatments of Bone Diseases (LYOS), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Hôtel-Dieu de Nantes, and CarMeN, laboratoire
Subjects: Hyperplasia, Calcium sensing receptor, Familial hypocalciuric hypercalcemia, Bone Density Conservation Agents, Hyperparathyroidism, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, Hypercalciuria, General Medicine, Hyperparathyroidism, Primary, [SDV] Life Sciences [q-bio], Endocrinology, Calcemia, Parathyroid Hormone, Hypercalcemia, Homeostasis, Humans, Calcium, Receptors, Calcium-Sensing
Abstract: International audience; Parathyroid hormone (PTH) is a hypercalcemic hormone acting on kidneys, bone and intestine. PTH promotes calcium release from the bone, renal calcium reabsorption and phosphate excretion, and conversion of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D-3. Hyperparathyroidism consists in PTH elevation, which may be adapted (secondary hyperparathyroidism) or non-adapted to calcemia levels (primary hyperparathyroidism, familial hypercalcemia/hypocalciuria, tertiary hyperparathyroidism). Primary hyperparathyroidism (PHP) features hypercalcemia and elevated or inappropriate PTH elevation. PHP may be revealed by biological abnormalities such as hypercalcemia and can be accompanied by renal complications (hypercalciuria, nephrolithiasis, nephrocalcinosis) and/or osteoporosis. However, it can also be normocalcemic and calcium loading will be necessary to diagnosis it. The differential diagnosis of PHP is familial hypocalciuric hypercalcemia (FHH), a dominant autosomal disease implicating a calcium sensing receptor-inactivating mutation. It impairs parathyroid cell sensitivity to calcemia elevation and thus induces excessive PTH stimulation, leading to hypercalcemia. Secondary HP (SHP) consists in PTH elevation secondary to a stimulus that needs to be corrected. 25 OHvitD deficiency, kidney failure, renal hypercalciuria, malabsorption and some drugs can induce SHP. Tertiary HP (THP) consists in autonomous PTH secretion by the parathyroid glands after prolonged stimulation under SHP, of whatever cause. This parathyroid autonomy results from the polyclonal hyperplasia observed in SHP progressing toward monoclonal nodular proliferation, leading to nodular hyperplasia or parathyroid adenoma (or, exceptionally, carcinoma), with reduced expression of CaSR and vitamin D receptor. In patients under dialysis, the frontier between SHP and THP is a matter of debate. This review will focus on the pathophysiology of calcium, diagnosis, and management of hyperparathyroidism.
Published: 2022

8. Transcatheter Pulmonary Valve Implantation in Carcinoid Heart Disease

Author: Flagiello, M., Pozzi, M., Francois, L., Al Harthy, A., Forestier, J., Boccalini, S., Rioufol, G., Walter, T., Obadia, J. F., Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Edouard Herriot [CHU - HCL], Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), 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)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], Transcatheter pulmonary valve implantation, General Medicine, Cardiology and Cardiovascular Medicine, Carcinoid heart desease
Abstract: International audience; Carcinoid heart disease is a rare condition affecting mostly tricuspid and pulmonary valves causing right-sided heart failure. Surgical valve replacement is the mainstay of treatment when patients become symptomatic and/or in the presence of right heart remodeling. We present a case of severe pulmonary valve regurgitation secondary to carcinoid heart disease occurring 4 years after a surgical tricuspid replacement, successfully treated with direct transcatheter pulmonary valve implantation without pre-stenting.
Published: 2022

9. Frequency and patterns of editorial rejections (rejections without peer review) across medical journals

Author: Vishnu, Harikumar, Kelly A, Reynolds, Rachel E, Christensen, Hoi Ting, Wan, Rachael, Winner, Sarah A, Ibrahim, Bianca Y, Kang, Denis, Fouque, Emily, Poon, Dirk M, Elston, Murad, Alam, CarMeN, laboratoire, Northwestern University [Chicago, Ill. USA], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Medical University of South Carolina [Charleston] (MUSC), Feinberg School of Medicine, and Northwestern University [Evanston]
Subjects: [SDV] Life Sciences [q-bio], frequency, [SDV]Life Sciences [q-bio], Humans, editorial rejections, patterns, Dermatology, Periodicals as Topic, medical journals
Abstract: International audience; No abstract available
Published: 2022

10. Effects of pediatric chronic kidney disease and its etiology on tissue sodium concentration: a pilot study

Author: Salerno, F. R., Akbari, A., Lemoine, S., Scholl, T. J., Mcintyre, C. W., Filler, G., CarMeN, laboratoire, London Health Sciences Center (LHSC), Western University [London, ON, Canada], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Ontario Institute for Cancer Research [Canada] (OICR), and Ontario Institute for Cancer Research
Subjects: [SDV] Life Sciences [q-bio], Etiology, Nephrology, [SDV]Life Sciences [q-bio], Pediatrics, Perinatology and Child Health, Ckd, Tissue sodium concentration
Abstract: International audience; BACKGROUND: Sodium-23 magnetic resonance imaging ((23)Na MRI) allows non-invasive assessment of tissue sodium concentration ([Na(+)]). Age and chronic kidney disease (CKD) are associated with increased tissue [Na(+)] in adults, but limited information is available pertaining to children and adolescents. We hypothesized that pediatric CKD is associated with altered tissue [Na(+)] compared to healthy controls. METHODS: This was a case-control exploratory study on healthy children and adults and pediatric CKD patients. Study participants underwent an investigational visit, blood/urine biochemistry, and leg (23)Na MRI for tissue [Na(+)] quantification (whole leg, skin, soleus muscle). CKD was stratified by etiology and patients' tissue [Na(+)] was compared against healthy controls by computing individual Z-scores. An absolute Z-score \textgreater 1.96 was deemed to deviate significantly from the mean of healthy controls. Pearson correlation was used to compute the associations between tissue [Na(+)] and kidney function. RESULTS: A total of 36 pediatric participants (17 healthy, 19 CKD) and 19 healthy adults completed the study. Healthy adults had significantly higher tissue [Na(+)] compared with pediatric groups; conversely, no significant differences were found between healthy children/adolescents and CKD patients. Four patients with glomerular disease and one kidney transplant recipient due to atypical hemolytic-uremic syndrome had elevated whole-leg [Na(+)] Z-scores. Reduced whole-leg [Na(+)] Z-scores were found in two patients with tubular disorders (Fanconi syndrome, proximal-distal renal tubular acidosis). All tissue [Na(+)] measures were significantly associated with proteinuria and hypoalbuminemia. CONCLUSIONS: Depending on etiology, pediatric CKD was associated with either increased (glomerular disease) or reduced (tubular disorders) tissue [Na(+)] compared with healthy controls. A higher resolution version of the Graphical abstract is available as Supplementary information.
Published: 2022

11. Functional Sodium MRI Helps to Measure Corticomedullary Sodium Content in Normal and Diseased Human Kidneys

Author: Alireza Akbari, Sandrine Lemoine, Fabio Salerno, Taylor L. Marcus, Tristan Duffy, Timothy J. Scholl, Guido Filler, Andrew A. House, Christopher W. McIntyre, London Health Sciences Center (LHSC), Western University [London, ON, Canada], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Lawson Health Research Institute, University of Western Ontario (UWO), and CarMeN, laboratoire
Subjects: Adult, Male, [SDV]Life Sciences [q-bio], Sodium, Water, Kidney, Magnetic Resonance Imaging, [SDV] Life Sciences [q-bio], Humans, Female, Radiology, Nuclear Medicine and imaging, Prospective Studies, Renal Insufficiency, Chronic, Aged
Abstract: International audience; Background To the knowledge of the authors, urinary osmolarity is the only tool currently available to assess kidney corticomedullary gradient (CMG). Comparisons between CMG and urinary osmolarity and the use of modalities such as sodium MRI to evaluate renal disease in humans are lacking. Purpose To investigate the ability of sodium MRI to measure CMG dynamics compared with urinary osmolarity after water load in healthy volunteers and CMG in participants with kidney disease. Materials and Methods A prospective study was conducted from July 2020 to January 2021 in fasting healthy volunteers undergoing water load and participants with chronic kidney disease (CKD) from cardiorenal syndrome included in a clinical trial. In both groups, CMG was estimated by measuring the medulla-to-cortex signal ratio from sodium MRI at 3.0 T. A custom-built two-loop (diameter, 18 cm) butterfly radiofrequency surface coil, tuned for sodium frequency (33.786 MHz), was used to acquire renal sodium images. Two independent observers measured all sodium MRI cortical and medullary values for each region of interest to compute the intraclass correlation coefficient. Pearson correlation was performed between urinary osmolarity and CMG. Results Five participants with CKD (mean age, 77 years ± 12 [standard deviation]; all men) and 10 healthy volunteers (mean age, 42 years ± 15; six men, four women) were evaluated. A reduction was observed between baseline and peak urinary dilution time for both mean medulla-to-cortex ratios (1.55 ± 0.11 to 1.31 ± 0.09, respectively; P < .001) and mean urinary osmolarity (756 mOsm/L ± 157 to 73 mOsm/L ± 14, respectively; P < .001) in healthy volunteers. Medulla-to-cortex and corresponding urinary osmolarity were correlated in both groups (r2 = 0.22; P < .001). Kidney sodium tissue content was successfully acquired in all five participants with CKD. The intraclass correlation coefficient measurement was 0.99 (P < .001). Conclusion Functional sodium MRI accurately depicted corticomedullary gradient (CMG) dynamic changes in healthy volunteers and demonstrated feasibility of CMG measurement in participants with reduced kidney function. Clinical trial registration no. NCT04170855. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Laustsen and Bøgh in this issue.
Published: 2022

12. Etiology-based dietary approach for managing hyperkalemia in people with chronic kidney disease

Author: Team1 Carmen, Carmen Lab, Denis Fouque, CarMeN, laboratoire, University of Nevada [Reno], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Université de Lyon
Subjects: [SDV] Life Sciences [q-bio], Kinetics, Nutrition and Dietetics, [SDV]Life Sciences [q-bio], Potassium, Humans, Hyperkalemia, Potassium, Dietary, Medicine (miscellaneous), Salts, Renal Insufficiency, Chronic, chronic kidney disease, Diet
Abstract: Diet therapy for hyperkalemia in chronic kidney disease (CKD) is at a crossroads: many researchers and clinicians are no longer recommending the low-potassium diet, which has defined practice for the last half century, and instead are favoring a high-potassium, plant-rich diet. Central to this shift is the observation that reported dietary potassium intake is not associated with plasma potassium concentrations. However, kinetic studies using potassium salts indicate that people with CKD have impaired potassium tolerance that may make them susceptible to transient increases in plasma potassium levels from dietary potassium (postprandial hyperkalemia). Observational studies generally measure plasma potassium in the fasting state and before hemodialysis treatment, and therefore may not detect the acute effects of dietary potassium on plasma potassium concentrations. Differences between the acute and chronic effects of dietary potassium on plasma potassium levels may help explain clinical experiences and case studies attributing hyperkalemic episodes in patients with CKD to intakes of high-potassium foods despite their apparent lack of association. To reconcile these findings, an etiology-based approach to managing hyperkalemia is proposed in this review. The approach combines key elements of the low-potassium and plant-rich diets, and adds new features of meal planning to lower the risk of postprandial hyperkalemia.
Published: 2022

13. Optical coherence tomography in coronary atherosclerosis assessment and intervention

Author: Makoto Araki, Seung-Jung Park, Harold L. Dauerman, Shiro Uemura, Jung-Sun Kim, Carlo Di Mario, Thomas W. Johnson, Giulio Guagliumi, Adnan Kastrati, Michael Joner, Niels Ramsing Holm, Fernando Alfonso, William Wijns, Tom Adriaenssens, Holger Nef, Gilles Rioufol, Nicolas Amabile, Geraud Souteyrand, Nicolas Meneveau, Edouard Gerbaud, Maksymilian P. Opolski, Nieves Gonzalo, Guillermo J. Tearney, Brett Bouma, Aaron D. Aguirre, Gary S. Mintz, Gregg W. Stone, Christos V. Bourantas, Lorenz Räber, Sebastiano Gili, Kyoichi Mizuno, Shigeki Kimura, Toshiro Shinke, Myeong-Ki Hong, Yangsoo Jang, Jin Man Cho, Bryan P. Yan, Italo Porto, Giampaolo Niccoli, Rocco A. Montone, Vikas Thondapu, Michail I. Papafaklis, Lampros K. Michalis, Harmony Reynolds, Jacqueline Saw, Peter Libby, Giora Weisz, Mario Iannaccone, Tommaso Gori, Konstantinos Toutouzas, Taishi Yonetsu, Yoshiyasu Minami, Masamichi Takano, O. Christopher Raffel, Osamu Kurihara, Tsunenari Soeda, Tomoyo Sugiyama, Hyung Oh Kim, Tetsumin Lee, Takumi Higuma, Akihiro Nakajima, Erika Yamamoto, Krzysztof L. Bryniarski, Luca Di Vito, Rocco Vergallo, Francesco Fracassi, Michele Russo, Lena M. Seegers, Iris McNulty, Sangjoon Park, Marc Feldman, Javier Escaned, Francesco Prati, Eloisa Arbustini, Fausto J. Pinto, Ron Waksman, Hector M. Garcia-Garcia, Akiko Maehara, Ziad Ali, Aloke V. Finn, Renu Virmani, Annapoorna S. Kini, Joost Daemen, Teruyoshi Kume, Kiyoshi Hibi, Atsushi Tanaka, Takashi Akasaka, Takashi Kubo, Satoshi Yasuda, Kevin Croce, Juan F. Granada, Amir Lerman, Abhiram Prasad, Evelyn Regar, Yoshihiko Saito, Mullasari Ajit Sankardas, Vijayakumar Subban, Neil J. Weissman, Yundai Chen, Bo Yu, Stephen J. Nicholls, Peter Barlis, Nick E. J. West, Armin Arbab-Zadeh, Jong Chul Ye, Jouke Dijkstra, Hang Lee, Jagat Narula, Filippo Crea, Sunao Nakamura, Tsunekazu Kakuta, James Fujimoto, Valentin Fuster, Ik-Kyung Jang, CarMeN, laboratoire, Massachusetts General Hospital [Boston, MA, USA], Harvard Medical School [Boston] (HMS), Asan Medical Center [Seoul, South Korea] (AMC), University of Vermont [Burlington], Kawasaki Medical School [Okayama, Japan] (KMS), Yonsei University College of Medicine [Seoul, South Korea] (YUCM), Azienda Ospedaliero-Universitaria Careggi [Firenze] (AOUC), University Hospitals Bristol, Azienda Ospedaliera Ospedale Papa Giovanni XXIII [Bergamo, Italy], Technische Universität München = Technical University of Munich (TUM), Munich Heart Alliance [Munich, Allemagne] (MHA), German Heart Center = Deutsches Herzzentrum München [Munich, Germany] (GHC), Aarhus University Hospital [Skejby, Denmark] (AUH), Hospital Universitario de La Princesa, National University of Ireland [Galway] (NUI Galway), University Hospitals Leuven [Leuven], Technische Hochschule Mittelhessen - University of Applied Sciences [Giessen] (THM), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Université de Lyon, Institut Mutualiste de Montsouris (IMM), CHU Clermont-Ferrand, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), National Institute of Cardiology [Warsaw, Poland] (NIC), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Massachusetts General Hospital [Boston], Cardiovascular Research Foundation [New York, NY, USA] (CRF), Icahn School of Medicine at Mount Sinai [New York] (MSSM), Barts Health NHS Trust [London, UK], Queen Mary University of London (QMUL), Bern University Hospital [Berne] (Inselspital), Centro Cardiologico Monzino [Milan, Italy] (2CM), Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Mitsukoshi Health and Welfare Foundation [Tokyo, Japan] (MHWF), Yokohama Minami Kyosai Hospital [Kanagawa, Japan] (YMKH), Showa University Hospital [Tokyo, Japan] (SUH), Kyung Hee University [Seoul, South Korea] (KHU), The Chinese University of Hong Kong [Hong Kong], Università degli studi di Genova = University of Genoa (UniGe), Università degli studi di Parma = University of Parma (UNIPR), Catholic University of the Sacred Heart [Rome, Italy] (CUSH), University Hospital [Ioannina, Greece] (UH), New York University School of Medicine (NYU Grossman School of Medicine), Vancouver General Hospital [Vancouver, British Columbia, Canada] (VGH), University of British Columbia (UBC), Brigham and Women’s Hospital [Boston, MA], New York Presbyterian Hospital, Columbia University Medical Center (CUMC), Columbia University [New York], Ospedale San Giovanni Bosco [Turin, Italy] (OSGB), Johannes Gutenberg - Universität Mainz = Johannes Gutenberg University (JGU), National and Kapodistrian University of Athens (NKUA), Tokyo Medical and Dental University [Japan] (TMDU), Kitasato University, Nippon Medical School Chiba Hokusoh Hospital [Chiba, Japan] (NMSC2H), The Prince Charles Hospital, Nara Medical University [Nara, Japan] (NMU), Tsuchiura Kyodo General Hospital [Ibaraki, Japan] (TKGH), Japanese Red Cross Musashino Hospital [Tokyo], St. Marianna University School of Medicine [Kanagawa, Japan], Kyoto University Graduate School of Medicine [Kyoto, Japan] (KUGSM), Jagiellonian University - Medical College (JUMC), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Mazzoni Hospital [Ascoli Piceno, Italy] (MH), Korea Advanced Institute of Science and Technology (KAIST), University of Texas Health Science Center, The University of Texas Health Science Center at Houston (UTHealth), Saint Camillus International University of Health Sciences [Rome, Italy] (SCIUHS), Fondazione IRCCS Policlinico San Matteo [Pavia], Università degli Studi di Pavia = University of Pavia (UNIPV), Universidade de Lisboa = University of Lisbon (ULISBOA), MedStar Washington Hospital Center [Washington, DC, USA] (MedStar WHC), CV Path Institute [Gaithersburg, MD, USA] (CV-PI), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Yokohama City University (YCU), Wakayama University, Tohoku University [Sendai], Mayo Clinic [Rochester, MN, USA], Mayo Clinic [Rochester], University hospital of Zurich [Zurich], Gifu University Graduate School of Medicine, Madras Medical Mission [Chennai, India] (3M), MedStar Health Research Institute [Washington, DC, USA] (MedStar-HRI), Chinese People's Liberation Army General Hospital [Beijing, China] (CPLAGH), Harbin Medical University [China] (HMU), Monash university, University of Melbourne, Royal Papworth Hospital [Cambridge, UK] (RPH), Johns Hopkins University (JHU), Leiden University Medical Center (LUMC), The Open University of Japan [Chiba] (OUJ), and Massachusetts Institute of Technology (MIT)
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], Cardiology and Cardiovascular Medicine
Abstract: Optical coherence tomography (OCT) has been widely adopted in research on coronary atherosclerosis and adopted clinically to optimize percutaneous coronary intervention. In this Review, Jang and colleagues summarize this rapidly progressing field, with the aim of standardizing the use of OCT in coronary atherosclerosis.Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing with the rapid progression of atherosclerosis. Accurate detection by OCT of sequelae from percutaneous coronary interventions that might be missed by angiography could improve clinical outcomes. In addition, OCT has become an essential diagnostic modality for myocardial infarction with non-obstructive coronary arteries. Insight into neoatherosclerosis from OCT could improve our understanding of the mechanisms of very late stent thrombosis. The appropriate use of OCT depends on accurate interpretation and understanding of the clinical significance of OCT findings. In this Review, we summarize the state of the art in cardiac OCT and facilitate the uniform use of this modality in coronary atherosclerosis. Contributions have been made by clinicians and investigators worldwide with extensive experience in OCT, with the aim that this document will serve as a standard reference for future research and clinical application.
Published: 2022

14. Sex differences in imaging and clinical characteristics of patients from the WAKE--UP trial

Author: Anke Wouters, Lauranne Scheldeman, Hannelore Liessens, Patrick Dupont, Florent Boutitie, Bastian Cheng, Martin Ebinger, Matthias Endres, Jochen B. Fiebach, Christian Gerloff, Keith W. Muir, Norbert Nighoghossian, Salvador Pedraza, Claus Z. Simonsen, Vincent Thijs, Götz Thomalla, Robin Lemmens, University Hospitals Leuven [Leuven], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Leuven Center for Cancer Biology (VIB-KU-CCB), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-Vlaams Instituut voor Biotechnologie [Ghent, Belgique] (VIB), Amsterdam UMC - Amsterdam University Medical Center, Leuven Brain Institute [Leuven, Belgium] (LBI), Hospices Civils de Lyon (HCL), 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), Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Medical Park Berlin Humboldtmühle [Berlin, Germany] (MPBH), German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), German Research Center for Neurodegenerative Diseases - Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), University of Glasgow, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), 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)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta - Girona Biomedical Research Institute (IDIBGI), Aarhus University Hospital, University of Melbourne, Austin Hospital [Melbourne], Austin Health, CarMeN, laboratoire, and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-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: Male, Sex Characteristics, Time Factors, Ischemic stroke, [SDV.BA] Life Sciences [q-bio]/Animal biology, [SDV.BA]Life Sciences [q-bio]/Animal biology, methods [Thrombolytic Therapy], wake-up, drug therapy [Stroke], therapeutic use [Tissue Plasminogen Activator], Neurology, Wake-up, methods [Diffusion Magnetic Resonance Imaging], diagnostic imaging [Stroke], ischemic stroke, Humans, drug therapy [Brain Ischemia], sex, Female, Sex, ddc:610, Neurology (clinical), Mri, MRI
Abstract: BACKGROUND AND PURPOSE: Sex-based differences in acute ischemic stroke are a well-known phenomenon. We aimed to explore these differences between women and men in the Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke (WAKE-UP) trial. METHODS: We compared baseline demographic and imaging characteristics (visual fluid-attenuated inversion recovery [FLAIR] positivity, relative FLAIR signal intensity, collateral status) between women and men in all screened patients. In randomized patients (i.e., those with diffusion-weighted imaging (DWI)-FLAIR mismatch), we evaluated a modifying role of sex on the treatment effect of alteplase in multivariable logistic regression, with treatment adjusted for National Institute of Health Stroke Scale (NIHSS) score and age. Dependent variables were modified Rankin Scale (mRS) score of 0-1 at 90 days and distribution of mRS scores at 90 days. RESULTS: Of 1362 screened patients, 529 (38.8%) were women. Women were older than men, had higher baseline NIHSS scores and smoked less frequently. FLAIR positivity of the DWI lesion was equally present in women (174/529, 33.1%) and men (273/833, 33.3%; p = 1.00) and other imaging variables also did not differ between the sexes. In a total of 503 randomized patients, of whom 178 were women (35.4%), sex did not modify the treatment effect of alteplase on mRS score 0-1 or on the total distribution of mRS scores. CONCLUSION: As in many other stroke trials, more men than women were included in the WAKE-UP trial, but the presence of a visual DWI-FLAIR mismatch and the relative FLAIR signal intensity did not differ between the sexes. The treatment effect of alteplase was not modified by sex. ispartof: EUROPEAN JOURNAL OF NEUROLOGY vol:30 issue:3 pages:641-647 ispartof: location:England status: published
Published: 2023

15. Long COVID and the cardiovascular system—elucidating causes and cellular mechanisms in order to develop targeted diagnostic and therapeutic strategies : A joint Scientific Statement of the ESC Working Groups on Cellular Biology of the Heart and Myocardial and Pericardial Diseases

Author: Mariann Gyöngyösi, Pilar Alcaide, Folkert W Asselbergs, Bianca J J M Brundel, Giovanni G Camici, Paula da Costa Martins, Péter Ferdinandy, Marianna Fontana, Henrique Girao, Massimiliano Gnecchi, Can Gollmann-Tepeköylü, Petra Kleinbongard, Thomas Krieg, Rosalinda Madonna, Melanie Paillard, Antonis Pantazis, Cinzia Perrino, Maurizio Pesce, Gabriele G Schiattarella, Joost P G Sluijter, Sabine Steffens, Carsten Tschöpe, Sophie Van Linthout, Sean M Davidson, Martins, Paula da Costa [0000-0002-0695-1187], Fontana, Marianna [0000-0002-9233-9831], Girao, Henrique [0000-0002-5786-8447], Gnecchi, Massimiliano [0000-0001-7435-4328], Kleinbongard, Petra [0000-0003-3576-3772], Krieg, Thomas [0000-0002-5192-580X], Perrino, Cinzia [0000-0002-2274-0048], Pesce, Maurizio [0000-0002-3097-8961], Sluijter, Joost PG [0000-0003-2088-9102], Steffens, Sabine [0000-0002-6892-9751], Van Linthout, Sophie [0000-0002-7581-7870], Apollo - University of Cambridge Repository, Medizinische Universität Wien = Medical University of Vienna, Tufts University School of Medicine [Boston], University Medical Center [Utrecht], Utrecht University [Utrecht], University College of London [London] (UCL), Amsterdam UMC - Amsterdam University Medical Center, Vrije Universiteit Amsterdam [Amsterdam] (VU), Universität Zürich [Zürich] = University of Zurich (UZH), University hospital of Zurich [Zurich], Maastricht University [Maastricht], Semmelweis University [Budapest], Pharmahungary Group [Szeged, Hungary] (PG), University of Coimbra [Portugal] (UC), Coimbra Institute for Clinical and Biomedical Research [Coimbra, Portugal] (iCBR - Faculty of Medicine), Università degli Studi di Pavia = University of Pavia (UNIPV), Fondazione IRCCS Policlinico San Matteo [Pavia], Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), Universitätsklinikum Essen [Universität Duisburg-Essen] (Uniklinik Essen), Addenbrooke's Hospital, Cambridge University NHS Trust, University of Pisa - Università di Pisa, Jefferson (Philadelphia University + Thomas Jefferson University), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Imperial College London, Royal Brompton and Harefield NHS Foundation Trust, University of Naples Federico II = Università degli studi di Napoli Federico II, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), Max Delbrück Center for Molecular Medicine [Berlin] (MDC), Helmholtz-Gemeinschaft = Helmholtz Association, Utrecht Brain Center [UMC], Ludwig-Maximilians-Universität München (LMU), Charité Campus Virchow-Klinikum (CVK), The Hatter Cardiovascular Institute (THCI), CarMeN, laboratoire, Gyöngyösi, Mariann, Alcaide, Pilar, Asselbergs, Folkert W, Brundel, Bianca J J M, Camici, Giovanni G, da Costa Martins, Paula, Ferdinandy, Péter, Fontana, Marianna, Girao, Henrique, Gnecchi, Massimiliano, Gollmann-Tepeköylü, Can, Kleinbongard, Petra, Krieg, Thoma, Madonna, Rosalinda, Paillard, Melanie, Pantazis, Antoni, Perrino, Cinzia, Pesce, Maurizio, Schiattarella, Gabriele G, Sluijter, Joost P G, Steffens, Sabine, Tschöpe, Carsten, Van Linthout, Sophie, and Davidson, Sean M
Subjects: Long COVID, Heart Diseases, Physiology, SARS-CoV-2, [SDV]Life Sciences [q-bio], Myocardium, Medizin, COVID-19, Heart, virus, Post COVID, Cardiovascular, [SDV] Life Sciences [q-bio], Post-Acute COVID-19 Syndrome, COVID-19 Testing, Cardiovascular and Metabolic Diseases, Physiology (medical), Humans, Cardiology and Cardiovascular Medicine, Cardiac
Abstract: Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multiorgan symptoms that endure for weeks or months after SARS-CoV-2 infection has already subsided. This scientific document aims to provide insight into the possible causes and therapeutic options available for the cardiovascular manifestations of long COVID. In addition to chronic fatigue, which is a common symptom of long COVID, patients may present with chest pain, ECG abnormalities, postural orthostatic tachycardia, or newly developed supraventricular or ventricular arrhythmias. Imaging of the heart and vessels has provided evidence of chronic, post-infectious perimyocarditis with consequent left or right ventricular failure, arterial wall inflammation, or microthrombosis in certain patient populations. Better understanding of the underlying cellular and molecular mechanisms of long COVID will aid in the development of effective treatment strategies for its cardiovascular manifestations. A number of mechanisms have been proposed, including those involving direct effects on the myocardium, microthrombotic damage to vessels or endothelium, or persistent inflammation. Unfortunately, existing circulating biomarkers, coagulation, and inflammatory markers, are not highly predictive for either the presence or outcome of long COVID when measured 3 months after SARS-CoV-2 infection. Further studies are needed to understand underlying mechanisms, identify specific biomarkers, and guide future preventive strategies or treatments to address long COVID and its cardiovascular sequelae.
Published: 2023

16. Cost-Effectiveness Evaluation of a Remote Monitoring Programme Including Lifestyle Education Software in Type 2 Diabetes: Results of the Educ@dom Study

Author: Michael, Mounié, Nadège, Costa, Pierre, Gourdy, Christelle, Latorre, Solène, Schirr-Bonnans, Jean-Marc, Lagarrigue, Henri, Roussel, Jacques, Martini, Jean-Christophe, Buisson, Marie-Christine, Chauchard, Jacqueline, Delaunay, Soumia, Taoui, Marie-France, Poncet, Valeria, Cosma, Sandrine, Lablanche, Magali, Coustols-Valat, Lucie, Chaillous, Charles, Thivolet, Caroline, Sanz, Alfred, Penfornis, Benoît, Lepage, Hélène, Colineaux, Hélène, Hanaire, Laurent, Molinier, Marie-Christine, Turnin, Université Fédérale Toulouse Midi-Pyrénées, Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut des Maladies Métaboliques et Casdiovasculaires (UPS/Inserm U1297 - I2MC), MSA Midi-Pyrénées Nord [Montauban] (MSA-MPN), Directions régionales du Service médical Occitanie [Toulouse] (DRSM / CNAM), DIAMIP Network [Toulouse] ( Association Diabète Occitanie), Ecole Nationale Supérieure d'Electrotechnique, d'Electronique, d'Informatique, d'Hydraulique et de Télécommunications (ENSEEIHT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Clinique Claude Bernard - ELSAN [Albi] (CCBE), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), CHU Grenoble, Clinique Ambroise Paré - ELSAN [Toulouse] (CAPE), Centre hospitalier universitaire de Nantes (CHU Nantes), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire de Lyon (CHU Lyon), Clinique Pasteur [Toulouse], Centre Hospitalier Sud Francilien, Educ@dom Study Group, and CarMeN, laboratoire
Subjects: [SDV] Life Sciences [q-bio], Telemonitoring, Educ@dom, Economic assessment, Tele-education, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, Internal Medicine, Lifestyle management, Type 2 diabetes, Cost-effectiveness
Abstract: Erratum inCorrection to: Cost-Effectiveness Evaluation of a Remote Monitoring Programme Including Lifestyle Education Software in Type 2 Diabetes: Results of the Educ@dom Study.Mounié M, Costa N, Gourdy P, Latorre C, Schirr-Bonnans S, Lagarrigue JM, Roussel H, Martini J, Buisson JC, Chauchard MC, Delaunay J, Taoui S, Poncet MF, Cosma V, Lablanche S, Coustols-Valat M, Chaillous L, Thivolet C, Sanz C, Penfornis A, Lepage B, Colineaux H, Hanaire H, Molinier L, Turnin MC; Educ@dom Study Group, Benhamou PY, Rodier M, Ayon F, Puel-Olivier F, Fontaine S, Perron M, Arrivié J, Cousty-Pech F, Rouby C, Lafon F, Moura I.Diabetes Ther. 2022 May;13(5):1131-1132. doi: 10.1007/s13300-022-01248-6.PMID: 35316510 Free PMC article. No abstract available.; International audience; INTRODUCTION: Telemedicine programs using health technological innovation to remotely monitor the lifestyles of patients with type 2 diabetes (T2D) can improve glycaemic control and thus reduce the incidence of complications as well as management costs. In this context, an assessment was made of the 1-year and 2-year cost-effectiveness of the EDUC@DOM telemonitoring and tele-education program. METHODS: The EDUC@DOM study was a multicentre randomized controlled trial conducted between 2013 and 2017 that compared a telemonitoring group (TMG) to a control group (CG) merged with health insurance databases to extract economic data on resource consumption. Economic analysis was performed from the payer perspective, and direct costs and indirect costs were considered. The clinical outcome used was the intergroup change in glycated haemoglobin (HbA1c) levels from baseline. Missing economic data were imputed using multiple imputation, and fitted values from a generalized linear mixed model were used to calculate the incremental cost-effectiveness ratio (ICER). Bootstrapped 95% confidence ellipses were drawn in the cost-effectiveness plan. RESULTS: The main analysis included data from 256 patients: 126 in the TMG and 130 in the CG. Incremental costs over 1 and 2 years were equal to €2129 and €5101, respectively, in favour of the TMG. Once imputed and adjusted for confounding factors, the TMG trends to a 21% cost decrease over 1 and 2 years of follow-up (0.79 [0.58; 1.08], p = 0.1452 and 0.79 [0.61; 1.03], p = 0.0879, respectively). The EDUC@DOM program led to a €1334 cost saving and a 0.17 decrease in HbA1c over 1 year and a €3144 cost saving and a 0.14 decrease in HbA1c over 2 years. According to the confidence ellipse, EDUC@DOM was a cost-effective strategy. CONCLUSION: This study provides additional economic information on telemonitoring and tele-education programs to enhance their acceptance and promote their use. In the light of this work, the EDUC@DOM program is a cost-saving strategy in T2D management. TRIAL REGISTRATION: This trial was registered in the Clinical Trials Database on 27 September 2013 under no. NCT01955031 and bears ID-RCB no. 2013-A00391-44.
Published: 2022

17. Does the Addition of a Gastroepiploic Artery to Bilateral Internal Thoracic Artery Improve Survival?

Author: Olivier Jegaden, Fadi Farhat, Amar O. Hassan, Margaux P. O. Jegaden, Armand Eker, Joel Lapeze, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Université de Lyon, Institut Necker Enfants-Malades (INEM - UM 111 (UMR 8253 / U1151)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Centre Cardio-Thoracique de Monaco (CCTM), Clinique de l'Infirmerie Protestante de Lyon (CIPL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), and CarMeN, laboratoire
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Internal thoracic artery, Coronary Artery Disease, Gastroepiploic Artery, 030204 cardiovascular system & hematology, Lower risk, Revascularization, 03 medical and health sciences, Coronary artery bypass surgery, 0302 clinical medicine, medicine.artery, medicine, Humans, Coronary Artery Bypass, Mammary Arteries, Radial artery, Retrospective Studies, business.industry, General Medicine, 3. Good health, Surgery, [SDV] Life Sciences [q-bio], Treatment Outcome, 030228 respiratory system, Right coronary artery, Arterial revascularization, Cardiology and Cardiovascular Medicine, business, Mace
Abstract: International audience; It is unclear whether the additional conduit to supplement bilateral internal thoracic arteries (BITA) influences the patient outcome in coronary surgery. This retrospective study compared long-term survival of patients undergoing left-sided BITA grafting in which the third conduit to the right coronary system (RCA) was either vein graft (SVG) or gastroepiploic artery (GEA). From 1989 to 2014, 1432 consecutive patients underwent left-sided revascularization with BITA associated with SVG (n = 599) or GEA (n = 833) to RCA. Propensity score was calculated by logistic regression model and patients were matched 1 to 1 leading to 2 groups of 320 matched patients. The primary end point was the overall mortality from any cause. GEA was used in significantly lower risk patients. The 30-day mortality was 1.6% without influence of the graft configuration. Postoperative follow-up was 13.6 ± 6.6 years and was 94% complete. The significant difference in patients' survival observed at 20 years in favor of GEA in unmatched groups (48 ± 4% vs 33 ± 6%, P \textless 0.001) was not confirmed in matched groups (41 ± 7% vs 36 ± 7%, P = 0.112). In multivariable Cox model analysis, the conduit used to RCA did not influence the long-term survival in matched groups, like no other graft configuration or operative parameter. Only complete revascularization remained predictor of survival (P = 0.016), with age (P \textless 0.0001), diabetes status (P = 0.007), and left ventricle ejection fraction (P \textless 0.0001). Long-term survival in patients undergoing BITA grafting is not affected by using GEA as third arterial conduit in alternative to SVG. Further studies are necessary to assess its impact on long-term cardiac events.
Published: 2022

18. Assessing Global Kidney Nutrition Care

Author: Angela Yee-Moon Wang, Ikechi G. Okpechi, Feng Ye, Csaba P. Kovesdy, Giuliano Brunori, Jerrilynn D. Burrowes, Katrina Campbell, Sandrine Damster, Denis Fouque, Allon N. Friedman, Giacomo Garibotto, Fitsum Guebre-Egziabher, David Harris, Kunitoshi Iseki, Vivekanand Jha, Kailash Jindal, Kamyar Kalantar-Zadeh, Brandon Kistler, Joel D. Kopple, Martin Kuhlmann, Meaghan Lunney, Denise Mafra, Charu Malik, Linda W. Moore, S. Russ Price, Alison Steiber, Christoph Wanner, Pieter ter Wee, Adeera Levin, David W. Johnson, Aminu K. Bello, The University of Hong Kong (HKU), University of Cape Town, University of Alberta, The University of Tennessee Health Science Center [Memphis] (UTHSC), University of Trento [Trento], Long Island University, Brooklyn (LIU Brooklyn), Service de pneumologie [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), International Society of Nephrology [Brussels, Belgium] (ISN), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Indiana University School of Medicine, Indiana University System, Università degli studi di Genova = University of Genoa (UniGe), University of New South Wales [Sydney] (UNSW), Okinawa Heart and Renal Association [Okinawa, Japan], Laboratoire d'innovation moléculaire et applications (LIMA), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), University of California [Irvine] (UC Irvine), University of California (UC), Ball State University [Muncie, Indiana] (BSU), Harbor UCLA Medical Center [Torrance, Ca.], Vivantes Klinikum Friedrichshain [Berlin, Germany] (VKF), University of Calgary, Federal University Fluminense [Rio de Janeiro, Brazil] (FUF), Houston Methodist Hospital [Houston, TX, USA], East Carolina University [Greenville] (ECU), University of North Carolina System (UNC), Academy of Nutrition and Dietetics [Chicago, Illinois] (AND), University Hospital of Würzburg, VU University Medical Center [Amsterdam], University of British Columbia (UBC), University of Queensland [Brisbane], Translational Research Institute [Brisbane, Australia] (TRI), Princess Alexandra Hospital, Brisbane, and CarMeN, laboratoire
Subjects: Transplantation, renal nutrition, dietitians, Epidemiology, [SDV]Life Sciences [q-bio], kidney nutrition care, global health, chronic kidney disease, global, nutrition supplement, nutritional status, Critical Care and Intensive Care Medicine, [SDV] Life Sciences [q-bio], Renal Dialysis, Nephrology, Humans, Kidney Failure, Chronic, Original Article
Abstract: International audience; BACKGROUND AND OBJECTIVES: Nutrition intervention is an essential component of kidney disease management. This study aimed to understand current global availability and capacity of kidney nutrition care services, interdisciplinary communication, and availability of oral nutrition supplements. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The International Society of Renal Nutrition and Metabolism (ISRNM), working in partnership with the International Society of Nephrology (ISN) Global Kidney Health Atlas Committee, developed this Global Kidney Nutrition Care Atlas. An electronic survey was administered among key kidney care stakeholders through 182 ISN-affiliated countries between July and September 2018. RESULTS: Overall, 160 of 182 countries (88%) responded, of which 155 countries (97%) answered the survey items related to kidney nutrition care. Only 48% of the 155 countries have dietitians/renal dietitians to provide this specialized service. Dietary counseling, provided by a person trained in nutrition, was generally not available in 65% of low-/lower middle-income countries and "never" available in 23% of low-income countries. Forty-one percent of the countries did not provide formal assessment of nutrition status for kidney nutrition care. The availability of oral nutrition supplements varied globally and, mostly, were not freely available in low-/lower middle-income countries for both inpatient and outpatient settings. Dietitians and nephrologists only communicated "sometimes" on kidney nutrition care in ≥60% of countries globally. CONCLUSIONS: This survey reveals significant gaps in global kidney nutrition care service capacity, availability, cost coverage, and deficiencies in interdisciplinary communication on kidney nutrition care delivery, especially in lower-income countries.
Published: 2022

19. Temporal Trend of Transient Ischemic Attack Management over a 10-Year Period: Data from the Rhône County, France

Author: Florent Isnard, Anne Termoz, Julie Haesebaert, Marie Viprey, Karim Tazarourte, Estelle Bravant, Nathalie Perreton, Serkan Cakmak, Sylvie Meyran, Catherine Ossedat, Bruno Ducreux, Christelle Pidoux, Thomas Bony, Marion Douplat, Veronique Potinet, Alain Sigal, Laurent Derex, Norbert Nighoghossian, Anne-Marie Schott-Pethelaz, Laura Mechtouff, CarMeN, laboratoire, Hospices Civils de Lyon (HCL), Health Service and Performance Research (HESPER), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Pôle de Santé Publique [Lyon], Hôpital Nord-Ouest de Villefranche-sur-Saône [Gleize] (HNOVS), Centre hospitalier Saint Joseph - Saint Luc [Lyon], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hôpital de la Croix-Rousse [CHU - HCL], Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), and Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Computed Tomography Angiography, [SDV]Life Sciences [q-bio], Patient Discharge, Management, [SDV] Life Sciences [q-bio], Hospitalization, Stroke, Neurology, Ischemic Attack, Transient, Humans, Neurology (clinical), Cohort study, Transient ischemic attack, Cardiology and Cardiovascular Medicine
Abstract: Background: Timely recognition and management of transient ischemic attack (TIA) offer the greatest opportunity to prevent subsequent stroke. But variability of TIA management quality exists across hospitals. Under the impetus of national plans, measures were adopted to improve TIA management, including a structured local pathway. Our objective was to compare TIA management between two periods over 10 years, before and after the implementation of these measures. Methods: A before-and-after study was conducted with two identical population-based cohort studies in 2006–2007 (AVC69) and 2015–2016 (STROKE69) including all patients with TIA diagnosis over a 7-month period in six public and private hospitals in the Rhône county in France. The primary outcome was the adequate TIA management defined as brain and vessel imaging within 24 h of admission and the prescription of antithrombotic treatment at discharge. Results: We identified 109 patients TIA patients in 2006–2007, and 458 over the same period in 2015–2016. A higher proportion of patients were adequately managed in 2015–2016 compared to 2006–2007 (14/96 [15%] in 2006–2007 vs. 306/452 [68%] in 2015–2016, p < 0.001). This difference was mainly driven by a marked increase of vessel imaging performed within 24 h of admission, most often by computed tomography angiography. Furthermore, patients called more often emergency medical dispatch before admission, were admitted with a shorter delay after symptom onset, and were more likely discharged to home in 2015–2016 compared to 2006–2007. Conclusion: Our study demonstrated an increasing rate of adequate TIA management, mainly driven by a marked increase of vessel imaging within 24 h of admission, over a 10-year period in the Rhône county in France.
Published: 2022

20. Funding kidney research as a public health priority

Author: Ziad A. Massy, Dimitrios S. Goumenos, Annette Bruchfeld, Ivan Rychlik, Carsten A. Wagner, Hans-Joachim Anders, Tom Oostrom, Carmine Zoccali, Giovambattista Capasso, Ron T. Gansevoort, María José Soler, Kate Stevens, Denis Fouque, Peter J. Blankestijn, Goce Spasovski, Danilo Fliser, Friedo W. Dekker, Kitty J Jager, Mario Cozzolino, Christoph Wanner, Raymond Vanholder, University of Zurich, Universita Mediterranea of Reggio Calabria [Reggio Calabria], Ghent University Hospital, European Kidney Health Alliance (EKHA), University hospital of Zurich [Zurich], Klinikum der Universität [München], University Medical Center [Utrecht], Karolinska University Hospital [Stockholm], University of the Study of Campania Luigi Vanvitelli, University of Milan, Leiden University Medical Center (LUMC), Saarland University [Saarbrücken], Université de la Sarre, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-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), University Medical Center Groningen [Groningen] (UMCG), General University Hospital of Patras, University of Amsterdam [Amsterdam] (UvA), Épidémiologie et recherches translationnelles sur les maladies rénales et cardiovasculaires (EPREC) (U1018 (Équipe 5)), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Dutch Kidney Foundation [Bussum, The Netherlands] (DKF), Charles University [Prague] (CU), Vall d’Hebron Research Institute (VHIR), Queen Elizabeth University Hospital (Glasgow), Ss. Cyril and Methodius University in Skopje, University of Würzburg, CarMeN, laboratoire, Università degli Studi di Milano = University of Milan (UNIMI), Université Claude Bernard Lyon 1 (UCBL), 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 National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Ss. Cyril and Methodius University in Skopje (UKIM)
Subjects: medicine.medical_specialty, kidney, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, 610 Medicine & health, 030204 cardiovascular system & hematology, 10052 Institute of Physiology, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, medicine, CKD, Humans, Transplantation, research, Health Priorities, business.industry, Public health, funding, Public relations, medicine.disease, Medical research, 3. Good health, [SDV] Life Sciences [q-bio], Europe, Seed money, Alliance, Framing (social sciences), scientific societies, Nephrology, 570 Life sciences, biology, Public Health, business, Working group, Social responsibility, Kidney disease
Abstract: Medical societies have a social responsibility to disseminate knowledge and inform health authorities on threats to public health posed by various diseases. Advocacy for health protection programmes and for medical research funding is now embedded into the missions of most scientific societies. To promote kidney research funding in Europe, the European Renal Association – European Dialysis and Transplant Association (ERA-EDTA), rather than acting as an individual society advocating for the fight against kidney disease, has actively helped to create an alliance of national associations centred on kidney diseases, the European Kidney Health Alliance (EKHA), and joined the Biomedical Alliance (BMA). The ERA-EDTA is fully committed to supporting its working groups (WGs) and consortia of its members to allow them to produce valuable kidney research. The framing and formalization of projects, and the regulatory issues related to submission to the European Commission, are complex. To help WGs to gain expert advice from agencies with specific know-how, the ERA-EDTA has adopted a competitive approach. The best research projects proposed by WGs and consortia of other European investigators will receive seed funding to cover the costs of consultancy by expert agencies. Via its broader platforms, the EKHA and the BMA, the ERA-EDTA will strive towards broader recognition of kidney disease and related clusters of non-communicable diseases, by European and national agencies, as major threats to the qualities of life of their populations and their economies.
Published: 2022

21. Critically ill patients with severe infections related to Geotrichum species: A French retrospective multicentre study

Author: Nadia Aissaoui, Benoit Champigneulle, Muriel Picard, Michael Darmon, Andrine Valade, Anne Sophie Moreau, Julien Mayaux, Laure Calvet, Etienne de Montmollin, Fabrice Bruneel, Frédéric Pène, Martin Murgier, Florence Boissier, Laurent Argaud, Elie Azoulay, Naïke Bigé, Djamel Mokart, CarMeN, laboratoire, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Cité (UPCité), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Centre Hospitalier de Versailles André Mignot (CHV), AP-HP - Hôpital Bichat - Claude Bernard [Paris], 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), Université Sorbonne Paris Cité (USPC), Université Paris Descartes - Paris 5 (UPD5), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre hospitalier universitaire de Poitiers (CHU Poitiers), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Hôpital Cochin [AP-HP], CHU Pitié-Salpêtrière [AP-HP], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Lille, and Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne)
Subjects: Adult, Antifungal, medicine.medical_specialty, multiple organ failure, medicine.drug_class, health care facilities, manpower, and services, [SDV]Life Sciences [q-bio], Critical Illness, Dermatology, Internal medicine, Intensive care, medicine, Humans, Geotrichum species, Hospital Mortality, intensive care, Retrospective Studies, invasive fungal infections, Adult patients, business.industry, Critically ill, Geotrichosis, General Medicine, Middle Aged, Geotrichum, Icu admission, [SDV] Life Sciences [q-bio], Intensive Care Units, Infectious Diseases, Respiratory failure, outcome, SOFA score, France, business
Abstract: International audience; OBJECTIVES: Geotrichum spp can be responsible for severe infections in immunocompromised patients. We aim to describe Geotrichum-related infections in the ICU and to assess risk factors of mortality. METHODS: Retrospective multicentre study, conducted in 14 French ICUs between 2002 and 2018, including critically ill adult patients with proven or probable infection related to Geotrichum species. Data were obtained from the medical charts. RESULTS: Thirty-six patients, median age 60 years IQR [53; 66] were included. Most of the patients had haematological malignancies (78%). The reason for ICU admission was shock in half of the patients (n = 19, 53%) and respiratory failure in thirteen patients (36%). Median SOFA score was 8.5 IQR [7; 15]. Time between ICU admission and fungal diagnosis was 2.5 days [-1; 4]. Infection was disseminated in 27 (75%) patients with positive blood cultures in 25 patients (69%). Thirty patients (83%) received curative antifungal treatment in the ICU, in a median time of 1 day [0;1] after ICU admission. Twenty-four patients (67%) died in the ICU and hospital mortality rate was 69%. The number and extent of organ failures, as represented by SOFA score, were associated with mortality. CONCLUSIONS: This study demonstrates poor outcome in critically ill patients with Geotrichum-related infections, which encourages a high level of suspicion.
Published: 2021

22. Ten-year outcomes of islet transplantation in patients with type 1 diabetes: Data from the Swiss-French GRAGIL network

Author: Lablanche, Sandrine, Borot, Sophie, Wojtusciszyn, Anne, Skaare, Kristina, Penfornis, Alfred, Malvezzi, Paolo, Badet, Lionel, Thivolet, Charles, Morelon, Emmanuel, Buron, Fanny, Renard, Eric, Tauveron, Igor, Villard, Oriane, Munch, Marion, Sommacal, Salomé, Clouaire, Léa, Jacquet, Morgane, Gonsaud, Laura, Camillo-Brault, Coralie, Colin, Cyrille, Bosson, Jean-Luc, Bosco, Domenico, Berney, Thierry, Kessler, Laurence, Benhamou, Pierre-Yves, GRAGIL Network, Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), CHU Grenoble, Université Grenoble Alpes (UGA), Pôle DigiDune, Hôpital JeanMinjoz, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire [Grenoble] (CHU), Modélisation et Évaluation des données complexes en Santé Publique (TIMC-MESP), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), 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 Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-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 Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Centre Hospitalier Sud Francilien, CH Evry-Corbeil, Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Clermont-Ferrand, Université Clermont Auvergne (UCA), Génétique, Reproduction et Développement (GReD), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), Nanomédecine Régénérative (NanoRegMed), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle Médecine Interne, Rhumatologie, Nutrition, Endocrinologie, Diabétologie (CHU de Strasbourg) (M.I.R.N.E.D), Les Hôpitaux Universitaires de Strasbourg (HUS), Université de Strasbourg (UNISTRA), Pôle de Santé Publique [Lyon], Geneva University Hospitals and Geneva University, and CarMeN, laboratoire
Subjects: Blood Glucose, medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Islets of Langerhans Transplantation, 030209 endocrinology & metabolism, 030230 surgery, clinical research/practice, Gastroenterology, Islets of Langerhans, 03 medical and health sciences, 0302 clinical medicine, Endocrinology/diabetology, Internal medicine, medicine, Humans, Immunology and Allergy, Pharmacology (medical), In patient, type 1 [Diabetes], Retrospective Studies, Glycemic, Transplantation, Kidney, Type 1 diabetes, geography, geography.geographical_feature_category, ddc:617, business.industry, Insulin, medicine.disease, Islet, 3. Good health, [SDV] Life Sciences [q-bio], Diabetes Mellitus, Type 1, Treatment Outcome, medicine.anatomical_structure, Metabolic control analysis, diabetes: type 1, Clinical research/practice, endocrinology/diabetology, islets of Langerhans, business, Switzerland
Abstract: International audience; To describe the 10-year outcomes of islet transplantation within the Swiss-French GRAGIL Network, in patients with type 1 diabetes experiencing high glucose variability associated with severe hypoglycemia and/or with functional kidney graft. We conducted a retrospective analysis of all subjects transplanted in the GRAGIL-1c and GARGIL-2 islet transplantation trials and analyzed components of metabolic control, graft function and safety outcomes over the 10-year period of follow-up. Forty-four patients were included between September 2003 and April 2010. Thirty-one patients completed a ten-year follow-up. Ten years after islet transplantation, median HbA1c was 7.2% [6.2-8.0] (55 mmol/mol [44-64]) vs 8.0% [7.1-9.1] (64 mmol/mol [54-76]) before transplantation (p\textless0.001). 17/23 (73.9%) recipients were free of severe hypoglycemia, 1/21 patient (4.8%) was insulin-independent and median C-peptide was 0.6 ng/ml [0.2-1.2]. Insulin requirements (UI/kg/day) were 0.3 [0.1-0.5] vs 0.5 [0.4-0.6] before transplantation (p\textless0.001). Median [IQR] β-score was 1 [0-4] (p\textless0.05 when comparing with pre-transplantation values) and 51.9% recipients had a functional islet graft at 10 years. With a 10-year follow up in a multicentric network, islet transplantation provided sustained improvement of glycemic control and was efficient to prevent severe hypoglycemia in almost 75% of the recipients.
Published: 2021

23. Cost-Effectiveness of Magnetic Resonance Imaging-Guided Thrombolysis for Patients With Stroke With Unknown Time of Onset

Author: Alexander Konnopka, Louisa-Kristin Muntendorf, Jochen B. Fiebach, Norbert Nighoghossian, Keith W. Muir, Matthias Endres, Hans-Helmut König, Florent Boutitie, Vincent Thijs, Claus Z Simonsen, Götz Thomalla, Salvador Pedraza, Christian Gerloff, Robin Lemmens, Martin Ebinger, CarMeN, laboratoire, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Hospices Civils de Lyon (HCL), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Klinik für Neurologie, Westfälische Wilhelms-Universität Münster = University of Münster (WWU), German Research Center for Neurodegenerative Diseases - Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany, Austin Health, University of Melbourne, The Florey Institute of Neuroscience and Mental Health, University Hospitals Leuven [Leuven], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), University of Glasgow, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta - Girona Biomedical Research Institute (IDIBGI), and Aarhus University Hospital
Subjects: thrombolysis, medicine.medical_specialty, Cost effectiveness, [SDV]Life Sciences [q-bio], Cost-Benefit Analysis, medicine.medical_treatment, Placebo, law.invention, methods [Magnetic Resonance Imaging], Randomized controlled trial, Modified Rankin Scale, law, economics [Thrombolytic Therapy], Acute care, economics [Magnetic Resonance Imaging], medicine, magnetic resonance imaging, Humans, methods [Cost-Benefit Analysis], Thrombolytic Therapy, ddc:610, cost-effectiveness, Stroke, quality-adjusted life-year, tissue-type plasminogen activator, health care economics and organizations, business.industry, Health Policy, Public Health, Environmental and Occupational Health, methods [Thrombolytic Therapy], Thrombolysis, medicine.disease, Magnetic Resonance Imaging, Markov Chains, Quality-adjusted life year, [SDV] Life Sciences [q-bio], Surgery, Computer-Assisted, Emergency medicine, Quality-Adjusted Life Years, business
Abstract: International audience; OBJECTIVES: Patients waking up with stroke symptoms are often excluded from intravenous thrombolysis with alteplase (IV-tpa). The WAKE-UP trial, a European multicenter randomized controlled trial, proved the clinical effectiveness of magnetic resonance imaging-guided IV-tpa for these patients. This analysis aimed to assess the cost-effectiveness of the intervention compared to placebo. METHODS: A Markov model was designed to analyze the cost-effectiveness over a 25-year time horizon. The model consisted of an inpatient acute care phase and a rest-of-life phase. Health states were defined by the modified Rankin Scale (mRS). Initial transition probabilities to mRS scores were based on WAKE-UP data and health state utilities on literature search. Costs were based on data from the University Medical Center Hamburg-Eppendorf, literature, and expert opinion. Incremental costs and effects over the patients' lifetime were estimated. The analysis was conducted from a formal German healthcare perspective. Univariate and probabilistic sensitivity analyses were performed. RESULTS: Treatment with IV-tpa resulted in cost savings of €51 009 and 1.30 incremental gains in quality-adjusted life-years at a 5% discount rate. Univariate sensitivity analysis revealed incremental cost-effectiveness ratio being sensitive to the relative risk of favorable outcome on mRS for placebo patients after stroke, the costs of long-term care for patients with mRS 4, and patient age at initial stroke event. In all cases, IV-tpa remained cost-effective. Probabilistic sensitivity analysis proved IV-tpa cost-effective in \textgreater95% of the simulations results. CONCLUSIONS: Magnetic resonance imaging-guided IV-tpa compared to placebo is cost-effective in patients with ischemic stroke with unknown time of onset.
Published: 2021

24. Fibroblast growth factor 19 as a countermeasure to muscle and locomotion dysfunctions in experimental cerebral palsy

Author: Hubert Vidal, Francisco Carlos Amanajás de Aguiar Júnior, Sabrina da Conceição Pereira, Stéphanie Chanon, Sandra Pesenti, Jérome Ruzzin, Aurélie Vieille-Marchiset, Ana Elisa Toscano, Bérengère Benoit, Federal University of Pernambuco [Recife], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University of Oslo (UiO), and CarMeN, laboratoire
Subjects: Male, Sarcopenia, medicine.medical_specialty, Small-Conductance Calcium-Activated Potassium Channels, [SDV]Life Sciences [q-bio], Skeletal muscle, Diseases of the musculoskeletal system, Fibroblast growth factor, Cerebral palsy, Mice, Pregnancy, Physiology (medical), Internal medicine, medicine, Animals, Orthopedics and Sports Medicine, Tibia, Rats, Wistar, Muscle, Skeletal, Fibroblast growth factor 19, business.industry, Cerebral Palsy, QM1-695, FGF19, Original Articles, medicine.disease, Muscle atrophy, Rats, Motor coordination, [SDV] Life Sciences [q-bio], Fibroblast Growth Factors, Endocrinology, medicine.anatomical_structure, RC925-935, Human anatomy, Original Article, Female, medicine.symptom, business, Locomotion
Abstract: International audience; BACKGROUND: Cerebral palsy (CP) associates cerebral function damages with strong locomotor defects and premature sarcopenia. We previously showed that fibroblast growth factor 19 (FGF19) exerts hypertrophic effects on skeletal muscle and improves muscle mass and strength in mouse models with muscle atrophy. Facing the lack of therapeutics to treat locomotor dysfunctions in CP, we investigated whether FGF19 treatment could have beneficial effects in an experimental rat model of CP. METHODS: Cerebral palsy was induced in male Wistar rat pups by perinatal anoxia immediately after birth and by sensorimotor restriction of hind paws maintained until Day 28. Daily subcutaneous injections with recombinant human FGF19 (0.1 mg/kg bw) were performed from Days 22 to 28. Locomotor activity and muscle strength were assessed before and after FGF19 treatment. At Day 29, motor coordination on rotarod and various musculoskeletal parameters (weight of tibia bone and of soleus and extensor digitorum longus (EDL) muscles; area of skeletal muscle fibres) were evaluated. In addition, expression of specific genes linked to human CP was measured in rat skeletal muscles. RESULTS: Compared to controls, CP rats had reduced locomotion activity (-37.8% of distance travelled, P \textless 0.05), motor coordination (-88.9% latency of falls on rotarod, P \textless 0.05) and muscle strength (-25.1%, P \textless 0.05). These defects were associated with reduction in soleus (-51.5%, P \textless 0.05) and EDL (-42.5%, P \textless 0.05) weight, smaller area of muscle fibres, and with lower tibia weight (-38%, P \textless 0.05). In muscles from rats submitted to CP, changes in the expression levels of several genes related to muscle development and neuromuscular junctions were similar to those found in wrist muscle of children with CP (increased mRNA levels of Igfbp5, Kcnn3, Gdf8, and MyH4 and decreased expression of Myog, Ucp2 and Lpl). Compared with vehicle-treated CP rats, FGF19 administration improved locomotor activity (+53.2%, P \textless 0.05) and muscle strength (+25.7%, P \textless 0.05), and increased tibia weight (+13.8%, P \textless 0.05) and soleus and EDL muscle weight (+28.6% and +27.3%, respectively, P \textless 0.05). In addition, it reduced a number of very small fibres in both muscles (P \textless 0.05). Finally, gene expression analyses revealed that FGF19 might counteract the immature state of skeletal muscles induced by CP. CONCLUSIONS: These results demonstrate that pharmacological intervention with recombinant FGF19 could restore musculoskeletal and locomotor dysfunction in an experimental CP model, suggesting that FGF19 may represent a potential therapeutic strategy to combat the locomotor disorders associated with CP.
Published: 2021

25. The ROMANOV study found impaired humoral and cellular immune responses to SARS-CoV-2 mRNA vaccine in virus-unexposed patients receiving maintenance hemodialysis

Author: Christine Bouz, Thomas Barba, X. Charmetant, E. Chalencon, Emilie Kalbacher, Olivier Thaunat, Denis Fouque, Laurence Pellegrina, Laetitia Koppe, Virginie Mathias, Caroline C. Pelletier, Laurent Juillard, Maxime Espi, Emmanuel Morelon, Emmanuelle Cart-Tanneur, Anne Ovize, 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), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Hôpital Edouard Herriot [CHU - HCL], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Etablissement Français du Sang [Décines-Charpieu] (EFS Auvergne-Rhône-Alpes), Eurofins Biomnis – Biologie Médicale Spécialisée [Lyon] (EB-BMS), Université de Lyon, CarMeN, laboratoire, Centre International de Recherche en Infectiologie (CIRI), 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: COVID-19 Vaccines, [SDV]Life Sciences [q-bio], medicine.medical_treatment, CD8-Positive T-Lymphocytes, Antibodies, Viral, Virus, Immune system, Renal Dialysis, Interferon, Humans, Medicine, Clinical Investigation, RNA, Messenger, BNT162 Vaccine, Immunity, Cellular, Messenger RNA, SARS-CoV-2, business.industry, Effector, COVID-19, [SDV] Life Sciences [q-bio], Vaccination, mRNA vaccine, Nephrology, Hemodialysis, Immunology, BNT162b2, business, CD8, medicine.drug
Abstract: Patients on maintenance hemodialysis (MHD), which are at high risk of infection by SARS-CoV-2 virus and death due to COVID-19, have been prioritized for vaccination. However, because they were excluded from pivotal studies and have weakened immune responses, it is not known whether these patients are protected after the “standard” two doses of mRNA vaccines. To answer this, anti-spike receptor binding domain (RBD) IgG and interferon gamma-producing CD4+ and CD8+ specific-T cells were measured in the circulation 10-14 days after the second injection of BNT162b2 vaccine in 106 patients receiving MHD (14 with history of COVID-19) and compared to 30 healthy volunteers (four with history of COVID-19). After vaccination, most (72/80, 90%) patients receiving MHD naïve for the virus generated at least one type of immune effector, but their response was weaker and less complete than that of healthy volunteers. In multivariate analysis, hemodialysis and immunosuppressive therapy were significantly associated with absence of both anti-RBD IgGs and anti-spike CD8+ T cells. In contrast, previous history of COVID-19 in patients receiving MHD correlated with the generation of both types of immune effectors anti-RBD IgG and anti-spike CD8+ T cells at levels similar to healthy volunteers. Patients receiving MHD naïve for SARS-Cov-2 generate mitigated immune responses after two doses of mRNA vaccine. Thus, the good response to vaccine of patients receiving MHD with a history of COVID-19 suggest that these patients may benefit from a third vaccine injection., Graphical abstract
Published: 2021

26. Is muscle and protein loss relevant in long‐term fasting in healthy men? A prospective trial on physiological adaptations

Author: Audrey Bergouignan, Claire Laurens, Yvon Le Maho, Françoise Wilhelmi de Toledo, Stéphane Blanc, Guillemette Gauquelin-Koch, Chantal Simon, Anthony Damiot, Anne-Laure Le Maho, Franziska Grundler, Isabelle Chery, Alexandre Zahariev, Centre National d’Études Spatiales [Paris] (CNES), Département Ecologie, Physiologie et Ethologie (DEPE-IPHC), Institut Pluridisciplinaire Hubert Curien (IPHC), Université de Strasbourg (UNISTRA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Buchinger Wilhelmi Clinic [Überlingen, Germany] (BWC), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Clinique Générale Annecy (CGA), Centre Scientifique de Monaco (CSM), University of Colorado Anschutz [Aurora], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), and CarMeN, laboratoire
Subjects: Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Blood lipids, Diseases of the musculoskeletal system, Body composition, chemistry.chemical_compound, Long-term fasting, Weight loss, Physiology (medical), Internal medicine, Ketogenesis, medicine, Humans, Orthopedics and Sports Medicine, Prospective Studies, Protein sparing, Exercise, Glycogen, business.industry, Muscles, QM1-695, Original Articles, Energy metabolism, Fasting, Middle Aged, Lipids, Adaptation, Physiological, [SDV] Life Sciences [q-bio], Protein catabolism, Blood pressure, Endocrinology, RC925-935, chemistry, Muscle function, Human anatomy, Basal metabolic rate, Apelin, Original Article, Long‐term fasting, medicine.symptom, business
Abstract: International audience; BACKGROUND: Fasting is attracting an increasing interest as a potential strategy for managing diseases, including metabolic disorders and complementary cancer therapy. Despite concerns of clinicians regarding protein catabolism and muscle loss, evidence-based clinical data in response to long-term fasting in healthy humans are scarce. The objective of this study was to measure clinical constants, metabolic, and muscular response in healthy men during and after a 10 day fast combined with a physical activity programme. METHODS: Sixteen men (44 ± 14 years; 26.2 ± 0.9 kg/m(2) ) fasted with a supplement of 200-250 kcal/day and up to 3 h daily low-intensity physical activity according to the peer-reviewed Buchinger Wilhelmi protocol. Changes in body weight (BW) and composition, basal metabolic rate (BMR), physical activity, muscle strength and function, protein utilization, inflammatory, and metabolic status were assessed during the 10 day fast, the 4 days of food reintroduction, and at 3 month follow-up. RESULTS: The 10 day fast decreased BW by 7% (-5.9 ± 0.2 kg, P \textless 0.001) and BMR by 12% (P \textless 0.01). Fat mass and lean soft tissues (LST) accounted for about 40% and 60% of weight loss, respectively, -2.3 ± 0.18 kg and -3.53 ± 0.13 kg, P \textless 0.001. LST loss was explained by the reduction in extracellular water (44%), muscle and liver glycogen and associated water (14%), and metabolic active lean tissue (42%). Plasma 3-methyl-histidine increased until Day 5 of fasting and then decreased, suggesting that protein sparing might follow early proteolysis. Daily steps count increased by 60% (P \textless 0.001) during the fasting period. Strength was maintained in non-weight-bearing muscles and increased in weight-bearing muscles (+33%, P \textless 0.001). Glycaemia, insulinemia, blood lipids, and blood pressure dropped during the fast (P \textless 0.05 for all), while non-esterified fatty acids and urinary beta-hydroxybutyrate increased (P \textless 0.01 for both). After a transient reduction, inflammatory cytokines returned to baseline at Day 10 of fasting, and LST were still lower than baseline values (-2.3% and -3.2%, respectively; P \textless 0.05 for both). CONCLUSIONS: A 10 day fast appears safe in healthy humans. Protein loss occurs in early fast but decreases as ketogenesis increases. Fasting combined with physical activity does not negatively impact muscle function. Future studies will need to confirm these first findings.
Published: 2021

27. Initial evaluation of extracorporeal immunomodulatory therapy for the treatment of critically ill COVID-19 infected patients

Author: Sandrine Lemoine, Jarrin Penny, Douglas D. Fraser, Fabio R. Salerno, Justin Dorie, Tanya Tamasi, Robert Arntfield, Andrew House, Marat Slessarev, Christopher W. McIntyre, CarMeN, laboratoire, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University of Western Ontario (UWO), Lawson Health Research Institute, Western University [London, ON, Canada], Victoria hospital, and London Health Sciences Center (LHSC)
Subjects: Respiratory Distress Syndrome, Multidisciplinary, [SDV.BA] Life Sciences [q-bio]/Animal biology, [SDV.BA]Life Sciences [q-bio]/Animal biology, Critical Illness, Vasoconstrictor Agents/therapeutic use, COVID-19 Drug Treatment, Immunomodulation, Extracorporeal Membrane Oxygenation, Extracorporeal Membrane Oxygenation/methods, Humans, Vasoconstrictor Agents
Abstract: Severe COVID-19 infection results in significant immune dysregulation resulting from excessive recruitment and activation of neutrophils. The aim of this study was to confirm feasibility, initial safety and detect signal of efficacy of a non-propriety device delivered using an intermittent extra-corporeal system (LMOD) allowing leucocytes modulation in the setting of Severe COVID-19 infection. Twelve patients were recruited. Inclusion criteria were > 18 years age, confirmed COVID-19, acute respiratory distress syndrome requiring mechanical support and hypotension requiring vasopressor support. Primary end point was vasopressor requirements (expressed as epinephrine dose equivalents) and principle secondary endpoints related to safety, ability to deliver the therapy and markers of inflammation assessed over five days after treatment initiation. LMOD treatment appeared safe, defined by hemodynamic stability and no evidence of white cell number depletion from blood. We demonstrated a significant decrease in vasopressor doses (−37%, p = 0.02) in patients receiving LMOD therapy (despite these patients having to tolerate an additional extracorporeal intermittent therapy). Vasopressor requirements unchanged/increasing in control group (+ 10%, p = 0.48). Although much about the use of this therapy in the setting of severe COVID-19 infection remains to be defined (e.g. optimal dose and duration), this preliminary study supports the further evaluation of this novel extracorporeal approach.
Published: 2022

28. Developing an Evidence and Theory Based Multimodal Integrative Intervention for the Management of Renal Cachexia: A Theory of Change

Author: Carolyn Blair, Adrian Slee, Andrew Davenport, Denis Fouque, William Johnston, Kamyar Kalantar-Zadeh, Peter Maxwell, Clare McKeaveney, Robert Mullan, Helen Noble, Sam Porter, David Seres, Joanne Shields, Ian Swaine, Miles Witham, Joanne Reid, CarMeN, laboratoire, Queen's University [Belfast] (QUB), University College of London [London] (UCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), University of California [Irvine] (UC Irvine), University of California (UC), Antrim Area Hospital - Northern Health and Social Care Trust [Antrim, Northern Ireland] (AAH-NHSCT), Bournemouth University [Poole] (BU), Columbia University Irving Medical Center (CUIMC), Belfast City Hospital, University of Greenwich, Newcastle University [Newcastle], and Newcastle Upon Tyne Hospitals NHS Foundation Trust
Subjects: theory of change, [SDV.BA] Life Sciences [q-bio]/Animal biology, Leadership and Management, [SDV.BA]Life Sciences [q-bio]/Animal biology, Health Policy, kidney disease, Health Informatics, have no competing interest, cachexia, Article, complex intervention, Health Information Management, renal disease, end-stage kidney disease, multimodal intervention, personal and public involvement
Abstract: In this study, we aimed to develop a theoretical framework for a multimodal, integrative, exercise, anti-inflammatory and dietary counselling (MMIEAD) intervention for patients with renal cachexia with reference to how this addresses the underlying causal pathways for renal cachexia, the outcomes anticipated, and how these will be evaluated. We used a Theory of Change (ToC) approach to guide six steps. Step 1 included inputs from a workshop to obtain key stakeholder views on the potential development of a multimodal intervention for renal cachexia. Step 2 included the findings of a mixed-methods study with Health Care Practitioners (HCPs) caring for individuals with End Stage Kidney Disease (ESKD) and cachexia. Step 3 included the results from our systematic literature review on multimodal interventions for cachexia management. In step 4, we used the body of our research team’s cachexia research and wider relevant research to gather evidence on the specific components of the multimodal intervention with reference to how this addresses the underlying causal pathways for renal cachexia. In steps 5 and 6 we developed and refined the ToC map in consultation with the core research team and key stakeholders which illustrates how the intervention components of MMIEAD interact to achieve the intended long-term outcomes and anticipated impact. The results of this study provide a theoretical framework for the forthcoming MMIEAD intervention for those with renal cachexia and in subsequent phases will be used to determine whether this intervention is effective. To the best of our knowledge no other multimodal intervention trials for cachexia management have reported a ToC. Therefore, this research may provide a useful framework and contribute to the ongoing development of interventions for cachexia management.
Published: 2022
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29. Nutri-Score: its benefits and limitations in children's feeding

Author: Jean-Pierre, Chouraqui, Christophe, Dupont, André, Briend, Dominique, Darmaun, Noel, Peretti, Alain, Bocquet, Martin, Chalumeau, Arnaud, De Luca, François, Feillet, Marie-Laure, Frelut, Dominique, Guimber, Alexandre, Lapillonne, Agnès, Linglart, Jean-Christophe, Rozé, Umberto, Simeoni, Dominique, Turck, CHU Grenoble, Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Clinique Marcel Sembat (CCBB) - Ramsay Santé [Boulogne Billancourt], IT University of Copenhagen (ITU), University of Tampere [Finland], Physiopathologie des Adaptations Nutritionnelles (PhAN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Association Française de Pédiatrie Ambulatoire (AFPA), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier d'Albi, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Fédération pour la recherche en explorations et thérapeutiques innovantes in utéro (FETUS (URP 7328)), Université Paris Cité (UPCité), Centre de Référence des Maladies Rares du Métabolisme du Phosphore et du Calcium and Filière de Santé Maladies Rares (OSCAR), Hôpital Bicêtre, Centre d'Investigation Clinique [Nantes] (CIC004), Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Lausanne = University of Lausanne (UNIL), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), and CarMeN, laboratoire
Subjects: [SDV.BA] Life Sciences [q-bio]/Animal biology, [SDV.BA]Life Sciences [q-bio]/Animal biology, Pediatrics, Perinatology and Child Health, Gastroenterology
Abstract: International audience; Reducing the burden of non-communicable diseases (NCDs) is one of the top priorities of public health policies worldwide. One of the recognized means of achieving this objective is to improve the diet quality. The Nutri-Score (N-S) is a [five-color - A, B, C, D, E letters] front-of-pack labelling logo intended to help consumers quickly identify the healthier prepackaged foods within a food category. Available studies have shown that the N-S is an efficient tool to achieve this aim in terms of consumers' awareness, perception, understanding and purchasing and that its use may help to reduce the prevalence of NCDs. The N-S is currently implemented on a voluntary basis in seven European countries and a discussion is underway within the European Commission to achieve a harmonized mandatory label. However, no study on the putative impact of the N-S on children's dietary patterns and health is available. The N-S is not applicable to infants' and young children's formulas and to specific baby foods, the compositions of which are already laid down in European Union regulations. The N-S does not replace age-appropriate dietary guidelines. As children consume an increasing number of adult type and processed foods, the relevance of the N-S for children should be evaluated considering the children's high specific requirements, especially in younger children. This is especially necessary for fitting fat and iron requirements, whereas protein-rich foods should be better framed. Moreover, efforts should be made to inform on how to use the N-S and in education on healthy diets.
Published: 2022

30. Prevalence of Her2-neu status and its clinicopathological association in newly diagnosed gastric cancer patients

Author: Joseph, Kattan, Fady El, Karak, Fadi, Farhat, Dany Abi, Gerges, Walid, Mokaddem, Georges, Chahine, Saad, Khairallah, Najla, Fakhruddin, Jawad, Makarem, Fadi, Nasr, CarMeN, laboratoire, Hôtel-Dieu de France (HDF), Université Saint-Joseph de Beyrouth (USJ), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hammoud Hospital University Medical Center [Saida, Lebanon] (HHUMC ), Middle East Institute of Health - University Hospital [Bsalim, Lebanon] (MEIH), Hopital Albert Haykel [Tripoli, Lebanon] (HAH), Institut National de Pathologie [Baabda, Lebanon] (INP), Hospital Ain Wazain [Ain W Zain, Lebanon] (HAW), and Hôpital Mont-Liban
Subjects: HER2-neu, Cancer Research, [SDV.BA] Life Sciences [q-bio]/Animal biology, Receptor, ErbB-2, In-situ hybridization (ISH), [SDV.BA]Life Sciences [q-bio]/Animal biology, Middle Aged, Prevalence, Immunohistochemistry, Immunohistochemistry (IHC), Cross-Sectional Studies, Oncology, Stomach Neoplasms, Biomarkers, Tumor, Genetics, Humans, Gastric cancer, In Situ Hybridization, Fluorescence, Aged
Abstract: Background This study aimed to report the prevalence of HER2-neu in newly diagnosed early or metastatic gastric cancer (GC) patients, to determine the percentage of patients achieving various IHC scores correlating with the ISH results and to establish a database for GC patients in Lebanon. Methods This was a national, multicenter, descriptive and cross-sectional study in patients with histologically confirmed early or metastatic GC newly diagnosed. All eligible patients underwent the IHC and ISH tests in a central laboratory. Demographics, medical history and histopathology data were collected. Results One hundred fifty-seven patients were included (mean age at diagnosis: 63 ± 14.1 years) during a 3.5 year period. The prevalence of HER2-neu over expression was 21% (95% CI: 15.3–27.4) using ICH and ISH. Agreement between IHC and ISH results was significantly substantial (kappa = 0.681; p-value Conclusions The prevalence of HER2-neu over expression in newly diagnosed early or metastatic GC patients seemed to be high in Lebanon. The database generated allows to monitor trends in the epidemiology and management of GC.
Published: 2022

31. HIV-1-Associated Kidney Disease in an Elite Controller

Author: Caroline Charre, Sandrine Lemoine, Vinca Icard, Rabeyrin Maud, Jean-Claude Tardy, Pierre Chiarello, Matthieu Godinot, Véronique Avettand-Fenoel, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Service de Virologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Laboratoire de Virologie [HCL, Lyon] (Institut des Agents Infectieux), Hospices civils de Lyon (HCL)-HCL Groupement Hospitalier Nord [Lyon]-Centre National de Reference des virus des Infections Respiratoires France Sud [HCL, Lyon], Service de Biochimie et Biologie Moléculaire Grand Est [HCL, Lyon] (Centre de Biologie et de Pathologie), Hôpital de la Croix-Rousse [CHU - HCL], and CarMeN, laboratoire
Subjects: [SDV.BA] Life Sciences [q-bio]/Animal biology, [SDV.BA]Life Sciences [q-bio]/Animal biology, Public Health, Environmental and Occupational Health, HIV Infections, Kidney Diseases/complications, CD4 Lymphocyte Count, HIV Seropositivity, Infectious Diseases, hiv-1, HIV Infections/complications, HIV-1, Humans, Kidney Diseases, Elite Controllers
Abstract: No abstract available
Published: 2022

32. Endoscopic hybrid resection and under-water snare resection of symptomatic duodenal duplication cysts in children

Author: Mariana Milashka-Brihay, Mariana Figueiredo, Miguel Pantaleón Sánchez, Clara Yzet, Sophie Collardeau-Frachon, Jérôme Rivory, Mathieu Pioche, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Gastroenterology, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract: No abstract available
Published: 2022

33. Prone Position in COVID-19 and -COVID-19 Acute Respiratory Distress Syndrome: An International Multicenter Observational Comparative Study*

Author: Davide Chiumello, Claude Guérin, Pascal Beuret, Vincent Piriou, Nicolas Terzi, Thomas Rimmelé, Laurent Argaud, Luigi Camporota, Barnaby Sanderson, Martin Cour, Romain Metuor, Aude Verstraete, Julien Bohé, CarMeN, laboratoire, Guy's and St Thomas' Hospital [London], King‘s College London, Università degli Studi di Milano = University of Milan (UNIMI), Université Grenoble Alpes (UGA), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Service de Médecine Intensive et Réanimation [Lyon] (MIR), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), and Centre Hospitalier de Roanne
Subjects: Male, medicine.medical_specialty, Respiratory Distress Syndrome/etiology/physiopathology/*therapy, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Disease, Critical Care and Intensive Care Medicine, Patient Positioning, Interquartile range, Internal medicine, Odds Ratio, Prone Position, medicine, Humans, Intubation, Lung, Artificial/*methods, Aged, Retrospective Studies, Respiratory Distress Syndrome, business.industry, Respiration, Lung/physiopathology, COVID-19, Odds ratio, Oxygenation, Middle Aged, Respiration, Artificial, Respiratory Function Tests, [SDV] Life Sciences [q-bio], Europe, Intensive Care Units, Prone position, COVID-19/complications/physiopathology/*therapy, Female, Observational study, business, Cohort study
Abstract: International audience; Objectives: Prone position is used in acute respiratory distress syndrome and in coronavirus disease 2019 acute respiratory distress syndrome. However, it is unclear how responders may be identified and whether an oxygenation response improves outcome. The objective of this study was to quantify the response to prone position, describe the differences between coronavirus disease 2019 acute respiratory distress syndrome and acute respiratory distress syndrome, and explore variables associated with survival.Design: Retrospective, observational, multicenter, international cohort study.Setting: Seven ICUs in Italy, United Kingdom, and France.Patients: Three hundred seventy-six adults (220 coronavirus disease 2019 acute respiratory distress syndrome and 156 acute respiratory distress syndrome).Intervention: None.Measurements and main results: Preproning, a greater proportion of coronavirus disease 2019 acute respiratory distress syndrome patients had severe disease (53% vs 40%), worse Pao2/Fio2 (13.0 kPa [interquartile range, 10.5-15.5 kPa] vs 14.1 kPa [interquartile range, 10.5-18.6 kPa]; p = 0.017) but greater compliance (38 mL/cm H2O [interquartile range, 27-53 mL/cm H2O] vs 31 mL/cm H2O [interquartile range, 21-37 mL/cm H2O]; p < 0.001). Patients with coronavirus disease 2019 acute respiratory distress syndrome had a longer median time from intubation to prone position (2.0 d [interquartile range, 0.7-5.0 d] vs 1.0 d [interquartile range, 0.5-2.9 d]; p = 0.03). The proportion of responders, defined by an increase in Pao2/Fio2 greater than or equal to 2.67 kPa (20 mm Hg), upon proning, was similar between acute respiratory distress syndrome and coronavirus disease 2019 acute respiratory distress syndrome (79% vs 76%; p = 0.5). Responders had earlier prone position (1.4 d [interquartile range, 0.7-4.2 d] vs 2.5 d [interquartile range, 0.8-6.2 d]; p = 0.06)]. Prone position less than 24 hours from intubation achieved greater improvement in oxygenation (11 kPa [interquartile range, 4-21 kPa] vs 7 kPa [interquartile range, 2-13 kPa]; p = 0.002). The variables independently associated with the "responder" category were Pao2/Fio2 preproning (odds ratio, 0.89 kPa-1 [95% CI, 0.85-0.93 kPa-1]; p < 0.001) and interval between intubation and proning (odds ratio, 0.94 d-1 [95% CI, 0.89-0.99 d-1]; p = 0.019). The overall mortality was 45%, with no significant difference observed between acute respiratory distress syndrome and coronavirus disease 2019 acute respiratory distress syndrome. Variables independently associated with mortality included age (odds ratio, 1.03 yr-1 [95% CI, 1.01-1.05 yr-1]; p < 0.001); interval between hospital admission and proning (odds ratio, 1.04 d-1 [95% CI, 1.002-1.084 d-1]; p = 0.047); and change in Pao2/Fio2 on proning (odds ratio, 0.97 kPa-1 [95% CI, 0.95-0.99 kPa-1]; p = 0.002).Conclusions: Prone position, particularly when delivered early, achieved a significant oxygenation response in ~80% of coronavirus disease 2019 acute respiratory distress syndrome, similar to acute respiratory distress syndrome. This response was independently associated with improved survival.
Published: 2021

34. Molar Sodium Lactate Attenuates the Severity of Postcardiac Arrest Syndrome: A Preclinical Study

Author: Gabriel Bidaux, Laurent Argaud, Louis Kreitmann, Neven Stevic, Martin Cour, Michel Ovize, Laurent Desmurs, Joseph Loufouat, CarMeN, laboratoire, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Male, Molar, Mean arterial pressure, Cardiac output, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Sodium, Hemodynamics, Diuresis, chemistry.chemical_element, cardiac arrest, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Random Allocation, sodium lactate, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, medicine, Sodium lactate, Animals, Post-Cardiac Arrest Syndrome, Saline, business.industry, brain mitochondria, Brain, 030208 emergency & critical care medicine, 3. Good health, [SDV] Life Sciences [q-bio], Disease Models, Animal, chemistry, postcardiac arrest syndrome, Anesthesia, Rabbits, business
Abstract: International audience; OBJECTIVES: To determine whether continuous IV infusion of molar sodium lactate would limit cardiac arrest-induced neurologic injury and cardiovascular failure. DESIGN: Randomized blinded study (animal model). SETTING: University animal research facility. SUBJECTS: Twenty-four adult male "New Zealand White" rabbits. INTERVENTIONS: Anesthetized rabbits underwent 12.5 minutes of asphyxial cardiac arrest and were randomized to receive either normal saline (control group, n = 12) or molar sodium lactate (molar sodium lactate group, n = 12) at a rate of 5 mL/kg/hr during the whole 120-minute reperfusion period. MEASUREMENTS AND MAIN RESULTS: Pupillary reactivity (primary outcome), levels of S100β protein, in vitro brain mitochondria functions, cardiovascular function, and fluid balance were assessed. Molar sodium lactate reduced brain injury, with a higher proportion of animals exhibiting pupillary reactivity to light (83% vs 25% in the CTRL group, p = 0.01) and lower S100β protein levels (189 ± 42 vs 412 ± 63 pg/mL, p \textless 0.01) at the end of the protocol. Molar sodium lactate significantly prevented cardiac arrest-induced decrease in oxidative phosphorylation and mitochondrial calcium-retention capacity compared with controls. At 120 minutes of reperfusion, survival did not significantly differ between the groups (10/12, 83% in the molar sodium lactate group vs nine of 12, 75% in the control group; p \textgreater 0.99), but hemodynamics were significantly improved in the molar sodium lactate group compared with the control group (higher mean arterial pressure [49 ± 2 vs 29 ± 3 mm Hg; p \textless 0.05], higher cardiac output [108 ± 4 vs 58 ± 9 mL/min; p \textless 0.05], higher left ventricle surface shortening fraction [38% ± 3% vs 19% ± 3%; p \textless 0.05], and lower left ventricular end-diastolic pressure [3 ± 1 vs 8 ± 2 mm Hg; p \textless 0.01]). While fluid intake was similar in both groups, fluid balance was higher in control animals (11 ± 1 mL/kg) than that in molar sodium lactate-treated rabbits (1 ± 3 mL/kg; p \textless 0.01) due to lower diuresis. CONCLUSIONS: Molar sodium lactate was effective in limiting the severity of the postcardiac arrest syndrome. This preclinical study opens up new perspectives for the treatment of cardiac arrest.
Published: 2021

35. Impact of Covid-19 on kidney transplant and waiting list patients: Lessons from the first wave of the pandemic

Author: Benoit Barrou, Yannick Le Meur, L. Sebbag, Lionel Couzi, Lisa M. McElroy, Sophie Caillard, Yuval A. Patel, Scott Sanoff, Olivier Thaunat, Mathias Büchler, Gilles Blancho, Jérôme Dumortier, Marc Hazzan, Brian I. Shaw, Dany Anglicheau, Mariya L. Samoylova, Miriam Manook, Eric Epailly, Sacha Mussot, CHU Bordeaux [Bordeaux], Immunology from Concept and Experiments to Translation (ImmunoConcept), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux (UB), Duke University [Durham], CHU Strasbourg, Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques ( IRTOMIT), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Néphrologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Centre Chirurgical Marie Lannelongue (CCML)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hôpital Louis Pradel [CHU - HCL], Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Nantes (UN), CHRU Brest - Service de Nephrologie (CHU - BREST - Nephrologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Néphrologie et Transplantation rénale [CHRU-lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CarMeN, laboratoire, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre chirurgical Marie Lannelongue-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre National de la Recherche Scientifique (CNRS)-Université de Bordeaux (UB)
Subjects: Male, medicine.medical_specialty, Waiting Lists, Patients, Coronavirus disease 2019 (COVID-19), [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Kidney, Kidney transplant, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Health care, Pandemic, Candidates, medicine, Humans, Pandemics, Kidney transplantation, Transplantation, business.industry, Communication, Patient Preference, Middle Aged, medicine.disease, Kidney Transplantation, 3. Good health, [SDV] Life Sciences [q-bio], Nephrology, Waiting list, Communicable Disease Control, Emergency medicine, Female, France, Covid-19, business, Attitude to Health
Abstract: International audience; BACKGROUND: The first wave of the Covid-19 pandemic resulted in a drastic reduction in kidney transplantation and a profound change in transplant care in France. It is critical for kidney transplant centers to understand the behaviors, concerns and wishes of transplant recipients and waiting list candidates. METHODS: French kidney patients were contacted to answer an online electronic survey at the end of the lockdown. RESULTS: At the end of the first wave of the pandemic in France (11 May 2020), 2112 kidney transplant recipients and 487 candidates answered the survey. More candidates than recipients left their home during the lockdown, mainly for health care (80.1% vs. 69.4%; P\textless0.001). More candidates than recipients reported being exposed to Covid-19 patients (2.7% vs. 1.2%; P=0.006). Many recipients and even more candidates felt inadequately informed by their transplant center during the pandemic (19.6% vs. 54%; P\textless0.001). Among candidates, 71.1% preferred to undergo transplant as soon as possible, 19.5% preferred to wait until Covid-19 had left their community, and 9.4% were not sure what to do. CONCLUSIONS: During the Covid-19 pandemic in France, the majority of candidates wished to receive a transplant as soon as possible without waiting until Covid-19 had left their community. Communication between kidney transplant centers and patients must be improved to better understand and serve patients' needs.
Published: 2021

36. Food consumption habits, gestational age and birth weight are predictive for children with excess weight: An analysis based on artificial neural network

Author: Isabele Góes Nobre, Gabriela Carvalho Jurema Santos, Tafnes Laís Pereira Santos de Almeida Oliveira, Isabella da Costa Ribeiro, Ravi Marinho dos Santos, Camilla Peixoto Santos Rodrigues, Marcos André Moura-dos-Santos, Julie-Anne Nazare, Luciano Pirola, Carol Gois Leandro, Universidade Federal de Pernambuco [Recife] (UFPE), Federal University of Pernambuco [Recife], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RA), Université de Lyon-Université de Lyon-CHU Grenoble-Hospices Civils de Lyon (HCL)-CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Grenoble Alpes (UGA), Centre Européen pour la Nutrition et la Santé (CENS), and CarMeN, laboratoire
Subjects: [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Nutrition and Dietetics, food consumption, sedentary behavior, Medicine (miscellaneous), birth weight, Pediatric obesity, General Medicine, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, artificial neural network
Abstract: The relationship between body weight gain and the onset of obesity is linked to environmental and behavioral factors, and may be dependent on biological predisposing. Artificial neural networks are useful predictive tools in the field of artificial intelligence, and can be used to identify risk factors related to obesity. The aim of this study is to establish, based on artificial neural networks, a predictive model for overweight/obesity in children based on the recognition and selection of patterns associated with birth weight, gestational age, height deficit, food consumption, and the physical activity level, TV time and family context. Sample consisted of 149 children (72 = eutrophic and 77 = overweight/obese). Collected data consisted of anthropometry and demographic characteristics, gestational age, birth weight, food consumption, physical activity level, TV time and family context. The gestational age, daily caloric intake and birth weight were the main determinants of the later appearance of overweight and obesity. In addition, the family context linked to socioeconomic factors, such as the number of residents in the household, had a great impact on excess weight. The physical activity level was the least important variable. Modifiable risk factors, such as the inadequate food consumption, and non-modifiable factors such as gestational age were the main determinants for overweight/obesity in children. Our data indicate that, combating excess weight should also be carried out from a social and preventive perspective during critical periods of development, such as pregnancy, lactation and early childhood, to reach a more effective strategy to combat obesity and its complications in childhood and adult life.
Published: 2022

37. Bioelectrical impedance analysis during deresuscitation: correlation and agreement with cumulative fluid balance in ICU patients

Author: Martin Ruste, Charlotte Chabanol, Jean-Luc Fellahi, Matthias Jacquet-Lagrèze, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: Bioelectrical impedance analysis, Continuous renal replacement therapy, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Anesthesiology and Pain Medicine, Cumulative fluid balance, Fluid overload, Health Informatics, Critical Care and Intensive Care Medicine, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Deresuscitation
Abstract: Bioelectrical impedance analysis (BIA) is a promising tool to evaluate the body composition of critically-ill patients. The present study aimed to assess its value as a fluid management monitoring tool during standardized deresuscitation strategy. A historical cohort of critically-ill adult patients with fluid overload and continuous renal replacement therapy was used to explore both relationship and agreement between changes in cumulative fluid balance and BIA-derived hydration variables within the 5 days following initiation of deresuscitation strategy using net ultrafiltration. Correlations were described using Spearman's rank correlation coefficient, and agreement using Bland-Altman analysis for repeated measurements. Sixty-one couples of fluid shift measurements from 30 patients were analyzed. The deresuscitation strategy induced a negative mean (± SD) cumulative fluid balance (- 4.2 ± 3.8 L) and a significant decrease in extra- and intracellular water (P < 0.001). Decreases in extra- and intracellular water were independent of weight variations inputted in the BIA device. Total body water (rho = 0.63), extracellular water (rho = 0.68), and intracellular water (rho = 0.67) were significantly correlated with cumulative fluid balance (all P values < 0.001). The limits of agreement did not allow interchangeability for a delta of 2L between cumulative fluid balance and BIA-derived hydration variables (P > 0.05). BIA hydration-derived variables are significantly correlated with cumulative fluid balance but the large limits of agreements exclude interchangeability of the measures.
Published: 2022

38. Estimation of glomerular filtration rate for drug dosing in patients with very high or low body mass index

Author: Erik M. Donker, Pierre Bet, Azam Nurmohamed, Erik Serné, George Louis Burchell, Allon N. Friedman, Antoine Bouquegneau, Sandrine Lemoine, Natalie Ebert, Massimo Cirillo, Michiel A. van Agtmael, Imke H. Bartelink, Internal medicine, Clinical pharmacology and pharmacy, APH - Mental Health, APH - Personalized Medicine, Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep, Nephrology, ACS - Diabetes & metabolism, ACS - Microcirculation, Vrije Universiteit Amsterdam [Amsterdam] (VU), Indiana University School of Medicine, Indiana University System, Centre Hospitalier Universitaire de Liège (CHU-Liège), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University of Naples Federico II = Università degli studi di Napoli Federico II, and CarMeN, laboratoire
Subjects: [SDV] Life Sciences [q-bio], Thinness, General Neuroscience, Creatinine, [SDV]Life Sciences [q-bio], Humans, General Medicine, Obesity, General Pharmacology, Toxicology and Pharmaceutics, Renal Insufficiency, Chronic, General Biochemistry, Genetics and Molecular Biology, Body Mass Index, Glomerular Filtration Rate
Abstract: International audience; An accurate estimated glomerular filtration rate (eGFR) is essential in drug dosing. This study demonstrates the limitations of indexed (ml/min/1.73 m(2) ) and de-indexed (ml/min) eGFR based drug dosing in patients with obesity or underweight. This systematic study aimed to determine the most appropriate approach to estimate the GFR for standardized eGFR based drug dosing in these patients. (Raw) data of 12 studies were selected to investigate the accuracy and bias of both the indexed and de-indexed estimations of the Modification of Diet in Renal Disease (MDRD) study equation and the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI), and of the Cockcroft-Gault (CG) in patients with obesity or underweight. Accuracy was calculated as the proportion of eGFR values within 30% of the measured GFR (P30) using an inert tracer (e.g., iohexol, inulin, (51) Cr-EDTA, or iothalamate clearance). An accuracy of at least 80% was considered acceptable. GFR values estimated with the CG, MDRD, and CKD-EPI differ significantly within a patient with obesity or underweight regardless of whether it is indexed or de-indexed. All studies, with two exceptions, show that all three equations are inaccurate for patients with underweight or class II obesity (P30: 55%-94%). De-indexing eGFR improves not or modestly the accuracy, and mostly remains below the 80% (P30: 62%-100%). CG was highly inaccurate in obese and underweight patients (P30: 7%-82%). Although these results show that CG is obsolete, the accuracy of MDRD and CKD-EPI is low in patients with obesity or underweight and de-indexing is not the solution. Better education and more accurate methods for appropriate drug dosing (e.g., measured GFR with inert tracer, therapeutic drug monitoring, or 24-h creatinine clearance) are recommended.
Published: 2022

39. Association of Blood Biomarkers of Inflammation With Penumbra Consumption After Mechanical Thrombectomy in Acute Ischemic Stroke Patients

Author: Laura MECHTOUFF, Noelie DEBS, Carole FRINDEL, Alexandre BANI-SADR, Thomas BOCHATON, Alexandre PACCALET, Claire CROLA DA SILVA, Marielle BUISSON, Camille AMAZ, Yves BERTHEZENE, Omer Faruk EKER, Morgane BOUIN, Charles DE BOURGUIGNON, Nathan Mewton, Michel Ovize, Gabriel Bidaux, Norbert Nighoghossian, Tae-Hee Cho, CarMeN, laboratoire, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), 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)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Centre d'Investigation Clinique [Bron] (CIC1407), and Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupement Hospitalier Est [Bron]
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], Neurology (clinical)
Abstract: Objectives:To assess the relationship between blood biomarkers of inflammation and lesion growth within the penumbra in acute ischemic stroke (AIS) patients treated with mechanical thrombectomy (MT).Methods:HIBISCUS-STROKE cohort enrolled patients admitted in the Lyon Stroke Center for an anterior circulation AIS treated with MT following MRI. Lesion growth within the penumbra was assessed on day-6 MRI using a voxel-based nonlinear coregistration method and dichotomized into low and high according to the median. C-reactive protein (CRP), interleukin (IL)-6, IL-8, IL-10, monocyte chemoattractant protein-1 (MCP-1), soluble tumor necrosis factor receptor I (sTNF-RI), soluble form suppression of tumorigenicity 2 (sST2), soluble P-selectin (sP-selectin), vascular cellular adhesion molecule-1 (VCAM-1) and matrix metalloproteinase-9 (MMP-9) were measured in sera at 4 timepoints within the first 48 hours. Reperfusion was considered as successful if Thrombolysis in Cerebral Infarction (TICI) score was 2b/2c/3. A multiple logistic regression model was performed to detect any association between area under the curve (AUC) of these biomarkers within the first 48 hours and a high lesion growth within the penumbra.Results:90 patients were included. Median lesion growth within the penumbra was 2.3 [0.7-6.2] mL. On multivariable analysis, a high sST2 AUC (odds ratio (OR) 3.77, 95% confidence interval (CI) 1.36-10.46) as well as a high baseline DWI volume (OR 3.65, 95% CI 1.32-10.12) and lack of successful reperfusion (OR 0.19, 95% CI 0.04-0.92) were associated with a high lesion growth within the penumbra. When restricting analyses to patients with successful reperfusion (n=76), a high sST2 AUC (OR 5.03, 95% CI 1.64-15.40), a high baseline DWI volume (OR 3.74, 95% CI 1.22-11.53) and a high penumbra volume (OR 3.25, 95% CI 1.10-9.57) remained associated with a high lesion growth within the penumbra.Conclusions: sST2 levels within the first 48 hours are associated with a high lesion growth within the penumbra.
Published: 2022

40. Adherence to recommendations after comprehensive geriatric assessment by mobile geriatric team during 500 home visits

Author: Pauget, A., Jomard, N., Termoz, A., Subtil, F., Chambard, V., Galamand, B., Genest, E., Chapelet, G., Bonnefoy, M., L'Hôpital Nord-Ouest [Villefranche sur Saône], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Pôle Information Médicale Evaluation Recherche (IMER), Hôpital Edouard Herriot [CHU - HCL], 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), Centre hospitalier universitaire de Nantes (CHU Nantes), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: Aged, 80 and over, Male, [SDV]Life Sciences [q-bio], Frail Elderly, inpatient geriatric consultation team, comprehensive geriatric assessment, [SDV] Life Sciences [q-bio], Hospitalization, House Calls, recommendation adherence rate, Humans, Female, Geriatric Assessment, Aged, Retrospective Studies
Abstract: Mobile geriatric team making home visit (MGT) were created to reinforce the link between home and hospital. Frail elderly patients can benefit from a comprehensive geriatric assessment (CGA) by a geriatric mobile team during a home visit. MGT at the hospital center of Lyon Sud presents recommendations after a CGA to better adjust healthcare to patients’ needs. There are few studies that have analysed the MGT who treat patients at home.The goal of the study was to determine adherence rate at 2 months and examines the socio-demographic profile of patients assessed by the MGT. We conducted a descriptive and retrospective study in single center, with 500 patients during 2 years (2016-2017).The mean adherence rate was 65,1%. The highest rate concerned recommendations on the future orientation. The lower rate concerned recommendations on lifestyle and environment. Mean age of the 500 patients was 83.5 years, 61% were women. The patients included in this study take an average of seven prescription medications (whitout psychotropic medications). The majority of the patients was GIR 3 and achieved an average score of 3 on ADL scale and 2 of IADL scale. Ninety-six per cent of the patients had a caregiver. It has been proven statistically that, adherence rate of recommendations (more than 65%), reduce unplanned hospitalizations.This study with a large sample of patients allows to better describe patients seen at home. It is a vulnerable population presenting a polypathology, dependence, associated with an unstable socio-family context. This work shows that the recommendations must be applied to limit hospitalizations and that the involvement of the team makes it possible to improve the follow-up of the recommendations.L'unité mobile extrahospitalière de gériatrie de Lyon-Sud propose une expertise gériatrique pluridisciplinaire au domicile des patients. Elle émet des recommandations pour rationaliser le parcours du sujet âgé en fonction de ses problématiques. L'objectif principal était de déterminer le taux de suivi à 2 mois des recommandations, et l'objectif secondaire de décrire le profil des patients suivis. Cette étude a inclus 500 patients sur 2 ans et a analysé 1 677 recommandations. Le taux de suivi global était de 65,1 %. Les patients avaient un âge médian de 83,5 ans, 61 % étaient des femmes et 88 % avaient un GIR ≤ 4. L'application des recommandations permet une diminution des hospitalisations non programmées. L'implication de l'équipe à l'issue de la visite optimise la mi%se en œuvre de ces recommandations. Le grand effectif de cette étude permet de mieux décrire les patients vus à domicile : une population vulnérable présentant une polypathologie, dépendance, associés à un contexte socio-familial instable. Ce travail montre que les recommandations doivent être appliquées pour limiter les hospitalisations et que l'implication de l'équipe permet d'améliorer le suivi des préconisations.
Published: 2022

41. Bacterial Cross-Transmission between Inanimate Surfaces and Patients in Intensive Care Units under Real-World Conditions: A Repeated Cross-Sectional Study

Author: Elisabetta Kuczewski, Laetitia Henaff, Anne Regard, Laurent Argaud, Anne-Claire Lukaszewicz, Thomas Rimmelé, Pierre Cassier, Isabelle Fredenucci, Sophie Loeffert-Frémiot, Nagham Khanafer, Philippe Vanhems, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), 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), Santé publique, épidémiologie et écologie évolutive des maladies infectieuses (PHE3ID), 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), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut des Agents Infectieux [Lyon] (IAI), Hôpital de la Croix-Rousse [CHU - HCL], HCL Groupement Hospitalier Nord [Lyon], Laboratoires Anios-Ecolab Company [Lezennes] (LAEC), CarMeN, laboratoire, 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), 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)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL)
Subjects: Acinetobacter baumannii, Cross Infection, hospital-acquired infection, Bacteria, environment, hospital, ICU, high-touch surfaces, bacteria, contamination, Health, Toxicology and Mutagenesis, [SDV]Life Sciences [q-bio], Public Health, Environmental and Occupational Health, [SDV] Life Sciences [q-bio], Intensive Care Units, Cross-Sectional Studies, Humans
Abstract: Background/Objectives: Contaminated surfaces play an important role in the nosocomial infection of patients in intensive care units (ICUs). This study, conducted in two ICUs at Edouard Herriot Hospital (Lyon, France), aimed to describe rooms’ microbial ecology and explore the potential link between environmental contamination and patients’ colonization and/or infection. Methods: Environmental samples were realized once monthly from January 2020 to December 2021 on surfaces close to the patient (bedrails, bedside table, and dedicated stethoscope) and healthcare workers’ high-touch surfaces, which were distant from the patient (computer, worktop/nurse cart, washbasin, and hydro-alcoholic solution/soap dispenser). Environmental bacteria were compared to the cultures of the patients hospitalized in the sampled room over a period of ± 10 days from the environmental sampling. Results: Overall, 137 samples were collected: 90.7% of the samples close to patients, and 87.9% of the distant ones were positives. Overall, 223 bacteria were isolated, mainly: Enterococcus faecalis (15.7%), Pantoea agglomerans (8.1%), Enterobacter cloacae/asburiae (6.3%), Bacillus cereus and other Bacillus spp (6.3%), Enterococcusfaecium (5.8%), Stenotrophomonas maltophilia (5.4%), and Acinetobacter baumannii (4.9%). Throughout the study, 142 patients were included, of which, n = 67 (47.2%) were infected or colonized by at least one bacterium. In fourteen cases, the same bacterial species were found both in environment and patient samples, with the suspicion of a cross-contamination between the patient–environment (n = 10) and environment–patient (n = 4). Conclusions: In this work, we found a high level of bacterial contamination on ICU rooms’ surfaces and described several cases of potential cross-contamination between environment and patients in real-world conditions.
Published: 2022
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42. Advances in the management of peritoneal malignancies

Author: Vahan Kepenekian, Aditi Bhatt, Julien Péron, Mohammad Alyami, Nazim Benzerdjeb, Naoual Bakrin, Claire Falandry, Guillaume Passot, Pascal Rousset, Olivier Glehen, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre pour l'innovation en cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Zydus hospital - Ahmedabad [Gujarat, India] (ZH), 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), King Khalid University [Abha], Université de Lyon, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: [SDV.BA] Life Sciences [q-bio]/Animal biology, Oncology, [SDV.BA]Life Sciences [q-bio]/Animal biology, Humans, Prospective Studies, Cytoreduction Surgical Procedures, Combined Modality Therapy, Peritoneal Neoplasms, Neoadjuvant Therapy, Peritoneal Neoplasms/drug therapy/pathology
Abstract: Peritoneal surface malignancies (PSMs) are usually associated with a poor prognosis. Nonetheless, in line with advances in the management of most abdominopelvic metastatic diseases, considerable progress has been made over the past decade. An improved understanding of disease biology has led to the more accurate prediction of neoplasia aggressiveness and the treatment response and has been reflected in the proposal of new classification systems. Achieving complete cytoreductive surgery remains the cornerstone of curative-intent treatment of PSMs. Alongside centralization in expert centres, enabling the delivery of multimodal and multidisciplinary strategies, preoperative management is a crucial step in order to select patients who are most likely to benefit from surgery. Depending on the specific PSM, the role of intraperitoneal chemotherapy and of perioperative systemic chemotherapy, in particular, in the neoadjuvant setting, is established in certain scenarios but questioned in several others, although more prospective data are required. In this Review, we describe advances in all aspects of the management of PSMs including disease biology, assessment and improvement of disease resectability, perioperative management, systemic therapy and pre-emptive management, and we speculate on future research directions.
Published: 2022

43. The spoils of war and the long-term spoiling of health conditions of entire nations

Author: Eliano P. Navarese, Klaudyna Grzelakowska, Francesco Mangini, Jacek Kubica, Maciej Banach, Marianne Benn, Christoph J. Binder, Jan Borén, Alberico Catapano, Florian Kronenberg, Ziad Mallat, Philippe Moulin, Katariina Öörni, Kausik K. Ray, Jeanine E. Roeters van Lennep, Stefano Romeo, Lale Tokgozoglu, Arnold von Eckardstein, Alberto Zambon, Paolo Raggi, Internal Medicine, University of Zurich, Raggi, Paolo, Nicolaus Copernicus University [Toruń], University of Alberta, Ospedale Di Summa - Perrino (Brindisi) [Italy] (OSP), Medical University of Łódź (MUL), Polish Mother’s Memorial Hospital Research Institute [Lodz] (ICZMP), Copenhagen University Hospital, Medizinische Universität Wien = Medical University of Vienna, University of Gothenburg (GU), Università degli Studi di Milano = University of Milan (UNIMI), Leopold Franzens Universität Innsbruck - University of Innsbruck, University of Cambridge [UK] (CAM), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Wihuri Research Institute [Helsinki, Finland], Imperial College London, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Università degli Studi 'Magna Graecia' di Catanzaro = University of Catanzaro (UMG), Hacettepe University = Hacettepe Üniversitesi, Universität Zürich [Zürich] = University of Zurich (UZH), University hospital of Zurich [Zurich], Università degli Studi di Padova = University of Padua (Unipd), and CarMeN, laboratoire
Subjects: Cardiovascular Diseases/epidemiology, Noncommunicable Diseases/epidemiology, [SDV]Life Sciences [q-bio], Healthcare systems, COVID-19, 610 Medicine & health, Cardiovascular disease, 2705 Cardiology and Cardiovascular Medicine, [SDV] Life Sciences [q-bio], Remote monitoring, SDG 3 - Good Health and Well-being, Cardiovascular Diseases, covid-19, 540 Chemistry, Humans, War, Noncommunicable Diseases, Cardiology and Cardiovascular Medicine, Ukraine, Pandemics, Delivery of Health Care, 10038 Institute of Clinical Chemistry
Abstract: International audience; The healthcare system of Ukraine was already suffering from several shortfalls before February 2022, but the war of aggression started by the Russian leadership is poised to inflict a further severe blow that will have long-lasting consequences for the health of all Ukrainians. In pre-war Ukraine, noncommunicable diseases (NCDs) contributed to 91% of deaths, especially cardiovascular diseases (67%). Ukrainians have a high prevalence of risk factors for NCDs ranking among the highest levels reported by the World Health Organization (WHO) in the European (EU) Region. Cardiovascular disease is one of the key health risks for the conflict-affected Ukrainian population due to significant limitations in access to health care and interruptions in the supply of medicines and resources. The excess mortality observed during the COVID-19 pandemic, due to a combination of viral illness and chronic disease states, is bound to increase exponentially from poorly treated NCDs. In this report, we discuss the impact of the war on the public health of Ukraine and potential interventions to provide remote health assistance to the Ukrainian population.
Published: 2022

44. Prognosis of Old Intensive Care COVID-19 Patients at a Glance: The Senior COVID Study

Author: Vacheron, C. H., Bitker, L., Thiolliere, F., Subtil, F., Ábrahám, P., Collange, V., Balança, B., Haine, M., Guichon, C., Leroy, C., Simon, M., Malapert, A., Roche, M., Pialat, J. B., Jallades, L., Lepape, A., Friggeri, A., Falandry, C., Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Pôle de Santé Publique [Lyon], Hôpital de la Croix-Rousse [CHU - HCL], Service d'anesthésie-réanimation [Centre Hospitalier Lyon Sud - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), 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), Hôpital Edouard Herriot [CHU - HCL], Université de Lyon, Médipôle Lyon-Villeurbanne (MLV), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Hôpital Nord-Ouest de Villefranche-sur-Saône [Gleize] (HNOVS), Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM ), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Centre Hospitalier Emile Roux [Le Puy-en-Velay] (CH Le Puy-en-Velay), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), 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), Hôpital Henry Gabrielle [CHU - HCL], 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), and CarMeN, laboratoire
Subjects: [SDV] Life Sciences [q-bio], Anesthesiology and Pain Medicine, General Veterinary, Ecology, [SDV]Life Sciences [q-bio], Animal Science and Zoology, Forestry, Surgery, Plant Science, Horticulture, General Agricultural and Biological Sciences, General Psychology
Abstract: International audience; OBJECTIVE: Admission in the intensive care unit of the old patient with coronavirus disease 19 raises an ethical question concerning the scarce resources and their short-term mortality. METHODS: Patients aged over 60 from 7 different intensive care units admitted between March 1, 2020 and May 6, 2020, with a diagnosis of coronavirus disease 19 were included in the cohort. Twenty variables were collected during the admission, such as age, severity (Simplified Acute Physiology Score [SAPS] II), several data on physiological status before intensive care unit comorbidities, evaluation of autonomy, frailty, and biological variables. The objective was to model the 30-day mortality with relevant variables, compute their odds ratio associated with their 95% CI, and produce a nomogram to easily estimate and communicate the 30-day mortality. The performance of the model was estimated with the area under the receiving operating curve. RESULTS: We included 231 patients, among them 60 (26.0%) patients have died on the 30th day. The relevant variables selected to explain the 30-day mortality were Instrumental Activities of Daily Living (IADL) score (0.82 [0.71-0.94]), age 1.12 (1.07-1.18), SAPS II 1.05 (1.02-1.08), and dementia 6.22 (1.00-38.58). A nomogram was computed to visually represent the final model. Area under the receiving operating curve was at 0.833 (0.776-0.889). CONCLUSIONS: Age, autonomy, dementia, and severity at admission were important predictive variables for the 30-day mortality status, and the nomogram could help the physician in the decision-making process and the communication with the family.
Published: 2022

45. Herpes Simplex Virus Encephalitis With Initial Negative Polymerase Chain Reaction in the Cerebrospinal Fluid: Prevalence, Associated Factors, and Clinical Impact

Author: Etienne, de Montmollin, Claire, Dupuis, Pierre, Jaquet, Benjamine, Sarton, Charline, Sazio, Vincent, Susset, Marie, Conrad, Laurent, Argaud, Sophie, Demeret, Jean Marc, Tadié, François, Barbier, Michel, Wolff, Jean-François, Timsit, Benoit, Visseaux, Romain, Sonneville, Guillaume, Franchineau, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Toulouse Neuro Imaging Center (ToNIC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, CHU Bordeaux [Bordeaux], Centre Hospitalier Métropole Savoie [Chambéry], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Service de Neurologie [CHU Pitié-Salpêtrière], IFR70-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 d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre Hospitalier Régional d'Orléans (CHRO), GHU Paris Psychiatrie et Neurosciences, Université Paris Cité (UPCité), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), ENCEPHALITICA Study Group: Julien Marechal, Bruno Mourvillier, Frederic Dailler, Fabrice Bruneel, Alexandre Lautrette, Emmanuel Novy, Bertrand Guidet, François Mateos, Clément Brault, Quentin Maestraggi, Keyvan Razazi, Jean-Pierre Quenot, Aurélie Joret, Albrice Levrat, Alexandre Massri, Alexandre Robert, Damien Contou, Jean-Paul Mira, Sarah Benghanem, Gaudry Stephane, Guillaume Voiriot, Asael Berger, Vincent Das, Nicolas Engrand, Martin Murgier, Shidasp Siami, Sami Hraiech, Eric Mariotte, Claire Ragot, Annabelle Stoclin, Pierre Trouiller, Mathieu Schmidt, Benjamin Rohaut, Guillaume Franchineau., CarMeN, laboratoire, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: [SDV] Life Sciences [q-bio], Critical Illness, [SDV]Life Sciences [q-bio], Prevalence, Acyclovir, Humans, Simplexvirus, Encephalitis, Herpes Simplex, Critical Care and Intensive Care Medicine, Polymerase Chain Reaction, Cerebrospinal Fluid
Abstract: International audience; OBJECTIVES: To describe the prevalence, associated factors, and clinical impact of an initial negative herpes simplex virus (HSV) polymerase chain reaction (PCR) in critically ill patients with PCR-proven HSV encephalitis. DESIGN: Retrospective multicenter study from 2007 to 2017. SETTING: Forty-seven French ICUs. PATIENTS: Critically ill patients admitted to the ICU with possible/probable acute encephalitis and a positive cerebrospinal fluid (CSF) PCR for HSV. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We included 273 patients with a median Glasgow Coma Scale score of 9 (6-12) at ICU admission. CSF HSV PCR was negative in 11 cases (4%), exclusively in lumbar punctures (LPs) performed less than 4 days after symptoms onset. Patients with an initial negative PCR presented with more frequent focal neurologic signs (4/11 [36.4%] vs 35/256 [13.7%]; p = 0.04) and lower CSF leukocytosis (4 cells/mm3 [3-25 cells/mm3] vs 52 cells/mm3 [12-160 cells/mm3]; p \textless 0.01). An initial negative PCR was associated with an increased delay between LP and acyclovir treatment (3 d [2-7 ] vs 0 d [0-0 d]; p \textless 0.01) and was independently associated with a poor neurologic outcome at hospital discharge (modified Rankin Scale score ≥ 4) (adjusted odds ratio, 9.89; 95% CI, 1.18-82.78). CONCLUSIONS: In severe herpes simplex encephalitis, initial negative CSF HSV PCR occurred in 4% of cases and was independently associated with worse neurologic outcome at hospital discharge. In these patients, a systematic multimodal diagnostic approach including early brain MRI and EEG will help clinicians avoid delayed acyclovir initiation or early inappropriate discontinuation.
Published: 2022

46. European Neuroendocrine Tumor Society (ENETS) 2022 Guidance Paper for Carcinoid Syndrome and Carcinoid Heart Disease

Author: Simona Grozinsky‐Glasberg, Joseph Davar, Johannes Hofland, Rebecca Dobson, Vikas Prasad, Andreas Pascher, Timm Denecke, Margot E. T. Tesselaar, Francesco Panzuto, Anders Albåge, Heidi M. Connolly, Jean‐Francois Obadia, Rachel Riechelmann, Christos Toumpanakis, Internal Medicine, CarMeN, laboratoire, The Hebrew University of Jerusalem (HUJ), Royal Free Hospital [London, UK], University College of London [London] (UCL), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Liverpool Heart and Chest Hospital NHS Trust [UK] (LH&CH), Universität Ulm - Ulm University [Ulm, Allemagne], University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), University Hospital Leipzig, Netherlands Cancer Institute (NKI), Antoni van Leeuwenhoek Hospital, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Uppsala University, Mayo Clinic [Rochester], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), and AC Camargo Cancer Center [São Paulo, Brazil] (AC3C)
Subjects: Neuroendocrine Tumors/complications/diagnosis/pathology, Endocrine and Autonomic Systems, Endocrinology, Diabetes and Metabolism, [SDV]Life Sciences [q-bio], carcinoid hearth disease, Carcinoid Heart Disease, carcinoid syndrome, Endocrinology and Diabetes, [SDV] Life Sciences [q-bio], Cellular and Molecular Neuroscience, neuroendocrine tumors, Endocrinology, SDG 3 - Good Health and Well-being, Endokrinologi och diabetes, Humans
Abstract: International audience; No abstract available
Published: 2022

47. Lenin's Stroke

Author: Laura Mechtouff, Tae-Hee Cho, Norbert Nighoghossian, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Hospices Civils de Lyon (HCL), and CarMeN, laboratoire
Subjects: medicine.medical_specialty, business.industry, Ischemic strokes, [SDV]Life Sciences [q-bio], Autopsy, medicine.disease, Atherosclerosis, 3. Good health, Neurosyphilis, [SDV] Life Sciences [q-bio], Stroke, 03 medical and health sciences, Health problems, 0302 clinical medicine, Bolchevik leader, Medicine, Neurology. Diseases of the nervous system, 030212 general & internal medicine, Neurology (clinical), RC346-429, business, Intensive care medicine, 030217 neurology & neurosurgery, Single Case − General Neurology
Abstract: International audience; Lenin's stroke remains a matter of debate. Here, we propose to assess the potential mechanisms. Lenin died on January 21, 1924 at the age of 53 years. Although some doctors suggested that the origin of his health problems was neurosyphilis, the autopsy findings were consistent with a severe atherosclerosis. This process might account for his recurrent ischemic strokes. In view of the family vascular history, an early hereditary atherosclerosis may be proposed.
Published: 2021

48. Comparison of two delayed strategies for renal replacement therapy initiation for severe acute kidney injury (AKIKI 2): a multicentre, open-label, randomised, controlled trial

Author: Nicolas de Prost, Saber Barbar, Stéphane Gaudry, Jean-Pierre Quenot, Christophe Vinsonneau, Laurent Argaud, Eric Boulet, Didier Thevenin, Didier Dreyfuss, Marion Beuzelin, Adrien Robine, Cyril Cadoz, Steven Grangé, Béatrice La Combe, Dimitri Titeca-Beauport, Julien Mayaux, Julio Badie, Saad Nseir, Guillaume Chevrel, Karim Asehnoune, Florent Poirson, Kada Klouche, Sébastien Moschietto, Guillaume Louis, Guillaume Thiery, Marc Leone, David Hajage, Pascal Andreu, Elisabeth Coupez, Bertrand Pons, Said Lebbah, Jean-Damien Ricard, Jean-Marie Forel, Laurent Martin-Lefevre, Julien Bohé, Guillaume Geri, Sébastien Besset, Karim Lakhal, Nicolas Chudeau, Alain Combes, Bertrand Rozec, Nadia Aissaoui, Guillaume Lacave, Jean Reignier, CarMeN, laboratoire, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), UFR Santé, Médecine et Biologie Humaine (UFR SMBH), Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Centre de Pharmacoépidémiologie de l'AP-HP (Cephepi), 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), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Laboratoire Informatique, Image et Interaction - EA 2118 (L3I), La Rochelle Université (ULR), Centre Hospitalier Henri Duffaut (Avignon), CHU Amiens-Picardie, Université de Bretagne Sud - Lorient (UBS Lorient), Université de Bretagne Sud (UBS), Centre d'Etudes Lasers Intenses et Applications (CELIA), Université de Bordeaux (UB)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS), Hôpital Henri Mondor, Laboratoire Sciences Analytiques, Bioanalytiques, et Miniaturisation (LSABM), Chimie-Biologie-Innovation (UMR 8231) (CBI), Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier de Dieppe, CH Belfort-Montbéliard, Centre Hospitalier Sud Francilien, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Centre Hospitalier Le Mans (CH Le Mans), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Assistance Publique - Hôpitaux de Marseille (APHM), Centre Hospitalier de Lens, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), 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), Géomécanique, Matériaux et Structures (GEOMAS), 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), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Centre Hospitalier de Versailles André Mignot (CHV), Centre d'Investigation Clinique - Innovation Technologique de Lille - CIC 1403 - CIC 9301 (CIC Lille), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Ambroise Paré [AP-HP], 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 Saint-Etienne (CHU de Saint-Etienne), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Service de Réanimation Médicale (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Louis Mourier - AP-HP [Colombes], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Programme Hospitalier de Recherche Clinique., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon, Université de La Rochelle (ULR), Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Bordeaux (UB), Laboratoire de Tribologie et Dynamique des Systèmes (LTDS), École Centrale de Lyon (ECL), Université de Lyon-Université de Lyon-École Nationale des Travaux Publics de l'État (ENTPE)-Ecole Nationale d'Ingénieurs de Saint Etienne-Centre National de la Recherche Scientifique (CNRS), Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Centre Hospitalier Fleyriat [Bourg en Bresse], Centre Hospitalier Sud Francilien [Corbeil-Essonnes] (CH Sud Francilien), Centre Hospitalier de Béthune Beuvry (CH Béthune Beuvry), Hôpital Nord [CHU - APHM], GH Carnelle Portes de l'Oise, Hôpital Lapeyronie [Montpellier] (CHU), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord
Subjects: medicine.medical_specialty, MESH: Acute Kidney Injury, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Population, 030204 cardiovascular system & hematology, urologic and male genital diseases, MESH: Severity of Illnes Index, 03 medical and health sciences, MESH: Aged, 80 and over, 0302 clinical medicine, Oliguria, Intensive care, Internal medicine, Medicine, MESH: Time-to-Treatment, 030212 general & internal medicine, Renal replacement therapy, education, Blood urea nitrogen, MESH: Aged, education.field_of_study, MESH: Humans, MESH: Middle Aged, business.industry, Hazard ratio, Acute kidney injury, General Medicine, medicine.disease, MESH: Male, MESH: Prospective Studies, 3. Good health, [SDV] Life Sciences [q-bio], MESH: France, MESH: Intensive Care Units, medicine.symptom, MESH: Renal Remplacement Therapy, business, MESH: Female, Kidney disease
Abstract: International audience; BACKGROUND: Delaying renal replacement therapy (RRT) for some time in critically ill patients with severe acute kidney injury and no severe complication is safe and allows optimisation of the use of medical devices. Major uncertainty remains concerning the duration for which RRT can be postponed without risk. Our aim was to test the hypothesis that a more-delayed initiation strategy would result in more RRT-free days, compared with a delayed strategy. METHODS: This was an unmasked, multicentre, prospective, open-label, randomised, controlled trial done in 39 intensive care units in France. We monitored critically ill patients with severe acute kidney injury (defined as Kidney Disease: Improving Global Outcomes stage 3) until they had oliguria for more than 72 h or a blood urea nitrogen concentration higher than 112 mg/dL. Patients were then randomly assigned (1:1) to either a strategy (delayed strategy) in which RRT was started just after randomisation or to a more-delayed strategy. With the more-delayed strategy, RRT initiation was postponed until mandatory indication (noticeable hyperkalaemia or metabolic acidosis or pulmonary oedema) or until blood urea nitrogen concentration reached 140 mg/dL. The primary outcome was the number of days alive and free of RRT between randomisation and day 28 and was done in the intention-to-treat population. The study is registered with ClinicalTrial.gov, NCT03396757 and is completed. FINDINGS: Between May 7, 2018, and Oct 11, 2019, of 5336 patients assessed, 278 patients underwent randomisation; 137 were assigned to the delayed strategy and 141 to the more-delayed strategy. The number of complications potentially related to acute kidney injury or to RRT were similar between groups. The median number of RRT-free days was 12 days (IQR 0-25) in the delayed strategy and 10 days (IQR 0-24) in the more-delayed strategy (p=0·93). In a multivariable analysis, the hazard ratio for death at 60 days was 1·65 (95% CI 1·09-2·50, p=0·018) with the more-delayed versus the delayed strategy. The number of complications potentially related to acute kidney injury or renal replacement therapy did not differ between groups. INTERPRETATION: In severe acute kidney injury patients with oliguria for more than 72 h or blood urea nitrogen concentration higher than 112 mg/dL and no severe complication that would mandate immediate RRT, longer postponing of RRT initiation did not confer additional benefit and was associated with potential harm. FUNDING: Programme Hospitalier de Recherche Clinique.
Published: 2021

49. The very last dance of unconjugated p-cresol… historical artefact of uraemic research

Author: Laetitia Koppe, Christophe O. Soulage, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), and CarMeN, laboratoire
Subjects: Transplantation, Artifact (error), Dance, business.industry, cardiovascular, [SDV]Life Sciences [q-bio], uremic toxins, Physiology, [SDV] Life Sciences [q-bio], p-cresol, EuTOX, Nephrology, Ckd, Uremic toxins, Medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; No abstract available
Published: 2021

50. Prognosis After Percutaneous Foramen Ovale Closure Among Patients With Platypnea-Orthodeoxia Syndrome

Author: Gilles Rioufol, Ahmad Hayek, R. Rossi, Nathan Mewton, François Derimay, Eric Bonnefoy-Cudraz, Alexandre Paccalet, Hélène Thibault, Thomas Bochaton, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: Male, Cardiac Catheterization, medicine.medical_specialty, Percutaneous, Septal Occluder Device, [SDV]Life Sciences [q-bio], Foramen Ovale, Patent, Prosthesis Implantation, Postoperative Complications, medicine, Humans, Mortality, Hypoxia, Platypnea orthodeoxia, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, business.industry, Surgery, [SDV] Life Sciences [q-bio], Outcome and Process Assessment, Health Care, Standing Position, Foramen ovale closure, Female, France, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; No abstract available
Published: 2021

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