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1. Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment in schizophrenia: results from the multicenter FACE-SZ cohort

Author

Nathan Vidal, Paul Roux, Mathieu Urbach, Cristobal Belmonte, Laurent Boyer, Delphine Capdevielle, Julie Clauss-Kobayashi, Thierry D’Amato, Romane Dassing, Caroline Dubertret, Julien Dubreucq, Guillaume Fond, Roxana-Mihaela Honciuc, Sylvain Leignier, Pierre-Michel Llorca, Jasmina Mallet, David Misdrahi, Baptiste Pignon, Romain Rey, Franck Schürhoff, Arnaud Tessier, the FACE-SZ (FondaMental Academic Centers of Expertise—Schizophrenia) Group, Christine Passerieux, Eric Brunet-Gouet, B. Aouizerate, V. Barteau, S. Bensalem, F. Berna, O. Blanc, E. Bourguignon, L. Boyer, D. CapdevielleI. Chéreau, G. Chesnoy-Servanin, T. D’Amato, A. Deloge, H. Denizot, JM. Dorey, C. Dubertret, J. Dubreucq, S. Esselin, C. Faget, C. Fluttaz, G. Fond, F. Gabayet, O. Godin, E. Haffen, RM. Honciuc, M. Jarroir, D. Lacelle, C. Lançon, H. Laouamri, M. Leboyer, PM Llorca, J. Mallet, E. Metairie, D. Misdrahi, C. Passerieux, J. Petrucci, P. Peri, B. Pignon, S. Pires, C. Portalier, R. Rey, C. Roman, F. Schürhoff, K. Souryis, A. Szöke, M. Urbach, F. Vaillant, A, Vehier, P. Vidailhet, E. Vilà, G. Wahiche, H. Yazbek, and A. Zinetti-Bertschy

Subjects
neuropsychological test, schizophrenia, cholinergic antagonist, psychotropic drug, polypharmacy, Therapeutics. Pharmacology, RM1-950
Abstract

AimThe anticholinergic properties of medications are associated with poorer cognitive performance in schizophrenia. Numerous scales have been developed to assess anticholinergic burden and yet, there is no consensus indicating which anticholinergic burden scale is more relevant for patients with schizophrenia. We aimed to identify valid scales for estimating the risk of iatrogenic cognitive impairment in schizophrenia.MethodsWe identified 27 scales in a literature review. The responses to neuropsychological tests of 839 individuals with schizophrenia or schizoaffective disorder in the FACE-SZ database were collected between 2010 and 2021. We estimated the association between objective global cognitive performance and the 27 scales, the number of psychotropic drugs, and chlorpromazine and lorazepam equivalents in bivariable regressions in a cross-sectional design. We then adjusted the bivariable models with covariates: the predictors significantly associated with cognitive performance in multiple linear regressions were considered to have good concurrent validity to assess cognitive performance.ResultsEight scales, the number of psychotropic drugs, and drug equivalents were significantly associated with cognitive impairment. The number of psychotropic drugs, the most convenient predictor to compute, was associated with worse executive function (Standardized β = −0.12, p = .004) and reasoning (Standardized β = −0.08, p = .037).ConclusionAnticholinergic burden, the number of psychotropic drugs, and drug equivalents were weakly associated with cognition, thus suggesting that cognitive impairment in schizophrenia and schizoaffective disorder is explained by factors other than medication. The number of psychotropic drugs was the most parsimonious method to assess the risk of iatrogenic cognitive impairment.

Published
2024
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2. Immuno-metabolic profile of patients with psychotic disorders and metabolic syndrome. Results from the FACE-SZ cohort

Author

Marianne Foiselle, Susana Barbosa, Ophélia Godin, Ching-Lien Wu, Wahid Boukouaci, Myrtille Andre, Bruno Aouizerate, Fabrice Berna, Caroline Barau, Delphine Capdevielle, Pierre Vidailhet, Isabelle Chereau, Laetitia Davidovic, Jean-Michel Dorey, Caroline Dubertret, Julien Dubreucq, Catherine Faget, Guillaume Fond, Sylvain Leigner, Pierre-Michel Llorca, Jasmina Mallet, David Misdrahi, Emanuela Martinuzzi, Christine Passerieux, Romain Rey, Baptiste Pignon, Mathieu Urbach, Franck Schürhoff, Nicolas Glaichenhaus, Marion Leboyer, Ryad Tamouza, F. Berna, E. Haffen, M. Leboyer, P.M. Llorca, F. Schürhoff, V. Barteau, S. Bensalem, O. Godin, H. Laouamri, K. Souryis, I. Offerlin-Meyer, B. Pignon, A. Szöke, B. Aouizerate, A. Deloge, D. Misdrahi, E. Vilà, O. Blanc, I. Chéreau, H. Denizot, R.M. Honciuc, D. Lacelle, S. Pires, C. Dubertret, J. Mallet, C. Portalier, J. Dubreucq, C. Fluttaz, F. Gabayet, C. Roman, G. Chesnoy-Servanin, T. D'Amato, J.M. Dorey, R. Rey, A. Vehier, C. Lançon, C. Faget, E. Metairie, P. Peri, F. Vaillant, L. Boyer, G. Fond, P. Vidailhet, A. Zinetti-Bertschy, D. Capdevielle, H. Yazbek, S. Esselin, M. Jarroir, C. Passerieux, and M. Urbach

Subjects
Metabolic syndrome, Schizophrenia, Psychosis, Inflammation, Machine learning, Precision medicine, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Background: Metabolic syndrome (MetS) is a highly prevalent and harmful medical disorder often comorbid with psychosis where it can contribute to cardiovascular complications. As immune dysfunction is a key shared component of both MetS and schizophrenia (SZ), this study investigated the relationship between immune alterations and MetS in patients with SZ, whilst controlling the impact of confounding clinical characteristics including psychiatric symptoms and comorbidities, history of childhood maltreatment and psychotropic treatments. Method: A total of 310 patients meeting DSM-IV criteria for SZ or schizoaffective disorders (SZA), with or without MetS, were systematically assessed and included in the FondaMental Advanced Centers of Expertise for Schizophrenia (FACE-SZ) cohort. Detailed clinical characteristics of patients, including psychotic symptomatology, psychiatric comorbidities and history of childhood maltreatment were recorded and the serum levels of 18 cytokines were measured. A penalized regression method was performed to analyze associations between inflammation and MetS, whilst controlling for confounding factors. Results: Of the total sample, 25% of patients had MetS. Eight cytokines were above the lower limit of detection (LLOD) in more than 90% of the samples and retained in downstream analysis. Using a conservative Variable Inclusion Probability (VIP) of 75%, we found that elevated levels of interleukin (IL)-6, IL-7, IL-12/23 p40 and IL-16 and lower levels of tumor necrosis factor (TNF)-α were associated with MetS. As for clinical variables, age, sex, body mass index (BMI), diagnosis of SZ (not SZA), age at the first episode of psychosis (FEP), alcohol abuse, current tobacco smoking, and treatment with antidepressants and anxiolytics were all associated with MetS. Conclusion: We have identified five cytokines associated with MetS in SZ suggesting that patients with psychotic disorders and MetS are characterized by a specific “immuno-metabolic” profile. This may help to design tailored treatments for this subgroup of patients with both psychotic disorders and MetS, taking one more step towards precision medicine in psychiatry.

Published
2022
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3. Integration of Behavioral Economic Models to Optimize ML performance and interpretability: a sandbox example

Author

Soria-Olivas, Emilio, Gisbert, José E. Vila, Cardeñosa, Regino Barranquero, and Gomez, Yolanda

Subjects
Economics - Theoretical Economics
Abstract

This paper presents a sandbox example of how the integration of models borrowed from Behavioral Economic (specifically Protection-Motivation Theory) into ML algorithms (specifically Bayesian Networks) can improve the performance and interpretability of ML algorithms when applied to Behavioral Data. The integration of Behavioral Economics knowledge to define the architecture of the Bayesian Network increases the accuracy of the predictions in 11 percentage points. Moreover, it simplifies the training process, making unnecessary training computational efforts to identify the optimal structure of the Bayesian Network. Finally, it improves the explicability of the algorithm, avoiding illogical relations among variables that are not supported by previous behavioral cybersecurity literature. Although preliminary and limited to 0ne simple model trained with a small dataset, our results suggest that the integration of behavioral economics and complex ML models may open a promising strategy to improve the predictive power, training costs and explicability of complex ML models. This integration will contribute to solve the scientific issue of ML exhaustion problem and to create a new ML technology with relevant scientific, technological and market implications.

Published
2022

5. Anesthetic considerations in placement of brain electrodes for anorexia surgery

Author

E. Vilà, S. Pacreu, Luis Moltó, and J.L. Fernández Candil

Subjects
medicine.medical_specialty, Anesthesiology and Pain Medicine, Text mining, business.industry, Anesthetic, medicine, Anorexia, medicine.symptom, Critical Care and Intensive Care Medicine, business, medicine.drug, Surgery
Published
2022

6. Effect of dexmedetomidine on evoked‐potential monitoring in patients undergoing brain stem and supratentorial cranial surgery

Author

E. Vilà, Alba León, Beatriz Fort, S. Pacreu, Luis Moltó, Juan Luis Fernández-Candil, and Yiyang Lin

Subjects
medicine.medical_treatment, Remifentanil, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, 030202 anesthesiology, Evoked Potentials, Somatosensory, medicine, Humans, In patient, Prospective Studies, Dexmedetomidine, Evoked potential, Propofol, Saline, business.industry, 030208 emergency & critical care medicine, General Medicine, Anesthesiology and Pain Medicine, Somatosensory evoked potential, Anesthesia, business, Brain Stem, medicine.drug, Intraoperative neurophysiological monitoring
Abstract

Background Dexmedetomidine is used as adjuvant in total intravenous anaesthesia (TIVA), but there have been few studies concerning its effect on intraoperative neurophysiological monitoring (IONM) during cranial surgery. Our aim was to study the effect of dexmedetomidine on IONM in patients undergoing brain stem and supratentorial cranial surgery. Methods Two prospective, randomized, double-blind substudies were conducted. In substudy 1, during TIVA with an infusion of propofol and remifentanil, 10 patients received saline solution (SS) (PR group) and another 10 (PRD group) received dexmedetomidine (0.5 mcg/kg/h). Total dosage of propofol and remifentanil, intensity, latency and amplitude of motor-evoked potentials following transcranial electrical stimulation (tcMEPs) as well as somatosensory-evoked potentials (SSEP) were recorded at baseline, 15, 30, 45 minutes, and at the end of surgery. In order to identify differences in the same patient after dexmedetomidine administration, we designed substudy 2 with 20 new patients randomized to two groups. After 30 minutes with TIVA, 10 patients received dexmedetomidine (0.5 mcg/kg/h) and 10 patients SS. The same variables were recorded. Results In substudy 1, propofol requirements were significantly lower (P = .004) and tcMEP intensity at the end of surgery was significantly higher in PRD group, but no statistically significant differences were observed for remifentanil requirements, SSEP and tcMEP latency or amplitude. In substudy 2, no differences in any of the variables were identified. Conclusions The administration of dexmedetomidine at a dosage of 0.5 mg/kg/h may reduce propofol requirements and adversely affect some neuromonitoring variables. However, it can be an alternative on IONM during cranial surgeries. REDEX EudraCT: 2014-000962-23.

Published
2021

7. Evaluation of the density spectral array in the Wada test: report of six cases

Author

S. Pacreu, Rodrigo Rocamora, Luis Moltó, Juan Luis Fernández-Candil, and E. Vilà

Subjects
medicine.medical_specialty, Amobarbital, Amnesia, Alpha wave, Alpha waves, Loss of consciousness, Epilepsy, Anesthesiology, medicine.artery, medicine, Epilepsy surgery, RD78.3-87.3, medicine.diagnostic_test, business.industry, General Medicine, medicine.disease, Density spectral array, Bispectral index, Wada test, Radiology, Internal carotid artery, medicine.symptom, business, medicine.drug
Abstract

Wada test is an invasive procedure used in the preoperative evaluation for epilepsy surgery to determine language lateralization, postoperative risk of amnesia syndrome, and to assess the risk of memory deficits. It involves injection of amobarbital into internal carotid artery of the affected hemisphere followed by the healthy hemisphere to shut down brain function. We performed an observational study evaluating the density spectral array (DSA) of the bilateral bispectral index VISTA™ Monitoring System (BVMS) in 6 patients with drug-resistant epilepsy undergoing Wada test. DSA revealed the presence of bifrontal alpha waves in absence of loss of consciousness in all patients.

Published
2021

8. A multi-dimensional approach to the relationship between insight and aggressiveness in schizophrenia: Findings from the FACE-SZ cohort

Author

A. Schandrin, J. Norton, S. Raffard, B. Aouizerate, F. Berna, L. Brunel, I. Chereau-Boudet, T. D'Amato, H. Denizot, C. Dubertret, J. Dubreucq, C. Faget, G. Fond, F. Gabayet, P.M. Llorca, J. Mallet, D. Misdrahi, C. Passerieux, R. Rey, F. Schurhoff, M. Urbach, S. Bonnet, D. Capdevielle, M. Andrianarisoa, N. Bazin, O. Blanc, E. Bulzacka, G. Chesnoy-Servanin, J.M. Danion, A. Deloge, C. Delorme, J.M. Dorey, C. Fluttaz, S. Fonteneau, E. Giraud-Baro, D. Lacelle, C. Lançon, H. Laouamri, M. Leboyer, T. Le Gloahec, Y. Le Strat, E. Metairie, I. Offerlin-Meyer, P. Peri, S. Pires, C. Portalier, L. Ramet, L. Rey, C. Roman, F. Schürhoff, A. Tessier, A.M. Tronche, F. Vaillant, A. Vehier, P. Vidailhet, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Université Montpellier 1 (UM1), Fondation FondaMental [Créteil], Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) (FEMTO-ST), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut Européen des membranes (IEM), Université de Montpellier (UM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Centre National de la Recherche Scientifique (CNRS), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Clermont-Ferrand-Université d'Auvergne - Clermont-Ferrand I (UdA), Psychopathologie et pharmacologie de la cognition, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier le Vinatier [Bron], Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA), Mécanique des Fluides, Energies et Environnement (EDF R&D MFEE), EDF R&D (EDF R&D), EDF (EDF)-EDF (EDF), Aix Marseille Université (AMU), Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Génétique moléculaire de la neurotransmission et des processus neurodégénératifs (LGMNPN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Astrophysique Interprétation Modélisation (AIM (UMR_7158 / UMR_E_9005 / UM_112)), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Universitaire [Grenoble] (CHU), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), CCSD, Accord Elsevier, Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital de la Colombière, Centre hospitalier Charles Perrens [Bordeaux], Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale (U1215 Inserm - UB), Université de Bordeaux (UB)-Institut François Magendie-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, CHU Strasbourg, Pôle de psychiatrie et d'addictologie des Hôpitaux Universitaires Henri-Mondor [Créteil], Centre hospitalier universitaire Henri-Mondor [Créteil], CHU Clermont-Ferrand, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Référent de Réhabilitation Psychosociale [CH Alpes Isère], Centre Hospitalier Alpes Isère, Centre Hospitalier de Versailles André Mignot (CHV), Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur (HANDIReSP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Montpellier (UM), FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) group: M Andrianarisoa 16 , B Aouizerate 17 , N Bazin 18 , F Berna 19 , O Blanc 20 , L Brunel 16 , E Bulzacka 16 , D Capdevielle 21 , I Chereau-Boudet 20 , G Chesnoy-Servanin 22 , J M Danion 19 , T D'Amato 22 , A Deloge 23 , C Delorme 24 , H Denizot 20 , J M Dorey 22 , C Dubertret 25 , J Dubreucq 24 , C Faget 26 , C Fluttaz 24 , G Fond 27 , S Fonteneau 18 , F Gabayet 24 , E Giraud-Baro 24 , D Lacelle 20 , C Lançon 26 , H Laouamri 27 , M Leboyer 16 , T Le Gloahec 16 , Y Le Strat 25 , P M Llorca 20 , J Mallet 25 , E Metairie 26 , D Misdrahi 23 , I Offerlin-Meyer 19 , C Passerieux 18 , P Peri 26 , S Pires 20 , C Portalier 25 , L Ramet 18 , L Rey 22 , C Roman 24 , A Schandrin 28 , F Schürhoff 16 , A Tessier 23 , A M Tronche 20 , M Urbach 18 , F Vaillant 26 , A Vehier 22 , P Vidailhet 19 , E Vilà 23 , H Yazbek 21 , A Zinetti-Bertschy 19, Hôpital Charles Perrens, Université de Franche-Comté (UFC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Technologie de Belfort-Montbeliard (UTBM), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Université d'Auvergne - Clermont-Ferrand I (UdA)-CHU Clermont-Ferrand, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie de la Plasticité Neuronale (Neurocentre Magendie - U1215 Inserm), and Centre de Psychiatrie et Neurosciences (U894)

Subjects
Adult, Male, Adolescent, media_common.quotation_subject, [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Hostility, Anger, Cohort Studies, Diagnostic Self Evaluation, Young Adult, 03 medical and health sciences, Aggressiveness, 0302 clinical medicine, medicine, Humans, Spectrum disorder, ComputingMilieux_MISCELLANEOUS, Biological Psychiatry, media_common, Aggression, Middle Aged, Awareness, 030227 psychiatry, 3. Good health, Psychiatry and Mental health, Psychotic Disorders, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Cohort, Schizophrenia, Multi dimensional, Female, medicine.symptom, Insight, Psychology, 030217 neurology & neurosurgery, Diagnosis of schizophrenia, Clinical psychology
Abstract

International audience; Background: Aggressiveness is a stigma frequently associated with schizophrenia. The role of insight as a risk factor of aggressiveness remains contradictory; mainly because single measures of these states mask their complexity and heterogeneity.Methods: This study was conducted on 666 patients aged 15 and above with a DSM-IV-TR diagnosis of schizophrenia spectrum disorder, drawn from the French national network of schizophrenia expert center database. Collected data comprised socio-demographics and standardized psychiatric assessments. Aggressiveness was evaluated using the Buss-Perry Aggression Questionnaire and insight using the Scale to assess Unawareness of Mental Disorder (SUMD) and Birchwood Insight Scale (BIS).Results: Hostility was the aggressiveness dimension the most strongly associated with SUMD insight dimensions. Patients aware of their illness were nearly twice as likely to show hostility than those seriously unaware (OR = 1.95, 95% CI.: 1.08-3.5), but not when further adjusting for depression. Similarly, those aware of the consequences of their illness and of their symptoms were more hostile. Patients moderately aware of illness consequences had a higher risk of both anger and physical aggressiveness than those unaware (OR = 2.63, 95% CI.: 1.42-4.86, OR = 2.47, 95% CI.: 1.33-4.60, respectively), even when adjusting for depression for anger.Conclusion: Our study confirms that a multi-dimensional approach to insight and aggressiveness is essential to understand the types of links between these clinical states. Insight may trigger the expression of an underlying hostile tendency, maybe via depression and self-stigmatisation. This should be taken into account in therapeutic approaches to improve insight.

Published
2019

9. Density spectral array during the intra and postoperative of a left frontal craniotomy

Author

Juan Luis Fernández-Candil, S. Pacreu, E. Vilà, Irina Adalid, and Luis Moltó

Subjects
medicine.diagnostic_test, Brain activity and meditation, business.industry, medicine.medical_treatment, Monitoring system, Electroencephalography, Critical Care and Intensive Care Medicine, medicine.disease, Lateralization of brain function, Resection, Meningioma, Anesthesiology and Pain Medicine, Bispectral index, medicine, Nuclear medicine, business, Craniotomy
Abstract

We present the case of an adult with an extensive left frontal meningioma. He was scheduled for resection by craniotomy. During the surgery we used the density spectral array (DSA) and asymmetry obtained from Bispectral Index VISTA Monitoring System Bilateral. We observed a power increase in low frequency (0.1-1 Hz) and alpha bands (8-12 Hz) in the left hemisphere, where the meningioma was located. In this case, DSA was useful during and after the surgery because it provided information about the hemisphere with maximum brain activity and its subsequent normalization, which may reflect the effectiveness of the surgery.

Published
2019

10. Efectividad del uso de ketamina perioperatoria en pacientes sometidos a cirugía de raquis en tratamiento crónico con opioides

Author

E. Vilà Barriuso, L. Trillo Urrutia, M Soldevilla García, J. García Álvarez, and U Rodríguez Rivas

Subjects
business.industry, Opioid consumption, Analgesic, Surgical wound, postoperatorio, espinal, Dexketoprofen, cirugía, Anesthesiology and Pain Medicine, Anesthesia, medicine, Ketamine, Tramadol, Bolus (digestion), Dolor, business, medicine.drug, Dolor postoperatorio, ketamina
Abstract

espanolIntroduccion: El numero de pacientes en tratamiento con opioides de forma cronica sometidos a una cirugia espinal ha aumentado en los ultimos anos. Los registros de dolor mediante la escala visual analogica (EVA) y el consumo de opioides durante el postoperatorio son mas elevados en esta clase de pacientes. Material y metodos: Siguiendo las recomendaciones de la American Pain Society (APS), en 2018 se diseno un nuevo protocolo analgesico intra y postoperatorio basado en el uso de ketamina. En el intraoperatorio, se administro un bolus de 0,5 mg/kg de ketamina, seguido por una perfusion a dosis de 0,2 mg/kg/h hasta el cierre de la herida. Durante las 48 horas postoperatorias, se mantuvo una bomba de analgesia controlada por el paciente (PCA) de morfina-ketamina junto con un regimen de analgesia multimodal con paracetamol y dexketoprofeno. Se realizo un analisis de la efectividad del nuevo protocolo (grupo ketamina) comparandolo con el protocolo seguido el ano anterior (grupo control), basado en el uso de tramadol 100 mg/6 h o PCA de morfina. Se analizaron los registros de dolor mediante la escala verbal numerica (EVN) durante las primeras 48 horas postoperatorias, la necesidad de administracion de bolus puntuales de morfina y la necesidad de iniciar una perfusion continua de morfina (grupo control) o morfina ketamina (grupo ketamina). Resultados: Los pacientes del grupo ketamina presentaron EVN inferiores a los del grupo control durante las dos primeras horas postoperatorias (p = 0,001) y menores necesidades de rescates de morfina en el segundo dia postoperatorio (p = 0,003). La necesidad de perfusion continua de morfina-ketamina fue significativamente inferior a la necesidad de inicio de perfusion continua de morfina en el grupo control (p = 0,011). Conclusion: El protocolo basado en el uso de ketamina consiguio mejorar el control del dolor postoperatorio y reducir de forma significativa el consumo de opioides en las primeras 48 horas tras la intervencion. EnglishIntroduction: The number of patients receiving chronic opioids undergoing spinal surgery has increased lately. Elevate records in visual analog scale (VAS) and opioid consumption are higher in this group of patients. Material and methods: Following the recommendations of the American Pain Society (APS), a new intra and postoperative analgesic protocol based on the use of ketamine was designed in 2018. Intraoperatively, a bolus of 0.5 mg/kg of ketamine was administered, followed by a dose infusion of 0.2 mg/kg/h until the surgical wound was closed. During the first 48 postoperative hours, a patient-controlled analgesia pump (PCA) of morphine-ketamine was maintained along with a multimodal analgesia regimen with paracetamol and dexketoprofen. An effectiveness analysis comparing the new protocol (ketamine group) with the previous one (control group), based on the use of tramadol 100 mg / 6h or PCA morphine, was done. During the first 48 postoperative hours, NVS records, need of rescue analgesia, morphine bolus or continuous morphine infusion (control group) or ketamine morphine infusion (ketamine group) were analyzed. Results: The patients in the ketamine group had lower NVS records than those in the control group during the first two postoperative hours (p = 0.001) and lower morphine rescues needs on the second postoperative day (p = 0.003). The need for continuous morphine-ketamine perfusion was significantly lower than the need for continuous morphine perfusion on the control group (p = 0.011). Conclusion: The protocol based on the use of ketamine, managed to improve the control of postoperative pain and significantly reduce the consumption of opioids in the first 48 hours after the intervention.

Published
2021

11. Immune Signatures of Treatment-Resistant Schizophrenia: A FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) Study

Author

Guillaume Fond, Philippe Le Corvoisier, F Schürhoff, A Szöke, Face-Sz Groups, I Offerlin-Meyer, Ryad Tamouza, T D′Amato, I Chéreau, J Dubreucq, E Vilà, F Gabayet, Julien Dubreucq, C Fluttaz, Wahid Boukouaci, D Misdrahi, P Vidailhet, David Misdrahi, J Mallet, B Pignon, Caroline Barau, A Vehier, C Lançon, Myrtille André, Jasmina Mallet, Baptiste Pignon, H Yazbek, Julie Clauss-Kobayashi, Christine Passerieux, J M Dorey, Caroline Dubertret, Sylvain Leignier, K Souryis, P Peri, Isabelle Chereau, F Berna, O Blanc, G Chesnoy-Servanin, S Pires, D Lacelle, A Deloge, Franck Schürhoff, Hakim Laouamri, P M Llorca, O Godin, Bruno Aouizerate, C. Portalier, Pierre-Michel Llorca, R Rey, A Zinetti-Bertschy, H Denizot, Mathieu Urbach, M Jarroir, V Barteau, C Roman, B Aouizerate, C Passerieux, S Esselin, R M Honciuc, C Dubertret, Christophe Lançon, H. Laouamri, F Vaillant, Andrei Szöke, E Metairie, Marion Leboyer, Ching-lieng Lu, M Urbach, Fabrice Berna, C Faget, Romain Rey, Ophélia Godin, E Haffen, M Leboyer, D Capdevielle, Delphine Capdevielle, Thierry D′Amato, S Bensalem, and Emilie Terro

Subjects
profile, medicine.medical_specialty, AcademicSubjects/MED00800, clozapine, Positive and Negative Syndrome Scale, immuno-inflammatory, Schizophrenia (object-oriented programming), treatment-resistant, 030227 psychiatry, schizophrenia, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Immune system, signatures, medicine, Treatment resistant schizophrenia, Psychology, Psychiatry, 030217 neurology & neurosurgery, Clozapine, Regular Articles, medicine.drug
Abstract

Treatment-resistant schizophrenia (TRS) affects around 30% of patients with schizophrenia (SZ) resulting in poor functioning, relapses, and reduced quality of life. Convergent findings show that inflammation could contribute to resistance. We thus search for immune signatures of patients with TRS/ultra TRS (UTRS) in a sample of community-dwelling outpatients with SZ. In total, 195 stabilized SZ patients (mean age = 31.2 years, 73% male gender) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia in France and received a thorough clinical assessment. At inclusion, psychotic symptomatology was evaluated by the Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Circulating serum/plasma levels of a large panel of markers reflecting the main inflammatory pathways were evaluated. TRS was defined by current treatment by clozapine (CLZ) and UTRS by current CLZ treatment + PANSS total score ≥ 70. The frequency of TRS and UTRS patients was, respectively, 20% and 7.7% and was defined using multivariable analysis elevated by high levels of interleukin (IL)-12/IL-23p40, IL-17A, IL-10, and beta 2 microglobulin (B2M) and IL-12/IL-23p40, IL-17A, IL-6, IL-10, IFNγ, and B2M, respectively. These observations suggest that resistance and ultra resistance to CLZ treatment are underpinned by pro-inflammatory molecules mainly belonging to the T helper 17 pathway, a finding making sense given the interplay between inflammation and antipsychotic treatment responses. If confirmed, our findings may allow us to consider IL-23/IL-17 pathway as a therapeutic target for patients with resistance to antipsychotics.

Published
2021

12. Gluteal Hidradenitis Suppurativa: Analysis of 83 Patients

Author

N. Riera-Martí, E. Vilarrasa, C. López-Llunell, M. Gamissans, M. Sin, and J. Romaní

Subjects
Acné inversa, Hidradenitis supurativa, Fenotipos de hidradenitis supurativa, Clasificación de hidradenitis supurativa, Inflamación, Dermatology, RL1-803, Internal medicine, RC31-1245
Abstract

Background: In 2013, Canoui-Poitrine et al. identified three hidradenitis suppurativa (HS) phenotypes by a latent class (LC) analysis, based on anatomical sites of involvement. Objective: To improve the classification of the gluteal phenotype (LC3) patients given their diverse lesion types and differences in clinical profile. Material and methods: We designed a bicentric study gathering all LC3 patients (n = 83) from two hospitals. We conducted a two-step cluster analysis among them and also compared their characteristics with the rest of the HS patients (n = 661). Results: Compared with global HS series, LC3 patients were more frequently non-obese men, with smoking habit, an associated arthropathy, and a more frequent history of pilonidal sinus. The analysis of LC3 patients yielded two clusters: cluster 1 (38.3%) included elderly female patients, with later diagnosis of the disease and more sinus tracts; cluster 2 (61.7%) encompassed more men with earlier disease onset and more nodules and folliculitis lesions. Limitations: The study's limitations include its retrospective nature, bicentric design, and small sample size. Conclusion: The heterogeneous clinical presentation of HS makes it essential to have a good classification of the patients. Gluteal phenotype could actually be classified into two “subphenotypes” with a different clinical profiles and management. Resumen: Antecedentes: En 2013 Canoui-Poitrine et al. identificaron tres fenotipos de hidradenitis supurativa (HS) mediante un análisis de clases latentes (LC) basado en las regiones anatómicas afectadas. Objetivo: Mejorar la clasificación de los pacientes con fenotipo glúteo (LC3) dados los diversos tipos de lesiones y diferencias en el perfil clínico. Material y métodos: Diseñamos un estudio bicéntrico que incluyó a todos los pacientes con LC3 (n = 83) de dos hospitales terciarios españoles. Realizamos un análisis de conglomerados en dos etapas dentro del grupo LC3 y también comparamos sus características con el resto de los pacientes con HS (n = 661). Resultados: En comparación con la serie global de HS, los pacientes con LC3 fueron más frecuentemente hombres no obesos, fumadores, con una artritis asociada y con mayor prevalencia de sinus pilonidal. El análisis de los pacientes LC3 resultó en dos grupos: el grupo 1 (38,3%), que incluía pacientes mayores, de sexo femenino, con diagnóstico más tardío de la enfermedad y más trayectos sinusales; y el grupo 2 (61,7%), que englobaba a más hombres con inicio temprano de la enfermedad y más nódulos y lesiones de foliculitis. Limitaciones: Las limitaciones del estudio incluyen su naturaleza retrospectiva, el diseño bicéntrico y el tamaño muestral reducido. Conclusión: La presentación clínica heterogénea de la HS hace que sea esencial disponer de una buena clasificación clínica de los pacientes. Como hemos visto, parece que el fenotipo glúteo podría clasificarse en dos «subfenotipos» con perfiles clínicos y, consecuentemente, enfoques terapéuticos diferentes.

Published
2024
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13. Largest scale dissociation of brain activity at propofol-induced loss of consciousness

Author

Irina Adalid, Joan Deus, Luis Moltó, Laura Blanco-Hinojo, Lluís Gallart, Jesús Pujol, Juan L. Fernández-Candil, E. Vilà, S. Pacreu, Gerard Martínez-Vilavella, and Víctor Pérez-Sola

Subjects
Dissociation (neuropsychology), Consciousness, Brain activity and meditation, media_common.quotation_subject, Dissociative Disorders, Unconsciousness, Arousal, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Neural Pathways, medicine, Humans, Propofol, Default mode network, 030304 developmental biology, media_common, 0303 health sciences, medicine.diagnostic_test, Brain, Magnetic Resonance Imaging, medicine.anatomical_structure, Cerebral cortex, Neurology (clinical), medicine.symptom, Psychology, Functional magnetic resonance imaging, Neuroscience, 030217 neurology & neurosurgery
Abstract

The brain is a functional unit made up of multilevel connected elements showing a pattern of synchronized activity that varies in different states. The wake–sleep cycle is a major variation of brain functional condition that is ultimately regulated by subcortical arousal- and sleep-promoting cell groups. We analyzed the evolution of functional MRI (fMRI) signal in the whole cortex and in a deep region including most sleep- and wake-regulating subcortical nuclei at loss of consciousness induced by the hypnotic agent propofol. Optimal data were obtained in 21 of the 30 healthy participants examined. A dynamic analysis of fMRI time courses on a time-scale of seconds was conducted to characterize consciousness transition, and functional connectivity maps were generated to detail the anatomy of structures showing different dynamics. Inside the magnet, loss of consciousness was marked by the participants ceasing to move their hands. We observed activity synchronization after loss of consciousness within both the cerebral cortex and subcortical structures. However, the evolution of fMRI signal was dissociated, showing a transient reduction of global cortico-subcortical coupling that was restored during the unconscious state. An exception to cortico-subcortical decoupling was a brain network related to self-awareness (i.e. the default mode network) that remained connected to subcortical brain structures. Propofol-induced unconsciousness is thus characterized by an initial, transitory dissociated synchronization at the largest scale of brain activity. Such cortico-subcortical decoupling and subsequent recoupling may allow the brain to detach from waking activity and reorganize into a functionally distinct state.

Published
2020

15. Dexmedetomidina en el manejo de la vía aérea difícil con fibrobroncoscopio en paciente despierto afecto de síndrome de Klippel-Feil

Author

S. Pacreu, S. Martínez, J. Fernández-Candil, E. Vilà, and Luis Moltó

Subjects
03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, 030202 anesthesiology, business.industry, Medicine, 030212 general & internal medicine, Critical Care and Intensive Care Medicine, business, Humanities
Abstract

Resumen El sindrome de Klippel-Feil es una enfermedad que se caracteriza por la fusion congenita de vertebras cervicales, que condiciona una limitacion e inestabilidad cervical. En estos casos la mejor opcion es la intubacion orotraqueal con fibrobroncoscopio con el paciente despierto. La ventaja es que se minimizan los movimientos cervicales que podrian conllevar un dano neurologico. En estos pacientes una sedacion adecuada, junto con la instilacion de anestesico local en la faringe y la hipofaringe es clave para reducir las molestias del paciente y conseguir la intubacion orotraqueal con exito. La dexmedetomidina es un agonista selectivo de los receptores α-2 adrenergicos que produce sedacion y ansiolisis al nivel del locus coeruleus, sin provocar depresion respiratoria, y preservando la colaboracion del paciente. Presentamos el caso de un paciente con sindrome de Klipple-Feil y via aerea dificil en el que utilizamos una perfusion de dexmedetomidina a dosis de 0,6 μg/kg/h como sedacion para la intubacion orotraqueal con fibrobroncoscopio con el paciente despierto.

Published
2018

16. Dexmedetomidine in difficult airway management with a fibre-optic bronchoscope in the awake patient with Klippel–Feil Syndrome

Author

S. Pacreu, S. Martínez, J. Fernández-Candil, E. Vilà, and Luis Moltó

Subjects
business.industry, Sedation, Pharynx, Klippel–Feil syndrome, General Medicine, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030202 anesthesiology, Anesthesia, Orotracheal intubation, Medicine, 030212 general & internal medicine, Respiratory system, medicine.symptom, Dexmedetomidine, business, Difficult airway, Depression (differential diagnoses), medicine.drug
Abstract

Klippel-Feil Syndrome is a disease characterised by congenital fusion of cervical vertebra, which leads to cervical limitation and instability. In these cases, the best option is the orotracheal intubation with the fibre-optic bronchoscope with the patient awake. The advantage is that cervical movements that could lead to neurological damage are minimised. In these patients, adequate sedation, together with instillation of local anaesthetic in the pharynx and hypopharynx, is the key to reducing patient discomfort and achieving successful orotracheal intubation. Dexmedetomidine is a selective α2- adrenergic receptor agonist that produces sedation and analgesia at the locus coeruleus without producing respiratory depression, as well as maintaining patient collaboration. The case is presented of a patient with Klippel-Feil Syndrome and difficult airway management, who was given a dexmedetomidine infusion at 0.6μg/kg/h as sedation for an awake fibre-optic endotracheal intubation.

Published
2018

17. Density spectral array of BIS VISTA™ monitoring system in a functional hemispherectomy

Author

J.L. Fernández Candila, Luis Moltó, S. Pacreu, E. Vilà, C. Luis, and A. Pardo

Subjects
medicine.medical_specialty, business.industry, Monitoring system, General Medicine, medicine.disease, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Functional hemispherectomy, Frontal lobe, 030202 anesthesiology, Bispectral index, medicine, Intraoperative Period, Radiology, Disconnection, Right hemisphere, business, 030217 neurology & neurosurgery
Abstract

We present the case of an adult patient with drug-resistant epilepsy caused by extensive inflammation in the right cerebral hemisphere. She was scheduled to undergo right functional hemispherectomy, which is common in pediatric surgery, but about which few studies have been published with respect to adult patients. During the intraoperative period, the density spectral array of the bilateral bispectral index (BIS) VISTA™ monitoring system was used. We observed a power increase in low frequency (0.1–4 Hz) and alpha bands (8–12 Hz) in the right hemisphere, where the epileptogenic focus was. During disconnection from the frontal lobe, there was a marked decrease of power in low frequency and alpha bands on the right side, with no changes during disconnection from other areas of the brain. We think that further studies are needed to determine whether the density spectral array can be a useful tool for monitoring the effectiveness of functional hemispherectomy.

Published
2018

18. Manejo anestésico en la cirugía de epilepsia con electrocorticografía intraoperatoria

Author

S. Pacreu, J.L. Fernández Candil, D. Bande, Luis Moltó, E. Vilà, and M. Rueda

Subjects
medicine.medical_specialty, business.industry, Epileptogenic lesion, Intraoperative Electrocorticography, Diagnostic test, Critical Care and Intensive Care Medicine, Epileptogenic zone, medicine.disease, Surgery, Resection, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Anesthesiology and Pain Medicine, 030202 anesthesiology, medicine, Epilepsy surgery, In patient, business, 030217 neurology & neurosurgery
Abstract

Epilepsy surgery is a well-established treatment for patients with drug-resistant epilepsy. The success of surgery depends on precise presurgical localisation of the epileptogenic zone. There are different techniques to determine its location and extension. Despite the improvements in non-invasive diagnostic tests, in patients for whom these tests are inconclusive, invasive techniques such intraoperative electrocorticography will be needed. Intraoperative electrocorticography is used to guide surgical resection of the epileptogenic lesion and to verify that the resection has been completed. However, it can be affected by some of the anaesthetic drugs used by the anaesthesiologist. Our objective with this case is to review which drugs can be used in epilepsy surgery with intraoperative electrocorticography.

Published
2018

19. Anaesthesia management in epilepsy surgery with intraoperative electrocorticography

Author

J.L. Fernández Candil, D. Bande, E. Vilà, Luis Moltó, S. Pacreu, and M. Rueda

Subjects
medicine.medical_specialty, Epileptogenic lesion, business.industry, Intraoperative Electrocorticography, General Medicine, medicine.disease, Epileptogenic zone, Drug Resistant Epilepsy, Surgery, Resection, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, 030202 anesthesiology, medicine, In patient, Epilepsy surgery, business, 030217 neurology & neurosurgery
Abstract

Epilepsy surgery is a well-established treatment for patients with drug-resistant epilepsy. The success of surgery depends on precise presurgical localisation of the epileptogenic zone. There are different techniques to determine its location and extension. Despite the improvements in non-invasive diagnostic tests, in patients for whom these tests are inconclusive, invasive techniques such intraoperative electrocorticography will be needed. Intraoperative electrocorticography is used to guide surgical resection of the epileptogenic lesion and to verify that the resection has been completed. However, it can be affected by some of the anaesthetic drugs used by the anaesthesiologist. Our objective with this case is to review which drugs can be used in epilepsy surgery with intraoperative electrocorticography.

Published
2018

20. The 10-year findings from the FondaMental Academic Center of Expertise for Schizophrenia (FACE-SZ): Review and recommendations for clinical practice

Author

F. Schürhoff, G. Fond, F. Berna, E. Bulzacka, O. Godin, L. Boyer, D. Misdrahi, M. Andrianarisoa, L. Brunel, N. Coulon, B. Aouizerate, D. Capdevielle, I. Chereau, T. D’Amato, C. Dubertret, J. Dubreucq, C. Faget, F. Gabayet, J. Mallet, R. Rey, C. Lancon, C. Passerieux, A. Schandrin, M. Urbach, P. Vidailhet, M. Leboyer, P.M. Llorca, N. Bazin, O. Blanc, I. Chereau-Boudet, G. Chesnoy-Servanin, J.M. Danion, A. Deloge, C. Delorme, H. Denizot, J.M. Dorey, C. Fluttaz, S. Fonteneau, E. Giraud-Baro, M. Jarroir, D. Lacelle, C. Lançon, H. Laouamri, T. Le Gloahec, Y. Le Strat, E. Metairie, I. Offerlin-Meyer, P. Peri, S. Pires, C. Portalier, L. Ramet, C. Roman, A. Tessier, A.M. Tronche, F. Vaillant, A. Vehier, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Fondation FondaMental [Créteil], Image Science for Interventional Techniques (ISIT), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), Nutrition et Neurobiologie intégrée (NutriNeuro), Université Bordeaux Segalen - Bordeaux 2-Institut National de la Recherche Agronomique (INRA)-Université Sciences et Technologies - Bordeaux 1 (UB)-Institut Polytechnique de Bordeaux-Ecole nationale supérieure de chimie, biologie et physique, Université de Strasbourg (UNISTRA), Institut Européen des membranes (IEM), Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Institut de Chimie du CNRS (INC)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), IMRB - 'Neuropsychiatrie translationnelle' [Créteil] (U955 Inserm - UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle de Psychiatrie [Hôpital Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital H. Mondor - A. Chenevier, CCSD, Accord Elsevier, Aix Marseille Université (AMU), Assistance Publique-Hôpitaux de Marseille (AP-HM), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Clermont Université-Centre National de la Recherche Scientifique (CNRS)-Université d'Auvergne - Clermont-Ferrand I (UdA), Université Montpellier 2 - Sciences et Techniques (UM2)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Génétique moléculaire de la neurotransmission et des processus neurodégénératifs (LGMNPN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) (FEMTO-ST), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), Université d'Auvergne - Clermont-Ferrand I (UdA)-CHU Clermont-Ferrand, Psychopathologie et pharmacologie de la cognition, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA), Mécanique des Fluides, Energies et Environnement (EDF R&D MFEE), EDF R&D (EDF R&D), EDF (EDF)-EDF (EDF), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Astrophysique Interprétation Modélisation (AIM (UMR_7158 / UMR_E_9005 / UM_112)), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Universitaire [Grenoble] (CHU), IHU-LIRYC, CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2, Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Université de Franche-Comté (UFC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Technologie de Belfort-Montbeliard (UTBM), Université de Montpellier (UM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Centre National de la Recherche Scientifique (CNRS), Université Montpellier 1 (UM1), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], and CHU Clermont-Ferrand-Université d'Auvergne - Clermont-Ferrand I (UdA)

Subjects
Inflammation, Depression, [SDV]Life Sciences [q-bio], Dépression, Syndrome métabolique, Centre expert, Metabolic syndrome, 3. Good health, 030227 psychiatry, Expert centre, Treatment, [SDV] Life Sciences [q-bio], 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Cognition, Arts and Humanities (miscellaneous), [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Schizophrenia, Schizophrénie, Traitement, ComputingMilieux_MISCELLANEOUS
Abstract

International audience; Objectives The present article is a synthesis of the first 10 years of follow-up of the FondaMental Academic Center of Expertise for Schizophrenia (FACE-SZ) cohort. Methods More than 700 community-dwelling stabilized subjects have been recruited and evaluated to date. The mean age was 32 years with 75 % males, the mean illness duration was 11 years, the mean age at illness onset was 21 years, the mean duration of untreated psychosis was 1.5 years and 55 % were current daily tobacco smokers. Results The major findings of the FACE-SZ cohort may be summarized as follows: the metabolic syndrome is twice more frequent in schizophrenia as compared to the general population and is not correctly assessed and treated; cognitive disturbances have been found in benzodiazepine consumers and in patients with chronic low-grade peripheral inflammation; major depressive disorder (MDD) is a common current comorbid condition in about 20% of the subjects at the evaluation. MDD is associated with impaired quality of life and with increased nicotine dependency in SZ daily tobacco smokers. Improving depression and negative symptoms may be the most effective strategies to improve quality of life in schizophrenia; the duration of untreated psychosis is much longer in cannabis smokers and in subjects with an age at illness onset < 19 years. Adherence to treatment is diminished in subjects who report a subjective negative feeling after treatment intake independent of objective side effects (extrapyramidal syndrome and weight gain). Akathisia has been found in 18% of the subjects and has been associated with antipsychotic polytherapy. Conclusions In the light of these results, some recommendations for clinical care may be suggested. The early detection of schizophrenia should be specifically increased in adolescents and/or cannabis smokers. All patients should be administered a comprehensive neuropsychological evaluation at the beginning of the illness and after stabilization under treatment. Improving metabolic parameters and lifestyle (diet and physical activity) should be reinforced. The benefit/risk ratio of benzodiazepine and antipsychotic polytherapy should be regularly reevaluated and withdrawn as soon as possible. If MDD remains underdiagnosed and undertreated, improving depression may strongly improve the quality of life of SZ subjects. In the end, Cognitive Remediation Therapy and anti-inflammatory strategies should be more frequently included in therapeutic strategies.; Objectifs Le présent article propose de faire un retour sur les 10 ans d’expérience du réseau national des 10 centres experts schizophrénie Français, à travers une revue des principales publications scientifiques qui en sont issues. Méthodes À ce jour, les données de plus de 700 patients ont pu être analysées. Globalement, cette population est composée de trois quarts d’hommes, est âgée en moyenne de 32 ans, la durée moyenne de maladie est d’environ 11 ans, l’âge moyen de début de maladie est de 21 ans, la durée de psychose non traitée est d’environ un an et demi. 55 % des sujets sont consommateurs de tabac au moment de l’évaluation. Enfin, un focus sera fait sur les projets de recherche multicentriques collaboratifs déployés au sein de ce réseau. Résultats Les principales données obtenues peuvent être résumées comme suit : le syndrome métabolique reste deux fois plus fréquent dans la schizophrénie qu’en population générale et n’est pas correctement pris en charge ; des troubles cognitifs spécifiques ont été identifiés chez les patients consommateurs de benzodiazépines et chez les patients présentant une inflammation périphérique. Des spécificités liées au sexe ont également été observées ; la dépression comorbide reste très fréquente, elle est associée à une diminution de la qualité de vie et à une augmentation de la dépendance nicotinique chez les fumeurs. Prendre en charge la dépression et les symptômes négatifs pourraient fortement améliorer la qualité de vie des patients ; le délai à l’instauration du traitement est plus long pour les schizophrénies se déclenchant avant 19 ans et chez les consommateurs de cannabis. L’adhésion au traitement est diminuée chez les patients rapportant un ressenti subjectif négatif du traitement, indépendamment de la prise de poids ou d’un syndrome extrapyramidal. Enfin, l’akathisie est très fréquente et fortement associée à la polythérapie antipsychotique. Conclusions Ces résultats conduisent à formuler plusieurs recommandations. Le dépistage du trouble et le traitement devraient être renforcés chez les adolescents et les consommateurs de cannabis. Tous les patients devraient bénéficier d’une évaluation neuropsychologique au début de leur trouble, après stabilisation sous traitement, puis de façon plus espacée au cours de leur suivi. La prise en charge des paramètres métaboliques, de l’alimentation et de l’activité physique devrait être renforcée. La balance bénéfice/risque de la prescription de benzodiazépines doit être réévaluée régulièrement au regard de son impact notamment sur la cognition. La monothérapie antipsychotique est recommandée autant que possible pour limiter les effets indésirables. La dépression reste sous-diagnostiquée et doit faire l’objet d’une évaluation systématique et d’un traitement spécifique. La remédiation cognitive doit également être plus largement proposée chez les patients présentant des troubles cognitifs.

Published
2019

21. Relationship between childhood trauma and level of insight in schizophrenia: A path-analysis in the national FACE-SZ dataset

Author

Baptiste Pignon, Mohamed Lajnef, Ophélia Godin, Marie-Maud Geoffray, Romain Rey, Jasmina Mallet, Caroline Dubertret, Paul Roux, Christine Passerieux, Laurent Marulaz, Lore Brunel, Julien Dubreucq, Sylvain Leignier, Delphine Capdevielle, Myrtille André, Bruno Aouizerate, David Misdrahi, Fabrice Berna, Pierre Vidailhet, Isabelle Chereau, Pierre-Michel Llorca, Guillaume Fond, Christophe Lançon, Marion Leboyer, Franck Schürhoff, M.D. Andrianarisoa, B. Aouizerate, F. Berna, O. Blanc, L. Brunel, E. Bulzacka, D. Capdevielle, I. Chereau-Boudet, G. Chesnoy-Servanin, Jm Danion, T. D'Amato, A. Deloge, C. Delorme, H. Denizot, J.M. Dorey, C. Dubertret, J. Dubreucq, C. Faget, C. Fluttaz, G. Fond, S. Fonteneau, F. Gabayet, E. Giraud-Baro, M.C. Hardy-Bayle, D. Lacelle, C. Lançon, H. Laouamri, M. Leboyer, T. Le Gloahec, Y. Le Strat, P.M. Llorca, J. Mallet, E. Metairie, D. Misdrahi, I. Offerlin-Meyer, C. Passerieux, P. Peri, S. Pires, C. Portalier, R. Rey, C. Roman, M. Sebilleau, A. Schandrin, F. Schurhoff, A. Tessier, Am Tronche, M. Urbach, F. Vaillant, A. Vehier, P. Vidailhet, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Pôle de Psychiatrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital H. Mondor - A. Chenevier, Service de psychiatrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, Université Pierre et Marie Curie - Paris 6 (UPMC), Laboratoire de sciences cognitives et psycholinguistique (LSCP), Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS), Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Clermont-Ferrand, Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Fondation FondaMental [Créteil], Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Clermont-Ferrand-Université d'Auvergne - Clermont-Ferrand I (UdA), Centre Hospitalier le Vinatier [Bron], Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Université de Toulouse (UT), Mécanique des Fluides, Energies et Environnement (EDF R&D MFEE), EDF R&D (EDF R&D), EDF (EDF)-EDF (EDF), Aix Marseille Université (AMU), Assistance Publique - Hôpitaux de Marseille (APHM), Pôle de psychiatrie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-CHU Marseille, Centre de Psychiatrie et Neurosciences (U894), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Astrophysique Interprétation Modélisation (AIM (UMR7158 / UMR_E_9005 / UM_112)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire [Grenoble] (CHU), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Pôle de Psychiatrie [Hôpital Henri Mondor], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital H. Mondor - A. Chenevier, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, École normale supérieure - Paris (ENS Paris)-École normale supérieure - Paris (ENS Paris)-Centre National de la Recherche Scientifique (CNRS)-École des hautes études en sciences sociales (EHESS), Université Grenoble Alpes (UGA), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Institut National des Sciences Appliquées (INSA), Assistance Publique-Hôpitaux de Marseille (AP-HM), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Astrophysique Interprétation Modélisation (AIM (UMR_7158 / UMR_E_9005 / UM_112)), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Institut National des Sciences Appliquées (INSA)-Université Fédérale Toulouse Midi-Pyrénées, Université d'Auvergne - Clermont-Ferrand I (UdA)-CHU Clermont-Ferrand, École normale supérieure - Paris (ENS Paris), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris)

Subjects
Adult, Male, Adolescent, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Psychological Trauma, Neglect, Diagnostic Self Evaluation, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Adverse Childhood Experiences, Humans, Medicine, Path analysis (statistics), Psychological abuse, Biological Psychiatry, Physical neglect, ComputingMilieux_MISCELLANEOUS, media_common, business.industry, Adult Survivors of Child Abuse, CTQ tree, Awareness, 3. Good health, 030227 psychiatry, Psychiatry and Mental health, Cross-Sectional Studies, Physical abuse, Adult Survivors of Child Adverse Events, Psychotic Disorders, Sexual abuse, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Schizophrenia, Female, business, 030217 neurology & neurosurgery, Psychopathology, Clinical psychology
Abstract

Introduction This study aimed was to investigate the relationship between different types of childhood trauma and the level of insight (i.e., awareness of having a psychiatric disorder) in subjects suffering from schizophrenia, as well as the putative role of clinical mediators. Methods 294 community-dwelling subjects with stable schizophrenia were included into FACE-SZ, a multicentre cross-sectional study. All patients were assessed by specialized multidisciplinary teams. The level of insight was assessed by the Scale to assess Unawareness of Mental Disorder (SUMD), and childhood trauma by the Childhood Trauma Questionnaire (CTQ). Path analyses from the five CTQ subscales (physical abuse and neglect, emotional abuse and neglect, and sexual abuse) and the SUMD, with current symptomatology (i.e., positive, negative, global psychopathology and depression) as mediator, was performed. Results Physical neglect (β = 0.14) and abuse (β = 0.13) were significantly associated with poor insight. Negative symptoms were a clinical mediator of the relationship between physical neglect and poor insight. Moreover, positive (β = 0.21) and negative (β = 0.30) symptoms were associated with poor insight, whereas depression (β = −0.14) was associated with higher levels of insight. Discussion For the first time, this study shows a significant relationship between childhood trauma, specifically physical neglect and abuse, and poor insight. The level of insight was linked to different clinical dimensions. Among subjects with schizophrenia, these results provide support for a role of childhood trauma in poorer management outcomes, and the need to provide treatment, including psycho-education that better targets the consequences of childhood trauma.

Published
2019

22. [Artículo traducido] Hidradenitis supurativa con afectación glútea: análisis de 83 pacientes

Author

N. Riera-Martí, E. Vilarrasa, C. López-Llunell, M. Gamissans, M. Sin, and J. Romaní

Subjects
Acne inversa, Hidradenitis suppurativa, Hidradenitis suppurativa phenotypes, Hidradenitis suppurativa classification, Inflammation, Dermatology, RL1-803, Internal medicine, RC31-1245
Abstract

Resumen: Antecedentes: En 2013 Canoui-Poitrine et al. identificaron tres fenotipos de hidradenitis supurativa (HS) mediante un análisis de clases latentes (LC) basado en las regiones anatómicas afectadas. Objetivo: Mejorar la clasificación de los pacientes con fenotipo glúteo (LC3) dados los diversos tipos de lesiones y diferencias en el perfil clínico. Material y métodos: Diseñamos un estudio bicéntrico que incluyó a todos los pacientes con LC3 (n = 83) de dos hospitales terciarios españoles. Realizamos un análisis de conglomerados en dos etapas dentro del grupo LC3 y también comparamos sus características con el resto de los pacientes con HS (n = 661). Resultados: En comparación con la serie global de HS, los pacientes con LC3 fueron más frecuentemente hombres no obesos, fumadores, con una artritis asociada y con mayor prevalencia de sinus pilonidal. El análisis de los pacientes LC3 resultó en dos grupos: el grupo 1 (38,3%), que incluía pacientes mayores, de sexo femenino, con diagnóstico más tardío de la enfermedad y más trayectos sinusales; y el grupo 2 (61,7%), que englobaba a más hombres con inicio temprano de la enfermedad y más nódulos y lesiones de foliculitis. Limitaciones: Las limitaciones del estudio incluyen su naturaleza retrospectiva, el diseño bicéntrico y el tamaño muestral reducido. Conclusión: La presentación clínica heterogénea de la HS hace que sea esencial disponer de una buena clasificación clínica de los pacientes. Como hemos visto, parece que el fenotipo glúteo podría clasificarse en dos «subfenotipos» con perfiles clínicos y, consecuentemente, enfoques terapéuticos diferentes. Abstract: Background: In 2013, Canoui-Poitrine et al. identified three hidradenitis suppurativa (HS) phenotypes by a latent class (LC) analysis, based on anatomical sites of involvement. Objective: To improve the classification of the gluteal phenotype (LC3) patients given their diverse lesion types and differences in clinical profile. Material and methods: We designed a bicentric study gathering all LC3 patients (n = 83) from two hospitals. We conducted a two-step cluster analysis among them and also compared their characteristics with the rest of the HS patients (n = 661). Results: Compared with global HS series, LC3 patients were more frequently non-obese men, with smoking habit, an associated arthropathy, and a more frequent history of pilonidal sinus. The analysis of LC3 patients yielded two clusters: cluster 1 (38.3%) included elderly female patients, with later diagnosis of the disease and more sinus tracts; cluster 2 (61.7%) encompassed more men with earlier disease onset and more nodules and folliculitis lesions. Limitations: The study's limitations include its retrospective nature, bicentric design, and small sample size. Conclusion: The heterogeneous clinical presentation of HS makes it essential to have a good classification of the patients. Gluteal phenotype could actually be classified into two “subphenotypes” with a different clinical profiles and management.

Published
2024
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24. Risk factors for increased duration of untreated psychosis. Results from the FACE-SZ dataset

Author

G. Fond, L. Boyer, M. Andrianarisoa, O. Godin, L. Brunel, E. Bulzacka, N. Coulon, P.M. Llorca, F. Berna, B. Aouizerate, D. Capdevielle, T. D'Amato, C. Dubertret, J. Dubreucq, C. Faget, F. Gabayet, J. Mallet, D. Misdrahi, R. Rey, R. Richieri, P. Roux, C. Passerieux, A. Schandrin, A.M. Tronche, P. Vidailhet, M. Leboyer, F. Schürhoff, O. Blanc, I. Chereau-Boudet, G. Chesnoy-Servanin, J.M. Danion, A. Deloge, C. Delorme, H. Denizot, J.M. Dorey, C. Fluttaz, S. Fonteneau, E. Giraud-Baro, M.C. Hardy-Bayle, D. Lacelle, C. Lançon, H. Laouamri, T. Le Gloahec, Y. Le Strat, E. Metairie, I. Offerlin-Meyer, P. Peri, S. Pires, C. Portalier, C. Roman, M. Sebilleau, F. Schurhoff, A. Tessier, M. Urbach, F. Vaillant, A. Vehier, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier le Vinatier [Bron], Génétique moléculaire de la neurotransmission et des processus neurodégénératifs (LGMNPN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), ONERA - The French Aerospace Lab [Toulouse], ONERA, Departement de Psychiatrie, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Information – Technologies – Analyse Environnementale – Procédés Agricoles (UMR ITAP), Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [APHP], Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Centre Hospitalier d'Annecy, Centre hospitalier d'Annecy, IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]-Centre National de la Recherche Scientifique (CNRS), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Centre de Psychiatrie et Neurosciences (U894)

Subjects
Adult, Male, congenital, hereditary, and neonatal diseases and abnormalities, Pediatrics, medicine.medical_specialty, Multivariate analysis, Delayed Diagnosis, medicine.medical_treatment, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Untreated psychosis, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Sex Factors, Prognosis of schizophrenia, Risk Factors, medicine, Humans, Bipolar disorder, Age of Onset, Psychiatry, Antipsychotic, Biological Psychiatry, ComputingMilieux_MISCELLANEOUS, Psychiatric Status Rating Scales, biology, [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, [SCCO.NEUR]Cognitive science/Neuroscience, [SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, medicine.disease, biology.organism_classification, 030227 psychiatry, 3. Good health, Psychiatry and Mental health, Psychotic Disorders, Schizophrenia, dup, Educational Status, Female, Schizophrenic Psychology, Cannabis, France, Independent Living, Psychology, 030217 neurology & neurosurgery
Abstract

Objectives Reducing the duration of untreated psychosis (DUP) may improve the prognosis of schizophrenia. This study investigated the prevalence, and associated risk factors, of long DUP in a large, non-selected sample of community-dwelling schizophrenia patients (SZ). Method 478 community-dwelling stable SZ participants (122 women and 356 men; mean age 32.37 ± 9.86 years) were recruited between 2010 and 2016. The mean retrospective DUP was evaluated from both patient and family reports, as well as hospital/psychiatrists records. Long DUP was defined as > 2 years. Results The mean DUP was 1.5 years. 80 participants (16.7%) had a DUP > 2 years. In multivariate analyses, after adjustment for sex, education level, history of childhood trauma and history of maternal schizophrenia or bipolar disorder, long DUP was associated with a younger age of illness onset (19.3 ± 6.67 years vs. 22.0 ± 6.51 years, adjusted odd ratio aOR = 0.91, 95%CI [0.86; 0.97], p = 0.003) and cannabis use disorder (20.0% vs. 10.3%, aOR = 2.41, 95%CI [1.14–5.09], p = 0.02). Conclusion A high proportion of SZ patients still have a long DUP. The present results suggest that illness onset before age 19 years and cannabis use are associated with long DUP in schizophrenia patients. Early psychosis detection programs should prioritize the targeting of these populations.

Published
2018

25. Psychiatric disability as mediator of the neurocognition-functioning link in schizophrenia spectrum disorders: SEM analysis using the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale

Author

Paul Roux, Mathieu Urbach, Sandrine Fonteneau, Fabrice Berna, Lore Brunel, Delphine Capdevielle, Isabelle Chereau, Julien Dubreucq, Catherine Faget-Agius, Guillaume Fond, Sylvain Leignier, Claire-Cécile Perier, Raphaëlle Richieri, Priscille Schneider, Franck Schürhoff, Anne-Marie Tronche, Hanan Yazbek, Anna Zinetti-Bertschy, Christine Passerieux, Eric Brunet-Gouet, M. Andrianarisoa, B. Aouizerate, N. Bazin, F. Berna, O. Blanc, L. Brunel, E. Bulzacka, D. Capdevielle, I. Chereau-Boudet, G. Chesnoy-Servanin, Jm Danion, T. D'Amato, A. Deloge, C. Delorme, H. Denizot, J.M. Dorey, C. Dubertret, J. Dubreucq, C. Faget, C. Fluttaz, G. Fond, S. Fonteneau, F. Gabayet, E. Giraud-Baro, D. Lacelle, C. Lançon, H. Laouamri, M. Leboyer, T. Le Gloahec, Y. Le Strat, null Llorca, J. Mallet, E. Metairie, D. Misdrahi, I. Offerlin-Meyer, C. Passerieux, P. Peri, S. Pires, C. Portalier, L. Ramet, R. Rey, C. Roman, A. Schandrin, F. Schürhoff, A. Tessier, Am Tronche, M. Urbach, F. Vaillant, A. Vehier, P. Vidailhet, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Fondation FondaMental [Créteil], Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur (HANDIReSP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Hospitalier de Versailles André Mignot (CHV), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département de psychiatrie adulte, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital La Colombière, Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre Référent de Réhabilitation Psychosociale [CH Alpes Isère], Centre Hospitalier Alpes Isère, Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Psychometrics, media_common.quotation_subject, Metacognition, Remediation, Cohort Studies, 03 medical and health sciences, Disability Evaluation, Young Adult, 0302 clinical medicine, Cognition, Visual memory, Neuropsychology, medicine, Humans, Effects of sleep deprivation on cognitive performance, Functioning, Psychiatry, Biological Psychiatry, media_common, Psychiatric Status Rating Scales, Disability, Middle Aged, 030227 psychiatry, Psychiatry and Mental health, Cross-Sectional Studies, Psychotic Disorders, Cognitive remediation therapy, Latent Class Analysis, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Schizophrenia, Female, Schizophrenic Psychology, Psychology, Neurocognitive, 030217 neurology & neurosurgery, Vigilance (psychology)
Abstract

International audience; The functional outcome in schizophrenia spectrum disorders is affected by multiple factors such as cognitive performance and clinical symptoms. Psychiatric disability may be another important determinant of functional outcome. The purpose of this study was to test whether schizophrenia symptoms and psychiatric disability mediated the association between cognition and functioning. Between April 2013 and July 2017, we included 108 community-dwelling adults with stable schizophrenia spectrum disorder in a multicenter study. Psychiatric disability was assessed with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale by relatives of patients. ECPDS focused on the broad array of motivational, neurocognitive, sociocognitive, and metacognitive impairments that result in activity restrictions. We used a battery of tests to assess seven cognition domains (processing speed, attention/vigilance, working, verbal and visual memory, reasoning and problem solving, and executive functioning) and cross-sectional structural equation modeling (SEM) for the mediation analyses. We estimated the one-year temporal stability of ECPDS scores in 45 participants. The model provided showed good fit and explained 43.9% of the variance in functioning. The effect of neurocognition on functioning was fully mediated by symptoms (proportion mediated: 36.5%) and psychiatric disability (proportion mediated: 31.3%). The ECPDS score had acceptable one-year temporal stability. The ECPDS scale has satisfactory psychometric properties, and shows significant convergence with neurocognition and functioning, suggesting a role for this tool in the routine evaluation of cognitive remediation needs. Our model validates psychiatric disability as a crucial step from cognitive impairment to restricted participation in life situations.

Published
2018

26. Supplemental_Material – Supplemental material for Screening for cognitive deficits with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale

Author

Roux, Paul, Urbach, Mathieu, Fonteneau, Sandrine, Berna, Fabrice, Brunel, Lore, Capdevielle, Delphine, Chereau, Isabelle, Dubreucq, Julien, Faget-Agius, Catherine, Fond, Guillaume, Leignier, Sylvain, Claire-Cécile Perier, Richieri, Raphaëlle, Schneider, Priscille, Schürhoff, Franck, Tronche, Anne Marie, Yazbek, Hanan, Zinetti-Bertschy, Anna, Passerieux, Christine, Brunet-Gouet, Eric, M Andrianarisoa, B Aouizerate, N Bazin, F Berna, O Blanc, L Brunel, E Bulzacka, D Capdevielle, I Chereau-Boudet, G Chesnoy-Servanin, JM Danion, T D’Amato, A Deloge, C Delorme, H Denizot, JM Dorey, C Dubertret, J Dubreucq, C Faget, C Fluttaz, G Fond, S Fonteneau, F Gabayet, E Giraud-Baro, D Lacelle, C Lançon, H Laouamri, M Leboyer, T Le Gloahec, Y Le Strat, PM Llorca, J Mallet, E Metairie, D Misdrahi, I Offerlin-Meyer, C Passerieux, P Peri, S Pires, C Portalier, L Ramet, R Rey, C Roman, A Schandrin, F Schürhoff, A Tessier, AM Tronche, M Urbach, F Vaillant, A Vehier, P Vidailhet, E Vilà, H Yazbek, and A Zinetti-Bertschy

Subjects
FOS: Clinical medicine, 110604 Sports Medicine, FOS: Health sciences, 110904 Neurology and Neuromuscular Diseases, 110314 Orthopaedics
Abstract

Supplemental material, Supplemental_Material for Screening for cognitive deficits with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale by Paul Roux, Mathieu Urbach, Sandrine Fonteneau, Fabrice Berna, Lore Brunel, Delphine Capdevielle, Isabelle Chereau, Julien Dubreucq, Catherine Faget-Agius, Guillaume Fond, Sylvain Leignier, Claire-Cécile Perier, Raphaëlle Richieri, Priscille Schneider, Franck Schürhoff, Anne Marie Tronche, Hanan Yazbek, Anna Zinetti-Bertschy, the FondaMental Advanced Centers of Expertise in Schizophrenia (FACE-SCZ) Collaborators, Christine Passerieux, Eric Brunet-Gouet, M Andrianarisoa, B Aouizerate, N Bazin, F Berna, O Blanc, L Brunel, E Bulzacka, D Capdevielle, I Chereau-Boudet, G Chesnoy-Servanin, JM Danion, T D’Amato, A Deloge, C Delorme, H Denizot, JM Dorey, C Dubertret, J Dubreucq, C Faget, C Fluttaz, G Fond, S Fonteneau, F Gabayet, E Giraud-Baro, D Lacelle, C Lançon, H Laouamri, M Leboyer, T Le Gloahec, Y Le Strat, PM Llorca, J Mallet, E Metairie, D Misdrahi, I Offerlin-Meyer, C Passerieux, P Peri, S Pires, C Portalier, L Ramet, R Rey, C Roman, A Schandrin, F Schürhoff, A Tessier, AM Tronche, M Urbach, F Vaillant, A Vehier, P Vidailhet, E Vilà, H Yazbek and A Zinetti-Bertschy in Clinical Rehabilitation

Published
2018
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27. Latent toxoplasma infection in real-world schizophrenia: Results from the national FACE-SZ cohort

Author

G. Fond, L. Boyer, F. Schürhoff, F. Berna, O. Godin, E. Bulzacka, M. Andrianarisoa, L. Brunel, B. Aouizerate, D. Capdevielle, I. Chereau, N. Coulon, T. D'Amato, C. Dubertret, J. Dubreucq, C. Faget, C. Lançon, S. Leignier, J. Mallet, D. Misdrahi, C. Passerieux, R. Rey, A. Schandrin, M. Urbach, P. Vidailhet, P.M. Llorca, M. Leboyer, N. Bazin, O. Blanc, I. Chereau-Boudet, G. Chesnoy-Servanin, J.M. Danion, A. Deloge, H. Denizot, J.M. Dorey, C. Fluttaz, S. Fonteneau, F. Gabayet, E. Giraud-Baro, M. Jarroir, D. Lacelle, H. Laouamri, T. Le Gloahec, Y. Le Strat, E. Metairie, I. Offerlin-Meyer, P. Peri, S. Pires, C. Portalier, L. Ramet, C. Roman, A. Tessier, A.M. Tronche, F. Vaillant, A. Vehier, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Fondation FondaMental [Créteil], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Les Hôpitaux Universitaires de Strasbourg (HUS), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Sorbonne Université (SU), Hôpital Charles Perrens, Université de Bordeaux (UB), Université Montpellier 1 (UM1), Hôpital de la Colombière, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Pôle de Psychiatrie [Hôpital Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital H. Mondor - A. Chenevier, Centre Hospitalier le Vinatier [Bron], Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Sorbonne Paris Cité (USPC), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier de Versailles André Mignot (CHV), Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur (HANDIReSP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg-Université de Strasbourg (UNISTRA), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en neurosciences de Lyon (CRNL), Centre hospitalier Charles Perrens [Bordeaux], 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 Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Male, Alogia, Population, Toxoplasma gondii, Antigens, Protozoan, Inflammation, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Extrapyramidal symptoms, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Prevalence, Humans, Medicine, Cognitive Dysfunction, education, Biological Psychiatry, education.field_of_study, biology, Depression, business.industry, C-reactive protein, medicine.disease, biology.organism_classification, 030227 psychiatry, 3. Good health, Treatment, Psychiatry and Mental health, C-Reactive Protein, Cross-Sectional Studies, Schizophrenia, Immunoglobulin G, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Cohort, Immunology, Symptoms, biology.protein, Female, Schizophrenic Psychology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.symptom, business, Toxoplasma, Toxoplasmosis, 030217 neurology & neurosurgery
Abstract

Objective Latent Toxoplasma infection has been associated with widespread brain immune activation, increased blood brain barrier permeability, neural disruption, increased dopamine release in dopaminergic neurons, with NMDA activation and with schizophrenia (SZ) onset risk. Toxoplasma has been suggested to be a source of chronic low-grade inflammation and this inflammation has been associated with cognitive impairment in SZ. The objective of the present study were (i) to determine if latent Toxoplasma infection was associated with specific clinical features in stabilized SZ subjects, with cognitive impairment and with increased low-grade peripheral inflammation and (ii) to determine if Treatments with Anti-Toxoplasmic Activity (TATA) were associated with improved outcomes in subjects with latent Toxoplasma infection. Methods A comprehensive 2 daylong clinical and neuropsychological battery was administered in 250 SZ subjects included between 2015 and 2017 in the national FondaMental Expert Center (FACE-SZ) Cohort. Solid phase-enzyme microplate immunoassay methods were used to measure IgG class of antibodies to T. gondii in blood sample. Latent Toxoplasma infection was defined by T . gondii IgG ratio ≥0.8, equivalent to ≥10 international units. Chronic peripheral inflammation was defined by highly sensitive C reactive protein blood level ≥ 3 mg/L. Results Latent Toxoplasma infection has been found in 184 (73.6%) of this national multicentric sample. In the multivariate analyses, latent Toxoplasma infection has been significantly associated with higher PANSS negative (aOR = 1.1 [1.1–1.1], p = 0.04) and excitement subscores (aOR = 1.3 [1.1–1.6], p = 0.01), with two specific symptoms (i.e., reference delusion (aOR = 3.6 [1.2–10.6] p = 0.01) and alogia (aOR = 16.7 [2.0–134.7], p = 0.008)) and with chronic low-grade peripheral inflammation (27.2% vs. 7.6%, aOR = 3.8 [1.4–10.3], p = 0.004). Extrapyramidal symptoms remained significantly associated with latent Toxoplasma infection. On the opposite, no significant association of latent Toxoplasma infection with age, gender, age at SZ onset, suicide behavior or cognitive deficits has been found in these models (all p > 0.05). TATA were associated with lower depressive symptoms (aOR = 0.8[0.7–0.9], p = 0.01), and with lower rates of chronic peripheral inflammation (20.9% vs. 48.6%, aOR = 3.5 [1.5–7.9], p = 0.003) but not with higher cognitive scores (p > 0.05). Conclusion The present findings suggest that Toxoplasma is almost 3 times more frequent in SZ population compared to general population in France. The potential cerebral underpinnings of the association of latent Toxoplasma infection and the above-mentioned outcomes have been discussed. Future studies should confirm that TATA may be effective to reduce Toxoplasma-associated depressive symptoms and low-grade peripheral inflammation.

Published
2018

28. Abordaje común del paciente con psoriasis y riesgo de esteatosis hepática metabólica: recomendaciones de un grupo de expertos multidisciplinar

Author

J.M. Carrascosa, E. Vilarrasa, I. Belinchón, P. Herranz, J. Crespo, F. Guimerá, and A. Olveira

Subjects
Psoriasis, Metabolic-associated fatty liver disease, MAFLD, Hepatotoxicity, Dermatology, RL1-803, Internal medicine, RC31-1245
Abstract

Resumen: En los últimos años se están haciendo notables esfuerzos para entender la relación existente entre la psoriasis y la esteatosis hepática metabólica (EHmet). No solo se presenta este trastorno en pacientes psoriásicos con una mayor prevalencia, sino que además se acompaña de una mayor gravedad. Con este precedente, se evidencia la necesidad de establecer un protocolo de abordaje precoz de la enfermedad hepática en los pacientes con psoriasis. Asimismo, es de especial relevancia la evaluación de riesgo y beneficio en referencia al uso de tratamientos con potencial hepatotóxico. En el presente manuscrito se exponen las recomendaciones de un panel de expertos en dermatología y hepatología para el cribado, diagnóstico, monitorización y criterios de derivación en pacientes con psoriasis, en caso de sospecha de esteatosis hepática metabólica. Abstract: Recent years have seen concerted efforts to understand the relation between psoriasis and metabolic-associated fatty liver disease (MAFLD). Not only is MALFD diagnosed more often in patients with psoriasis, but its clinical course is also more aggressive. A common approach is therefore needed to enable early detection of liver disease coincident with psoriasis. Especially important is an analysis of risks and benefits of potentially hepatotoxic treatments. This consensus paper presents the recommendations of a group of experts in dermatology and hepatology regarding screening for MALFD as well as criteria for monitoring patients and referring them to hepatologists when liver disease is suspected.

Published
2023
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29. Changes in bilateral bispectral index VISTA monitoring system during Wada test

Author

R. Arroyo, E. Vilà, S. Pacreu, C. Rodríguez, S. Fernández, and J.L. Fernández

Subjects
Male, Amobarbital, Diagnostic Techniques, Neurological, Amnesia, Electroencephalography, Critical Care and Intensive Care Medicine, Catheterization, Congenital Abnormalities, Consciousness Monitors, medicine.artery, Preoperative Care, Humans, Hypnotics and Sedatives, Medicine, Epilepsy surgery, Epilepsy, medicine.diagnostic_test, business.industry, Cerebral Arteries, Middle Aged, Carotid Arteries, Anesthesiology and Pain Medicine, Bispectral index, Anesthesia, Wada test, medicine.symptom, Internal carotid artery, Verbal memory, business, medicine.drug
Abstract

The Wada test is a procedure used in the preoperative assessment before epilepsy surgery in order to determine language lateralization, to assess the post-operative risk of an amnesia syndrome, and to evaluate the risk of material-specific memory deficits, in particular verbal memory deficits. This test involves inserting a cannula into the internal carotid artery via the femoral artery, and then to inject amobarbital to shut down brain function, usually in one of the brain hemispheres. The bilateral bispectral index (BIS) VISTA™ monitoring system (BVMS) was used to detect changes in EEG, and in the power spectrum distribution using the density spectral array (DSA) of both hemispheres. We describe a patient with an agenesis of the A1 segment of the right anterior cerebral artery, scheduled for a Wada test, in whom the BVMS demonstrated its potential value.

Published
2014

30. Valorization of wipe wastes for the synthesis of microporous carbons and their application in CO2 capture, gas separation and H2-storage

Author

J.A. Cecilia, E. Vilarrasa-García, D.C.S. Azevedo, A. Vílchez-Cózar, A. Infantes-Molina, D. Ballesteros-Plata, I. Barroso-Martín, and E. Rodríguez-Castellón

Subjects
Wipe wastes, Biochar, CO2-Adsorption, H2-purification, H2-storage, Science (General), Q1-390, Social sciences (General), H1-99
Abstract

Wipe wastes have been used as a cellulosic source to synthesize biochars. Prior to the synthesis of the adsorbents by the pyrolysis of wipes wastes, this waste was treated to remove the pathogenic agents. Then, the wipe wastes were pyrolyzed between 500 and 900 °C to obtain biochars, whose microporosity increased proportionally to the pyrolysis temperature, achieving a maximum CO2-adsorption uptake of 2.53 mmol/g at a pressure of 760 mm of Hg and 25 °C for the biochar pyrolized at 900 °C. The synthesized biochars are also highly selective towards CO2-adsorption in CO2/N2 or CO2/H2 mixtures. Hence, these adsorbents have shown a great potential to be used in flue gas treatment and H2-purification processes. Biochar treatment with KOH further improves microporosity due to chemical activation although the addition of a large amount of KOH leads to excessive microporosity causing a collapse in the pore structure and decreasing CO2-adsorption capacity.

Published
2023
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31. Cigarette smoking and schizophrenia: a specific clinical and therapeutic profile? Results from the FACE-Schizophrenia cohort

Author

J. Mallet, Y. Le Strat, F. Schürhoff, N. Mazer, C. Portalier, M. Andrianarisoa, B. Aouizerate, F. Berna, L. Brunel, D. Capdevielle, I. Chereau, T. D'Amato, H. Denizot, J. Dubreucq, C. Faget, F. Gabayet, C. Lançon, P.M. Llorca, D. Misdrahi, R. Rey, P. Roux, A. Schandrin, M. Urbach, P. Vidailhet, G. Fond, C. Dubertret, N. Bazin, O. Blanc, E. Bulzacka, I. Chereau-Boudet, G. Chesnoy-Servanin, J.M. Danion, A. Deloge, C. Delorme, J.M. Dorey, C. Fluttaz, S. Fonteneau, E. Giraud-Baro, D. Lacelle, H. Laouamri, M. Leboyer, T. Le Gloahec, E. Metairie, I. Offerlin-Meyer, C. Passerieux, P. Peri, S. Pires, L. Ramet, C. Roman, A. Tessier, A.M. Tronche, F. Vaillant, A. Vehier, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Génétique moléculaire de la neurotransmission et des processus neurodégénératifs (LGMNPN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Université Montpellier 1 (UM1), Centre Hospitalier le Vinatier [Bron], ONERA - The French Aerospace Lab [Toulouse], ONERA, Information – Technologies – Analyse Environnementale – Procédés Agricoles (UMR ITAP), Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) (FEMTO-ST), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Centre Hospitalier d'Annecy, Centre hospitalier d'Annecy, IHU-LIRYC, CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2, Centre de Psychiatrie et Neurosciences (U894), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Université de Franche-Comté (UFC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Technologie de Belfort-Montbeliard (UTBM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Population, Comorbidity, Anticholinergic agents, Cigarette Smoking, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Prevalence, medicine, Humans, Antipsychotic, education, Psychiatry, Biological Psychiatry, Clozapine, ComputingMilieux_MISCELLANEOUS, Psychiatric Status Rating Scales, Pharmacology, education.field_of_study, [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, business.industry, [SCCO.NEUR]Cognitive science/Neuroscience, Confounding, [SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, medicine.disease, 030227 psychiatry, 3. Good health, Cross-Sectional Studies, Schizophrenia, Multivariate Analysis, Cohort, Educational Status, Female, Aripiprazole, France, Independent Living, business, 030217 neurology & neurosurgery, Antipsychotic Agents, medicine.drug
Abstract

Background Tobacco use is common in patients with schizophrenia (SZ) but little is known on the role of tobacco in the physiopathology or on the course of the disease. Only few studies embrace an extensive examination of clinical and therapeutic characteristics in stabilized patients. The objective of the present study was to determine the prevalence of tobacco smoking in stabilized SZ outpatients and the clinical and treatment characteristics associated with daily tobacco use in a large community-dwelling sample of patients. Methods Three-hundred-and-sixty-one patients were included in the network of the FondaMental Expert Centers for Schizophrenia. Current tobacco status was self-declared. Results 53.7% were smokers. Mean age at tobacco onset was 17.2 years old. In multivariate analyses, after adjustment for confounding factors, positive symptoms and mean daily antipsychotic dose were associated with a higher frequency of tobacco use (OR = 1.06 95%IC[1.02–1.12], for positive symptoms, OR = 1.1, 95%IC[1.02–1.18] for daily antipsychotic dose). Education level, negative symptoms, anticholinergic agents, clozapine or aripiprazole administration were independently associated with a lower frequency of tobacco use (respectively OR = 0.87, 95%IC [0.79, 0.95], OR = 0.95, 95%IC[0.91–0.98], OR = 0.41, 95%IC[0.22–0.76], OR = 0.56, 95%IC = [0.32, 0.99] and OR = 0.49, 95%IC [0.26–0.91]). Conclusion The prevalence of current tobacco smoking in a French community-dwelling SZ patients is higher that observed in the general population. Patients with tobacco use present clinical and therapeutic specificities that may involve interaction between cholinergic-nicotinic and dopaminergic systems. The present study suggests that some therapeutics may improve daily smoking behavior in smokers. These results should be confirmed in longitudinal studies.

Published
2017

32. Density spectral array of BIS VISTA™ monitoring system in a functional hemispherectomy

Author

C, Luis, E, Vilà, L, Moltó, A, Pardo, J L, Fernández Candil, and S, Pacreu

Subjects
Adult, Consciousness Monitors, Hemispherectomy, Monitoring, Intraoperative, Humans, Female, Anesthesia, General
Abstract

We present the case of an adult patient with drug-resistant epilepsy caused by extensive inflammation in the right cerebral hemisphere. She was scheduled to undergo right functional hemispherectomy, which is common in pediatric surgery, but about which few studies have been published with respect to adult patients. During the intraoperative period, the density spectral array of the bilateral bispectral index (BIS) VISTA

Published
2017

33. Childhood trauma, depression and negative symptoms are independently associated with impaired quality of life in schizophrenia. Results from the national FACE-SZ cohort

Author

M. Andrianarisoa, L. Boyer, O. Godin, L. Brunel, E. Bulzacka, B. Aouizerate, F. Berna, D. Capdevielle, J.M. Dorey, C. Dubertret, J. Dubreucq, C. Faget, F. Gabayet, P.M. Llorca, J. Mallet, D. Misdrahi, R. Rey, R. Richieri, C. Passerieux, A. Schandrin, A.M. Tronche, M. Urbach, P. Vidailhet, F. Schürhoff, G. Fond, O. Blanc, I. Chereau-Boudet, G. Chesnoy-Servanin, J.M. Danion, T. D'Amato, A. Deloge, C. Delorme, H. Denizot, C. Fluttaz, S. Fonteneau, E. Giraud-Baro, M.C. Hardy-Bayle, D. Lacelle, C. Lançon, H. Laouamri, M. Leboyer, T. Le Gloahec, Y. Le Strat, E. Metairie, I. Offerlin-Meyer, P. Peri, S. Pires, C. Portalier, C. Roman, M. Sebilleau, F. Schurhoff, A. Tessier, F. Vaillant, A. Vehier, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Fondation FondaMental [Créteil], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle de Psychiatrie [Hôpital Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital H. Mondor - A. Chenevier, Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Perrens, Physiopathologie du système nerveux central - Institut François Magendie, Université Bordeaux Segalen - Bordeaux 2-IFR8-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Strasbourg, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Département de psychiatrie adulte, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital La Colombière, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Référent de Réhabilitation Psychosociale [CH Alpes Isère], Centre Hospitalier Alpes Isère, Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier le Vinatier [Bron], Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre Hospitalier de Versailles André Mignot (CHV), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Jeanne d'Arc, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre hospitalier Charles Perrens [Bordeaux], Centre de Psychiatrie et Neurosciences (U894), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital H. Mondor - A. Chenevier, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Strasbourg (UNISTRA)-Hôpital Civil de Strasbourg, Neuropsychiatrie : recherche épidémiologique et clinique, Hopital Louis Mourier - AP-HP [Colombes], Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Centre Hospitalier de Versailles (CHV), UFR des Sciences de la Santé Simone Veil, Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg-Université de Strasbourg (UNISTRA)

Subjects
Child abuse, Adult, Male, Quality of life, medicine.medical_specialty, Childhood trauma, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, medicine, Humans, Child Abuse, Major depressive episode, Psychiatry, Child, Biological Psychiatry, Depression (differential diagnoses), Psychiatric Status Rating Scales, Positive and Negative Syndrome Scale, Depression, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Schizophrenia, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Cohort, Multivariate Analysis, Female, Schizophrenic Psychology, Negative symptoms, medicine.symptom, Psychology, 030217 neurology & neurosurgery, Cohort study
Abstract

International audience; OBJECTIVES:Depression and negative symptoms have been associated with impaired Quality of life (QoL) in schizophrenia (SZ). However, childhood trauma may influence both QoL and depression in SZ patients, with consequences for the management of impaired QoL in SZ patients. The aim of the present study was to determine if childhood trauma was associated with impaired QoL in schizophrenia.METHOD:A sample of 544 community-dwelling stabilized SZ patients enrolled in FACE-SZ cohort were utilized in this study (74.1% males, mean aged 32.3years, mean illness duration 10.6years). QoL was self-reported with the S-QoL18 questionnaire. Childhood trauma was self-reported with the Childhood Trauma Questionnaire. Depression was measured by the Calgary Depression Rating Scale for Schizophrenia. Psychotic severity was measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS). Other clinical factors, treatments, comorbidities, functioning and sociodemographical variables were also recorded, with validated scales.RESULTS:Overall, 151 participants (27.8%) had a current major depressive episode and 406 (82.5%) reported at least one episode of historical childhood trauma. In multivariate analyses, lower QoL total score was associated with a history of childhood trauma (β=-0.21, p

Published
2017

34. Anaesthesia management in epilepsy surgery with intraoperative electrocorticography

Author

S, Pacreu, E, Vilà, L, Moltó, D, Bande, M, Rueda, and J L, Fernández Candil

Subjects
Drug Resistant Epilepsy, Intraoperative Neurophysiological Monitoring, Anesthesia, General, Middle Aged, Amygdala, Brain Waves, Combined Modality Therapy, Hippocampus, Neurosurgical Procedures, Fentanyl, Remifentanil, Humans, Anticonvulsants, Female, Electrocorticography, Epilepsies, Partial, Rocuronium, Propofol, Dexmedetomidine, Anesthetics
Abstract

Epilepsy surgery is a well-established treatment for patients with drug-resistant epilepsy. The success of surgery depends on precise presurgical localisation of the epileptogenic zone. There are different techniques to determine its location and extension. Despite the improvements in non-invasive diagnostic tests, in patients for whom these tests are inconclusive, invasive techniques such intraoperative electrocorticography will be needed. Intraoperative electrocorticography is used to guide surgical resection of the epileptogenic lesion and to verify that the resection has been completed. However, it can be affected by some of the anaesthetic drugs used by the anaesthesiologist. Our objective with this case is to review which drugs can be used in epilepsy surgery with intraoperative electrocorticography.

Published
2017

35. Influence of Venus and Mars in the cognitive sky of schizophrenia. Results from the first-step national FACE-SZ cohort

Author

G. Fond, L. Boyer, M. Leboyer, O. Godin, P.M. Llorca, M. Andrianarisoa, F. Berna, L. Brunel, B. Aouizerate, D. Capdevielle, I. Chereau, T. D'Amato, C. Dubertret, J. Dubreucq, C. Faget, F. Gabayet, J. Mallet, D. Misdrahi, R. Rey, C. Lancon, C. Passerieux, P. Roux, P. Vidailhet, H. Yazbek, F. Schürhoff, E. Bulzacka, O. Blanc, I. Chereau-Boudet, G. Chesnoy-Servanin, Jm Danion, A. Deloge, C. Delorme, H. Denizot, J.M. Dorey, C. Fluttaz, S. Fonteneau, E. Giraud-Baro, M.C. Hardy-Bayle, D. Lacelle, C. Lançon, H. Laouamri, T. Le Gloahec, Y. Le Strat, null Llorca, E. Metairie, I. Offerlin-Meyer, P. Peri, S. Pires, C. Portalier, C. Roman, M. Sebilleau, A. Schandrin, F. Schurhoff, A. Tessier, Am Tronche, M. Urbach, F. Vaillant, A. Vehier, E. Vilà, A. Zinetti-Bertschy, Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Université Montpellier 1 (UM1), Génétique moléculaire de la neurotransmission et des processus neurodégénératifs (LGMNPN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), ONERA - The French Aerospace Lab [Toulouse], ONERA, Information – Technologies – Analyse Environnementale – Procédés Agricoles (UMR ITAP), Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [APHP], Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Centre Hospitalier d'Annecy, Centre hospitalier d'Annecy, IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre de Psychiatrie et Neurosciences (U894), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]-Centre National de la Recherche Scientifique (CNRS), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, and CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2

Subjects
Adult, Male, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Neuropsychological Tests, Verbal learning, Developmental psychology, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Borderline intellectual functioning, medicine, Verbal fluency test, Humans, Biological Psychiatry, ComputingMilieux_MISCELLANEOUS, Psychiatric Status Rating Scales, Analysis of Variance, Sex Characteristics, [SDV.NEU.PC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Psychology and behavior, [SCCO.NEUR]Cognitive science/Neuroscience, Neuropsychology, Cognitive flexibility, [SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, Cognition, Middle Aged, medicine.disease, Executive functions, 030227 psychiatry, 3. Good health, Psychiatry and Mental health, Schizophrenia, Female, Schizophrenic Psychology, Independent Living, Psychology, 030217 neurology & neurosurgery, Clinical psychology
Abstract

Objectives Sex differences can yield important clues regarding illness pathophysiology and its treatment. Schizophrenia (SZ) has a lower incidence rate, and a better prognosis, in women versus men. The present study investigated the cognitive profiles of both sexes in a large multi-centre sample of community-dwelling SZ patients. Method 544 community-dwelling stable SZ subjects (141 women and 403 men; mean age 34.5 ± 12.1 and 31.6 ± 8.7 years, respectively) were tested with a comprehensive battery of neuropsychological tests. Results Although community-dwelling SZ men had more risk factors for impaired cognition (including first-generation antipsychotics administration and comorbid addictive disorders), women had lower scores on a wide range of cognitive functions, including current and premorbid intellectual functioning, working memory, semantic memory, non-verbal abstract thinking and aspects of visual exploration. However, women scored higher in tests of processing speed and verbal learning, as well as having a lower verbal learning bias. No sex difference were evident for visuospatial learning abilities, cued verbal recall, sustained attention and tests of executive functions, including cognitive flexibility, verbal abstract thinking, verbal fluency and planning abilities. Conclusion Sex differences are evident in the cognitive profiles of SZ patients. The impact on daily functioning and prognosis, as well as longitudinal trajectory, should be further investigated in the FACE-SZ follow-up study. Sex differences in cognition have implications for precision-medicine determined therapeutic strategies. Limits Given the restricted age range of the sample, future research will have to determine cognitive profiles across gender in late onset SZ.

Published
2017

36. 130TiP SOLTI-1303 PATRICIA 2 randomized phase II trial of palbociclib plus trastuzumab and endocrine therapy (ET) versus treatment of physician's choice (TPC) in metastatic HER2-positive and hormone receptor-positive (HER2+/HR+) breast cancer (BC) with PAM50 luminal intrinsic subtype

Author

Ciruelos, E.M., Garcia, A.A., Cortés, J., Pernas Simon, S., Garate, E., Melé, M., Montaño, Á., Martinez-Jañez, N., Oliveira, M., Haba-Rodríguez, J. de la, Vega, E., Martorell, A. Perello, Bermejo De Las Heras, B., Cantos Sanchez De Ibarguen, B., Martínez, E., Navarro, E. Vila, Pascual, T., González-Farré, X., Villagrasa, P., and Prat, A.

Published
2021
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38. Fenómeno de Kernohan-Woltman secundario a un hematoma epidural craneal

Author

E. Vilà Barriuso, J. Mejía Kattah, L. Gallart Gallego, and C. García Bernedo

Subjects
Anisocoria, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Cerebral peduncle, medicine.medical_treatment, Magnetic resonance imaging, Critical Care and Intensive Care Medicine, medicine.disease, Surgery, Anesthesiology and Pain Medicine, Hematoma, Epidural hematoma, Midline shift, medicine, medicine.symptom, business, Motor Deficit, Craniotomy
Abstract

Kernohan-Woltman notch phenomenon is a paradoxical neurological manifestation which involves a motor deficit on the same side as the primary brain injury. It is produced mainly by acute or chronic subdural hematomas, and less frequently by post-traumatic epidural ones. It should be taken into consideration in cases of ipsilateral motor deficit, as it may lead to surgical procedures being performed on the incorrect side. We report the case of a 40 year old man who sustained a major head injury which was followed by a decreased level of consciousness and anisocoria. Computed tomography of the brain revealed a frontal and parietal epidural hematoma with right midline shift and uncal herniation. Craniotomy and drainage of the hematoma was performed, and on the sixth day after surgery it was observed that the patient had a brachio-crural right hemiparesis. Magnetic resonance imaging showed an ischemic area on the left capsule and cerebral peduncle consistent with the diagnosis of Kernohan-Woltman notch phenomenon.

Published
2014

39. La leucocitosis extrema puede inducir a un diagnóstico erróneo de hipoxemia severa. Descripción de un caso

Author

S. Pacreu, N. Baldomà, C. Rodríguez, A. Mases, E. Vilà, and S. Sánchez

Subjects
Thrombocytosis, medicine.diagnostic_test, business.industry, Context (language use), Perioperative, Critical Care and Intensive Care Medicine, medicine.disease, Hypoxemia, Pulse oximetry, Anesthesiology and Pain Medicine, Respiratory failure, Anesthesia, medicine, Arterial blood, In patient, medicine.symptom, business
Abstract

The diagnosis and treatment of respiratory failure is a part of the anaesthesist's daily practice, as well as the hypoxaemia that is one of its physiological and analytical consequences. Patients with an extreme leucocytosis secondary to leukaemia can suffer an incorrect diagnosis of hypoxemia, called “pseudohypoxaemia”. This is basically due to the rapid in vitro oxygen consumption, and is characterized by a low partial pressure of oxygen in arterial blood (PaO2) despite a normal oxygen saturation (SpO2) measured by pulse oximetry. Pseudohypoxaemia appears in patients with thrombocytosis or hyper-leucocytosis occurring during blastic crisis of a leukaemia. It must be suspected in patients with a discrepancy between the SpO2 measured by oximetry and the PaO2. In this context, pulse oximetry is the most accurate way to establish the diagnosis and to avoid unnecessary actions. We report the case of a patient with chronic myeloid leukaemia and extreme leucocytosis requiring emergency surgery, and diagnosed with pseudohypoxaemia during the perioperative period that led to a delay in the extubation of the patient.

Published
2014

41. Sedación con propofol y remifentanilo para la ultrasonografía endobronquial con punción-aspiración en tiempo real

Author

Anna Mases, Albert Sánchez-Font, Víctor Curull, Enrique Vela, E. Vilà, Luis Moltó, and Lluís Gallart

Subjects
Anesthesiology and Pain Medicine, Endosonografía, Bronchoscopy, Anesthesia, Critical Care and Intensive Care Medicine, Propofol, Broncoscopia, Anestesia, Endosonography
Abstract

ResumenIntroducciónPara la óptima realización de la ultrasonografía endobronquial (USEB) lineal es imprescindible que el paciente esté sedado para que se mantenga tranquilo, no tosa ni se mueva y el endoscopista trabaje cómodamente con un buen rendimiento de la exploración. Actualmente la técnica anestésica no está estandarizada y varía desde una anestesia general a una sedación. El objetivo del presente trabajo es conocer la dosificación, la seguridad y la satisfacción de la sedación endovenosa con propofol y remifentanilo e identificar los posibles factores predictivos de tos durante el procedimiento.Pacientes y métodosSe estudió prospectivamente a los pacientes a quienes se realizó la USEB bajo sedación en un hospital de tercer nivel.ResultadosSe realizó la USEB a 90pacientes bajo sedación con remifentanilo y propofol, a una velocidad de infusión de 0,13 (0,09-0,17)μgkg−1min−1 y 2,34 (1,5-3,6)mgkg−1h−1, respectivamente. El 81% de los pacientes tosieron en algún momento de la exploración. En el 8% de los pacientes se interrumpió el procedimiento puntualmente por tos y desaturación. No se registraron complicaciones graves directamente relacionadas con la sedación. El nivel de satisfacción del neumólogo y del paciente con el procedimiento fue excelente o bueno en la mayoría de casos. No se observó relación estadísticamente significativa entre el número de episodios de tos durante la ecobroncoscopia y las variables test de la tos, ser tosedor habitual, hábito tabáquico o grado de severidad de la EPOC.ConclusionesLa sedación con remifentanilo y propofol realizada por un anestesiólogo permite realizar la USEB lineal en ventilación espontánea aunque con una elevada incidencia de tos y desaturación, siendo esta última la complicación más frecuente. No se encontraron factores predictivos de la tos durante el procedimiento.AbstractIntroductionOptimal linear endobronchial ultrasound (EBUS) outcomes require sedation to ensure that the patient remains calm, immobile, and does not cough, and so that the bronchoscopist can work comfortably. The choice of anesthesia techniques, on a spectrum ranging from general anesthesia to sedation, is not standardized. The aims of this study were to determine doses, safety and satisfaction for intravenous sedation with propofol and remifentanil, and identify potential predictors of coughing during the procedure, and determine patient and bronchoscopist satisfaction with the procedure.Patients and methodsThe prospective study included patients undergoing EBUS under sedation in a tertiary hospital.ResultsA total of 90 patients underwent EBUS under sedation with remifentanil and propofol, at infusion rates of 0,13 (0,09–0,17) g kg−1 min−1 and 2.34 (1.5–3.6) mg kg−1 h−1, respectively. Just over four fifths of the patients (81%) coughed at some point during the ultrasound procedure. In 8% of patients the procedure was promptly discontinued due to coughing and desaturation. There were no major complications directly related to sedation. Bronchoscopists and patients rated their satisfaction with the procedure as excellent or good in most cases. There was no statistically significant relationship between the number of coughing episodes during the procedure and any of the following variables: positive cough test, a habitual cough, tobacco dependence, or severity of chronic obstructive pulmonary disease.ConclusionsRemifentanil and propofol administered by an anesthesiologist enabled spontaneously breathing patients to undergo linear EBUS, although with a high incidence of coughing and particularly desaturation. No predictors for coughing during EBUS were identified.

Published
2013
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42. Sedation with propofol and remifentanil for real-time endobronchial ultrasound needle aspiration

Author

Víctor Curull, E. Vilà, Enrique Vela, Anna Mases, Luis Moltó, Albert Sánchez-Font, and Lluís Gallart

Subjects
Bronchoscopist, medicine.medical_specialty, business.industry, Sedation, Incidence (epidemiology), Ultrasound, Remifentanil, Critical Care and Intensive Care Medicine, Broncoscopia, Anestesia, Endosonography, Surgery, Anesthesiology and Pain Medicine, Endosonografía, Anesthesia, Bronchoscopy, Breathing, Medicine, medicine.symptom, business, Propofol, Prospective cohort study, medicine.drug
Abstract

Introducción: Para la óptima realización de la ultrasonografía endobronquial (USEB) lineal es imprescindible que el paciente esté sedado para que se mantenga tranquilo, no tosa ni se mueva y el endoscopista trabaje cómodamente con un buen rendimiento de la exploración. Actualmente la técnica anestésica no está estandarizada y varía desde una anestesia general a una sedación. El objetivo del presente trabajo es conocer la dosificación, la seguridad y la satisfacción de la sedación endovenosa con propofol y remifentanilo e identificar los posibles factores predictivos de tos durante el procedimiento. Pacientes y métodos: Se estudió prospectivamente a los pacientes a quienes se realizó la USEB bajo sedación en un hospital de tercer nivel. Resultados: Se realizó la USEB a 90pacientes bajo sedación con remifentanilo y propofol, a una velocidad de infusión de 0,13 (0,09-0,17) ixgkg-¹ min^¹ y 2,34 (1,5-3,6) mgkg-¹ h_1, respectivamente. El 81% de los pacientes tosieron en algún momento de la exploración. En el 8% de los pacientes se interrumpió el procedimiento puntualmente por tos y desaturación. No se registraron complicaciones graves directamente relacionadas con la sedación. El nivel de satisfacción del neumólogo y del paciente con el procedimiento fue excelente o bueno en la mayoría de casos. No se observó relación estadísticamente significativa entre el número de episodios de tos durante la ecobroncoscopia y las variables test de la tos, ser tosedor habitual, hábito tabáquico o grado de severidad de la EPOC. Conclusiones: La sedación con remifentanilo y propofol realizada por un anestesiólogo permite realizar la USEB lineal en ventilación espontánea aunque con una elevada incidencia de tos y desaturación, siendo esta última la complicación más frecuente. No se encontraron factores predictivos de la tos durante el procedimiento. Introduction: Optimal linear endobronchial ultrasound (EBUS) outcomes require sedation to ensure that the patient remains calm, immobile, and does not cough, and so that the bronchoscopist can work comfortably. The choice of anesthesia techniques, on a spectrum ranging from general anesthesia to sedation, is not standardized. The aims of this study were to determine doses, safety and satisfaction for intravenous sedation with propofol and remifentanil, and identify potential predictors of coughing during the procedure, and determine patient and bronchoscopist satisfaction with the procedure. Patients and methods: The prospective study included patients undergoing EBUS under sedation in a tertiary hospital. Results: A total of 90 patients underwent EBUS under sedation with remifentanil and propofol, at infusion rates of 0,13 (0,09-0,17) g kg-¹ min^¹ and 2.34 (1.5-3.6) mg kg-¹ Lr¹, respectively. Just over four fifths of the patients (81%) coughed at some point during the ultrasound procedure. In 8% of patients the procedure was promptly discontinued due to coughing and desaturation. There were no major complications directly related to sedation. Bronchoscopists and patients rated their satisfaction with the procedure as excellent or good in most cases. There was no statistically significant relationship between the number of coughing episodes during the procedure and any of the following variables: positive cough test, a habitual cough, tobacco dependence, or severity of chronic obstructive pulmonary disease. Conclusions: Remifentanil and propofol administered by an anesthesiologist enabled spontaneously breathing patients to undergo linear EBUS, although with a high incidence of coughing and particularly desaturation. No predictors for coughing during EBUS were identified.

Published
2013

43. Lessons learned from European and Japanese production of ITER toroidal field coils

Author

T. Hemmi, B. Bellesia, S. Hasegawa, P. Aprili, A. Bonito Oliva, E. Boter, M. P. Casas, M. Cornelis, K. Gomikawa, R. Harrison, A. Hernandez, M. Iguchi, T. Isono, M. Jimenez, H. Kajitani, S. Koczorowski, N. Koizumi, A. Lo Bue, K. Matsui, M. Nakahira, M. Nakamoto, K. Saito, K. Sakamoto, T. Sakurai, T. Shimizu, T. Suwa, K. Takano, K. Takebayashi, N. Tanaka, F. Tsutsumi, Y. Uno, and E. Viladiu

Subjects
fusion, ITER, magnet, TF coil, manufacturing, Nuclear and particle physics. Atomic energy. Radioactivity, QC770-798
Abstract

In 2023, the manufacturing of all the ITER TF coils has been completed 15 years after the sign of procurement arrangements in 2008. This paper has been jointly submitted by F4E and QST to recollect the lessons learnt in the production of the two parties along the last 15 years.

Published
2024
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44. Akathisia: prevalence and risk factors in a community-dwelling sample of patients with schizophrenia. Results from the FACE-SZ dataset

Author

F. Berna, D. Misdrahi, L. Boyer, B. Aouizerate, L. Brunel, D. Capdevielle, I. Chereau, J.M. Danion, J.M. Dorey, C. Dubertret, J. Dubreucq, C. Faget, F. Gabayet, C. Lancon, J. Mallet, R. Rey, C. Passerieux, A. Schandrin, F. Schurhoff, A.M. Tronche, M. Urbach, P. Vidailhet, P.M. Llorca, G. Fond, O. Blanc, E. Bulzacka, I. Chereau-Boudet, G. Chesnoy-Servanin, T. D'Amato, A. Deloge, C. Delorme, H. Denizot, M. De Pradier, C. Fluttaz, S. Fonteneau, E. Giraud-Baro, M.C. Hardy-Bayle, D. Lacelle, C. Lançon, H. Laouamri, M. Leboyer, T. Le Gloahec, Y. Le Strat, E. Metairie, I. Offerlin-Meyer, P. Peri, S. Pires, C. Portalier, C. Roman, M. Sebilleau, A. Tessier, F. Vaillant, A. Vehier, J. Vilain, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Fondation FondaMental [Créteil], CHU Strasbourg, CHU Bordeaux [Bordeaux], Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Hôpital Charles Perrens, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre Hospitalier le Vinatier [Bron], Université Paris Diderot - Paris 7 (UPD7), Assistance Publique - Hôpitaux de Marseille (APHM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre hospitalier Charles Perrens [Bordeaux], and Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)

Subjects
Adult, Male, medicine.medical_specialty, Databases, Factual, Psychomotor agitation, medicine.medical_treatment, Schizoaffective disorder, Antidepressant, Akathisia, Severity of Illness Index, Antipsychotic, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Anticholinergic drug, Severity of illness, Prevalence, medicine, Humans, Psychiatry, Psychomotor Agitation, Biological Psychiatry, Benzodiazepine, medicine.disease, 030227 psychiatry, 3. Good health, Barnes Akathisia Scale, Psychiatry and Mental health, Psychotic Disorders, Schizophrenia, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Female, Independent Living, medicine.symptom, Psychology, 030217 neurology & neurosurgery, Antipsychotic Agents
Abstract

International audience; The main objective of this study was to determine the prevalence of akathisia in a community-dwelling sample of patients with schizophrenia, and to determine the effects of treatments and the clinical variables associated with akathisia. 372 patients with schizophrenia or schizoaffective disorder were systematically included in the network of FondaMental Expert Center for Schizophrenia and assessed with validated scales. Akathisia was measured with the Barnes Akathisia Scale (BAS). Ongoing psychotropic treatment was recorded. The global prevalence of akathisia (as defined by a score of 2 or more on the global akathisia subscale of the BAS) in our sample was 18.5%. Patients who received antipsychotic polytherapy were at higher risk of akathisia and this result remained significant (adjusted odd ratio=2.04, p=.025) after controlling the influence of age, gender, level of education, level of psychotic symptoms, substance use comorbidities, current administration of antidepressant, anticholinergic drugs, benzodiazepines, and daily-administered antipsychotic dose. The combination of second-generation antipsychotics was associated with a 3-fold risk of akathisia compared to second-generation antipsychotics used in monotherapy. Our results indicate that antipsychotic polytherapy should be at best avoided and suggest that monotherapy should be recommended in cases of akathisia. Long-term administration of benzodiazepines or anticholinergic drugs does not seem to be advisable in cases of akathisia, given the potential side effects of these medications.

Published
2015

45. [Translated article] Common Approach to Metabolic-Associated Fatty Liver Disease in Patients With Psoriasis: Consensus-Based Recommendations From a Multidisciplinary Group of Experts

Author

J.M. Carrascosa, E. Vilarrasa, I. Belinchón, P. Herranz, J. Crespo, F. Guimerá, and A. Olveira

Subjects
Psoriasis, Esteatosis hepática metabólica, EHmet, Hepatotoxicidad, Dermatology, RL1-803, Internal medicine, RC31-1245
Abstract

Recent years have seen concerted efforts to understand the relation between psoriasis and metabolic-associated fatty liver disease (MAFLD). Not only is MALFD diagnosed more often in patients with psoriasis, but its clinical course is also more aggressive. A common approach is therefore needed to enable early detection of liver disease coincident with psoriasis. Especially important is an analysis of risks and benefits of potentially hepatotoxic treatments. This consensus paper presents the recommendations of a group of experts in dermatology and hepatology regarding screening for MALFD as well as criteria for monitoring patients and referring them to hepatologists when liver disease is suspected. Resumen: En los últimos años se están haciendo notables esfuerzos para entender la relación existente entre la psoriasis y la esteatosis hepática metabólica (EHmet). Este trastorno no solo se presenta con una mayor prevalencia en pacientes psoriásicos, sino que además se acompaña de una mayor gravedad. Con este precedente se evidencia la necesidad de establecer un protocolo de abordaje precoz de la enfermedad hepática en los pacientes con psoriasis. Asimismo, es de especial relevancia la evaluación del riesgo y del beneficio en referencia al uso de tratamientos con potencial hepatotóxico. En el presente manuscrito se exponen las recomendaciones de un panel de expertos en dermatología y hepatología para el cribado, el diagnóstico, la monitorización y los criterios de derivación en pacientes con psoriasis, en caso de sospecha de esteatosis hepática metabólica.

Published
2023
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46. Metabolic syndrome, abdominal obesity and hyperuricemia in schizophrenia: Results from the FACE-SZ cohort

Author

O. Godin, M. Leboyer, A. Gaman, B. Aouizerate, F. Berna, L. Brunel, D. Capdevielle, I. Chereau, J.M. Dorey, C. Dubertret, J. Dubreucq, C. Faget, F. Gabayet, Y. Le Strat, P.M. Llorca, D. Misdrahi, R. Rey, R. Richieri, C. Passerieux, A. Schandrin, F. Schürhoff, M. Urbach, P. Vidalhet, N. Girerd, G. Fond, O. Blanc, E. Bulzacka, I. Chereau-Boudet, G. Chesnoy-Servanin, J.M. Danion, T. D'Amato, A. Deloge, C. Delorme, H. Denizot, M. Depradier, C. Fluttaz, S. Fonteneau, E. Giraud-Baro, M.C. Hardy-Bayle, D. Lacelle, C. Lançon, H. Laouamri, T. Le Gloahec, E. Metairie, I. Offerlin-Meyer, P. Peri, S. Pires, C. Portalier, C. Roman, M. Sebilleau, A. Tessier, A.M. Tronche, F. Vaillant, A. Vehier, P. Vidailhet, E. Vilà, H. Yazbek, A. Zinetti-Bertschy, Fondation FondaMental [Créteil], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Psychiatrie et Neurologie personnalisées [AP-HP Hôpital Henri-Mondor] (DHU PePsy), Hôpital Henri Mondor, Centre Hospitalier Charles PERRENS, Physiopathologie du système nerveux central - Institut François Magendie, Université Bordeaux Segalen - Bordeaux 2-IFR8-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie (NCPS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Civil de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Hôpital de la Colombière, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre Hospitalier le Vinatier [Bron], Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Référent de Réhabilitation Psychosociale [CH Alpes Isère], Centre Hospitalier Alpes Isère, Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM] (Hôpitaux Sud), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud )-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Perrens, Centre Hospitalier de Versailles André Mignot (CHV), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), AP-HP Hôpital Henri Mondor (Créteil), Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Strasbourg (UNISTRA)-Hôpital Civil de Strasbourg, Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux - Clermont Auvergne (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne (UCA), Hopital Louis Mourier - AP-HP [Colombes], Pôle de Psychiatrie Universitaire Solaris, Marseille, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre Hospitalier de Versailles (CHV), UFR des Sciences de la Santé Simone Veil, Centre d'investigation clinique plurithématique Pierre Drouin (CIC-P), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre de Psychiatrie et Neurosciences (U894), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier Charles Perrens [Bordeaux], and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)

Subjects
Male, MESH: Psychiatric Status Rating Scales, MESH: Chi-Square Distribution, Blood Pressure, MESH: Metabolic Diseases, Comorbidity, MESH: Lipoproteins, HDL, Body Mass Index, Cohort Studies, 0302 clinical medicine, Prevalence, Hyperuricemia, MESH: Cohort Studies, Abdominal obesity, Anthropometry, MESH: Blood Pressure, MESH: Hyperuricemia, Metabolic syndrome, 3. Good health, Psychiatry and Mental health, MESH: Young Adult, Obesity, Abdominal, Cohort, Female, France, medicine.symptom, Lipoproteins, HDL, Adult, medicine.medical_specialty, MESH: Obesity, Abdominal, MESH: Body Mass Index, Young Adult, 03 medical and health sciences, Metabolic Diseases, MESH: Anthropometry, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Humans, Risk factor, Biological Psychiatry, MESH: Prevalence, Psychiatric Status Rating Scales, Chi-Square Distribution, MESH: Humans, business.industry, MESH: Adult, medicine.disease, MESH: Male, MESH: Schizophrenia, 030227 psychiatry, MESH: France, Endocrinology, Schizophrenia, business, Body mass index, MESH: Female, 030217 neurology & neurosurgery, Dyslipidemia
Abstract

Objective Abdominal obesity was suggested to be a better predictor than Metabolic Syndrome (MetS) for cardiovascular mortality, however this is has not been extensively studied in schizophrenia. Hyperuricemia (HU) was also suggested to be both an independent risk factor for greater somatic comorbidity and a global metabolic stress marker in patients with schizophrenia. The aim of this study was to estimate the prevalence of MetS, abdominal obesity and HU, to examine the association between metabolic parameters with HU in a cohort of French patients with schizophrenia or schizo-affective disorder (SZ), and to estimate the prevalence rates of treatment of cardio-vascular risk factors. Method 240 SZ patients (age = 31.4 years, male gender 74.3%) were systematically included. Metabolic syndrome was defined according to the International Diabetes Federation and HU if serum uric acid level was above 360 μmol/L. Results MetS, abdominal obesity and HU were found respectively in 24.2%, 21.3% and 19.6% of patients. In terms of risk factors, multiple logistic regression showed that after taking into account the potential confounders, the risk for HU was higher in males (OR = 5.9, IC95 [1.7–21.4]) and in subjects with high waist circumference (OR = 3.1, IC95 [1.1–8.3]) or hypertriglyceridemia (OR = 4.9, IC95 [1.9–13]). No association with hypertension, low HDL cholesterol or high fasting glucose was observed. Only 10% of patients with hypertension received a specific treatment, 18% for high fasting glucose and 8% for dyslipidemia. Conclusions The prevalence of MetS, abdominal obesity and hyperuricemia is elevated in French patients with schizophrenia, all of which are considerably under-diagnosed and undertreated. HU is strongly associated with abdominal obesity but not with psychiatric symptomatology.

Published
2015

47. Riesgo de aparición de segundas neoplasias cutáneas en una cohorte de pacientes diagnosticados de carcinoma queratinocítico (carcinoma basocelular y carcinoma epidermoide) tratados con cirugía de Mohs. Estudio de cohortes prospectivo nacional

Author

R. Miñano Medrano, J.L. López Estebaranz, O. Sanmartin-Jiménez, J.R. Garcés, M.A. Rodríguez-Prieto, E. Vilarrasa-Rull, E. de Eusebio-Murillo, B. Escutia-Muñoz, Á. Flórez-Menéndez, J.L. Artola-Igarza, A. Alfaro-Rubio, P. Redondo, Y. Delgado-Jiménez, J.M. Sánchez-Schmidt, I. Allende-Markixana, M.L. Alonso-Pacheco, B. García-Bracamonte, P. de la Cueva-Dobao, R. Navarro-Tejedor, C. Ciudad-Blanco, L. Carnero-González, H. Vázquez-Veiga, N. Cano-Martínez, V. Ruiz-Salas, P. Sánchez-Sambucety, R. Botella-Estrada, B. González-Sixto, A. Martorell-Calatayud, P. Gil, V. Morales-Gordillo, A. Toll-Abelló, I. Ocerin-Guerra, M. Mayor-Arenal, R. Suárez-Fernández, L. Sainz-Gaspar, M.A. Descalzo, and I. García-Doval

Subjects
Mohs micrographic surgery, Basal cell carcinoma, Squamous cell carcinoma, Second cancer, Incidence, Risk factors, Dermatology, RL1-803, Internal medicine, RC31-1245
Abstract

Resumen: Objetivo: Los pacientes diagnosticados de cáncer queratinocítico (carcinoma basocelular y carcinoma epidermoide cutáneo) o cáncer cutáneo no melanoma (CCNM) tienen un riesgo aumentado de desarrollar una segunda neoplasia cutánea. Nuestro objetivo es describir la frecuencia, tasa de incidencia y factores de riesgo predisponentes para desarrollar una segunda neoplasia cutánea en una cohorte de pacientes tratados mediante cirugía micrográfica de Mohs (CMM). Material y métodos: Estudio prospectivo de una cohorte nacional de pacientes incluidos para realización de CMM para tratar CCNM en 22 centros españoles (julio 2013-febrero 2020) REGESMOHS. Las variables analizadas incluyen las características demográficas, la frecuencia de aparición de segundas neoplasias cutáneas, sus tasas de incidencia y factores de riesgo, y se estimaron utilizando un modelo de regresión logístico multivariante de efectos mixtos. Resultados: Fueron intervenidos 4.768 pacientes: 4.397 (92%) carcinomas basocelulares, y 371 (8%) carcinomas epidermoides. El tiempo medio de seguimiento fue de 2,4 años. Se diagnosticó un nuevo tumor durante el seguimiento en 1.201 pacientes (25%); 1.013 (21%) fueron carcinomas basocelulares, 154 (3%) carcinomas epidermoides cutáneos, 20 melanomas (0,4%) La tasa de incidencia fue de 107 (101-113) por 1.000 personas/año para cualquier tumor; 90 (85-96) para el carcinoma basocelular, 14 (12-16) para el carcinoma epidermoide cutáneo y 2 (1-3) para el melanoma. El riesgo de nueva neoplasia fue mayor en varones que en mujeres 738 (61%) vs. 463 (39%). Los factores de riesgo más significativos fueron la historia de múltiples tumores previos al diagnóstico (RR: 4,6; IC 95%: 2,9-7,1); la inmunosupresión (RR: 2,1; IC 95%: 1,4-3,1) y paciente varón (RR: 1,6; IC 95%: 1,4-1,9). Conclusión: Los pacientes diagnosticados de cáncer queratinocítico intervenido mediante cirugía de Mohs tienen un riesgo aumentado de aparición de segundas neoplasias, sobre todo en aquellos pacientes con historia de tumores múltiples al diagnóstico, inmunodeprimidos y varones. Abstract: Objective: Patients with nonmelanoma skin cancer (NMSC)—ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)—have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). Material and methods: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. Results: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). Conclusion: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.

Published
2022
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48. Changes in Density Spectral Array of BIS VISTA Monitoring System in Epilepsy Surgery

Author

Cristina Rodríguez, Juan Fernández C, Luis Moltó, S. Pacreu, German Ortega, Susana Fernández Galinski, and E. Vilà

Subjects
medicine.medical_specialty, business.industry, Sedation, Amygdalohippocampectomy, Monitoring system, Drug Resistant Epilepsy, medicine.disease, Surgery, body regions, Epilepsy, Bispectral index, Anesthesia, medicine, Epilepsy surgery, medicine.symptom, Propofol, business, medicine.drug
Abstract

We report the case of a patient with drug resistant epilepsy scheduled for amygdalohippocampectomy (AHS). During this type of surgery, Density Spectral Array (DSA) belonging to the Bilateral Bispectral Index (BIS) VISTATM Monitoring System (BVMS) was used. DSA, but no BIS trend, was helpful to detect differences in the power spectrum between both cerebral hemispheres during propofol- remifentanyl-dexmedetomidine anesthesia. This case provides novel evidence to support the clinical utility of DSA in monitoring depth of anaesthesia and sedation.

Published
2014

50. [Extreme leucocytosis can lead to an erroneous diagnosis of severe hypoxaemia. Description of a case]

Author

C, Rodríguez, S, Pacreu, N, Baldomà, S, Sánchez, E, Vilà, and A, Mases

Subjects
Male, Rupture, Spontaneous, Leukocytosis, Partial Pressure, Blood Component Transfusion, Splenic Rupture, Oxygen, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Hemoperitoneum, Airway Extubation, Splenectomy, Humans, Oximetry, Diagnostic Errors, Emergencies, Hypoxia, Aged
Abstract

The diagnosis and treatment of respiratory failure is a part of the anaesthesist's daily practice, as well as the hypoxaemia that is one of its physiological and analytical consequences. Patients with an extreme leucocytosis secondary to leukaemia can suffer an incorrect diagnosis of hypoxemia, called "pseudohypoxaemia". This is basically due to the rapid in vitro oxygen consumption, and is characterized by a low partial pressure of oxygen in arterial blood (PaO2) despite a normal oxygen saturation (SpO2) measured by pulse oximetry. Pseudohypoxaemia appears in patients with thrombocytosis or hyper-leucocytosis occurring during blastic crisis of a leukaemia. It must be suspected in patients with a discrepancy between the SpO2 measured by oximetry and the PaO2. In this context, pulse oximetry is the most accurate way to establish the diagnosis and to avoid unnecessary actions. We report the case of a patient with chronic myeloid leukaemia and extreme leucocytosis requiring emergency surgery, and diagnosed with pseudohypoxaemia during the perioperative period that led to a delay in the extubation of the patient.

Published
2012

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