159 results on '"Hôpital Privé d'Antony"'
Search Results
2. Cytotoxic lesion of the corpus callosum as presenting neuroradiological manifestation of COVID-2019 infection
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Grégoire Bornet, Isaure de Beaurepaire, Gregoire Boulouis, Géraud Forestier, Service de Neuroradiologie interventionnelle [CHU Limoges], CHU Limoges, Service de Radiologie [Hôpital Privé d'Antony], Hôpital Privé d'Antony, Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Martinez Rico, Clara, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)
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2019-20 coronavirus outbreak ,Pathology ,medicine.medical_specialty ,Neurology ,Clinical Neurology ,Corpus callosum ,Letter to the Editors ,030218 nuclear medicine & medical imaging ,Corpus Callosum ,Lesion ,[SCCO]Cognitive science ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,medicine ,Cytotoxic T cell ,Humans ,ComputingMilieux_MISCELLANEOUS ,Neuroradiology ,Brain Diseases ,medicine.diagnostic_test ,business.industry ,SARS-CoV-2 ,[SCCO.NEUR]Cognitive science/Neuroscience ,[SCCO.NEUR] Cognitive science/Neuroscience ,COVID-19 ,Magnetic resonance imaging ,[SCCO] Cognitive science ,Magnetic Resonance Imaging ,Diffusion Magnetic Resonance Imaging ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
International audience; No abstract available
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- 2020
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3. Cerebral perfusion using ASL in patients with COVID-19 and neurological manifestations: A retrospective multicenter observational study
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François-Daniel Ardellier, Seyyid Baloglu, Magdalena Sokolska, Vincent Noblet, François Lersy, Olivier Collange, Jean-Christophe Ferré, Adel Maamar, Béatrice Carsin-Nicol, Julie Helms, Maleka Schenck, Antoine Khalil, Augustin Gaudemer, Sophie Caillard, Julien Pottecher, Nicolas Lefèbvre, Pierre-Emmanuel Zorn, Muriel Matthieu, Jean Christophe Brisset, Clotilde Boulay, Véronique Mutschler, Yves Hansmann, Paul-Michel Mertes, Francis Schneider, Samira Fafi-Kremer, Mickael Ohana, Ferhat Meziani, Nicolas Meyer, Tarek Yousry, Mathieu Anheim, François Cotton, Hans Rolf Jäger, Stéphane Kremer, Fabrice Bonneville, Gilles Adam, Guillaume Martin-Blondel, Jérémie Pariente, Thomas Geeraerts, Hélène Oesterlé, Federico Bolognini, Julien Messie, Ghazi Hmeydia, Joseph Benzakoun, Catherine Oppenheim, Jean-Marc Constans, Serge Metanbou, Adrien Heintz, Blanche Bapst, Imen Megdiche, Lavinia Jager, Patrick Nesser, Yannick Talla Mba, Thomas Tourdias, Juliette Coutureau, Céline Hemmert, Philippe Feuerstein, Nathan Sebag, Sophie Carre, Manel Alleg, Claire Lecocq, Emmanuel Schmitt, René Anxionnat, François Zhu, Géraud Forestier, Aymeric Rouchaud, Pierre-Olivier Comby, Frederic Ricolfi, Pierre Thouant, Sylvie Grand, Alexandre Krainik, Isaure de Beaurepaire, Grégoire Bornet, Audrey Lacalm, Patrick Miailhes, Julie Pique, Claire Boutet, Xavier Fabre, Béatrice Claise, Sonia Mirafzal, Laure Calvet, Hubert Desal, Jérome Berge, Grégoire Boulouis, Apolline Kazemi, Nadya Pyatigorskaya, Augustin Lecler, Suzana Saleme, Myriam Edjlali-Goujon, Basile Kerleroux, Jean-Christophe Brisset, Samir Chenaf, Les Hôpitaux Universitaires de Strasbourg (HUS), Hôpital de Hautepierre [Strasbourg], Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), University College of London [London] (UCL), Nouvel Hôpital Civil de Strasbourg, Département de Neuroradiology [Rennes], Neuroimagerie: méthodes et applications (EMPENN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Inria Rennes – Bretagne Atlantique, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-SIGNAL, IMAGE ET LANGAGE (IRISA-D6), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), CHU Pontchaillou [Rennes], Service de Médecine Intensive et Réanimation [Strasbourg], CHU Strasbourg, Département de Radiologie [Bichat] (DR- Bichat), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Groupe d'Analyse des Itinéraires et des Niveaux Salariaux (GAINS), Le Mans Université (UM), Les Hôptaux universitaires de Strasbourg (HUS), Observatoire Français de la Sclérose En Plaques [Lyon] (OFSEP), Centre for Integrative Biology - CBI (Inserm U964 - CNRS UMR7104 - IGBMC), Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Louis Pasteur [Colmar] (CH Colmar), Hôpital Sainte-Anne [Paris], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), SFNR-COVID Group, CHU Henri Mondor [Créteil], Hôpital Marie Madeleine [Forbach] (CHIC Unisanté+), CHU de Bordeaux Pellegrin [Bordeaux], Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Centre Hospitalier de Haguenau, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Dupuytren [CHU Limoges], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Universitaire [Grenoble] (CHU), Hôpital privé d’Antony, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), CHU Clermont-Ferrand, and Société Française de Neuroradiologie [Paris] (SFNR)
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Multicenter Study ,Radiological and Ultrasound Technology ,Cerebrovascular Circulation ,COVID-19 ,Radiology, Nuclear Medicine and imaging ,Neuroimaging ,Neurology (clinical) ,Magnetic Resonance Imaging ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Background and purpose: Cerebral hypoperfusion has been reported in patients with COVID-19 and neurological manifestations in small cohorts. We aimed to systematically assess changes in cerebral perfusion in a cohort of 59 of these patients, with or without abnormalities on morphological MRI sequences.Methods: Patients with biologically-confirmed COVID-19 and neurological manifestations undergoing a brain MRI with technically adequate arterial spin labeling (ASL) perfusion were included in this retrospective multicenter study. ASL maps were jointly reviewed by two readers blinded to clinical data. They assessed abnormal perfusion in four regions of interest in each brain hemisphere: frontal lobe, parietal lobe, posterior temporal lobe, and temporal pole extended to the amygdalo-hippocampal complex.Results: Fifty-nine patients (44 men (75%), mean age 61.2 years) were included. Most patients had a severe COVID-19, 57 (97%) needed oxygen therapy and 43 (73%) were hospitalized in intensive care unit at the time of MRI. Morphological brain MRI was abnormal in 44 (75%) patients. ASL perfusion was abnormal in 53 (90%) patients, and particularly in all patients with normal morphological MRI. Hypoperfusion occurred in 48 (81%) patients, mostly in temporal poles (52 (44%)) and frontal lobes (40 (34%)). Hyperperfusion occurred in 9 (15%) patients and was closely associated with post-contrast FLAIR leptomeningeal enhancement (100% [66.4%-100%] of hyperperfusion with enhancement versus 28.6% [16.6%-43.2%] without, p=0.002). Studied clinical parameters (especially sedation) and other morphological MRI anomalies had no significant impact on perfusion anomalies.Conclusion: Brain ASL perfusion showed hypoperfusion in more than 80% of patients with severe COVID-19, with or without visible lesion on conventional MRI abnormalities.
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- 2023
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4. An Investigation of O-Demethyl Tramadol/Tramadol Ratio for Cytochrome P450 2D6 Phenotyping: The CYTRAM Study
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Blandine De La Gastine, Soizic Percevault, Laurent Varin, Nicolas Richard, Fabienne Fobe, Benoît Plaud, Georges Daccache, Vincent Compere, Jean-Jacques Parienti, Antoine Coquerel, Magalie Loilier, Nathalie Bleyzac, Laurent Bourguignon, Sylvain Goutelle, Véronique Lelong-Boulouard, Hospices Civils de Lyon (HCL), Hôpital Privé d'Antony, Service de Génétique [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Biologie, génétique et thérapies ostéoarticulaires et respiratoires (BIOTARGEN), Normandie Université (NU)-Normandie Université (NU), Service d'Anesthésie - Réanimation Chirurgicale [CHU Caen], Service d'anesthésie-réanimation-CTB, Université Paris Cité & AP-HP, Institute for Research and Innovation in Biomedicine (IRIB), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Direction de la Recherche Clinique et de l'innovation, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Mobilités : Vieillissement, Pathologie, Santé (COMETE), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Pharmacologie [CHU Caen], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon, Service de Pharmacologie, and HUE, Erika
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pharmacogenomics ,tramadol ,CYP2D6 ,pharmacogenetics ,[SDV.BA.MVSA]Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health ,[SDV.BA.MVSA] Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health ,Pharmaceutical Science - Abstract
International audience; Cytochrome P450 2D6 (CYP2D6) gene polymorphisms influence the exposure to tramadol (T) and its pharmacologically active metabolite, O-demethyl tramadol (O-dT). Tramadol has been considered as a candidate probe drug for CYP2D6 phenotyping. The objective of the CYTRAM study was to investigate the value of plasma O-dT/T ratio for CYP2D6 phenotyping. European adult patients who received IV tramadol after surgery were included. CYP2D6 genotyping was performed and subjects were classified as extensive (EM), intermediate (IM), poor (PM), or ultra-rapid (UM) CYP2D6 metabolizers. Plasma concentrations of tramadol and O-dT were determined at 24 h and 48 h. The relationship between O-dT/T ratio and CYP2D6 phenotype was examined in both a learning and a validation group. Genotype data were obtained in 301 patients, including 23 PM (8%), 117 IM (39%), 154 EM (51%), and 7 UM (2%). Tramadol trough concentrations at 24 h were available in 297 patients. Mean value of O-dT/T ratio was significantly lower in PM than in non-PM individuals (0.061 ± 0.031 versus 0.178 ± 0.09, p < 0.01). However, large overlap was observed in the distributions of O-dT/T ratio between groups. Statistical models based on O-dT/T ratio failed to identify CYP2D6 phenotype with acceptable sensitivity and specificity. Those results suggest that tramadol is not an adequate probe drug for CYP2D6 phenotyping.
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- 2022
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5. A national healthcare response to intensive care bed requirements during the COVID-19 outbreak in France
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Lefrant, Jean-Yves, Fischer, Marc-Olivier, Potier, Hugo, Degryse, Cécile, Jaber, Samir, Muller, Laurent, Pottecher, Julien, Charboneau, Hélène, Meaudre, Eric, Lanot, Pierre, Bruckert, Vincent, Plaud, Benoît, Dureuil, Bertrand, Samain, Emmanuel, Bouaziz, Hervé, Ecoffey, Claude, Capdevila, Xavier, Lammens, Stéphane, Bonnet, Vincent, Prevost, Fabrice, Aussant, Philippe, Merouani, Karim, Alaoui, Samir Sidiki, Kalfon, Pierre, Mfam, Willy-Serge, Oilleau, Jean-Ferréol, Moussa, Mouhamed, Arab, Osama Abou, FELLAHI, Jean-Luc, Suzanne, Stéphanie, Coucoravas, Jérémy, Espitalier, Fabien, Bavozet, Florent, Fermier, Brice, Vincent, Jean-François, Ouchikhe, Abdelali, Herbland, Alexandre, Godde, Fréféric, Frasca, Denis, Desebe, Oliver, Riu, Béatrice, Faure, Henri, Hurel, Dominique, Bedos, Jean-Pierre, Lefevres-Scelles, Antoine, Hayon, Jan, Chanques, Gerald, Boutonnet, Mathieu, Pasquier, Pierre, Audibert, Gérard, Mertes, Paul Michel, Losser, Marie Reine, Collange, Olivier, Pottecher, Thierry, Aubrun, Frédéric, Payen, Jean François, Albaladejo, Pierre, Bouzat, Pierre, Ichaï, Carole, Leone, Marc, Bruder, Nicolas, Velly, Lionel, Fourcade, Olivier, Biais, Matthieu, Ouattara, Alexandre, Debaene, Bertrand, Fizelier, Claire Dahyot, Asehnoune, Karim, Lasocki, Sigismond, Roquilly, Antoine, Tavernier, Benoit, Kipnis, Eric, Lorne, Emmanuel, Bouhemad, Belaid, Dupont, Hervé, Morel, Jérome, Molliex, Serge, Beuret, Pascal, Constantin, Jean-Michel, Gayat, Etienne, Mebazaa, Alexandre, Schoeffler, Mathieu, Mateu, Philippe, Verdier, Philippe, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Initial MAnagement and prevention of acute orGan failures IN critically ill patiEnts (IMAGINE), Université de Montpellier (UM), Université de Caen Normandie (UNICAEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), BESPIM, CHU Bordeaux [Bordeaux], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Les Hôpitaux Universitaires de Strasbourg (HUS), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Clinique Pasteur [Toulouse], Hôpital d'Instruction des Armées Sainte Anne, Service de Santé des Armées, École du Val de Grâce (EVDG), Hôpital Privé d'Antony, Centre Hospitalier Universitaire de Nice (CHU Nice), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Paris (UP), CHU Rouen, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Pontchaillou [Rennes], Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
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medicine.medical_specialty ,National Health Programs ,Coronavirus disease 2019 (COVID-19) ,[SDV]Life Sciences [q-bio] ,health care facilities, manpower, and services ,Personnel Staffing and Scheduling ,Context (language use) ,Critical Care and Intensive Care Medicine ,Pacu ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Acute care ,Intensive care ,Bed availability ,Health care ,medicine ,Humans ,Bed Conversion ,030212 general & internal medicine ,Pandemics ,ComputingMilieux_MISCELLANEOUS ,Retrospective Studies ,Ventilators, Mechanical ,biology ,SARS-CoV-2 ,business.industry ,COVID-19 ,Outbreak ,030208 emergency & critical care medicine ,General Medicine ,biology.organism_classification ,medicine.disease ,Intensive care unit ,3. Good health ,Hospitalization ,Personnel, Hospital ,Intensive Care Units ,Anesthesiology and Pain Medicine ,Hospital Bed Capacity ,Health Care Surveys ,ICU ,Original Article ,France ,Medical emergency ,business - Abstract
Background Whereas 5415 Intensive Care Unit (ICU) beds were initially available, 7148 COVID-19 patients were hospitalised in the ICU at the peak of the outbreak. The present study reports how the French Health Care system created temporary ICU beds to avoid being overwhelmed. Methods All French ICUs were contacted for answering a questionnaire focusing on the available beds and health care providers before and during the outbreak. Results Among 336 institutions with ICUs before the outbreak, 315 (94%) participated, covering 5054/5531 (91%) ICU beds. During the outbreak, 4806 new ICU beds (+95% increase) were created from Acute Care Unit (ACU, 2283), Post Anaesthetic Care Unit and Operating Theatre (PACU & OT, 1522), other units (374) or real build-up of new ICU beds (627), respectively. At the peak of the outbreak, 9860, 1982 and 3089 ICU, ACU and PACU beds were made available. Before the outbreak, 3548 physicians (2224 critical care anaesthesiologists, 898 intensivists and 275 from other specialties, 151 paediatrics), 1785 residents, 11,023 nurses and 6763 nursing auxiliaries worked in established ICUs. During the outbreak, 2524 physicians, 715 residents, 7722 nurses and 3043 nursing auxiliaries supplemented the usual staff in all ICUs. A total number of 3212 new ventilators were added to the 5997 initially available in ICU. Conclusion During the COVID-19 outbreak, the French Health Care system created 4806 ICU beds (+95% increase from baseline), essentially by transforming beds from ACUs and PACUs. Collaboration between intensivists, critical care anaesthesiologists, emergency physicians as well as the mobilisation of nursing staff were primordial in this context.
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- 2020
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6. Characteristics and outcomes of acute respiratory distress syndrome related to COVID-19 in Belgian and French intensive care units according to antiviral strategies: the COVADIS multicentre observational study
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David Grimaldi, Nadia Aissaoui, Gauthier Blonz, Giuseppe Carbutti, Romain Courcelle, Stephane Gaudry, Aurelie Gaultier, Alain D’hondt, Julien Higny, Geoffrey Horlait, Sami Hraiech, Laurent Lefebvre, Francois Lejeune, Andre Ly, Michael Piagnerelli, Bertrand Sauneuf, Nicolas Serck, Thibaud Soumagne, Piotr Szychowiak, Julien Textoris, Benoit Vandenbunder, Christophe Vinsonneau, Jean- Baptiste Lascarrou, for the COVADIS study group, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Services des soins intensifs, Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Départemental site de la Roche-sur-Yon (CHD de la Roche-sur-Yon), hospital universitaire de Mons-Hainaut, Hopital de Jolimont, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Plateforme de Méthodologie et Biostatistique, Direction de la Recherche [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Ambroise Paré [Mons, Belgium], CHU Dinant-Godinne UCL Namur [Yvoir, Belgique], Hôpital Nord [CHU - APHM], Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Centre Hospitalier du Pays d'Aix, 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), Université libre de Bruxelles (ULB), Grand Hôpital de Charleroi [Belgium], Service de Réanimation Polyvalente [CHPC - Site Louis Pasteur], Site Louis Pasteur [CHPC], CH Centre Hospitalier Public du Cotentin (CHPC)-CH Centre Hospitalier Public du Cotentin (CHPC), Saint Pierre clinic of Ottignies (CSPO), Saint Pierre clinic of Ottignies, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de Médecine Intensive et Réanimation [Tours], Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Réseau CRICS-TRIGGERSEP [CHRU Tours] (F-CRIN research network), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hospices Civils de Lyon (HCL), Laboratoire Commun de Recherche Hospices Civils de Lyon – bioMérieux (Cancer Biomarkers Research Group), Hospices Civils de Lyon (HCL)-BIOMERIEUX, Hôpital Privé d'Antony, Centre Hospitalier de Béthune (CH Béthune), GHT de l'Artois, and COVADIS study group: Patrick Biston, Gwenhael Colin, Oriane de Maere, Nathan Ebstein, Stephan Ehrmann, Frederic Foret, Lionel Haentjens, Thibault Helbert, Jean-Baptiste Mesland, Celine Monard, Nicolas Mongardon, Gregoire Ottavy, Thomas Pasau, Gael Piton, Ester Ponzetto, Caroline Sejourne, Morgane Snacken, Xavier Souloy, Aude Sylvestre, Nicolas Tartrat, Cedric Vanbrussel
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ARDS ,medicine.medical_specialty ,medicine.medical_treatment ,Remdesivir ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Lopinavir ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Intensive care ,Internal medicine ,medicine ,030212 general & internal medicine ,Renal replacement therapy ,Mechanical ventilation ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Ritonavir ,business.industry ,Research ,Acute kidney injury ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,lcsh:RC86-88.9 ,medicine.disease ,Cohort ,[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,medicine.drug ,Hydroxychloroquine - Abstract
Background Limited data are available regarding antiviral therapy efficacy in most severe patients under mechanical ventilation for Covid-19-related acute respiratory distress syndrome (ARDS). Methods Comparison of antiviral strategies (none, hydroxychloroquine (OHQ), lopinavir/ritonavir (L/R), others (combination or remdesivir) in an observational multicentre cohort of patients with moderate-to-severe Covid-19 ARDS. The primary endpoint was the number of day 28 ventilator-free days (VFD). Patients who died before d28 were considered as having 0 VFD. The variable was dichotomized into “patients still ventilated or dead at day 28” versus “patients weaned and alive at day 28”. Results We analyzed 415 patients (85 treated with standard of care (SOC), 57 with L/R, 220 with OHQ, and 53 others). The median number of d28-VFD was 0 (IQR 0–13) and differed between groups (P = 0.03), SOC patients having the highest d28-VFD. After adjustment for age, sex, Charlson Comorbidity Index, PaO2/FiO2 ratio and plateau pressure and accounting for center effect with a generalized linear mixed model, none of the antiviral strategies increased the chance of being alive and weaned from MV at day 28 compared to the SOC strategy (OR 0.48 CI95% (0.18–1.25); OR 0.96 (0.47–2.02) and OR 1.43 (0.53–4.04) for L/R, OHQ and other treatments, respectively). Acute kidney injury during ICU stay was frequent (55%); its incidence was higher in patients receiving lopinavir (66 vs 53%, P = 0.03). After adjustment for age, sex, BMI, chronic hypertension and chronic renal disease, the use of L/R was associated with an increased risk of renal replacement therapy (RRT). (OR 2.52 CI95% 1.16–5.59). Conclusion In this multicentre observational study of moderate-to-severe Covid-19 ARDS patients, we did not observe any benefit among patients treated with OHQ or L/R compared with SOC. The use of L/R treatment was associated with an increased need for RRT. Take home message Neither hydroxychloroquine nor lopinavir/ritonavir as COVID-19 antiviral treatment is associated with higher ventilator-free days at day 28 when compared with standard of care (no antiviral treatment) in ICU patients under invasive mechanical ventilation. Lopinavir/ritonavir is associated with an increased risk of renal replacement therapy requirement. Tweet COVID-19: Insights from ARDS cohort: no signal of efficacy of any antiviral drugs. Lopinavir/ritonavir may be associated with need for RRT
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- 2020
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7. Tocilizumab plus dexamethasone versus dexamethasone in patients with moderate-to-severe COVID-19 pneumonia: A randomised clinical trial from the CORIMUNO-19 study group
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Olivier Hermine, Xavier Mariette, Raphael Porcher, Felix Djossou, Yann Nguyen, Jean-Benoît Arlet, Laurent Savale, Jean Luc Diehl, Sophie Georgin-Lavialle, Jacques Cadranel, Gilles Pialoux, Karine Lacombe, Arsène Mekinian, Hélène Gros, Xavier Lescure, Jade Ghosn, Elisabeth Coupez, Kevin Grapin, Christophe Rapp, Marc Michel, Anne Lise Lecapitaine, Jean Marie Michot, Nathalie Costedoat-Chalumeau, Liem Binh Luong Nguyen, Luca Semerano, François Raffi, Claire Aguillar, Claire Rouzaud, Jacques Eric Gottenberg, Yves Hansmann, Boris Bienvenu, Jonathan London, Franklin Samou Fantchou, Felix Ackermann, Antoine Gros, Alexandre Morel, Nicolas Gambier, Damien Sène, Bruno Mégarbane, Elie Azoulay, Serge Bureau, Maxime Dougados, Joseph Emmerich, Muriel Fartoukh, Bertrand Guidet, Marc Humbert, Mathieu Mahevas, Frédéric Pène, Frédéric Schlemmer, Valérie Pourcher-Martinez, Annick Tibi, Gabriel Baron, Elodie Perrodeau, Stéphanie Baron, Gabriel Steg, Yazdan Yazdapanah, Tabassome Simon, Matthieu Resche-Rigon, Pierre-Louis Tharaux, Philippe Ravaud, Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Bicêtre, Université Paris-Saclay, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Hôtel-Dieu [Paris], Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Hôpital Beaujon [AP-HP], Université Paris Cité (UPCité), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Sorbonne Paris Cité (USPC), Université Sorbonne Paris Nord, CHU Saint-Antoine [AP-HP], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hôpital Robert Ballanger [Aulnay-sous-Bois], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Hôpital Américain de Paris, Hôpital Henri Mondor, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Compiègne-Noyon (CHCN), Centre Hospitalier Compiègne-Noyon, Institut Gustave Roussy (IGR), Département d'hématologie [Gustave Roussy], Hôpital Cochin [AP-HP], Sorbonne Université (SU), CIC Cochin Pasteur (CIC 1417), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Avicenne [AP-HP], Hôtel-Dieu de Nantes, Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Université Paris Descartes - Paris 5 (UPD5), Centre hospitalier Saint-Joseph [Paris], Les Hôpitaux Universitaires de Strasbourg (HUS), Université de Strasbourg (UNISTRA), Hôpital Saint-Joseph [Marseille], Groupe Hospitalier Diaconesses Croix Saint-Simon, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Hôpital Foch [Suresnes], Centre Hospitalier de Versailles André Mignot (CHV), Hôpital privé d'Antony - Ramsay Santé (HPA-RS), Hôpital Delafontaine, Centre Hospitalier de Saint-Denis [Ile-de-France], Hôpital Lariboisière-Fernand-Widal [APHP], Université Paris Diderot - Paris 7 (UPD7), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Hopital Saint-Louis [AP-HP] (AP-HP), Université Paris-Est (UPE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Pitié-Salpêtrière [AP-HP], Agence Générale des Equipements et Produits de Santé [Paris] (AGEPS), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Pneumologie = Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Service de médecine interne [CHU Saint-Antoine], and Tharaux, Pierre-Louis
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[SDV] Life Sciences [q-bio] ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,[SDV]Life Sciences [q-bio] ,COVID-19 ,General Medicine ,Randomized clinical trial ,Tocilizumab+Dexamethasone ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Background: In moderate-to-severe COVID-19 pneumonia, dexamethasone (DEX) and tocilizumab (TCZ) reduce the occurrence of death and ventilatory support. We investigated the efficacy and safety of DEX+TCZ in an open randomized clinical trial.Methods: From July 24, 2020, through May 18, 2021, patients with moderate-to-severe COVID-19 pneumonia requiring oxygen (>3 L/min) were randomly assigned to receive DEX (10 mg/d 5 days tapering up to 10 days) alone or combined with TCZ (8 mg/kg IV) at day 1, possibly repeated with a fixed dose of 400 mg i.v. at day 3. The primary outcome was time from randomization to mechanical ventilation support or death up to day 14, analysed on an intent-to-treat basis using a Bayesian approach. ClinicalTrials.gov number, NCT04476979.Findings: A total of 453 patients were randomized, 3 withdrew consent, 450 were analysed, of whom 226 and 224 patients were assigned to receive DEX or TCZ+DEX, respectively. At day 14, mechanical ventilation or death occurred in 32/226 (14%) and 27/224 (12%) in the DEX and TCZ+DEX arms, respectively (hazard ratio [HR] 0·85, 90% credible interval [CrI] 0·55 to 1·31). At day 14, the World health Organization (WHO) clinical progression scale (CPS) was significantly improved in the TCZ+DEX arm (OR 0·69, 95% CrI, 0·49 to 0.97). At day 28, the cumulative incidence of oxygen supply independency was 82% in the TCZ+DEX arms and 72% in the DEX arm (HR 1·36, 95% CI 1·11 to 1·67). On day 90, 24 deaths (11%) were observed in the DEX arm and 18 (8%) in the TCZ+DEX arm (HR 0·77, 95% CI 0·42-1·41). Serious adverse events were observed in 25% and 21% in DEX and TCZ+DEX arms, respectively.Interpretation: Mechanical ventilation need and mortality were not improved with TCZ+DEX compared with DEX alone. The safety of both treatments was similar. However, given the wide confidence intervals for the estimate of effect, definitive interpretation cannot be drawn.Funding: Programme Hospitalier de Recherche Clinique [PHRC COVID-19-20-0151, PHRC COVID-19-20-0029], Fondation de l'Assistance Publique - Hôpitaux de Paris (Alliance Tous Unis Contre le Virus) and from Fédération pour la Recherche Médicale" (FRM). Tocilizumab was provided by Roche.
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- 2021
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8. Clinical characteristics of pediatric hidradenitis suppurativa: a cross-sectional multicenter study of 140 patients
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Amelia Głowaczewska, Lukasz Matusiak, Mateja Dolenc-Voljč, Nayera H. Moftah, Jorge Romaní, V. Sigsgaard, Burcu Beksaç, Jan Lapins, Hessel H. van der Zee, Moetaz El-Domyati, Errol P. Prens, Eugènia Agut-Busquet, Axel Patrice Villani, Lerinza van den Worm, Mehmet Ali Gürer, Lennart Emtestam, Hassan Riad Kottb, Annika M J D Vanlaerhoven, Farida Benhadou, Maïa Delage-Toriel, Lisa Weibel, Hossam Abdel-Wahab, José C. Pascual, Ditte Marie Saunte, Vincenzo Bettoli, Véronique Del Marmol, Thi Lam, Dorra Bouazzi, Giada Calamo, Mohammad Fatani, Pierre-Andre Becherel, Martin Theiler, Peter Theut Riis, Jacek C Szepietowski, Aude Nassif, Philippe Guillem, Rania Abdelghani, Carol Hlela, Nejib Doss, Gregor B.E. Jemec, Naomi N Kappe, Zealand University Hospital [Roskilde, Denmark], University of Copenhagen = Københavns Universitet (UCPH), Service de dermatologie [HCL Lyon], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Clinique du Val d'Ouest, Hospital Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-FISABIO), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana [Espagne] (FISABIO), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Minia University, Al-Azhar University [Cairo, Egypt], Armed Forces College of Medicine [Cairo, Egypt] (AFCM), Universitat Autònoma de Barcelona (UAB), Hospital de la Santa Creu i Sant Pau, Hospital Universitari Parc Taulí of Sabadell, Barcelona, University of Cape Town, Red Cross Children's Hospital [Cape Town, South Africa], Azienda Ospedaliero Universitaria di Ferrara [Cona, Italy], Gazi University, Wrocław Medical University, Karolinska Institutet [Stockholm], Hamad medical corporation, Hera General Hospital [Makkah, Saudi Arabia], University Children’s Hospital Zurich, University hospital of Zurich [Zurich], Centre Médical de l'Institut Pasteur (CMIP), Institut Pasteur [Paris] (IP), Hôpital privé d’Antony, University of Ljubljana, University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Department of Dermatology, Military Hospital of Tunis, Hôpital militaire de Tunis, Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Université libre de Bruxelles (ULB), University of Copenhagen = Københavns Universitet (KU), Wroclaw Medical University [Wrocław, Pologne], Centre Médical de l'Institut Pasteur, Institut Pasteur [Paris], and Dermatology
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Male ,Hirsutism ,[SDV]Life Sciences [q-bio] ,Dermatologic Surgical Procedures ,Administration, Oral ,Disease ,Comorbidity ,Severity of Illness Index ,Body Mass Index ,030207 dermatology & venereal diseases ,0302 clinical medicine ,Risk Factors ,Acne Vulgaris ,Medicine ,Hidradenitis suppurativa ,Child ,Children ,Acne ,hirsutism ,Pediatric ,medicine.diagnostic_test ,Clindamycin ,Smoking ,General Medicine ,Sciences bio-médicales et agricoles ,3. Good health ,Anti-Bacterial Agents ,Treatment Outcome ,030220 oncology & carcinogenesis ,Drug Therapy, Combination ,Female ,Rifampin ,medicine.drug ,medicine.medical_specialty ,Adolescent ,Physical examination ,Dermatology ,Administration, Cutaneous ,03 medical and health sciences ,Young Adult ,Pilonidal Sinus ,Internal medicine ,Humans ,Obesity ,business.industry ,Resorcinols ,Acne inversa ,Tetracycline ,medicine.disease ,Cross-Sectional Studies ,business ,Rifampicin ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,[SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology - Abstract
Hidradenitis suppurativa (HS) rarely affects pediatric patients. The literature on pediatric HS patients is scarce. This is a cross-sectional study based on case note review or interviews and clinical examination of 140 pediatric patients undergoing secondary or tertiary level care. Patients were predominantly female (75.5%, n = 105) with a median age of 16. 39% reported 1st-degree relative with HS. Median BMI percentile was 88, and 11% were smokers (n = 15). Median modified Sartorius score was 8.5. Notable comorbidities found were acne (32.8%, n = 45), hirsutism (19.3%, n = 27), and pilonidal cysts (16.4%, n = 23). Resorcinol (n = 27) and clindamycin (n = 25) were the most frequently used topical treatments. Patients were treated with tetracycline (n = 32), or oral clindamycin and rifampicin in combination (n = 29). Surgical excision was performed in 18 patients, deroofing in five and incision in seven patients. Obesity seemed to be prominent in the pediatric population and correlated to parent BMI, suggesting a potential for preventive measures for the family. Disease management appeared to be similar to that of adult HS, bearing in mind that the younger the patient, the milder the disease in majority of cases., info:eu-repo/semantics/published
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9. Inferring the dynamic of mutated hematopoietic stem and progenitor cells induced by IFNα in myeloproliferative neoplasms
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Cécile Le Sueur, François Girodon, Matthieu Mosca, Stefan N. Constantinescu, Cyril Catelain, Rémi Favier, Hana Raslova, Julien Lenglet, Bruno Cassinat, Robert Noble, Christophe Marzac, Hugo Campario, Florence Pasquier, Philippe Rameau, Caroline Marty, Amandine Tisserand, Gurvan Hermange, Cyril Gella, Isabelle Plo, Gaëlle Vertenoeil, Paul-Henry Cournède, Mira El-Khoury, Jean-Jacques Kiladjian, Jean-Luc Villeval, William Vainchenker, Eric Solary, Michael E. Hochberg, Nicole Casadevall, Institut des Sciences de l'Evolution de Montpellier (UMR ISEM), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université de Montpellier (UM)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UR226, Cellules souches hématopoïétiques et développement des hémopathies myéloïdes (CSHMyelo), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Mathématiques et Informatique pour la Complexité et les Systèmes (MICS), CentraleSupélec-Université Paris-Saclay, Institute of Evolutionary Biology and Environmental Studies, Zurich University, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université de Montpellier (UM)-Institut de recherche pour le développement [IRD] : UR226-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Ludwig Institute for Cancer Research, Université Catholique de Louvain = Catholic University of Louvain (UCL), Analyse moléculaire, modélisation et imagerie de la maladie cancéreuse (AMMICa), Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Hôpital Privé d'Antony, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de Recherche Saint-Louis - Hématologie Immunologie Oncologie (Département de recherche de l’UFR de médecine, ex- Institut Universitaire Hématologie-IUH) (IRSL), Université de Paris (UP), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-École Pratique des Hautes Études (EPHE), Université Paris Cité (UPCité), and ANR-18-IBHU-0002,PRISM,PRecISion Medicine Institute in oncology(2018)
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[SDV]Life Sciences [q-bio] ,Immunology ,Alpha interferon ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Biochemistry ,03 medical and health sciences ,0302 clinical medicine ,[MATH.MATH-ST]Mathematics [math]/Statistics [math.ST] ,Tumor Cells, Cultured ,Humans ,Immunologic Factors ,Longitudinal Studies ,Prospective Studies ,Progenitor cell ,QA ,Gene ,030304 developmental biology ,Thrombopoietin receptor ,0303 health sciences ,Myeloproliferative Disorders ,biology ,Interferon-alpha ,Cell Biology ,Hematology ,Janus Kinase 2 ,Hematopoietic Stem Cells ,3. Good health ,Haematopoiesis ,030220 oncology & carcinogenesis ,Molecular Response ,Mutation ,biology.protein ,Cancer research ,Stem cell ,[INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM] ,Calreticulin ,Receptors, Thrombopoietin - Abstract
Classical BCR-ABL–negative myeloproliferative neoplasms (MPNs) are clonal disorders of hematopoietic stem cells (HSCs) caused mainly by recurrent mutations in genes encoding JAK2 (JAK2), calreticulin (CALR), or the thrombopoietin receptor (MPL). Interferon α (IFNα) has demonstrated some efficacy in inducing molecular remission in MPNs. To determine factors that influence molecular response rate, we evaluated the long-term molecular efficacy of IFNα in patients with MPN by monitoring the fate of cells carrying driver mutations in a prospective observational and longitudinal study of 48 patients over more than 5 years. We measured the clonal architecture of early and late hematopoietic progenitors (84 845 measurements) and the global variant allele frequency in mature cells (409 measurements) several times per year. Using mathematical modeling and hierarchical Bayesian inference, we further inferred the dynamics of IFNα-targeted mutated HSCs. Our data support the hypothesis that IFNα targets JAK2V617F HSCs by inducing their exit from quiescence and differentiation into progenitors. Our observations indicate that treatment efficacy is higher in homozygous than heterozygous JAK2V617F HSCs and increases with high IFNα dose in heterozygous JAK2V617F HSCs. We also found that the molecular responses of CALRm HSCs to IFNα were heterogeneous, varying between type 1 and type 2 CALRm, and a high dose of IFNα correlates with worse outcomes. Our work indicates that the long-term molecular efficacy of IFNα implies an HSC exhaustion mechanism and depends on both the driver mutation type and IFNα dose.
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- 2021
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10. Nasopharyngeal and serological anti SARS-CoV-2 IgG/IgA responses in COVID-19 patients
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Sylvie van der Werf, Caroline Demeret, Bernadette Crescenzo-Chaigne, Lila Bouadma, Jade Ghosn, Vincent Enouf, Sarah Tubiana, Stéphane Petres, Marie Noelle Ungeheuer, Sylvie Behillil, Nicolas Escriou, Génétique Moléculaire des Virus à ARN - Molecular Genetics of RNA Viruses (GMV-ARN (UMR_3569 / U-Pasteur_2)), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPC), Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR), Institut Pasteur [Paris], Plateforme de Microbiologie Mutualisée (PIBnet) - Mutualized Platform for Microbiology (P2M), Laboratoire d’innovation : vaccins – Innovation lab : vaccines, Plateforme technologique Production et purification de protéines recombinantes – Production and Purification of Recombinant Proteins Technological Platform (PPR), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Université Sorbonne Paris Nord, Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'Investigations Cliniques [CHU Bichat] (CIC plurithématique), This work was supported by the « URGENCE COVID-19 » fundraising campaign of Institut Pasteur, by REACTING (Research & Action Emerging Infectious Diseases) and by the H2020 project 101003589 (RECOVER). The French Covid Cohort is funded through the Ministry of Health and Social Affairs (PHRC n°20-0424) and Ministry of Higher Education and Research dedicated COVID19 fund., List of the membership of the French COVID cohort study group : Mélanie RORIZ, Patrick RISPAL, Sarah REDL (CHG d'Agen), Laurent LEFEBVRE, Pascal GRANIER, Laurence MAULIN (CH du Pays d'Aix, Aix en Provence), Cédric JOSEPH, Julien MOYET, Sylvie LION-DAOLIO (CHU Amiens Nord), Rafael MAHIEU, Alexandra DU-CANCELLE, Vincent DUBEE (CHU d'Angers), Stéphane SALLA-BERRY, Aldric MANUEL, Gabriel MACHEDA, Mylène MAILLET, Bruno CHANZY (CH d'Annecy Genevois), Jean-Charles GAGNARD (Hôpital privé d'Antony), Guillermo GIORDANO, Clara MOUTON PERROT, Vincent PESTRE (CH Henri Duffaut, Avignon), Cécile FICKO, Marie GOMINET, Aurore BOUSQUET (Hôpital d'instruction des armées Begin), Charline VAUCHY, Kévin BOUILLER, Maïder PAGADOY, Solène MARTY-QUINTERNET, Quentin LEPILLER (CHU Jean Minjoz, Besançon), Cyril LE BRIS, Benoit THILL, Marie-Laure CASANOVA, Georges LE FALHER, Eric OZIOL (CH de Béziers), Hugues CORDEL, Nathalie DOURNON, Olivier BOUCHAUD, Ségolène BRICHLER (Hôpital Avicenne, Bobigny), Duc NGUYEN, Pantxika BELLECAVE, Camille CICCONE, Marie-Edith LAFON (CHU Pellegrin, Bordeaux), Ségolène GREFFE (CHU Ambroise Paré, Boulogne Billancourt), Camille BOUISSE, Nicholas SEDILLOT, Damien BOUHOUR (CH Fleyriat, Bourg en Bresse), Camille CHASSIN (CH Pierre Oudot, Bourgoin-Jallieu), Erwan L'HER, Séverine ANSART, Cécile TROMEUR, Dewi GUELLEC (CHRU de Brest), Antoine MERCKX (CH de Cahors), Felix DJOSSOU (CH Andrée Rosemon, Cayenne), Vincent PEIGNE, Carola PIEROBON, Marie-Christine CARRET, Florence JEGO, Margaux ISNARD (CHMS Chambéry NH), Johann AUCHABIE, Roxane COURTOIS (CH de Cholet), Olivier LESENS (CHU Gabriel Montpied, Clermont-Ferrand), Martin MARTINOT (Hôpital Pasteur, Colmar), Olivier PICONE (Hôpital Louis Mourier, Colombes), Marie LACOSTE (CH Alpes Leman Contamine sur Arve), Brigitte ELHAR-RAR, Valérie GARRAIT, Isabelle DELACROIX, Thomas MAITRE, Jean Baptiste ASSIE (Centre Hospitalier Intercommunal de Créteil), Elsa NYAMANKOLLY (CH de Dax), François Xavier CATHERINE, Ma-thieu BLOT, Sophie MAHY, Marielle BUISSON, Lionel PIROTH, Florence GUILLOTIN, Alexis DE ROUGEMONT (CHU de Dijon Bourgogne), Valentine CAMPANA, Jérémie PASQUIER, André CABIE (CHU de Martinique, Fort de France), Simon BESSIS (Hôpital Raymond Poincaré, Garches), Olivier EPAULARD, Nicolas TERZI, Jean-François PAYEN, Laurence BOUILLET, Rebecca HAMIDFAR, Marion Le MARECHAL (CHU de Grenoble), Moïse MACHADO, Audrey BARRELET, Alexandra BEDOSSA (Grand Hôpital de l'Est Francilien site Marne-la-Vallée, Jossigny), Gwenhaël COLIN, Romain DECOURS, Thomas GUIMARD (CHD Les Oudairies, La Roche Sur Yon), Cécile GOUJARD, Stéphane JAUREGUIBERRY, Antoine CHERET (Hôpital Universitaire Bicêtre, Le Kremlin-Bicêtre), Anne Sophie RESSEGUIER (CH Emile Roux, Le Puy en Velay), Julien POISSY, Daniel MATHIEU, Saad NSEIR, Ilka ENGELMANN, Martine REMY (CHRU de Lille, Hôpital Salengro), Fanny VUOTTO, Benoit GACHET, Karine FAURE, Marielle BOYER-BESSEYRE, Kazali Enagnon (CHRU de Lille, Hôpital Fourrier), Marc LAMBERT, Arnaud SCHERPEREEL, Dominique DEPLANQUE, Stéphanie FRY, Cécile YELNIK (CHRU de Lille, Hôpital Albert Calmette), Laurent BITKER, Mehdi MEZIDI, Hodane YONIS, Nicolas BENECH, Thomas PERPOINT, Anne CONRAD, Vinca ICARD, Martine VALETTE (Hôpital de la Croix Rousse, Lyon), Simon-Djamel THIBERVILLE (Hôpital Louis Raffalli, Manosque), Stanislas REBAUDET (Hôpital Européen de Marseille), Bertrand DUSSOL (Hôpital Conception, Marseille), Sylvain DIAMANTIS, Catherine CHAKVEATZE, Clara FLATEAU (Groupe Hospitalier Sud Ile De France, hôpital de Melun), Vincent DINOT, Rostane GACI, Nadia OUAMARA (Hôpital de Mercy, CHR Metz-Thionville, Ars laquenexy), Hajnal-Gabriela ILLES, Louis GER-BAUD MORLAES, Jérôme DIMET (CH de Mont Marsan), Vincent LE MOING, Nathalie PANSU, Clément LE BIHAN, Brigitte MONTES (CHU de Montpellier), Anne Sophie BOUREAU, Clotilde ALLAVENA, Sabelline BOUCHEZ, Romain GUERY, Paul LE TURNIER, Cécile MEAR-PASSARD, Virginie FERRE (CHU de Nantes), Christophe RAPP (Hôpital Américain de Paris, Neuilly sur Seine), Elisa DE-MONCHY, Céline MICHELANGELLI, Karine RISSO (CHU de Nice), Paul LOUBET, Jean-Phillippe LAVIGNE (CHU Caremeau, Nîmes), Etienne DE MONTMOLLIN, Juliette PATRIER, Paul Henri WICKY, Lucie LE FEVRE, Pierre JACQUET, Raphael BORIE, Antoine DOSSIER, Dominique LUTON, Valentina ISERNIA, Sylvie LE GAC (Hôpital Bichat, Paris), Cécile AZOULAY, Nicolas CARLIER, Liem LUONG, Marie LACHATRE, Odile LAUNAY (Hôpital Cochin, Paris), Younes KERROUMI, Vanina MEYSSONNIER (Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris), Jean-Luc DIEHL, Jean-Sébastien HULOT, Bernard CHOLLEY, Jean-Benoît ARLET, Olivier SANCHEZ (Hôpital Européen Georges Pompidou, Paris), Victoria MANDA, Laurène AZEMAR, Guylaine CASTOR-ALEXANDRE (Hôpital Lariboisière, Paris), Karine LACOMBE, Thibault CHIARABINI, Bénédicte LEFEBVRE, Laurence MORAND-JOUBERT, Djeneba FOFANA, Aurélie SCHNURIGER (Hôpital Saint Antoine, Paris), Nathalie DE CASTRO, Constance DELAUGERRE, Marie-Laure CHAIX (Hôpital Saint Louis, Paris), Julie CHAS (Hôpital Tenon, Paris), Valérie GABORIEAU, Eve LE COUSTUMIER, Walter PICARD (CH de Pau), Jean-Benoît ZABBE, Florent PEELMAN, Edouard SOUM (CH de Périgueux), Hugues AUMAÎTRE (CH de Perpignan), Elodie CURLIER, Rachida OUISSA, Isabelle FABRE (CHU de Pointe à Pitre, Guadeloupe), Blandine RAMMAERT (CHU de Poitiers), Nadia SAIDANI (CH Quimper), Firouzé BANI-SADR, Maxime HENTZIEN, Yohan N 'GUYEN, Juliette ROMARU, Kévin DIDIER (CHU Reims), Isabelle ENDERLE, Vincent THIBAULT, Fabrice LAINE, Matthieu LESOU-HAITIER, Matthieu REVEST, Pierre TATTEVIN (CHU Rennes), Jean-Christophe PLANTIER, Manuel ETIENNE, Véronique LEMEE, Eglantine FERRAND DEVOUGE, Kévin ALEXANDRE, Elise ARTAUD-MACCARI (CHU Rouen), Nathalie ALLOU, Marie LAGRANGE, Julien JABOT (CH Saint Denis et Saint Pierre, La réunion), Benoît ROZE, Delphine BREGEAUD, Younes AIT TAMLIHAT (CH Saintes), Ali HACHEMI (CH Soisson), Hélène SALVATOR, Erwan FOURN, David ZUCMAN (Hôpital Foch, Suresnes), Eric DELAVEUVE, Coline JAUD-FISCHER, Paul DUNAND (Hôpital Bel Air, Thionville), François BISSUEL (CH Thonon les Bains), Karen DELAVIGNE, Marie PIEL-JULIAN, Pierre DELOBEL, Benjamine SARTON, Marie RAFIQ, Guillaume MARTIN-BLONDEL, Laurent GUILLEMINAULT, Marlène MURRIS, Agnès SOMMET (CHU de Toulouse), Eric SENNEVILLE, Olivier ROBINEAU, Agnès MEYBECK (CH Tourcoing), Denis GAROT, Laurent PLANTIER, Valérie GISSOT, Julien MARLET, Karl STEFIC, Catherine GAUDY-GRAFFIN, Francis BARIN, Adrien LEMAIGNEN (CHU Bretonneau, Tours), Grégory CORVAISIER, Delphine LARIVIERE, Marie LANGELOT-RICHARD (CH Vannes), Elisabeth BOTELHO-NEVERS , Amandine GAGNEUX-BRUNON, Tiffany TROUILLON, Thomas BOURLET, Thomas BOURLET, Sylvie PILLET, Bruno POZZETTO (CHU de St Etienne), Antoine KIMMOUM, Bruno LEVY, Mathieu MATTEI, François GOEHRINGER, Christian RABAUD, Sibylle BEVILACQUA, Benjamin LEFEVRE, Anne GUILLAUMOT, Véronique VENARD, Hélène JEULIN, Evelyne SCHVOERER, Cédric HARTARD (CHU de Nancy, Vandoeuvre les Nancy), Pauline CARAUX PAZ, Laurent RICHIER, Mohamed EL SANHARAWI (CH Villeneuve St Georges)., European Project: 101003589, H2020-SC1-PHE-CORONAVIRUS-2020,RECOVER(2020), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR - laboratoire coordonnateur), Institut Pasteur [Paris] (IP), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord
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Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,[SDV]Life Sciences [q-bio] ,Severe disease ,Infectious and parasitic diseases ,RC109-216 ,Article ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Mucosal Immunity ,030304 developmental biology ,0303 health sciences ,biology ,030306 microbiology ,business.industry ,Epithelium ,3. Good health ,Nucleoprotein ,medicine.anatomical_structure ,Antibody response ,SARS CoV ,030220 oncology & carcinogenesis ,Immunology ,biology.protein ,Antibody ,business - Abstract
BackgroundThe systemic antibody responses to SARS-CoV-2 in COVID-19 patients has been extensively studied. However, much less is known about the mucosal responses in the upper airways at the site of initial SARS-CoV-2 replication. Local antibody responses in the nasopharyngeal epithelium, that are likely to determine the course of infection, have not been analysed so far nor their correlation with antibody responses in serum.MethodsThe IgG and IgA antibody responses were analysed in the plasma as well as in nasopharyngeal swabs (NPS) from the first four COVID-19 patients confirmed by RT-qPCR in France. Two were pauci-symptomatic while two developed severe disease. Taking advantage of a comprehensive series of plasma and nasopharyngeal samples, we characterized their antibody profiles from the second week post symptoms onset, by using an in-house ELISA to detect anti-SARS-CoV-2 Nucleoprotein (N) IgG and IgA.ResultsAnti-N IgG and IgA antibodies were detected in the NPS of severe patients. Overall, the levels of IgA and IgG antibodies in plasma and NPS appeared specific to each patient.ConclusionsAnti-N IgG and IgA antibodies are detected in NPS, and their levels are related to antibody levels in plasma. The two patients with severe disease exhibited different antibody profiles that may reflect different disease outcome. For the pauci-symptomatic patients, one showed a low anti-N IgG and IgA response in the plasma only, while the other one did not exhibit overt serological response.
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11. Interstitial lung disease-related pneumomediastinum in COVID-19 patients
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Nicolas Bonnet, Michel Arnaout, Kim Blanc, Yacine Tandjaoui-Lambiotte, Elise Ouedraogo, Maxime Patout, Centre Hospitalier Intercommunal André Grégoire [Montreuil] (CHI André Gregoire), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Sorbonne Paris Nord, Hôpital Privé d'Antony, Service des Pathologies du sommeil [CHU Pitié-Salpêtrière], 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), Neurophysiologie Respiratoire Expérimentale et Clinique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), HAL-SU, Gestionnaire, Service de Pathologies du sommeil [CHU Pitié-Salpêtrière], and Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158)
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Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Exacerbation ,lcsh:Medicine ,Inflammation ,macromolecular substances ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,03 medical and health sciences ,Idiopathic pulmonary fibrosis ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Parenchyma ,Correspondence ,medicine ,030212 general & internal medicine ,Pneumomediastinum ,[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Lung ,business.industry ,lcsh:R ,Interstitial lung disease ,respiratory system ,medicine.disease ,respiratory tract diseases ,3. Good health ,medicine.anatomical_structure ,030228 respiratory system ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,medicine.symptom ,business - Abstract
We read with interest the work of Lemmers et al. [1] published recently in this journal. We also found that spontaneous pneumomediastinum is an uncommon presentation of severe coronavirus disease 2019 (COVID-19) patients. The mechanisms of pneumomediastinum remain unclear [2]. From March 2020 to November 2020 we identified eight patients with pneumomediastinum at intensive care unit admission among 401 COVID-19 patients in two Seine-Saint-Denis hospitals in the Paris (France) area. Neither risk factor nor underlying respiratory disease was identified in these patients. Spontaneous pneumomediastinum occurred without mechanical ventilation (neither noninvasive nor invasive) for four patients and on the day following tracheal intubation despite lung-protective invasive ventilation for the others. Tracheal and bronchial integrity was verified by direct bronchoscopic examination and high-resolution chest computed tomography. As reported by Lemmers et al. [1], plateau pressure was constantly, Pneumomediastinum in severe #COVID19 presentations could be due to a lung parenchymal retractive process generated by intense inflammation as in acute exacerbation of idiopathic pulmonary fibrosis or MDA-5 acute interstitial lung disease https://bit.ly/3qzBYMW
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12. Understanding maternal mortality in women with obesity and the role of care they receive: a national case-control study
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Saucedo, Monica, Esteves-Pereira, Ana Paula, Pencolé, Lucile, Rigouzzo, Agnès, Proust, Alain, Bouvier-Colle, Marie-Hélène, Deneux-Tharaux, Catherine, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation-Oswaldo Cruz Foundation, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Obstetrics and Gynecology, Hôpital Privé d'Antony, French National Public Health agency (Sante Publique France)Institut National de la Sante et de la Recherche Medicale (Inserm)Appeared in source as:French National Institute of Health and Medical Research (Inserm)Ministry of Health, Lallemant, Christopher, and Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
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Adult ,Epidemiology ,Comorbidity ,Article ,Body Mass Index ,Association ,Young Adult ,Pregnancy ,Risk Factors ,Body-mass Index ,Humans ,Obesity ,[SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism ,Pregnancy Outcomes ,[SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism ,Preeclampsia ,Pregnancy Complications ,Risk-factors ,Maternal Mortality ,Case-Control Studies ,Deaths ,Female ,France ,Gestational Weight-gain ,Trends ,Morbidity - Abstract
International audience; Abstract Objective Obesity has significant implications for the health of pregnant women. However, few studies have quantified its association with maternal mortality or examined the relevant underlying causes and the role of care, although this remains the most severe maternal outcome. Our objectives were to quantify the risk of maternal death by prepregnancy body mass index and to determine whether obesity affected the quality of care of the women who died. Desing This is a national population-based case–control study in France. Cases were 364 maternal deaths from the 2007–2012 National Confidential Enquiry. Controls were 14,681 parturients from the nationally representative 2010 perinatal survey. We studied the association between categories of prepregnancy BMI and maternal death by multivariable logistic regression, estimating adjusted odds ratios and 95% confidence intervals, overall and by specific causes of death. Individual case reviews assessed the quality of care provided to the women who died, by obesity status. Results Compared with women with normal BMI, underweight women (
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13. Identifying Clinical Phenotypes in Moderate to Severe Acute Respiratory Distress Syndrome Related to COVID-19: The COVADIS Study
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Jean-Baptiste Lascarrou, Aurelie Gaultier, Thibaud Soumagne, Nicolas Serck, Bertrand Sauneuf, Michael Piagnerelli, Andre Ly, Francois Lejeune, Laurent Lefebvre, Sami Hraiech, Geoffrey Horlait, Julien Higny, Alain D'hondt, Stephane Gaudry, Romain Courcelle, Giuseppe Carbutti, Gauthier Blonz, Gregoire Ottavy, Nadia Aissaoui, Christophe Vinsonneau, Benoit Vandenbunder, Julien Textoris, Piotr Szychowiak, David Grimaldi, the COVADIS study group, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Services des soins intensifs, UCL - (MGD) Service de cardiologie, Anesthésiologie et Réanimation [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Plateforme de Méthodologie et Biostatistique, Direction de la Recherche [CHU Nantes], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Saint Pierre clinic of Ottignies (CSPO), Saint Pierre clinic of Ottignies, CH Centre Hospitalier Public du Cotentin (CHPC), Université libre de Bruxelles (ULB), Hôpital Henri Mondor, Centre Hospitalier d'Aix en Provence [Aix-en-Provence] (CHIAP ), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Hôpital Nord [CHU - APHM], CHU Dinant-Godinne UCL Namur [Yvoir, Belgique], CHU Ambroise Paré [Mons, Belgium], Université Sorbonne Paris Nord, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hopital de Jolimont, hospital universitaire de Mons-Hainaut, Centre Hospitalier Départemental site de la Roche-sur-Yon (CHD de la Roche-sur-Yon), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier de Béthune (CH Béthune), GHT de l'Artois, Hôpital Privé d'Antony, Hospices Civils de Lyon (HCL), BIOMERIEUX, CRICS-TRIGGERSEP, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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medicine.medical_specialty ,ARDS ,phenotype ,Fulminant ,Disease ,mechanical ventilation ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,intubation ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Intensive care ,Internal medicine ,Diabetes mellitus ,Medicine ,Original Research ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,lcsh:R5-920 ,business.industry ,Acute kidney injury ,COVID-19 ,Généralités ,General Medicine ,medicine.disease ,Pulmonary embolism ,Venous thrombosis ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,lcsh:Medicine (General) - Abstract
Objectives: Different phenotypes have been identified in acute respiratory distress syndrome (ARDS). Existence of several phenotypes in coronavirus disease (COVID-19) related acute respiratory distress syndrome is unknown. We sought to identify different phenotypes of patients with moderate to severe ARDS related to COVID-19. Methods: We conducted an observational study of 416 COVID-19 patients with moderate to severe ARDS at 21 intensive care units in Belgium and France. The primary outcome was day-28 ventilatory free days. Secondary outcomes were mortality on day 28, acute kidney injury, acute cardiac injury, pulmonary embolism, and deep venous thrombosis. Multiple factor analysis and hierarchical classification on principal components were performed to distinguish different clinical phenotypes. Results: We identified three different phenotypes in 150, 176, and 90 patients, respectively. Phenotype 3 was characterized by short evolution, severe hypoxemia, and old comorbid patients. Phenotype 1 was mainly characterized by the absence of comorbidities, relatively high compliance, and long duration of symptoms, whereas phenotype 2 was characterized female sex, and the presence of mild comorbidities such as uncomplicated diabetes or chronic hypertension. The compliance in phenotype 2 was lower than that in phenotype 1, with higher plateau and driving pressure. Phenotype 3 was associated with higher mortality compared to phenotypes 1 and 2. Conclusions: In COVID-19 patients with moderate to severe ARDS, we identified three clinical phenotypes. One of these included older people with comorbidities who had a fulminant course of disease with poor prognosis. Requirement of different treatments and ventilatory strategies for each phenotype needs further investigation., SCOPUS: ar.j, info:eu-repo/semantics/published
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14. Neurologic and neuroimaging findings in patients with COVID-19: A retrospective multicenter study
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Ghazi Hmeydia, Xavier Fabre, Géraud Forestier, Catherine Oppenheim, Manel Alleg, Julie Helms, Sophie Carré, Julien Messie, Muriel Mathieu, Grégoire Bornet, Claire Lecocq, M Edjlali-Goujon, R. Anxionnat, Jean-Christophe Brisset, Pierre-Emmanuel Zorn, Francis Schneider, Olivier Collange, Stéphane Kremer, Nadya Pyatigorskaya, François Cotton, Frédéric Ricolfi, François Lersy, Pierre-Olivier Comby, Nicolas Meyer, Jean-Christophe Ferré, Lavinia Jager, Augustin Lecler, Joseph Benzakoun, Béatrice Carsin-Nicol, Maleka Schenck, Suzana Saleme, Thibault Willaume, Emmanuelle Schmitt, Samira Fafi-Kremer, Pierre Thouant, Isaure de Beaurepaire, François Zhu, Seyyid Baloglu, Claire Boutet, Augustin Gaudemer, Federico Bolognini, Hubert Desal, Sophie Caillard, Mathieu Anheim, Jean-Marc Constans, Yannick Talla, Hélène Oesterlé, François-Daniel Ardellier, Hamid Merdji, Basile Kerleroux, Apolline Kazémi, Adel Maamar, Paul Michel Mertes, Antoine Khalil, Patrick Nesser, Mickaël Ohana, Ferhat Meziani, Jérôme Berge, Gregoire Boulouis, Les Hôptaux universitaires de Strasbourg (HUS), CHU Strasbourg, Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Nanomédecine Régénérative (NanoRegMed), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpitaux Civils de Colmar, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier de Haguenau, Centre Hospitalier Universitaire de Nancy (CHU Nancy), Hôpital Marie-Madeleine [Forbach], Département de Radiologie [CHU de Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), CHU Pontchaillou [Rennes], CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Centre Hospitalier de Roanne (CH Roanne), CH de Roanne, CHU Limoges, Hôpital Privé d'Antony, Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Bordeaux [Bordeaux], CHU Lille, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), 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)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), Observatoire Français de la Sclérose En Plaques [Lyon] (OFSEP), Immuno-Rhumatologie Moléculaire, Nouvel Hôpital Civil de Strasbourg, Hospices Civils de Lyon (HCL), Ferré, Jean-Christophe, École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)
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medicine.medical_specialty ,business.industry ,[SCCO.NEUR]Cognitive science/Neuroscience ,[SCCO.NEUR] Cognitive science/Neuroscience ,Meningoencephalitis ,Retrospective cohort study ,medicine.disease ,3. Good health ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Pneumonia ,0302 clinical medicine ,Neurologic manifestation ,Internal medicine ,Corticospinal tract ,Cohort ,medicine ,Neurology (clinical) ,Young adult ,business ,030217 neurology & neurosurgery ,Encephalitis - Abstract
ObjectiveTo describe neuroimaging findings and to report the epidemiologic and clinical characteristics of patients with coronavirus disease 2019 (COVID-19) with neurologic manifestations.MethodsIn this retrospective multicenter study (11 hospitals), we included 64 patients with confirmed COVID-19 with neurologic manifestations who underwent a brain MRI.ResultsThe cohort included 43 men (67%) and 21 women (33%); their median age was 66 (range 20–92) years. Thirty-six (56%) brain MRIs were considered abnormal, possibly related to severe acute respiratory syndrome coronavirus. Ischemic strokes (27%), leptomeningeal enhancement (17%), and encephalitis (13%) were the most frequent neuroimaging findings. Confusion (53%) was the most common neurologic manifestation, followed by impaired consciousness (39%), presence of clinical signs of corticospinal tract involvement (31%), agitation (31%), and headache (16%). The profile of patients experiencing ischemic stroke was different from that of other patients with abnormal brain imaging: the former less frequently had acute respiratory distress syndrome (p= 0.006) and more frequently had corticospinal tract signs (p= 0.02). Patients with encephalitis were younger (p= 0.007), whereas agitation was more frequent for patients with leptomeningeal enhancement (p= 0.009).ConclusionsPatients with COVID-19 may develop a wide range of neurologic symptoms, which can be associated with severe and fatal complications such as ischemic stroke or encephalitis. In terms of meningoencephalitis involvement, even if a direct effect of the virus cannot be excluded, the pathophysiology seems to involve an immune or inflammatory process given the presence of signs of inflammation in both CSF and neuroimaging but the lack of virus in CSF.ClinicalTrials.gov identifierNCT04368390.
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- 2020
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15. Recurrence after elective incisional hernia repair is more frequent than you think: an international prospective cohort from the French Society of Surgery (AFC)
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Benoît Romain, Yohann Renard, Christine Binquet, Tigran Poghosyan, David Moszkowicz, Jean-François Gillion, Pablo Ortega-Deballon, Naziha Gadiri, Smain Mesli, Jean-Luc Bouillot, Christophe Mariette, Amélie Chau, Catherine Arvieux, Emeric Abet, Yohann Marion, Vincent Dubuisson, Anaelle David, Henry-Alexis Mercoli, Simone Manfredelli, Olivier Glehen, Guillaume Passot, Antoine Lamblin, Laurent Arnalsteen, Maita Constantin, Arthus Vauchaussade, Issam El Nakadi, Hassan Demian, Jean-Marc Régimbeau, Nicolas Demartines, Benoit Romain, Jean-Michel Chollet, Daniel Binot, Damien Massalou, Emmanuel Benizri, Virginie Pichot, Benjamin Blanc, Oussama Baraket, Florent Jurczak, Delphine Rouquié, Zeineb Mzoughi, Marc Soler, Jean-Baptiste Putinier, Jean-François Ain, Arnauld Bellouard, Muriel Mathonnet, Mohammed Najim, Edouard Vinatier, Marc Lepère, Olivier Cas, Jean-Pierre Cossa, Pascal Frileux, Dimitri Tzanis, Sandra Hennequin, Sebastien Demaret, Mustapha Merabet, Djaouad Bilem, Tayb Boukortt, Denis Blazquez, Eric Magne, Haitham Khalil, Claude Largenton, Marianne Lavy, Milène Isambert, Olivier Bréhant, Emmanuel Odet, Olivier Firtion, Jean-Luc Manouvrier, Jacques Soufron, Nathalie Letoux, Pôle des Pathologies Digestives Hépatiques et Transplantation [Hôpital Hautepierre-Strasbourg], Hôpital de Hautepierre [Strasbourg], Service de Chirurgie Digestive [CHU Reims], Centre Hospitalier Universitaire de Reims (CHU Reims), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Ecole Supérieure Privée d'Ingénierie et de Technologies (ESPRIT), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Privé d'Antony, Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale (INSERM), Participating surgeons' list: Jean-François Gillion, Pablo Ortega-Deballon, Naziha Gadiri, Smain Mesli, Tigran Poghosyan, David Moszkowicz, Jean-Luc Bouillot, Christophe Mariette, Amélie Chau, Catherine Arvieux, Emeric Abet, Yohann Renard, Yohann Marion, Vincent Dubuisson, Anaelle David, Henry-Alexis Mercoli, Simone Manfredelli, Olivier Glehen, Guillaume Passot, Antoine Lamblin, Laurent Arnalsteen, Maita Constantin, Arthus Vauchaussade, Issam El Nakadi, Hassan Demian, Jean-Marc Régimbeau, Nicolas Demartines, Benoit Romain, Jean-Michel Chollet, Daniel Binot, Damien Massalou, Emmanuel Benizri, Virginie Pichot, Benjamin Blanc, Oussama Baraket, Florent Jurczak, Delphine Rouquié, Zeineb Mzoughi, Marc Soler, Jean-Baptiste Putinier, Jean-François Ain, Arnauld Bellouard, Muriel Mathonnet, Mohammed Najim, Edouard Vinatier, Marc Lepère, Olivier Cas, Jean-Pierre Cossa, Pascal Frileux, Dimitri Tzanis, Sandra Hennequin, Sebastien Demaret, Mustapha Merabet, Djaouad Bilem, Tayb Boukortt, Denis Blazquez, Eric Magne, Haitham Khalil, Claude Largenton, Marianne Lavy, Milène Isambert, Olivier Bréhant, Emmanuel Odet, Olivier Firtion, Jean-Luc Manouvrier, Jacques Soufron, Nathalie Letoux, Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, and Ortega Deballon, Pablo
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Male ,medicine.medical_specialty ,[SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery ,[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery ,030230 surgery ,Lower risk ,Odds ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Recurrence ,medicine ,Humans ,Incisional Hernia ,Hernia ,Prospective Studies ,Prospective cohort study ,Herniorrhaphy ,Aged ,business.industry ,Middle Aged ,medicine.disease ,3. Good health ,Surgery ,Surgical mesh ,Concomitant ,Cohort ,030211 gastroenterology & hepatology ,Female ,France ,business ,Tomography, X-Ray Computed - Abstract
International audience; Background: The French Society of Surgery has endorsed a cohort aiming to prospectively assess the frequency of recurrence after incisional hernia repair and to identify the risk factors.Methods: Consecutive patients undergoing incisional hernia repair in the participating centers were included in the prospective French Society of Surgery cohort over a 6-month period. Patients were followed up with a computed tomography scan at 1 y and a clinical assessment by the surgeon at 2 years.Results: A total of 1,075 patients undergoing incisional hernia repair were included in 61 participating centers. The median follow-up was 24.0 months (interquartile range: 14.0-25.3). The follow-up rates were 83.0% and 68.5% at 1 and 2 years, respectively. The recurrence rates were 18.1% at 1 year and 27.7% at 2 years. Recurrence risk factors at 2 years were a history of hernia (odds ratio = 1.57, 95% confidence interval = 1.05-2.35, P = .028), a lateral hernia (odds ratio = 1.84, 95% confidence interval = 1.19-2.86, P = .007), a concomitant digestive operation (odds ratio = 1.97, 95% confidence interval = 1.20-3.22, P = .007), and the occurrence of early surgical site complications (odds ratio = 1,90, 95% confidence interval = 1.06-3.38, P = .030). The use of surgical mesh was strongly associated with a lower risk of recurrence at 2 years (P < .001).Conclusion: After incisional hernia repair, the 2-year recurrence rate is as high as 27.7%. History of hernia, lateral hernia, concomitant digestive operation, the onset of surgical site complications, and the absence of mesh are strong risk factors for recurrence.
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- 2020
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16. Brain MRI Findings in Severe COVID-19: A Retrospective Observational Study
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Kremer, S. (Stéphane), Boulay, C. (Clotilde), de Sèze, J. (Jérome), Ferré, J. (Jean-Christophe), Maamar, A. (Adel), Carsin-Nicol, B. (Béatrice), Collange, O. (Olivier), Bonneville, F. (Fabrice), Adam, G. (Gilles), Martin-Blondel, G. (Guillaume), Rafiq, M. (Marie), Geeraerts, T. (Thomas), Delamarre, L. (Louis), Grand, S. (Sylvie), Krainik, A. (Alexandre), Kremer, S. (Stephane), Alleg, M. (Manel), Anheim, M. (Mathieu), Anxionnat, R. (René), Ardellier, F. (François-Daniel), Baloglu, S. (Seyyid), Bapst, B. (Blanche), Benzakoun, J. (Joseph), Berge, J. (Jérome), Bolognini, F. (Federico), Bornet, G. (Grégoire), Boulouis, G. (Grégoire), Boutet, C. (Claire), Brisset, J. (Jean Christophe), Caillard-ohlmann, S. (Sophie), Carré, S. (Sophie), Comby, P. (Pierre-Olivier), Constans, J. (Jean Marc), David, J. (Jean-Stéphane), de Beaurepaire, I. (Isaure), De Seze, J. (Jerome), Desal, H. (Hubert), Edjlali-Goujon, M. (Myriam), Fabre, X. (Xavier), Fafi-Kremer, S. (Samira), Feuerstein, P. (Philippe), Henry Feugeas, M. (Marie-Cécile), Forestier, G. (Géraud), Gaudemer, A. (Augustin), Hansmann, Y. (Yves), Heintz, A. (Adrien), Boisrame, J. (Julie), Hemmert, C. (Céline), Hmeydia, G. (Ghazi), Jager, L. (Lavinia), Kazémi, A. (Apolline), Kerleroux, B. (Basile), Khalil, A. (Antoine), Lacalm, A. (Audrey), Lecler, A. (Augustin), Lecocq, C. (Claire), Lefebvre, N. (Nicolas), Lersy, F. (François), Matthieu, M. (Muriel), Megdiche, I. (Imen), Mertes, P. (Paul-michel), Messié, J. (Julien), Metanbou, S. (Serge), Meyer, N. (Nicolas), Meziani, F. (Ferhat), Mutschler, V. (Veronique), Nesser, P. (Patrick), Oesterlé, H. (Hélène), Ohana, M. (Mickaël), Oppenheim, C. (Catherine), Pyatigorskaya, N. (Nadya), Ricolfi, F. (Frédéric), Saleme, S. (Suzana), Schenck, M. (Maleka), Schmitt, E. (Emmanuelle), Schneider, F. (Francis), Sebag, N. (Nathan), Talla Mba, Y. (Yannick), Thouant, P. (Pierre), Willaume, T. (Thibault), Zhu, F. (François), Zorn, P. (Pierre-Emmanuel), Cotton, F. (François), Les Hôpitaux Universitaires de Strasbourg (HUS), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département de Radiologie [CHU de Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], CHU Toulouse [Toulouse], CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Centre hospitalier de Haguenau, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Nancy (CHU Nancy), CHU Henri Mondor, Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), CHU Bordeaux [Bordeaux], Hôpitaux Civils de Colmar, Hôpital Privé d'Antony, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Observatoire Français de la Sclérose En Plaques [Lyon] (OFSEP), Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Amiens-Picardie, Hospices Civils de Lyon (HCL), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier de Roanne (CH Roanne), CH de Roanne, Groupe hospitalier de la région de Mulhouse Sud-Alsace (GHRMSA), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Limoges, CHU Strasbourg, Nouvel Hôpital Civil de Strasbourg, Université de Strasbourg (UNISTRA), Hôpital Marie-Madeleine [Forbach], CHU Lille, Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Les Hôptaux universitaires de Strasbourg (HUS), Nanomédecine Régénérative (NanoRegMed), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), 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)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UR), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Henri Mondor [Créteil], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Ferré, Jean-Christophe, and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
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Adult ,Male ,medicine.medical_specialty ,Sciences du Vivant [q-bio]/Neurosciences [q-bio.NC] ,Adolescent ,Pneumonia, Viral ,Gastroenterology ,030218 nuclear medicine & medical imaging ,Temporal lobe ,White matter ,Cohort Studies ,03 medical and health sciences ,symbols.namesake ,Betacoronavirus ,Young Adult ,0302 clinical medicine ,Cerebrospinal fluid ,Internal medicine ,Intensive care ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,10. No inequality ,Child ,Pandemics ,Fisher's exact test ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,SARS-CoV-2 ,[SCCO.NEUR]Cognitive science/Neuroscience ,[SCCO.NEUR] Cognitive science/Neuroscience ,Brain ,COVID-19 ,Retrospective cohort study ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,3. Good health ,Venous thrombosis ,medicine.anatomical_structure ,Neuroradiology ,030220 oncology & carcinogenesis ,symbols ,Female ,business ,Coronavirus Infections - Abstract
International audience; BackgroundBrain MRI parenchymal signal abnormalities have been associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).PurposeTo describe the neuroimaging findings (excluding ischemic infarcts) in patients with severe coronavirus disease 2019 (COVID-19) infection.Materials and MethodsThis was a retrospective study of patients evaluated from March 23, 2020, to April 27, 2020, at 16 hospitals. Inclusion criteria were (a) positive nasopharyngeal or lower respiratory tract reverse transcriptase polymerase chain reaction assays, (b) severe COVID-19 infection defined as a requirement for hospitalization and oxygen therapy, (c) neurologic manifestations, and (d) abnormal brain MRI findings. Exclusion criteria were patients with missing or noncontributory data regarding brain MRI or brain MRI showing ischemic infarcts, cerebral venous thrombosis, or chronic lesions unrelated to the current event. Categorical data were compared using the Fisher exact test. Quantitative data were compared using the Student t test or Wilcoxon test. P < .05 represented a significant difference.ResultsThirty men (81%) and seven women (19%) met the inclusion criteria, with a mean age of 61 years ± 12 (standard deviation) (age range, 8–78 years). The most common neurologic manifestations were alteration of consciousness (27 of 37, 73%), abnormal wakefulness when sedation was stopped (15 of 37, 41%), confusion (12 of 37, 32%), and agitation (seven of 37, 19%). The most frequent MRI findings were signal abnormalities located in the medial temporal lobe in 16 of 37 patients (43%; 95% confidence interval [CI]: 27%, 59%), nonconfluent multifocal white matter hyperintense lesions seen with fluid-attenuated inversion recovery and diffusion-weighted sequences with variable enhancement, with associated hemorrhagic lesions in 11 of 37 patients (30%; 95% CI: 15%, 45%), and extensive and isolated white matter microhemorrhages in nine of 37 patients (24%; 95% CI: 10%, 38%). A majority of patients (20 of 37, 54%) had intracerebral hemorrhagic lesions with a more severe clinical presentation and a higher admission rate in intensive care units (20 of 20 patients [100%] vs 12 of 17 patients without hemorrhage [71%], P = .01) and development of the acute respiratory distress syndrome (20 of 20 patients [100%] vs 11 of 17 patients [65%], P = .005). Only one patient had SARS-CoV-2 RNA in the cerebrospinal fluid.ConclusionPatients with severe coronavirus disease 2019 and without ischemic infarcts had a wide range of neurologic manifestations that were associated with abnormal brain MRI scans. Eight distinctive neuroradiologic patterns were described.
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- 2020
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17. Clinical Activity of Sunitinib and Regorafenib in Endometriosis
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Philippe Morice, Paul Berveiller, Stanislas Ropert, Olivier Mir, Institut Gustave Roussy (IGR), Oncologie gynécologique, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Hôpital Privé d'Antony, Département de chirurgie gynécologique [Gustave Roussy], centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Gamètes, implantation, gestation (GIG), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
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Oncology ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,business.industry ,Sunitinib ,Endometriosis ,[SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology ,General Medicine ,[SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics ,medicine.disease ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,030220 oncology & carcinogenesis ,Internal medicine ,Regorafenib ,medicine ,business ,ComputingMilieux_MISCELLANEOUS ,medicine.drug - Abstract
International audience
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- 2019
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18. Patient's satisfaction at 2 years after groin hernia repair: any difference according to the technique?
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P. Ortega-Deballon, Club Hernie, J. F. Gillion, N. Meyer, Benoit Romain, Service de chirurgie digestive [Strasbourg-Hautepierre], Hôpital de Hautepierre [Strasbourg], Equipe 2 'Réponse au Stress Cellulaire & Thérapies Innovantes' / 'Stress Response & Innovative Therapies' (STREINTH - Inserm U1113), Interface de Recherche Fondamentale et Appliquée en Cancérologie (IRFAC - Inserm U1113), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Paul Strauss : Centre Régional de Lutte contre le Cancer (CRLCC)-Fédération de Médecine Translationelle de Strasbourg (FMTS)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Paul Strauss : Centre Régional de Lutte contre le Cancer (CRLCC)-Fédération de Médecine Translationelle de Strasbourg (FMTS), Hôpital privé d’Antony, Service de Chirurgie Digestive, Cancérologique, Générale, Endocrinienne et Urgences (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), and CHU Strasbourg
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Male ,medicine.medical_specialty ,Registry ,Multivariate analysis ,medicine.medical_treatment ,TIPP ,Hernia, Inguinal ,030230 surgery ,TAPP ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Inguinal hernia repair ,medicine ,Severe pain ,Humans ,Registries ,Herniorrhaphy ,Aged ,Retrospective Studies ,Groin ,business.industry ,Extraperitoneal approach ,Middle Aged ,medicine.disease ,Hernia repair ,Surgery ,Inguinal hernia ,medicine.anatomical_structure ,TEP ,Patient Satisfaction ,030220 oncology & carcinogenesis ,Quality of Life ,Lichtenstein ,Female ,France ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Abdominal surgery ,Follow-Up Studies - Abstract
IF 2.417; International audience; BackgroundLong-term patient’s satisfaction after groin hernia repair is rarely studied in the literature. The aim of this study was to compare the four main techniques of inguinal hernia repair in terms of patient‘s satisfaction and quality of life at the 2-year follow-up in a prospective registry.MethodsFrom September 2011 to March 2014, consecutive patients underwent groin hernia repair and were prospectively included in the Club Hernie registry, which also consisted of expert surgeons in parietal repair. The data on patient demographics, clinical presentation, initial workup, operative technique, postoperative course, clinical follow-up, and quality of life at 2 years (2Y-FU) were recorded.ResultsOverall, 5670 patients were included in the study: 1092 undergoing Lichtenstein’s technique, 1259 for trans-inguinal preperitoneal technique (TIPP), 1414 for totally extraperitoneal approach (TEP) and 1905 for transabdominal preperitoneal approach (TAPP). The patients undergoing Lichtenstein’s technique were significantly older, with more inguinoscrotal hernias and co-morbidities than those undergoing other techniques. A total of 83% patients had a complete 2Y-FU. The patient’s satisfaction at 2Y-FU was similar between the different techniques. In the univariate and multivariate analyses, pain on postoperative day 1 was the only independent prognostic factor of the patient’s satisfaction at 2Y-FU.ConclusionIn this large series, no statistical differences were found between the four studied techniques regarding the 2Y-Fu results and patients’ satisfaction. Provided the technique has been done properly (expert surgeon) the results and the patients’ satisfaction are fair and equivalent among the four studied techniques. In a multivariate analysis, the only factor predictive of bad late results was severe pain at D1.
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- 2018
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19. Early-onset neonatal infection: Assessment of professional practices in 14 maternity wards in the Île-de-France region in 2013
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Sikias, Patrick, Parmentier, Cyrielle, Imbert, Patrick, Rajguru, Mandovi, Chavet, M. S., Coquery, Sarah, Foix-L'Hélias, Laurence, Boileau, Pascal, Hôpital privé d’Antony, Service d'hématologie-immunologie-oncologie pédiatrique [CHU Trousseau], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital d'Instruction des Armées Begin, Service de Santé des Armées, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut hospitalier Franco-Britannique [Levallois-Perret], Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and CHI Poissy-Saint-Germain
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Adult ,Gastric Juice ,Bacteria ,[SDV]Life Sciences [q-bio] ,Infant, Newborn ,Bacterial Infections ,Infectious Disease Transmission, Vertical ,Anti-Bacterial Agents ,C-Reactive Protein ,Pregnancy ,Practice Guidelines as Topic ,Humans ,Female ,France ,Guideline Adherence ,Prospective Studies ,Practice Patterns, Physicians' ,Pregnancy Complications, Infectious ,Hospital Units - Abstract
International audience; Introduction: Early-onset neonatal infection remains a major cause of morbidity and mortality in neonates. Both universal vaginal screening for group-B streptococcus (GBS) and intrapartum antibiotic prophylaxis have decreased the incidence of early-onset GBS disease. Almost 12 years after the implementation of the French recommendations, we assessed the practices around screening, diagnosis, and treatment of early-onset neonatal infection in the Île-de-France region. Patients and methods: We conducted a prospective, multicenter, observational study in 14 volunteer maternity wards from 18 to 31 March 2013. All live newborn infants delivered at 35 gestational weeks or more were eligible. Maternal, obstetrical, and neonatal characteristics were collected, as well as the management of suspected early-onset neonatal infections. Results: A total of 1194 mothers and 1217 neonates were included. Among the latter, 54% had bacteriological samplings at birth, with at least a gastric aspirate. Bacteriological samples were collected at birth in 85% of cases based on major or minor anamnestic infection criteria defined by the French National Authority for Health in 2002. In addition, 26% of neonates had at least one blood sample taken. Antibiotic treatment was administered in 4% of the infants with cefotaxime administered in two thirds of cases. Conclusion: An update of the French guidelines for the management of early-onset neonatal infections is required in order to improve targeting of newborn infants suspected of having an infection and to optimize the antibiotics administered. Moreover, the role of bacteriological sampling at birth needs to be clarified.
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- 2015
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20. Recombinant human FVIIa for reducing the need for invasive second-line therapies in severe refractory postpartum hemorrhage: a multicenter, randomized, open controlled trial
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A. Mignon, Géraldine Lavigne-Lissalde, E. Morau, Céline Chauleur, S. Bouvet, A. Bongain, S. Roger-Christoph, P. De Moerloose, A.G. Aya, F.J. Mercier, Jean-Christophe Gris, Pascale Fabbro-Peray, A.-S. Ducloy-Bouthors, M. Raucoules, Françoise Boehlen, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Service d'anesthésie [Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital privé d’Antony, CHU Saint-Etienne, Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Unité de Soins Intensifs [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Centre Hospitalier Universitaire de Nice (CHU Nice), Hôpital Universitaire de Genève, BESPIM, and Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP)
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Compassionate Use Trials ,Time Factors ,FVIIa activated ,Deep vein ,Factor XIIa ,Severity of Illness Index ,law.invention ,Second line ,treatment efficacy ,Randomized controlled trial ,law ,Pregnancy ,Risk Factors ,Venous Thrombosis/chemically induced ,Treatment Failure ,hysterectomy ,Infusions, Intravenous ,ComputingMilieux_MISCELLANEOUS ,Venous Thrombosis ,ddc:616 ,[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology ,Hematology ,Delivery mode ,Thrombosis ,Postpartum Hemorrhage/diagnosis/drug therapy/mortality ,3. Good health ,Pulmonary embolism ,medicine.anatomical_structure ,postpartum hemorrhage ,Female ,France ,Switzerland ,Adult ,medicine.medical_specialty ,macromolecular substances ,Hysterectomy ,Coagulants/administration & dosage/adverse effects/therapeutic use ,Dinoprostone ,Drug Administration Schedule ,Factor VIII/administration & dosage/adverse effects/therapeutic use ,Refractory ,medicine ,Humans ,Hemostatic Techniques/adverse effects ,Coagulants ,Hemostatic Techniques ,business.industry ,medicine.disease ,Surgery ,Dinoprostone/analogs & derivatives/therapeutic use ,Relative risk ,treatment outcome ,business - Abstract
SummaryBackground Case reports on recombinant human factor VIIa (rhuFVIIa) use in women with severe postpartum hemorrhage (PPH) showed encouraging results, but no randomized controlled trial (RCT) is available. Patients and methods Eighty-four women with severe PPH unresponsive to uterotonics were randomized to receive one early single rhuFVIIa infusion (n = 42) or standard care (no rhuFVIIa; n = 42). The primary efficacy outcome measure was the reduction of the need for specific second-line therapies, such as interventional hemostatic procedures, for blood loss and transfusions. The primary safety outcome measure was the number of deaths and thrombotic events during the 5 days following rhuFVIIa infusion. Results rhuFVIIa was associated with a reduction in the number of patients who needed second-line therapies compared with controls (standard care). Specifically, 39/42 (93%) patients in the standard care arm received second-line therapies and 22/42 (52%) patients in the rhuFVIIa arm (absolute difference, 41%; range, 18–63%; relative risk RR, 0.56 [0.42–0.76]). The delivery mode (vaginal or Cesarean section) did not affect the primary outcome. No death occurred. Two venous thrombotic events were recorded in the rhuFVIIa arm: one ovarian vein thrombosis and one deep vein thrombosis with a non-severe pulmonary embolism. Conclusion This open RCT in women with severe PPH refractory to uterotonics shows that rhuFVIIa reduces the need for specific second-line therapies in about one in three patients, with the occurrence of non-fatal venous thrombotic events in one in 20 patients.
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- 2015
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21. Anterior tibial tubercle internal torsion osteotomy (ATTITO) in patient with patellar instability.
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Loddo G, Donnez M, Blin JL, Khiami F, Zeitoun JM, Ollivier M, and Chassaing V
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Anterior tibial tuberosity osteotomy is a well-described therapeutic option for the treatment of patellar instability. External torsion of the anterior tibial tuberosity can be one of several factors that adversely affect the patellofemoral joint and its stability. The Anterior Tibial Tubercle Internal Torsion Osteotomy (ATTITO) allows the correction of excessive external torsion of the tibial tuberosity in a safe and reproducible manner. LEVEL OF EVIDENCE: V., Competing Interests: Declaration of competing interest V. Chassaing is a consultant for Société ISO (Implants Service Orthopédie). J–L Blin, G. Loddo, F. Khiami, M. Donnez declare that they have no competing interests (financial or nonfinancial). J–M Zeitoun is a consultant for Société ISO (Implants Service Orthopédie). M. Ollivier is a consultant for Newclip Technics, Arthrex and Smith & Nephew., (Copyright © 2025 Elsevier Masson SAS. All rights reserved.)
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- 2025
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22. Extension patellar engagement index: a new measurement of patellar height.
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Chassaing V, Chancelier MD, Blin JL, Curado J, and Zeitoun JM
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Introduction: Patellar instability is a multifactorial pathology requiring precise evaluation of its contributing factors, particularly patella alta. Patellotibial height measurement indexes, such as the Caton-Deschamps index, have the disadvantage of being referenced to the tibia. Patellotrochlear indexes are more appropriate but fail to account for variable knee flexion during magnetic resonance imaging (MRI)., Objective: This study aims to validate a new MRI-based patellotrochlear measurement, the extension patellar engagement (EPE) index, which is reproducible and measures patellar height relative to the trochlea independently of knee flexion during MRI., Materials and Methods: A retrospective study was conducted on 77 MRIs (37 unstable patients with a history of patellar dislocation, 40 controls with meniscal injury). The EPE index is the ratio between the patellar engagement length on the cartilaginous trochlea and the patellar cartilage length, measured on a knee virtually extended. Four measurements on multiple sagittal slices were used to calculate the EPE index., Results: The inteobserver intraclass correlation coefficient (ICC) was excellent (0.79). The mean EPE index's value for all knees was 0.22. It was significantly higher (p = 0.034) in the instability group (0.26) compared to the control group (0.19). The average knee flexion during MRI was 11 ° (range: -8 ° to 25 °)., Discussion: The EPE index is reproducible. It is an anatomical index to classify patella alta when the patella does not reach the trochlea in knee extension (EPE index ≤0). It is also a functional index, with a mean value of 0.19 in the control group., Conclusion: The EPE index measures the patellar engagement on the trochlea taking into account the knee flexion during MRI. It may guide surgical decision-making for patellar distalization and quantify the required correction., Level of Evidence: III; retrospective comparative study., Competing Interests: Declaration of competing interest VC, JMZ: Designers of a knee prosthesis, ISO (Implants Service Orthopédie). MDC, JLB: No conflicts of interest. JC: Educationaly consultant for Viatris and Health Events., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
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- 2024
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23. Multicenter evaluation of patient safety incidents in lung surgery: The Epithor Patient Safety Incident study.
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Bottet B, Seguin-Givelet A, Fourdrain A, Sarsam M, Boddaert G, Boulate D, Gillibert A, Mariolo A, Vasse M, Grigoroiu M, Trousse D, Brian E, Brioude G, Chenesseau J, Braggio C, Gust L, Thomas PA, Gossot D, Baste JM, and D'Journo XB
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Objective: To determine the incidence of patient safety incidents (PSIs) occurring during perioperative care for lung surgery and their influence on postoperative outcomes at 90 days., Methods: A multicenter study was conducted in three French thoracic surgery departments. Consecutive patients older than age 18 years, who had lung surgery (open, video-assisted, or robotic) for benign or malignant diseases were included. PSIs occurring during lung surgery were reported in Epithor, the French national thoracic database. The primary outcome was the incidence of perioperative PSI. Secondary outcomes were the rates of complications, readmission, and mortality at 90 days. All data were prospectively entered in the Epithor database., Results: From January 1, 2021, to December 31, 2021, 1919 surgical procedures were screened and finally, 953 procedures were included. PSIs were observed in 305 out of 953 procedures (32%) cumulating a total number of 369 PSIs. PSI were related to human factors in 179 lout of 369 (48.5%), organization in 101 out of 369 (27.4%), and technology in 85 out of 369 (23%). PSIs were categorized as near-miss events in 97 (26%), no harm incidents (HI) in 125 (34%), mild HI in 83 (22%), moderate HI in 39 (11%), severe HI in 21 (6%), and mortality in 4 (1%). The relative risk of outcome at 90 days was significantly increased according to PSI severity: no PSI/near-miss versus no-HI/HI: relative risk, 2.02 (95% CI, 1.70-2.40) for complications, 2.51 (95% CI, 1.57-8.30) for readmission, and 3.09 (95% CI, 1.15-8.30) for mortality., Conclusions: Incidence of PSIs in thoracic surgery may occur in approximately one-third of procedures. Human factors play a crucial role in the occurrence of these PSIs., Competing Interests: Conflict of Interest Statement The authors reported no conflicts of interest. The Journal style requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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24. Is surgeon annual case volume related with intra and postoperative complications after ventral hernia repair? Uni- and multivariate analysis of prospective registry-based data.
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van den Berg R, den Hartog FPJ, Menon AG, Tanis PJ, and Gillion JF
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- Humans, Male, Female, Middle Aged, Prospective Studies, Aged, Intraoperative Complications epidemiology, Intraoperative Complications etiology, Surgeons statistics & numerical data, Multivariate Analysis, Length of Stay statistics & numerical data, France epidemiology, Adult, Hernia, Ventral surgery, Herniorrhaphy adverse effects, Postoperative Complications epidemiology, Postoperative Complications etiology, Registries
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Background: Literature on a potential relationship between surgeon case volume and intra- or postoperative complications after ventral hernia repair remains scarce., Methods: Patients who underwent ventral hernia repair between 2011 and 2023 were selected from the prospectively maintained French Hernia-Club Registry. Outcome variables were: intraoperative events, postoperative general complications, surgical site occurrences, surgical site infections, length of intensive care unit (ICU), and patient-reported scar bulging during follow-up. Surgeons' annual case volume was categorized as 1-5, 6-50, 51-100, 101-125, and > 125 cases, and its association with outcome volume was evaluated using uni- and multivariable analyses., Results: Over the study period, 199 titular or temporary members registered 15,332 ventral hernia repairs, including 7869 primary, 6173 incisional, and 212 parastomal hernia repairs. In univariate analysis, surgeons' annual case volume was significantly related with all the postoperative studied outcomes. After multivariate regression analysis, annual case volume remained significantly associated with intra-operative complications, postoperative general complications and length of ICU stay. A primary repair was independently associated with fewer intra- and post-operative complications., Conclusion: In the present multivariable analysis of a large registry on ventral hernia repairs, higher surgeon annual case volume was significantly related with fewer postoperative general complications and a shorter length of stay, but not with fewer surgical site occurrences, nor with less patient-reported scar bulging. Factors in the surgeons' case mix such as the type of hernia have significant impact on complication rates., (© 2024. The Author(s).)
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- 2024
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25. Obesity increases the surgical complexity and risk of recurrence after midline primary ventral hernia repair: results on 2307 patients from the French Society of hernia surgery (SFCP-CH) registry database.
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Turmine J, Florence AM, Tardivon C, Passot G, Gillion JF, and Moszkowicz D
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- Humans, Male, Female, Middle Aged, Retrospective Studies, Risk Factors, Aged, Obesity complications, France epidemiology, Obesity, Morbid surgery, Obesity, Morbid complications, Adult, Hernia, Ventral surgery, Hernia, Ventral complications, Herniorrhaphy, Recurrence, Registries
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Purpose: Obesity is a known risk factor of recurrence after hernia surgery, but available data often concern pooled cases of primary and incisional hernia, with short follow-up. We aimed to analyze the impact of severe obesity (BMI ≥ 35 kg/m
2 ) on the results of midline primary ventral hernia repair (mPVHR), in comparison with non-severely obese patients., Methods: Data were extracted from a multicentric registry, in which patients' data are consecutively and anonymously collected. We conducted a retrospective comparative study on patients with severe obesity (sOb) versus non-severely obese patients (non-sOb), who underwent surgery, with a minimal 2-year follow-up after their mPVHR., Results: Among 2307 patients, 267 sOb and 2040 non-sOb matched inclusion criteria. Compared with non-sOb, sOb group gathered all the worse conditions and risk factors: more ASA3-4 (39.3% vs. 10.2%; p < 0.001), symptomatic hernia (15.7% vs. 6.8%; p < 0.001), defect > 4 cm in diameter (24.3% vs. 8.8%; p < 0.001), emergency surgery (6.1% vs. 2.5%; p = 0.003), and Altemeir class > 1 (9.4% vs. 2.9%; p < 0.001). Laparoscopic IPOM was used more often in sOb patients (40% vs. 32%; p = 0.016), but with smaller Hauters' ratio (46 vs. 73; p < 0.001). Compared with the non-sOb, the rate of day-case surgery was lower (48% vs. 68%; p < 0.001), the surgical site occurrences were significantly more frequent (6.4 %vs. 2.5%; p < 0.001). The main outcome, 2-year recurrence, was 5.9% in the sOb vs. 2.1% (p = 0.008), and 2-year reoperations was 3% vs. 0.3% (p = 0.006). In the adjusted analysis, severe obesity was an independent risk factor for recurrence [OR = 2.82, (95%CI, 1.45; 5.22); p = 0.003]., Conclusion: In patients with severe obesity, mPVHR is technically challenging and recurrence rate is three times higher than that of non-severely obese patients., (© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)- Published
- 2024
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26. Severe asthma care trajectories: the French RAMSES cohort.
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Perotin JM, Gauquelin L, Just N, Devouassoux G, Chenivesse C, Bourdin A, Garcia G, Saint Raymond C, Boudjemaa A, Bonniaud P, Chanez P, Barnig C, Beurnier A, Maurer C, Freymond N, Didi T, Tcherakian C, Russier M, Drucbert M, Guillo S, Estellat C, and Taillé C
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Background: The French RAMSES study is an observational prospective multicentre real-life cohort including severe asthmatic subjects. The objective of the study was to compare the characteristics of patients, in terms of phenotype and asthma care trajectories, between those managed by tertiary referral centres (TRCs) or secondary care centres (SCCs)., Methods: Patients were prospectively recruited and enrolled for a 5-year follow-up. Patients' characteristics were analysed at inclusion and compared between TRCs and SCCs., Results: 52 centres (24 TRCs and 28 SCCs) included 2046 patients: 1502 (73.4%) were included by a TRC and 544 (26.6%) by a SCC. Patients were mainly women (62%), 53±15 years old, 67% with Asthma Control Test <20; at inclusion, 14% received oral corticosteroids (OCS) and 66% biologics. Compared with the SCC group, the TRC group had more frequent comorbidities and lower blood eosinophil counts (262 versus 340 mm
-3 ; p=0.0036). OCS and biologics use did not differ between groups, but patients in the TRC group benefited more frequently from an educational programme (26% versus 18%; p=0.0008) and received more frequently two or more sequential lines of biologics (33% versus 24%; p=0.0105). In-depth investigations were more frequently performed in the TRC group (allergy tests: 74% versus 62%; p<0.0001; exhaled nitric oxide fraction: 56% versus 21%; p<0.0001; induced sputum: 6% versus 3%; p=0.0390)., Conclusions: Phenotypes and care trajectories differed in the RAMSES cohort between SCCs and TRCs, probably related to different levels of asthma severity and differences in medical resources and practices among centres. This highlights the need for standardisation of severe asthma care., Competing Interests: Conflict of interest: J-M. Perotin reports lecture honoraria from AstraZeneca, support for attending meetings from AstraZeneca and Chiesi, and membership of working groups and associations receiving financial support from AstraZeneca, Chiesi, Novartis and Sanofi; outside the submitted work. N. Just participated or participates as an investigator in clinical trials with Chiesi, and reports honoraria from Chiesi and AstraZeneca. G. Devouassoux reports lecture honoraria from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Mundi Pharma, Novartis Pharma, Vivisol, Sanofi, ALK and Menarini; consultancy fees from AGIR Adom, ALK, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Meda, MSD, Novartis Pharma, Orkyn, Takeda, TEVA, Sanofi and Cipla; has served as a principal investigator and/or study coordinator for AB Science, ALK, Amgen, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Lilly, Novartis Pharma, Roche, Regeneron Pharmaceuticals Inc., Sanofi, TEVA, VitalAire, Gossamer and Zambon; and reports research grants from AGIR Adom, ALLP, Chiesi, GlaxoSmithKline, MSD, Novartis Pharma, Orkyn, Takeda and Vivisol. C. Chenivesse reports grants from AstraZeneca, GlaxoSmithKline, Novartis and Santelys, personal fees from ALK-Abello, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline and Sanofi, and congress support from AstraZeneca, Boehringer Ingelheim, Chiesi, Novartis and Sanofi. C. Saint Raymond reports lecture honoraria, support for attending meetings, and membership of working groups and associations receiving financial support from AstraZeneca, Novartis, GlaxoSmithKline and Sanofi. A. Bourdin reports grants from Boehringer Ingelheim, AstraZeneca, GlaxoSmithKline, AB Science, Celltrion, Cipla, Areteia, Novartis, Sanofi Regeneron and Chiesi, consulting fees, lecture fees and support for meetings from Boehringer Ingelheim, AstraZeneca, GlaxoSmithKline, AB Science, Celltrion, Cipla, Novartis, Sanofi Regeneron and Chiesi, and participation on an advisory board for AB Science. G. Garcia reports personal fees from AstraZeneca, Sanofi, Novartis, Chiesi and GlaxoSmithKline, and congress support from Sanofi and Oxyvie. A. Boudjemaa reports personal fees from AstraZeneca, Sanofi, Chiesi and GlaxoSmithKline, and congress support from GlaxoSmithKline and Oxyvie. P. Bonniaud reports research grants from AstraZeneca, personal fees from AstraZeneca, Boehringer Ingelheim, Sanofi, Novartis and GlaxoSmithKline, and congress support from AstraZeneca, Sanofi, Boehringer Ingelheim, Stallergenes and Novartis. P. Chanez reports grants, consulting fees, lectures fees and support for meetings from ALK, AstraZeneca, Biopharm, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis and Sanofi-Aventis. C. Barnig reports support for attending meetings from AstraZeneca, GlaxoSmithKline, Sanofi, ALK and Chiesi. A. Beurnier reports lecture fees from AstraZeneca and Sanofi. N. Freymond reports lecture honoraria from AstraZeneca, Sanofi and GlaxoSmithKline, and support for attending meetings from AstraZeneca and Sanofi; outside the submitted work. C. Tcherakian reports a grant from Air Liquide Foundation, lecture fees from AstraZeneca, GlaxoSmithKline, Chiesi, Novartis and Sanofi, and meeting support from Sanofi and GlaxoSmithKline. M. Drucbert reports lecture honoraria from GlaxoSmithKline and AstraZeneca, and membership of working group receiving financial support from AstraZeneca; outside the submitted work. S. Guillo reports no personal fees, congress support or research grants with conflicting interests to disclose other than the funding of the RAMSES cohort. C. Estellat reports no personal fees, congress support or research grants with conflicting interests to disclose other than the funding of the RAMSES cohort. C. Taillé reports lecture or advisory board fees and grants from AstraZeneca, Sanofi, GlaxoSmithKline, Chiesi, Stallergenes and Novartis. All other authors have nothing to declare. There are no further conflicting interests to disclose., (Copyright ©The authors 2024.)- Published
- 2024
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27. Robotic surgery for inguinal and ventral hernia repair: a systematic review and meta-analysis.
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de'Angelis N, Schena CA, Moszkowicz D, Kuperas C, Fara R, Gaujoux S, Gillion JF, Gronnier C, Loriau J, Mathonnet M, Oberlin O, Perez M, Renard Y, Romain B, Passot G, and Pessaux P
- Subjects
- Humans, Blood Loss, Surgical, Herniorrhaphy methods, Postoperative Complications etiology, Postoperative Complications surgery, Retrospective Studies, Surgical Wound Infection surgery, Hernia, Inguinal surgery, Hernia, Inguinal complications, Hernia, Ventral surgery, Hernia, Ventral complications, Laparoscopy adverse effects, Laparoscopy methods, Robotic Surgical Procedures adverse effects, Robotic Surgical Procedures methods
- Abstract
Background: This systematic review and meta-analysis assessed the effectiveness of robotic surgery compared to laparoscopy or open surgery for inguinal (IHR) and ventral (VHR) hernia repair., Methods: PubMed and EMBASE were searched up to July 2022. Meta-analyses were performed for postoperative complications, surgical site infections (SSI), seroma/hematoma, hernia recurrence, operating time (OT), intraoperative blood loss, intraoperative bowel injury, conversion to open surgery, length of stay (LOS), mortality, reoperation rate, readmission rate, use of opioids, time to return to work and time to return to normal activities., Results: Overall, 64 studies were selected and 58 were used for pooled data analyses: 35 studies (227 242 patients) deal with IHR and 32 (158 384 patients) with VHR. Robotic IHR was associated with lower hernia recurrence (OR 0.54; 95%CI 0.29, 0.99; I
2 : 0%) compared to laparoscopic IHR, and lower use of opioids compared to open IHR (OR 0.46; 95%CI 0.25, 0.84; I2 : 55.8%). Robotic VHR was associated with lower bowel injuries (OR 0.59; 95%CI 0.42, 0.85; I2 : 0%) and less conversions to open surgery (OR 0.51; 95%CI 0.43, 0.60; I2 : 0%) compared to laparoscopy. Compared to open surgery, robotic VHR was associated with lower postoperative complications (OR 0.61; 95%CI 0.39, 0.96; I2 : 68%), less SSI (OR 0.47; 95%CI 0.31, 0.72; I2 : 0%), less intraoperative blood loss (- 95 mL), shorter LOS (- 3.4 day), and less hospital readmissions (OR 0.66; 95%CI 0.44, 0.99; I2 : 24.7%). However, both robotic IHR and VHR were associated with significantly longer OT compared to laparoscopy and open surgery., Conclusion: These results support robotic surgery as a safe, effective, and viable alternative for IHR and VHR as it can brings several intraoperative and postoperative advantages over laparoscopy and open surgery., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)- Published
- 2024
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28. Unplanned readmissions after hernia repair.
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Christou N, Drissi F, Naumann DN, Blazquez D, Mathonnet M, and Gillion JF
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- Humans, Herniorrhaphy adverse effects, Herniorrhaphy methods, Prospective Studies, Patient Readmission, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications surgery, Risk Factors, Length of Stay, Retrospective Studies, Hernia, Ventral surgery, Incisional Hernia surgery, Hernia, Inguinal complications
- Abstract
Introduction: Several quality indices have been set up for evaluating the impact of the reduction of the length of stay (LOS), such as the 30-day unplanned readmission (UR
30 ) rate. The main goal of our study was to analyze the UR30 following groin hernia repair (GHR), primary- (PVHR), and incisional ventral hernia repairs (IVHR)., Methods: A French registry-based multicenter study was conducted using prospective data from all consecutive patients registered from 2015 to 2021., Results: The overall incidence of UR30 was 1.32%. This included 160/18,042 (0.87%) for GHR, 41/4012 (1.02%) for PVHR, and 145/3754 (3.86%) for IVHR. The leading cause of UR30 was postoperative complications (PO C). The nature of the predominant complications varied among the three categories. The correlation between UR30 and PO C (and risk factors for PO C) was strong in GHR but was not in IVHR due to a 'protective' longer LOS in this subgroup. As the LOS has decreased over the last years, this has 'mechanically' resulted in an increase in the occurrence of UR30 , but not in a rise of PO C, neither in volume nor in severity. The reduction of LOS just shifted the problem from inpatient to outpatient settings., Conclusion: Since the steady development of day-care surgery, the prevention of the UR not only hinges on the prevention of the PO C but newly on a better organization of outpatient care which is currently a huge challenge due to a GPs' and nurses' shortage in France., (© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)- Published
- 2023
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29. Auto-adjusted versus fixed positive airway pressure in patients with severe OSA: A large randomized controlled trial.
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Bironneau V, Ingrand P, Pontier S, Iamandi C, Portel L, Martin F, Mallart A, Lerousseau L, Alfandary D, Levrat V, Portier F, Tamisier R, Goutorbe F, Rabec C, Codron F, Auregan G, Mercy M, Attali V, Soyez F, Launois C, Recart D, Vecchierini MF, Gagnadoux F, and Meurice JC
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- Humans, Quality of Life, Continuous Positive Airway Pressure, Blood Pressure physiology, Research Design, Sleep Apnea, Obstructive therapy
- Abstract
Background and Objective: Continuous positive airway pressure (CPAP) in the treatment of severe obstructive sleep apnoea (OSA) can be used in fixed CPAP or auto-adjusted (APAP) mode. The aim of this prospective randomized controlled clinical study was to evaluate the 3 month-efficacy of CPAP used either in fixed CPAP or APAP mode., Methods: Eight hundred one patients with severe OSA were included in twenty-two French centres. After 7 days during which all patients were treated with APAP to determine the effective pressure level and its variability, 353 and 351 patients were respectively randomized in the fixed CPAP group and APAP group. After 3 months of treatment, 308 patients in each group were analysed., Results: There was no difference between the two groups in terms of efficacy whatever the level of efficient pressure and pressure variability (p = 0.41). Exactly, 219 of 308 patients (71.1%) in the fixed CPAP group and 212 of 308 (68.8%) in the APAP group (p = 0.49) demonstrated residual apnoea hypopnoea index (AHI) <10/h and Epworth Score <11. Tolerance and adherence were also identical with a similar effect on quality of life and blood pressure evaluation., Conclusion: The two CPAP modes, fixed CPAP and APAP, were equally effective and tolerated in severe OSA patients., (© 2023 Asian Pacific Society of Respirology.)
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- 2023
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30. Suture versus open mesh repair for small umbilical hernia: Results of a propensity-matched cohort study.
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Frey S, Beauvais A, Soler M, Beck M, Dugué T, Pavis d'Escurac X, Dabrowski A, Jurczak F, and Gillion JF
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- Humans, Cohort Studies, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications surgery, Surgical Mesh adverse effects, Pain, Postoperative epidemiology, Pain, Postoperative etiology, Herniorrhaphy adverse effects, Herniorrhaphy methods, Sutures adverse effects, Recurrence, Suture Techniques adverse effects, Hernia, Umbilical surgery
- Abstract
Background: The objective was to compare the outcomes of open mesh repair versus suture repair for small (≤1 cm in diameter) umbilical hernia. The primary endpoint was the 30-day outcomes including pain, and secondary endpoints were the 2-year outcomes including recurrences and patient-reported outcomes., Methods: This propensity-matched, multicenter study was carried out on data collected prospectively in the Hernia-Club database between 2011 and 2021. A total of 590 mesh repairs and 590 suture repairs were propensity score matched (age, sex, body mass index) at a ratio of 1:1. Postoperative pain was assessed using the Verbal Rating Scale-4 and 0‒10 Numerical Rating Scale-11., Results: Mesh insertion was intraperitoneal in 331 patients (56.1%), extraperitoneal in 249 (42.2%), and onlay in 10 (1.7%). The rate of 30-day complications and Numerical Rating Scale-11 pain scores on postoperative days 8 and 30 were similar between the groups, including surgical site occurrences (2.2 vs 1.4% after suture repair). At 1 month, postoperative discomfort (sensation of something different from before) was significantly (P < .0001) more frequent after mesh repair, whereas the rate of relevant (moderate or severe) pain (mesh repair: 1.1% vs suture repair: 2.6%) and the distribution of Numerical Rating Scale-11 scores did not differ between the groups. At the 2-year follow-up, mesh repair patients had fewer reoperated recurrences (0.2% vs 1.7%; P = .035) and no more pain or discomfort than suture repair patients., Conclusion: Both techniques are effective and safe. Mesh repair is likely to reduce the rate of recurrences. Concerns about postoperative pain and infection might not prevent the use of mesh in smallest umbilical hernias., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2023
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31. Impact of robotic access on outcomes after lung cancer surgery in France: Analysis from the Epithor database.
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Madelaine L, Baste JM, Trousse D, Vidal R, Durand M, and Pagès PB
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Introduction: We aimed to compare postoperative outcomes after pulmonary resection for lung cancer after open thoracotomy (OT), video-assisted (VATS), and robotic-assisted (RA) thoracic surgery using a propensity score analysis., Methods: From 2010 to 2020, 38,423 patients underwent resection for lung cancer. In total, 58.05% (n = 22,306) were operated by thoracotomy, 35.35% (n = 13,581) by VATS, and 6.6% (n = 2536) by RA. A propensity score was used to create balanced groups with weighting. End points were in-hospital mortality, postoperative complications, and length of hospital stay, reported by odds ratios (ORs) and 95% confidence intervals (CIs)., Results: VATS decreased in-hospital mortality compared with OT (OR, 0.64; 95% CI, 0.58-0.79; P < .0001) but not compared with RA (OR, 1.09; 95% CI, 0.77-1.52; P = .61). VATS reduced major postoperative complications compared with OT (OR, 0.83; 95% CI, 0.76-0.92; P < .0001) but not RA (OR, 1.01; 95% CI, 0.84-1.21; P = .17). VATS reduced prolonged air leaks rate compared with OT (OR, 0.9; 95% CI, 0.84-0.98; P = .015) but not RA (OR, 1.02; 95% CI, 0.88-1.18; P = .77). As compared with OT, VATS and RA decreased the incidence of atelectasis (respectively: OR, 0.57; 95% CI, 0.50-0.65; P < .0001 and OR, 0.75; 95% CI, 0.60-0.95; P = .016); the incidence of pneumonia (OR, 0.75; 95% CI, 0.67-0.83; P < .0001 and OR, 0.62; 95% CI, 0.50-0.78; P < .0001); and the number of postoperative arrhythmias (OR, 0.69; 95% CI, 0.61-0.78; P < .0001 and OR, 0.75; 95% CI, 0.59-0.96; P = .024). Both VATS and RA resulted in shorter hospital stays (-1.91 days [-2.24; -1.58]; P < .0001 and -2.73 days [-3.1; -2.36]; P < .0001, respectively)., Conclusions: RA appeared to decrease postoperative pulmonary complications as well as VATS compared with OT. VATS decreased postoperative mortality as compared with RA and OT., (© 2023 The Author(s).)
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- 2023
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32. Reverse Shoulder Arthroplasty for Patients with Massive Rotator Cuff Tears or Cuff Tear Arthropathies at a Minimum Follow-up of 7 Years.
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De La Selle H, Lascar T, Clappaz P, Decrette E, van Rooij F, Saffarini M, and Obert L
- Abstract
Purpose: To evaluate indications and factors that influence long-term clinical outcomes and revision rates for reverse shoulder arthroplasty (RSA) in shoulders with irreparable massive rotator cuff tears (mRCTs) or cuff tear arthropathies (CTAs)., Methods: The authors retrospectively evaluated a consecutive series of shoulders with no fracture sequelae that underwent primary RSA between 2011 and 2013. Independent observers collected demographic data, surgical techniques, and implant types, as well as primary outcome measures such as American Shoulder and Elbow Society (ASES) score and Constant score (CS)., Study Design: Case series, level IV., Results: From the initial series of 123 patients that underwent RSA, 29 patients died (24%) for reasons unrelated to the shoulder arthroplasty, 11 were lost to follow-up (9%), and 4 required revision surgery (3%). The final cohort of 79 patients comprised 55 women (70%), and 24 men (30%), aged 72.7 ± 7.0. At a final follow-up of 8.9 ± 0.6 years (range: 7.4-10.3) the absolute CS was 59.0 ± 16.2, the age-/sex-adjusted CS was 76.6 ± 41.2, and ASES was 77.1 ± 20.3. Univariable analysis revealed no associations for absolute CS, but revealed that age-/sex-adjusted CS was significantly lower for patients with high blood pressure (β = -15.8, p = .025)., Conclusions: At a minimum follow-up of 7.4 years, the absolute CS was 59.0 ± 16.2, the age-/sex-adjusted CS was 87.4 ± 24.1 and ASES was 77.1 ± 20.3. When stratifying the outcomes of RSA by indication, there were no significant differences in patients with mRCTs versus CTA in terms of absolute CS, age-/sex-adjusted CS, and ASES. Univariable analysis revealed no association with absolute and age-/sex-adjusted CS for type of indication or surgical approach., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: TL and LO: This author receives royalties from FX Solutions and will receive fees from FX Solutions for data collection in relation to this study, but no other financial payments or other benefits from any commercial entity related to the subject of this article. HdlS, PC, and ED: This author will receive fees from FX Solutions for data collection in relation to this study, but no other financial payments or other benefits from any commercial entity related to the subject of this article. FVR and MS: This author is an employee of ReSurg SA which received fees from FX Solutions for statistical analysis and manuscript preparation for this study., (© The Author(s) 2023.)
- Published
- 2023
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33. Head-to-Head Comparison Between Rabbit Sign and EANM/SNMMI Criteria for the 18F-DOPA Visual Assessment of Parkinsonian Syndromes in PET/MRI: A Multiple Expert-Based and Blinded Controlled Study.
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Goldfarb L, Iep A, Chawki MB, Nguyen L, Lun F, Carpentier AAN, de Recondo A, Blin J, Bourdinaud V, Morin L, Andriatsiferana H, Ferreira A, Deschiens AM, Brulon V, Comtat C, Lebon V, and Besson FL
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- Humans, Rabbits, Animals, Prospective Studies, Magnetic Resonance Imaging, Sensitivity and Specificity, Dihydroxyphenylalanine, Positron-Emission Tomography, Parkinsonian Disorders diagnostic imaging
- Abstract
Purpose: The aim of this study was to compare the diagnostic performance of the rabbit visual pattern versus the one endorsed by the EANM/SNMMI for the diagnosis of parkinsonian syndromes in PET/MRI., Patients and Methods: The 18F-DOPA PET images of 129 consecutive patients (65 Park+ and 64 controls) with 1 year of clinical follow-up were reviewed independently by 5 experienced readers on the same imaging workstation, blinded to the final clinical diagnosis. Two visual methods were assessed independently, with several days to months of interval: the criteria endorsed by EANM/SNMMI and the "rabbit" shape of the striate assessed on 3D MIP images. The sensitivities, specificities, likelihood ratios, and predictive values of the 2 diagnostic tests were estimated simultaneously by using the "comparison of 2 binary diagnostic tests to a paired design" method., Results: The estimated 95% confidence interval (CI) of sensitivities and specificities ranged from 49.4% to 76.5% and from 83.2% to 97.7%, respectively. The 95% CI estimates of positive and negative likelihood ratios ranged from 3.8 to 26.7 and from 0.26 to 0.56, respectively. The 95% CI estimates of the positive and negative predictive values ranged from 78.1% to 96.7% and from 60.3% to 81.4%, respectively. For all the parameters, no statistical difference was observed between the 2 methods (P > 0.05). The rabbit sign reduced the readers' discrepancies by 25%, while maintaining the same performance., Conclusions: The rabbit visual pattern appears at least comparable to the current EANM/SNMMI reference procedure for the assessment of parkinsonian syndromes in daily clinical practice, without the need of any image postprocessing. Further multicenter prospective studies would be of relevance to validate these findings., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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34. The full range of ophthalmological clinical manifestations in systemic lupus erythematosus.
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Kedia N, Theillac V, Paez-Escamilla M, Indermill C, Gallagher DS, Adam R, Qu-Knafo AL, Amari F, Bottin C, Chotard G, Caillaux V, Strého M, Sedira N, Héron E, Becherel PA, Bodaghi B, Mrejen-Uretski S, Sahel AJ, Saadoun D, and Errera MH
- Abstract
Purpose: To determine the full range of ophthalmological clinical manifestations in systemic lupus erythematosus (SLE) and to compare the systemic features associated with them., Methods: Files of 13 patients with ocular SLE ( n = 20 eyes) diagnosed as per the American College of Rheumatology (ACR) 2012 revised criteria were retrospectively reviewed., Results: The following clinical manifestations were found: keratoconjunctivitis sicca ( n = three patients), anterior uveitis associated with an inflammatory pseudo-tumor orbital mass ( n = one patient, one eye), episcleritis and periorbital edema ( n = one patient, two eyes), posterior scleritis ( n = one patient, two eyes), bilateral papillary edema in the context of idiopathic intracranial hypertension ( n = one patient, one eye), inflammatory optic neuritis ( n = one patient, one eye), and lupus retinopathies with varying degrees of capillary occlusions mainly arteriolar ( n = seven patients, 13 eyes) and larger arteries or veins (retinal arteries occlusions and retinal veins occlusions) ( n = one patient, two eyes). Some patients presented with combined ophthalmological manifestations.Systemic SLE was discovered by its ophthalmic manifestation in three cases (23%) and was previously known in the other 10 cases (77%). On average, ocular symptoms were seen 8 years after the initial diagnosis of SLE. Other systemic SLE disorders included cutaneous disorders (77%), joint disorders (38%), central nervous system (CNS) disorders (23%), renal disorders (38%), and oral ulcers (23%).Treatment of the ophthalmic system manifestations of lupus included local steroid therapies along with systemic immunosuppression.The most common laboratory ACR criteria were: high levels of antinuclear antibodies (ANA) (100%), positive anti-Sm (64%), anti-dsDNA (27%), low complement levels (27%), and positive antiphospholipid (APL) antibodies (18%)., Discussion: SLE activity in the ophthalmic system is characterized by its functional severity and the range of involvement can be categorized by anatomical involvement: presence of anterior uveitis, episcleritis, scleritis, periorbital edema, posterior uveitis with retinal vascular ischemia, or papillary edema. Not currently part of the diagnosis criteria of the SLE ACR given its rarity, the ocular localization of the pathology led to the diagnosis of SLE in three cases; thus, developing a greater understanding of ocular lupus may help in identifying and treating systemic manifestations of lupus earlier., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kedia, Theillac, Paez-Escamilla, Indermill, Gallagher, Adam, Qu-Knafo, Amari, Bottin, Chotard, Caillaux, Strého, Sedira, Héron, Becherel, Bodaghi, Mrejen-Uretski, Sahel, Saadoun and Errera.)
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- 2023
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35. [What imaging and what tools for modern cardiac rehabilitation ?]
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Ghannem M, Boaouina MS, and Ghannem L
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- Humans, Exercise Therapy methods, Exercise, Cardiac Rehabilitation methods, Telerehabilitation methods, Smoking Cessation
- Abstract
Conventional Cardiovascular Rehabilitation (RCV) is a global approach; it integrates reconditioning with personalized effort, physical activity (PA), therapeutic education, dietary management, smoking cessation, medication compliance. It requires a multidisciplinary approach with interventions by cardiologists, paramedics, physiotherapists, teachers of adapted physical activity (APA), dieticians, addictologists, and a specialized technical platform for evaluation and reconditioning at the 'effort. The benefit of cardiovascular rehabilitation is supported by numerous studies, it is strongly recommended class IA [1], but the supply of care is insufficient. It is therefore necessary to develop a modality of care in RCV at home, subject to the same requirements as the programs in the center, thanks to the contributions of new technology and connected objects. Technological innovations have made it technically possible to treat and monitor patients remotely [14]. Telerehabilitation is an example of the application of technology-based care. It can be defined as the provision of Secondary Prevention at a distance. It consists of remote monitoring of patient physiological data, remote coaching, e-learning and social interaction [10]. From a theoretical point of view, cardiac telerehabilitation has the potential to go beyond traditional rehabilitation; it removes the barriers that prevent patients with ischemic heart disease from participating in rehabilitation programs in conventional centers. Several studies show that telerehabilitation represents an alternative, less expensive, effective, and profitable, it could, in addition to existing services, improve access to rehabilitation [15]. Increasing participation rates in cardiac rehabilitation can reduce disease burden. The study of the economic and social impact of increasing the use of cardiac rehabilitation and cardiac telerehabilitation shows that and the resulting benefits exceed its costs. Mots-clés: Réadaptation en centre; réadaptation à domicile; téléréadaptation., (Copyright © 2022. Published by Elsevier Masson SAS.)
- Published
- 2022
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36. Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement.
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Rodríguez de Santiago E, Dinis-Ribeiro M, Pohl H, Agrawal D, Arvanitakis M, Baddeley R, Bak E, Bhandari P, Bretthauer M, Burga P, Donnelly L, Eickhoff A, Hayee B, Kaminski MF, Karlović K, Lorenzo-Zúñiga V, Pellisé M, Pioche M, Siau K, Siersema PD, Stableforth W, Tham TC, Triantafyllou K, Tringali A, Veitch A, Voiosu AM, Webster GJ, Vienne A, Beilenhoff U, Bisschops R, Hassan C, Gralnek IM, and Messmann H
- Subjects
- Ecosystem, Endoscopy, Gastrointestinal methods, Humans, Gastroenterology
- Abstract
Climate change and the destruction of ecosystems by human activities are among the greatest challenges of the 21st century and require urgent action. Health care activities significantly contribute to the emission of greenhouse gases and waste production, with gastrointestinal (GI) endoscopy being one of the largest contributors. This Position Statement aims to raise awareness of the ecological footprint of GI endoscopy and provides guidance to reduce its environmental impact. The European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) outline suggestions and recommendations for health care providers, patients, governments, and industry. MAIN STATEMENTS 1: GI endoscopy is a resource-intensive activity with a significant yet poorly assessed environmental impact. 2: ESGE-ESGENA recommend adopting immediate actions to reduce the environmental impact of GI endoscopy. 3: ESGE-ESGENA recommend adherence to guidelines and implementation of audit strategies on the appropriateness of GI endoscopy to avoid the environmental impact of unnecessary procedures. 4: ESGE-ESGENA recommend the embedding of reduce, reuse, and recycle programs in the GI endoscopy unit. 5: ESGE-ESGENA suggest that there is an urgent need to reassess and reduce the environmental and economic impact of single-use GI endoscopic devices. 6: ESGE-ESGENA suggest against routine use of single-use GI endoscopes. However, their use could be considered in highly selected patients on a case-by-case basis. 7: ESGE-ESGENA recommend inclusion of sustainability in the training curricula of GI endoscopy and as a quality domain. 8: ESGE-ESGENA recommend conducting high quality research to quantify and minimize the environmental impact of GI endoscopy. 9: ESGE-ESGENA recommend that GI endoscopy companies assess, disclose, and audit the environmental impact of their value chain. 10: ESGE-ESGENA recommend that GI endoscopy should become a net-zero greenhouse gas emissions practice by 2050., Competing Interests: M. Arvanitakis is providing consultancy to Ambu (September 2021 to September 2022). E. Bak is Chair of the Polish Society of Endoscopic Nurses and Assistants (from 2019, ongoing). M. Dinis-Ribeiro has provided consultancy to Medtronic (from 2021 and Roche (from 2022); his department has received a research grant (loan) from Fujifilm (2021–2022); he is Co-Editor-in-Chief of Endoscopy journal. A. Eickhoff has provided consultancy to Ambu Medical (2012–2020). L. Donnelly is an elected member of the British Society of Gastroenterology – Nurses Association (2022, ongoing). C. Hassan has provided consultancy to and/or received research grants from Alfasigma, Fujifilm, Medtronic, Norgine, Olympus, and Pentax. B.H. Hayee is receiving grant support for sustainability research from Boston Scientific (from April 2022 for 24 months). M.F. Kaminski has provided consultancy to Olympus and Erbe (from 2021), and lectured for Boston Scientific (from 2016) and Recordati (from 2020). H. Messmann has received consultation fees from Ambu, Boston Scientific, and Olympus (in the past 3 years); his department has received financial support from Olympus and Satisfai. M. Pellisé has provided consultancy to Norgine Iberia (2015–2019), CI Supply (2019), and Fujifilm Europe (from 2021, ongoing); her department has received research support from Fujifilm Spain (2019), Fujifilm Europe (from 2020, ongoing), Casen Recordati (2020), ZiuZ (2021), and 3D-Matrix (2022); she is Chair of the ESGE Diversity and Equity Working Group (2021–2022) and a Councillor for SEED (Sociedad Española de Endoscopia Digestiva) (2016–2022). H. Pohl is Co-Editor-in-Chief of Endoscopy journal. E. Rodríguez de Santiago receives support for academic and educational activities with Olympus (from 2021, ongoing); his department receives support for academic and educational activities with Olympus, Boston Scientific, Casen Recordati, and Norgine (from 2016, ongoing). P.D. Siersema receives research support from Pentax, Japan (from 2019), The E-Nose Company, Netherlands (from 2018), Lucid Diagnostics, US (from 2021), MicroTech, China (from 2019), and Magentiq Eye, Israel (from 2021); he receives research support from and advises Motus GI, US (from 2018), and support from Endo Tools Therapeutics, Belgium (2022); he is Editor-in-Chief of Endoscopy journal. A. Veitch has received speaker’s fees from Olympus (March 2022). G.J. Webster has received honoraria for teaching from Boston Scientific (2010–2022). D. Agrawal, R. Baddeley, U. Beilenhoff, P. Bhandari, R. Bisschops, M. Bretthauer, P. Burga, I.M. Gralnek, K. Karlović, V. Lorenzo-Zuniga, M. Pioche, K. Siau, W. Stableforth, T.C. Tham, K. Triantafyllou, A. Tringali, A. Vienne, and A. Voiosu have no competing interests., (European Society of Gastrointestinal Endoscopy. All rights reserved.)
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- 2022
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37. A better understanding of daily life abdominal wall mechanical solicitation: Investigation of intra-abdominal pressure variations by intragastric wireless sensor in humans.
- Author
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Soucasse A, Jourdan A, Edin L, Gillion JF, Masson C, and Bege T
- Subjects
- Exercise, Humans, Male, Prospective Studies, Abdominal Wall
- Abstract
Intra-abdominal pressure (IAP), as the main mechanical load applied to the abdominal wall, is decisive in the occurrence of ventral hernia. The objective of the study was to propose a comprehensive evaluation of IAP based on a limited risk and discomfort method. A prospective study was carried out in 20 healthy volunteers. The intragastric pressure, validated for estimating IAP, was assessed by an ingestible pressure sensor. Volunteers realized a set of supervised exercises, then resumed their daily activities with the pressure continuously recorded until gastric emptying. Coughing and jumping exercises resulted in the highest IAP levels with maximum peaks of 65 ± 35 and 67 ± 31 mmHg and pressure rates of 121 and 114 mmHg.s
-1 respectively. The position did not affect the IAP variation. Men had significantly higher pressure values for pushing against a wall (P < 0.01), Valsalva maneuver and legs raising (P<0.05) exercises. During daily life, IAP greater than 50, 100, and 150 mmHg occurred on average five times, twice, and once per hour, respectively. This study provides a real-life characterization of the IAP allowing the quantification of mechanical solicitation applied to the abdominal wall and the identification of risk situations for the occurrence of ventral hernias., (Copyright © 2022. Published by Elsevier Ltd.)- Published
- 2022
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38. Intrahospital trauma flowcharts - Cognitive aids for intrahospital trauma management from the French Society of Anaesthesia and Intensive Care Medicine (SFAR) and the French Society of Emergency Medicine (SFMU).
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Gauss T, Quintard H, Bijok B, Bouhours G, Clavier T, Cook F, de Courson H, David JS, Duracher-Gout C, Garrigue D, Geeraerts T, Hamada S, Joannes-Boyau O, Jouffroy R, Lamblin A, Langeron O, Lanot P, Lasocki S, Leone M, Mirek S, Muller L, Pasquier P, Prunet B, Perbet S, Raux M, Richards J, Roger C, Roquilly A, Weiss E, Bouzat P, and Pottecher J
- Subjects
- Cognition, Critical Care, Humans, Software Design, Anesthesia, Emergency Medicine
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- 2022
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39. Tocilizumab plus dexamethasone versus dexamethasone in patients with moderate-to-severe COVID-19 pneumonia: A randomised clinical trial from the CORIMUNO-19 study group.
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Hermine O, Mariette X, Porcher R, Djossou F, Nguyen Y, Arlet JB, Savale L, Diehl JL, Georgin-Lavialle S, Cadranel J, Pialoux G, Lacombe K, Mekinian A, Gros H, Lescure X, Ghosn J, Coupez E, Grapin K, Rapp C, Michel M, Lecapitaine AL, Michot JM, Costedoat-Chalumeau N, Nguyen LBL, Semerano L, Raffi F, Aguillar C, Rouzaud C, Gottenberg JE, Hansmann Y, Bienvenu B, London J, Fantchou FS, Ackermann F, Gros A, Morel A, Gambier N, Sène D, Mégarbane B, Azoulay E, Bureau S, Dougados M, Emmerich J, Fartoukh M, Guidet B, Humbert M, Mahevas M, Pène F, Schlemmer F, Pourcher-Martinez V, Tibi A, Baron G, Perrodeau E, Baron S, Steg G, Yazdapanah Y, Simon T, Resche-Rigon M, Tharaux PL, and Ravaud P
- Abstract
Background: In moderate-to-severe COVID-19 pneumonia, dexamethasone (DEX) and tocilizumab (TCZ) reduce the occurrence of death and ventilatory support. We investigated the efficacy and safety of DEX+TCZ in an open randomized clinical trial., Methods: From July 24, 2020, through May 18, 2021, patients with moderate-to-severe COVID-19 pneumonia requiring oxygen (>3 L/min) were randomly assigned to receive DEX (10 mg/d 5 days tapering up to 10 days) alone or combined with TCZ (8 mg/kg IV) at day 1, possibly repeated with a fixed dose of 400 mg i.v. at day 3. The primary outcome was time from randomization to mechanical ventilation support or death up to day 14, analysed on an intent-to-treat basis using a Bayesian approach. ClinicalTrials.gov number, NCT04476979., Findings: A total of 453 patients were randomized, 3 withdrew consent, 450 were analysed, of whom 226 and 224 patients were assigned to receive DEX or TCZ+DEX, respectively. At day 14, mechanical ventilation or death occurred in 32/226 (14%) and 27/224 (12%) in the DEX and TCZ+DEX arms, respectively (hazard ratio [HR] 0·85, 90% credible interval [CrI] 0·55 to 1·31). At day 14, the World health Organization (WHO) clinical progression scale (CPS) was significantly improved in the TCZ+DEX arm (OR 0·69, 95% CrI, 0·49 to 0.97). At day 28, the cumulative incidence of oxygen supply independency was 82% in the TCZ+DEX arms and 72% in the DEX arm (HR 1·36, 95% CI 1·11 to 1·67). On day 90, 24 deaths (11%) were observed in the DEX arm and 18 (8%) in the TCZ+DEX arm (HR 0·77, 95% CI 0·42-1·41). Serious adverse events were observed in 25% and 21% in DEX and TCZ+DEX arms, respectively., Interpretation: Mechanical ventilation need and mortality were not improved with TCZ+DEX compared with DEX alone. The safety of both treatments was similar. However, given the wide confidence intervals for the estimate of effect, definitive interpretation cannot be drawn., Funding: Programme Hospitalier de Recherche Clinique [PHRC COVID-19-20-0151, PHRC COVID-19-20-0029], Fondation de l'Assistance Publique - Hôpitaux de Paris (Alliance Tous Unis Contre le Virus) and from Fédération pour la Recherche Médicale" (FRM). Tocilizumab was provided by Roche., Competing Interests: The authors have the following interests to declare: Laurent Savale reports personal fees from Janssen and Janssen, andMSD, grants and personal fees from GSK, non-financial support from Acceleron, outside the submitted work. Gilles Pialoux has received consulting fees from Gilead, Abbvie, ViiVHealthcare, MSD and research grants from Gilead. Karine Lacombe Advisory boards in the Covid19 field of MSD, Gilead, GSK, Educational activities in the Covid19 field Chiesi, Sobi, MSD, Gilead, MSD. Xavier Lescure is COVID-19 advisor and has received grant from French ministry of health Jade Ghosn reports grants and personal fees from Gilead, personal fees from MSD, personal fees from ViiV Healthcare, personal fees from Janssen, personal fees from Astra Zeneca, outside the submitted work. Jean Marie Michot reports investigator fees from Amgen, BMS-Celgene, Roche, Sanofi, Xencor, Astex, outside the submitted work. François Raffi personal fees from Gilead Sciences, Janssen, MSD, Pfizer, Roche, ViiV Healthcare, outside the submitted work. Muriel Fartoukh Advisory board (community acquired pneumonia) of Pfizer, educational activities (community acquired pneumonia) of BioMérieux, (ARDS) of Fisher&Paykel. Marc Humbert personal fees from Acceleron, AstraZeneca, Bayer, Merck, Novartis, Roche, Sanofi, GSK, outside the submitted work. Frédéric Pene reports grants from ALEXION, personal fees from GILEAD, outside the submitted work. Gabriel Steg reports grants from Amarin, Bayer, Sanofi, Servier, consulting fees from Amarin, Amgen, AstraZeneca, Bayer, BMS, Idorsia, Merck, Novartis, Novo Nordisk, Pfizer, PhaseBio, Sanofi, Servier, honoraria for lectures from Mylan, support for travels from Astra Zeneca, Co inventor on Patent on alirocumab to reduce cardiovascular risk with all royalties to Sanofi, Participation on a Data Safety Monitoring Board or Advisory Board of Sanofi, New Amsterdam Pharma, Co founder of Bioquantis, all outside the submitted work. Philippe Ravaud has received grant from French ministry of health. All other authors have nothing to declare., (© 2022 The Author(s).)
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- 2022
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40. Phase III randomized trial comparing systemic versus intra-arterial oxaliplatin, combined with LV5FU2 +/- irinotecan and a targeted therapy, in the first-line treatment of metastatic colorectal cancer restricted to the liver (OSCAR): PRODIGE 49.
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Pernot S, Pellerin O, Mineur L, Monterymard C, Smith D, Lapuyade B, Gallois C, Khemissa Akouz F, De Baere T, Tougeron D, Thirot-Bidault A, Audemar F, Simon M, Lecaille C, Louafi S, Lepage C, Ducreux M, and Taieb J
- Subjects
- Colorectal Neoplasms pathology, Fluorouracil administration & dosage, Hepatic Artery, Humans, Infusions, Intra-Arterial, Leucovorin administration & dosage, Liver Neoplasms secondary, Organoplatinum Compounds administration & dosage, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Bevacizumab administration & dosage, Colorectal Neoplasms drug therapy, Liver Neoplasms drug therapy, Oxaliplatin administration & dosage
- Abstract
Introduction: In patients with unresectable liver metastases from colorectal cancer (CRCLM), systemic doublet or triplet chemotherapy and targeted therapy is considered a standard first-line treatment. Hepatic arterial infusion of oxaliplatin (HAI-ox) generates a high response rate, but this still needs to be confirmed in a randomized trial. We incorporated HAI-ox in doublet or triplet + targeted therapy to validate its efficacy., Aim: The OSCAR study is an ongoing randomized phase III trial comparing FOLFOX + targeted therapy according to RAS status, or FOLFOXIRI + bevacizumab in patients eligible for triplet therapy, with the same regimen but with HAI-ox instead of IV-ox as the first-line treatment for CRCLM., Materials and Methods: Main eligibility criteria are colorectal cancer, unresectable liver metastasis, no extra-hepatic metastases except pulmonary nodules if ≤3 and <10 mm, ECOG performance status 0 or 1., Endpoint: The primary endpoint is progression-free survival (PFS). A difference of 4 months for the median PFS in favor of HAI-ox is expected (HR = 0.73). Secondary endpoints include overall survival, overall response rate, secondary liver resection, safety, and quality of life., Conclusion: This study is planned to include 348 patients to demonstrate the superiority of HAI-ox over systemic oxaliplatin in first-line CRCLM treatment (NCT02885753)., Competing Interests: Conflict of interest PRODIGE 49 – Oscar Trial is funded in part by Amen Simon Pernot has received honoraria as a speaker and/or in an advisory role from Merck KGaA, Sanofi, Astra Zeneca, Servier, Pierre Fabre, and Amgen David Tougeron has received honoraria as a speaker and/or in an advisory role from Merck KGaA, Sanofi, Roche Genentech, MSD, BMS, Astra Zeneca, Servier, Pierre Fabre, Sandoz and Amgen Claire Gallois has received honoraria as a speaker and/or in an advisory role from Sanofi, Servier Faiza Khemissa has received honoraria as a speaker and/or in an advisory role from Sanofi, Bayer Michel Ducreux has received honoraria as a speaker and/or in an advisory role from Merck KGaA, Sanofi, Roche Genentech, MSD, BMS, Astra Zeneca, Servier, Pierre Fabre, Sandoz and Amgen Julien Taieb has received honoraria as a speaker and/or in an advisory role from Merck KGaA, Sanofi, Roche Genentech, MSD, BMS, Astra Zeneca, Servier, Pierre Fabre, Sandoz and Amgen Other authors didn't declare any conflict of interest., (Copyright © 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
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- 2022
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41. Longitudinal cohort study on preoperative pain as a risk factor for chronic postoperative inguinal pain after groin hernia repair at 2-year follow-up.
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Romain B, Fabacher T, Ortega-Deballon P, Montana L, Cossa JP, and Gillion JF
- Subjects
- Cohort Studies, Follow-Up Studies, Groin surgery, Herniorrhaphy adverse effects, Humans, Longitudinal Studies, Pain, Postoperative etiology, Pain, Postoperative surgery, Risk Factors, Surgical Mesh adverse effects, Chronic Pain etiology, Chronic Pain surgery, Hernia, Inguinal complications, Hernia, Inguinal surgery
- Abstract
Purpose: To assess the rate of late chronic postoperative inguinal pain (CPIP) after groin hernia repair in patients with different categories of preoperative VRS (Verbal Rating Scale) pain and to make a pragmatic evaluation of the rates of potentially surgery-related CPIP vs. postoperative continuation of preexisting preoperative pain., Methods: Groin pain of patients operated from 01/11/2011 to 01/04/2014 was assessed preoperatively, postoperatively and at 2-year follow-up using a VRS-4 in 5670 consecutive groin hernia repairs. A PROM (Patient Related Outcomes Measurement) questionnaire studied the impact of CPIP on the patients' daily life., Results: Relevant (moderate or severe VRS) pain was registered preoperatively in 1639 of 5670 (29%) cases vs. 197 of 4704 (4.2%) cases at the 2-year follow-up. Among the latter, 125 (3.7%) cases were found in 3353 cases with no-relevant preoperative pain and 72 (5.3%) in 1351 cases with relevant preoperative pain. Relevant CPIP consisted of 179 (3.8%) cases of moderate pain and 18 (0.4%) cases of severe pain. The rate of severe CPIP was independent of the preoperative VRS-pain category while the rate of moderate CPIP (3.1%, 3.4%, 4.1%, 6.8%) increased in line with the preoperative (none, mild, moderate, and severe) VRS-pain categories. The VRS probably overestimated pain since 71.6% of the relevant CPIP patients assessed their pain as less bothersome than the hernia., Conclusion: At the 2-year follow-up, relevant CPIP was registered in 4.2% cases, of which 63.5% were potentially surgery-related (no-relevant preoperative pain) and 36.5% possibly due to the postoperative persistence of preoperative pain. The rate of severe CPIP was constant around 0.4%., (© 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
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- 2022
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42. Risk factors for surgical site infection after groin hernia repair: does the mesh or technique matter?
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Christou N, Ris F, Naumann D, Robert-Yap J, Mathonnet M, and Gillion JF
- Subjects
- Adult, Female, Groin surgery, Herniorrhaphy adverse effects, Herniorrhaphy methods, Humans, Male, Polyesters, Polypropylenes, Retrospective Studies, Risk Factors, Surgical Mesh adverse effects, Surgical Wound Infection epidemiology, Surgical Wound Infection etiology, Surgical Wound Infection surgery, Hernia, Inguinal complications, Laparoscopy methods
- Abstract
Introduction: Surgical site infections (SSIs) following groin hernia repair (GHR) are getting rarer in high income countries despite a wider use of meshes. Among the risk factors for SSIs, those related to the mesh and the surgical technique have rarely been described., Methods: A registry-based multicenter study using prospectively collected data, including SSIs and their potential risk factors, was conducted in the French Hernia-Club., Results: Between 2012 and 2019, 21,976 consecutive unselected adult patients aged 64.8 ± 15.4 years old (88.9% male) underwent GHR (83.5% unilateral). Fifty four percent were laparoscopic; 97.6% used mesh. The overall incidence of SSI was 0.26%. The incidence of SSI was respectively, 0.24% and 0.19% (p = 0.420) in open vs laparoscopic repairs; 0.19% and 0.25% (p = 0.638) for polyester vs polypropylene mesh; In adjusted multivariate analysis focusing on macroporous meshes (which were the most implanted meshes: 23,148 out of 24,099), there were no differences in terms of SSIs' rates regarding the technique: open versus laparoscopy (p = 0.762) nor the type of mesh used: polypropylene versus polyester (p = 0.557)., Conclusion: The rate of SSI following GHR was low in this large registry study. Mesh type and surgical technique did not affect SSIs rates. Caution is advised when interpreting these data due to this very low rate of SSI and the potential for a type II error., (© 2021. The Author(s).)
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- 2022
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43. Are the relative benefits of open versus laparoscopic intraperitoneal mesh repair of umbilical hernias dependent on the diameter of the defect?
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Frey S, Jurczak F, Fromont G, Dabrowski A, Soler M, Cossa JP, Magne E, Zaranis C, Beck M, and Gillion JF
- Subjects
- Adult, Aged, Female, Hernia, Umbilical diagnosis, Herniorrhaphy adverse effects, Herniorrhaphy instrumentation, Humans, Incidence, Laparoscopy instrumentation, Male, Middle Aged, Postoperative Complications etiology, Prospective Studies, Recurrence, Registries statistics & numerical data, Reoperation statistics & numerical data, Retrospective Studies, Risk Assessment statistics & numerical data, Risk Factors, Severity of Illness Index, Treatment Outcome, Hernia, Umbilical surgery, Herniorrhaphy methods, Laparoscopy adverse effects, Postoperative Complications epidemiology, Surgical Mesh adverse effects
- Abstract
Background: The aim of this study was to assess whether the respective values of open and laparoscopic intraperitoneal repairs of umbilical hernias are related to the European Hernia Society diameter of defects., Methods: This registry-based study compared the early and 2-year outcomes of 776 open versus 1,019 consecutive laparoscopic intraperitoneal repairs performed from 2011 to 2019., Results: Intraperitoneal mesh repair, either laparoscopic or open, was found to be a safe procedure at the 2-year follow-up. The incidence of reoperated bowel obstructions was 0.3%. Compared with the open group: (1) postoperative surgical site occurrences in small (<2 cm) or medium (2-4 cm) hernias (0.3% vs 2.4%; P = .041; 1.4% vs 5.9%; P = .0002); (2) recurrence rates in large (≥4 cm) umbilical hernias (0.0% vs 8.6%; P = .0195); and (3) cumulative reoperation rates (0.9% vs 2.2%; P = .021) were significantly better in the laparoscopic group. Conversely, the rate of early pain on day 1 and 1 month postsurgery was higher in the laparoscopic group, for all hernia sizes (P < .001). The rate of moderate or severe chronic pain at 2 years was significantly higher in the laparoscopic group (8.1% vs 2.4%; P = .049) for small hernias., Conclusion: The respective benefit to drawback ratios for open versus laparoscopic intraperitoneal repairs were related to the European Hernia Society diameter of hernia defect. In medium-large hernias, the benefits of laparoscopic repair overrode its drawbacks. In small hernias, the low recurrence rate, reduced early and chronic pain, and better rate of ambulatory surgery suggest there is still a place for open repair., (Copyright © 2021 Elsevier Inc. All rights reserved.)
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- 2022
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44. Correction of ulnar claw hand and Wartenberg's sign.
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Bauer B and Chaise F
- Subjects
- Fingers innervation, Humans, Tendons surgery, Ulnar Nerve surgery, Hand surgery, Hand Deformities, Acquired etiology, Hand Deformities, Acquired surgery
- Abstract
Ulnar claw hand usually occurs when the ulnar nerve is damaged distally. Claw hand deformity is characterized by metacarpophalangeal hyperextension and interphalangeal flexion, making it impossible to oppose the fingers and thumb. Bouvier's test is used to guide the procedure. Palliative surgery requires prior preparation of paralytic hands. In case of a positive Bouvier's test, Zancolli's lasso technique is preferred because of its effectiveness. Capsuloplasty with anteroposterior transosseous fixation is used if the bone is strong enough and when flexor digitorum profondus muscle is inactive and does not allow flexor digitorum superficialis tendon transfer. In case of a negative Bouvier's test with interphalangeal extension deficit of 45° of less, direct interossei muscle restoration techniques by active transfers are performed. If the interphalangeal extension deficit is more than 45°, proximal interphalangeal arthrodesis is indicated. Wartenberg first described actively irreducible abduction of the little finger. Wartenberg's sign is seen when ulnar paralysis occurs, and during ulnar nerve regeneration. Treatment of isolated Wartenberg's sign consists of re-routing the extensor digiti minimi. Among the other techniques, Belmahi's "tie lasso" is preferred when flexible claw hand is associated with Wartenberg's sign., (Copyright © 2021 SFCM. Published by Elsevier Masson SAS. All rights reserved.)
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- 2022
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45. Tendon transfer surgery for radial nerve palsy.
- Author
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Tordjman D, d'Utruy A, Bauer B, Bellemère P, Pierrart J, and Masmejean E
- Subjects
- Hand, Humans, Tendons, Wrist Joint surgery, Radial Neuropathy surgery, Tendon Transfer methods
- Abstract
Palliative tendon transfer is an integral part of radial nerve palsy treatment. It can be considered in the first weeks when the possibility of nerve repair by direct suture or nerve grafting is not feasible or reasonable. Mostly, it is discussed secondarily when it is too late for nerve surgery and motor recovery cannot be expected, or after failure or incomplete recovery after nerve repair. The goal of tendon transfers is to restore wrist, finger and thumb extension. For wrist extension, the use of pronator teres is well accepted. The best tendon transfer for finger extension is debated. This can be restored doing a flexor carpi ulnaris (FCU), flexor carpi radialis or flexor digitorum superficialis (FDS) to extensor digitorum communis transfer. Regarding thumb extension and abduction, a palmaris longus (PL) or one FDS tendon to the rerouted extensor pollicis longus (EPL) transfer can be performed. If a transfer is done on the EPL without rerouting it, abduction can be restored by doing a tendon transfer to the abductor pollicis longus (APL) or an APL tenodesis. The different tendon transfer options are selected based on the surgeon's preference, and most importantly, discussed with the patients to define the objectives together. The transfer is chosen based on the clinical examination (high or low radial nerve palsy, tendon available for transfer like PL, wrist mobility) and based on the patient's needs and expectations (activities requiring the FCU, finger independence, independence of thumb extension or abduction). If the surgical rules and the postoperative instructions for rehabilitation are followed, tendon transfers for radial nerve palsy regularly produce very satisfactory results., (Copyright © 2021 SFCM. Published by Elsevier Masson SAS. All rights reserved.)
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- 2022
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46. Inferring the dynamics of mutated hematopoietic stem and progenitor cells induced by IFNα in myeloproliferative neoplasms.
- Author
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Mosca M, Hermange G, Tisserand A, Noble R, Marzac C, Marty C, Le Sueur C, Campario H, Vertenoeil G, El-Khoury M, Catelain C, Rameau P, Gella C, Lenglet J, Casadevall N, Favier R, Solary E, Cassinat B, Kiladjian JJ, Constantinescu SN, Pasquier F, Hochberg ME, Raslova H, Villeval JL, Girodon F, Vainchenker W, Cournède PH, and Plo I
- Subjects
- Calreticulin genetics, Hematopoietic Stem Cells metabolism, Hematopoietic Stem Cells pathology, Humans, Immunologic Factors pharmacology, Interferon-alpha pharmacology, Janus Kinase 2 genetics, Longitudinal Studies, Myeloproliferative Disorders genetics, Myeloproliferative Disorders pathology, Prospective Studies, Receptors, Thrombopoietin genetics, Tumor Cells, Cultured, Hematopoietic Stem Cells drug effects, Immunologic Factors therapeutic use, Interferon-alpha therapeutic use, Mutation drug effects, Myeloproliferative Disorders drug therapy
- Abstract
Classical BCR-ABL-negative myeloproliferative neoplasms (MPNs) are clonal disorders of hematopoietic stem cells (HSCs) caused mainly by recurrent mutations in genes encoding JAK2 (JAK2), calreticulin (CALR), or the thrombopoietin receptor (MPL). Interferon α (IFNα) has demonstrated some efficacy in inducing molecular remission in MPNs. To determine factors that influence molecular response rate, we evaluated the long-term molecular efficacy of IFNα in patients with MPN by monitoring the fate of cells carrying driver mutations in a prospective observational and longitudinal study of 48 patients over more than 5 years. We measured the clonal architecture of early and late hematopoietic progenitors (84 845 measurements) and the global variant allele frequency in mature cells (409 measurements) several times per year. Using mathematical modeling and hierarchical Bayesian inference, we further inferred the dynamics of IFNα-targeted mutated HSCs. Our data support the hypothesis that IFNα targets JAK2V617F HSCs by inducing their exit from quiescence and differentiation into progenitors. Our observations indicate that treatment efficacy is higher in homozygous than heterozygous JAK2V617F HSCs and increases with high IFNα dose in heterozygous JAK2V617F HSCs. We also found that the molecular responses of CALRm HSCs to IFNα were heterogeneous, varying between type 1 and type 2 CALRm, and a high dose of IFNα correlates with worse outcomes. Our work indicates that the long-term molecular efficacy of IFNα implies an HSC exhaustion mechanism and depends on both the driver mutation type and IFNα dose., (© 2021 by The American Society of Hematology.)
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- 2021
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47. Safety and Tolerance of a Novel Anti-Regurgitation Formula: A Double-Blind, Randomized, Controlled Trial.
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Bellaiche M, Ludwig T, Arciszewska M, Bongers A, Gomes C, Świat A, Dakhlia F, Piollet A, Oozeer R, and Vandenplas Y
- Subjects
- Crying, Double-Blind Method, Feces, Humans, Infant, Vomiting, Infant Formula, Oligosaccharides adverse effects
- Abstract
Objectives: A novel anti-regurgitation (AR) formula has been designed to support gut health and improve gastrointestinal (GI) symptoms beyond regurgitation. This study assessed the tolerance and safety of this new AR formula., Methods: This was a 4-week double-blind, randomized, controlled trial with a 4-week extension in formula-fed infants with regurgitation. The new AR (Test) formula contained 0.4 g/100 mL locust bean gum (LBG) as thickener, partly fermented formula with postbiotics, and short-chain galacto-oligosaccharides (scGOS) and long-chain fructo-oligosaccharides (lcFOS) (0.4 g/100 mL, ratio 9:1). The Control AR formula contained LBG (0.4 g/100 mL) with postbiotics and has a history of safe use. The primary outcome was the Infant Gastrointestinal Symptom Questionnaire (IGSQ) sum score including stooling, spitting-up/vomiting, crying, fussiness and flatulence., Results: All 182 infants screened were enrolled in the study. The primary analysis showed the equivalence of the IGSQ sum scores at Week 4 between groups. IGSQ sum scores improved significantly within 1 week (Mixed Model Repeated Measurement [MMRM], P < 0.001). Post-hoc analyses showed a bigger improvement of the IGSQ score in the Test (n = 38) versus Control (n = 44) group (MMRM, P = 0.008) in infants with more severe gastrointestinal (GI) symptoms (IGSQ score ≥35). Stool characteristics were comparable between groups. Growth related z scores were in line with the WHO child growth standards and both groups showed improvement of regurgitation. Adverse events did not show any safety concerns., Conclusions: The novel AR formula combining LBG, scGOS/lcFOS and postbiotics is well-tolerated, safe and supports adequate growth during the intervention. Post-hoc analyses suggest that the formula results in more improvement of GI symptom burden in infants with more severe symptoms., Competing Interests: Conflicts of Interest: T.L., A.B. and R.O. are employees of Danone Nutricia Research (Utrecht, The Netherlands). None of the other authors have a conflict of interest., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
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- 2021
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48. Robotic lobectomy in children with severe bronchiectasis: A worthwhile new technology.
- Author
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Durand M, Musleh L, Vatta F, Orofino G, Querciagrossa S, Jugie M, Bustarret O, Delacourt C, Sarnacki S, Blanc T, and Khen-Dunlop N
- Subjects
- Child, Humans, Length of Stay, Pneumonectomy, Retrospective Studies, Thoracic Surgery, Video-Assisted, Treatment Outcome, Bronchiectasis surgery, Lung Neoplasms surgery, Robotic Surgical Procedures
- Abstract
Background/purpose: Lobectomy is required in children affected by non-responsive, symptomatic, localized bronchiectasis, but inflammation makes thoracoscopy challenging. We present the first published series of robotic-assisted pulmonary lobectomy in children with bronchiectasis., Methods: Retrospective analysis of all consecutive patients who underwent pulmonary lobectomy for severe localized bronchiectasis (2014-2019) via thoracoscopic versus robotic lobectomy. Four 5 mm ports were used for thoracoscopy; a four-arm approach was used for robotic surgery (Da Vinci Surgical Xi System, Intuitive Surgical, California)., Results: Eighteen children were operated (robotic resection, n = 7; thoracoscopy, n = 11) with infected congenital pulmonary malformation, primary ciliary dyskinesia, and post-viral infection. There were no conversions to open surgery with robotic surgery, but five with thoracoscopy. Total operative time was significantly longer with robotic versus thoracoscopic surgery (mean 247 ± 50 versus 152 ± 57 min, p = 0.008). There were no significant differences in perioperative complications, length of thoracic drainage, or total length of stay (mean 7 ± 2 versus 8 ± 3 days, respectively). No blood transfusions were required. Two thoracoscopic patients had a type-3 postoperative complication., Conclusions: Pediatric robotic lung lobectomy is feasible and safe, with excellent visualization and bi-manual hand-wrist dissection - useful properties in difficult cases of infectious pathologies. However, instrumentation dimensions limit use in smaller thoraxes., (Copyright © 2020. Published by Elsevier Inc.)
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- 2021
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49. Authors' Reply: Outcomes of Incisional Hernia Repair Surgery After Multiple Recurrences: A Propensity Score-Matched Analysis.
- Author
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Sneiders D, de Smet GHJ, den Hartog F, Lange JF, and Gillion JF
- Subjects
- Herniorrhaphy, Humans, Propensity Score, Recurrence, Hernia, Ventral surgery, Incisional Hernia surgery
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- 2021
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50. Outcomes of Incisional Hernia Repair Surgery After Multiple Re-recurrences: A Propensity Score Matched Analysis.
- Author
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Sneiders D, de Smet GHJ, Hartog FD, Yurtkap Y, Menon AG, Jeekel J, Kleinrensink GJ, Lange JF, and Gillion JF
- Subjects
- Herniorrhaphy, Humans, Propensity Score, Prospective Studies, Recurrence, Surgical Mesh, Hernia, Ventral surgery, Incisional Hernia surgery
- Abstract
Background: Patients with a re-recurrent hernia may account for up to 20% of all incisional hernia (IH) patients. IH repair in this population may be complex due to an altered anatomical and biological situation as a result of previous procedures and outcomes of IH repair in this population have not been thoroughly assessed. This study aims to assess outcomes of IH repair by dedicated hernia surgeons in patients who have already had two or more re-recurrences., Methods: A propensity score matched analysis was performed using a registry-based, prospective cohort. Patients who underwent IH repair after ≥ 2 re-recurrences operated between 2011 and 2018 and who fulfilled 1 year follow-up visit were included. Patients with similar follow-up who underwent primary IH repair were propensity score matched (1:3) and served as control group. Patient baseline characteristics, surgical and functional outcomes were analyzed and compared between both groups., Results: Seventy-three patients operated on after ≥ 2 IH re-recurrences were matched to 219 patients undergoing primary IH repair. After propensity score matching, no significant differences in patient baseline characteristics were present between groups. The incidence of re-recurrence was similar between groups (≥ 2 re-recurrences: 25% versus control 24%, p = 0.811). The incidence of complications, as well as long-term pain, was similar between both groups., Conclusion: IH repair in patients who have experienced multiple re-recurrences results in outcomes comparable to patients operated for a primary IH with a similar risk profile. Further surgery in patients who have already experienced multiple hernia re-recurrences is justifiable when performed by a dedicated hernia surgeon.
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- 2021
- Full Text
- View/download PDF
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