1,788 results on '"Lariboisière hospital"'
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2. Study of the Reliability of a Device (HumanSens Plus) Allowing Immediate Measurement Uric Acid in the Blood Obtained by Finger Tip Puncture. (URICA)
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ART-Viggo, Rheumatology department, Lariboisière Hospital, Paris, France
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- 2021
3. Very early management of acute heart failure syndromes
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Alain Cohen-Solal, Alexandre Mebazaa, Mehmet Yilmaz, and Yilmaz, M.B., Department of Cardiology, Lariboisière Hospital INSERM U 942, Denis Diderot University, Paris, France, Department of Cardiology, Medicine Faculty of Cumhuriyet University, Sivas, Turkey -- Cohen-Solal, A., Department of Cardiology, Lariboisière Hospital INSERM U 942, Denis Diderot University, Paris, France -- Mebazaa, A., Department of Anesthesiology and Critical Care Medicine, Lariboisière Hospital INSERM U 942, Denis Diderot University, Paris, France
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Heart Failure ,medicine.medical_specialty ,Turkey ,business.industry ,Decision Trees ,Emergency department ,Syndrome ,medicine.disease ,Early initiation ,Blood pressure ,Internal medicine ,Heart failure ,Daily practice ,Practice Guidelines as Topic ,medicine ,Cardiology ,Humans ,Cardiology and Cardiovascular Medicine ,business ,Emergency Service, Hospital ,Heart failure/diagnosis/therapy ,Algorithms ,Acute disease - Abstract
Diagnosis and management of acute heart failure syndromes are described in the most recent ESC/ESICM guidelines. However, physicians dealing with these patients in their daily practice may need guidance in choosing therapeutic alternatives as soon as the dyspneic patient arrives to the emergency department. Herein, practical recommendations for the very early management of patients with acute heart failure syndromes are presented. Blood pressure- and symptomdriven strategy along with early initiation of goal-directed therapies are key take-home messages. Furthermore, early and frequent reassessment is also an imperative part of management so that adjustments in the initial therapeutic plan can be achieved in a timely fashion. © 2011 Turkish Society of Cardiology., Mebazaa, A.; Université Diderot-Paris 7, 2 Rue Ambroise Paré, 75475 Paris Cedex 10, France; email: alexandre.mebazaa@lrb.aphp.fr
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- 2011
4. Risk factors associated with COVID-19-associated pulmonary aspergillosis in ICU patients: a French multicentric retrospective cohort
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Sofiane Fodil, Magalie Collet, Benoit Plaud, Pierre-Antoine Oillic, Emmanuel Dudoignon, Bruno Mégarbane, Elie Azoulay, Stéphane Bretagne, Théo Ghelfenstein-Ferreira, Sarah Dellière, François Dépret, Sebastian Voicu, Alexandre Mebazaa, Benjamin G. Chousterman, Alexandre Alanio, Maud Salmona, Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals (CNRMA), Institut Pasteur [Paris], Hopital Saint-Louis [AP-HP] (AP-HP), Service de Réanimation Médicale et Toxicologique [Hôpital Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Hôpital Lariboisière-Fernand-Widal [APHP], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP)-Université Sorbonne Paris Nord, Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], No external funding was received for the present study, We thank Dr Pierre Gazeau for providing follow-up information regarding patients transferred to Brest University Hospital. We thank all staff, nurses, lab technicians who were essential to patients care in intensive care and medical mycology from Saint Louis Hospital and Lariboisière Hospital., Institut Pasteur [Paris] (IP), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Immunologie humaine, physiopathologie & immunothérapie (HIPI (UMR_S_976 / U976)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Génomique évolutive, modélisation et santé (GEMS), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), and Alanio, Alexandre
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0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,030106 microbiology ,Azithromycin ,[SDV.BID.SPT]Life Sciences [q-bio]/Biodiversity/Systematics, Phylogenetics and taxonomy ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Internal medicine ,[SDV.BID.SPT] Life Sciences [q-bio]/Biodiversity/Systematics, Phylogenetics and taxonomy ,Medicine ,Corticosteroids ,Medical history ,030212 general & internal medicine ,skin and connective tissue diseases ,[SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology ,azithromycin ,business.industry ,SARS-CoV-2 ,Incidence (epidemiology) ,COVID-19 ,Retrospective cohort study ,Odds ratio ,General Medicine ,bacterial infections and mycoses ,Intensive care unit ,[SDV.MP.MYC] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology ,Confidence interval ,3. Good health ,respiratory tract diseases ,Coronavirus ,Research Note ,Critical care ,Aspergillus ,Infectious Diseases ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Complication ,business ,medicine.drug - Abstract
Objectives The main objective of this study was to determine the incidence of invasive pulmonary aspergillosis (IPA) in patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU), and to describe the patient characteristics associated with IPA occurrence and to evaluate its impact on prognosis. Methods We conducted a retrospective cohort study including all successive COVID-19 patients, hospitalized in four ICUs, with secondary deterioration and one or more respiratory samples sent to the mycology department. We used a strengthened IPA testing strategy including seven mycological criteria. Patients were classified as probable IPA according to the European Organization for Research and Treatment of Cancer (EORTC)/Mycoses Study Group Education and Research Consortium (MSGERC) classification if immunocompromised, and according to the recent COVID-19-associated IPA classification otherwise. Results Probable IPA was diagnosed in 21 out of the 366 COVID-19 patients (5.7%) admitted to the ICU and in the 108 patients (19.4%) who underwent respiratory sampling for deterioration. No significant differences were observed between patients with and without IPA regarding age, gender, medical history and severity on admission and during hospitalization. Treatment with azithromycin for ≥3 days was associated with the diagnosis of probable IPA (odds ratio 3.1, 95% confidence interval 1.1–8.5, p=0.02). A trend was observed with high-dose dexamethasone and the occurrence of IPA. Overall mortality was higher in the IPA patients (15/21, 71.4% versus 32/87, 36.8%, p Conclusion IPA is a relatively frequent complication in severe COVID-19 patients and is responsible for increased mortality. Azithromycin, known to have immunomodulatory properties, may contribute to increase COVID-19 patient's susceptibility to IPA.
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- 2021
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5. Development of a computed cleansing score to assess quality of bowel preparation in colon capsule endoscopy
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Philippe Marteau, Xavier Dray, Ulriikka Chaput, Einas Abou Ali, Isabelle Nion-Larmurier, Olivier Romain, Aymeric Histace, Marine Camus, Christian Florent, Aymeric Becq, Cynthia Li, Olivia Pietri, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), ASTRE [Cergy-Pontoise], Equipes Traitement de l'Information et Systèmes (ETIS - UMR 8051), CY Cergy Paris Université (CY)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA)-CY Cergy Paris Université (CY)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de rhumatologie [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Drexel University, gastroenterology, Lariboisière hospital, Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), and Université Pierre et Marie Curie - Paris 6 (UPMC)
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Original article ,Scoring system ,Receiver operating characteristic ,business.industry ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,Colon mucosa ,law.invention ,Random order ,03 medical and health sciences ,0302 clinical medicine ,Capsule endoscopy ,law ,[INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV] ,030220 oncology & carcinogenesis ,Bowel preparation ,Medicine ,lcsh:Diseases of the digestive system. Gastroenterology ,030211 gastroenterology & hepatology ,Pharmacology (medical) ,lcsh:RC799-869 ,Nuclear medicine ,business ,[SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing - Abstract
Background and study aims Colon capsule endoscopy (CCE) does not possess an objective and reliable scoring system to assess the quality of visualization of the colon mucosa. The aim of this study was to establish a colonic computed assessment of cleansing (CAC) score able to discriminate “adequately cleansed” from “inadequately cleansed” CCE still frames. Patients and methods Twelve normal and complete CCEs, using the Pillcam Colon 2 system (Medtronic, Minnesota, United States), were prospectively selected amongst a database. A CAC score, defined as the ratio of color intensities red over green (R/G ratio), and red over brown (R/(R + G) ratio) was calculated for each extracted colonic frame. After sorting and random selection, two sets of still frames representative of the range of these ratios were obtained. These images were analyzed twice in random order by two experienced CCE readers who were blinded to the CAC scores. A receiver operating characteristic (ROC) curve was forged for both types of ratios and a threshold established, yielding the highest diagnostic performance in terms of adequate cleansing assessment. Results Four-hundred-and-eight frames were extracted. Regarding the R/G ratio, a threshold value of 1.55 was calculated, with a sensitivity of 86.5 % and a specificity of 77.7 %. Regarding the R/(R + G) ratio, a threshold value of 0.58 was calculated with a sensitivity of 95.5 % and a specificity of 62.9 %. Conclusion The two proposed CAC scores based on the ratio of color intensities come with high sensitivities for discriminating between “adequately cleansed” and “inadequately cleansed” CCE still frames, but they lack specificity. Further refinement, with implementation of additional image parameters, is warranted.
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- 2018
6. Sevoflurane for procedural sedation in critically ill patients: A pharmacokinetic comparative study between burn and non-burn patients
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Sébastien Perbet, Claire Biboulet, Jean-Marie Launay, Daniel Bourdeaux, Malha Sadoune, Alexandre Mebazaa, Valérie Sautou, Pascal Houzé, Matthieu Legrand, Alexandre Lenoire, Jean-Etienne Bazin, Benoit Plaud, Bruno Pereira, Jean-Michel Constantin, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Intensive et Réanimation [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service Pharmacie [CHU Clermont-Ferrand], CHU Louise Michel [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Department of Anaesthesiology and Critical Care and Burn Unit, St-Louis Hospital, service de Biostatistiques, DRCI, Service de biochimie INSERM UMR-S942, Hôpital Lariboisière-APHP, Université Paris Diderot - Paris 7 (UPD7), Department of biochemistry, Lariboisière hospital, Institut de Chimie de Clermont-Ferrand (ICCF), SIGMA Clermont (SIGMA Clermont)-Institut de Chimie du CNRS (INC)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Department of Pharmacology, St-Louis hospital, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], and CHU Clermont-Ferrand-CHU Louise Michel [Clermont-Ferrand]
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Adult ,Male ,Critical Care ,Propanols ,Sedation ,Critical Illness ,[SDV]Life Sciences [q-bio] ,Conscious Sedation ,Critical Care and Intensive Care Medicine ,Kidney Function Tests ,Sevoflurane ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Pharmacokinetics ,Lipocalin-2 ,Intensive care ,medicine ,Humans ,Prospective Studies ,Aged ,Volume of distribution ,Aged, 80 and over ,Critically ill ,business.industry ,Distribution volume ,030208 emergency & critical care medicine ,General Medicine ,Acute Kidney Injury ,Middle Aged ,Respiration, Artificial ,3. Good health ,Pharmacokinetic analysis ,Anesthesiology and Pain Medicine ,Metabolism ,030228 respiratory system ,Anesthesia ,Toxicity ,Anesthetics, Inhalation ,Female ,medicine.symptom ,business ,Burns ,medicine.drug ,Half-Life - Abstract
International audience; BackgroundSevoflurane has anti-inflammatory proprieties and short lasting effects making it of interest for procedural sedation in critically ill patients. We evaluated the pharmacokinetics of sevoflurane and metabolites in severely ill burn patients and controls. The secondary objective was to assess potential kidney injury.MethodsProspective interventional study in a burn and a surgical intensive care unit; 24 mechanically ventilated critically ill patients (12 burns, 12 controls) were included. The sevoflurane was administered with an expired fraction target of 2% during short-term procedural sedation. Plasma concentrations of sevoflurane, hexafluoroisopropanolol (HFIP) and free fluoride ions were recorded at different times. Kinetic Pro (Wgroupe, France) was used for pharmacokinetic analysis. Kidney injury was assessed with neutrophil gelatinase-associated lipocalin (NGAL).ResultsThe mean total burn surface area was 36 ± 11%. The average plasma concentration of sevoflurane was 70.4 ± 37.5 mg·L−1 in burns and 57.2 ± 28.1 mg·L−1 in controls at the end of the procedure (P = 0.58). The volume of distribution was higher (46.8 ± 7.2 vs 22.2 ± 2.50 L, P < 0.001), and the drug half-life longer in burns (1.19 ± 0.28 h vs 0.65 ± 0.04 h, P < 0.0001). Free metabolite HFIP was higher in burns. Plasma fluoride was not different between burns and controls. NGAL did not rise after procedures.ConclusionWe observed an increased volume of distribution, slower elimination rate, and altered metabolism of sevoflurane in burn patients compared to controls. Repeated use for procedural sedation in burn patients needs further evaluation. No renal toxicity was detected.
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- 2018
7. Outcomes 7 Years After Infliximab Withdrawal for Patients With Crohn’s Disease in Sustained Remission
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Reenaers, Catherine, Mary, Jean-Yves, Nachury, Maria, Bouhnik, Yoram, Laharie, David, Allez, Matthieu, Fumery, Mathurin, Amiot, Aurélien, Savoye, Guillaume, Altwegg, Romain, Devos, Martine, Malamut, Georgia, Bourreille, Arnaud, Flourie, Bernard, Marteau, Philippe, Vuitton, Lucine, Coffin, Benoit, Viennot, Stéphanie, Lambert, Jérôme, Colombel, Jean-Frédéric, Louis, Edouard, Getaid, Groupe d'Etude Thérapeutique Des Affections, Université de Liège, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biostatistique et épidemiologie clinique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gastro-entérologie et assistance nutritive, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Infection à helicobacter, inflammation et cancer, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), CHU Amiens-Picardie, Service d'hépato-gastro-entérologie [APHP 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), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Hépato-gastro-entérologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Universiteit Gent = Ghent University [Belgium] (UGENT), Service de gastroenterologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Neuropathies du système nerveux entérique et pathologies digestives, implication des cellules gliales entériques, Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hepato-Gastroenterology, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), gastroenterology, Lariboisière hospital, Hôpital Lariboisière-Fernand-Widal [APHP], Service de Gastro-Entérologie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Gastroenterology Unit, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Côte de Nacre [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Icahn Medical Institute-Mount Sinai School of Medicine, Department of Gene and Cell Medicine and Institute for Immunology, Groupe d’Étude Thérapeutique des Affections Inflammatoires du Tube Digestif (GETAID), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Faculty of Medicine and Health Science, University of Ghent, Ghent, Belgium, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre hospitalier universitaire d'Amiens (CHU Amiens-Picardie), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'Hépato-Gastroentérologie [Rouen], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Lariboisière, AP-HP, Paris, Service d'Hépato-gastro-entérologie [Hôpital Jean Minjoz], Hôpital Jean Minjoz, Hopital Louis Mourier - AP-HP [Colombes], GETAID, and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)
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musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Maintenance therapy ,Belgium ,Crohn Disease ,Gastrointestinal Agents ,Interquartile range ,Recurrence ,Internal medicine ,medicine ,Humans ,Prospective Studies ,ComputingMilieux_MISCELLANEOUS ,Crohn's disease ,Hepatology ,biology ,business.industry ,C-reactive protein ,Gastroenterology ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,medicine.disease ,Infliximab ,3. Good health ,Surgery ,Discontinuation ,Treatment Outcome ,030220 oncology & carcinogenesis ,Cohort ,biology.protein ,030211 gastroenterology & hepatology ,Female ,France ,business ,medicine.drug ,Follow-Up Studies - Abstract
Background & Aims Little is known about long-term outcomes of patients with Crohn's disease (CD) after infliximab withdrawal. We aimed to describe the long-term outcomes of patients with CD in clinical remission after infliximab treatment was withdrawn. Methods We performed a retrospective analysis of data from the 115 patients included in the infliximab discontinuation in patients with CD in stable remission on combined therapy with antimetabolites (STORI) study, performed at 20 centers in France and Belgium from March 2006 through December 2009. The STORI cohort was a prospective analysis of risk and factors associated with relapse following withdrawal of maintenance therapy with infliximab, maintained on antimetabolites, while in clinical remission. We collected data from the end of the study until the last available follow-up examination on patient surgeries, new complex perianal lesions (indicating major complications), and need for and outcomes of restarting therapy with infliximab or another biologic agent. The de-escalation strategy was considered to have failed when a major complication or infliximab restart failure occurred. Results Of the 115 patients initially included, data from 102 patients (from 19 of the 20 study centers) were included in the final analysis. The median follow-up time was 7 years. Twenty-one percent of the patients did not restart treatment with infliximab or another biologic agent and did not have a major complication 7 years after infliximab withdrawal (95% CI, 13.1–30.3). Among patients who restarted infliximab, treatment failed for 30.1% 6 years after restarting (95% CI, 18.5–42.5). Overall, at 7 years after stopping infliximab therapy, major complications occurred in 18.5% of patients (95% CI, 10.2–26.8) whereas 70.2% of patients had no failure of the de-escalation strategy (95% CI, 60.2–80.1). Factors independently associated with major complications were upper-gastrointestinal location of disease, white blood cell count ≥ 5.0 × 109/L, and hemoglobin level ≤12.5 g/dL at the time of infliximab withdrawal. Patients with at least 2 of these factors had a more than 40% risk of major complication in the 7 years following infliximab withdrawal. Conclusions In a long-term follow-up of the STORI cohort (7 years) one fifth of the patients did not restart infliximab or another biologic agent and did not develop major complications. Seventy percent of patients had no failure of the de-escalation strategy (no major complication and no failure of infliximab restart).
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- 2018
8. Disruption of melatonin synthesis is associated with impaired 14-3-3 and miR-451 levels in patients with autism spectrum disorders
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Marion Benabou, Marion Leboyer, Thomas Bourgeron, Jacques Callebert, Fabien Fauchereau, Pauline Chaste, Richard Delorme, Guillaume Huguet, Frédérique Amsellem, Cécile Pagan, Erik Maronde, Stéphane Jamain, Kerren Murray, Jean-Marie Launay, Hany Goubran-Botros, Nathalie Lemière, Gènes, Synapses et Cognition (CNRS - UMR3571 ), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Service de biochimie et biologie moléculaire, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-IFR139, Hospices Civils de Lyon (HCL), Génétique humaine et fonctions cognitives - Human Genetics and Cognitive Functions (GHFC (UMR_3571 / U-Pasteur_1)), Institut Pasteur [Paris] (IP)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Fondation FondaMental [Créteil], AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Psychiatrie Translationnelle (Equipe 15), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil], Goethe-Universität Frankfurt am Main, This work was supported by academic institutions (Institut Pasteur, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Assistance Publique – Hôpitaux de Paris, University Paris Diderot), academic grants: ANR (SynDivAutism) and Neuron-ERANET (EUHF-AUTISM), charity foundations: Bettencourt-Schueller foundation, Orange foundation, FondaMental foundation, Conny-Maeva foundation, Cognacq-Jay foundation., We thank the patients and their families, and the controls who accepted to participate in this study. Some tissue used in this research was obtained from Autism BrainNet that is sponsored by the Simons Foundation, and from the Maryland Brain and Tissue Bank. The authors also acknowledge the Autism Tissue Program that was the predecessor to Autism BrainNet. The Clinical Investigation Centers of Robert-Debré and Henri Mondor Hospitals obtained and processed blood samples, the Hematology departments from both hospitals (Dr MF Hurtaud and Pr M Imbert) performed platelet counts, the Anatomopathology department of Lariboisière Hospital (Pr F Gray) performed immunohistochemistry analyses, ANR-13-SAMA-0006,SynDivAutism,Diversité Synaptique dans l'autisme(2013), ANR-10-NEUR-0003,EUHFAUTISM(2010), Baran, Corinne, Santé Mentale et Addictions - Diversité Synaptique dans l'autisme - - SynDivAutism2013 - ANR-13-SAMA-0006 - SAMENTA - VALID, Appel à projets transnational sur les maladies neurodégénératives, dans le cadre de l'ERAnet NEURON - - EUHFAUTISM2010 - ANR-10-NEUR-0003 - ERAnet NEURON - VALID, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), IFR139-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur [Paris]-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil]-Fondation FondaMental [Créteil]-Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Gènes, Synapses et Cognition, Institut Pasteur [Paris] - Université Paris Diderot - Paris 7 (UPD7) - Centre National de la Recherche Scientifique (CNRS), IFR139 - Hôpital Lariboisière - Assistance publique - Hôpitaux de Paris (AP-HP), Génétique humaine et Fonctions cognitives - Human Genetics and Cognitive Functions, Institut Pasteur [Paris] - Centre National de la Recherche Scientifique (CNRS), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12) - Institut National de la Santé et de la Recherche Médicale (INSERM) - IFR10 - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12) - Institut National de la Santé et de la Recherche Médicale (INSERM) - IFR10 - Réseau de coopération scientifique en santé mentale, Fondation FondaMental [Créteil] - Fondation FondaMental [Créteil], ANR-13-SAMA-0006, SynDivAutism, Diversité Synaptique dans l'autisme(2013), and ANR-10-NEUR-0003, EUHFAUTISM(2010)
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0301 basic medicine ,Male ,AANAT ,Autism Spectrum Disorder ,[SDV]Life Sciences [q-bio] ,[SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[SDV.GEN] Life Sciences [q-bio]/Genetics ,Pineal Gland ,Pineal gland ,[SCCO]Cognitive science ,0302 clinical medicine ,Intestinal Mucosa ,Child ,Melatonin ,Multidisciplinary ,Neurochemistry ,Autism spectrum disorders ,Middle Aged ,Pathophysiology ,[SDV] Life Sciences [q-bio] ,medicine.anatomical_structure ,Medicine ,Female ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug ,Acetylserotonin O-Methyltransferase ,Adult ,Blood Platelets ,medicine.medical_specialty ,endocrine system ,Adolescent ,Science ,Arylalkylamine N-Acetyltransferase ,Article ,03 medical and health sciences ,Cellular neuroscience ,Internal medicine ,medicine ,Humans ,[SDV.GEN]Life Sciences [q-bio]/Genetics ,business.industry ,[SCCO] Cognitive science ,medicine.disease ,MicroRNAs ,030104 developmental biology ,Endocrinology ,14-3-3 Proteins ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Case-Control Studies ,Autism ,Serotonin ,Circadian rhythms and sleep ,business ,030217 neurology & neurosurgery - Abstract
Autism spectrum disorders (ASD) are characterized by a wide genetic and clinical heterogeneity. However, some biochemical impairments, including decreased melatonin (crucial for circadian regulation) and elevated platelet N-acetylserotonin (the precursor of melatonin) have been reported as very frequent features in individuals with ASD. To address the mechanisms of these dysfunctions, we investigated melatonin synthesis in post-mortem pineal glands - the main source of melatonin (9 patients and 22 controls) - and gut samples - the main source of serotonin (11 patients and 13 controls), and in blood platelets from 239 individuals with ASD, their first-degree relatives and 278 controls. Our results elucidate the enzymatic mechanism for melatonin deficit in ASD, involving a reduction of both enzyme activities contributing to melatonin synthesis (AANAT and ASMT), observed in the pineal gland as well as in gut and platelets of patients. Further investigations suggest new, post-translational (reduced levels of 14-3-3 proteins which regulate AANAT and ASMT activities) and post-transcriptional (increased levels of miR-451, targeting 14-3-3ζ) mechanisms to these impairments. This study thus gives insights into the pathophysiological pathways involved in ASD.
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- 2016
9. Abdominal obesity and lower gray matter volume: a Mendelian randomization study
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Christophe Tzourio, Bernard Mazoyer, Sabrina Schilling, Philippe Amouyel, Aïcha Soumaré, Stéphanie Debette, Alexis Elbaz, Carole Dufouil, Christiane Wolf, Jean-Charles Lambert, F. Crivello, Yi-Cheng Zhu, Hal, GIN, Boston University School of Medicine (BUSM), Boston University [Boston] (BU), INSERM, Neuroepidemiology U708, Paris and Bordeaux, France, Department of Epidemiology, University of Versailles Saint-Quentin-en-Yvelines, Garches, France, Department of Neurology, Lariboisière Hospital, Paris 7 University, Paris, France, Statistical Genetics [Munich], Max Planck Institute of Psychiatry, Max-Planck-Gesellschaft-Max-Planck-Gesellschaft, Epidemiology and Public Health, INSERM U744, Lille, France, Groupe d'Imagerie Neurofonctionnelle (GIN - UMR 5296), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS)-Service NEUROSPIN (NEUROSPIN), Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Department of Neurology, Peking Union Medical College Hospital, Beijing, China, INSERM U897, Université Bordeaux Segalen, Bordeaux, France, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service NEUROSPIN (NEUROSPIN), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Male ,Aging ,Inverse Association ,medicine.medical_specialty ,Pathology ,Waist ,Population ,Gray matter volume ,Population-based ,Hippocampus ,Body Mass Index ,Cohort Studies ,Genetic ,Risk Factors ,Internal medicine ,Mendelian randomization ,medicine ,Humans ,Periaqueductal Gray ,Obesity ,education ,Abdominal obesity ,Aged ,education.field_of_study ,Brain volume ,Anthropometry ,General Neuroscience ,[SCCO.NEUR]Cognitive science/Neuroscience ,[SCCO.NEUR] Cognitive science/Neuroscience ,Brain ,nutritional and metabolic diseases ,Cerebral Infarction ,Organ Size ,Mendelian Randomization Analysis ,Magnetic Resonance Imaging ,Brain size ,Cardiology ,Female ,Nimodipine ,Neurology (clinical) ,Geriatrics and Gerontology ,medicine.symptom ,Psychology ,Body mass index ,Developmental Biology ,MRI - Abstract
International audience; We investigated the relationship of anthropometric markers of obesity with quantitative magnetic resonance imaging markers of brain aging, including measures of total brain volume (TBV), gray matter volume (GMV), hippocampal volume, white matter hyperintensity volume (WMHV), and brain infarcts, and examined causality using Mendelian randomization (MR). Analyses were performed in 1779 individuals (60.4% women, 72.8 ± 4.1 years of age) from the 3C-Dijon population-based cohort study (N = 1555 for the MR). Larger waist-to-hip-ratio (WHR) and waist circumference (WC) were associated with lower TBV (p = 0.0001 and p = 0.005), and lower GMV (p = 0.0008 and p = 0.003), independently of age, gender, body mass index (BMI), and vascular risk factors. Higher BMI, WC, and WHR were associated with larger WMHV and WC with brain infarcts, before adjusting for vascular risk factors only. We used MR to investigate the inverse relationship between WHR and GMV. One valid instrumental variable was available in women only (rs6905288), which was associated with GMV (p = 0.015). Age and BMI-adjusted effect estimates from the MR analysis confirmed the inverse association between GMV and WHR and are in favor of a causal association.
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- 2014
10. Crohn's disease of the vulva
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Vincent de Parades, Nicolas Lemarchand, Maximilien Barret, Philippe Marteau, Harry Sokol, Maxime Battistella, Gvh et Gvl : Physiopathologie Chez l'Homme et Chez l'Animal, Incidence et Role Therapeutique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), gastroenterology, Lariboisière hospital, Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)
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medicine.medical_specialty ,Azathioprine ,Disease ,Vulva ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Crohn Disease ,Biopsy ,medicine ,Humans ,030212 general & internal medicine ,Prospective cohort study ,Ulcer ,Crohn's disease ,medicine.diagnostic_test ,business.industry ,[CHIM.ORGA]Chemical Sciences/Organic chemistry ,Gastroenterology ,General Medicine ,Hypertrophy ,medicine.disease ,Infliximab ,Abscess ,3. Good health ,Surgery ,Metronidazole ,medicine.anatomical_structure ,Female ,Vulvar Diseases ,business ,medicine.drug - Abstract
International audience; : Crohn's disease (CD) of the vulva is a rare, yet under recognized condition. Fistulae arising from the digestive tract account for the greater part of genital lesions in CD. However, cutaneous so-called metastatic lesions of the vulva have been reported in the literature. They are clinically challenging for gastroenterologists as well as for gynecologists, with numerous differential diagnoses, especially among venereal diseases, and require a multidisciplinary approach. The most frequently observed features of the disease are labial swelling, vulvar ulcers, and hypertrophic lesions. Biopsy samples for histological study are mandatory, in order to establish the diagnosis of vulvar CD. Treatment options include oral prolonged courses of metronidazole and systemic immunosuppressive therapy such as corticosteroids and azathioprine, with promising data published on the efficacy of infliximab. Surgery remains restricted to medical treatment failures or resection of unsightly lesions. Prospective studies or case series with long follow-up data are still missing to guide the treatment of this condition.
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- 2013
11. Towards a multimodal wireless video capsule for detection of colonic polyps as prevention of colorectal cancer
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Bertrand Granado, Jade Ayoub, Andrea Pinna, Olivier Romain, Philippe Marteau, Aymeric Histace, Xavier Dray, Juan S. Silva, ASTRE [Cergy-Pontoise], Equipes Traitement de l'Information et Systèmes (ETIS - UMR 8051), Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA)-Centre National de la Recherche Scientifique (CNRS)-CY Cergy Paris Université (CY)-Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA)-Centre National de la Recherche Scientifique (CNRS)-CY Cergy Paris Université (CY), ICI, ASTRE/ICI, Systèmes Electroniques (SYEL), Laboratoire d'Informatique de Paris 6 (LIP6), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), i-Tec, Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), gastroenterology, Lariboisière hospital, IEEE, Cyclope, Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA)-Université de Cergy Pontoise (UCP), Université Paris-Seine-Université Paris-Seine-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA)-Université de Cergy Pontoise (UCP), Université Paris-Seine-Université Paris-Seine-Centre National de la Recherche Scientifique (CNRS), and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7)
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Machine vision ,Computer science ,Colorectal cancer ,multispectral ,Multispectral image ,Feature extraction ,colorectal cancer ,02 engineering and technology ,law.invention ,[INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing ,Capsule endoscopy ,law ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,videocapsule ,Computer vision ,polyps ,business.industry ,020208 electrical & electronic engineering ,Multimodal therapy ,medicine.disease ,digestive system diseases ,3. Good health ,[SPI.TRON]Engineering Sciences [physics]/Electronics ,Support vector machine ,ComputingMethodologies_PATTERNRECOGNITION ,[INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV] ,020201 artificial intelligence & image processing ,Artificial intelligence ,business ,Classifier (UML) ,[SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing - Abstract
International audience; Wireless capsule endoscopy (WCE) is commonly used for noninvasive gastrointestinal tract evaluation, including the identification of polyps. In this paper, a new multimodal embeddable method for polyp detection and classification in wireless capsule endoscopic images was developed and tested. The multimodal wireless capsule used both 2D and 3D data to identify possible polyps and to deliver cancerous information of the polyps based on 3D geometric features. Possible polyps within the image (2D) were extracted using simple geometric shape features and, in a second step, the candidate regions of interest (ROI) were evaluated with a boosting-based method using textural features. Once the 2D identification of polyps has been performed, the two-class ("malignant" or "begnin") classification of the polyps is achieved using the 3D parameters computed from the preselected ROI using an active stereo vision system. At this stage, a Support Vector Machine (SVM) classifier is used to proceed to the final classification and to make possible a pre diagnosis. The new proposed multimodal approach based on 2D - 3D feature extraction improves WCE capabilities to identify and classify polyps: The boosting-based polyp classification demonstrated a sensitivity of 91%, a specificity of 95% and a false detection rate of 4.8% on a database composed of 300 hundred positive examples and 1200 negative ones; Considering the 3D performance, a large scale demonstrator was evaluated and tested to perform in vitro experiments on an ad hoc polyp database. The performance of the 3D approach achieved a correct classification rate (malignant or benin) of approximately 95%.
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- 2013
12. Développement et validation d'un algorithme de reconnaissance automatique de polypes coliques
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Silva, Juan S., Histace, Aymeric, Romain, Olivier, Dray, Xavier, Granado, Bertrand, Marteau, Philippe, Pinna, Andrea, ICI-ASTRE, Equipes Traitement de l'Information et Systèmes (ETIS - UMR 8051), Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA)-Centre National de la Recherche Scientifique (CNRS)-CY Cergy Paris Université (CY)-Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA)-Centre National de la Recherche Scientifique (CNRS)-CY Cergy Paris Université (CY), ICI, ASTRE [Cergy-Pontoise], i-Tec, Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Systèmes Electroniques (SYEL), Laboratoire d'Informatique de Paris 6 (LIP6), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), gastroenterology, Lariboisière hospital, Cyclope, Histace, Aymeric, Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA)-Université de Cergy Pontoise (UCP), Université Paris-Seine-Université Paris-Seine-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de l'Electronique et de ses Applications (ENSEA)-Université de Cergy Pontoise (UCP), Université Paris-Seine-Université Paris-Seine-Centre National de la Recherche Scientifique (CNRS), and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7)
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[INFO.INFO-TI] Computer Science [cs]/Image Processing [eess.IV] ,[INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing ,[INFO.INFO-TS] Computer Science [cs]/Signal and Image Processing ,boosting ,[INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV] ,polyp ,VCE ,[SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing ,ComputingMilieux_MISCELLANEOUS ,détection ,[SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing - Abstract
National audience
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- 2013
13. Saccharomyces Boulardii Does Not Prevent Relapse of Crohn's Disease
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Bourreille, Arnaud, Cadiot, Guillaume, Le Dreau, Gérard, Laharie, David, Beaugerie, Laurent, Dupas, Jean-Louis, Marteau, Philippe, Rampal, Patrick, Moyse, Dominique, Saleh, Ashraf, Le Guern, Marie-Emmanuelle, Galmiche, Jean-Paul, Renseigné, Non, Neuropathies du système nerveux entérique et pathologies digestives, implication des cellules gliales entériques, Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Université de Reims Champagne-Ardenne (URCA), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hepato-Gastroenterologie, CHU Amiens-Picardie, gastroenterology, Lariboisière hospital, Department of Gastroenterology and Hepatology, CIC 004, Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Drug-Related Side Effects and Adverse Reactions ,Anti-Inflammatory Agents ,Placebo ,Gastroenterology ,Inflammatory bowel disease ,Placebos ,03 medical and health sciences ,Saccharomyces ,Young Adult ,0302 clinical medicine ,Maintenance therapy ,Crohn Disease ,Internal medicine ,Clinical endpoint ,Secondary Prevention ,Medicine ,Humans ,Prospective Studies ,Crohn's disease ,Intention-to-treat analysis ,Hepatology ,biology ,business.industry ,[CHIM.ORGA]Chemical Sciences/Organic chemistry ,Probiotics ,Middle Aged ,biology.organism_classification ,medicine.disease ,Crohn's Disease Activity Index ,3. Good health ,Biological Therapy ,Aminosalicylic Acids ,Treatment Outcome ,030220 oncology & carcinogenesis ,Immunology ,030211 gastroenterology & hepatology ,Female ,Steroids ,business ,Saccharomyces boulardii - Abstract
International audience; BACKGROUND & AIMS: Saccharomyces boulardii is a probiotic yeast that has been shown to have beneficial effects on the intestinal epithelial barrier and digestive immune system. There is preliminary evidence that S boulardii could be used to treat patients with Crohn's disease (CD). We performed a randomized, placebo-controlled trial to evaluate the effects of S boulardii in patients with CD who underwent remission during therapy with steroids or aminosalicylates. METHODS: We performed a prospective study of 165 patients who achieved remission following treatment with steroids or salicylates; they were randomly assigned to groups given S boulardii (1 g/day) or placebo for 52 weeks. The primary endpoint was the percentage of patients in remission at week 52. Time to relapse, Crohn's disease activity index (CDAI) scores, and changes in parameters of inflammation were secondary endpoints. RESULTS: CD relapsed in 80 patients: 38 in the S boulardii group (47.5%) and 42 in the placebo group (53.2%; a nonsignificant difference). The median time to relapse did not differ significantly between patients given S boulardii (40.7 weeks) vs placebo (39.0 weeks). There were no significant differences between groups in mean CDAI scores or erythrocyte sedimentation rates, or in median levels of C-reactive protein. In a post-hoc analysis, nonsmokers given S boulardii were less likely to experience a relapse of CD than nonsmokers given placebo, but this finding requires confirmation. CONCLUSION: Although the probiotic yeast, Sboulardii, is safe and well tolerated, it does not appear to have any beneficial effects for patients with CD in remission following steroid or salicylate therapies.
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- 2013
14. Portomesenteric Vein Thrombosis in Patients With Inflammatory Bowel Disease
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Philippe Marteau, Yoram Bouhnik, Jacques Moreau, Non Renseigné, Cécilia Landman, Michel Veyrac, Vered Abitbol, Stéphane Nahon, David Laharie, Jérôme Filippi, Benoit Coffin, Jean-Frederic Colombel, Jacques Cosnes, Guillaume Savoye, Guillaume Bouguen, Hedia Brixi-Benmansour, Matthieu Allez, Université Pierre et Marie Curie - Paris 6 (UPMC), Pole des maladies de l'appareil digestif, gastroentérologie et assistance nutritive, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Gastro-entérologie, Centre hospitalier Universitaire, Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service d'Hépato-gastroentérologie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Université Paris Diderot - Paris 7 (UPD7), Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Nice (CHU Nice), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Chirurgie Générale et Digestive [Rangueil], CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Fédération Médico-Chirurgicale des Maladies de l'Appareil Digestif, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi, gastroenterology, Lariboisière hospital, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
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Adult ,Male ,medicine.medical_specialty ,Hyperhomocysteinemia ,Disease ,Severity of Illness Index ,Inflammatory bowel disease ,Gastroenterology ,03 medical and health sciences ,Mesenteric Veins ,0302 clinical medicine ,Crohn Disease ,Risk Factors ,Internal medicine ,Mesenteric Vascular Occlusion ,Severity of illness ,medicine ,Humans ,Immunology and Allergy ,Vein ,ComputingMilieux_MISCELLANEOUS ,Aged ,Retrospective Studies ,Venous Thrombosis ,Incidental Findings ,Portal Vein ,business.industry ,[CHIM.ORGA]Chemical Sciences/Organic chemistry ,Anticoagulants ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Ulcerative colitis ,3. Good health ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Concomitant ,Colitis, Ulcerative ,Female ,030211 gastroenterology & hepatology ,business - Abstract
BACKGROUND:: Inflammatory bowel disease (IBD) is associated with a high risk of deep venous thromboembolism. However, few data are available so far on portomesenteric vein thrombosis (PMVT). The aim of this study was to describe the characteristics of PMVT in patients with IBD. METHODS:: A retrospective study was conducted at 13 GETAID (Groupe d'Etude Therapeutique des Affections Inflammatoires du Tube Digestif) centers from January 1995 to June 2010. The following data were collected, using a standardized questionnaire: characteristics of IBD, disease status at the time of PMVT, PMVT characteristics and mode of discovery, concomitant prothrombotic disorders, anticoagulant therapy, and evolution of PMVT. RESULTS:: Fifty cases (29 men and 21 women; median age, 41 years) were identified, including 14 patients with ulcerative colitis and 36 with Crohn's disease. Thirty-one patients (62%) presented with acute PMVT. Twenty-four patients had previously undergone surgical treatment, and IBD was active in 23 cases (77%) of acute thrombosis. The discovery of PMVT was fortuitous in 40% of our cases. Among the 43 patients screened for a prothrombotic disorder, abnormalities were observed in 17 patients (40%) (mainly hyperhomocysteinemia, n = 12). Forty-four patients (88%) were treated with anticoagulants. Recanalization of the vein was significantly more successful in patients with acute thrombosis (65% versus 37%, P = 0.05). CONCLUSIONS:: PMVT can occur when IBD is inactive, and its diagnosis was fortuitous in 40% of our cases. Screening for prothrombotic disorders is essential because it is positive in more than one third of cases.
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- 2013
15. Ciclosporin versus infliximab in patients with severe ulcerative colitis refractory to intravenous steroids: a parallel, open-label randomised controlled trial
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Philippe Marteau, Marc Lémann, Jean Yves Mary, Jean-Charles Delchier, Elena Ricart, Xavier Roblin, Jean-Frederic Colombel, Jacques Moreau, Antonio López-Sanromán, Javier P. Gisbert, Martti Färkkilä, Maria Esteve, Frank Zerbib, Julien Branche, Gilles Bommelaer, Jean-Louis Dupas, Matthieu Allez, Yoram Bouhnik, Maria Nachury, Franck Carbonnel, Jacques Cosnes, Guillaume Savoye, Gert Van Assche, Benoit Coffin, Martine De Vos, Stéphane Nahon, David Laharie, Denis Franchimont, Arnaud Bourreille, Jérôme Filippi, Olivier Dewit, Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Neuropathies du système nerveux entérique et pathologies digestives, implication des cellules gliales entériques, Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Pole des maladies de l'appareil digestif, gastroentérologie et assistance nutritive, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Nice (CHU Nice), Department of Gastroenterology, Hôpital Saint-André, Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Chirurgie Générale et Digestive [Rangueil], CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service d'hépato-gastro-entérologie [APHP Henri Mondor], Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Gastro-Entérologie et Nutrition, Gastroenterology, Hospital Clinic, Hepato-Gastroenterologie, CHU Amiens-Picardie, Hépatogastroentérologie, CHU de Bicêtre, Gastroenterology Unit, Hôpital Louis Mourier - AP-HP [Colombes], Université Paris Diderot - Paris 7 (UPD7), gastroenterology, Hospital Mutua de Terrassa, La Princesa University Hospital, Lariboisière hospital, Biostatistique et épidemiologie clinique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hépato-gastroentérologie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes (UN), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Charles Nicolle [Rouen], CHU Rouen, and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Drug Resistance ,Azathioprine ,Inflammatory bowel disease ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Humans ,Treatment Failure ,Infusions, Intravenous ,Colectomy ,Intention-to-treat analysis ,business.industry ,[CHIM.ORGA]Chemical Sciences/Organic chemistry ,Anti-Inflammatory Agents, Non-Steroidal ,Antibodies, Monoclonal ,General Medicine ,Middle Aged ,medicine.disease ,Ciclosporin ,Ulcerative colitis ,Infliximab ,3. Good health ,Surgery ,030220 oncology & carcinogenesis ,Acute Disease ,Cyclosporine ,030211 gastroenterology & hepatology ,Colitis, Ulcerative ,Female ,Steroids ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
International audience; BACKGROUND: Ciclosporin and infliximab are potential rescue treatments to avoid colectomy in patients with acute severe ulcerative colitis refractory to intravenous corticosteroids. We compared the efficacy and safety of these drugs for this indication. METHODS: In this parallel, open-label, randomised controlled trial, patients were aged at least 18 years, had an acute severe flare of ulcerative colitis defined by a Lichtiger score greater than 10 points, and had been given an unsuccessful course of high-dose intravenous steroids. None of the patients had previously received ciclosporin or infliximab. Between June 1, 2007, and Aug 31, 2010, patients at 27 European centres were randomly assigned (via computer-derived permutation tables; 1:1) to receive either intravenous ciclosporin (2 mg/kg per day for 1 week, followed by oral drug until day 98) or infliximab (5 mg/kg on days 0, 14, and 42). In both groups, azathioprine was started at day 7 in patients with a clinical response. Neither patients nor investigators were masked to study treatment. The primary efficacy outcome was treatment failure defined by absence of a clinical response at day 7, a relapse between day 7 and day 98, absence of steroid-free remission at day 98, a severe adverse event leading to treatment interruption, colectomy, or death. Analysis was by intention to treat. This trial is registered with EudraCT (2006-005299-42) and ClinicalTrials.gov (NCT00542152). FINDINGS: 115 patients were randomly assigned; 58 patients were allocated to receive ciclosporin and 57 to receive infliximab. Treatment failure occurred in 35 (60%) patients given ciclosporin and 31 (54%) given infliximab (absolute risk difference 6%; 95% CI -7 to 19; p=0*52). Nine (16%) patients in the ciclosporin group and 14 (25%) in the infliximab group had severe adverse events. INTERPRETATION: Ciclosporin was not more effective than infliximab in patients with acute severe ulcerative colitis refractory to intravenous steroids. In clinical practice, treatment choice should be guided by physician and centre experience. FUNDING: Association François Aupetit, Société Nationale Française de Gastroentérologie, and the International Organization for the study of Inflammatory Bowel Disease.
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- 2012
16. Low prevalence of colonoscopic surveillance of inflammatory bowel disease patients with longstanding extensive colitis: a clinical practice survey nested in the CESAME cohort
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Vienne, A., Simon, T., Cosnes, J., Baudry, C., Bouhnik, Y., Soulé, J. C., Chaussade, S., Marteau, P., Jian, R., Delchier, J.-C., Coffin, B., Admane, H., Carrat, F., Drouet, E., Beaugerie, L., Gastroenterology, AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Saint-Louis Hospital, Pole des maladies de l'appareil digestif, gastroentérologie et assistance nutritive, Hôpital Beaujon [AP-HP], Service d'Hépato-Gastroentérologie, AP-HP - Hôpital Bichat - Claude Bernard [Paris], gastroenterology, Lariboisière hospital, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service d'hépato-gastro-entérologie [APHP Henri Mondor], Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Gastroenterology Unit, Hôpital Louis Mourier - AP-HP [Colombes], Université Paris Diderot - Paris 7 (UPD7), Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Département de Mathématiques [Evry], Université d'Évry-Val-d'Essonne (UEVE), Université Pierre et Marie Curie - Paris 6 (UPMC), AP-HP, Hôpital Lariboisière, Hôpital Lariboisière-Fernand-Widal [APHP], Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
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Adult ,Male ,Time Factors ,[CHIM.ORGA]Chemical Sciences/Organic chemistry ,Colonoscopy ,Middle Aged ,Cohort Studies ,Population Surveillance ,Surveys and Questionnaires ,Prevalence ,Humans ,Medicine ,Colitis, Ulcerative ,Female ,France - Abstract
International audience; Background: Surveillance colonoscopy is recommended for inflammatory bowel disease (IBD) patients with longstanding extensive colitis (LEC). Aims: To assess modalities and results of colonoscopic surveillance in a subset of CESAME cohort patients at high risk of colorectal cancer (CRC) and followed in university French hospitals. Methods: Among 910 eligible patients with more than a 7-year history of extensive colitis at CESAME enrolment, 685 patients completed a questionnaire on surveillance colonoscopy and 102 were excluded because of prior proctocolectomy. Finally, 583 patients provided information spanning a median period of 41 months (IQR 38-43) between cohort enrolment and the end of follow-up. Details of the colonoscopic procedures and histological findings were obtained for 440 colonoscopies in 270 patients. Results: Only 53.5% (n=312) of the patients with LEC had at least one surveillance colonoscopy during the study period, with marked variations across the 9 participating centres (27.3% to 70.0%, p= < 0.0001). Surveillance rate was significantly lower in Crohn's colitis than in ulcerative colitis (UC) (47.6% vs 68.5%, p=< 0.0001). Independent predictors of colonoscopic surveillance were male sex, UC IBD subtype, longer disease duration, previous history of CRC, and disease management in a centre with large IBD population. Random biopsies, targeted biopsies and chromoendoscopy were performed during respectively 70.7%, 26.6 and 30.0% of surveillance colonoscopies. Two cases of high-grade dysplasia were detected in patients undergoing colonoscopic surveillance. Two advanced-stage CRC were diagnosed in patients who did not have colonosocopic surveillance. Conclusions: Colonoscopic surveillance rate is low in IBD patients with longstanding extensive colitis.
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- 2011
17. Endpoints for clinical trials evaluating disease modification and structural damage in adults with Crohn's disease
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d'Haens, Geert R, Fedorak, Richard, Lémann, Marc, Feagan, Brian G, Kamm, Michael A, Cosnes, Jacques, Rutgeerts, Paul J, Marteau, Philippe, Travis, Simon, Schölmerich, Jürgen, Hanauer, Steven, Sandborn, William J, Renseigné, Non, Service de gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Pierre et Marie Curie - Paris 6 (UPMC), gastroenterology, Lariboisière hospital, and Other departments
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Adult ,medicine.medical_specialty ,Endpoint Determination ,MEDLINE ,Disease ,Stable Disease ,Crohn Disease ,medicine ,Humans ,Immunology and Allergy ,Intensive care medicine ,Pharmaceutical industry ,Clinical Trials as Topic ,Crohn's disease ,business.industry ,[CHIM.ORGA]Chemical Sciences/Organic chemistry ,Gastroenterology ,medicine.disease ,Clinical trial ,Treatment Outcome ,Practice Guidelines as Topic ,Physical therapy ,Position paper ,business ,Immunosuppressive Agents - Abstract
International audience; The management of Crohn's disease is rapidly changing. The advent of potent immunomodulatory and biologic therapies has led to more demanding endpoints for clinical trials than only clinical response and remission. Complete withdrawal of corticosteroids, healing of endoscopically visible lesions, and prevention of structural damage are only a few new endpoints that are finding their way into the clinical trials of today and those that are being developed for the future. Given the importance of selecting the most appropriate and relevant endpoints, the International Organization for Inflammatory Bowel Diseases (IOIBD) decided to develop guidelines that could be used by individual researchers, the pharmaceutical industry, and the regulatory bodies. The current document is to be read as a "position paper," which is the result of several years of discussion and consensus finding that was finally approved by the entire membership of the group. The proposed instruments will need further validation and standardization to demonstrate that they are reliable in stable disease and responsive to change, and to determine the cutoff points for response and remission.
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- 2009
18. Is there any place for alimentary probiotics, prebiotics or synbiotics, for patients with inflammatory bowel disease?
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Harry Sokol, Philippe Marteau, Xavier Dray, Philippe Seksik, Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), gastroenterology, Lariboisière hospital, CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
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medicine.medical_specialty ,Colon ,Synbiotics ,Oligosaccharides ,Disease ,Pouchitis ,Gastroenterology ,Inflammatory bowel disease ,law.invention ,03 medical and health sciences ,Probiotic ,0302 clinical medicine ,Crohn Disease ,Randomized controlled trial ,law ,Internal medicine ,Humans ,Medicine ,Colitis ,Randomized Controlled Trials as Topic ,030304 developmental biology ,0303 health sciences ,Bacteria ,business.industry ,[CHIM.ORGA]Chemical Sciences/Organic chemistry ,Probiotics ,Inflammatory Bowel Diseases ,medicine.disease ,Ulcerative colitis ,digestive system diseases ,3. Good health ,Immunology ,Colitis, Ulcerative ,030211 gastroenterology & hepatology ,business ,Food Science ,Biotechnology - Abstract
International audience; The pathogenesis of inflammatory bowel disease (IBD) involves an interaction between genetically determined host susceptibility, dysregulated immune response, and the enteric microbiota. Ecological treatments including probiotics, prebiotics, and synbiotics are actively studied in Crohn's disease (CD), ulcerative colitis (UC) and pouchitis. We review herein the literature on the rational use of probiotics in IBD considering efficacy (as evaluated in randomized controlled trials), mechanisms of action and safety issues. A probiotic effect is strictly restricted to one defined strain and cannot be generalized from one to another. There is evidence of efficacy of some probiotic drugs in pouchitis (VSL#3), and in the prevention of recurrence of UC (Escherichia coli Nissle 1917). However, the evidence for efficacy of probiotic drugs in CD is still low as well as that of dietary ecological treatments. Despite an ecological (hopefully nutritional) treatment of IBD is promising, many questions remain unanswered and further clinical and fundamental studies are needed.
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- 2008
19. Faecalibacterium prausnitzii is an anti-inflammatory commensal bacterium identified by gut microbiota analysis of Crohn disease patients
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Philippe Pochart, Gérard Corthier, Jean-Jacques Gratadoux, Joël Doré, Sébastien Blugeon, Philippe Marteau, Omar Lakhdari, Germain Trugnan, Hervé M. Blottière, Philippe Langella, Philippe Seksik, Laurie Watterlot, Harry Sokol, Ginette Thomas, Bénédicte Pigneur, Chantal Bridonneau, Nadia Vasquez, Jean-Pierre Furet, Corinne Grangette, Luis G. Bermúdez-Humarán, Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Unité de recherche d'Écologie et Physiologie du Système Digestif (UEPSD), Institut National de la Recherche Agronomique (INRA), MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), Institut National de la Recherche Agronomique (INRA)-AgroParisTech, Laboratoire de Bactéries Lactiques et Immunité des Muqueuses, Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-IFR142, Trafic Membranaire et Signalisation Dans les Cellules Epitheliales, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), gastroenterology, Lariboisière hospital, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
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Firmicutes ,Faecalibacterium prausnitzii ,Organic chemistry ,Gut flora ,Peripheral blood mononuclear cell ,law.invention ,Microbiology ,03 medical and health sciences ,Probiotic ,0302 clinical medicine ,law ,In vivo ,medicine ,Colitis ,030304 developmental biology ,0303 health sciences ,Multidisciplinary ,biology ,[CHIM.ORGA]Chemical Sciences/Organic chemistry ,Biological Sciences ,biology.organism_classification ,medicine.disease ,3. Good health ,Chimie organique ,Immunology ,030211 gastroenterology & hepatology ,Dysbiosis - Abstract
A decrease in the abundance and biodiversity of intestinal bacteria within the dominant phylum Firmicutes has been observed repeatedly in Crohn disease (CD) patients. In this study, we determined the composition of the mucosa-associated microbiota of CD patients at the time of surgical resection and 6 months later using FISH analysis. We found that a reduction of a major member of Firmicutes, Faecalibacterium prausnitzii , is associated with a higher risk of postoperative recurrence of ileal CD. A lower proportion of F. prausnitzii on resected ileal Crohn mucosa also was associated with endoscopic recurrence at 6 months. To evaluate the immunomodulatory properties of F. prausnitzii we analyzed the anti-inflammatory effects of F. prausnitzii in both in vitro (cellular models) and in vivo [2,4,6-trinitrobenzenesulphonic acid (TNBS)-induced] colitis in mice. In Caco-2 cells transfected with a reporter gene for NF-κB activity, F. prausnitzii had no effect on IL-1β-induced NF-κB activity, whereas the supernatant abolished it. In vitro peripheral blood mononuclear cell stimulation by F. prausnitzii led to significantly lower IL-12 and IFN-γ production levels and higher secretion of IL-10. Oral administration of either live F. prausnitzii or its supernatant markedly reduced the severity of TNBS colitis and tended to correct the dysbiosis associated with TNBS colitis, as demonstrated by real-time quantitative PCR (qPCR) analysis. F. prausnitzii exhibits anti-inflammatory effects on cellular and TNBS colitis models, partly due to secreted metabolites able to block NF-κB activation and IL-8 production. These results suggest that counterbalancing dysbiosis using F. prausnitzii as a probiotic is a promising strategy in CD treatment.
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- 2008
20. Predictive factors of response to cyclosporine in steroid-refractory ulcerative colitis
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Jacques Cosnes, Marc Lémann, Isabelle Nion-Larmurier, Philippe Marteau, Fady Daniel, Laurent Beaugerie, Pauline Afchain, Philippe Seksik, Wulfran Cacheux, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC), Service de gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), gastroenterology, Lariboisière hospital, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Population ,Drug Resistance ,Colonoscopy ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,[ CHIM.ORGA ] Chemical Sciences/Organic chemistry ,Adrenal Cortex Hormones ,Risk Factors ,Internal medicine ,medicine ,Humans ,Colitis ,education ,Colectomy ,Aged ,education.field_of_study ,Hepatology ,medicine.diagnostic_test ,business.industry ,[CHIM.ORGA]Chemical Sciences/Organic chemistry ,Hazard ratio ,Middle Aged ,Ciclosporin ,medicine.disease ,Ulcerative colitis ,Confidence interval ,3. Good health ,Treatment Outcome ,030220 oncology & carcinogenesis ,Cyclosporine ,030211 gastroenterology & hepatology ,Colitis, Ulcerative ,Female ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
International audience; OBJECTIVES: Cyclosporine is an effective rescue therapy in steroid-refractory ulcerative colitis (UC) and may avoid immediate colectomy. However, the individual's response to cyclosporine is poorly predictable. The aim of this study was to identify predictive factors of the response to cyclosporine in steroid-refractory UC. METHODS: One hundred thirty-five patients with steroid-refractory UC, admitted consecutively between 1992 and 2004, were included. Data were collected on the first day of the cyclosporine therapy. Colonoscopy was performed within 2 days preceding or following the cyclosporine treatment in 118 patients for assessing the presence of severe endoscopic lesions. RESULTS: The actuarial rate of colectomy was 0.45 at 6 months. Cox analysis in the whole population selected three predictive criteria of colectomy: body temperature >37.5 degrees C (adjusted hazard ratio = 1.94, 95% confidence interval 1.51-2.49), heart rate >90 bpm (1.86, 1.45-2.38), and C-reactive protein (CRP) >45 mg/L (1.70, 1.34-2.16). In the 118 patients who underwent colonoscopy, the presence of severe endoscopic lesions was an independent predictive factor of colectomy (2.38, 1.80-3.14). Colonoscopy was decisive and changed the therapeutic decision in patients with one or two criteria: 71% of the patients with severe endoscopic lesions were colectomized versus 17% of the patients without severe endoscopic lesions (P < 0.001). Finally, the clinical, biological, and endoscopic criteria allowed the classification of the patients into two different groups (80%vs 20% colectomy at 6 months). CONCLUSION: In patients with steroid-refractory UC, the combination of simple criteria is useful to predict the response to cyclosporine. Colonoscopy is crucial in patients with intermediate clinical and biological severity.
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- 2007
21. [Refractory proctitis]
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Philippe SEKSIK, Fady Daniel, Philippe Marteau, Laurent Beaugerie, Jacques Cosnes, Université Pierre et Marie Curie - Paris 6 (UPMC), gastroenterology, Lariboisière hospital, Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
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Nicotine ,Time Factors ,Biopsy ,Administration, Oral ,Gastrointestinal Agents ,Adrenal Cortex Hormones ,Azathioprine ,Escherichia coli ,Humans ,Proctitis ,Anesthetics, Local ,ComputingMilieux_MISCELLANEOUS ,Randomized Controlled Trials as Topic ,Aspirin ,[CHIM.ORGA]Chemical Sciences/Organic chemistry ,Probiotics ,Suppositories ,Rectum ,Antibodies, Monoclonal ,Lidocaine ,Infliximab ,Methotrexate ,Cyclosporine ,Patient Compliance ,Drug Therapy, Combination ,Algorithms ,Immunosuppressive Agents ,Forecasting - Abstract
International audience
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- 2007
22. A genome-wide association analysis reveals new pathogenic pathways in gout.
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Major TJ, Takei R, Matsuo H, Leask MP, Sumpter NA, Topless RK, Shirai Y, Wang W, Cadzow MJ, Phipps-Green AJ, Li Z, Ji A, Merriman ME, Morice E, Kelley EE, Wei WH, McCormick SPA, Bixley MJ, Reynolds RJ, Saag KG, Fadason T, Golovina E, O'Sullivan JM, Stamp LK, Dalbeth N, Abhishek A, Doherty M, Roddy E, Jacobsson LTH, Kapetanovic MC, Melander O, Andrés M, Pérez-Ruiz F, Torres RJ, Radstake T, Jansen TL, Janssen M, Joosten LAB, Liu R, Gaal OI, Crişan TO, Rednic S, Kurreeman F, Huizinga TWJ, Toes R, Lioté F, Richette P, Bardin T, Ea HK, Pascart T, McCarthy GM, Helbert L, Stibůrková B, Tausche AK, Uhlig T, Vitart V, Boutin TS, Hayward C, Riches PL, Ralston SH, Campbell A, MacDonald TM, Nakayama A, Takada T, Nakatochi M, Shimizu S, Kawamura Y, Toyoda Y, Nakaoka H, Yamamoto K, Matsuo K, Shinomiya N, Ichida K, Lee C, Bradbury LA, Brown MA, Robinson PC, Buchanan RRC, Hill CL, Lester S, Smith MD, Rischmueller M, Choi HK, Stahl EA, Miner JN, Solomon DH, Cui J, Giacomini KM, Brackman DJ, Jorgenson EM, Liu H, Susztak K, Shringarpure S, So A, Okada Y, Li C, Shi Y, and Merriman TR
- Abstract
Gout is a chronic disease that is caused by an innate immune response to deposited monosodium urate crystals in the setting of hyperuricemia. Here, we provide insights into the molecular mechanism of the poorly understood inflammatory component of gout from a genome-wide association study (GWAS) of 2.6 million people, including 120,295 people with prevalent gout. We detected 377 loci and 410 genetically independent signals (149 previously unreported loci in urate and gout). An additional 65 loci with signals in urate (from a GWAS of 630,117 individuals) but not gout were identified. A prioritization scheme identified candidate genes in the inflammatory process of gout, including genes involved in epigenetic remodeling, cell osmolarity and regulation of NOD-like receptor protein 3 (NLRP3) inflammasome activity. Mendelian randomization analysis provided evidence for a causal role of clonal hematopoiesis of indeterminate potential in gout. Our study identifies candidate genes and molecular processes in the inflammatory pathogenesis of gout suitable for follow-up studies., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)
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- 2024
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23. Migraine treatment: Position paper of the French Headache Society.
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Moisset X, Demarquay G, de Gaalon S, Roos C, Donnet A, Giraud P, Guégan-Massardier E, Lucas C, Mawet J, Valade D, Corand V, Gollion C, Moreau N, Grangeon L, Lantéri-Minet M, and Ducros A
- Abstract
The French migraine management recommendations were published in 2021. However, in the last three years, new data have come to light and new drugs have been approved (eptinezumab, rimegepant and atogepant) by the European Medicines Agency that require us to take a position on their use and to update certain elements of the recommendations. The first important message concerns the position of the French Headache Society on the use of preventive treatments (monoclonal antibodies and gepants) targeting the calcitonin gene-related peptide (CGRP) pathway. In terms of efficacy and safety, and as suggested by other national headache societies, these treatments can be offered as first-line treatment, although the scope defined by the French national health authority for possible reimbursement is limited to patients with severe migraine, at least eight headache days per month and for whom two previous preventive treatments have failed. Another important change concerns the position of topiramate as a preventive treatment for migraine in women of childbearing age. This treatment has been proposed as a first-line treatment for chronic migraine. However, recent pharmacovigilance data have highlighted a potential adverse effect on neurodevelopment in children exposed in utero. As a result, this treatment is formally contraindicated during pregnancy and must be used with extreme caution in women of childbearing age (effective contraception, no therapeutic alternative available and annual follow-up as with valproate). It can therefore no longer be offered as first-line treatment for women of childbearing age., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
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- 2024
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24. One-stage exchange strategy with extensive debridement for chronic periprosthetic joint infection following total knee arthroplasty is associated with a low relapse rate in non-selected patients: a prospective single-center analysis.
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Pioger C, Marmor S, Bouché PA, Kerroumi Y, Lhotellier L, Graff W, Mouton A, Heym B, and Zeller V
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Purpose: This prospective clinical cohort was undertaken to determine the long-term risks of reinfection and all-cause aseptic failure after 1-stage exchange total knee arthroplasties (TKA) in a large series of consecutive patients with periprosthetic joint infection (PJI) following TKA., Hypothesis: One-stage exchange for chronic PJI is an effective strategy, even in a non-selected population., Patients and Methods: Non-selected patients (152 with 154 PJI) undergoing 1-stage-exchange TKA for PJI (January 2003-August 2015) were prospectively included and monitored for ≥2 years. PJI following TKA satisfying Musculoskeletal Infection Society diagnostic criteria were documented by microbiological culture results of preoperative joint aspirates and/or intraoperative samples. The cumulative incidences of total reinfections (i.e., relapses or new infections) and aseptic revisions were assessed. The mean follow-up (FU) duration was 7.5 years post-reimplantation., Results: At the last follow-up, 35 knees had developed reinfections: 7 relapses and 28 new infections, with respective 14-year cumulative incidences of 4.8% and 20.6%. The 2-, 5- and 14-year cumulative total reinfection incidences were 12.3%, 21.3% and 24.3%, respectively. Respective 2-, 5-, 10- and 14-year aseptic component-revision incidences were 0.7%, 3.2%, 5.4% and 13.4%. Multivariate analysis retained male sex (HR 3.27, p < 0.01) and preoperative atrial fibrillation (HR 3.03; p = 0.01) as being significantly associated with greater risk of reinfection., Conclusions: One-stage-exchange TKA with aggressive debridement for chronic PJI is apparently a valid strategy, even for non-selected patients. It was associated with a low relapse rate, prevented morbidity and avoided economic social costs of 2-stage exchange. New infections with a different microorganism were observed more frequently and occurred even after years of FU., Level of Evidence: II; Therapeutic., Competing Interests: Declaration of competing interest No conflicts concerning this study., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
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- 2024
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25. Inside out: the neural basis of spontaneous and creative thinking.
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Lopez-Persem A, Mandonnet E, and Volle E
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- Humans, Brain physiology, Creativity, Thinking physiology
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- 2024
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26. Sex Differences in Frequency, Severity, and Distribution of Cerebral Microbleeds.
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Fandler-Höfler S, Eppinger S, Ambler G, Nash P, Kneihsl M, Lee KJ, Lim JS, Shiozawa M, Koga M, Li L, Lovelock C, Chabriat H, Hennerici M, Wong YK, Mak HKF, Prats-Sanchez L, Martínez-Domeño A, Inamura S, Yoshifuji K, Arsava EM, Horstmann S, Purrucker J, Lam BYK, Wong A, Kim YD, Song TJ, Lemmens R, Uysal E, Tanriverdi Z, Bornstein NM, Ben Assayag E, Hallevi H, Molad J, Nishihara M, Tanaka J, Coutts SB, Polymeris A, Wagner B, Seiffge DJ, Lyrer P, Kappelle LJ, Salman RA, Hernandez MV, Jäger HR, Lip GYH, Fischer U, El-Koussy M, Mas JL, Legrand L, Karayiannis C, Phan T, Gunkel S, Christ N, Abrigo J, Chu W, Leung T, Chappell F, Makin S, Hayden D, Williams DJ, Mess WH, Kooi ME, Barbato C, Browning S, Tuladhar AM, Maaijwee N, Guevarra AC, Mendyk AM, Delmaire C, Köhler S, van Oostenbrugge R, Zhou Y, Xu C, Hilal S, Robert C, Chen C, Lou M, Staals J, Bordet R, Kandiah N, de Leeuw FE, Simister R, Bos D, Kelly PJ, Wardlaw J, Soo Y, Fluri F, Srikanth V, Calvet D, Jung S, Kwa VIH, Engelter ST, Peters N, Smith EE, Hara H, Yakushiji Y, Orken DN, Thijs V, Heo JH, Mok V, Veltkamp R, Ay H, Imaizumi T, Lau KK, Jouvent E, Rothwell PM, Toyoda K, Bae HJ, Marti-Fabregas J, Wilson D, Best J, Fazekas F, Enzinger C, Werring DJ, and Gattringer T
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- Humans, Male, Female, Aged, Middle Aged, Sex Factors, Magnetic Resonance Imaging, Prospective Studies, Severity of Illness Index, Cerebral Small Vessel Diseases epidemiology, Cerebral Small Vessel Diseases diagnostic imaging, Cerebral Small Vessel Diseases complications, Aged, 80 and over, Cohort Studies, Cerebral Hemorrhage epidemiology, Cerebral Hemorrhage diagnostic imaging, Cerebral Hemorrhage mortality
- Abstract
Importance: Cerebral small vessel disease (SVD) is associated with various cerebrovascular outcomes, but data on sex differences in SVD are scarce., Objective: To investigate whether the frequency, severity, and distribution of cerebral microbleeds (CMB), other SVD markers on magnetic resonance imaging (MRI), and outcomes differ by sex., Design, Setting, and Participants: This cohort study used pooled individual patient data from the Microbleeds International Collaborative Network, including patients from 38 prospective cohort studies in 18 countries between 2000 and 2018, with clinical follow-up of at least 3 months (up to 5 years). Participants included patients with acute ischemic stroke or transient ischemic attack with available brain MRI. Data were analyzed from April to December 2023., Main Outcomes and Measures: Outcomes of interest were presence of CMB, lacunes, and severe white matter hyperintensities determined on MRI. Additionally, mortality, recurrent ischemic stroke, and intracranial hemorrhage during follow-up were assessed. Multivariable random-effects logistic regression models, Cox regression, and competing risk regression models were used to investigate sex differences in individual SVD markers, risk of recurrent cerebrovascular events, and death., Results: A total of 20 314 patients (mean [SD] age, 70.1 [12.7] years; 11 721 [57.7%] male) were included, of whom 5649 (27.8%) had CMB. CMB were more frequent in male patients, and this was consistent throughout different age groups, locations, and in multivariable models (female vs male adjusted odds ratio [aOR], 0.86; 95% CI, 0.80-0.92; P < .001). Female patients had fewer lacunes (aOR, 0.82; 95% CI, 0.74-0.90; P < .001) but a higher prevalence of severe white matter hyperintensities (aOR, 1.10; 95% CI, 1.01-1.20; P = .04) compared with male patients. A total of 2419 patients (11.9%) died during a median (IQR) follow-up of 1.4 (0.7-2.5) years. CMB presence was associated with a higher risk of mortality in female patients (hazard ratio, 1.15; 95% CI, 1.02-1.31), but not male patients (hazard ratio, 0.95; 95% CI, 0.84-1.07) (P for interaction = .01). A total of 1113 patients (5.5%) had recurrent ischemic stroke, and 189 patients (0.9%) had recurrent intracranial hemorrhage, with no sex differences., Conclusions and Relevance: This cohort study using pooled individual patient data found varying frequencies of individual SVD markers between female and male patients, indicating potential pathophysiological differences in manifestation and severity of SVD. Further research addressing differences in pathomechanisms and outcomes of SVD between female and male patients is required.
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- 2024
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27. Clinical correlates of lifetime and current comorbidity patterns in autoimmune and inflammatory diseases.
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Hässler S, Lorenzon R, Binvignat M, Ribet C, Roux A, Johanet C, Amouyal C, Amselem S, Berenbaum F, Benveniste O, Cacoub P, Grateau G, Hartemann A, Saadoun D, Salem JE, Sellam J, Seksik P, Vicaut E, Mariotti-Ferrandiz E, Rosenzwajg M, and Klatzmann D
- Abstract
Background: Autoimmune and inflammatory diseases (AIDs) are a heterogeneous group of disorders with diverse etiopathogenic mechanisms. This study explores the potential utility of family history, together with present and past comorbidities, in identifying distinct etiopathogenic subgroups. This approach may facilitate more accurate diagnosis, prognosis and personalized therapy., Methods: We performed a multiple correspondence analysis on patients' comorbidities, followed by hierarchical principal component clustering of clinical data from 48 healthy volunteers and 327 patients with at least one of 19 selected AIDs included in the TRANSIMMUNOM cross-sectional study., Results: We identified three distinct clusters characterized by: 1) the absence of comorbidities, 2) polyautoimmunity, and 3) polyinflammation. These clusters were further distinguished by specific comorbidities and biological parameters. Autoantibodies, allergies, and viral infections characterized the polyautoimmunity cluster, while older age, BMI, depression, cancer, hypertension, periodontal disease, and dyslipidemia characterized the polyinflammation cluster. Rheumatoid arthritis patients were distributed across all three clusters. They had higher DAS28 and prevalence of extra-articular manifestations when belonging to the polyinflammation and polyautoimmunity clusters, and also lower ACPA and RF seropositivity and higher pain scores within the polyinflammation cluster. We developed a model allowing to classify AID patients into comorbidity clusters., Conclusions: In this study, we have uncovered three distinct comorbidity profiles among AID patients. These profiles suggest the presence of distinct etiopathogenic mechanisms underlying these subgroups. Validation, longitudinal stability assessment, and exploration of their impact on therapy efficacy are needed for a comprehensive understanding of their potential role in personalized medicine., Competing Interests: Declaration of competing interest JS declares honoraria from Roche, Chugai, Pfizer, BMS, MSD, AbbVie, Sandoz, Hospira, Janssen, Novartis, Fresenius Kabi, Sanofi Genzyme, Galapagos. PC declares consultancies, honoraria, advisory board, and speakers’ fees from Alnylam, Innotech, Servier and Vifor. PS declares financial support for scientific works from Biocodex, MSD, Takeda, Janssen, and Sandoz, and consultant fees from Abbvie, Merk, MSD, Gilead, Pfizer, Sandoz, Janssen, and Fresenius Kabi. EV declares consulting fees from Abbott, Coloplast and Boston Scientific., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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28. CYSTOID MACULAR EDEMA IN BIRDSHOT RETINOCHOROÏDITIS: Long-Term Treatment Study in 142 Patients.
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Fardeau C, Breville G, Jeannerot AL, Herrmann F, Touati M, Bonnin S, Sales de Gauzy T, Sadegh A, Toumi A, Baglivo E, Cohen D, Karmochkine M, Bodaghi B, Seebach JD, and Le Hoang P
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- Humans, Retrospective Studies, Male, Female, Middle Aged, Adult, Aged, Follow-Up Studies, Glucocorticoids therapeutic use, Glucocorticoids administration & dosage, Fluorescein Angiography methods, Aged, 80 and over, Treatment Outcome, Immunosuppressive Agents therapeutic use, Macular Edema drug therapy, Macular Edema diagnosis, Macular Edema etiology, Tomography, Optical Coherence, Birdshot Chorioretinopathy, Chorioretinitis drug therapy, Chorioretinitis diagnosis, Visual Acuity
- Abstract
Purpose: To assess the long-term efficacy and safety of treatments for cystoid macular edema in birdshot retinochoroïditis., Methods: Observational retrospective study of 142 HLA-A29-positive patients with cystoid macular edema; the main outcome was the optical coherence tomography intraretinal cysts resolution., Results: During the mean follow-up of 75 months (12-178), 61.3% of patients were successfully treated using 1 to 3 treatment steps, while the others needed more steps. At 6 months, there were no significant effects on ME for anti-TNF (tumor necrosis factor) and IVIg (immunoglobulin) in contrast to antimetabolites (OR 1.98), systemic GCS (glucocorticosteroids), CsA (cyclosporine A) and tocilizumab (odds ratio closed to 2.7), intraocular injected GCS (odds ratio of 4.2), and interferon (odds ratio of 4.4). The percentages of therapeutic success trend to decrease from the initial three treatment steps to the subsequent treatment steps, for systemic GCS (84% to 70%), for anti-TNF (42% to 33%), and for CsA (71% to 33%); the success percentages did not decrease for injected GCS (83% to 89%). Macular edema recurrence occurred with the highest percentage for injected GCS (86.8%, P = 0.01) and the lowest for tocilizumab (10.5%, P = 0.001). Interferons-α and tocilizumab were associated with the lowest prednisone daily doses., Conclusion: The classical uveitic cystoid macular edema therapeutic algorithm could be adapted to birdshot retinochoroïditis.
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- 2024
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29. Neuromuscular blocking agent drug challenge: a literature review and protocol proposal with biological evaluation.
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Gouel-Chéron A, Neukirch C, Chollet-Martin S, Valent A, Plaud B, Longrois D, Nicaise-Roland P, Montravers P, and de Chaisemartin L
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- Humans, Male, Middle Aged, Perioperative Period, Cholecystectomy, Laparoscopic, Exanthema etiology, False Positive Reactions, Dose-Response Relationship, Drug, Mast Cells enzymology, Skin enzymology, Neuromuscular Blocking Agents administration & dosage, Neuromuscular Blocking Agents adverse effects, Drug Hypersensitivity diagnosis, Drug Hypersensitivity ethnology, Skin Tests adverse effects, Skin Tests statistics & numerical data, Tryptases analysis
- Abstract
Background: Drug challenge is the gold standard for identifying causative agents of drug allergies. Although clinical guidelines have recently been published, they do not recommend neuromuscular blocking agent (NMBA) drug challenges. NMBA challenges are rendered difficult by the lack of homogeneity of routine allergy work-ups and the necessity of a specialised setting. Several scenarios support NMBA challenges, such as an ambiguous allergy work-up, a high suspicion of a false-positive skin test or identification of a well tolerated alternative NMBA strategy. Furthermore, routine allergy work-ups may not recognise non-IgE mechanisms, such as IgG or MRGPRX2, whereas drug challenges may reveal them. Finally, if the culprit NMBA is not identified, subsequent anaesthesia regimens will be challenging to implement, resulting in increased risk., Objectives: This literature review discusses the indications, strategies, doses, monitoring methods, limitations, and unresolved issues related to drug challenges for NMBAs., Design: The literature review included randomised controlled trials, observational studies, reviews, case reports, series, and comments on humans., Data Sources: Studies were retrieved from databases (PubMed) and electronic libraries (OVID, EMBASE, Scopus, etc.)., Eligibility Criteria: All studies that referred to the NMBA challenge were included without publication date limitations., Results: NMBA challenge may be considered in NMBA anaphylaxis patients with inconclusive or ambivalent IgE diagnostic work-up under controlled conditions (presence of anaesthetists and allergists with continuous monitoring in a secured environment). To illustrate its utility, a case report of a double NMBA challenge in a patient with NMBA cross-reactivity is presented, along with biological explorations to detect subclinical cellular activation, a novel aspect of this procedure., Conclusion: Drug challenges could be implemented during the NMBA allergy work-up under strict safety conditions at specialised centres with close collaboration between anaesthetists and allergists. This could decrease uncertainty and contribute to defining a safer strategy for subsequent anaesthetic drug regimens., (Copyright © 2024 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.)
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- 2024
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30. Angiographic Evolution of Brain Arteriovenous Malformation Angioarchitecture After Partial Endovascular Treatment.
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Quarta Colosso G, Aubertin M, Rius E, Guerra X, Burel J, Mathon B, Nouet A, Premat K, Drir M, Allard J, Lenck S, Sourour NA, Clarençon F, and Shotar E
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- Humans, Male, Female, Adult, Retrospective Studies, Middle Aged, Treatment Outcome, Aged, Follow-Up Studies, Young Adult, Intracranial Arteriovenous Malformations diagnostic imaging, Intracranial Arteriovenous Malformations therapy, Intracranial Arteriovenous Malformations surgery, Embolization, Therapeutic methods, Endovascular Procedures methods, Cerebral Angiography
- Abstract
Background and Objectives: Endovascular embolization of brain arteriovenous malformations (AVMs) is sometimes intentionally partial, in the case of staged treatment for instance. Residual AVMs may be prone to angioarchitectural modification during follow-up. The objective of this work is to evaluate the nature and extent of these modifications., Methods: We performed a retrospective monocentric study on a cohort of adult patients treated by incomplete endovascular embolization for ruptured and unruptured AVMs with an available angiographic follow-up, without any intervening confounding event between the 2 angiographic examinations. AVM angioarchitectural modifications (arterial, nidal, and venous) were analyzed. Clinical and radiological data were tested in univariate analyses for association with the occurrence of AVM regression or progression., Results: Eighty-two partial embolization sessions in 57 patients were included in the study. A 40% (33/82) rate of modification was found on follow-up, with 23/82 (28%) controls showing at least one angioarchitectural regression feature and 15/82 (18.3%) showing at least one angioarchitectural progression item. Nidal growth was the most frequent modification occurring after 12/82 (14.6%) embolizations. The only factor associated with nidal volume growth was a longer time interval between embolization and follow-up (median [IQR]: 190 [250] days vs 89.5[133] days in the subgroup without nidal growth; P = .02). Specific modifications of arterial supply, nidal anatomy, and venous drainage were identified and documented., Conclusion: Angioarchitectural modifications (both progression and regression) of brain AVMs are frequent findings after partial embolization. Nidal volume growth is associated with longer time intervals between embolization and follow-up., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)
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- 2024
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31. Gender Differences in Perceptions of Psoriatic Arthritis Disease Impact, Management, and Physician Interactions: Results from a Global Patient Survey.
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Eder L, Richette P, Coates LC, Azevedo VF, Cappelleri JC, Johnson EP, Hoang M, Moser J, and Kessouri M
- Abstract
Introduction: We evaluated the impact of gender on disease severity, health-related quality of life (HRQoL), treatment management, and patient-healthcare professional (HCP) interactions from the perspectives of patients with psoriatic arthritis (PsA)., Methods: Data were collected from a global online patient survey conducted by The Harris Poll (November 2, 2017 to March 12, 2018). Eligible patients were aged ≥ 18 years, with a self-reported diagnosis of PsA for > 1 year, had visited a rheumatologist/dermatologist in the past 12 months, and had reported previously using ≥ 1 conventional synthetic or biologic disease-modifying antirheumatic drug. Data were stratified by gender and analyzed descriptively, inferentially by binomial (chi-square) tests, and by multivariate logistic regression models., Results: Data from 1286 patients who participated were included: 52% were female, 48% were male. Varying perceptions of disease severity between males and females were indicated by differences in symptoms leading to a diagnosis of PsA, and in symptoms reported despite treatment; more females than males reported joint tenderness, skin patches/plaques, and enthesitis. More females than males reported a major/moderate impact of PsA on their physical activity and emotional/mental well-being. Reasons for switching medication differed between genders, with more females switching because they perceived their medication to not be effective enough related to their joint symptoms. More females than males were very satisfied with their communication with their rheumatologist and were more likely to discuss the impact of PsA on their daily lives, their treatment satisfaction, and treatment goals with their rheumatologist., Conclusions: Patients' perceptions of the impact of PsA on HRQoL, treatment management, and interactions with HCPs varied between males and females. More females than males reported major/moderate physical and emotional impacts of PsA. When treating patients, it is important for HCPs to consider the potential impact of gender on patients' experience of PsA and its symptoms. Graphical plain language summary available for this article., (© 2024. The Author(s).)
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- 2024
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32. Type 2N von Willebrand disease: genotype drives different bleeding phenotypes and treatment needs.
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Daniel MY, Ternisien C, Castet S, Falaise C, D'Oiron R, Volot F, Itzhar N, Pan-Petesch B, Jeanpierre E, Paris C, Zawadzki C, Desvages M, Dupont A, Veyradier A, Repessé Y, Babuty A, Trossaërt M, Boisseau P, Denis CV, Lenting PJ, Goudemand J, Rauch A, and Susen S
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- Humans, Male, Female, Adult, France, Middle Aged, Hemostatics therapeutic use, Young Adult, Heterozygote, Homozygote, Registries, Treatment Outcome, Adolescent, Child, Aged, Deamino Arginine Vasopressin therapeutic use, Phenotype, Hemorrhage genetics, Hemorrhage chemically induced, Hemorrhage blood, von Willebrand Disease, Type 2 genetics, von Willebrand Disease, Type 2 drug therapy, von Willebrand Disease, Type 2 diagnosis, von Willebrand Disease, Type 2 blood, von Willebrand Factor genetics, Genotype
- Abstract
Background: Type 2 Normandy von Willebrand disease (VWD2N) is usually perceived as a mild bleeding disorder that can be treated with desmopressin (DDAVP). However, VWD2N patients can be compound heterozygous or homozygous for different variants, with p.Arg854Gln (R854Q) being the most frequent causative one. There are limited data about the impact of 2N variants on VWD2N phenotype and DDAVP response., Objectives: This study aims to describe the phenotype of VWD2N, including DDAVP response, according to genotype., Methods: VWD2N patients with a complete genotype/phenotype characterization by the French reference center for VWD, including MCMDM-1VWD bleeding score, were eligible to be included in the study. Results of the DDAVP trial were also collected., Results: A total of 123 VWD2N patients from the French registry were included in this study. Results were stratified according to the presence (R854QPos, n = 114) or absence (R854QNeg, n = 9) of at least 1 R854Q allele. Three R854QPos subgroups were further individualized: patients homozygous (R854QHmz, n = 55), compound heterozygous for R854Q and a null allele (R854Q/3, n = 48), or compound heterozygous for R854Q and another 2N variant (R854Q/2N, n = 11)., Fviii: C levels were significantly lower in R854QNeg and R854Q/3 patients compared with R854QHmz ones (P < .001 and P < .0001, respectively). R854QNeg patients were diagnosed earlier due to bleeding symptoms and had a higher bleeding score than R854QPos patients (P < .001). In DDAVP trial, FVIII:C survival was lower in VWD type 2N than in type 1 patients. R854QPos patients had a heterogeneous DDAVP response, which was best predicted by baseline FVIII:C level., Conclusion: The heterogeneous genetic background of VWD2N drives different bleeding phenotypes and response patterns to DDAVP, underlining the clinical relevance of DDAVP trial to identify patients potentially eligible to alternative therapeutic options., Competing Interests: Declaration of competing interests F.V. has received honoraria for consultancy, board, or oral presentations from CSL/Behring, LFB, Roche/Chugai, Takeda, Pfizer, and Sobi. Y.R. has received research support outside this work from Stago, Roche-Chugai, CSL Behring, and LFB and received Honoria for lectures or consultancy from Sobi, LFB, Octapharma, Roche-Chugai, CSL Behring, and Shire-Takeda. C.V.D. and P.J.L. are inventors on patents related to VWF. P.J.L. receives research support to institute from BioMarin, Sanofi, Sobi, and Roche. S.S. has received research support outside this work from CSL Behring, Roche-Chugai, Stago, and Siemens Healthineers and received honoraria for lectures or consultancy from BioMarin, Bioverativ, CSL Behring, Hemosonics, LFB, Novo Nordisk, Roche/Chugai, Sanofi, Siemens Healthineers, Shire-Takeda, and Sobi. The other authors have no competing interests to disclose., (Copyright © 2024 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved.)
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- 2024
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33. Evaluation of bone density and microarchitecture in adult patients with X-linked hypophosphatemic rickets: A pilot longitudinal study.
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Funck-Brentano T, Vanjak A, Ostertag A, Nethander M, Fernandez S, Collet C, Hans D, van Rietbergen B, and Cohen-Solal M
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- Humans, Female, Male, Middle Aged, Pilot Projects, Adult, Case-Control Studies, Longitudinal Studies, Tomography, X-Ray Computed, Cancellous Bone diagnostic imaging, Cancellous Bone pathology, Cancellous Bone physiopathology, Familial Hypophosphatemic Rickets diagnostic imaging, Familial Hypophosphatemic Rickets pathology, Familial Hypophosphatemic Rickets physiopathology, Bone Density, Absorptiometry, Photon
- Abstract
X-linked Hypophosphatemia (XLH) is the most common type of inherited rickets. Although the clinical features are well characterized, bone structure, mineralization, and biomechanical properties are poorly known. Our aim was to analyze bone properties in the appendicular and axial skeleton of adults with XLH. In this observational case-control study, each affected patient (N = 14; 9 females; age 50 ± 15 years) was matched by sex, age and body mass index to a minimum of two healthy controls (N = 34). Dual-energy X-ray Absorptiometry (DXA) analyses revealed that areal bone mineral density (aBMD) was higher in XLH patients at the lumbar spine (Z score mean difference = +2.47 SD, P value = 1.4 × 10
-3 ). Trabecular Bone Score was also higher at the lumbar spine (P value = 1.0 × 10-4 ). High Resolution peripheral Quantitative Computed Tomography (HRpQCT) demonstrated that bone cross-sectional area was larger at the distal radius (P value = 6 × 10-3 ). Total and trabecular volumetric BMD were lower at both sites. Trabecular bone volume fraction was also lower with fewer trabecular numbers at both sites. However, bone strength evaluated by micro-finite element analyzes revealed unaffected bone stiffness and maximum failure load. Evaluation of bone mineralization with aBMD by DXA at the distal radius correlated with vBMD by HRpQCT measurements at both sites. PTH levels were inversely correlated with trabecular vBMD and BV/TV at the tibia. We then followed a subset of nine patients (median follow-up of 4 years) and reassessed HRpQCT. At the tibia, we observed a greater decrease than expected from an age and sex standardized normal population in total and cortical vBMD as well as a trabecularization of the cortical compartment. In conclusion, in adult patients with XLH, bone mineral density is high at the axial skeleton but low at the appendicular skeleton. With time, microarchitectural alterations worsen. We propose that noninvasive evaluation methods of bone mineralization such as DXA including the radius should be part of the management of XLH patients. Larger studies are needed to evaluate the clinical significance of BMD changes in XLH patients under conventional or targeted therapies., Competing Interests: Declaration of competing interest TFB and MCS disclose their participation in a sponsored symposium by Kyowa Kirin. MCS received a research grant by Kyowa Kirin., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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34. Risk Factors and Outcome Associated With Fungal Infections in Patients With Severe Burn Injury: 10-year Retrospective IFI-BURN Study.
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Dudoignon E, Chevret S, Tsague S, Hamane S, Chaouat M, Plaud B, Vicault E, Mebazaa A, Legrand M, Alanio A, Denis B, Dépret F, and Dellière S
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- Humans, Retrospective Studies, Male, Female, Middle Aged, Risk Factors, Adult, Aged, Incidence, Intensive Care Units, Burn Units, Burns complications, Burns microbiology, Invasive Fungal Infections mortality, Invasive Fungal Infections epidemiology, Invasive Fungal Infections microbiology
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Background: In burn patients, skin barrier disruption and immune dysfunctions increase susceptibility to invasive fungal diseases (IFDs) like invasive candidiasis (IC) and invasive mold infections (IMI). We provide an in-depth analysis of IFD-related factors and outcomes in a 10-year cohort of severe burn patients., Methods: This retrospective cohort study includes adult patients admitted to the burn intensive care unit (BICU) between April 2014 and May 2023 with total burn surface area (TBSA) ≥15%. Patients were classified as proven IFD according to EORTC/MSGERC criteria applicable for IC. Putative IMIs were defined with: ≥2 positive cultures from a skin biopsy/bronchoalveolar lavage or ≥2 positive blood specific-quantitative polymerase chain reactions (qPCRs) or a combination of both., Results: Among 1381 patients admitted, 276 consecutive patients with TBSA ≥15% were included. Eighty-seven (31.5%; IC n = 30; IMI n = 43; both n = 14) patients fulfilled the criteria for probable/putative IFD. At Day 30 after the burn injury, the estimated cumulative incidence proven/putative (pr/pu) IFD was 26.4% (95% confidence interval [CI], 21.4%-31.8%). Factors independently associated with IFDs were TBSA, severity scores and indoor burn injury (ie, from confined space fire). Overall mortality was 15.3% and 36.8% in the no IFD, pr/pu IFD groups respectively (P < .0001). IFD was independently associated with a risk of death (hazard ratio [HR]: 1.94 for pr/pu IFD; 95% CI, 1.12-3.36; P = .019)., Conclusions: This study describes twenty-first-century characteristics of IFDs in severe burn patients confirming known risk factors with thresholds and identifying the indoor injury as an independent factor associated to IFDs. This suggests a link to contamination caused by fire damage, which is highly susceptible to aerosolizing spores., Competing Interests: Potential conflicts of interest. The authors: No reported conflicts of interest for this study. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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35. Early-Onset Osteoporosis: Molecular Analysis in Large Cohort and Focus on the PLS3 Gene.
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Mancini M, Chapurlat R, Isidor B, Desjonqueres M, Couture G, Guggenbuhl P, Coutant R, El Chehadeh S, Fradin M, Frazier A, Goldenberg A, Guillot P, Koumakis E, Mehsen-Cêtre N, Rossi M, Schaefer É, Sigaudy S, Porquet-Bordes V, Fontanges É, Letard P, Edouard T, Javier RM, Cohen-Solal M, Funck-Brentano T, and Collet C
- Abstract
Osteoporosis is a skeletal disorder characterized by abnormal bone microarchitecture and low bone mineral density (BMD), responsible for an increased risk of fractures and skeletal fragility. It is a common pathology of the aging population. However, when osteoporosis occurs in children or young adults, it strongly suggests an underlying genetic etiology. Over the past two decades, several genes have been identified as responsible for this particular kind of considered monogenic early-onset osteoporosis (EOOP) or juvenile osteoporosis, the main ones being COL1A1, COL1A2, LRP5, LRP6, WNT1, and more recently PLS3. In this study, the objective was to characterize a large cohort of patients diagnosed with primary osteoporosis and to establish its diagnosis yield. The study included 577 patients diagnosed with primary osteoporosis and its diagnosis yield was established. To this end, next-generation sequencing (NGS) of a panel of 21 genes known to play a role in bone fragility was carried out. A genetic etiology was explained in about 18% of cases, while the others remain unexplained. The most frequently identified gene associated with EOOP is LRP5, which was responsible for 8.2% of the positive results (47 patients). As unexpected, 17 patients (2.9%) had a variant in PLS3 which encodes plastin 3. Alterations of PLS3 are associated with dominant X-linked osteoporosis, an extremely rare disease. Given the rarity of this disease, we focused on it. It was observed that males were more affected than females, but it is noteworthy that three females with a particularly severe phenotype were identified. Of these three, two had a variant in an additional gene involved in EOP, illustrating the probable existence of digenism. We significantly increase the number of variants potentially associated with EOOP, especially in PLS3. The results of our study demonstrate that molecular analysis in EOOP is beneficial and useful., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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36. Hydrochloric acid ingestion in adults: presentation and outcomes in a 10-year retrospective cohort study.
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Sabzé A, Coutrot M, Dudoignon E, Corte H, Plaud B, Dépret F, and Deniau B
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- 2024
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37. Factors associated with dietary practices and beliefs on food of patients with rheumatic and musculoskeletal diseases: a multicentre cross-sectional study.
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Renard D, Tuffet S, Dieudé P, Claudepierre P, Gossec L, Fautrel B, Molto A, Miceli-Richard C, Richette P, Maheu E, Carette C, Czernichow S, Jamakorzyan C, Rousseau A, Berenbaum F, Beauvais C, and Sellam J
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Objectives: To investigate dietary practices and beliefs of patients with rheumatic and musculoskeletal diseases (RMDs) and associated factors., Methods: In 2019-2020, a cross-sectional multicentre study enrolled patients with inflammatory arthritis (IA) (rheumatoid arthritis [RA], axial spondyloarthritis [axSpA]) or hand osteoarthritis (HOA) from secondary- and tertiary-care centres. A self-administered questionnaire explored dietary practices and patients' perceived effects of diet, foods and beverages on symptoms. Univariable and multivariable analyses investigated factors associated with diets and patients' views., Results: Of 448 included patients, data for 392 were analysed (123 with RA, 161 with axSpA, 108 with HOA), 26% were on or had been on at least one exclusion diet (mostly cow's milk- and gluten-free diets in IA, mostly cow's milk-free diet and detox/fasting in HOA). Only 5% of patients followed the Mediterranean diet. Among patients who had tried a diet, 51% reported a decrease in pain. Overall, 42% of patients identified at least one food or beverage that increased or decreased pain. On multivariable analyses, dieting or the perceived effect of food on pain was associated with health beliefs (positive or negative), the use of complementary and alternative medicines, and lack of support or information from healthcare professionals. Patients had received little dietary information from their physicians., Conclusions: This study provides insights into patients' dietary practices and factors associated with these practices, including patients' health beliefs and insufficient support by health professionals, in RMDs., (Copyright © 2024. Published by Elsevier Masson SAS.)
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- 2024
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38. Surrogate Markers and Clinical Outcomes.
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Richette P, Dalbeth N, and Stamp LK
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- Humans, Biomarkers blood, Chronic Disease drug therapy, Treatment Outcome, Gout Suppressants therapeutic use, Gout blood, Gout diagnosis, Gout drug therapy, Uric Acid blood
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- 2024
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39. Sex inequalities in cardiovascular risk factors and their management in primary prevention in adults living with type 1 diabetes in Germany and France: findings from DPV and SFDT1.
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Cosson E, Auzanneau M, Aguayo GA, Karges W, Riveline JP, Augstein P, Sablone L, Jehle P, Fagherazzi G, and Holl RW
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- Humans, Male, Female, France epidemiology, Adult, Germany epidemiology, Sex Factors, Middle Aged, Risk Assessment, Treatment Outcome, Time Factors, Biomarkers blood, Hypoglycemic Agents therapeutic use, Prospective Studies, Diabetes Mellitus, Type 1 diagnosis, Diabetes Mellitus, Type 1 epidemiology, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 1 blood, Diabetes Mellitus, Type 1 therapy, Heart Disease Risk Factors, Cardiovascular Diseases prevention & control, Cardiovascular Diseases epidemiology, Cardiovascular Diseases diagnosis, Registries, Primary Prevention, Healthcare Disparities, Health Status Disparities
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Introduction & Objectives: To evaluate whether cardiovascular risk factors and their management differ in primary prevention between adult males and females with type 1 diabetes (T1D) in two European countries in 2020-2022 and sex inequalities in achievement of standards of care in diabetes., Methods: We used 2020-2022 data of patients without a cardiovascular history in the Prospective Diabetes Follow-up registry (DPV) centres, in Germany, and the Société Francophone du Diabète- Cohorte Diabète de Type 1 cohort (SFDT1), in France., Results: We included 2,657 participants from the DPV registry and 1,172 from the SFDT1 study. Body mass indexes were similar in females and males with similar proportions of HbA1c < 7% (DPV: 36.6 vs 33.0%, p = 0.06, respectively; SFDT1: 23.4 vs 25.7%, p = 0.41). Females were less overweight compared to men in DPV (55.4 vs 61.0%, p < 0.01) but not in SFDT1 (48.0 vs 44.9%, p = 0.33) and were less prone to smoke (DPV: 19.7 vs 25.8%, p < 0.01; SFDT1: 21.0 vs 26.0%, p = 0.07). Systolic blood pressure was lower in females than males with a higher rate of antihypertensive therapy in case of hypertension in females in DPV (70.5 vs 63.7%, p = 0.02) but not in SFDT1 (73.3 vs 68.6%, p = 0.64). In the case of microalbuminuria, ACEi-ARB were less often prescribed in women than men in DPV (21.4 vs 37.6%, p < 0.01) but not SFDT1 (73.3 vs 67.5.0%, p = 0.43). In females compared to males, HDL-cholesterol levels were higher; triglycerides were lower in both countries. In those with LDL-cholesterol > 3.4 mmol/L (DPV: 19.9 (females) vs 23.9% (males), p = 0.01; SFDT1 17.0 vs 19.2%, p = 0.43), statin therapy was less often prescribed in females than males in DPV (7.9 vs 17.0%, p < 0.01), SFDT1 (18.2 vs 21.0%, p = 0.42)., Conclusion: In both studies, females in primary prevention have a better cardiovascular risk profile than males. We observed a high rate of therapeutic inertia, which might be higher in females for statin treatment and nephroprotection with ACEi-ARB, especially in Germany. Diabetologists should be aware of sex-specific differences in the management of cardiorenal risk factors to develop more personalized prevention strategies., (© 2024. The Author(s).)
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- 2024
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40. Post-capillary pulmonary hypertension in heart failure: impact of current definition in the PH-HF multicentre study.
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Fauvel C, Damy T, Berthelot E, Bauer F, Eicher JC, de Groote P, Trochu JN, Picard F, Renard S, Bouvaist H, Logeart D, Roubille F, Sitbon O, and Lamblin N
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- Humans, Male, Female, Middle Aged, Aged, Prognosis, Prospective Studies, Cardiac Catheterization methods, Prevalence, Heart Failure complications, Heart Failure physiopathology, Heart Failure epidemiology, Hypertension, Pulmonary physiopathology, Hypertension, Pulmonary diagnosis, Vascular Resistance physiology
- Abstract
Background and Aims: Based on retrospective studies, the 2022 European guidelines changed the definition of post-capillary pulmonary hypertension (pcPH) in heart failure (HF) by lowering the level of mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR). However, the impact of this definition and its prognostic value has never been evaluated prospectively., Methods: Stable left HF patients with the need for right heart catheterization were enrolled from 2010 to 2018 and prospectively followed up in this multicentre study. The impact of the successive pcPH definitions on pcPH prevalence and subgroup [i.e. isolated (IpcPH) vs. combined pcPH (CpcPH)] was evaluated. Multivariable Cox regression analysis was used to assess the prognostic value of mPAP and PVR on all-cause death or hospitalization for HF (primary outcome)., Results: Included were 662 HF patients were (median age 63 years, 60% male). Lowering mPAP from 25 to 20 mmHg resulted in +10% increase in pcPH prevalence, whereas lowering PVR from 3 to 2 resulted in +60% increase in CpcPH prevalence (with significant net reclassification improvement for the primary outcome). In multivariable analysis, both mPAP and PVR remained associated with the primary outcome [hazard ratio (HR) 1.02, 95% confidence interval (CI) 1.00-1.03, P = .01; HR 1.07, 95% CI 1.00-1.14, P = .03]. The best PVR threshold associated with the primary outcome was around 2.2 WU. Using the 2022 definition, pcPH patients had worse survival compared with HF patients without pcPH (log-rank, P = .02) as well as CpcPH compared with IpcPH (log-rank, P = .003)., Conclusions: This study is the first emphasizing the impact of the new pcPH definition on CpcPH prevalence and validating the prognostic value of mPAP > 20 mmHg and PVR > 2 WU among HF patients., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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41. Unmet needs and knowledge gaps in aortic stenosis: A position paper from the Heart Valve Council of the French Society of Cardiology.
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Fauvel C, Coisne A, Capoulade R, Bourg C, Diakov C, Ribeyrolles S, Jouan J, Folliguet T, Kibler M, Dreyfus J, Magne J, Bohbot Y, Pezel T, Modine T, and Donal E
- Abstract
Nowadays, valvular heart disease remains a significant challenge among cardiovascular diseases, affecting millions of people worldwide and exerting substantial pressure on healthcare systems. Within the spectrum of valvular heart disease, aortic stenosis is the most common valvular lesion in developed countries. Despite notable advances in understanding its pathophysiological processes, improved cardiovascular imaging techniques and expanding therapeutic options in recent years, there are still unmet needs and knowledge gaps regarding aortic stenosis pathophysiology, severity assessment, management and decision-making strategy. This review, prepared on behalf of the Heart Valve Council of the French Society of Cardiology, describes these gaps and future research perspectives to improve the outcome of patients with aortic stenosis., (Copyright © 2024. Published by Elsevier Masson SAS.)
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- 2024
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42. Fully automated epicardial adipose tissue volume quantification with deep learning and relationship with CAC score and micro/macrovascular complications in people living with type 2 diabetes: the multicenter EPIDIAB study.
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Gaborit B, Julla JB, Fournel J, Ancel P, Soghomonian A, Deprade C, Lasbleiz A, Houssays M, Ghattas B, Gascon P, Righini M, Matonti F, Venteclef N, Potier L, Gautier JF, Resseguier N, Bartoli A, Mourre F, Darmon P, Jacquier A, and Dutour A
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Diabetic Angiopathies diagnostic imaging, Diabetic Angiopathies etiology, Diabetic Angiopathies diagnosis, Risk Assessment, Radiographic Image Interpretation, Computer-Assisted, Computed Tomography Angiography, Adiposity, Coronary Angiography, Risk Factors, Reproducibility of Results, Prognosis, Epicardial Adipose Tissue, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 diagnosis, Pericardium diagnostic imaging, Deep Learning, Adipose Tissue diagnostic imaging, Vascular Calcification diagnostic imaging, Coronary Artery Disease diagnostic imaging, Predictive Value of Tests, Automation
- Abstract
Background: The aim of this study (EPIDIAB) was to assess the relationship between epicardial adipose tissue (EAT) and the micro and macrovascular complications (MVC) of type 2 diabetes (T2D)., Methods: EPIDIAB is a post hoc analysis from the AngioSafe T2D study, which is a multicentric study aimed at determining the safety of antihyperglycemic drugs on retina and including patients with T2D screened for diabetic retinopathy (DR) (n = 7200) and deeply phenotyped for MVC. Patients included who had undergone cardiac CT for CAC (Coronary Artery Calcium) scoring after inclusion (n = 1253) were tested with a validated deep learning segmentation pipeline for EAT volume quantification., Results: Median age of the study population was 61 [54;67], with a majority of men (57%) a median duration of the disease 11 years [5;18] and a mean HbA1c of7.8 ± 1.4%. EAT was significantly associated with all traditional CV risk factors. EAT volume significantly increased with chronic kidney disease (CKD vs no CKD: 87.8 [63.5;118.6] vs 82.7 mL [58.8;110.8], p = 0.008), coronary artery disease (CAD vs no CAD: 112.2 [82.7;133.3] vs 83.8 mL [59.4;112.1], p = 0.0004, peripheral arterial disease (PAD vs no PAD: 107 [76.2;141] vs 84.6 mL[59.2; 114], p = 0.0005 and elevated CAC score (> 100 vs < 100 AU: 96.8 mL [69.1;130] vs 77.9 mL [53.8;107.7], p < 0.0001). By contrast, EAT volume was neither associated with DR, nor with peripheral neuropathy. We further evidenced a subgroup of patients with high EAT volume and a null CAC score. Interestingly, this group were more likely to be composed of young women with a high BMI, a lower duration of T2D, a lower prevalence of microvascular complications, and a higher inflammatory profile., Conclusions: Fully-automated EAT volume quantification could provide useful information about the risk of both renal and macrovascular complications in T2D patients., (© 2024. The Author(s).)
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- 2024
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43. Exploration of sleep quality and rest-activity rhythms characteristics in Bilateral Vestibulopathy patients.
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Milot E, Martin T, Kuldavletova O, Bessot N, Toupet M, Hautefort C, Van Nechel C, Clément G, Quarck G, and Denise P
- Abstract
Sleep and circadian timing systems are constantly regulated by both photic and non-photic signals. Connections between the vestibular nuclei and the biological clock raise the question of the effect of peripheral vestibular loss on daily rhythms, such as the sleep-wake cycle and circadian rhythm. To answer this question, we compared the sleep and rest-activity rhythm parameters of 15 patients with bilateral vestibulopathy (BVP) to those of 15 healthy controls. Sleep and rest-activity cycle were recorded by a device coupling actimetry with the heart rate and actigraphy at home over 7 days. Subjective sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Sleep efficiency and subjective sleep quality were significantly reduced, and sleep fragmentation was increased in BVP patients compared to controls. BVP patients displayed a damped amplitude of the rest-activity rhythm and higher sleep fragmentation, reflected by a higher nocturnal activity compared to controls. These results suggest that both rest-activity and sleep cycles are impaired in BVP patients compared to healthy controls. BVP patients seem to have greater difficulty maintaining good sleep at night compared to controls. BVP pathology appears to affect the sleep-wake cycle and disturb the circadian rhythm synchronization. Nevertheless, these results need further investigation to be confirmed, particularly with larger sample sizes., Competing Interests: Declaration of competing interest We confirm that this work is original, has not been published elsewhere, and is not currently under consideration for publication elsewhere. All authors have approved the manuscript and agree with its submission to Sleep Medecine. We have no conflicts of interest to disclose. We have no financial/personal/competing interests that could affect our objectivity. This work was supported by the Senior Excellence Chair supported by Région Normandie grant #00115524-210E06581 (Réseaux d’Intérêts Normands, RIN)., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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44. PrP C controls epithelial-to-mesenchymal transition in EGFR-mutated NSCLC: implications for TKI resistance and patient follow-up.
- Author
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Lailler C, Didelot A, Garinet S, Berthou H, Sroussi M, de Reyniès A, Dedhar S, Martin-Lannerée S, Fabre E, Le Pimpec-Barthes F, Perrier A, Poindessous V, Mansuet-Lupo A, Djouadi F, Launay JM, Laurent-Puig P, Blons H, and Mouillet-Richard S
- Subjects
- Humans, Acrylamides pharmacology, Acrylamides therapeutic use, Aniline Compounds pharmacology, Aniline Compounds therapeutic use, Cell Line, Tumor, Follow-Up Studies, Indoles, Mutation, Pyrimidines, Carcinoma, Non-Small-Cell Lung genetics, Carcinoma, Non-Small-Cell Lung drug therapy, Carcinoma, Non-Small-Cell Lung pathology, Drug Resistance, Neoplasm genetics, Epithelial-Mesenchymal Transition genetics, Epithelial-Mesenchymal Transition drug effects, ErbB Receptors genetics, Lung Neoplasms genetics, Lung Neoplasms drug therapy, Lung Neoplasms pathology, Protein Kinase Inhibitors pharmacology, Protein Kinase Inhibitors therapeutic use, PrPC Proteins genetics, PrPC Proteins metabolism
- Abstract
Patients with EGFR-mutated non-small cell lung cancer (NSCLC) benefit from treatment with tyrosine kinase inhibitors (TKI) targeting EGFR. Despite improvements in patient care, especially with the 3rd generation TKI osimertinib, disease relapse is observed in all patients. Among the various processes involved in TKI resistance, epithelial-to-mesenchymal transition (EMT) is far from being fully characterized. We hypothesized that the cellular prion protein PrP
C could be involved in EMT and EGFR-TKI resistance in NSCLC. Using 5 independent lung adenocarcinoma datasets, including our own cohort, we document that the expression of the PRNP gene encoding PrPC is associated with EMT. By manipulating the levels of PrPC in different EGFR-mutated NSCLC cell lines, we firmly establish that the expression of PrPC is mandatory for cells to maintain or acquire a mesenchymal phenotype. Mechanistically, we show that PrPC operates through an ILK-RBPJ cascade, which also controls the expression of EGFR. Our data further demonstrate that PrPC levels are elevated in EGFR-mutated versus wild-type tumours or upon EGFR activation in vitro. In addition, we provide evidence that PRNP levels increase with TKI resistance and that reducing PRNP expression sensitizes cells to osimertinib. Finally, we found that plasma PrPC levels are increased in EGFR-mutated NSCLC patients from 2 independent cohorts and that their longitudinal evolution mirrors that of disease. Altogether, these findings define PrPC as a candidate driver of EMT-dependent resistance to EGFR-TKI in NSCLC. They further suggest that monitoring plasma PrPC levels may represent a valuable non-invasive strategy for patient follow-up and warrant considering PrPC -targeted therapies for EGFR-mutated NSCLC patients with TKI failure., (© 2024. The Author(s).)- Published
- 2024
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45. Effects of Hemorrhagic Shock and Rhabdomyolysis on Renal Microcirculation, Oxygenation, and Function in a Female Swine Model.
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Bergis B, Laemmel E, Laitselart P, Isnard P, Terzi F, Seguret M, Hejl C, Huertas A, Decante B, Vicaut E, Duranteau J, Harrois A, and Libert N
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- Animals, Female, Swine, Renal Circulation physiology, Oxygen blood, Kidney Function Tests methods, Shock, Hemorrhagic physiopathology, Shock, Hemorrhagic complications, Shock, Hemorrhagic therapy, Microcirculation physiology, Rhabdomyolysis physiopathology, Disease Models, Animal, Kidney blood supply, Kidney physiopathology
- Abstract
Background: Hemorrhagic shock (HS) and rhabdomyolysis (RM) are two important risk factors for acute kidney injury after severe trauma; however, the effects of the combination of RM and HS on kidney function are unknown. The purpose of this study was to determine the impact of RM and HS on renal function, oxygenation, perfusion, and morphology in a pig model., Methods: Forty-seven female pigs were divided into five groups: sham, RM, HS, HS and moderate RM (RM4/HS), and HS and severe RM (RM8/HS). Rhabdomyolysis was induced by intramuscular injection of glycerol 50% with a moderate dose (4 ml/kg for the RM4/HS group) or a high dose (8 ml/kg for the RM and RM8/HS groups). Among animals with HS, after 90 min of hemorrhage, animals were resuscitated with fluid followed by transfusion of the withdrawn blood. Animals were followed for 48 h. Macro- and microcirculatory parameters measurements were performed., Results: RM alone induced a decrease in creatinine clearance at 48 h (19 [0 to 41] vs. 102 [56 to 116] ml/min for RM and sham, respectively; P = 0.0006) without alteration in renal perfusion and oxygenation. Hemorrhagic shock alone impaired temporarily renal microcirculation, function, and oxygenation that were restored with fluid resuscitation. The RM4/HS and RM8/HS groups induced greater impairment of renal microcirculation and function than HS alone at the end of blood spoliation that was not improved by fluid resuscitation. Mortality was increased in the RM8/HS and RM4/HS groups in the first 48 h (73% vs. 56% vs. 9% for the RM8/HS, RM4/HS, and HS groups, respectively)., Conclusions: The combination of HS and RM induced an early deleterious effect on renal microcirculation, function, and oxygenation with decreased response to resuscitation and transfusion compared with HS or RM alone., (Copyright © 2024 American Society of Anesthesiologists. All Rights Reserved.)
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- 2024
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46. Clinical spectrum and outcome of Takayasu's arteritis in children.
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Hassold N, Dusser P, Laurent A, Lemelle I, Pillet P, Comarmond C, Mekinian A, Lambert M, Mirault T, Benhamou Y, Belot A, Jeziorski E, Reumaux H, Sibilia J, Desdoits A, Espitia O, Faye A, Quartier P, Saadoun D, and Koné-Paut I
- Subjects
- Humans, Male, Female, Retrospective Studies, Child, Adult, Adolescent, Severity of Illness Index, Prognosis, Risk Assessment, Age Factors, Cohort Studies, Europe epidemiology, Young Adult, Middle Aged, Treatment Outcome, Takayasu Arteritis diagnosis, Takayasu Arteritis drug therapy, Takayasu Arteritis complications, Takayasu Arteritis epidemiology
- Abstract
Objectives: We aimed to compare clinical spectrum and outcome between adults and children with Takayasu's arteritis (TAK) in a European population., Methods: We made a nationwide retrospective observational study between 1988 and 2019. All adult patients met the ACR diagnostic criteria for TAK and all children met the EULAR/PRINTO/PRES criteria for paediatric TAK., Results: We identified 46 children and 389 adults with TAK. The male to female ratio was 34/46 (0.74) in the paediatric group compared to 241/274 (0.88) in the adult group (P<0.05). Children presented with significantly more systemic symptoms; i.e., fever (P<0.05), fatigue (P<0.001), weight loss (P<0.001), abdominal pain (P<0.05), and myalgia (P<0.05) while adults had more upper limb claudication (P<0.01). Topography of the lesions differed significantly between the two groups: adults had more damage at the cerebral vasculature (P<0.01), upper and lower limbs (P<0.001) while children had more kidney lesions (P<0.05). Children TAK had more frequent (P<0.01) and higher (P<0.001) biological inflammation than adults. Children received higher dose-weight of corticosteroids (P=0.001) and less biotherapy (P<0.010) at diagnosis. Relapses (P<0.05) and death (8.6% vs 4.9%) were more frequent in children TAK than in adults., Conclusion: Paediatric TAK seems more severe than adult TAK. Therefore, paediatrics patients may require closer monitoring and systemic use of biological treatment., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
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- 2024
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47. Hippocampal activations obtained during language fMRI tasks: A complementary tool for predicting postoperative memory prognosis.
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Salleles E, Samson S, Denos M, Mere M, Lehericy S, Herlin B, and Dupont S
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- Humans, Male, Female, Adult, Middle Aged, Retrospective Studies, Young Adult, Prognosis, Memory Disorders etiology, Memory Disorders diagnostic imaging, Memory physiology, Adolescent, Brain Mapping methods, Magnetic Resonance Imaging, Hippocampus diagnostic imaging, Hippocampus physiopathology, Epilepsy, Temporal Lobe surgery, Epilepsy, Temporal Lobe physiopathology, Epilepsy, Temporal Lobe diagnostic imaging, Neuropsychological Tests, Language
- Abstract
In medial temporal lobe epilepsy (MTLE), the benefits of surgery must be balanced against the risk of post-operative memory decline. Prediction of postoperative outcomes based on functional magnetic resonance imaging (fMRI) tasks is increasingly common but remains uncertain. The aim of this retrospective study was to determine whether hippocampal activations elicited by fMRI language tasks could enhance or refine memory fMRI in MTLE patients candidates to surgery. Forty-six patients were included: 30 right and 16 left MTLE, mostly with hippocampal sclerosis. Preoperative assessment included neuropsychological tests and fMRI with language (syntactic verbal fluency) and memory tasks (encoding, delayed, and immediate recognition of images of objects). Thirty patients underwent surgery and had neuropsychological evaluations one year after surgery. Worsening was defined as a degradation of more than 10 % in postoperative forgetting scores compared to preoperative scores in verbal, non-verbal and global memory. Memory fMRI had the best sensitivity with hippocampal activations obtained in 95 % of patients, versus 65 % with language fMRI. Considering the patients who elicited an hippocampal activation, language fMRI led to 80 %, 65 % and 85 % of correct predictions for respectively global, verbal and non verbal memory (versus 71 %, 64 % and 68 % with memory fMRI). Memory and language fMRI predictions outperformed those made by neuropsychological tests. In summary, language fMRI was less sensitive than memory fMRI to elicit hippocampal activations but when it did, the proportion of correct memory predictions was better. Moreover, it proved to be an independent predictive factor regardless of the side of the epileptic focus. Given the ease of setting up a language task in fMRI, we recommend the systematic combination of memory and language tasks to predict the post-operative memory outcome of MTLE patients undergoing epilepsy surgery., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to disclose. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2024 Elsevier B.V. All rights reserved.)
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- 2024
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48. Lacertus syndrome: recent advances.
- Author
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Apard T, Martinel V, Batby G, Draznieks G, and Descamps J
- Subjects
- Humans, Median Nerve physiopathology, Electromyography, Physical Examination, Nerve Compression Syndromes therapy, Nerve Compression Syndromes diagnosis, Nerve Compression Syndromes physiopathology, Nerve Compression Syndromes surgery
- Abstract
Lacertus syndrome consists in proximal median nerve entrapment with median nerve compression at the lacertus fibrosus, causing hand weakness and fatigue, forearm pain and occasional numbness. Recent advances emphasized the importance of clinical examination, due to limitations in electromyographic diagnosis and delayed diagnosis. The Hagert clinical triad, lacertus notch sign, lacertus antagonist test and taping help accurate diagnosis. Non-operative treatment should be tried; and surgical techniques, whether open or ultrasound-guided under WALANT (wide-awake, local anesthesia, no tourniquet) show promising outcomes. Improved awareness, accurate diagnosis and innovative treatments enhance patient care for this challenging condition., (Copyright © 2024 SFCM. Published by Elsevier Masson SAS. All rights reserved.)
- Published
- 2024
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49. Fluorescence guidance in skull base surgery: Applications and limitations - A systematic review.
- Author
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Suero Molina E, Bruneau M, Reuter G, Shahein M, Cavallo LM, Daniel RT, Kasper EM, Froelich S, Jouanneau E, Manet R, Messerer M, Mazzatenta D, Meling TR, Roche PH, Schroeder HW, Tatagiba M, Visocchi M, Prevedello DM, Stummer W, and Cornelius JF
- Abstract
Introduction: Intraoperative fluorescence guidance is a well-established surgical adjunct in high-grade glioma surgery. In contrast, the clinical use of such dyes and technology has been scarcely reported in skull base surgery., Research Question: We aimed to systematically review the clinical applications of different fluorophores in both open and endonasal skull base surgery., Material and Methods: We performed a systematic review and discussed the current literature on fluorescence guidance in skull base surgery., Results: After a comprehensive literature search, 77 articles on skull base fluorescence guidance were evaluated. A qualitative analysis of the articles is presented, discussing clinical indications and current controversies. The use of intrathecal fluorescein was the most frequently reported in the literature. Beyond that, 5-ALA and ICG were two other fluorescent dyes most extensively discussed, with some experimental fluorophore applications in skull base surgery., Discussion and Conclusion: Intraoperative fluorescence imaging can serve as an adjunct technology in skull base surgery. The scope of initial indications of these fluorophores has expanded beyond malignant glioma resection alone. We discuss current use and controversies and present an extensive overview of additional indications for fluorescence imaging in skull base pathologies. Further quantitative studies will be needed in the future, focusing on tissue selectivity and time-dependency of the different fluorophores currently commercially available, as well as the development of new compounds to expand applications and facilitate skull base surgeries., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Eric Suero Molina reports a relationship with Carl Zeiss Meditec AG that includes: funding grants. Walter Stummer has received speaker and consultant fees from Medac, Carl Zeiss Meditec AG, Leica Microsystems, Photonamic, and NXDC and funding grants from Carl Zeiss Meditec AG. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)
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- 2024
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50. The right heart in patients with cancer. A scientific statement of the Heart Failure Association (HFA) of the ESC and the ESC Council of Cardio-Oncology.
- Author
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Keramida K, Farmakis D, Rakisheva A, Tocchetti CG, Ameri P, Asteggiano R, Barac A, Bax J, Bayes-Genis A, Bergler Klein J, Bucciarelli-Ducci C, Celutkiene J, Coats AJS, Cohen Solal A, Dent S, Filippatos G, Ghosh A, Hermann J, Koop Y, Lenihan D, Lopez Fernandez T, Lyon AR, Mercurio V, Moura B, Piepoli M, Sener YZ, Suter T, Sverdlov AL, Tadic M, Thum T, van der Meer P, van Linthout S, Metra M, and Rosano G
- Published
- 2024
- Full Text
- View/download PDF
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