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3 results on '"Nathan, Malka"'

1. Advanced practice nurse intervention versus usual care for hypertension control: study protocol for an open-label randomized controlled trial

Author

Juliette Vay-Demouy, Alexandre Cinaud, Nathan Malka, Baptiste Mion, Sandrine Kretz, Hélène Lelong, and Jacques Blacher

Subjects
Advanced practice nurse, Hypertension, Control, Blood pressure, Protocol study, Medicine (General), R5-920
Abstract

Abstract Background Hypertension is the most frequent chronic pathology in France and in the world. It is one of the main modifiable cardiovascular risk factors. In France, 50% of treated hypertensives are uncontrolled and only 30% of treated patients are fully adherent to their antihypertensive treatment. Poor adherence to drug treatments is considered as one of the main causes of non-control of hypertension. Since 2018, a new profession has entered the French healthcare system: advanced practice nurses (APN). They have many broad-based skills, at the interface of nursing and medical exercises. The purpose of this study is to assess the impact of an APN intervention versus usual care on hypertension control. Methods The study will take place at the Hôtel-Dieu University Hospital, Paris, France, as prospective, open-label, controlled, randomized 1-to-1, monocentric, and superiority trial. The participants will be recruited during day hospitalization for cardiovascular assessment in the context of their hypertension management. Patients will be divided into two groups: a “usual care” group which will continue traditional follow-up (day hospitalization followed by consultation with a medical doctor (MD) within approximately 2–12 months) and an “intervention” group which will meet an APN between the day hospitalization and the MD consultation. Participants will be monitored until 12 months after the day hospitalization, depending on their last follow-up study appointment (MD consultation). The primary outcome is the rate of controlled BP (BP < 140/90 mmHg in office BP measurement) in each group. The hypothesis formulated is that an individual APN intervention, included in usual hypertension management, improves hypertension control. Discussion This innovative study will be the first in France where APNs are beginning to be established in the healthcare system. It will provide an objective look at this new profession and the impact it can have in the framework of global management of hypertension. Trial registration ClinicalTrials.gov NCT0448249. Registered on June 24, 2020.

Published
2023
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2. Extracardiac soft tissue uptake, evidenced on early 99mTc-HMDP SPECT/CT, helps typing cardiac amyloidosis and demonstrates high prognostic value

Author

Arnault Galat, Anissa Moktefi, Thibaud Damy, Benoît Funalot, Silvia Oghina, Pascale Fanen, Emmanuel Itti, Paul Blanc-Durand, Jean-François Deux, Soulef Guendouz, Valérie Molinier-Frenkel, Mukedaisi Abulizi, Nathan Malka, Vincent Audard, Diane Bodez, Mounira Kharoubi, Jean-Pascal Lefaucheur, and Fabien Le Bras

Subjects
medicine.medical_specialty, biology, medicine.diagnostic_test, business.industry, Amyloidosis, Soft tissue, General Medicine, medicine.disease, Scintigraphy, Gastroenterology, 030218 nuclear medicine & medical imaging, Clinical Practice, 03 medical and health sciences, Transthyretin, 0302 clinical medicine, Cardiac amyloidosis, 030220 oncology & carcinogenesis, Internal medicine, medicine, biology.protein, Radiology, Nuclear Medicine and imaging, Digestive tract, Typing, business
Abstract

Increased cardiac uptake (CU) on early-phase 99mTc-HMDP scintigraphy has demonstrated diagnostic and prognostic values in amyloid transthyretin (ATTR) cardiac amyloidosis (CA). Extracardiac uptake (ECU) has been poorly studied. We assessed the clinical value of ECU, in combination with CU, on 99mTc-HMDP scintigraphy using a novel Methodological Amyloidosis Diagnostic Index (MADI). We reviewed all patients referred for suspicion of CA, who underwent 99mTc-HMDP scintigraphy over an 8-year period. ECU, CU, and MADI were determined: MADI0 = neither ECU or CU, MADI1 = ECU alone, MADI2 = CU alone, and MADI3 = ECU + CU. Of 308 eligible patients, 247 had CA, including 75 ATTRv, 107 ATTRwt, and 65 light-chain (AL), while 61 had another cardiopathy (controls). ECU was observed in 29% of CA and 3% of controls. Most frequent sites of ECU were pleuropulmonary (16% of CA, 3% of controls) followed by the digestive tract and subcutaneous tissues. The liver and spleen ECU was only observed in AL-CA (n = 8). CU was only observed in CA patients (n = 187), of whom 182 had ATTR-CA vs. 5 AL-CA, P 0 vs. MADI0 in AL and MADI3 vs. MADI2 in ATTR were associated with a worse prognosis (P = 0.03 and P = 0.002, respectively). ECU combined with CU demonstrates high diagnostic and prognostic values in CA patients. MADI seems an easy and reliable score in clinical practice.

Published
2020
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3. Extracardiac soft tissue uptake, evidenced on early

Author

Nathan, Malka, Mukedaisi, Abulizi, Mounira, Kharoubi, Silvia, Oghina, Arnault, Galat, Fabien, Le Bras, Anissa, Moktefi, Soulef, Guendouz, Valérie, Molinier-Frenkel, Pascale, Fanen, Benoît, Funalot, Jean-Pascal, Lefaucheur, Paul, Blanc-Durand, Jean-François, Deux, Vincent, Audard, Diane, Bodez, Emmanuel, Itti, and Thibaud, Damy

Subjects
Single Photon Emission Computed Tomography Computed Tomography, Heart Diseases, Humans, Amyloidosis, Prognosis, Radionuclide Imaging
Abstract

Increased cardiac uptake (CU) on early-phaseWe reviewed all patients referred for suspicion of CA, who underwentOf 308 eligible patients, 247 had CA, including 75 ATTRv, 107 ATTRwt, and 65 light-chain (AL), while 61 had another cardiopathy (controls). ECU was observed in 29% of CA and 3% of controls. Most frequent sites of ECU were pleuropulmonary (16% of CA, 3% of controls) followed by the digestive tract and subcutaneous tissues. The liver and spleen ECU was only observed in AL-CA (n = 8). CU was only observed in CA patients (n = 187), of whom 182 had ATTR-CA vs. 5 AL-CA, P 0.001. MADI0 was only observed in controls (97%) and in AL-CA (60%). MADI1 was mainly observed in AL-CA (positive predictive value, PPV = 91%) while MADI2/3 were more frequent in ATTR-CA (PPV = 97%), P 0.0001. MADI 0 vs. MADI0 in AL and MADI3 vs. MADI2 in ATTR were associated with a worse prognosis (P = 0.03 and P = 0.002, respectively).ECU combined with CU demonstrates high diagnostic and prognostic values in CA patients. MADI seems an easy and reliable score in clinical practice.

Published
2020

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