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64 results on '"P. Vigeral"'

1. Zero-sum Stochastic Games: Limit Optimal Trajectories

Author

Sorin, Sylvain and Vigeral, Guillaume

Subjects
Mathematics - Optimization and Control
Abstract

We consider zero sum stochastic games. For every discount factor $\lambda$, a time normalization allows to represent the game as being played on the interval [0, 1]. We introduce the trajectories of cumulated expected payoff and of cumulated occupation measure up to time t $\in$ [0, 1], under $\epsilon$-optimal strategies. A limit optimal trajectory is defined as an accumulation point as the discount factor tends to 0. We study existence, uniqueness and characterization of these limit optimal trajectories for absorbing games.

Published
2018

2. Semi-algebraic sets and equilibria of binary games

Author

Vigeral, Guillaume and Viossat, Yannick

Subjects
Mathematics - Optimization and Control
Abstract

Any nonempty, compact, semi-algebraic set in [0, 1] n is the projection of the set of mixed equilibria of a finite game with 2 actions per player on its first n coordinates. A similar result follows for sets of equilibrium payoffs. The proofs are constructive and elementary.

Published
2016
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3. Operator approach to values of stochastic games with varying stage duration

Author

Sorin, Sylvain and Vigeral, Guillaume

Subjects
Mathematics - Optimization and Control
Abstract

We study the links between the values of stochastic games with varying stage duration $h$, the corresponding Shapley operators $\bf{T}$ and ${\bf{T}}\_h$and the solution of $\dot f\_t = ({\bf{T}} - Id )f\_t$. Considering general non expansive maps we establish two kinds of results, under both the discounted or the finite length framework, that apply to the class of "exact" stochastic games. First, for a fixed length or discount factor, the value converges as the stage duration go to 0. Second, the asymptotic behavior of the value as the length goes to infinity, or as the discount factor goes to 0, does not depend on the stage duration. In addition, these properties imply the existence of the value of the finite length or discounted continuous time game (associated to a continuous time jointly controlled Markov process), as the limit of the value of any time discretization with vanishing mesh., Comment: 22 pages, International Journal of Game Theory, Springer Verlag, 2016

Published
2015
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5. A Zero-Sum Stochastic Game with Compact Action Sets and no Asymptotic Value

Author

Vigeral, Guillaume

Subjects
Mathematics - Optimization and Control, Computer Science - Computer Science and Game Theory
Abstract

We give an example of a zero-sum stochastic game with four states, compact action sets for each player, and continuous payoff and transition functions, such that the discounted value does not converge as the discount factor tends to 0, and the value of the n-stage game does not converge as n goes to infinity.

Published
2013
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6. Definable zero-sum stochastic games

Author

Bolte, Jérôme, Gaubert, Stéphane, and Vigeral, Guillaume

Subjects
Mathematics - Optimization and Control
Abstract

Definable zero-sum stochastic games involve a finite number of states and action sets, reward and transition functions that are definable in an o-minimal structure. Prominent examples of such games are finite, semi-algebraic or globally subanalytic stochastic games. We prove that the Shapley operator of any definable stochastic game with separable transition and reward functions is definable in the same structure. Definability in the same structure does not hold systematically: we provide a counterexample of a stochastic game with semi-algebraic data yielding a non semi-algebraic but globally subanalytic Shapley operator. Our definability results on Shapley operators are used to prove that any separable definable game has a uniform value; in the case of polynomially bounded structures we also provide convergence rates. Using an approximation procedure, we actually establish that general zero-sum games with separable definable transition functions have a uniform value. These results highlight the key role played by the tame structure of transition functions. As particular cases of our main results, we obtain that stochastic games with polynomial transitions, definable games with finite actions on one side, definable games with perfect information or switching controls have a uniform value. Applications to nonlinear maps arising in risk sensitive control and Perron-Frobenius theory are also given

Published
2013
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7. Asymptotic Properties of Optimal Trajectories in Dynamic Programming

Author

Sorin, Sylvain, Venel, Xavier, and Vigeral, Guillaume

Subjects
Mathematics - Optimization and Control
Abstract

We prove in a dynamic programming framework that uniform convergence of the finite horizon values implies that asymptotically the average accumulated payoff is constant on optimal trajectories. We analyze and discuss several possible extensions to two-person games., Comment: 9 pages

Published
2010

8. A maximin characterization of the escape rate of nonexpansive mappings in metrically convex spaces

Author

Gaubert, Stephane and Vigeral, Guillaume

Subjects
Mathematics - Metric Geometry, Mathematics - Dynamical Systems, 47H09, 15A48
Abstract

We establish a maximin characterisation of the linear escape rate of the orbits of a non-expansive mapping on a complete (hemi-)metric space, under a mild form of Busemann's non-positive curvature condition (we require a distinguished family of geodesics with a common origin to satisfy a convexity inequality). This characterisation, which involves horofunctions, generalises the Collatz-Wielandt characterisation of the spectral radius of a non-negative matrix. It yields as corollaries a theorem of Kohlberg and Neyman (1981), concerning non-expansive maps in Banach spaces, a variant of a Denjoy-Wolff type theorem of Karlsson (2001), together with a refinement of a theorem of Gunawardena and Walsh (2003), concerning order-preserving positively homogeneous self-maps of symmetric cones. An application to zero-sum stochastic games is also given., Comment: 26 pages, 1 figure; v3: final version To appear in "Mathematical Proceedings of the Cambridge Philosophical Society"

Published
2010
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9. A uniform Tauberian theorem in optimal control

Author

Oliu-Barton, Miquel and Vigeral, Guillaume

Subjects
Mathematics - Optimization and Control
Abstract

In an optimal control framework, we consider the value $V_T(x)$ of the problem starting from state $x$ with finite horizon $T$, as well as the value $V_\lambda(x)$ of the $\lambda$-discounted problem starting from $x$. We prove that uniform convergence (on the set of states) of the values $V_T(\cdot)$ as $T$ tends to infinity is equivalent to uniform convergence of the values $V_\lambda(\cdot)$ as $\lambda$ tends to 0, and that the limits are identical. An example is also provided to show that the result does not hold for pointwise convergence. This work is an extension, using similar techniques, of a related result in a discrete-time framework \cite{LehSys}., Comment: 14 pages

Published
2010

10. Evolution equations in discrete and continuous time for nonexpansive operators in Banach spaces

Author

Vigeral, Guillaume

Subjects
Mathematics - Classical Analysis and ODEs, Mathematics - Optimization and Control, 47H09, 47J35, 34E10
Abstract

We consider some discrete and continuous dynamics in a Banach space involving a non expansive operator $J$ and a corresponding family of strictly contracting operators $\Phi(\lambda,x):=\lambda J(\frac{1-\lambda}{\lambda}x)$ for $\lambda\in]0,1]$. Our motivation comes from the study of two-player zero-sum repeated games, where the value of the $n$-stage game (resp. the value of the $\lambda$-discounted game) satisfies the relation $v_n=\Phi(\frac{1}{n},v_{n-1})$ (resp. $v_\lambda=\Phi(\lambda,v_\lambda)$) where $J$ is the Shapley operator of the game. We study the evolution equation $u'(t)=J(u(t))-u(t)$ as well as associated Eulerian schemes, establishing a new exponential formula and a Kobayashi-like inequality for such trajectories. We prove that the solution of the non-autonomous evolution equation $u'(t)=\Phi(\bm{\lambda}(t),u(t))-u(t)$ has the same asymptotic behavior (even when it diverges) as the sequence $v_n$ (resp. as the family $v_\lambda$) when $\bm{\lambda}(t)=1/t$ (resp. when $\bm{\lambda}(t)$ converges slowly enough to 0)., Comment: 28 pages To appear in ESAIM:COCV

Published
2009
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11. Magnetic Resonance Imaging Findings in 13 Neurologic Pot-Bellied Pigs

Author

Aude Castel, Vincent Doré, Mariana Vigeral, and Silke Hecht

Subjects
MRI, porcine, swine, neurology, brain, spine, Veterinary medicine, SF600-1100
Abstract

This study reports the magnetic resonance imaging (MRI) findings in 13 pot-bellied pigs presented to our institution with neurological deficits. Nine pigs had abnormal MRI findings (7 with spinal cord localization and 2 with brain localization), with three of them having histopathological confirmation of the diagnoses. MRI diagnoses included a myopathy suspected to be secondary to Erysipelothrix rhusiopathiae, a round cell neoplasia involving the vertebral canal, myelomalacia, a cervical cyst like extradural lesion, pelvic fracture with secondary cauda equina involvement, two cases of fibrocartilaginous embolism or acute non-compressive nucleus pulposus extrusion, multifocal brain infarcts, and a cystic fourth ventricle dilation resulting in obstructive hydrocephalus and syringomyelia. Four pigs had normal MRI studies, with one of them ultimately diagnosed with idiopathic vestibular disease. This retrospective study illustrates the wide variety of diagnoses achieved with MRI of the head or vertebral column in pigs, several of them having never been described in this species. Some of the conditions identified had a good outcome. This justifies using MRI as an ante-mortem diagnostic tool as it can provide relevant information about the prognosis which can significantly influence treatment recommendations. Our findings suggest that MRI should be considered as a valuable imaging modality, when feasible, in pigs with neurological deficits.

Published
2020
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12. Limit Optimal Trajectories in Zero-Sum Stochastic Games

Author

Sorin, Sylvain and Vigeral, Guillaume

Abstract

We consider zero-sum stochastic games. For every discount factor λ, a time normalization allows to represent the discounted game as being played during the interval [0, 1]. We introduce the trajectories of cumulated expected payoff and of cumulated occupation measure on the state space up to time t∈[0,1], under ε-optimal strategies. A limit optimal trajectory is defined as an accumulation point as (λ,ε)tend to 0. We study existence, uniqueness and characterization of these limit optimal trajectories for compact absorbing games.

Published
2024
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15. Adéquation en dialyse péritonéale : mise au point

Author

Belkacem Issad, Pierre-Yves Durand, Pascale Siohan, Éric Goffin, Joëlle Cridlig, Guillaume Jean, Jean-Philippe Ryckelynck, W. Arkouche, J.-P. Bourdenx, J. Cridlig, B. Dallaporta, H. Fessy, M. Fischbach, P. Giaime, E. Goffin, B. Issad, G. Jean, D. Joly, L. Mercadal, J.-M. Poux, J.-P. Ryckelynck, P. Siohan, M. Souid, D. Toledano, C. Verger, P. Vigeral, and M. Uzan

Subjects
Nephrology, medicine.medical_specialty, business.industry, Peritoneal membrane, medicine.medical_treatment, Renal function, Improved survival, Surgery, Peritoneal dialysis, Internal medicine, Medicine, Mineral metabolism, Dialisis peritoneal, business, Intensive care medicine, Cardiovascular mortality
Abstract

The optimal method to assess the adequacy of peritoneal dialysis therapies is controversial. Today, the adequacy must not be considered as a number or a concept assessed only by two parameters (total KT/V urea and total solute clearance) but defined by many more items. In the absence of data, based on theoretical considerations, the reanalysis of the CANUSA study showed that renal kidney function, rather than peritoneal clearance, was associated with improved survival. Residual renal function is considered as a major predictor factor of cardiovascular mortality. Results of this reanalysis were supported by the adequacy data in ADEMEX, EAPOS and ANZDATA studies. Therefore, clinical assessment plays a major role in PD adequacy. The management of fluid balance, the regular monitoring of malnutrition, the control of mineral metabolism and particularly the glucose load, considered as the "corner-stone" of the system, are the main points to be considered in the adequacy of PD patients. The essential goal is to minimize glucose load by glucose-sparing strategies in order to reduce the neoangiogenesis of the peritoneal membrane.

Published
2013

16. Vascular access

Author

L. Coentrao, C. Ribeiro, C. Santos-Araujo, R. Neto, M. Pestana, E. Rahman, H. Rahman, D. Ahmed, D. Mousa, M. El Bishlawi, H. Shibahara, N. Shibahara, S. Takahashi, E. Dupuis, X. Duval, Q. Dornic, C. Bonnal, J.-C. Lucet, O. Cerceau, C. Randoux, C. Balde, F. Besson, F. Mentre, F. Vrtovsnik, G. Koutroubas, P. Malindretos, G. Zagotsis, P. Makri, C. Syrganis, E. Mambelli, E. Mancini, C. Elia, V. Guadagno, M. G. Facchini, A. Zucchelli, M. Grazia, L. Patregnani, A. Santoro, G. Stefan, S. Stancu, C. Capusa, O. R. Ailioaiei, G. Mircescu, S. Anwar, C. Little, R. Kingston, P. Diwakar, R. Kaikini, E. Nikolaou, G. Loukas, A. Sabry, K. Alsaran, S. Al Sherbeiny, M. Abdulkader, I. Kwak, S. Song, E. Seong, S. Lee, D. Lee, I. Kim, H. Rhee, F. Silva, J. Queiros, J. Malheiro, A. Cabrita, A. Rocha, P. Bamidis, C. Liaskos, I. Chryssogonidis, C. Frantzidis, A. Papagiannis, D. Vrochides, A. Lasaridis, P. Nikolaidis, S. Kotwal, C. Muir, C. Hawley, P. Snelling, M. Gallagher, M. Jardine, K. Shibata, Y. Toya, S. Umemura, T. Iwamoto, S. Ono, E. Ikeda, A. Kitazawa, T. Kuji, N. Koguchi, H. Satta, M. Nishihara, S. Kawata, T. Kaneda, Y. Yamada, T. Murakami, M. Yanagi, G. Yasuda, S. Mathieu, D. Yves, T. Jean-Michel, Q. Nicolas, C. Jean-Francois, M. Ibrahim, M. Abdel Salam, A. Awadalla, W. Bichari, S. Zaki, R. Roca-Tey, R. Samon, O. Ibrik, A. Roda, J. C. Gonzalez-Oliva, R. Martinez-Cercos, J. Viladoms, C.-C. Lin, W.-C. Yang, Y.-O. Kim, S.-A. Yoon, Y.-S. Yun, H.-C. Song, B.-S. Kim, M.-A. Cheong, T. Ogawa, T. Kiba, S. Okazaki, M. Hatano, M. Iwanaga, C. Noiri, A. Matsuda, H. Hasegawa, T. Mitarai, A. DI Napoli, D. DI Lallo, L. Tazza, C. De Cicco, M. F. Salvatori, S. Chicca, G. Guasticchi, S. Gelev, L. Trajceska, E. Srbinovska, S. Pavleska, A. Oncevski, P. Dejanov, V. Gerasomovska, G. Selim, A. Sikole, S. Wilson, T. Mayne, M. Krishnan, J. Holland, A. Volz, L. Good, A. Nissenson, A. Stavroulopoulos, V. Aresti, G. Maragkakis, S. Kyriakides, C. Rikker, E. Juhasz, L. Tornoci, S. Tovarosi, J. Greguschik, O. Mag, L. Rosivall, T. Golebiowski, E. Watorek, M. Kusztal, K. Letachowicz, W. Letachowicz, K. Madziarska, H. Augustyniak Bartosik, M. Krajewska, W. Weyde, M. Klinger, A. Capitanini, S. Lange, A. Cupisti, T. Schier, G. Gobel, C. Bosmuller, I. Gruber, M. Tiefenthaler, T. Shipley, J. Adam, D. Sweeney, S. Fenwick, H. Mansy, S. Ahmed, I. Moore, P. Vigeral, S. Saksi, M. Flamant, H. Boulanger, W.-D. Park, M. A. Cheong, M. Nikam, A. Tavakoli, E. Chemla, J. Evans, H. Malete, L. Matyas, I. Mogan, M. Lazarides, A. Ebner, Y. Shi, J. Zhang, J. Cheng, L. R. Frank, H. Melanie, B. Dominique, G. Michel, K. Ikeda, T. Yasuda, H. Yotueda, L. Ebah, A. Jayanti, D. Kanigicherla, A. Summers, G. Manley, G. Dutton, N. Chalmers, S. Mitra, I.-A. Checherita, A. Niculae, D. Radulescu, C. David, F. L. Turcu, A. Ciocalteu, V. Persic, J. Buturovic-Ponikvar, R. Ponikvar, M. Touam, V. Menoyo, T. Drueke, M. Rifaat, C. Muresan, M. Abtahi, Z. Koochakipour, D. Joly, J. Baharani, S. Rizvi, K. P. Ng, L. Buzzi, C. Sarcina, E. Alberghini, F. Ferrario, I. Baragetti, G. Santagostino, S. Furiani, E. Corghi, V. Terraneo, F. Rastelli, G. Bacchini, C. Pozzi, M. Adorati Menegato, R. Mortellaro, A. Locicero, A. Romano, P. P. Manzini, D. Steckiph, S. Shintaku, H. Kawanishi, M. Moriishi, M. Bansyodani, S. Nakamura, M. Saito, S. Tsuchiya, F. Barros, R. Vaz, B. Carvalho, P. Martins, E. Likaj, S. Seferi, M. Rroji, A. Idrizi, A. Duraku, M. Barbullushi, and N. Thereska

Subjects
Transplantation, Nephrology
Published
2013

17. Low incidence of SARS-CoV-2, risk factors of mortality and the course of illness in the French national cohort of dialysis patients

Author

Couchoud, Cécile, Bayer, Florian, Ayav, Carole, Béchade, Clémence, Brunet, Philippe, Chantrel, François, Frimat, Luc, Galland, Roula, Hourmant, Maryvonne, Laurain, Emmanuelle, Lobbedez, Thierry, Mercadal, Lucile, Moranne, Olivier, Abbassi, Abdelhamid, Debure, Alain, Guerraoui, Abdallah, Benmoussa, Abdelatif, Hamani, Abdelaziz, Ziane, Abdelaziz, Nefti, Abdelhamid, Hadj, Abdelkader, El Amari, Abderrahim, Ghazali, Abderrahmane, Abd El Fatah Mohamed, Abo Bakr, Laradi, Achour, Ben Ahmed, Adel, Sahar, Adel, Pillet, Adele, Lacraz, Adeline, Moinat, Adnan, Massoumi, Afshin, Pardon, Agathe, Beaudoin, Agnes Caillette, Debout, Agnes Chapelet, Mariot, Agnes, Rachi, Ahmed, Afiani, Aida, Boula, Aime Remy, Jalaby, Al, Cremault, Alain, Fournier, Alain, Jeanson, Alain, Lyon, Alain, Nony, Alain, Robert, Alain, Slingeneyer, Alain, Labatide, Alanor Agnes, Sartorius, Albane Brodin, Bensman, Albert, Fournier, Albert, Ranlin, Alex, Sandor, Alex Vido, Colombo, Alexandra, Duhem, Alexandra, Stancu, Alexandra, Dufay, Alexandre, Dumoulin, Alexandre, Ebel, Alexandre, Klein, Alexandre, Martin, Alexandre, Mouneimne, Alexandre, Seidowsky, Alexandre, De Martin, Alfio, Zannier, Alfredo, Aizel, Ali, Hafi, Ali, Diddaoui, Ali Zineddine, Heyani, Alim, Mocanu, Alina, Preda, Alina, Hafi, Aline, Talaszka, Aline, Duquesne, Alyette, Amaouche, Amar, Ghemmour, Amel, Simon, Amelie, Skalli, Amina, Boukadida, Amine, Ragab Eid, Amr Ekhlas, Fedorca, Ana, Baillet, Anabelle, Poyet, Anais, Giorgita, Ancuta Bouffandeau, Ratsimbazafy, Anderson, Pruna, Andre, Argiles, Angel, Testa, Angelo, Vandooren, Ann Karolien, Jolivot, Anne, Labadens, Anne Kolko, Lataste, Anne, Maisin, Anne, Paris, Anne, Sechet, Anne, Wuillai, Anne, Heng, Anne Elisabeth, Josse, Anne Gaelle, Querard, Anne Helene, Reboux, Anne Helene, Adra, Anne Laure, Faller, Anne Laure, Leclerc, Anne Laure, Poitou, Anne Laure, Manucci, Annie Lahoche, Jacquet, Antoine, Pommereau, Antoine, Thierry, Antoine, Adem, Arezki, Chapelet, Arielle, Del Bello, Arnaud, Delezire, Arnaud, Garnier, Arnaud, Guerard, Arnaud, Klisnick, Arnaud, Lionet, Arnaud, Roccabianca, Arnaud, Stolz, Arnaud, Capdeville, Arthur, Allal, Asma, Alrifai, Assem, Diarrassouba, Assetou, Djema, Assia, Carre, Assia Ferhat, Dubrasquet, Astrid Godron, Elmrabet, Atman Haddj, Jegado, Audrey, Thomas, Aurelia Bertholet, Salandre, Aurelie Davourie, Pajot, Aurelie, Lorthioir, Aurelien, Tiple, Aurelien, Sury, Aurore, Abokasem, Ayman, Sarraj, Ayman, Henaoui, Bachir, Chaghouri, Baher, Wehbe, Bassem, Ball, Beatrice, Viron, Beatrice, Issad, Belkassem, Corne, Benedicte Hodemon, Janbon, Benedicte, Deroure, Benjamin, Savenkoff, Benjamin, Jonon, Benoit, Vendrely, Benoit, Djelaleddine, Benyakoub, Ohry, Bernard, Painchart, Bernard, Strullu, Bernard, Temperville, Bernard, Ebikili, Bertin, Hacq, Bertrand, Morel, Bertrand, Aoun, Bilal, Muniz, Blanca, Chlih, Bouchra, Amara, Brahim, Mayor, Brice, Gilson, Brigitte, Llanas, Brigitte, Zins, Brigitte, Bourgeon, Bruno, Coevoet, Bruno, Guery, Bruno, Legallicier, Bruno, Paris, Bruno, Ranchin, Bruno, Seigneuric, Bruno, Dita, Camelia Ghiciuc, Prelipcean, Camelia, Hottelart, Carine Achard, Diet, Carine, Frangie, Carlos, Vela, Carlos, Muresan, Carmina, Deprele, Carole, Araujo, Caroline, Bidault, Caroline, Creput, Caroline, Delclaux, Caroline, Du Halgouet, Caroline, Favennec, Caroline, Freguin, Caroline, Vercel, Caroline Gourraud, Mesguen, Caroline, Obama, Caroline Ndomo, Poitou, Caroline, Dirhold, Caroline Preissig, Roubiou, Caroline, Albert, Catherine, Bessin, Catherine, De Marion Gaja, Catherine, Godart, Catherine, Lasseur, Catherine, Leocardi, Catherine, Lumbroso, Catherine, Melander, Catherine, Michel, Catherine, Maurouard, Catherine Quere, Rouannet, Catherine, Taddei, Catherine, Verove, Cathy, Guiraud, Cecile, Tafelin, Cecile, Baron, Cecile Turc, Formet, Cedric, Pinier, Cedric, De Ste Foy, Celia Lessore, Granolleras, Celine, Bennini, Chaouki, Cartou, Charles, Chazot, Charles, Jouzel, Charlotte, Badid, Cherif, Roubicek, Christa, Viaud, Christel, Verrier, Christelle, Chuet, Christian, Combe, Christian, Dabot, Christian, Duvic, Christian, Emond, Christian, Lagarde, Christian, Lamotte, Christian, Pain, Christian, Mousson, Christiane, Lorriaux, Christie, Beauchamp, Christine, Fumeron, Christine, Le Gurun, Christine, Leroy, Christine, Pietrement, Christine, Richer, Christine, Bouaka, Christophe, Charasse, Christophe, Goupy, Christophe, Ridel, Christophe, Castrale, Cindy, Detourne, Cindy, Francois, Clair, Presne, Claire, Trivin, Claire, Von Kotze, Clarissa, Bernard, Claude, Bonniol, Claude, Desvergnes, Claude, Raharivelina, Claude, Nistor, Claudia, Gueret, Claudine, Lloret, Claudine, Saltiel, Claudine, Rosati, Clelia, Rabate, Clementine, Stanescu, Corina, Ferrandini, Corinne, Guibergia, Corinne, Lemoine, Corinne, Passeron, Corinne, Kahil, Cynthia, Garrouste, Cyril, Van, Cyril Vo, Jolimoy, Cyrille, Kesraoui, Dalila, Jolly, Damien, Thibaudin, Damien, Teboulle, Dan, Daubresse, Daniel, Louvet, Daniel, Rasamimanantsoa, Daniel, Toledano, Daniel, Babici, Daniela, David, Daniela, Dincu, Daniela, Bruno, Danielle, May, Delia, Haussaire, Delphine, Viprey, Delphine Henriet, Bugnon, Denis, Fouque, Denis, Morin, Denis, Nour, Derradji, Mahmoud, Diab Mohamed, Cristescu, Diana Istrati, Aguilera, Didier, Coste, Didier, Hamel, Didier, Le Chapois, Didier, Testou, Didier, Erbilgin, Dilaver, Dahmane, Djamal, Quang, Doan Bui, Bertrand, Dominique, Besnier, Dominique, Blanchier, Dominique, Briffa, Dominique, Caux, Dominique, Durand, Dominique, Fleury, Dominique, Guerrot, Dominique, Hestin, Dominique, Jaubert, Dominique, Joly, Dominique, Lombart, Dominique, Pagniez, Dominique, Pierre, Dominique, Schohn, Dominique, Ikonga, Donatien, Visanica, Dorina, Bazin, Dorothee, Boury, Edouard, Maksour, Edouard, Agbonon, Ekoue, Harrami, Elarbi, Marcu, Elena, Tudorache, Elena, Caniot, Elisabeth, Semjen, Elisabeth, Tomkiewicz, Elisabeth, Scheidt, Elise, Gaboriau, Elke, Lamouroux, Elodie, Guiard, Elsa, Passos, Elsa Martin, Nsembani, Emerson, Fache, Emilie, Kalbacher, Emilie, Pambrun, Emilie, Pincon, Emilie, Launay, Emma Allain, Baron, Emmanuel, Dupuis, Emmanuel, Villar, Emmanuel, Charlin, Emmanuelle, Hecquet, Emmanuelle, Kohler, Emmanuelle, Laurain, Emmanuelle, Rosier, Emmanuelle, Figueroa, Enrique, Azoulay, Eric, Canivet, Eric, Daugas, Eric, Gauthier, Eric, Laruelle, Eric, Le Guen, Eric, Legrand, Eric, Moumas, Eric, Postec, Eric, Prinz, Eric, Renaudineau, Eric, Desport, Estelle, Sutra, Estelle Ricard, Berard, Etienne, Ged, Etienne, Robin, Etienne, Vilaine, Eve, Bargas, Evelyne, Namara, Evelyne Mac, Combarnous, François, Yazbeck, Fatima, Gerard, Fabien, Metivier, Fabien, Parazols, Fabien, Soulis, Fabien, Garnier, Fabrice, Messaoudene, Fadhila Pech, Haidar, Fadi, Boullenger, Fanny, Lepeytre, Fanny, Leroy, Fanny, Frejate, Fares, Bellahsene, Farid, Bellhasene, Farid, Saidani, Farid, Toure, Fatouma, Kriaa, Faycal, Nemmar, Fazia, Vetromile, Fernando, Chalmin, Florence, Lucats, Florence, Sens, Florence, Villemain, Florence, Plasse, Florent, Lebhour, Fouad, Schillinger, Francis, Berge, Franck, Bourdon, Franck, Bridoux, Franck, Reynaud, Franck, Babinet, Francois, Basse, Francois, Chantrel, Francois, Clair, Francois, Coulomb, Francois, De Cornelissen, Francois, Glowacki, Francois, Marchal, Francois, Maurice, Francois, Nobili, Francois, Pourreau, Francois, Provot, Francois, Amani, Francois Roux, Broux, Francoise, Bulte, Francoise, Heibel, Francoise, Leonetti, Francoise, Schott, Francoise Moussion, Le Roy, Frank, Besson, Frederic, Lavainne, Frederic, Tollis, Frederic, Bocquentin, Frederique, Meeus, Frederique, Vecina, Frederique, Von Ey, Friederike, Balit, Gabriel, Choukroun, Gabriel, Gruget, Gabriel, Huchard, Gabriel, Golea, Gabriella, Duneau, Gabrielle, Lefrancois, Gaelle, Pelle, Gaelle, Lebrun, Gaetan, Dumont, Genevieve, Brillet, Georges, Deschenes, Georges, Mourad, Georges, Stamatakis, Georges, Cazajous, Geraldine, D'ythurbide, Geraldine, Wiart, Geraldine Robitaille, Cardon, Gerard, Champion, Gerard, Deschodt, Gerard, Mangenot, Gerard, Motte, Gerard, Schortgen, Gerard, Boulahia, Ghada, Maakaroun, Ghassan, Michel, Ghylene Bourdat, Zanetta, Gilbert, Hufnagel, Gilles, Messier, Gilles, Piccoli, Giorgina, Desvergnes, Gregoire Couvrat, Bobrie, Guillaume, Bonnard, Guillaume, Clement, Guillaume, Jean, Guillaume, Queffeulou, Guillaume, Seret, Guillaume, Vernin, Guillaume, Delavaud, Guy, Lambrey, Guy, Rostoker, Guy, Poussard, Gwenaelle, Kesler, Gwenaelle Roussey, Leon, H., Aboubekr, Habib, Boulechfar, Hacene, Sekhri, Hacene, Hebibi, Hadia, Benalia, Hadjira, Fessi, Hafed, Atchia, Hafsabhai, Bittar, Haiat, Maiza, Hakim, Mazouz, Hakim, El Ali, Hamid, Bougrida, Hammouche, Van Der Pijl, Hans, Lokmane, Hassan, Izzedine, Hassane, Adda, Hassen, De Preneuf, Helene, Leray, Helene, Philippot, Helene, Boulanger, Henri, Merault, Henri, Renaud, Henri, Bonarek, Herve, Maheut, Herve, Nzeyimana, Hilaire, Mehama, Hocine, Zaidi, Hocine, Weclawiak, Hugo, Flodrops, Hugues, Karaaslan, Huseyin, Haskour, Ibrahim, Belhadj, Ihssen, Almoubarak, Imad, Haddad, Imad, Castellano, Ines, Ferrandiz, Ines, Daniliuc, Ioana, Darie, Ioana, Enache, Ioana, Prunescu, Ionut, Djiconkpode, Irenee, Shahapuni, Irina, Bouchoule, Isabelle, Devriendt, Isabelle, Kazes, Isabelle, Kolb, Isabelle, Landru, Isabelle, Poli, Isabelle, Rey, Isabelle, Segalen, Isabelle, Selcer, Isabelle, Vernier, Isabelle, Vrillon, Isabelle, Guenifi, Ismahane, Gheerbrandt, J. Dominique, Potier, Jacky, Becart, Jacques, Cledes, Jacques, Ducros, Jacques, Duvic, Jacques, Fourcade, Jacques, Gaultier, Jacques, Jurine, Jacques, Lebleu, Jacques, Ollier, Jacques, Charles, Jacques Ibsen, Yazji, Jamal, Mansour, Janette, Arnautou, Jean, Brocard, Jean, Carolfi, Jean, Montoriol, Jean, Gouin, Jean Baptiste, Palcoux, Jean Bernard, Bendini, Jean Christophe, Aldigier, Jean Claude, Alphonse, Jean Claude, Delbet, Jean Daniel, Bonne, Jean Francois, Cantin, Jean Francois, De Fremont, Jean Francois, Dessassis, Jean Francois, Subra, Jean Francois, Valentin, Jean Francois, Verdier, Jean Francois, Dion, Jean Jacques, Haultier, Jean Jacques, Montseny, Jean Jacques, Bacri, Jean Louis, Bouchet, Jean Louis, Mahe, Jean Luc, Chalopin, Jean Marc, Gabriel, Jean Marc, Hurot, Jean Marc, Lanau, Jean Marc, Batho, Jean Marie, Coulibaly, Jean Marie, Hardin, Jean Michel, Marc, Jean Michel, Poux, Jean Michel, Rebibou, Jean Michel, Tivollier, Jean Michel, Ottavioli, Jean Noel, Faucon, Jean Paul, Imiela, Jean Paul, Jaulin, Jean Paul, Masselot, Jean Paul, Ortiz, Jean Paul, Bourdenx, Jean Philippe, Devaux, Jean Philippe, Hammelin, Jean Philippe, Rivory, Jean Pierre, Wauquier, Jean Pierre, Larue, Jean Rene, Mondain, Jean Rene, Borde, Jean Sebastien, Virot, Jean Simon, Bosc, Jean Yves, Achiche, Jedjiga, Parasote, Jennifer, Diolez, Jeremie, Harambat, Jerome, Potier, Jerome, Sampol, Jerome, Mustel, Jihad, Lefevre, Jean Jacques, Maurizi, Jocelyne, Gamberoni, Joel, Claudeon, Joelle, Terzic, Joelle, Rogol, Joffrey, Sayegh, Johnny, Cardozo, Jorge, Brasseur, Jose, Guiserix, Jose, Barsumau, Joseph, Albaret, Julie, Beaume, Julie, Attias, Julie Sohier, Dehay, Julien, Hogan, Julien, Journet, Julien, Ott, Julien, Baleynaud, Juliette, Bacchetta, Justine, Faucher, Justine, Yousfi, Kamel, Dardim, Karim, Clabault, Karine, Moreau, Karine, Thomas, Kedna, Sirajedine, Khaled, Chedid, Khalil, El Kaeoui, Khalil, El Karoui, Khalil, Bouachi, Khedidja, Hue, Kheira, El Nasser, Khuzama, Akposso, Kodso, Kunz, Kristian, Bijak, Krzysztof, Kihal, Lilia, Rasoloarijaona, L., Harbouche, Laid, Bencheikh, Larbi, Lamriben, Larbie, Hanafi, Latifa, Parvez, Laura Braun, Champion, Laure, Croze, Laure, Eprinchard, Laure, Patrier, Laure, Nicolet, Laurence, Vrigneaud, Laurence, Duflot, Laurent, Mackaya, Leandre, Chenine, Leila, Odry, Leon, Tamiji, Lili Taghipour, Bouzar, Lilia Antri, Nga Messi, Liliane Ngango, Le Mouellic, Lionel, Mandart, Lise, Weis, Lise, Pouteau, Lise Marie, Georgieva, Lora, Vitanova, Lorita, Chalabi, Lotfi, Delvallez, Luc, Frimat, Luc, Fromentin, Luc, Marty, Luc, Monjot, Luc, Spataru, Luciana, Bessenay, Lucie, Boissinot, Lucie, Wajsbrot, Lucie, Rakoff, Lucien, Lebourg, Ludivine, Perez, Lydie, Lafage, Lyliane, Azzouz, Lynda, Dumoulin, Madeleine, Ouziala, Messaoud, Joseph, Maan, Brahimi, Mabrouk, Fat, Maeva Wong, Fort, Magalie, Nakhla, Magued, Abtahi, Mahdi, Albadawy, Mahen, Alouach, Mahmoud, Mezghani, Mahmoud, Daroux, Maite, Boukelmoune, Maklouf, Dhib, Malek, Touam, Malik, Dubau, Malina, Balde, Mamadou, Khoa, Man Nguyen, Ismer, Manfred, Mehdi, Manolie, Laforet, Manon, Bouiller, Marc, Eugene, Marc, Fila, Marc, Hazzan, Marc, Kribs, Marc, Ladriere, Marc, Lebot, Marc, Padilla, Marc, Souid, Marc, Marraoui, Marcel, Burbach, Maren, Manescu, Maria, Noguera Gonzalez, Maria Eugenia, Revenco, Mariana, Terrasse, Marianne, Essi, Marie, Macher, Marie Alice, Nogier, Marie Beatrice, Cazin, Marie Cecile, Schweitzer Camoin, Marie Christine, Thouret, Marie Christine, Hannaert, Marie Claude, Servel, Marie France, Chabannier, Marie Helene, Coudert Krier, Marie Jeanne, Catoliquot, Marie Noelle, Guillodo, Marie Paule, Gavard, Marie Sophie, Vairon Codaccioni, Marie Xaviere, Rabec, Marina, Freist, Marine, Gauthier, Marion, Lemaire, Marion, Mehrenberger, Marion, Venot, Marion, Pongas, Marios, Diant, Marlene Beaubrun, Levannier, Martial, Bertaux, Martine, Jablonski, Mathieu, Sacquepee, Mathieu, Dargelos, Mathilde, Lemoine, Mathilde, Tamain, Mathilde, Monge, Matthieu, Reberolle, Matthieu, Cousin, Maud, Francois, Maud, Baron, Maurice, Hoffmann, Maxime, Ingwiller, Maxime, Touzot, Maxime, Mohajer, Mederick, Maaz, Mehadji, Hanoy, Melanie, Marroc, Melanie, Cuny, Melodie, Van Der Straaten, Menno, Serveaux, Mf., Basteri, Michel, Chong, Michel Fen, Hecht, Michel, Massad, Michel, Normand, Michel, Olmer, Michel, Tolani, Michel, Tsimaratos, Michel, Hemery, Michele, Kessler, Michele, Esposito, Miguel, Shenouda, Milad, Kareche, Mimi, Khalili, Mina, Diaconita, Mirella, Rifard, Mohamad Khair, Aladib, Mohamed, Belmouaz, Mohamed, Brahim, Mohamed, Diouani, Mohamed, Cherif, Mohamed Fodil, Jamali, Mohamed, Maghlaoua, Mohamed, Meddeb, Mohamed, Ramdane, Mohamed, Rifaat, Mohamed, Islam, Mohamed Sharifull, Abbade, Mohamed Adnan, Amrandi, Mokhtar, Chawki, Mokhtar, Ciobotaru, Monica, Indrieis, Monica, Chanas, Monique, Hoarau, Monique, Tomeh, Monzer, Bellou, Moufida, Bouzernidj, Mouloud, Ammor, Mounia, Guergour, Mounir, Benzakour, Mountassir, Hachicha, Mourad, Coulibaly, Moussa, Smati, Mustafa, Al Morabiti, Mustapha, Amirou, Mustapha, Isnard, Myriam, Pastural, Myriam, Pujo, Myriam, Boumendjel, Nourredine, Majbri, Nabil, Goumri, Nabila, Mingat, Nadege, Bassilios, Nader, Kerkeni, Nadia, Sedrati, Nadia, Soltani, Nadia, Maroun, Nadine, Neyrat, Nadine, Luang, Nahn, El Esper, Najeh, Ammar, Naji, Ghali, Nasredine, Hamdini, Nasser, Noel, Natacha, Potelune, Natacha, Maisonneuve, Nathalie, Pertuiset, Nathalie, Raynal, Nathalie, Vittoz, Nathalie, Terki, Nazim, Castin, Nelly, Nankeu, Nestor, Bouvier, Nicolas, Keller, Nicolas, Legros, Nicolas, Peters, Nicolas, Quirin, Nicolas, Lefrancois, Nicole, Monnier, Nicole, Rance, Nicole, Bruckmann, Niels, Mertens, Noel, Lorcy, Nolwenn, Gilbert, Olivia, Coldefy, Olivier, Drouineau, Olivier, Dunand, Olivier, Fritz, Olivier, Imhoff, Olivier, Kourilsky, Olivier, Lavelle, Olivier, Moranne, Olivier, Papin, Olivier, Roques, Olivier, Le Maner, Ophelie, Benbrahim, Oussamah Fikri, Erina Torres, Pablo Antonio, Urena Torres, Pablo Antonio, Malvezzi, Paolo, Bindi, Pascal, Cluzel, Pascal, Fontanier, Pascal, Wheatley, Pascal, Depraetre, Pascale, Dubosq, Pascale, Halin, Pascale, Sebahoun, Pascale, Siohan, Pascale, Testevuide, Pascale, Deteix, Patrice, Nolen, Patrice, Hue, Patricia, Lemarchand, Patricia, Donnadieu, Patrick, Fievet, Patrick, Fohrer, Patrick, Francais, Patrick, Giraud, Patrick, Hallonet, Patrick, Henri, Patrick, Michaut, Patrick, Michaut, Patrick, Niaudet, Patrick, Pauly, Patrick, Thomas, Patrick, Deleaval, Patrik, Finielz, Paul, Stroumza, Paul, Yverneau, Paule Hardy, Caillard, Pauline, Palacin, Pedro, Aubertin, Perrine, Attias, Philippe, Brunet, Philippe, Chauveau, Philippe, Coindre, Philippe, Coste, Philippe, Dubot, Philippe, Fournier, Philippe, Hiernaux, Philippe, Jousset, Philippe, Yue Wah, Philippe Lan, Lang, Philippe, Le Cacheux, Philippe, Dupont, Philippe Martin, Michel, Philippe, Mirgaine, Philippe, Moriniere, Philippe, Nicoud, Philippe, Rieu, Philippe, Rousseau, Philippe, Sporer, Philippe, Thorel, Philippe, Vanhille, Philippe, Vigeral, Philippe, Zaoui, Philippe, Bataille, Pierre, Brignon, Pierre, Filipozzi, Pierre, Housset, Pierre, Peyronnet, Pierre, Ramperez, Pierre, Vautrin, Pierre, Michel, Pierre Alexandre, Westeel, Pierre Francois, Carron, Pierre Louis, Durand, Pierre Yves, Parent, Pierrot, Seniuta, Piotr, Kuentz, François, Fraoui, Rabah, Tetaz, Rachel, Amaria, Rachid, Bourouma, Rachid, Djeffal, Rachid, Nebbad, Rachida, Allal, Radia, Dimulescu, Radu, Boustani, Rafaat, Mesbah, Rafik, Makdassi, Raifat, Diab, Raji, Puslenghea, Raluca, Roura, Raoul, Khayat, Rateb, Azar, Raymond, Frayssinet, Raymond, Monkam, Regine, Boulahrouz, Rehouni, Boudet, Remi, Demontis, Renato, Gansey, Renaud, Cuvelier, Rene, Schmitt, Renee, Noordally, Reschad, Binaut, Reynald, Latif, Rezkallah, Dufresne, Richard, Montagnac, Richard, Reade, Richard, Genin, Robert, Novo, Robert, Fickl, Rocsana, Dufresne, Roger, Magnol, Roger, Issautier, Roland, Mortelette, Romain, Delaval, Ronan, Lohro, Ronan, M'barga, Roseline, Beau, S., Dupuis, Clémentine, Vidil, Marie Jacques, Hacini, Sabria, Dahmoune, Said, Lekhal, Saliha, Sakso, Salima Ahriz, Saksi, Salima, Citarda, Salvatore, Boubenider, Samir, Kassis, Samuel, Verhille, Sandra, Genestier, Sandrine, Muller, Sandrine, Krid, Saoussen, Richter, Sarah, Delbes, Sebastien, Mailliez, Sebastien, Veillon, Sebastien, Nony, Sébastien, Benarbia, Seddick, Beaudreuil, Severine, Benyaghla, Sidi Ali, Duquennoy, Simon, Baluta, Simona, Boncila, Simona, Mzoughi, Sonia, Ribal, Sonia, Acamer, Sophie, Chauvet, Sophie, Girerd, Sophie, Ozenne, Sophie, Parahy, Sophie, Duval, Sophie Rubens, Taque, Sophie, Menouer, Soraya, Chargui, Soumaya, Bataille, Stanislas, Barbier, Stephane, Billion, Stephane, Roueff, Stephane, Torner, Stephane, Martin, Stephane Jean, Coupel, Stephanie, Cloarec, Sylvie, Lavaud, Sylvie, Leou, Sylvie, Chatelet, T., Onesta, Tania, Benhabib, Tassadit, Bensalem, Tayeb, Dimulescu, Theodora, Sawadogo, Theophile, Hitze, Thibault Dolley, Baranger, Thierry, Boudemaghe, Thierry, Hannedouche, Thierry, Krummel, Thierry, Lobbedez, Thierry, Milcent, Thierry, Dervaux, Thomas, Guincestre, Thomas, Kofman, Thomas, Raphael, Thomas, Sadreux, Thomas, Ulinski, Tim, Roger, Tiphaine Guyon, Serrato, Tomas, Kofman, Tomek, Wong, Tony, Boubia, Toufik, Gbindoun, Ubald Assogba, Khuzaie, Usama, Caudwell, Valerie, Chatelet, Valerie, Crougneau, Valerie, De Precigout, Valerie, Drouillat, Valerie, Galantine, Valerie, Hugot, Valerie Granveau, Leroy, Valerie, Boubia, Veronique, Falque, Veronique, Fournier, Veronique, Queron, Veronique, Viviani, Veronique, Gueuttin, Victor, Panescu, Victor, Calonge, Victorio Menoyo, Nguyen, Viet, Allot, Vincent, Delattre, Vincent, Leduc, Vincent, Pradier, Vincent, Aglae, Violaine Emal, Badulescu, Viorica, Molina, Virginia, Besson, Virginie, Chaigne, Virginie, Jaber, Waddah, Boudi, Wael, El Haggan, Wael, Guillon, Wen Qin, Aneni, Wided Tabbi, Hanf, William, Kohn, Wladimir, Bellenfant, Xavier, Gaudry, Xavier Moreau, Delmas, Yahsou, Knefati, Yannick, Saingra, Yannick, Tirolien, Yannick, Mann, Youssef, Brunak, Yvan, Dimitrov, Yves, Doussy, Yves, Tanter, Yves, Benabid, Zaid, Soltani, Zaara, Boukerroucha, Zacharia, Takla, Zafer, Ramanantsialonina, Zana, Dickson, Zara, Tubail, Zead, Pour, Zoe Koochaki, Boukhalfa, Zohra, and Jacquot, Zohra

Abstract

The aim of this study was to estimate the incidence of COVID-19 disease in the French national population of dialysis patients, their course of illness and to identify the risk factors associated with mortality. Our study included all patients on dialysis recorded in the French REIN Registry in April 2020. Clinical characteristics at last follow-up and the evolution of COVID-19 illness severity over time were recorded for diagnosed cases (either suspicious clinical symptoms, characteristic signs on the chest scan or a positive reverse transcription polymerase chain reaction) for SARS-CoV-2. A total of 1,621 infected patients were reported on the REIN registry from March 16th, 2020 to May 4th, 2020. Of these, 344 died. The prevalence of COVID-19 patients varied from less than 1% to 10% between regions. The probability of being a case was higher in males, patients with diabetes, those in need of assistance for transfer or treated at a self-care unit. Dialysis at home was associated with a lower probability of being infected as was being a smoker, a former smoker, having an active malignancy, or peripheral vascular disease. Mortality in diagnosed cases (21%) was associated with the same causes as in the general population. Higher age, hypoalbuminemia and the presence of an ischemic heart disease were statistically independently associated with a higher risk of death. Being treated at a selfcare unit was associated with a lower risk. Thus, our study showed a relatively low frequency of COVID-19 among dialysis patients contrary to what might have been assumed.

Published
2020
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18. [Focusing on peritoneal dialysis adequacy]

Author

Belkacem, Issad, Pierre-Yves, Durand, Pascale, Siohan, Eric, Goffin, Joëlle, Cridlig, Guillaume, Jean, Jean-Philippe, Ryckelynck, W, Arkouche, J-P, Bourdenx, J, Cridlig, B, Dallaporta, H, Fessy, M, Fischbach, P, Giaime, E, Goffin, B, Issad, G, Jean, D, Joly, L, Mercadal, J-M, Poux, J-P, Ryckelynck, P, Siohan, M, Souid, D, Toledano, C, Verger, P, Vigeral, and M, Uzan

Subjects
Chronic Kidney Disease-Mineral and Bone Disorder, Glucose, Metabolic Clearance Rate, Malnutrition, Humans, Water-Electrolyte Balance, Kidney, Peritoneal Dialysis, Glomerular Filtration Rate, Phosphates
Abstract

The optimal method to assess the adequacy of peritoneal dialysis therapies is controversial. Today, the adequacy must not be considered as a number or a concept assessed only by two parameters (total KT/V urea and total solute clearance) but defined by many more items. In the absence of data, based on theoretical considerations, the reanalysis of the CANUSA study showed that renal kidney function, rather than peritoneal clearance, was associated with improved survival. Residual renal function is considered as a major predictor factor of cardiovascular mortality. Results of this reanalysis were supported by the adequacy data in ADEMEX, EAPOS and ANZDATA studies. Therefore, clinical assessment plays a major role in PD adequacy. The management of fluid balance, the regular monitoring of malnutrition, the control of mineral metabolism and particularly the glucose load, considered as the "corner-stone" of the system, are the main points to be considered in the adequacy of PD patients. The essential goal is to minimize glucose load by glucose-sparing strategies in order to reduce the neoangiogenesis of the peritoneal membrane.

Published
2013

20. Telemedicine and type 1 diabetes: Is technology per se sufficient to improve glycaemic control?

Author

Franc, S., Borot, S., Ronsin, O., Quesada, J.-L., Dardari, D., Fagour, C., Renard, E., Leguerrier, A.-M., Vigeral, C., Moreau, F., Winiszewski, P., Vambergue, A., Mosnier-Pudar, H., Kessler, L., Reffet, S., Guerci, B., Millot, L., Halimi, S., Thivolet, C., and Benhamou, P.-Y.

Abstract

Abstract: Aim: In the TELEDIAB-1 study, the Diabeo system (a smartphone coupled to a website) improved HbA1c by 0.9% vs controls in patients with chronic, poorly controlled type 1 diabetes. The system provided two main functions: automated advice on the insulin doses required; and remote monitoring by teleconsultation. The question is: how much did each function contribute to the improvement in HbA1c? Methods: Each patient received a smartphone with an insulin dose advisor (IDA) and with (G3 group) or without (G2 group) the telemonitoring/teleconsultation function. Patients were classified as “high users” if the proportion of “informed” meals using the IDA exceeded 67% (median) and as “low users” if not. Also analyzed was the respective impact of the IDA function and teleconsultations on the final HbA1c levels. Results: Among the high users, the proportion of informed meals remained stable from baseline to the end of the study 6months later (from 78.1±21.5% to 73.8±25.1%; P =0.107), but decreased in the low users (from 36.6±29.4% to 26.7±28.4%; P =0.005). As expected, HbA1c improved in high users from 8.7% [range: 8.3–9.2%] to 8.2% [range: 7.8–8.7%] in patients with (n =26) vs without (n =30) the benefit of telemonitoring/teleconsultation (−0.49±0.60% vs −0.52±0.73%, respectively; P =0.879). However, although HbA1c also improved in low users from 9.0% [8.5–10.1] to 8.5% [7.9–9.6], those receiving support via teleconsultation tended to show greater improvement than the others (−0.93±0.97 vs −0.46±1.05, respectively; P =0.084). Conclusion: The Diabeo system improved glycaemic control in both high and low users who avidly used the IDA function, while the greatest improvement was seen in the low users who had the motivational support of teleconsultations. [Copyright &y& Elsevier]

Published
2014
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21. Ambulatory 24-hour fast using flexible insulin therapy in patients with type 1 diabetes.

Author

Vigeral, C., Sola-Gazagnes, A., Nejjar, S., M’Bemba, J., Boitard, C., Slama, G., Elgrably, F., and Larger, E.

Subjects
TREATMENT of diabetes, TYPE 1 diabetes, INSULIN therapy, FASTING, MEDICAL care, PATIENT monitoring, GLUCOSE analysis
Abstract

Copyright of Diabetes & Metabolism is the property of Masson Editeur and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2011
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22. Evaluation of Post-Puncture Bleeding Time of Arteriovenous Fistulas with IRIS® Bandage

Author

Boulanger, Henri, Ahriz-Saksi, Salima, Flamant, Martin, and Vigeral, Philippe

Abstract

Purpose Our aim was to evaluate the safety and effectiveness of the IRIS® bandage (Nephrokit®) on post-puncture bleeding compared to conventional manual compression.Methods Sixty-four patients, hemodialyzed with an arteriovenous fistula, were enrolled in a 3-week prospective study. Conventional manual compression was used during the first week, the IRIS® bandage during the second week and conventional manual compression again during the third week. The outcomes analyzed were the persistence or absence of bleeding 3 minutes post-puncture with IRIS® device compared to conventional manual compression. The safety of the IRIS® bandage was also evaluated.Results Rates of persistent bleeding 3 minutes post-puncture at arterial sites were 53±6% and 56±5%, respectively, during the first and third weeks (conventional compression) versus 18±5% during the second week (IRIS® bandage). Similarly, rates of persistent bleeding 3 minutes post-puncture at venous sites were 45±6% and 45±6%, respectively, with conventional compression versus 23±5% with the IRIS® bandage. The difference between the IRIS® device and conventional compression therefore proved highly statistically significant (p<0.05) for both arterial and venous puncture sites. No particular adverse events were observed with the IRIS® device.Conclusions Post-puncture bleeding time at arteriovenous fistula sites is significantly shortened by the IRIS® bandage in comparison with conventional manual compression.

Published
2014
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23. PROPHYLACTIC USE OF OKT3 MONOCLONAL ANTIBODY IN CADAVER KIDNEY RECIPIENTS UTILIZATION OF OKT3 AS THE SOLE IMMUNOSUPPRESSIVE AGENT

Author

N Chkoff, Henri Kreis, Jean-Marie Bach, Droz D, P Vigeral, Gideon Goldstein, Lacombe M, Henri Campos, and Lucienne Chatenoud

Subjects
Adult, Graft Rejection, Male, medicine.medical_specialty, medicine.drug_class, T-Lymphocytes, medicine.medical_treatment, chemical and pharmacologic phenomena, Azathioprine, Monoclonal antibody, Gastroenterology, Postoperative Complications, Internal medicine, Cadaver, medicine, Humans, Kidney transplantation, Transplantation, Kidney, biology, business.industry, Antibodies, Monoclonal, Immunosuppression, Drug Tolerance, medicine.disease, Kidney Transplantation, Antibodies, Anti-Idiotypic, medicine.anatomical_structure, Acute Disease, Immunology, Monoclonal, biology.protein, Female, Chills, medicine.symptom, Antibody, business, Immunosuppressive Agents, medicine.drug
Abstract

We describe the first clinical trial of OKT3, a monoclonal anti-T-cell antibody, for prevention of kidney transplant rejection. 13 patients receiving a first cadaveric kidney transplant were randomly assigned to conventional treatment with azathioprine and high-dose steroids (7 patients) or to treatment with daily injection of OKT3 alone (6 patients). The first OKT3 injection resulted in a dramatic decrease in T3+, T4+, and T8+ cells, while patients simultaneously experienced fever, chills, and diarrhea. These symptoms did not recur with subsequent injections. All six OKT3-treated patients had a rejection necessitating introduction of steroids 12.8 +/- 2.9 days after surgery. Rejection was related to appearance of anti-OKT3 antibodies leading to disappearance of detectable OKT3 in the serum. Modulating (T3-, T4+ or T3-, T8+) cells were observed in all patients but were functionally inactive. As no rejection was observed before day 9 posttransplant, despite the lack of additional immunosuppressive agents, we conclude that OKT3 is a powerful, well-tolerated immunosuppressive agent. However, it is highly immunogenic and anti-OKT3 antibodies lead to loss of clinical effectiveness in this protocol. The use of OKT3 alone for prevention of kidney graft rejection cannot be recommended until a method for reducing the effects of anti-OKT3 immunization is developed.

Published
1986

24. PROPHYLACTIC USE OF OKT3 MONOCLONAL ANTIBODY IN CADAVER KIDNEY RECIPIENTS UTILIZATION OF OKT3 AS THE SOLE IMMUNOSUPPRESSIVE AGENT

Author

VIGERAL, P., CHKOFF, N., CHATENOUD, L., CAMPOS, H., LACOMBE, H. M., DROZ, D., GOLDSTEIN, G., BACH, J. F., and KREIS, H.

Abstract

We describe the first clinical trial of OKT3, a monoclonal anti-T-cell antibody, for prevention of kidney transplant rejection. 13 patients receiving a first cadaveric kidney transplant were randomly assigned to conventional treatment with azathioprine and high-dose steroids (7 patients) or to treatment with daily injection of OKT3 alone (6 patients). The first OKT3 injection resulted in a dramatic decrease in T3+, T4+, and T8+cells, while patients simultaneously experienced fever, chills, and diarrhea. These symptoms did not recur with subsequent injections. All six OKT3-treated patients had a rejection necessitating introduction of steroids 12.8±2.9 days after surgery. Rejection was related to appearance of anti-OKT3 antibodies leading to disappearance of detectable OKT3 in the serum. Modulating (T3−, T4+or T3−, T8+) cells were observed in all patients but were functionally inactive.

Published
1986

25. [Late epilepsy in cerebral cysticercosis. 2 cases confirmed by tomodensitometry]

Author

D, Roswag, P, Vigeral, P, Der Agopian, and F, Loison

Subjects
Adult, Male, Cysticercosis, Seizures, Encephalitis, Humans, Female, Tomography, X-Ray Computed
Abstract

Invasion of the central nervous system by the larvae of Tenia Solium classically leads to severe illness. In some instances, however, the course is protracted and benign. The authors report on two patients with cysticercosis cerebri, revealed by delayed seizures without cerebral hypertension or any other manifestation. Computerized tomography established the diagnosis by demonstrating calcifications disseminated throughout the cerebral parenchyma. Such calcifications result from encapsulation of dead larvae. The possible diversity of the anatomic lesions caused directly or indirectly by the parasite explains why clinical manifestations are polymorphic. Diagnostic procedures are discussed.

Published
1983

26. [Drug-induced renal insufficiency. Results of consensus meetings]

Author

P, Vigeral, A, Baumelou, C, Bénichou, A, Castot, G, Danan, C, Kreft-Jais, G, Lagier, E, Rothschild, P, Druet, and J P, Grünfeld

Subjects
Humans, Kidney Diseases
Abstract

We report the conclusions of consensus meetings organized by the "Direction de la Pharmacovigilance" of Roussel Uclaf, and attended by University Hospital Nephrologists, members of the National Network of Pharmacovigilance and representatives of Roussel Uclaf Drug Monitoring Department, in order to define more accurately, as regards drug-induced renal failure, the criteria and the terminology proposed by the French method of causality assessment of adverse drug reactions.

Published
1989

29. Bartter's syndrome with normal chloride reabsorption during indomethacin treatment

Author

A. Hornych, Y. Huet de Barochez, J. Bariéty, G.F. Branca, P. Vigeral, J.F. Girard, M. Kazatchkine, J.L. De Gennes, J. Truffert, L. Bocquet, and M. Paris

Subjects
Male, medicine.medical_specialty, endocrine system diseases, Adolescent, Indomethacin, Renal function, urologic and male genital diseases, Kidney, Kidney Function Tests, Electrolytes, Internal medicine, Hyperaldosteronism, medicine, Humans, chemistry.chemical_classification, Normal chloride, business.industry, Reabsorption, Fatty Acids, Bartter Syndrome, female genital diseases and pregnancy complications, Hypokalemia, Hormones, Bartter's syndrome, Endocrinology, chemistry, Male patient, Prostaglandins, medicine.symptom, business, Polyunsaturated fatty acid
Abstract

A 17-year-old male patient with Bartter's syndrome was admitted for renal function studies. This patient had persistent hypokalemia, first found at age 5; the diagnosis of Bartter's syndrome with renal hypersecretion of prostaglandins E2 and F2 alpha had been established at age 13. A congenital defect of chloride reabsorption was expected, but after 4 years of indomethacin treatment no such defect was found. Withdrawal of indomethacin for 1 week resulted in profound hypokalemia and the appearance of a chloride reabsorption defect, with an excessive urinary PGE2 and PGF2 alpha excretion, and a parallel decrease in plasma prostaglandin precursors. The cause of Bartter's syndrome in this patient seems to be renal hyperprostaglandinism.

Published
1987

31. [Biermer's disease without anemia, nor megaloblastosis. Value of the study of antibodies, vitamin assays, and the dU suppression test for the early diagnosis]

Author

R, Zittoun, J, Zittoun, J P, Arrago, P, Vigeral, and M, Cadiou

Subjects
Adult, Vitamin B 12, Time Factors, Anemia, Pernicious, Humans, Female, Vitamin B 12 Deficiency, Middle Aged, Deoxyuridine, Autoantibodies
Abstract

In two patients, a diagnosis of pernicious anemia was made without anemia, megaloblastosis and even macrocytosis. The diagnosis of pernicious anemia was suggested by the autoimmune abnormalities which are frequently associated with this disease: goitre with anti-thyroid and anti parietal cell antibodies, and besides this, idiopathic thrombocytopenic purpura in the first patient, vitiligo in the second. The morphological abnormalities were limited to slight macrocytosis in the first patient and to hypersegmentation of polymorphonuclear leucocyte in both. Vitamin B12 deficiency was demonstrated by serum assay as well as deoxyuridine suppression test ("dU suppression"). The diagnosis was confirmed by demonstration of atrophic gastritis, failure of secretion of Intrinsic Factor and Schilling test. These observations show that the Addison-Biermer disease can be detected early in persons at high risk by looking for vitamin B12 deficiency and specific antibodies.

Published
1983

33. [Interstitial nephropathies induced by meticillin: demonstration of distal tubule functional anomalies]

Author

P, Vigeral, A, Kanfer, S, Kenouch, F, Blanchet, B, Mougenot, and J P, Méry

Subjects
Adult, Male, Methicillin, Kidney Tubules, Humans, Nephritis, Interstitial, Middle Aged, Kidney, Kidney Tubules, Distal
Abstract

Renal tubular dysfunction was investigated in two patients with meticillin-induced interstitial nephritis. Some degree of renal failure persisted after the acute episode in both cases. The first patient was investigated 10 weeks after the onset of the nephropathy. Nephrogenic diabetes insipidus and distal tubular acidosis were demonstrated. The second patient was investigated 7 months after the onset of the nephropathy. A major impairment in urinary concentration ability was demonstrated. Neither patient had proximal tubular dysfunction. These data show that meticillin-induced interstitial nephritis may be responsible for distal tubular abnormalities, namely nephrogenic diabetes insipidus and distal tubular acidosis, which may persist long after the onset of the nephropathy.

Published
1987

34. Therapeutic use of monoclonal antibodies in kidney transplantation

Author

H, Kreis, N, Chkoff, P, Vigeral, L, Chatenoud, M, Lacombe, H, Campos, A, Pruna, G, Goldstein, J F, Bach, and J, Crosnier

Subjects
Adult, Graft Rejection, Male, Prednisolone, T-Lymphocytes, Antibodies, Monoclonal, Kidney Transplantation, Antibodies, Anti-Idiotypic, Mice, Azathioprine, Animals, Humans, Female, Immunization, Immunosuppressive Agents, Follow-Up Studies
Published
1985

36. P1135 Technologie, soutien motivationnel et télémédecine : quelle est la bonne combinaison ? Analyse épidémiologique de l’étude Télédiab 1.

Author

Franc, S., Borot, S., Ronsin, O., Quesada, J.-L., Dardari, D., Fagour, C., Renard, E., Leguerrier, A.-M., Vigeral, C., Moreau, F., Winiszewski, P., Vambergue, A., Mosnier-Pudar, H., Thivolet, C., and Hanaire, H.

Subjects
TREATMENT of diabetes, TELEMEDICINE, EPIDEMIOLOGY, MEDICAL technology, MOTIVATION (Psychology), DIET therapy, INSULIN
Abstract

Introduction: L’étude Télédiab1 a montré une amélioration de 0,9 % de l’HbA1c chez des diabétiques de type 1 (DT1) chroniquement déséquilibrés bénéficiant de l’adaptateur de doses d’insuline du système DIABEO et d’un télésuivi médical pendant 6 mois. Quel était l’impact respectif de la technique (calcul automatique des doses) et du soutien motivationnel (télésuivi) ? Patients et méthodes: Les patients qui ont reçu le smartphone contenant l’adaptateur de doses, avec (G3) ou sans (G2) télésuivi, ont été classés comme ű forts utilisateurs Ƈ si leur proportion de repas renseignés dépassait 67 % (médiane), sinon comme ű faibles utilisateurs Ƈ. On a étudié le taux d’utilisation de l’adaptateur pendant les 6 mois d’étude et la part supplémentaire d’amélioration de l’HbA1c liée aux téléconsultations (G3). Résultats: Le taux d’utilisation du système s’est maintenu pendant les 6 mois de l’étude avec une baisse d’utilisation très modérée chez les faibles utilisateurs (de 35,2 % à 30,2 % ; delta-5 %) comme chez les forts utilisateurs (de 84,1 % à 81 % ; delta-3,1 %). Seuls 4 patients ont changé de groupe (2/groupe). L’HbA1c des forts utilisateurs s’est améliorée, passant de 9,0 [8,5 ; 10,1] à 8,5 % [7,8 ; 8,7], que ces patients aient bénéficié (n=26) ou pas (n=30) d’un soutien motivationnel au travers des téléconsultations (- 0,49±0,60 % vs - 0,52±0,73 %, p=0,879). Les faibles utilisateurs ont aussi vu leur HbA1c s’améliorer, passant de 8,7 [8,3 ; 9,2] à 8,2 [7,8 ; 8,7]. Toutefois, ces patients de G3 qui ont bénéficié du soutien motivationnel via 9,2±2,4 téléconsultations ont eu tendance à plus améliorer leur HbA1c que ceux de G2 qui ne l’ont pas eu (− 0,93±0,97 vs. - 0,46±1,05 ; p=0,084). Conclusion: Le système DIABEO a permis une amélioration de l’équilibre glycémique aussi bien chez les forts que chez les faibles utilisateurs de l’adaptateur ayant bénéficié du soutien motivationnel. Ces résultats soulignent l’importance du suivi motivationnel grâce aux téléconsultations et devraient inciter les développeurs d’outils de télémédecine à proposer des solutions technologiques qui visent à favoriser l’interaction avec le soignant. [ABSTRACT FROM AUTHOR]

Published
2013
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37. P298 Étude Télédiab 1 : l’utilisation effective de DIABEO est-elle un facteur déterminant dans l’amélioration du contrôle glycémique ?

Author

Franc, S., Benhamou, P.Y., Borrot, S., Penfornis, A., Ronsin, O., Quesada, J.-L., Dardari, D., Fagour, C., Renard, E., Leguerrier, A.M., Vigeral, C., Moreau, F., Winiszewski, P., Vambergue, A., Charpentier, G., and Hanaire, H.

Subjects
GLYCEMIC index, PEOPLE with diabetes, INSULIN therapy, MEDICAL consultation, DIABETES prevention, DATA analysis
Abstract

Introduction: Le système Diabeo, un smartphone assurant l’adaptation automatique des doses d’insuline basale et prandiale et la télétransmission des données a déjà fait la preuve de son efficacité chez les patients diabétiques de type 1 mal contrôlés (HbA1c - 8 %). Dans l’étude Telediab 1, la réduction d’HbA1c était de 0,9 % à 6 mois dans le groupe 3 (DIABEO + téléconsultations) vs. groupe 1 (contrôle) avec des résultats intermédiaires dans le groupe 2 (DIABEO + consultations en face-face trimestrielles). Notre objectif était ici de déterminer si dans les groupes 2 et 3 dotés de DIABEO, l’utilisation effective du système avait été en soi un facteur déterminant dans l’amélioration du contrôle glycémique. Patients et méthodes: Les patients des groupes 2 et 3 ont été classés suivant leur niveau d’utilisation du système. Les utilisateurs ont été définis comme ayant une proportion de repas renseignés supérieure à 67 % (médiane de la population). Résultats: Les utilisateurs du système étaient plus âgés et plus souvent des cadres; ils avaient un diabète plus ancien, une HbA1c initiale plus basse (8,9±0,9 % vs 9,4±1,2 %, p=0,02) et pratiquaient plus souvent l’insulinothérapie fonctionnelle que les non-utilisateurs. À 6 mois leur HbA1c était significativement plus basse (8,4±0,9 % vs. 8,7±1,2 %, p=0,005). La baisse d’HbA1c était cependant plus importante chez les non-utilisateurs et dépassait 1 % chez 43 % d’entre eux (contre 16 % chez les utilisateurs, p=0,002). Conclusion: Au travers du caractère utilisateur/non utilisateur, nous faisons l’hypothèse que deux catégories de patients coexistent 1) Ceux modérément déséquilibrés, relativement observants, qui font leurs injections et ont bénéficié de l’aide au calcul des doses, 2) ceux mal équilibrés, avec un problème majeur d’observance, qui semblent avoir bénéficié plus du soutien motivationnel régulier, au travers des consultations fréquentes, que de l’adaptateur de doses. Des analyses complémentaires sont nécessaires pour confirmer cette hypothèse. [Copyright &y& Elsevier]

Published
2012
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38. Emergent technologies applied to diabetes: What do we need to integrate continuous glucose monitoring into daily practice?: Where the long-term use of continuous glucose monitoring stands in 2011.

Author

Sola-Gazagnes, A. and Vigeral, C.

Subjects
INSULIN pumps, TYPE 1 diabetes, GLUCOSE, HYPOGLYCEMIC agents
Abstract

Copyright of Diabetes & Metabolism is the property of Masson Editeur and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2011
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39. PP3 - Comment la formation et la dynamique d’une équipe soignante autour du thème activité physique permettent d’initialiser un changement de comportement chez des DT2 au cours d’une hospitalisation.

Author

Rigoir-Louvel, A., Vigeral, C., Berné, C., Grignon, J., Le Cren, F., Buffet, G., David, M.-C., Etcheverry, L., Larger, E., and Elgrably, F.

Subjects
HEALTH care teams, PHYSICAL activity, TYPE 2 diabetes, HOSPITAL care, LENGTH of stay in hospitals, FEASIBILITY studies, PHYSICAL therapists, HYPERCHOLESTEREMIA
Abstract

Introduction: L’objectif était de sensibiliser les patients DT2 à la réduction de la sédentarité et au développement de l’activité physique au cours d’une hospitalisation programmée. Patients et méthodes: Il s’agit d’une étude de faisabilité. Les moyens développés étaient : 1/ Formation de l’équipe soignante. 2/ Programme quotidien proposé aux patients, autour du thème activité physique, impliquant chaque membre de l’équipe: infirmier, aide-soignant, diététicien, médecin, kinésithérapeute. 3/ Présence d’un « expert » sport et sélection de quelques patients pour le programme DiabetAction (programme canadien en cours d’implantation et d’évaluation en France. 4/ Séance de synthèse de semaine réunissant l’équipe et l’expert sport. Résultats: 42 DT2, âgés de 60±10 (m±DS), 45% Femmes, diabétiques depuis 15±9 ans, IMC: 33,5±5,5kg/m2 HbA1c 8,5%±1,8. Complications et facteurs de risque: rétinopathie (32%), HTA (78%), hypercholestérolémie (73%), tabagisme(10%),apnée du sommeil (43%). Il s’agit d’une population inactive : score moyen d’activité (Ricci et Gagnon) 14±7 et sédentaire (temps moyen de sédentarité : 6h±4. Les patients ont tous participé avec enthousiasme à ce programme, et ont découvert la possibilité de « bouger » avec plaisir. Huit patients volontaires ont été sélectionné pour suivre la « passerelle » PASS club = objectif initial. Les patients sélectionnés ne différaient en aucun point des autres patients. Conclusion: Cette étude de faisabilité a été un succès et nous conduit à développer une étude prospective à long terme qui sera évaluée. La dynamique, la cohérence et la cohésion de l’équipe soignante ont été renforcées autour de ce thème que chacun s’est approprié. [Copyright &y& Elsevier]

Published
2011
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40. OP3 Incidence de l’estimation des glucides sur l’équilibre du diabète chez des patients traités par pompe à insuline.

Author

Marchand, S., Rigoir-Louvel, A., Sola, A., Vigeral, C., Fiquet, P., and Rossignol, V.

Subjects
CARBOHYDRATE content of food, TREATMENT of diabetes, INSULIN pumps, DRUG dosage, MEDICAL care
Abstract

Introduction: La réévaluation annuelle obligatoire du traitement par pompe à insuline externe a été organisée dans le service sur une journée. Celle-ci est l’occasion d’une évaluation individuelle des connaissances puis de leur ajustement au cours de 3 ateliers. L’estimation des glucides (G) est déterminante dans le choix de la dose d’insuline prandiale. Ces connaissances sont appréciées par auto-questionnaires. Nous avons tenté de savoir si la durée du diabète ou du traitement par pompe, si l’HbA1c ou le fait d’avoir bénéficié ou non de notre programme d’insulinothérapie fonctionnelle (AT1), influençaient leurs compétences diététiques. Nous avons également cherché à savoir si, sur les 6 thèmes d’aliments proposés, certains étaient plus faciles à évaluer. Patients et méthodes: Les connaissances diététiques de nos 74 premiers patients sous pompe (58 % de femmes, 96 % de type 1), ayant participés à cette journée ont été analysées. Ces patient, en moyenne, âgés de 44 ans sont diabétiques depuis 23 ans, sous pompe depuis 3,4 ans (< 4 mois chez 1/3) avec une HbA1c a 7,1 %. Seuls 1/3 des patients ont suivi l’AT1. Chaque patient a estimé la quantité de G de 31 aliments, à partir de photos ; une estimation±20 % est jugée correcte. Résultats: La quantification des G est exacte chez 60 % des patients, ce, indépendamment de l’HbA1c, de la formation AT1, de la durée du diabète ou de pompe. Certains aliments sont bien mieux évalués que d’autres. La réponse est juste dans 74 % des cas pour les fruits, 68 % pour les laitages ou les entrées courantes et 64 % pour les aliments conseillés en cas d’hypoglycémies. En revanche, les féculents restent mal estimés avec seulement 35 % de bonnes réponses. L’HbA1c des patients ayant bien répondu n’est pas meilleure. Conclusion: Le comptage des glucides reste difficile, même pour des patients aguerris. Les aliments les mieux appréciés sont ceux en portion individuelle. L’évaluation des féculents ou plats composés reste imparfaite en rapport probablement avec la difficulté d’estimation des volumes. Dans ce travail, l’aptitude à compter les G, n’est pas associée à une meilleure HbA1c chez des patients cependant déjà correctement équilibrés. La possibilité de répondre aussi en “dose d’insuline à faire” permettrait sûrement d’améliorer les performances. [Copyright &y& Elsevier]

Published
2009
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41. P143 Réévaluation annuelle du traitement par pompe à insuline externe : une obligation ; une opportunité ?

Author

Sola-Gazagnes, A., Vigeral, C., Nobécourt, E., Radu, A., Philippe, M.F., M’Bemba, J., Elgrably, F., Buffet, G., Boitard, C., and Larger, E.

Subjects
TREATMENT of diabetes, INSULIN pumps, MEDICAL care costs, MEDICAL care laws, PEOPLE with diabetes, DIABETIC retinopathy, DRUG delivery systems, SAFETY
Abstract

Introduction: L’arrêté ministériel du 17 juillet 2006 créé l’obligation d’une réévaluation annuelle de l’opportunité de la poursuite du traitement par pompe à insuline externe. Nous avons créé une structure et un programme spécifique pour répondre à cette exigence. Nous rapportons 5 mois d’expérience sur les 87 premiers patients, en présentant spécifiquement les données recueillies concernant la sécurité des patients. Patients et méthodes: Quatre vingt sept patients dont 30 avaient la pompe depuis moins de 6 mois. Ancienneté diabète : 22 ans (3-58) et durée de pompe 3 ans (0,16-28). 50 % des patients avaient une rétinopathie. Les patients sont accueillis en hôpital de jour (HDJ) par un trio infirmière, diététicienne, médecin senior. La journée comprend des temps individuels avec chacun des intervenants, une évaluation par auto-questionnaire et un ajustement des connaissances en atelier de groupe. Chacun des 3 ateliers concerne un aspect du traitement : diététique, vie sous pompe et sécurité. Résultats: L’indication de la pompe a été dans 60 % des cas une recherche d’un meilleur contrôle, dont 12 femmes en préparation de grossesse et dans 18 % des cas une instabilité glycémique. HbA1c avant pompe 7,9 % (5,7-11,6), sous pompe 7,1 % (5,2-13,5) sur l’ensemble du groupe ; 6,9± 0,6 chez les patients à 3 mois et 7,2± 1,2 chez les autres, ancienneté de pompe 4,9±5,6 ans. Ces patients font en moyenne 5,7 autocontrôles glycémiques (médiane 6, 75 %≥5). La sécurité a été évaluée par un questionnaire comportant 8 points. Quatre-vingt neuf pour cent des patients recherchent l’acétone si la glycémie est > 2,5g/ l, 60 % font alors un bolus au stylo, 37 % malheureusement à la pompe. 73 % ont un stylo de rapide en permanence sur eux. Par contre seuls 42 % savent interpréter un dosage de beta-hydroxybutyrate. Conclusion: Nos patients sous pompe, initiée souvent après plusieurs années de diabète, ont un bénéfice qui se manifeste dès les premiers mois et persiste au long cours. Ce bénéfice est à mettre en relation avec une autosurveillance intensive. Nos résultats montrent que les règles de sécurité sont majoritairement connues, et nous ne déplorons qu’une cétoacidose depuis 10 ans. [Copyright &y& Elsevier]

Published
2009
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43. [Focusing on peritoneal dialysis adequacy].

Author

Issad B, Durand PY, Siohan P, Goffin E, Cridlig J, Jean G, Ryckelynck JP, Arkouche W, Bourdenx JP, Cridlig J, Dallaporta B, Fessy H, Fischbach M, Giaime P, Goffin E, Issad B, Jean G, Joly D, Mercadal L, Poux JM, Ryckelynck JP, Siohan P, Souid M, Toledano D, Verger C, Vigeral P, and Uzan M

Subjects
Chronic Kidney Disease-Mineral and Bone Disorder physiopathology, Glomerular Filtration Rate physiology, Glucose metabolism, Humans, Kidney physiopathology, Malnutrition diagnosis, Malnutrition physiopathology, Malnutrition prevention & control, Metabolic Clearance Rate physiology, Phosphates metabolism, Water-Electrolyte Balance, Peritoneal Dialysis methods
Abstract

The optimal method to assess the adequacy of peritoneal dialysis therapies is controversial. Today, the adequacy must not be considered as a number or a concept assessed only by two parameters (total KT/V urea and total solute clearance) but defined by many more items. In the absence of data, based on theoretical considerations, the reanalysis of the CANUSA study showed that renal kidney function, rather than peritoneal clearance, was associated with improved survival. Residual renal function is considered as a major predictor factor of cardiovascular mortality. Results of this reanalysis were supported by the adequacy data in ADEMEX, EAPOS and ANZDATA studies. Therefore, clinical assessment plays a major role in PD adequacy. The management of fluid balance, the regular monitoring of malnutrition, the control of mineral metabolism and particularly the glucose load, considered as the "corner-stone" of the system, are the main points to be considered in the adequacy of PD patients. The essential goal is to minimize glucose load by glucose-sparing strategies in order to reduce the neoangiogenesis of the peritoneal membrane., (Copyright © 2013. Published by Elsevier SAS.)

Published
2013
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46. [Late epilepsy in cerebral cysticercosis. 2 cases confirmed by tomodensitometry].

Author

Roswag D, Vigeral P, Der Agopian P, and Loison F

Subjects
Adult, Cysticercosis complications, Encephalitis complications, Female, Humans, Male, Seizures etiology, Tomography, X-Ray Computed, Cysticercosis diagnosis, Encephalitis diagnosis, Seizures diagnosis
Abstract

Invasion of the central nervous system by the larvae of Tenia Solium classically leads to severe illness. In some instances, however, the course is protracted and benign. The authors report on two patients with cysticercosis cerebri, revealed by delayed seizures without cerebral hypertension or any other manifestation. Computerized tomography established the diagnosis by demonstrating calcifications disseminated throughout the cerebral parenchyma. Such calcifications result from encapsulation of dead larvae. The possible diversity of the anatomic lesions caused directly or indirectly by the parasite explains why clinical manifestations are polymorphic. Diagnostic procedures are discussed.

Published
1983

47. [Interstitial nephropathies induced by meticillin: demonstration of distal tubule functional anomalies].

Author

Vigeral P, Kanfer A, Kenouch S, Blanchet F, Mougenot B, and Méry JP

Subjects
Adult, Humans, Kidney pathology, Male, Middle Aged, Nephritis, Interstitial physiopathology, Nephritis, Interstitial urine, Kidney Tubules drug effects, Kidney Tubules, Distal drug effects, Methicillin adverse effects, Nephritis, Interstitial chemically induced
Abstract

Renal tubular dysfunction was investigated in two patients with meticillin-induced interstitial nephritis. Some degree of renal failure persisted after the acute episode in both cases. The first patient was investigated 10 weeks after the onset of the nephropathy. Nephrogenic diabetes insipidus and distal tubular acidosis were demonstrated. The second patient was investigated 7 months after the onset of the nephropathy. A major impairment in urinary concentration ability was demonstrated. Neither patient had proximal tubular dysfunction. These data show that meticillin-induced interstitial nephritis may be responsible for distal tubular abnormalities, namely nephrogenic diabetes insipidus and distal tubular acidosis, which may persist long after the onset of the nephropathy.

Published
1987

50. [Biermer's disease without anemia, nor megaloblastosis. Value of the study of antibodies, vitamin assays, and the dU suppression test for the early diagnosis].

Author

Zittoun R, Zittoun J, Arrago JP, Vigeral P, and Cadiou M

Subjects
Adult, Autoantibodies analysis, Deoxyuridine, Female, Humans, Middle Aged, Time Factors, Vitamin B 12 blood, Vitamin B 12 Deficiency diagnosis, Anemia, Pernicious diagnosis
Abstract

In two patients, a diagnosis of pernicious anemia was made without anemia, megaloblastosis and even macrocytosis. The diagnosis of pernicious anemia was suggested by the autoimmune abnormalities which are frequently associated with this disease: goitre with anti-thyroid and anti parietal cell antibodies, and besides this, idiopathic thrombocytopenic purpura in the first patient, vitiligo in the second. The morphological abnormalities were limited to slight macrocytosis in the first patient and to hypersegmentation of polymorphonuclear leucocyte in both. Vitamin B12 deficiency was demonstrated by serum assay as well as deoxyuridine suppression test ("dU suppression"). The diagnosis was confirmed by demonstration of atrophic gastritis, failure of secretion of Intrinsic Factor and Schilling test. These observations show that the Addison-Biermer disease can be detected early in persons at high risk by looking for vitamin B12 deficiency and specific antibodies.

Published
1983

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