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15 results on '"Pharmacologie du Sepsis et Choc Septique"'

1. Mupirocin/chlorexidine to prevent methicillin-resistant Staphylococcus aureus infections: post hoc analysis of a placebo-controlled, randomized trial using mupirocin/chlorhexidine and polymyxin/tobramycin for the prevention of acquired infections in intubated patients

Author

Eric Bellissant, Arnaud Gacouin, P. Le Corre, A. Legras, Pierre-Yves Donnio, Dominique Perrotin, Véronique Sébille, Y. Le Tulzo, Bernard Garo, Anne Renault, Christophe Camus, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Biostatistique, Recherche Clinique et Mesures Subjectives en Santé, Université de Nantes (UN), Service de réanimation médicale, Université de Tours (UT), Service de maladies infectieuses, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Réanimation Médicale (BREST - Réa Med), Laboratoire de Pharmacie Galenique, Biopharmacie et Pharmacie Clinique [Rennes], Université de Rennes (UR), Laboratoire de Virologie [Rennes] = Virology [Rennes], Pharmacologie du Sepsis et Choc Septique, Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], This study was conducted with financial support from the French Ministry of Health (Clinical Research Hospital Program, PHRC 94, Direction des Hôpitaux, Paris, France) and from a grant from GlaxoSmithKline. The grant covered the additional costs of processing and culture of colonization samples and susceptibility testing of S. aureus isolates to mupirocin. GlaxoSmithKline had no role in the design, analysis or drafting of the manuscript., Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours (UT)-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Laboratoire de Pharmacie Galenique, Biopharmacie et Pharmacie Clinique, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], Université de Tours-Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), and Cadieu, Muriel

Subjects
Male, Administration, Topical, MRSA, medicine.disease_cause, Rate ratio, Hospitals, University, Placebos, ICU-acquired infection, chemistry.chemical_compound, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Tobramycin, 030212 general & internal medicine, Aged, 80 and over, 0303 health sciences, Incidence, Incidence (epidemiology), Chlorhexidine, Selective digestive decontamination, General Medicine, Middle Aged, Staphylococcal Infections, Anti-Bacterial Agents, 3. Good health, Mupirocin, Treatment Outcome, Infectious Diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Drug Therapy, Combination, Female, France, medicine.drug, Adult, Methicillin-Resistant Staphylococcus aureus, Microbiology (medical), Staphylococcus aureus, medicine.medical_specialty, Placebo, Young Adult, 03 medical and health sciences, Double-Blind Method, Internal medicine, Intensive care, medicine, Humans, Polymyxins, Aged, 030306 microbiology, business.industry, Methicillin-resistant Staphylococcus aureus, Surgery, Regimen, chemistry, Intubation, business
Abstract

International audience; PURPOSE: The reduction in acquired infections (AI) due to methicillin-resistant Staphylococcus aureus (MRSA) with the mupirocin/chlorhexidine (M/C) decontamination regimen has not been well studied in intubated patients. We performed post hoc analysis of a prior trial to assess the impact of M/C on MRSA AI and colonization. METHODS: We conducted a multicenter, placebo-controlled, randomized, double-blind study with the primary aim to reduce all-cause AI. The two regimens used [topical polymyxin and tobramycin (P/T), nasal mupirocin with chlorhexidine body wash (M/C), or corresponding placebos for each regimen] were administered according to a 2 × 2 factorial design. Participants were intubated patients in the intensive care units of three French university hospitals. The patients enrolled in the study (n = 515) received either active P/T (n = 130), active M/C (n = 130), both active regimens (n = 129), or placebos only (n = 126) for the period of intubation and an additional 24 h. The incidence and incidence rates (per 1,000 study days) of MRSA AI were assessed. Due to the absence of a statistically significant interaction between the two regimens, analysis was performed at the margins by comparing all patient receiving M/C (n = 259) to all patients not receiving M/C (n = 256), and all patients receiving P/T (n = 259) to all patients not receiving P/T (n = 256). RESULTS: Incidence [odds ratio (OR) 0.39, 95 % confidence interval (CI) (0.16-0.96), P = 0.04] and incidence rates [incidence rate ratio (IRR) 0.41, 95 % CI 0.17-0.97, P = 0.05] of MRSA AI were significantly lower with the use of M/C. We also observed an increase in the incidence (OR 2.50, 95 % CI 1.01-6.15, P = 0.05) and the incidence rate (IRR 2.90, 95 % CI 1.20-8.03, P = 0.03) of MRSA AI with the use of P/T. CONCLUSION: Among our study cohort of intubated patients, the use of M/C significantly reduced MRSA AI.

Published
2014

2. Cerebral Microdialysis Effects of Propofol versus Midazolam in Severe Traumatic Brain Injury

Author

M. Tanguy, Yannick Mallédant, Bruno Laviolle, Philippe Seguin, Jean-Paul Bleichner, Xavier Morandi, Service d'anesthésie réanimation chirurgicale [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou, Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Foie, métabolismes et cancer, 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 )-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 de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes]-Service de réanimation chirurgicale, Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de neurochirurgie [Rennes] = Neurosurgery [Rennes], CHU Pontchaillou [Rennes], Le Corre, Morgane, Hôpital Pontchaillou-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Foie, métabolismes et cancer, 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 )-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 de Pharmacologie [Rennes], and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]

Subjects
Glycerol, Male, Microdialysis, medicine.medical_treatment, 0302 clinical medicine, MESH: Hypnotics and Sedatives, Pyruvic Acid, Hypnotics and Sedatives, Single-Blind Method, MESH: Microdialysis, MESH: Brain Chemistry, 030212 general & internal medicine, Propofol, Cerebral Cortex, Glutamate receptor, MESH: Neuroprotective Agents, MESH: Glutamic Acid, 3. Good health, MESH: Glucose, Neuroprotective Agents, MESH: Propofol, Anesthesia, Female, medicine.symptom, medicine.drug, Adult, Traumatic brain injury, Midazolam, Sedation, Glutamic Acid, Neuroprotection, 03 medical and health sciences, MESH: Glycerol, medicine, Humans, Lactic Acid, MESH: Pyruvic Acid, Brain Chemistry, MESH: Humans, business.industry, Vitamin E, MESH: Biological Markers, MESH: Adult, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, MESH: Single-Blind Method, medicine.disease, MESH: Male, MESH: Cerebral Cortex, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Glucose, Brain Injuries, MESH: Midazolam, MESH: Brain Injuries, MESH: Lactic Acid, Neurology (clinical), business, MESH: Female, Biomarkers, 030217 neurology & neurosurgery
Abstract

International audience; Propofol, an anesthetic agent acting as an analogue of vitamin E, has been advocated to be an ideal neuroprotective agent both in animal models and in clinical practice, due to its positive effects on oxidative stress. Nevertheless, no studies have compared this agent to another sedative agent used for sedation after traumatic brain injury (TBI). The objective was to compare the effects of propofol to midazolam on cerebral biomarkers at the acute phase of severe TBI patients. Thirty patients aged 35±18 years were prospectively randomized to receive propofol or midazolam and 29 were analyzed (n=15 for propofol, and n=14 for midazolam). A cerebral microdialysis catheter was used to measure the lactate:pyruvate (L:P) ratio, glutamate, glycerol, and glucose for 72 h. No difference between groups was observed for the L:P ratio (time effect p=0.201, treatment effect p=0.401, time×treatment interaction p=0.101). Similarly, no difference was observed for glutamate (time effect p=0.930, treatment effect p=0.651, time×treatment interaction p=0.353), glycerol (time effect p=0.223, treatment effect p=0.922, time×treatment interaction p=0.308), or glucose (time effect p=0.116, treatment effect p=0.088, time×treatment interaction p=0.235). These results do not support a difference between propofol and midazolam for sedation for the cerebral metabolic profile in severe TBI.

Published
2012

3. Effectiveness of simple daily sensitization of physicians to the duration of central venous and urinary tract catheterization

Author

Aurélie Coué, Philippe Seguin, Sonia Isslame, Yannick Mallédant, Bruno Laviolle, Foie, métabolismes et cancer, 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 ), Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], 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 ), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes]

Subjects
Male, Time Factors, medicine.medical_treatment, Urinary tract catheter, Critical Care and Intensive Care Medicine, 0302 clinical medicine, Infection rate, Interquartile range, Prospective Studies, MESH: Incidence, 030212 general & internal medicine, Practice Patterns, Physicians', Prospective cohort study, Cross Infection, MESH: Catheterization, Central Venous, 0303 health sciences, MESH: Middle Aged, Incidence, Incidence (epidemiology), Middle Aged, Duration of catheterization, 3. Good health, Intensive Care Units, Catheter, Anesthesia, Female, Urinary Catheterization, Central venous catheter, Catheterization, Central Venous, Critical Care, Reminder Systems, Urinary system, MESH: Reminder Systems, Urinary catheterization, 03 medical and health sciences, Intensive care, medicine, Humans, MESH: Intensive Care, MESH: Physician's Practice Patterns, MESH: Humans, 030306 microbiology, business.industry, MESH: Time Factors, MESH: Cross Infection, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, MESH: Prospective Studies, MESH: Male, MESH: Urinary Catheterization, MESH: Intensive Care Units, business, MESH: Female
Abstract

International audience; PURPOSE: To evaluate the effectiveness of simple daily sensitization of physicians to the duration of central venous and urinary tract catheterization, and impact on infection rates. METHODS: A prospective, before-after study in a surgical intensive care unit. All consecutive patients who had a central venous catheter (CVC) and/or urinary tract catheter (UTC) were included during two consecutive periods. Period 1 (August 2005 to May 2006) served as the control period. During Period 2 (July 2006 to April 2007), a red square, added to the patient's daily care sheet, questioned the physician about the utility of the CVC and/or UTC. If the response was "No", the CVC and/or the UTC were removed by a nurse. RESULTS: A total of 1,271 patients were analyzed (Period 1, n = 676; Period 2, n = 595). The duration of catheterization (median [interquartile range]) was significantly reduced in Period 2 compared to Period 1 (from (5 [3-9] to 4 [3-7] days, p < 0.001, for CVC, and from 5 [3-11] to 4 [3-8] days, p < 0.001, for UTC). The incidence and density incidence of CVC infection decreased in Period 2 compared to Period 1 (from 1.8% to 0.3%, p = 0.010, and from 2.8 to 0.7/1,000 CVC-days, p = 0.051) whereas UTC infections were not significantly different (4.3 to 3.0%, p = 0.230, and 5.0 to 4.9/1,000 UTC-days, p = 0.938, respectively). CONCLUSIONS: A simple daily reminder to physicians on the patients' care sheets decreased the duration of central venous and urinary tract catheterization, and tended to decrease CVC infection rate without affecting UTC infection.

Published
2010

4. W48 Response Rate of Boceprevir-PegIFN-RBV in Treatment-Experienced HIV Coinfected Patients with HCV genotype 1: ANRS-HC27 BocepreVIH Study

Author

Poizot-Martin, Isabelle, Bellissant, Eric, Piroth, Lionel, Renault, Alain, Bourliere, Marc, Halfon, Philippe, Solas, Caroline, Lacarelle, Bruno, Philippe Colson, Garraffo, Rodolphe, Molina, Jean-Michel, Département de Recherche CLinique, CISIH-Sud, Hôpital Sainte-Marguerite, Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Département d'infectiologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes], Service d'Hépato-Gastroentérologie, Hôpital St Joseph, Laboratoire de pharmacocinétique et toxicologie, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre de Recherches en Oncologie biologique et Oncopharmacologie (CRO2), Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Service de pharmacologie, Hôpital Pasteur [Nice] (CHU)-Centre Hospitalier Universitaire de Nice (CHU Nice), Service des Maladies Infectieuses et Tropicales, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)

Subjects
[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, [SDV.TOX]Life Sciences [q-bio]/Toxicology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2013

5. Subthalamic nucleus modulates social and anxogenic-like behaviors

Author

Bruno Laviolle, Stephan Saikali, Morgane Pihan, Danièle Bentué-Ferrer, Jean-Michel Reymann, Florian Naudet, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 - Faculté de Médecine (UR1 Médecine), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service des explorations fonctionnelles neurologiques, CHU Pontchaillou [Rennes], Laboratoire d'Anatomopathologie, Pharmacologie du Sepsis et Choc Septique, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 - Faculté de Médecine (UR1 Médecine), Rennes 1 University UFR of Medicine, Jonchère, Laurent, Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR), Service des explorations fonctionnelles [CHU Rennes], Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 - Faculté de Médecine (UR1 Médecine), Université de Rennes - Faculté de Médecine (UR Médecine), and Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes - Faculté de Médecine (UR Médecine)

Subjects
STN, Male, Elevated plus maze, Parkinson's disease, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Stimulation, Anxiety, Lesion, 03 medical and health sciences, Behavioral Neuroscience, 0302 clinical medicine, Subthalamic Nucleus, Basal ganglia, medicine, Animals, Interpersonal Relations, Social behavior, Rats, Wistar, 030304 developmental biology, Elevated Plus Maze, 0303 health sciences, Parkinson's Disease, [SDV.NEU.NB] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, medicine.disease, Rats, Subthalamic nucleus, Disease Models, Animal, Hindlimb Suspension, Exploratory Behavior, Linear Models, PD, medicine.symptom, Psychology, Neuroscience, EPM, 030217 neurology & neurosurgery
Abstract

The sponsor had no role concerning: design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. There are no conflicts of interest regarding this paper.; International audience; In Parkinson's disease, global social maladjustment and anxiety are frequent after subthalamic nucleus (STN) stimulation and are generally considered to be linked with sociofamilial alterations induced by the motor effects of stimulation. We hypothesized that the STN is per se involved in these changes and aimed to explore the role of STN in social and anxogenic-like behaviors using an animal model. Nineteen male Wistar rats with bilateral lesions of the STN were compared with 26 sham-lesioned rats by synchronizing an ethological approach based upon direct observation of social behaviors and a standardized approach, the elevated plus maze (EPM). Comparisons between groups were performed by a Mann-Whitney-Wilcoxon test. Lesioned rats showed impairments in their social (P=0.05) and aggressive behaviors with a diminution of attacking (P=0.04) and chasing (P=0.06). In the EPM, concerning the open arms, the percentage of distance, time, inactive time, and entry were significantly decreased in lesioned rats (P=0.02, P=0.01, P=0.04, and P=0.05). The time spent in non-protected head dips was also diminished in the lesioned rats (P=0.01). These results strongly implicate the STN in social behavior and anxogenic-like behavior. In human, as DBS induces changes in the underlying dynamics of the stimulated brain networks, it could create an abnormal brain state in which anxiety and social behavior are altered. These results highlight another level of complexity of the behavioral changes after stimulation.

Published
2013

6. Quantitative assessment of the microcirculation in healthy volunteers and in patients with septic shock

Author

Can Ince, Arnaldo Dubin, Carolina Enrico, Vanina Siham Kanoore Edul, Alejandro Vazquez, Bruno Laviolle, Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], Intensive Care, Other departments, ACS - Amsterdam Cardiovascular Sciences, and Translational Physiology

Subjects
Male, shock, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, law.invention, sepsis, 0302 clinical medicine, law, MESH: Microcirculation, Prospective Studies, MESH: Aged, MESH: Blood Flow Velocity, Shock, Septic, Intensive care unit, MESH: Case-Control Studies, 3. Good health, Intensive Care Units, hypoperfusion, medicine.anatomical_structure, Shock (circulatory), MESH: Mouth Floor, Cardiology, Female, medicine.symptom, Perfusion, Blood Flow Velocity, Adult, medicine.medical_specialty, MESH: Shock, Septic, microcirculation, Microcirculation, Sepsis, 03 medical and health sciences, Internal medicine, medicine, Humans, Mouth Floor, Aged, MESH: Capillaries, MESH: Humans, Septic shock, business.industry, 030208 emergency & critical care medicine, MESH: Adult, Blood flow, medicine.disease, MESH: Prospective Studies, MESH: Male, Capillaries, Surgery, Red blood cell, red blood cell velocity, Case-Control Studies, MESH: Intensive Care Units, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract

International audience; OBJECTIVE: The microcirculation of septic patients has been characterized only semiquantitatively. Our goal was to characterize the sublingual microcirculation in healthy volunteers and patients with septic shock quantitatively. Our hypotheses were that 1) hyperdynamic blood flow is absent in septic shock; 2) nonsurvivors show more severe alterations than survivors; and 3) quantitative and semiquantitative microcirculatory parameters have a similar performance. DESIGN: Prospective, observational study. SETTING: Teaching intensive care unit in a university-affiliated hospital. SUBJECTS: Twenty-five normal volunteers and 25 patients with septic shock. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The sublingual microcirculation was evaluated by means of sidestream dark field imaging. Semiquantitative and quantitative microcirculatory parameters were determined through the use of applied software. Septic patients showed decreased perfused capillary density (13.2±4.4 mm/mm² vs. 16.6±1.6 mm/mm²), proportion of perfused capillaries (0.78±0.23 vs. 1.00±0.01), microvascular flow index (2.15±0.61 vs. 2.97±0.03), and red blood cell velocity (830±183 µm/sec vs. 1332±187 µm/sec) along with increased heterogeneity flow index (1.64±1.14 vs. 0.25±0.19) compared with controls. No differences were found in total capillary density (16.9±2.2 vs. 16.7±1.6). Only 4% of capillaries analyzed showed red blood cell velocities>75th percentile of the velocities of the normal volunteers. The nonsurvivors exhibited decreased perfused capillary density, proportion of perfused capillaries, and microvascular flow index along with increased heterogeneity flow index compared with the survivors. The correlations between microvascular flow index and proportion of perfused capillaries, total capillary density and number of grid-crossing capillaries, and red blood cell velocities and microvascular flow index gave high R values (0.92, 0.65, and 0.52, respectively; p

Published
2012

7. Are enterococci playing a role in postoperative peritonitis in critically ill patients?

Author

Pierre-Yves Donnio, Yannick Mallédant, Philippe Seguin, C. Brianchon, Nicolas Nesseler, Bruno Laviolle, Yoann Launey, 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 ), Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Microbiologie : Risques Infectieux, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), 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 ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), Université de Rennes (UR)-Université de Rennes (UR), Brébion, Alice, and Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Male, 0302 clinical medicine, Postoperative Complications, MESH: Postoperative Complications, 030212 general & internal medicine, Prospective Studies, MESH: Drug Utilization, Abscess, Postoperative peritonitis, MESH: Aged, First episode, 0303 health sciences, MESH: Middle Aged, biology, General Medicine, Middle Aged, 3. Good health, Predictive factor, Anti-Bacterial Agents, Infectious Diseases, MESH: Young Adult, MESH: Survival Analysis, MESH: Critical Illness, Female, MESH: Enterococcus, Microbiology (medical), Adult, medicine.medical_specialty, MESH: Peritonitis, Abdominal Abscess, Adolescent, Critical Illness, Peritonitis, 03 medical and health sciences, Young Adult, MESH: Abdominal Abscess, MESH: Anti-Bacterial Agents, Intensive care, Internal medicine, medicine, Humans, Antibiotic use, Gram-Positive Bacterial Infections, Aged, MESH: Adolescent, MESH: Humans, 030306 microbiology, business.industry, Critically ill, MESH: Adult, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, biology.organism_classification, medicine.disease, Survival Analysis, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, MESH: Male, MESH: Prospective Studies, Drug Utilization, Surgery, Enterococcus, MESH: Gram-Positive Bacterial Infections, business, MESH: Female
Abstract

International audience; This prospective non-interventional study is aimed at evaluating the role of enterococci in the postoperative course of postoperative peritonitis (POP) and the predictive factors for isolating Enterococcus spp. All adult patients, hospitalized in intensive care, who had POP between September 2006 and February 2010 were analysed. The patients' baseline clinical characteristics and microbiological and surgical characteristics of the first episode of POP were recorded. The rates of surgical and non-surgical complications and mortality were studied. A total of 139 patients were analysed and Enterococcus spp. were recovered in 61 patients (43%). The presence of enterococci was associated with significantly more intra-abdominal abscesses (26% vs 12%, p=0.025), but did not affect the rate of reoperation or mortality. Antibiotic use before reoperation was the only independent predictive factor for isolating enterococci (OR=2.19, CI95%: 1.02-4.70, p

Published
2011

8. Effect of an anesthesia with propofol compared with desflurane on free radical production and liver function after partial hepatectomy

Author

Laviolle, Bruno, Basquin, Cédric, Aguillon, David, Compagnon, Philippe, Morel, Isabelle, Turmel, Valérie, Seguin, Philippe, Boudjema, Karim, Bellissant, Eric, Mallédant, Yannick, Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Service d'anesthésie réanimation chirurgicale [Rennes], Hôpital Pontchaillou-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, 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 ), Unité de Biométrie, the French Ministry of health (2003 Regional Clinical Research Program, PHRC regional 2003), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou, and 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 )

Subjects
Male, monoethylglycinexylidide, Free Radicals, Isoflurane, Lidocaine, [SDV.CAN]Life Sciences [q-bio]/Cancer, Recovery of Function, Middle Aged, Oxidative Stress, Treatment Outcome, Liver, Liver Function Tests, Malondialdehyde, alpha-glutathione S-transferase, Anesthetics, Inhalation, Hepatectomy, Humans, Female, Single-Blind Method, Prospective Studies, Desflurane, Propofol, Aged
Abstract

International audience; Propofol has shown antioxidant properties, but no study has focused on liver resection surgery. The aim of this study was to investigate the effect of an anesthesia with propofol compared with desflurane on oxidative stress and hepatic function during and after partial hepatectomy. This was a prospective randomized study performed on two parallel groups. The primary endpoint was malondialdehyde (MDA) plasma concentration 30 min after hepatic vascular unclamping. Hepatic damages were evaluated by plasma levels of alpha-glutathione S-transferase (α-GST) 120 min after hepatic vascular unclamping and of aminotransferases at 120 min and on days 1, 2, 5, and 10. Liver function recovery was assessed by monoethylglycinexylidide (MEGX) formation 15 min after lidocaine injection on day 2 and by prothrombin time and plasma factor V at 120 min and on days 1, 2, 5, and 10. Thirty patients were analyzed (propofol group: 17; desflurane group: 13). There was no significant difference between groups for MDA plasma concentration 30 min after hepatic vascular unclamping (mean ± standard-deviation: 1.28 ± 0.40 and 1.21 ± 0.29 in propofol and desflurane groups, respectively, P = 0.608). Plasma levels of α-GST at 120 min were lower in propofol than in desflurane group (142.2 ± 75.4 vs. 205.7 ± 66.5, P = 0.023), and MEGX on day 2 was higher (0.092 ± 0.096 vs. 0.036 ± 0.020, P = 0.007). No differences between groups were observed with regard to plasma levels of aminotransferases, prothrombin time, and plasma factor V. Our study showed that in patients undergoing partial hepatectomy, propofol did not reduce MDA formation but seemed to display a protective effect on hepatic damages and liver function when compared to desflurane.

Published
2011

9. Determination of daptomycin in human plasma by liquid chromatography-tandem mass spectrometry. Clinical application

Author

Nicolas Collet, Danièle Bentué-Ferrer, Olivier Tribut, Eric Bellissant, Matthieu Revest, Marie-Clémence Verdier, Unité Laboratoire CIC, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de pharmacologie biologique et toxicologie [Rennes], CHU Pontchaillou [Rennes]-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pharmacologie biologique et toxicologie [Rennes], CHU Pontchaillou [Rennes]-Hôpital Pontchaillou, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Pharmacologie du Sepsis et Choc Septique, Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de pharmacologie biologique et toxicologie [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Hôpital Pontchaillou-CHU Pontchaillou [Rennes]

Subjects
daptomycin, Clinical Biochemistry, Bacteremia, Tandem mass spectrometry, 01 natural sciences, MESH: Daptomycin, Drug Stability, Liquid chromatography–mass spectrometry, Tandem Mass Spectrometry, MESH: Drug Monitoring, liquid chromatography-tandem mass spectrometry, MESH: Bacteremia, Chromatography, High Pressure Liquid, Antibacterial agent, 0303 health sciences, MESH: Middle Aged, medicine.diagnostic_test, Chemistry, General Medicine, Middle Aged, Staphylococcal Infections, 3. Good health, Anti-Bacterial Agents, Calibration, Drug Monitoring, medicine.drug, Electrospray ionization, therapeutic drug monitoring, MESH: Staphylococcus epidermidis, MESH: Staphylococcal Infections, Mass spectrometry, MESH: Calibration, 03 medical and health sciences, MESH: Drug Stability, MESH: Anti-Bacterial Agents, medicine, Staphylococcus epidermidis, Protein precipitation, Humans, MESH: Chromatography, High Pressure Liquid, Chromatography, MESH: Humans, 030306 microbiology, 010401 analytical chemistry, Biochemistry (medical), MESH: Tandem Mass Spectrometry, 0104 chemical sciences, Therapeutic drug monitoring, Daptomycin, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background: Daptomycin is a recently developed cyclic lipopeptide antibiotic active against most Gram-positive pathogens including vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus. To optimize treatment efficacy and safety, especially in patients undergoing multiple drug regimens and/or co-morbidities, a specific liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed for the quantification of daptomycin in plasma. Methods: A C18 column was used for separation, with a mobile phase initially consisting of 0.1% formic acid, water, and acetonitrile (ACN) in a linear gradient from 20% to 70%. After protein precipitation with ACN, the clear upper layer was diluted in water:ACN (50:50, v/v) before injection. Detection was performed using an electrospray ionization technique. MS/MS transitions, monitored in the positive ion mode were m/z 811.1 → m/z 313.1 for daptomycin, and m/z 609.4 → m/z 194.9 for reserpine, used as internal standard. Results: Elution of daptomycin and reserpine occurred at 4.5 and 3.9 min, respectively. The method was validated over a range of concentrations from 1 mg/L to 120 mg/L. The assay met recommended acceptance criteria: coefficients of variation were Conclusions: This method appears well-adapted to routine hospital practice for therapeutic drug monitoring of daptomycin considering its time of analysis, range of concentrations measured, precision and accuracy.

Published
2011

10. Heterogeneity of dietary profiles in highly sedentary young Guadeloupean women

Author

François Paillard, Sophie Antoine-Jonville, Bruno Laviolle, Olivier Hue, Stéphane Sinnapah, Adaptations au Climat Tropical, Exercice et Santé (ACTES), Université des Antilles et de la Guyane (UAG), Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], and Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Gerontology, Health Behavior, Medicine (miscellaneous), MESH: Food Habits, 030204 cardiovascular system & hematology, Body Mass Index, Correlation, 0302 clinical medicine, Surveys and Questionnaires, Medicine, Cluster Analysis, MESH: Obesity, Orthopedics and Sports Medicine, Nutritional Physiological Phenomena, 030212 general & internal medicine, Guadeloupe, West indies, 2. Zero hunger, Principal Component Analysis, Nutrition and Dietetics, MESH: Diet Surveys, Food frequency questionnaire, General Medicine, Adaptation, Physiological, Quartile, MESH: Young Adult, Female, MESH: Sedentary Lifestyle, MESH: Health Behavior, Physical activity, Diet Surveys, MESH: Body Mass Index, 03 medical and health sciences, Young Adult, MESH: Diet, Humans, MESH: Guadeloupe, Obesity, MESH: Nutritional Physiological Phenomena, Exercise, MESH: Principal Component Analysis, MESH: Humans, Recall, business.industry, MESH: Questionnaires, Feeding Behavior, MESH: Adaptation, Physiological, MESH: Cluster Analysis, Physical activity level, Diet, MESH: Exercise, Fruit intake, Sedentary Behavior, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Demography
Abstract

Objective:The aim was to examine the relationship between physical activity pattern and dietary profile. Although some clustering of the variables related to these major determinants of cardiovascular risk has been demonstrated, they have not been extensively studied together.Participants, Design, and Setting:Two hundred two female university students from the main Guadeloupe (French West Indies) campus participated. They self-administered a validated Food Frequency Questionnaire and the 1-yr recall Modifiable Activity Questionnaire. Principal-component analysis was performed on the scores and the variables related to the physical activity pattern and dietary profile.Results:A model including 10 variables explained 84.9% of the total variance. The physical activity pattern was not associated with the dietary profile, apart from fruit intake. The physical activity level was homogeneously low (median 1.58, first and last quartile cutoffs 1.54 and 1.66, respectively). There was no correlation between the physical activity level and the Food Frequency Questionnaire score (r = –.005).Conclusions:The absence of a strong relationship between the food and physical activity profiles is interpreted as a possible reflection of a dysregulation of the quality of food intake in this population with a sedentary lifestyle.

Published
2010

11. Early effects of erythropoietin on serum hepcidin and serum iron bioavailability in healthy volunteers

Author

Olivier Loréal, Fabrice Lainé, Martine Ropert, Guillaume Bouguen, Jeff Morcet, Yves Deugnier, Bruno Laviolle, Mark Westermann, Catherine Massart, Catherine Hamon, Fer et Métabolismes, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Foie, métabolismes et cancer, 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 )-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 ), Pharmacologie du Sepsis et Choc Septique, Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Foie, métabolismes et cancer, 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 ), Laboratoire de Biochimie Pharmaceutique, Université de Rennes (UR), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'hépato-gastroentérologie, Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Unité de Biométrie, Unité Laboratoire CIC, the Comité de la Recherche Clinique, CHU de Rennes, Clinicaltrials.gov identifier: NCT 00687518, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Foie, métabolismes et cancer, 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 )-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 ), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), 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 ), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)

Subjects
Male, Time Factors, Physiology, Hepcidin, MESH: Hematinics, MESH: Recombinant Proteins, Placebos, 0302 clinical medicine, MESH: Doping in Sports, Iron-Binding Proteins, Orthopedics and Sports Medicine, MESH: Double-Blind Method, MESH: Receptors, Cell Surface, MESH: Biological Availability, Doping in Sports, 0303 health sciences, MESH: Iron, Cross-Over Studies, biology, medicine.diagnostic_test, MESH: Antimicrobial Cationic Peptides, Transferrin, MESH: Enzyme-Linked Immunosorbent Assay, General Medicine, Recombinant Proteins, 3. Good health, Substance Abuse Detection, MESH: Young Adult, 030220 oncology & carcinogenesis, Injections, Intravenous, Serum iron, Erythropoiesis, France, MESH: Transferrin, medicine.drug, Adult, medicine.medical_specialty, Growth Differentiation Factor 15, Iron, MESH: Substance Abuse Detection, MESH: Placebos, Pharmacokinetic, MESH: Ferritins, Biological Availability, Enzyme-Linked Immunosorbent Assay, Receptors, Cell Surface, Placebo, MESH: Cross-Over Studies, 03 medical and health sciences, Young Adult, Pharmacokinetics, Double-Blind Method, Hepcidins, Physiology (medical), Internal medicine, medicine, Humans, MESH: Erythropoietin, MESH: Iron-Binding Proteins, Healthy volunteers, Erythropoietin, 030304 developmental biology, MESH: Humans, Transferrin saturation, business.industry, MESH: Growth Differentiation Factor 15, MESH: Time Factors, Public Health, Environmental and Occupational Health, MESH: Adult, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, MESH: Injections, Intravenous, MESH: Male, Bioavailability, MESH: France, Endocrinology, Ferritins, biology.protein, Hematinics, business, Antimicrobial Cationic Peptides
Abstract

International audience; Hepcidin regulates plasma iron bioavailability and subsequently iron availability for erythropoiesis. rHuEPO has been reported to decrease hepcidin expression in case of repeated subcutaneous injections. Thus, hepcidin level measurement could be a candidate marker for detection of rHuEPO abuse. However, when used for doping, rHuEPO can be injected intravenously and the scheme of injection is unknown. Our aim was to evaluate the early effects of a single intravenous rHuEPO injection on serum hepcidin levels. Fourteen male healthy volunteers received one intravenous injection of 50 U/Kg of rHuEPO during a placebo-controlled, randomized, double-blind, cross-over study. Serum hepcidin, quantified by a competitive ELISA method and iron parameters was then evaluated for 24 h. Serum levels of hepcidin were significantly increased 4 h after rHuEPO injection when compared with placebo injection (78.3 ± 55.5 vs. 57.5 ± 34.6 ng/ml, respectively; +36%, p

Published
2010

12. Biological and hemodynamic effects of low doses of fludrocortisone and hydrocortisone, alone or in combination, in healthy volunteers with hypoaldosteronism

Author

F. Laine, Eric Bellissant, Marie-Clémence Verdier, Bruno Laviolle, Audrey Lavenu, Erwan Donal, Catherine Massart, Danielle Pape, P. Le Maguet, Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité Laboratoire CIC, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-University of Brussels, University of Brussels-University of Brussels, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fer et Métabolismes, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Foie, métabolismes et cancer, 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 )-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 ), Modélisation PK et PK-PD, Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-University of Brussels, Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Foie, métabolismes et cancer, and 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 )-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 )

Subjects
Blood Glucose, Male, Hydrocortisone, MESH: Renin, Anti-Inflammatory Agents, Hemodynamics, 030204 cardiovascular system & hematology, 0302 clinical medicine, Renin, MESH: Sodium, Pharmacology (medical), MESH: Double-Blind Method, 030212 general & internal medicine, MESH: Hypoaldosteronism, Aldosterone, Cross-Over Studies, Water-Electrolyte Balance, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, MESH: Hydrocortisone, 3. Good health, MESH: Young Adult, Fludrocortisone, Corticosteroid, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Hypoaldosteronism, medicine.drug, Adult, medicine.medical_specialty, MESH: Hemodynamics, medicine.drug_class, MESH: Cross-Over Studies, 03 medical and health sciences, Young Adult, Double-Blind Method, Internal medicine, medicine, Humans, MESH: Fludrocortisone, MESH: Urodynamics, Pharmacology, MESH: Humans, business.industry, Septic shock, Sodium, MESH: Aldosterone, MESH: Adult, medicine.disease, Crossover study, MESH: Male, Urodynamics, Endocrinology, Mineralocorticoid, MESH: Anti-Inflammatory Agents, MESH: Water-Electrolyte Balance, MESH: Blood Glucose, business
Abstract

International audience; Low doses of hydrocortisone (HC) and fludrocortisone (FC) administered together improve the prognosis after septic shock; however, there continues to be disagreement about the utility of FC for this indication. The biological and hemodynamic effects of HC (50 mg intravenously) and FC (50 microg orally) were assessed in 12 healthy male volunteers with saline-induced hypoaldosteronism in a placebo-controlled, randomized, double-blind, crossover study performed according to a 2 x 2 factorial design. HC and FC significantly decreased urinary sodium and potassium levels (from -58% at 4 h to -28% at 10 h and from -35% at 8 h to -24% at 12 h, respectively) with additive effects. At 4 h after administration, HC significantly increased cardiac output (+14%), decreased systemic vascular resistances (-14%), and slightly increased heart rate (+4 beats/min), whereas FC had no hemodynamic effect. At doses used in septic shock, HC induced greater mineralocorticoid effect than FC did. HC also induced transient systemic hemodynamic effects, whereas FC did not. New studies are required to better define the optimal dose of FC in septic shock.

Published
2010

13. An unfavorable dietary pattern is associated with symptomatic ischemic stroke and carotid atherosclerosis

Author

François Paillard, Véronique Golfier, Guillaume Mahé, Jean-Michel De Bray, Bruno Laviolle, Thomas Ronzière, Thomas Cochery, Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Neurologie [Rennes] = Neurology [Rennes], CHU Pontchaillou [Rennes], Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Service de neurologie [Angers], Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], and Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes]

Subjects
Carotid Artery Diseases, Male, MESH: Food Habits, 030204 cardiovascular system & hematology, Gastroenterology, Brain Ischemia, Brain ischemia, Fatty Acids, Monounsaturated, Hospitals, University, 0302 clinical medicine, MESH: Fatty Acids, Omega-3, Risk Factors, MESH: Risk Factors, Vegetables, MESH: Diet Records, MESH: Fatty Acids, Omega-6, Stroke, chemistry.chemical_classification, Ultrasonography, Doppler, Duplex, MESH: Middle Aged, Cerebral infarction, Fatty Acids, food and beverages, MESH: Brain Ischemia, MESH: Life Style, Middle Aged, MESH: Case-Control Studies, Diet Records, 3. Good health, MESH: Fatty Acids, MESH: Fatty Acids, Monounsaturated, Female, France, Cardiology and Cardiovascular Medicine, MESH: Fruit, Polyunsaturated fatty acid, Adult, medicine.medical_specialty, MESH: Ultrasonography, Doppler, Duplex, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Hospitals, General, MESH: Stroke, Central nervous system disease, Duplex scanning, 03 medical and health sciences, MESH: Diet, Internal medicine, Fatty Acids, Omega-6, Fatty Acids, Omega-3, medicine, Humans, Life Style, MESH: Hospitals, University, MESH: Humans, Vascular disease, business.industry, MESH: Carotid Artery Diseases, Case-control study, MESH: Hospitals, General, MESH: Adult, Feeding Behavior, medicine.disease, MESH: Vegetables, MESH: Male, Surgery, Diet, MESH: France, chemistry, Case-Control Studies, Fruit, business, MESH: Female, 030217 neurology & neurosurgery
Abstract

International audience; OBJECTIVE: Ischemic strokes represent more than 80% of total strokes in Western countries. The influence of dietary factors on ischemic stroke risk is debated mainly because available data are limited. Our objective was to compare the dietary pattern of symptomatic ischemic stroke patients under 65 years old with control subjects using a validated 14-item food frequency questionnaire (FFQ). We also compared symptomatic ischemic stroke patients with carotid atherosclerosis with those without according to the presence or the absence of carotid plaque defined by duplex scanning. METHODS: This was a case-control multi-center study that took place in one University hospital and two general hospitals in France. One hundred twenty-four symptomatic ischemic stroke patients (confirmation by a neurologist and imaging; 66% smokers) and 50 controls (34% smokers) without any known cardiovascular disease or previous nutritional advice were included. The main outcome measure(s) were intake scores for saturated (SFA), monounsaturated (MUFA), Omega-3 polyunsaturated (Omega-3 PUFA), and Omega-6 polyunsaturated fatty acids (Omega-6PUFA). Fruit and vegetables and an overall cardiovascular dietary score were evaluated with the FFQ. The overall cardiovascular score is calculated as (MUFA + Omega-3 PUFA + fruits and vegetables) - (SFA) scores. RESULTS: Compared with controls, ischemic stroke patients had a higher SFA score (6.6 +/- 3.0 vs 4.9 +/- 2.7; P < .001), lower scores of MUFA (0.8 +/- 0.9 vs 1.5 +/- 1.2; P < .001), Omega-3 PUFA (1.7 +/- 1.6 vs 2.2 +/- 1.5; P = .013), Omega-6PUFA (2.6 +/- 2.5 vs 3.9 +/- 2.7; P = .002), fruit and vegetables (2.9 +/- 1.7 vs 3.8 +/- 1.6; P = .005), and a lower overall dietary score (-1.2 +/- 5.0 vs 2.5 +/- 4.4; P < .001). These results remained statistically significant after adjustment for age, gender, and smoking status. Ischemic stroke patients with carotid atherosclerosis (n = 54) had a worse overall cardiovascular dietary score than those without (n = 68): -2.2 +/- 4.4 vs -0.2 +/- 5.2; P = .024. CONCLUSION: Compared with controls, ischemic stroke patients, especially those with carotid atherosclerosis, have an unfavorable dietary pattern (high SFA, low fruit and vegetables, and Omega-3 PUFA consumptions) that may have been a facilitating condition of the ischemic stroke. Dietary recommendations of a healthy diet should be useful in ischemic stroke prevention, especially in patients with cardiovascular risk factors.

Published
2010

14. Risk factors for multidrug-resistant bacteria in patients with post-operative peritonitis requiring intensive care

Author

Yannick Fédun, Philippe Seguin, Pierre-Yves Donnio, Bruno Laviolle, Nicolas Nesseler, Yannick Mallédant, 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 ), Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Microbiologie : Risques Infectieux, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Faculté de Chirurgie Dentaire de Rennes-Faculté d'Odontologie-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), 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 ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes - UFR d'Odontologie (UR Odontologie), and Université de Rennes (UR)-Université de Rennes (UR)

Subjects
Male, empirical therapy, antimicrobial therapy, surgery, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Drug Resistance, Multiple, Bacterial, Pharmacology (medical), 030212 general & internal medicine, First episode, MESH: Aged, MESH: Microbial Sensitivity Tests, MESH: Middle Aged, Bacterial Infections, Middle Aged, 3. Good health, Anti-Bacterial Agents, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Piperacillin/tazobactam, Female, medicine.drug, Microbiology (medical), medicine.medical_specialty, MESH: Peritonitis, Critical Care, MESH: Bacterial Infections, Cefepime, Microbial Sensitivity Tests, Peritonitis, Tazobactam, 03 medical and health sciences, Intensive care, Clavulanic acid, Internal medicine, MESH: Anti-Bacterial Agents, medicine, Humans, Surgical Wound Infection, MESH: Intensive Care, MESH: Surgical Wound Infection, Aged, in vitro susceptibility, Pharmacology, MESH: Humans, Bacteria, business.industry, 030208 emergency & critical care medicine, MESH: Drug Resistance, Multiple, Bacterial, Amoxicillin, MESH: Male, Surgery, MESH: Bacteria, business, MESH: Female, Piperacillin
Abstract

International audience; OBJECTIVES: This prospective non-interventional study investigated the risk factors for multidrug-resistant bacteria (MDRB) in patients with post-operative peritonitis (POP), to provide guidance for empirical antimicrobial therapy. METHODS: All consecutive patients, >15 years old, admitted to a surgical intensive care unit (ICU) between September 2006 and January 2009 for a first episode of POP were included. Antibiotic susceptibilities of microorganisms recovered from blood cultures and peritoneal fluid were determined by disc diffusion. Amoxicillin/clavulanic acid, ticarcillin/clavulanic acid, piperacillin/tazobactam, cefotaxime, ceftazidime, cefepime, imipenem, gentamicin, amikacin and ciprofloxacin were tested against Gram-negative bacteria, and oxacillin, amoxicillin, vancomycin, gentamicin and erythromycin were tested against aerobic Gram-positive bacteria. Results were reported as susceptible or resistant. RESULTS: MDRB were isolated from 20/115 (17%) patients. In univariate analysis, use of antimicrobial therapy during the 3 months prior to hospitalization and a long duration between hospital admission or first operation and relaparotomy were significantly associated with MDRB recovery. In multivariate analysis, only antimicrobial treatment in the 3 months preceding hospitalization and duration between first operation and relaparotomy were independent risk factors for MDRB [odds ratio (OR) = 5.80, 95% confidence interval (95% CI) = 1.99-16.91 and OR = 1.10, 95% CI = 1.02-1.19, respectively]. No MDRB were found when the delay between the first operation and relaparotomy was 5 days between the first operation and relaparotomy.

Published
2010

15. Evolution of the upper and lower landing site after endovascular aortic aneurysm repair

Author

Adrien Kaladji, Jean-François Heautot, Guillaume Pinel, Alain Cardon, Bruno Laviolle, Antoine Lucas, Laboratoire Traitement du Signal et de l'Image (LTSI), 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), Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], CHU Pontchaillou [Rennes], Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Senhadji, Lotfi

Subjects
Male, Time Factors, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, Endoleak, 030232 urology & nephrology, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Aortic aneurysm, MESH: Blood Vessel Prosthesis, 0302 clinical medicine, MESH: Aged, 80 and over, Foreign-Body Migration, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, ComputingMilieux_MISCELLANEOUS, MESH: Treatment Outcome, Aged, 80 and over, MESH: Aged, Endovascular Procedures, MESH: Iliac Artery, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Treatment Outcome, Female, Stents, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, MESH: Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, MESH: Aortic Aneurysm, Abdominal, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, MESH: Prosthesis Design, Reoperation, medicine.medical_specialty, MESH: Endovascular Procedures, [INFO.INFO-TS] Computer Science [cs]/Signal and Image Processing, MESH: Foreign-Body Migration, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Prosthesis Design, Aortography, Iliac Artery, MESH: Reoperation, 03 medical and health sciences, Blood Vessel Prosthesis Implantation, Aneurysm, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Blood vessel prosthesis, medicine.artery, MESH: Analysis of Variance, MESH: Endoleak, medicine, Humans, MESH: Aortography, In patient, Endovascular treatment, Renal artery, MESH: Kaplan-Meier Estimate, [SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing, Aged, Retrospective Studies, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Analysis of Variance, Aortic aneurysm repair, MESH: Humans, business.industry, MESH: Time Factors, MESH: Retrospective Studies, MESH: Blood Vessel Prosthesis Implantation, medicine.disease, MESH: Male, Surgery, Blood Vessel Prosthesis, MESH: France, MESH: Stents, business, Tomography, X-Ray Computed, MESH: Female, Abdominal surgery, Aortic Aneurysm, Abdominal
Abstract

BACKGROUND: The evolution and correlation between the aortic neck and distally located iliac necks after endovascular treatment of abdominal aortic aneurysms (AAAs) was studied. METHODS: Of 179 patients who had undergone AAA repair between 2003 and 2007, 61 received the same radiologic follow-up and were included in this retrospective study. Data for 61 aortic necks and 115 iliac arteries were analyzed using the preoperative scan, 1-month visit, and final follow-up, with a minimum mean follow-up of 24 ± 15.2 months. Three measurements were taken of the aortic neck: subrenal (D1a), 15 mm below the lowest renal artery (D1b), and at the origin of the aneurysm (D1c). Three measurements were taken at the level of the iliac arteries: origin (Da), middle (Db), and the iliac bifurcation (Dc). These measurements were analyzed using analysis of variance and Spearman correlation coefficient. The results were evaluated for subsequent endoleaks, migrations, and reinterventions. All diameters were compared between patients with a regression of >10% in the greatest diameter of AAA at last follow-up (group A, n = 35) and those without (group B, n = 26). RESULTS: All diameters (in mm) increased significantly over time at the level of the proximal neck (D1a = 3.7 ± 2.8, P = .018; D1b = 4.4 ± 2.5, P = .016; D1c = 4.3 ± 3.1, P = .036) and iliac arteries (Da = 2.1 ± 0.2, P = .0006; Db = 2.5 ± 0.5, P = .0006; Dc = 3 ± 0.7, P = .007). The increase in diameters at the proximal neck and iliac arteries evolved independently (insignificant correlation), with the exception of D1b and Dc (P = .006), which showed a weak correlation (r = 0.363). The group A patients presented increases in all diameters, although to a less significant extent (P < .05) than group B patients. During follow-up, a proximal endoleak and a distal endoleak occurred, both requiring reintervention. CONCLUSIONS: Our results show a trend toward dilatation of the aortic neck and iliac arteries, with no correlation between the two levels, even in patients with a regression of the aneurysm sac during follow-up. Although this study found no correlation with the occurrence of endoleaks, our results suggest the need for a longer follow-up, especially on the landing sites.

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