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1. Development of an ex vivo respiratory pediatric model of bronchopulmonary dysplasia for aerosol deposition studies

Author

Anthony Clotagatide, Sophie Perinel, Yoann Montigaud, Jean-Christophe Dubus, Clémence Goy, Nathalie Prevot, Jérémie Pourchez, Lara Leclerc, Marie Suau, Santé Ingénierie Biologie Saint-Etienne (SAINBIOSE), Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-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, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Service d'Histologie Embryologie, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Service de Médecine Nucléaire [Saint-Etienne], INSERM U1059, SAINBIOSE - Santé, Ingénierie, Biologie, Saint-Etienne (SAINBIOSE-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), CHRU Saint-Etienne, and CHU Saint-Etienne-Hôpital Bellevue

Subjects
0301 basic medicine, Thorax, Models, Anatomic, lcsh:Medicine, Article, 03 medical and health sciences, 0302 clinical medicine, In vivo, medicine, Tidal Volume, Humans, Respiratory system, lcsh:Science, Lung, ComputingMilieux_MISCELLANEOUS, Bronchopulmonary Dysplasia, Aerosols, Multidisciplinary, Inhalation, business.industry, Respiration, lcsh:R, Infant, Newborn, respiratory system, medicine.disease, 030104 developmental biology, medicine.anatomical_structure, Bronchopulmonary dysplasia, Printing, Three-Dimensional, Breathing, lcsh:Q, [SDV.IB]Life Sciences [q-bio]/Bioengineering, business, Nuclear medicine, Pulmonary Ventilation, 030217 neurology & neurosurgery, Ex vivo
Abstract

Ethical restrictions are limitations of in vivo inhalation studies, on humans and animal models. Thus, in vitro or ex vivo anatomical models offer an interesting alternative if limitations are clearly identified and if extrapolation to human is made with caution. This work aimed to develop an ex vivo infant-like respiratory model of bronchopulmonary dysplasia easy to use, reliable and relevant compared to in vivo infant data. This model is composed of a 3D-printed head connected to a sealed enclosure containing a leporine thorax. Physiological data and pleural-mimicking depressions were measured for chosen respiratory rates. Homogeneity of ventilation was assessed by 81mkrypton scintigraphies. Regional radioaerosol deposition was quantified with 99mtechnetium-diethylene triamine pentaacetic acid after jet nebulization. Tidal volumes values are ranged from 33.16 ± 7.37 to 37.44 ± 7.43 mL and compliance values from 1.78 ± 0.65 to 1.85 ± 0.99 mL/cmH2O. Ventilation scintigraphies showed a homogenous ventilation with asymmetric repartition: 56.94% ± 9.4% in right lung and 42.83% ± 9.36 in left lung. Regional aerosol deposition in lungs exerted 2.60% ± 2.24% of initial load of radioactivity. To conclude the anatomical model satisfactorily mimic a 3-months old BPD-suffering bronchopulmonary dysplasia and can be an interesting tool for aerosol regional deposition studies.

Published
2019
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2. Limited screening with versus without 18F-fluorodeoxyglucose PET/CT for occult malignancy in unprovoked venous thromboembolism: an open-label randomised controlled trial

Author

Olivier Couturier, Grégoire Le Gal, Pierre-Yves Le Roux, Philippe Robin, Bernard Tardy, Nadia Ghazzar, Benjamin Planquette, Olivier Sanchez, Sandrine Accassat, Pierre-Yves Salaun, Nathalie Prevot-Bitot, Francis Couturaud, Pierre-Marie Roy, Aurélien Delluc, Service de médecine nucléaire [Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Hôpital Morvan [Brest], Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service de Pneumologie, soins intensifs (Pneumo - HEGP), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Innovations thérapeutiques en hémostase (IThEM - U1140), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Vasculaire et Thérapeutique, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Département de Médecine d'Urgence (Urgences - ANGERS), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Médecine Nucléaire (Med Nuc - HEGP), Service de Médecine Nucléaire [Saint-Etienne], CHU Saint-Etienne-Hôpital Bellevue, Biologie intégrative du tissu osseux, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Nucléaire (Med Nuc - ANGERS), Service des Urgences et de Réanimation Médicale (Urg - SAINT ETIENNE), CIC Saint Etienne, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Nord (Saint Etienne), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Ottawa Hospital Research Institute [Ottawa] (OHRI), Hôpital Morvan [Brest]-Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Service de Pneumologie ( Pneumo - HEGP ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Innovations thérapeutiques en hémostase ( IThEM - U1140 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Saint-Etienne ( CHU de Saint-Etienne ), Département de Médecine d'Urgence ( Urgences - ANGERS ), CHU Angers, Département de Médecine Interne et Pneumologie [Brest] ( DMIP - Brest ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Service de Médecine Nucléaire ( Med Nuc - HEGP ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Jean Monnet [Saint-Étienne] ( UJM ), Service de Médecine Nucléaire ( Med Nuc - ANGERS ), Service des Urgences et de Réanimation Médicale ( Urg - SAINT ETIENNE ), Centre Hospitalier Universitaire de Saint-Etienne ( CHU de Saint-Etienne ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Nord (Saint Etienne), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital de la Cavale Blanche, Ottawa Hospital Research Institute [Ottawa] ( OHRI ), Hôpital Morvan [Brest]-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Université de Brest (UBO), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)

Subjects
Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Population, Physical examination, Context (language use), 030204 cardiovascular system & hematology, Multimodal Imaging, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Fluorodeoxyglucose F18, law, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Internal medicine, medicine, Humans, Whole Body Imaging, 030212 general & internal medicine, Risk factor, education, Early Detection of Cancer, Aged, Neoplasm Staging, Aged, 80 and over, education.field_of_study, Intention-to-treat analysis, [ SDV ] Life Sciences [q-bio], medicine.diagnostic_test, business.industry, Absolute risk reduction, Cancer, Venous Thromboembolism, Middle Aged, medicine.disease, Intention to Treat Analysis, 3. Good health, Oncology, Positron-Emission Tomography, Neoplasms, Unknown Primary, Female, Radiology, Radiopharmaceuticals, Tomography, X-Ray Computed, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Summary Background Clear guidelines for the investigation of occult malignancy after unprovoked venous thromboembolism are not yet available. 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT could serve as a comprehensive screening strategy for occult malignancy in this context. We aimed to compare a screening strategy based on 18 F-FDG PET/CT with a limited screening strategy for detection of malignant disease in patients with unprovoked venous thromboembolism. Methods In an open-label, multicentre, randomised study we enrolled patients from four French university hospitals. Patients aged 18 years or older, diagnosed with unprovoked venous thromboembolism (not provoked by a major inherited or acquired risk factor) were invited to participate. Patients were randomly assigned in a 1:1 ratio to a limited screening strategy (physical examination, usual laboratory tests, and basic radiographs) or a screening strategy consisting of the limited strategy plus an 18 F-FDG PET/CT scan. Randomisation was done with a dedicated central web-based randomisation system, in block sizes of six, stratified by centre, and concealed from the investigators. Patients and investigators were not masked to study group assignment. Patients were followed up for 2 years. The primary outcome was the proportion of patients with a cancer diagnosis in each group after the initial screening assessment. Analyses were conducted in modified intention-to-test and per-protocol populations. This trial is completed and registered with ClinicalTrials.gov, number NCT00964275. Findings Between March 3, 2009, and Aug 18, 2012, we enrolled and randomly assigned 399 patients; five withdrew consent, leaving 197 in each group for the modified intention-to-test analysis. After initial screening assessment, cancer was diagnosed in 11 (5·6%) patients in the 18 F-FDG PET/CT group and four (2·0%) patients in the limited screening group (absolute risk difference 3·6%, 95% CI −0·4 to 7·9; p=0·07). At the initial screening assessment, seven (64%) of the 11 cancers diagnosed in the 18 F-FDG PET/CT group were early-stage compared with two of four cancers diagnosed in the limited screening group (p=1·00). One (0·5%) occult malignancy was detected in 186 patients who had negative initial screening in the 18 F-FDG PET/CT group, compared with nine (4·7%) in 193 patients in the limited screening group (absolute risk difference 4·1%, 95% CI 0·8 to 8·4, p=0·01). Overall, five (42%) of the 12 cancers diagnosed in the 18 F-FDG PET/CT group were advanced stage, compared with seven (54%) of the 13 cancers diagnosed in the limited screening group (p=0·70). 16 patients died during follow-up, eight (4·1%) in each group. Two (1·0%) patients in the 18 F-FDG PET/CT group and five (2·5%) in the limited screening group had cancer-related deaths. Interpretation A strategy including limited screening and a 18 F-FDG PET/CT was not associated with a significantly higher rate of cancer diagnosis after unprovoked venous thromboembolism. The risk of subsequent cancer diagnosis was, however, lower in patients who had negative initial screening that included 18 F-FDG PET/CT than in patients who had negative initial limited screening. Whether or not 18 F-FDG PET/CT might be useful in a more selected population of patients with a high risk of cancer remains to be determined. Funding Programme Hospitalier de Recherche Clinique (French Department of Health).

Published
2016
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3. Risk factors of occult malignancy in patients with unprovoked venous thromboembolism

Author

Pierre-Yves Le Roux, Christian Lavigne, Grégoire Le Gal, Philippe Robin, Adel Merah, Jean Pastre, Cécile Tromeur, Francis Couturaud, Pierre-Yves Salaun, Benjamin Planquette, Nathalie Prevot-Bitot, Calvez, Ghislaine, CHRU Brest - Service de médecine nucléaire (CHU - BREST - Med Nucléaire), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier de Versailles André Mignot (CHV), Service de Médecine Nucléaire [Saint-Etienne], CHU Saint-Etienne-Hôpital Bellevue, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CIC Brest, and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche

Subjects
Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Internal medicine, medicine, Occult malignancy, Humans, In patient, 030212 general & internal medicine, Leukocytosis, Risk factor, ComputingMilieux_MISCELLANEOUS, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Univariate analysis, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Thrombocytosis, business.industry, Cancer, Hematology, Venous Thromboembolism, Middle Aged, medicine.disease, 3. Good health, Surgery, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV] Life Sciences [q-bio], [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, medicine.symptom, business, Venous thromboembolism, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Venous thromboembolism (VTE) can occur as the first manifestation of an underlying occult malignancy. It remains unclear whether or not a better selection of high risk patients might lead to more efficient occult cancer screening strategies. Our aim was to assess the predictors of occult malignancy diagnosis in patients with unprovoked VTE. Univariate analyses were performed to assess the effect of candidate predictors on occult cancer detection in patients enrolled in a prospective, multicenter, randomized, controlled study (MVTEP study) whose primary aim was to compare a limited screening strategy with a strategy combining limited screening and FDG PET/CT in patients with unprovoked VTE. This trial is completed and registered with ClinicalTrials.gov, number NCT00964275. Between March 3, 2009, and August 18, 2012, 399 patients were included. Five patients withdrew consent and refused the use of their data, and no VTE was confirmed in 2 patients who were excluded from this analysis. A total of 25 (6.4%) out of the 392 analysed patients received a new diagnosis of malignancyduring the 2-years follow-up. Age≥50years (p=0.01), male gender (p=0.04), leukocytes count (p=0.01), and platelets count (p=0.03) were associated with occult cancer detection. Patients with leukocytosis or thrombocytosis had a risk of cancer way above 10%. Previous VTE and smoker status (combining previous and current smokers) were not associated with occult cancer diagnosis (p>0.05). Demographic characteristics (age and sex), and laboratory tests (high platelets and leukocytes counts) may be associated with cancer detection in patients withunprovoked VTE.

Published
2017

4. Performance of 18F-fluorodesoxyglucose positron-emission tomography combined with low-dose computed tomography for cancer screening in patients with unprovoked venous thromboembolism

Author

Robin, Philippe, Le Roux, Pierre-Yves, Lacut, Karine, Planquette, Benjamin, Prevot-Bitot, Nathalie, Lavigne, Christian, Pastre, Jean, Merah, Adel, Le Gal, Grégoire, Salaun, Pierre-Yves, Zhang, Qinghui, CHRU Brest - Service de médecine nucléaire (CHU - BREST - Med Nucléaire), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Centre Hospitalier de Versailles André Mignot (CHV), Service de Médecine Nucléaire [Saint-Etienne], CHU Saint-Etienne-Hôpital Bellevue, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), and Calvez, Ghislaine

Subjects
[SDV] Life Sciences [q-bio], [SDV.IB] Life Sciences [q-bio]/Bioengineering, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [SDV.CAN] Life Sciences [q-bio]/Cancer, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV]Life Sciences [q-bio], [SDV.IB]Life Sciences [q-bio]/Bioengineering, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine
Abstract

International audience

Published
2017

5. Additional testing following screening strategies for occult malignancy diagnosis in patients with unprovoked venous thromboembolism

Author

Emmanuelle Le Moigne, Jean Pastre, Nathalie Prevot-Bitot, Francis Couturaud, Pierre-Yves Le Roux, Philippe Robin, Benjamin Planquette, Pierre-Marie Roy, Pierre-Yves Salaun, Grégoire Le Gal, Adel Merah, Calvez, Ghislaine, CHRU Brest - Service de médecine nucléaire (CHU - BREST - Med Nucléaire), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier de Versailles André Mignot (CHV), Service de Médecine Nucléaire [Saint-Etienne], CHU Saint-Etienne-Hôpital Bellevue, Centre de Recherche Clinique (CRC 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), CIC Brest, and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche

Subjects
Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Statistical difference, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, law.invention, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, law, Fluorodeoxyglucose F18, Cancer screening, Occult malignancy, medicine, Humans, In patient, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Early Detection of Cancer, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, medicine.diagnostic_test, business.industry, Absolute risk reduction, Hematology, Venous Thromboembolism, Middle Aged, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV] Life Sciences [q-bio], Positron emission tomography, Positron-Emission Tomography, Neoplasms, Unknown Primary, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, Radiology, business, Nuclear medicine, Tomography, X-Ray Computed, Venous thromboembolism, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

18F-Fluorodesoxyglucose Positron-Emission-Tomography combined with Computed-Tomography (FDG PET/CT) might be an attractive tool for cancer screening in patients with venous thromboembolism (VTE), allowing non-invasive whole-body imaging. One of the frequent criticisms to the use of FDG PET/CT for screening is the potential for false positive results leading to unnecessary/invasive investigations. Our aim was to compare the frequency and invasiveness of additional testing following extensive and limited screening strategies for occult malignancy in patients with unprovoked VTE. We analysed patients included in the MVTEP study, a randomized trial that compared a screening strategy based on FDG-PET/CT with a limited screening strategy for occult malignancy diagnosis in patients with unprovoked VTE. All additional diagnostic procedures following screening were recorded and classified as invasive or non-invasive. A total of 394 patients were analysed. Additional diagnostic procedures realized in patients of each group consisted of 59 tests in patients of the FDG PET/CT group versus 53 tests among the patients from the limited screening group (p=0.65). Overall, 45 (22.8%) patients in the FDG PET/CT group underwent additional diagnostic tests, versus 32 (16.2%) in the limited screening group (absolute risk difference+6.6%, 95% CI -1.3 to +14.4%, p=0.13). Sixteen (8.1%) patients in the FDG PET/CT group underwent invasive procedures, versus 6 (3%) in the limited screening group (absolute risk difference+5.1%, 95% CI +0.5 to +10.0%, p=0.03). We found no statistical difference in the number of additional procedures following each screening strategy. However, a higher number of invasive tests were performed in the FDG PET/CT group.

Published
2017

6. Assessment of new-generation high-power electronic nicotine delivery system as thermal aerosol generation device for inhaled bronchodilators

Author

Fabien de Oliveira, Thierry Basset, Sophie Perinel-Ragey, Jean-Michel Vergnon, Nathalie Prevot, Jérémie Pourchez, Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), INSERM U1059, SAINBIOSE - Santé, Ingénierie, Biologie, Saint-Etienne (SAINBIOSE-ENSMSE), Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Ingénierie et Santé (CIS-ENSMSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Université de Lyon, Toxicology Department, CHU Saint-Etienne, Service de Pneumologie [Saint-Etienne], Service de Médecine Nucléaire [Saint-Etienne], CHU Saint-Etienne-Hôpital Bellevue, and Chatagnon, Amélie

Subjects
Drug, Nicotine, Hot Temperature, [CHIM.ANAL] Chemical Sciences/Analytical chemistry, Materials science, medicine.drug_class, media_common.quotation_subject, Pharmaceutical Science, Nanotechnology, Electronic Nicotine Delivery Systems, Power level, 03 medical and health sciences, Drug Delivery Systems, 0302 clinical medicine, [CHIM.ANAL]Chemical Sciences/Analytical chemistry, Bronchodilator, Administration, Inhalation, Terbutaline, medicine, 030212 general & internal medicine, Particle Size, ComputingMilieux_MISCELLANEOUS, media_common, Aerosols, Chromatography, Inhalation, Terbutaline Sulfate, Bronchodilator Agents, Aerosol, 030228 respiratory system, Nicotine delivery, Drug delivery
Abstract

Purpose A need remains for alternative devices for aerosol drug delivery that are low cost, convenient and easy to use for the patient, but also capable of producing small-sized aerosol particles. This study investigated the potential of recent high power electronic nicotine delivery systems (ENDS) as aerosol generation devices for inhaled bronchodilators. Methods The particle size distribution was measured using a cascade impactor. The delivery of terbutaline sulfate, a current bronchodilator used for asthma or COPD therapy by inhalation, was studied. This drug was quantified by liquid chromatography coupled with tandem mass spectrometry. Results The particle size distribution in terms of mass frequency (in two ways, gravimetrically and quantitatively through drug assay on each stage) and the terbutaline sulfate concentration in the aerosol were elucidated. The mass median aerodynamic diameter (MMAD) and the drug delivery rose when the power level increased, to reach 5.6 ± 0.4 μg/puff with a MMAD of 0.78 ± 0.03 μm at 25 W. Conclusion New generation high-power ENDS are very efficient to generate carrier-droplets in the submicron range containing drug molecules with a constant drug concentration whatever the size-fractions. ENDS appear to be highly patient-adaptive.

Published
2017

7. Performance of 18F fluoro-2-désoxy-D-glucose positron emission tomography/computed tomography for the diagnosis of venous thromboembolism

Author

Philippe Robin, Abdelmalek Reffad, Bernard Tardy, Grégoire Le Gal, Pierre-Yves Le Roux, Aurélien Delluc, Francis Couturaud, Pierre-Yves Salaun, Ronan Abgral, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Department of Nuclear Medicine, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Département des Urgences (Urgences - SAINT ETIENNE), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Service de Médecine Nucléaire [Saint-Etienne], CHU Saint-Etienne-Hôpital Bellevue, Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Ottawa Hospital Research Institute [Ottawa] (OHRI)

Subjects
Adult, Male, medicine.medical_specialty, pulmonary embolism, Deep vein, [SDV]Life Sciences [q-bio], Population, venous thromboembolism, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, FDG-Positron Emission Tomography, Scintigraphy, Multimodal Imaging, deep vein thrombosis, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Pulmonary angiography, medicine, Humans, Prospective Studies, education, Aged, Ultrasonography, education.field_of_study, Lung, medicine.diagnostic_test, business.industry, Reproducibility of Results, Hematology, Middle Aged, medicine.disease, Thrombosis, FDG PET/CT, 3. Good health, Pulmonary embolism, Perfusion, Treatment Outcome, medicine.anatomical_structure, inflammation, Positron-Emission Tomography, Female, Radiology, Tomography, X-Ray Computed, Nuclear medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Thrombosis and inflammation are intimately linked. Inflammatory component of venous thromboembolism (VTE) may allow the use of FDG positron emission tomography / computed tomography (FDG PET/CT) in the detection of thrombotic process. Published studies remain limited and contradictory. We aimed at evaluating the performance of FDG PET/CT in the detection of VTE in a population of patients enrolled in a prospective study evaluating FDG PET/CT for cancer screening in etiological assessment of idiopathic VTE. The first consecutive 100 patients who underwent FDG PET/CT were included. Visual and quantitative analyses of vascular axes was performed and compared with lower limb veins compression ultrasonography, lung scintigraphy and/or computed tomography pulmonary angiography. Out of the 100 patients, 63 presented lobar pulmonary embolism for a total of 217 embolic sites and 62 had a deep vein thrombosis for a total of 143 thrombotic sites. Regarding pulmonary embolism, sensitivity and specificity of FDG PET/CT were 3% (95%CI: 1-6%) and 99% (95%CI: 98-100%). SUV max ratio between pulmonary embolism location and non-pathological contralateral vessel was 1.04±0.18 (p=0.7). Regarding deep vein thrombosis, sensitivity and specificity were 31% (95%CI: 24-39%) and 88% (95%CI: 81-92%). The metabolic activity was significantly higher than in contralateral vessels (p

Published
2014
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