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Gellen B, Canoui-Poitrine F, Lesault PF, Le Thuaut A, Lim P, Gueret P, Guendouz S, Pongas D, Teiger E, Dubois-Randé JL, Hittinger L, Damy T. Usefulness of tissue Doppler imaging for assessing left ventricular filling pressure in patients with stable severe systolic heart failure. Am J Cardiol 2013; 112:1619-24. [PMID: 24012031 DOI: 10.1016/j.amjcard.2013.07.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 07/12/2013] [Accepted: 07/12/2013] [Indexed: 11/17/2022]
Abstract
The ratio of early transmitral blood flow velocity over tissue Doppler early diastolic mitral annulus velocity (E/e') was found unreliable for estimating pulmonary capillary wedge pressure (PCWP) in patients with decompensated systolic heart failure (HF). The objective of this study was to test its reliability in stable HF. Therefore, 130 consecutive patients with a left ventricular (LV) ejection fraction of <35% and stable HF underwent right-sided cardiac catheterization and transthoracic echocardiography with measurement of transmitral flow velocities (E, A) and mitral annulus velocities during systole (s') and diastole (e'). Mean age was 56 ± 11 years and mean LV ejection fraction was 28 ± 8%; 48% had PCWP of >15 mm Hg. E/e'septal correlated more strongly with PCWP (r = 0.53) compared with E/e'lateral (r = 0.41) and E/e'mean (r = 0.50; all p values <0.001). The area under the receiver operating characteristic curve (AUC) of E/e' ratios for PCWP estimation was 0.79 (95% confidence interval [CI] 0.70 to 0.87) for E/e'septal, 0.72 (95% CI 0.63 to 0.82) for E/elateral, and 0.79 (95% CI 0.70 to 0.87) for E/emean (all p values <0.0001). AUCs of E/eseptal and E/emean did not vary with s'septal, QRS width, or resynchronization. Using a cutoff of 8, negative predictive value of E/e'septal was 89% and negative likelihood ratio of 0.15. E/e'lateral showed good diagnostic performance only in patients with s'lateral of >4.5 cm/s (n = 77, 59%; AUC = 0.82; 95% CI 0.71 to 0.92; s'lateral of ≤4.5 cm/s: AUC = 0.54; 95% CI 0.38 to 0.70; p = 0.005). In conclusion, e' is useful for estimating LV filling pressure in stable severe systolic HF. E/e'septal showed good diagnostic performance for detecting normal filling pressures.
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Affiliation(s)
- Barnabas Gellen
- Department of Cardiology, Henri Mondor University Hospital, Université Paris Est, Assistance Publique-Hôpitaux de Paris, Créteil, France; Department of Cardiac Rehabilitation, Albert Chenevier University Hospital, Université Paris Est, Assistance Publique-Hôpitaux de Paris, Créteil, France; Department of Physiology, Henri Mondor University Hospital, Université Paris Est, Assistance Publique-Hôpitaux de Paris, Créteil, France.
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102
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Bastuji-Garin S, Sbidian E, Gaudy-Marqueste C, Ferrat E, Roujeau JC, Richard MA, Canoui-Poitrine F. Impact of STROBE statement publication on quality of observational study reporting: interrupted time series versus before-after analysis. PLoS One 2013; 8:e64733. [PMID: 23990867 PMCID: PMC3753332 DOI: 10.1371/journal.pone.0064733] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 04/17/2013] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND In uncontrolled before-after studies, CONSORT was shown to improve the reporting of randomised trials. Before-after studies ignore underlying secular trends and may overestimate the impact of interventions. Our aim was to assess the impact of the 2007 STROBE statement publication on the quality of observational study reporting, using both uncontrolled before-after analyses and interrupted time series. METHODS For this quasi-experimental study, original articles reporting cohort, case-control, and cross-sectional studies published between 2004 and 2010 in the four dermatological journals having the highest 5-year impact factors (≥ 4) were selected. We compared the proportions of STROBE items (STROBE score) adequately reported in each article during three periods, two pre STROBE period (2004-2005 and 2006-2007) and one post STROBE period (2008-2010). Segmented regression analysis of interrupted time series was also performed. RESULTS Of the 456 included articles, 187 (41%) reported cohort studies, 166 (36.4%) cross-sectional studies, and 103 (22.6%) case-control studies. The median STROBE score was 57% (range, 18%-98%). Before-after analysis evidenced significant STROBE score increases between the two pre-STROBE periods and between the earliest pre-STROBE period and the post-STROBE period (median score2004-05 48% versus median score2008-10 58%, p<0.001) but not between the immediate pre-STROBE period and the post-STROBE period (median score2006-07 58% versus median score2008-10 58%, p = 0.42). In the pre STROBE period, the six-monthly mean STROBE score increased significantly, by 1.19% per six-month period (absolute increase 95%CI, 0.26% to 2.11%, p = 0.016). By segmented analysis, no significant changes in STROBE score trends occurred (-0.40%; 95%CI, -2.20 to 1.41; p = 0.64) in the post STROBE statement publication. INTERPRETATION The quality of reports increased over time but was not affected by STROBE. Our findings raise concerns about the relevance of uncontrolled before-after analysis for estimating the impact of guidelines.
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Affiliation(s)
- Sylvie Bastuji-Garin
- Université Paris Est Créteil (UPEC), LIC EA4393 (Laboratoire d'Investigation Clinique), Créteil, France
- AP-HP, Hôpital Henri-Mondor, Department of Clinical Research and Public Health, Créteil, France
- AP-HP, Hôpital Henri-Mondor, Unité de Recherche Clinique (URC), Créteil, France
- * E-mail:
| | - Emilie Sbidian
- Université Paris Est Créteil (UPEC), LIC EA4393 (Laboratoire d'Investigation Clinique), Créteil, France
- AP-HP, Hôpital Henri-Mondor, Department of Dermatology, Créteil, France
| | | | - Emilie Ferrat
- Université Paris Est Créteil (UPEC), LIC EA4393 (Laboratoire d'Investigation Clinique), Créteil, France
- Université Paris Est Créteil (UPEC), Faculté de Medecine, Department of General Practice, Créteil, France
| | | | | | - Florence Canoui-Poitrine
- Université Paris Est Créteil (UPEC), LIC EA4393 (Laboratoire d'Investigation Clinique), Créteil, France
- AP-HP, Hôpital Henri-Mondor, Department of Clinical Research and Public Health, Créteil, France
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103
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Blachier M, Canoui-Poitrine F, Poulain C, Dougados M, Ferkal S, Fautrel B, Le Corvoisier P, Rahmouni A, Farrenq V, Bastugi-Garin S, Claudepierre P. FRI0404 Which factors are associated with X-rays lesions in early axial spondyloarthritis? Results from the desir cohort. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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104
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Sobhani I, Mansour H, Furet JP, Belkacemi Y, Langella P, Aparicio T, Tournigand C, Canoui-Poitrine F. Accuracy of Wif1 methylated gene test and microbial changes identifying colorectal cancer. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e14525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14525 Background: Faecal blood test (FOBT) is recommended for CRC screening. However, it had fair sensitivity and specificity (both around 50%). CRC results from genetic and epigenetic alterations involving Wnt pathway. Environmental factors can methylate Wnt inhibitory factor1 (Wif1). Colon microbiota dysbiosis, consequence of environment, is also associated with CRC. The aim was to assess the diagnosis accuracies of dysbiosis, methylated genes and FOBT for identifying CRC versus colonoscopy. Methods: A cross-sectional study included subjects referred (2003 up to 2007) for colonoscopy. Clinical factors (age, gender, personal/familial history of cancer, BMI, diabetes, and treatments) were recorded. Effluents (fresh stools, sera-S and urines-U) were harvested prior to colonoscopy and FOBT was performed. Seven dominant and subdominant bacterial populations in stools and methylation genes’ (Wif1, ALX4, and vimentin) levels in stools, S and U were quantified using qPCR. Gene markers (Kras mutations, Bat25, Bat 26) have been detected in tissues and stools. Calibration was assessed by Hosmer-Lemeshow chisquare and discrimination by Area Under ROC curve (AUC). Results: 247 patients were included (mean age 60.8, 52% men). Colonoscopy and pathology identified 90 pts with CRC (n=66) or large adenomas (>10 cm). Wif1 was the more sensitive gene marker. A multivariate model adjusted for age, gender, previous personal/familial history of polyps/cancer leaded to AUC of 81.5% (95%CI: 75.7-87.4). After supplementary adjustment in different models, for dysbiosis, AUC increased to 83.4% (77.9-88.9) (bacteroides and leptum levels) (p= 0.08), to 84.9% (79.6-90.3) (p=0.02) after adjustment for FOBT, to 90.1% (85.8-94.4) (p<0.001) after adjustment for Wif1 (S or U). When adjusted jointly for clinical parameters, FOBT, dysbiosis and Wif1, FOBT and wif1 remained independently associated with CRC whereas dysbiosis were not. However, the AUC of the full-adjusted multivariate model did not increase significantly (91.7; 87.8-95.6; p=0.075). Conclusions: Wif1 methylated marker in S or U improved diagnosis accuracy for identifying CRC compared to FOBT while microbial changes in dominant or subdominant bacteria populations did not.
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Affiliation(s)
| | - Hicham Mansour
- Université Paris Est Créteil UPEC and KAUST (Bioscience Laboratory-KAUST-Saudi Arabia), Creteil, Saudi Arabia
| | | | - Yazid Belkacemi
- Department of Radiotherapy Henri Mondor Hospital APHP, Creteil, France
| | | | | | | | - Florence Canoui-Poitrine
- Assistance Publique–Hôpitaux de Paris, Hopital Mondor-Chenevier, Universite Paris Est, Creteil, France
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105
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Cambot M, Mazurier C, Canoui-Poitrine F, Hebert N, Picot J, Clay D, Picard V, Ripoche P, Douay L, Dubart-Kupperschmitt A, Cartron JP. In vitro generated Rh(null) red cells recapitulate the in vivo deficiency: a model for rare blood group phenotypes and erythroid membrane disorders. Am J Hematol 2013; 88:343-9. [PMID: 23417980 DOI: 10.1002/ajh.23414] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 02/08/2013] [Accepted: 02/09/2013] [Indexed: 11/08/2022]
Abstract
Lentiviral modification combined with ex vivo erythroid differentiation was used to stably inhibit RhAG expression, a critical component of the Rh(rhesus) membrane complex defective in the Rh(null) syndrome. The cultured red cells generated recapitulate the major alterations of native Rh(null) cells regarding antigen expression, membrane deformability, and gas transport function, providing the proof of principle for their use as model of Rh(null) syndrome and to investigate Rh complex biogenesis in human primary erythroid cells. Using this model, we were able to reveal for the first time that RhAG extinction alone is sufficient to explain ICAM-4 and CD47 loss observed on native Rh(null) RBCs. Together with the effects of RhAG forced expression in Rh(null) progenitors, this strongly strengthens the hypothesis that RhAG is critical to Rh complex formation. The strategy is also promising for diagnosis purpose in order to overcome the supply from rare blood donors and is applicable to other erythroid defects and rare phenotypes, providing models to dissect membrane biogenesis of multicomplex proteins in erythroid cells, with potential clinical applications in transfusion medicine.
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Affiliation(s)
- Marie Cambot
- Institut National de la Transfusion Sanguine (INTS); 75015; Paris; France
| | | | | | | | - Julien Picot
- Institut National de la Transfusion Sanguine (INTS); 75015; Paris; France
| | | | - Véronique Picard
- Laboratoire d'Hématologie; Centre Hospitalier Universitaire de Bicêtre; 94275; Le Kremlin-Bicêtre; France
| | - Pierre Ripoche
- Institut National de la Transfusion Sanguine (INTS); 75015; Paris; France
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106
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Jouveshomme S, Canoui-Poitrine F, Le Thuaut A, Bastuji-Garin S. Results of platinum-based chemotherapy in unselected performance status (PS) 2 patients with advanced non-small cell lung cancer: a cohort study. Med Oncol 2013; 30:544. [DOI: 10.1007/s12032-013-0544-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 03/15/2013] [Indexed: 01/05/2023]
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107
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Tilleul J, Querques G, Canoui-Poitrine F, Leveziel N, Souied EH. Assessment of a Spectral Domain OCT Segmentation Software in a Retrospective Cohort Study of Exudative AMD Patients. Ophthalmologica 2013; 229:80-5. [DOI: 10.1159/000342980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 08/14/2012] [Indexed: 12/15/2022]
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108
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Confavreux CB, Canoui-Poitrine F, Schott AM, Ambrosi V, Tainturier V, Chapurlat RD. Persistence at 1 year of oral antiosteoporotic drugs: a prospective study in a comprehensive health insurance database. Eur J Endocrinol 2012; 166:735-41. [PMID: 22258112 DOI: 10.1530/eje-11-0959] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Treatments against osteoporosis have demonstrated fracture risk reduction but persistence to therapy remains a major issue. Intermittent regimens have been developed to improve persistence. The aim of this 1-year prospective study was to compare, in the general population, the persistence of various oral regimens of antiosteoporotic treatment. METHODS We conducted this prospective study in the French comprehensive public health insurance database of the Rhône-Alpes region. Women aged 45 years or older who had a first reimbursement of an oral antiosteoporotic treatment during February 2007 composed the study cohort. Persistence was defined by the proportion of patients refilling a prescription in the pharmacist delivery register (ERASME). Using statistical analyses like Kaplan-Meier survival curves and log-rank tests, we compared the treatment persistence of strontium ranelate, raloxifene, and daily-, weekly-, and monthly bisphosphonates. RESULTS Two thousand four hundred and nineteen patients were included over a period of 1 month and followed up for 12 months. Two hundred and eighty-nine (11.9%) patients were treated with monthly bisphosphonates, 1298 (53.7%) with weekly bisphosphonates, and 832 (34.4%) with daily treatments (526 strontium ranelate (21.7%), 296 raloxifene (12.2%), and 10 bisphosphonates (0.4%)). At 1 year, overall persistence was 34%. Fifty percent of patients on monthly bisphosphonates were still persistent while only 37% of patients on weekly bisphosphonates, 34% on raloxifene, and 16% on strontium ranelate were persistent. Therapy monitoring with biochemical markers or bone mineral density was associated with improved persistence. CONCLUSION Overall persistence at 1 year was low, but intermittent regimens were associated with higher persistence rates, along with women who had therapy monitoring.
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Affiliation(s)
- Cyrille B Confavreux
- INSERM UMR 1033-Université de Lyon, Department of Rheumatology, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5 Place d'Arsonval, Lyon, France.
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109
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Mechtouff L, Canoui-Poitrine F, Schott AM, Nighoghossian N, Trouillas P, Termoz A, Porthault-Chatard S, David JS, Chasles V, Derex L. Lack of association between air pollutant exposure and short-term risk of ischaemic stroke in Lyon, France. Int J Stroke 2012; 7:669-74. [PMID: 22309254 DOI: 10.1111/j.1747-4949.2011.00737.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Some observational and experimental studies have suggested a short-term relationship between air pollutants and ischaemic stroke; however, the results conflict. AIMS The objective of this study was to investigate the association between particulate matter less than 2·5 and 10 microns in aerodynamic diameter, nitrogen dioxide, sulphur dioxide and ozone, and short-term risk of ischaemic stroke in Lyon, France. METHODS The AVC69 study was a multicenter cohort study in which all consecutive adult patients admitted to one of the emergency or neurological departments of the Rhône area for suspicion of stroke were included during a seven-month period. Only patients with ischaemic stroke living within the study area, composed of Lyon and 18 neighbouring communities with homogenous air pollutants exposure, formed the basis of our study. We adopted a time-stratified case-crossover design to analyse the short-term effect (up to two-days) of air pollutants on ischaemic stroke incidence. Models were adjusted for temperature, variation of atmospheric pressure, minimal relative humidity, influenza epidemics, pollen count, and holidays. Stratified analyses by gender and class age were performed. Different lag times were analysed. RESULTS 376 patients were included. Mean age was 76·6 years (± 13·7). 53·7% were women. No association was observed between air pollutants and short-term risk of ischaemic stroke after adjustment for main confounding factors. Results remained unchanged whatever the gender or age. CONCLUSIONS These results suggest a lack of association between air pollutant exposure and short-term risk of ischaemic stroke in a French urban area.
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Affiliation(s)
- Laura Mechtouff
- Hôpital Pierre Wertheimer, Stroke Center, Hospices Civils de Lyon, Bron-Lyon, France.
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110
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Gellen B, Lesault PF, Canoui-Poitrine F, Lim P, Guéret P, Teiger E, Dubois-Randé JL, Hittinger L, Damy T. 163 Diagnostic value of Doppler transthoracic echocardiography in the estimation of left ventricular filling pressure in patients with severe symptomatic systolic heart failure. Archives of Cardiovascular Diseases Supplements 2012. [DOI: 10.1016/s1878-6480(12)70559-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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111
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Badet-Phan A, Moreau A, Colin C, Canoui-Poitrine F, Schott-Pethelaz AM, Flori M. Obstacles au dépistage du cancer du col de l'utérus rencontrés par les médecins généralistes chez les femmes âgées de 50 à 65 ans. ACTA ACUST UNITED AC 2012. [DOI: 10.3917/pos.434.0261] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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112
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Caillet P, Canoui-Poitrine F, Vouriot J, Berle M, Reinald N, Krypciak S, Bastuji-Garin S, Culine S, Paillaud E. Comprehensive Geriatric Assessment in the Decision-Making Process in Elderly Patients With Cancer: ELCAPA Study. J Clin Oncol 2011; 29:3636-42. [DOI: 10.1200/jco.2010.31.0664] [Citation(s) in RCA: 315] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Purpose To identify Comprehensive Geriatric Assessment (CGA) components independently associated with changes in planned cancer treatment. Patients and Methods We prospectively included 375 consecutive elderly patients with cancer (ELCAPA01 study) assessed by geriatricians using the CGA. Multivariate analysis was used to identify factors associated with changes in the cancer treatment (intensification, decrease, or delayed > 2 weeks). Change was defined as a difference between the initial treatment proposal and the final treatment selected in a multidisciplinary meeting. Results Mean age was 79.6 years (standard deviation [SD], 5.6 years), and 197 (52.5%) were women. The most common tumor location was the digestive system (58.7%). The mean number of comorbidities was 4.2 (SD, 2.7) per patient, and the mean Cumulative Illness Rating Scale for Geriatrics score was 11.8 (SD, 5.3). After the CGA, the initial cancer treatment plan was modified for 78 (20.8%) of 375 patients (95% CI, 16.8 to 25.3), usually to decrease treatment intensity (63 [80.8%] of 78 patients). By univariate analysis, cancer treatment changes were associated with Eastern Cooperative Oncology Group performance status ≥ 2 (73.3% in the group with changes v 41.1% in the in the group without changes; P < .001), dependency for one or more activities of daily living (ADL; 59.0% v 24.2%; P < .001), malnutrition (81.8% v 51.2%; P < .001), cognitive impairment (38.5% v 24.9%; P = .023), depression (52.6% v 21.7%; P < .001), and greater number of comorbidities (mean, 4.8 [SD, 2.9] v 4.0 [SD, 2.6]; P = .02). By multivariate analysis, factors independently associated with cancer treatment changes were a lower ADL score (odds ratio [OR], 1.25 per 0.5-point decrease; CI, 1.04 to 1.49; P = .016) and malnutrition (OR, 2.99; CI, 1.36 to 6.58; P = .007). Conclusion Functional status assessed by the ADL score and malnutrition were independently associated with changes in cancer treatment.
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Affiliation(s)
- Philippe Caillet
- From the University of Paris Est Creteil, Laboratoire d'Investigation Clinicque EA 4393; Assitance Publique-Hôpitaux de Paris Henri Mondor, Créteil, France
| | - Florence Canoui-Poitrine
- From the University of Paris Est Creteil, Laboratoire d'Investigation Clinicque EA 4393; Assitance Publique-Hôpitaux de Paris Henri Mondor, Créteil, France
| | - Johanna Vouriot
- From the University of Paris Est Creteil, Laboratoire d'Investigation Clinicque EA 4393; Assitance Publique-Hôpitaux de Paris Henri Mondor, Créteil, France
| | - Muriel Berle
- From the University of Paris Est Creteil, Laboratoire d'Investigation Clinicque EA 4393; Assitance Publique-Hôpitaux de Paris Henri Mondor, Créteil, France
| | - Nicoleta Reinald
- From the University of Paris Est Creteil, Laboratoire d'Investigation Clinicque EA 4393; Assitance Publique-Hôpitaux de Paris Henri Mondor, Créteil, France
| | - Sebastien Krypciak
- From the University of Paris Est Creteil, Laboratoire d'Investigation Clinicque EA 4393; Assitance Publique-Hôpitaux de Paris Henri Mondor, Créteil, France
| | - Sylvie Bastuji-Garin
- From the University of Paris Est Creteil, Laboratoire d'Investigation Clinicque EA 4393; Assitance Publique-Hôpitaux de Paris Henri Mondor, Créteil, France
| | - Stephane Culine
- From the University of Paris Est Creteil, Laboratoire d'Investigation Clinicque EA 4393; Assitance Publique-Hôpitaux de Paris Henri Mondor, Créteil, France
| | - Elena Paillaud
- From the University of Paris Est Creteil, Laboratoire d'Investigation Clinicque EA 4393; Assitance Publique-Hôpitaux de Paris Henri Mondor, Créteil, France
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113
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Querques G, Querques L, Rafaeli O, Canoui-Poitrine F, Bandello F, Souied EH. Preferential hyperacuity perimeter as a functional tool for monitoring exudative age-related macular degeneration in patients treated by intravitreal ranibizumab. Invest Ophthalmol Vis Sci 2011; 52:7012-8. [PMID: 21885622 DOI: 10.1167/iovs.11-7517] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To analyze the response to anti vascular endothelial growth factor (VEGF) treatment for exudative age-related macular degeneration (AMD), with respect to changes in the Preferential Hyperacuity Perimeter (PHP), best-corrected visual acuity (BCVA), and spectral-domain optical coherence tomography (SD-OCT), and to investigate whether the PHP score predicts the need for reinjection. METHODS Consecutive patients with newly diagnosed exudative AMD underwent the PHP metamorphopsia test, BCVA, and SD-OCT at five time points after initiation of ranibizumab therapy (0.05 mL/0.5 mg). At the third and sixth months, reevaluation for additional injections was done. The relationships between PHP, BCVA, and SD-OCT parameters over time as well as their ability to predict the need for reinjection were examined. RESULTS Analysis included 17 eyes (17 patients, 70% females; mean age, 83.2 years). The mean PHP metamorphopsia test score improved from 25.6 ± 41 (baseline) to 10.7 ± 20.1 (P < 0.05) over 6 months, after a mean of 4.2 (±1.0) injections. Mean reduction in SD-OCT parameters well reflected the functional improvements as evaluated by PHP (Spearman correlation = 0.9, P < 0.05). Mean BCVA did not improve over 6 months (0.6 vs. 0.58 logMAR), and neither correlated with SD-OCT morphologic changes (Spearman correlation = 0.1, P > 0.05) nor with PHP functional changes (Spearman correlation = 0.1, P > 0.05). The PHP predicted the need for reinjection with an accuracy of 75% (sensitivity, 83 ± 12%; specificity, 67 ± 15%), whereas a combination of all the measurements (PHP, BCVA, and SD-OCT) yielded an accuracy of 87% (sensitivity, 83 ± 12%; specificity, 90 ± 10%). CONCLUSIONS Improvement in the metamorphopsia test score after intravitreal injections of ranibizumab, as well as its ability to predict the need for retreatment, suggest that PHP may be used to monitor response to anti-VEGF therapy in patients with exudative AMD.
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Affiliation(s)
- Giuseppe Querques
- Department of Ophthalmology, University of Paris XII, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
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114
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Salameh C, Canoui-Poitrine F, Cortet M, Lafon A, Rudigoz RC, Huissoud C. [Does persistent occiput posterior position increase the risk of severe perineal laceration?]. ACTA ACUST UNITED AC 2011; 39:545-8. [PMID: 21873097 DOI: 10.1016/j.gyobfe.2011.07.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 03/01/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the risk of severe perineal lacerations (III and IV degrees) during vaginal deliveries in occiput posterior position. PATIENTS AND METHODS We conducted a retrospective cohort study of 9097 vaginal deliveries in a teaching hospital's maternity between January 1st 2005 and December 31st 2008. Risk factors associated with tears of the 3rd or 4th degree were studied by a multivariate logistic regression. RESULTS Severe perineal lacerations occurred in 1.69% of cases (n=152) and did not significantly vary between 2005 and 2008. Parity was a protective factor (OR 0.42; P<0.001; IC(95%) 0.29-0.60) whereas instrumental extraction was associated with an increased risk: vacuum (OR 3.95; P<0.001, IC(95%) 2.23-7.00) and forceps (OR 3.55; P<0.001, IC(95%) 2.33-5.42). macrosomia. Risks were also increased in fetal macrosomia and episiotomy did not protect the mother (respectively OR 1.41 P<0.001, IC(95%) 1.19-1.68 and OR 1.73; P<0.001, IC(95%) 1.16-2.57). Persistent occiput posterior position was not significantly associated with an anal sphincter injury (OR=1.70 P=0.059; IC(95%) 0.98-2.94). DISCUSSION AND CONCLUSION In our series, occiput posterior position did not significantly impact the risk of severe perineal laceration. A manual rotation of the fetal head should be performed in case of associated risk factors.
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Affiliation(s)
- C Salameh
- Service de gynécologie-obstétrique, hôpital de la Croix-Rousse, hospices civils de Lyon, 103 Grande-Rue-de-la-Croix-Rousse, Lyon cedex 04, France.
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Goubard A, Marzouk M, Canoui-Poitrine F, Launay S, Le Thuaut A, Legrand P. Performance of the Iris iQ®200 Elite analyser in the cell counting of serous effusion fluids and cerebrospinal drainage fluids. J Clin Pathol 2011; 64:1123-7. [DOI: 10.1136/jcp.2010.084285] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AimsEvaluation of the Iris iQ®200 Elite analyser, initially designed for urinary cell counting, for the analysis of biological fluids (serous effusion fluids and cerebrospinal drainage fluids) and comparison of its performance with that of the manual microscopic method.MethodsRoutine samples (ascite fluids, pleural fluids and cerebrospinal fluids) were evaluated in terms of red blood cells and nucleated elements using the iQ®200 analyser and the manual method. The authors compared the reliability, repeatability and speed of the two techniques. In addition, the authors assessed the contribution of two different sample dilution processes to the improvement of iQ®200 analyser cytological results.ResultsVery good agreements were found between the two methods and between the two sample dilution processes. Regarding the repeatability, the coefficients of variation obtained with the iQ200 were slightly higher than those obtained by the manual method. Besides, the difference in the speed of the two methods was not significantly different for series with <10 samples.ConclusionsThe Iris iQ®200 Elite analyser has allowed us to obtain reliable results, equivalent to that of the manual method, for cell enumeration in biological fluids. Although the speed of this instrument needs to be improved for larger series of samples, it enables standardised and objective cytological results to be obtained and represents an alternative to the usual manual microscopic method. Moreover, automation of such analyses permits saving of technician time.
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Canoui-Poitrine F, Laurent M, Paillaud E, Caillet P, Verlinde-Carvalho M, Reynald N, Vesval T, Le Thuaut A, Bastuji-Garin S, Culine S. FOLFOX4 relative dose intensity and factors associated with dose reduction or stop: A cohort study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Canoui-Poitrine F, Jaglal S, Chapurlat R, Tainturier V, Colin C, Schott AM. Has reimbursement of bone mineral density testing and anti-osteoporotic treatments improved management of osteoporosis in France? Bone 2010; 47:790-4. [PMID: 20601300 DOI: 10.1016/j.bone.2010.06.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 06/20/2010] [Accepted: 06/22/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Since July 1, 2006 bone mineral density (BMD) testing has been reimbursed for osteoporosis screening under specific clinical conditions in France. Concurrently, drug coverage has been extended to all anti-osteoporotic treatments in women with low BMD. It was thus expected that the utilisation of BMD testing and subsequent treatment would increase significantly. OBJECTIVE To examine the pattern of use of BMD testing following reimbursement by the French National Health Insurance and subsequent prescriptions reimbursed for anti-osteoporotic treatment in the general population of the Rhone-Alpes area, France. METHODS Time trends, age and sex distribution of the population, and specialty of the physicians who performed the test were examined from all physicians' claims for BMD testing between 2006 and 2009 in Rhone-Alpes. A prospective inception cohort of all women aged 50 years and older, without prior reimbursement for anti-osteoporotic treatment and who had a BMD test between January 1, 2007 and March 31, 2007, was then created. Women were followed for 1 year for their reimbursements of estrogen or other anti-osteoporotic treatment (bisphosphonates, raloxifene, teriparatide and strontium ranelate) after their initial BMD test. RESULTS Between July 2006 and August 2009, 140,038 BMD tests were reimbursed in Rhone-Alpes, France, among which 94.8% were performed in women aged 50 years and older. In women, the number of BMD tests tended to significantly decrease during the study period (p for trend=0.047). The inception cohort was composed of 9635 women without prior anti-osteoporotic treatment. Among women without prior estrogen treatment, 27.3% (n=2339) initiated an anti-osteoporotic treatment within 4 months after a BMD test, mostly with bisphosphonates (16.8% n=1441), followed by strontium ranelate (5.8% n=498) and raloxifene (3.4% n=290). At 1 year 1702 women (71.7%) were still on treatment. CONCLUSION Following the decision by the French National Health Insurance of repayment of BMD measurement, the proportion of women who had BMD testing tended to decrease instead of increase over the time period. Although BMD screening is focused in France on high risk women, only 25% of those who had an initial BMD test were subsequently treated with an anti-osteoporotic medication.
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Affiliation(s)
- F Canoui-Poitrine
- Hospices Civils de Lyon, Pole Information Médicale Evaluation Recherche, Unité d'Epidémiologie, 162 Avenue Lacassagne, Lyon, France
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Huissoud C, Dupont C, Canoui-Poitrine F, Touzet S, Dubernard G, Rudigoz RC. Decision-to-delivery interval for emergency caesareans in the Aurore perinatal network. Eur J Obstet Gynecol Reprod Biol 2010; 149:159-64. [PMID: 20079963 DOI: 10.1016/j.ejogrb.2009.12.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2009] [Revised: 11/26/2009] [Accepted: 12/24/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the interval between decision and delivery (DDI) for urgent and very urgent caesarean deliveries within a perinatal network, to compare the results according to maternity ward level and organisation, and to assess the impact of DDI on neonatal outcome. STUDY DESIGN Prospective observational study in the 31 maternity units of the Aurore perinatal network (17 Level I, 12 Level II, and two Level III). The obstetric team defined the degree of urgency for the caesareans, measured the DDI, and reported neonatal outcome. RESULTS The study includes 666 unplanned caesarean sections. The median DDI for emergency caesareans (n=365) was 48 min for Level I units, 40 min for Level II, and 22 min for Level III (P<0.05). For the very urgent caesareans (n=82), the median DDI was respectively 35, 24, and 13 min (P<0.05) and the percentage with a DDI<or=30 min were 45%, 62%, and 100% (P<0.05). The proportion of DDI<or=30 min was 0% in maternity units where obstetricians and anaesthetists were not always onsite, 67% when only the anaesthetist was always present (P<0.05) and 88% for units where both were always present. The neonate's condition did not differ significantly according to DDI. CONCLUSIONS DDI varies very substantially according to the level and organisation of the maternity units in the Aurore network. It was not significantly correlated with neonatal outcome in our population.
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Affiliation(s)
- Cyril Huissoud
- Hospices Civils de Lyon Service de Gynécologie-Obstétrique, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, 69317 Lyon Cedex 04, France.
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Canoui-Poitrine F, Revuz JE, Wolkenstein P, Viallette C, Gabison G, Pouget F, Poli F, Faye O, Bastuji-Garin S. Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severity. J Am Acad Dermatol 2009; 61:51-7. [PMID: 19406505 DOI: 10.1016/j.jaad.2009.02.013] [Citation(s) in RCA: 196] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Revised: 02/08/2009] [Accepted: 02/08/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND Factors associated with the severity of hidradenitis suppurativa (HS) are not known. OBJECTIVE We sought to identify factors associated with the severity of HS. METHODOLOGY The severity of disease in a series of 302 consecutive patients with HS was assessed using the Sartorius score. RESULTS Atypical locations were more common in men than in women (47.1% vs 14.8%; P < .001). Men also had more severe disease (median Sartorius score: 20.5 vs 16.5; P = .02). Increased body mass index (P < .001), atypical locations (P = .002), a personal history of severe acne (P = .04), and absence of a family history of HS (P = .06) were associated with an increased Sartorius score. The Sartorius score was highly correlated with the intensity and duration of pain and suppuration (all P values < .001). LIMITATIONS The referral center base of the study may have biased recruitment. CONCLUSION Our data showed a significant association between the severity of HS and several clinical and behavioral factors. Prospective studies are needed to confirm the prognostic role of these factors.
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Gener G, Canoui-Poitrine F, Revuz J, Faye O, Poli F, Gabison G, Pouget F, Viallette C, Wolkenstein P, Bastuji-Garin S. Combination Therapy with Clindamycin and Rifampicin for Hidradenitis Suppurativa: A Series of 116 Consecutive Patients. Dermatology 2009; 219:148-54. [DOI: 10.1159/000228334] [Citation(s) in RCA: 174] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Accepted: 03/27/2009] [Indexed: 11/19/2022] Open
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Canoui-Poitrine F, Jeanblanc G, Alberti C, Armoogum P, Cebrian A, Carrié D, Henry P, Teiger E, Slama M, Spaulding C, Durand-Zaleski I. Cost effectiveness of sirolimus-eluting stents compared with bare metal stents in acute myocardial infarction: insights from the TYPHOON trial. Appl Health Econ Health Policy 2009; 7:19-29. [PMID: 19558192 DOI: 10.1007/bf03256139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Drug-eluting stents have been shown to reduce the rate of repeat revascularization after percutaneous coronary intervention for acute myocardial infarction (AMI) as compared with bare metal stents (BMS). A few studies have reported the cost effectiveness of sirolimus-eluting stents (SES) in several countries, but none in the particular setting of AMI in France. OBJECTIVES To assess the cost effectiveness of SES compared with BMS in a pre-specified subgroup of French patients with AMI in the randomized, multicentre TYPHOON trial. METHODS A prospective economic evaluation was conducted for the 337 patients in the TYPHOON trial who were enrolled in the French centres. In the TYPHOON trial, patients with AMI with ST-segment elevation less than 12 hours after the onset of chest pain were randomized to undergo percutaneous coronary intervention with either SES or BMS. Data on clinical outcomes and resource use were collected prospectively over a 1-year follow-up period (from October 2003 to October 2005). Unit costs were applied to the resource utilization data. The main outcome measure was the incremental cost-effectiveness ratio (ICER) for additional cost per target-vessel revascularization (TVR) avoided. The perspective of the study was the French healthcare system and costs were expressed in 2007 values. RESULTS SES significantly reduced the rate of TVR (6.6% vs 22.2% with BMS, p < 0.0001). There was no difference in the rate of death, recurrent myocardial infarction or stent thrombosis after 1 year of follow-up between the SES and BMS groups. Mean index admission costs, including the angioplasty procedure, were increased by 282 Euro per patient in the SES group, mostly driven by the price of the SES. Mean follow-up costs were 140 Euro per patient lower in the SES group. Mean aggregate 1-year costs showed a euro 1142 per-patient increase in the SES group compared with the BMS group. The ICER was 7321 Euro per TVR avoided. CONCLUSIONS In this pre-specified subgroup analysis of the TYPHOON trial, the use of SES in patients with AMI with ST-segment elevation less than 12 hours after the onset of chest pain reduced the rate of TVR compared with BMS. However, SES had a debatable ICER for the payer if it was based only on the specific benefit of TVR avoided.
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Affiliation(s)
- Florence Canoui-Poitrine
- Assistance Publique - Hopitaux de Paris (AP-HP), Henri Mondor Hospital, EA 4393, Paris 12 Medical School, Créteil, France
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Soria A, Canoui-Poitrine F, Wolkenstein P, Poli F, Gabison G, Pouget F, Viallette C, Revuz J. Absence of Efficacy of Oral Isotretinoin in Hidradenitis Suppurativa: A Retrospective Study Based on Patients’ Outcome Assessment. Dermatology 2008; 218:134-5. [DOI: 10.1159/000182261] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 08/22/2008] [Indexed: 11/19/2022] Open
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Revuz JE, Canoui-Poitrine F, Wolkenstein P, Viallette C, Gabison G, Pouget F, Poli F, Faye O, Roujeau JC, Bonnelye G, Grob JJ, Bastuji-Garin S. Prevalence and factors associated with hidradenitis suppurativa: results from two case-control studies. J Am Acad Dermatol 2008; 59:596-601. [PMID: 18674845 DOI: 10.1016/j.jaad.2008.06.020] [Citation(s) in RCA: 399] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Revised: 06/16/2008] [Accepted: 06/17/2008] [Indexed: 12/14/2022]
Abstract
BACKGROUND Conflicting opinions have been reported regarding the epidemiology of hidradenitis suppurativa. OBJECTIVE We sought to evaluate the prevalence of hidradenitis suppurativa and to identify associated factors. METHODOLOGY Prevalence was evaluated using a representative sample of the French population (n=10,000). Associated risk factors were assessed using two case-control studies, one population-based with 67 self-reported patients and 200 control subjects, and the other clinic-based with 302 medically assessed patients and 906 control subjects. RESULTS The prevalence was 1% of the French population. Multivariate analyses showed a strong association with current smoking in self-reported (odds ratio=4.16, 95% confidence interval [2.99-8.69]) and in medically assessed (odds ratio=12.55 [8.58-18.38]) populations. Association with body mass index was significant in medically assessed patients (odds ratio=1.12 [1.08-1.15]) for each increase of 1 U of BMI. LIMITATIONS A causal relationship could not be established with such a cross-sectional study. CONCLUSION Hidradenitis suppurativa is a common disease, frequently associated with smoking and being overweight.
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Affiliation(s)
- Jean E Revuz
- AP-HP, Groupe Henri-Mondor Albert-Chenevier, Service de Dermatologie, Creteil, France, Universite Paris 12, Faculte de Medecine, Creteil, France
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Empana JP, Canoui-Poitrine F, Luc G, Juhan-Vague I, Morange P, Arveiler D, Ferrieres J, Amouyel P, Bingham A, Montaye M, Ruidavets JB, Haas B, Evans A, Ducimetiere P. Contribution of novel biomarkers to incident stable angina and acute coronary syndrome: the PRIME Study. Eur Heart J 2008; 29:1966-74. [DOI: 10.1093/eurheartj/ehn331] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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