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McKenzie J, Sneath E, Trinh A, Nolan M, Spain L. Updates in the pathogenesis and management of immune-related enterocolitis, hepatitis and cardiovascular toxicities. Immunooncol Technol 2024; 21:100704. [PMID: 38357008 PMCID: PMC10865026 DOI: 10.1016/j.iotech.2024.100704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Immune checkpoint inhibitors (ICIs) have become a cornerstone of treatment for many solid organ malignancies. Alongside increasing use, the occurrence of immune-related adverse events (irAEs) has also increased and remains a significant challenge when treating patients with ICI. The underlying pathophysiology of irAE development for many organ systems is yet to be elucidated, but may involve unmasking of latent autoimmunity, increased T-cell recognition of shared antigens on cancer and normal tissue and ICI-triggered immune dysregulation with overactivation of proinflammatory pathways and suppression of immune control pathways. Management strategies for irAEs have historically been borrowed from paradigms for conventional autoimmune conditions such as inflammatory bowel disease and autoimmune hepatitis; however, recent translational efforts have clearly demonstrated key differences in underlying immune signalling pathways. As we begin to understand these differences, we must adapt a more targeted approach to immunosuppression and exercise a more nuanced approach with the multiple biologic agents available to mitigate ICI-related toxicity without reversing the antitumour effect of ICI. In this review, we focus on three key immune-related toxicities where recent clinical and translational work has provided nuanced insights into pathogenesis and treatment strategies: enterocolitis, hepatitis and cardiovascular toxicity including myocarditis.
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Affiliation(s)
- J. McKenzie
- Department of Medical Oncology, Melbourne, Australia
| | - E. Sneath
- Department of Medical Oncology, Melbourne, Australia
| | - A. Trinh
- Department of Gastroenterology, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Australia
| | - M. Nolan
- Department of Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - L. Spain
- Department of Medical Oncology, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
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Peillex M, Marchandot B, Matsushita K, Prinz E, Hess S, Reydel Dedieu A, Carmona A, Heger J, Trimaille A, Petit-Eisenmann H, Trinh A, Jesel L, Ohlmann P, Morel O. Acute kidney injury and Acute kidney recovery following TAVR: Conflicting results with regards to earlier studies. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.164] [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: 10/22/2022]
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Matsushita K, Lachmet-Thebaud L, Marchandot B, Sato C, Dagrenat C, Greciano S, De Poli F, Leddet P, Trimaille A, Heger J, Reydel A, Trinh A, Ohlmann P, Jesel L, Morel O. Incomplete recovery of takotsubo cardiomyopathy is a major determinant of cardiovascular mortality. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1184] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Although there is an apparent rapid and spontaneous recovery of left ventricular ejection fraction (LVEF) in patients with takotsubo cardiomyopathy, recent studies have demonstrated the long-lasting functional impairment in those patients.
Purpose
We sought to evaluate the predictors of incomplete recovery in chronic phase and its impact on cardiovascular mortality after takotsubo cardiomyopathy.
Methods
Patients with takotsubo cardiomyopathy between 2008 and 2018 were retrospectively enrolled in three different institutions. Takotsubo cardiomyopathy was diagnosed according to the European Society of Cardiology Heart Failure Association criteria. After exclusion of in-hospital deaths, 407 patients were split into 2 subgroups according whether their LVEF were >50% (recovery group; n=333), or ≤50% (incomplete recovery group; n=74) at follow-up. The primary endpoint was the impact of incomplete recovery on cardiovascular mortality.
Results
Patients with incomplete recovery were more likely to be male, to have dementia, pacemaker, and supraventricular arrhythmia. C-reactive protein (CRP) levels on admission, at peak, and at discharge were significantly higher in patients with incomplete recovery. By multivariate logistic regression analysis, lower EF at discharge (odds ratio [OR]: 0.91; 95% confidence interval [CI]: 0.88 to 0.95; p<0.001) and higher CRP levels (OR: 5.56; 95% CI: 1.86 to 16.61; p<0.001) were independent predictors of incomplete recovery at follow-up. The cumulative event-free survival rate according to cardiovascular death was significantly lower in the incomplete recovery group (p<0.001; log-rank test).
Conclusions
We demonstrate that incomplete recovery after takotsubo cardiomyopathy is characterized by a residual systemic inflammation and an increased cardiac mortality at follow-up. Altogether, our findings underline patients with persistent inflammation as a high-risk subgroup, to target in future clinical trials with specific therapies to attenuate inflammation.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Matsushita
- University Hospital of Strasbourg, Strasbourg, France
| | | | - B Marchandot
- University Hospital of Strasbourg, Strasbourg, France
| | - C Sato
- University Hospital of Strasbourg, Strasbourg, France
| | - C Dagrenat
- Haguenau Hospital Centre, Haguenau, France
| | - S Greciano
- Civil Hospital of Colmar, Colmar, France
| | - F De Poli
- Haguenau Hospital Centre, Haguenau, France
| | - P Leddet
- Haguenau Hospital Centre, Haguenau, France
| | - A Trimaille
- University Hospital of Strasbourg, Strasbourg, France
| | - J Heger
- University Hospital of Strasbourg, Strasbourg, France
| | - A Reydel
- University Hospital of Strasbourg, Strasbourg, France
| | - A Trinh
- University Hospital of Strasbourg, Strasbourg, France
| | - P Ohlmann
- University Hospital of Strasbourg, Strasbourg, France
| | - L Jesel
- University Hospital of Strasbourg, Strasbourg, France
| | - O Morel
- University Hospital of Strasbourg, Strasbourg, France
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Lachmet Thebaud L, Marchandot B, Matsushita K, Dagrenat C, Peillex M, Reydel A, Trinh A, Ohlmann P, Jesel L, Morel O. Systemic inflammatory response syndrome is a major determinant of late cardiovascular outcome in Takotsubo syndrome. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.413] [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: 10/25/2022]
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Trimaille A, Marchandot B, Kibler M, Heger J, Peillex M, Carmona A, Matsushita K, Trinh A, Reydel A, Zeyons F, Petit-Eisenmann H, Jesel L, Ohlmann P, Morel O. Outcomes of patients with active cancer undergoing transcatheter aortic-valve replacement. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.166] [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: 11/28/2022]
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Heger J, Trimaille A, Kibler M, Marchandot B, Peillex M, Carmona A, Matsushita K, Trinh A, Reydel A, Zeyons F, Petit-Eisenmann H, Jesel L, Ohlmann P, Morel O. Electrocardiographic strain pattern is a major determinant of rehospitalization for heart failure after Transcatheter Aortic-Valve Replacement. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.188] [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: 10/25/2022]
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Heger J, Marchandot B, Kibler M, Peillex M, Trimaille A, Carmona A, Matsushita K, Trinh A, Reydel A, Zeyons F, Petit-Eisenmann H, Jesel L, Ohlmann P, Morel O. P6485Incremental prognostic value of electrocardiographic strain after transcatheter aortic valve replacement for aortic stenosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1075] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Electrocardiographic (ECG) strain pattern has recently been associated with increased adverse outcome in aortic stenosis (AS) and after surgical aortic valve replacement (AVR). However, the relation linking ECG strain and cardiovascular MACE in patients with transcatheter aortic valve replacement (TAVR) has not been yet described.
Objectives
The aim of our study was to determine the impact and incremental value of ECG Strain pattern in predicting adverse outcome after TAVR.
Methods
585 patients with severe AS (mean age: 83±7 male 39.8%) were enrolled from November 2012 to May 2018. ECG strain pattern was defined as ≥1 mm concave down-sloping ST-segment depression and asymmetrical T-wave inversion in the lateral leads. Patients with baseline left bundle branch block (LBBB), right bundle branch block (RBBB) or ventricular paced rhythm were excluded. All patients underwent transthoracic echocardiography (TTE) before TAVR and at 30 days follow up. The primary endpoints of the study were the overall all-cause mortality after TAVR, rehospitalization for Hearth failure (HF), myocardial infarction and stroke.
Results
178 (30.4%) patients were excluded from analyses owing to the presence of either LBBB (n=103) or RBBB (n=75). Among the 407 remaining patients, 106 had ECG strain pattern (26.04%). Patients with ECG strain were significantly younger (81.6±8 years vs 83.5±6.8 years; p=0.022), had lower BMI (23±4.5 kg.m2 vs 27.9±6.8 kg.m2; p=0.02) more severe AS (mean gradient 52.3±15.2 mmHg vs 47.9±11.8 mmHg; p=0.003), significant lower LVEF (51.8±15% vs 58.4±10.7%; p<0.001). Left ventricular hypertrophy (LVH) was more frequent in patients with ECG Strain (indexed left ventricular mass (135.9±33.4 g.m2 vs 123.6±31.9 g.m2; p=0.002)). Death from any cause (22 (20.8%) vs 61 (20.3%); p=0.508) did not differ significantly between groups. Major adverse cardiovascular events (MACE) including death, stroke and heart failure at 1 month showed similar incidence (7 (6.6%) vs 17 (5.6%), p=0.439). Rehospitalization for hearth failure (HF) was significantly higher (33 (31.1%) vs 33 (11%); p<0.001) in patients with ECG strain pattern. In univariate model, ECG Strain was a strong predictor of rehospitalization for HF (HR 2.621 95% CI (1.607–4.277), p=0.001), independently of LVH assessed either by ECG criteria (HR 1.181 95% CI (0.698–1.997; p=0.536) or TTE (HR 1.557 95% (CI 0.701–3.458; p=0.277). ECG Strain remained associated with a higher risk of rehospitalization for hearth failure in multivariate analyses (HR 2.747 95% (CI 1.614- 4.674); p<0.001)
Conclusion
In patients with AS eligible for TAVR, ECG Strain Pattern is frequent and associated with an increased risk of post interventional heart failure regardless of preoperative LVH. ECG Strain pattern represents an easy, objective, reliable and low-cost tool to identify patients who may benefit from an extend and intensified post-interventional follow-up.
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Affiliation(s)
- J Heger
- University Hospital of Strasbourg, Strasbourg, France
| | - B Marchandot
- University Hospital of Strasbourg, Strasbourg, France
| | - M Kibler
- University Hospital of Strasbourg, Strasbourg, France
| | - M Peillex
- University Hospital of Strasbourg, Strasbourg, France
| | - A Trimaille
- University Hospital of Strasbourg, Strasbourg, France
| | - A Carmona
- University Hospital of Strasbourg, Strasbourg, France
| | - K Matsushita
- University Hospital of Strasbourg, Strasbourg, France
| | - A Trinh
- University Hospital of Strasbourg, Strasbourg, France
| | - A Reydel
- University Hospital of Strasbourg, Strasbourg, France
| | - F Zeyons
- University Hospital of Strasbourg, Strasbourg, France
| | | | - L Jesel
- University Hospital of Strasbourg, Strasbourg, France
| | - P Ohlmann
- University Hospital of Strasbourg, Strasbourg, France
| | - O Morel
- University Hospital of Strasbourg, Strasbourg, France
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Waugh JLS, Huang E, Fraser JE, Beyer KB, Trinh A, Mcilroy WE, Kulic D. Online Learning of Gait Models From Older Adult Data. IEEE Trans Neural Syst Rehabil Eng 2019; 27:733-742. [PMID: 30872234 DOI: 10.1109/tnsre.2019.2904477] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper proposes a novel approach for online, individualized gait analysis, based on an adaptive periodic model of any gait signal. The proposed method learns a model of the gait cycle during online measurement, using a continuous representation that can adapt to inter- and intra-personal variability by creating an individualized model. Once the algorithm has converged to the input signal, key gait events can be identified based on the estimated gait phase and amplitude. The approach is implemented and tested on retirement home resident 6 min walk (6MW) data using wearable accelerometers at the ankle. The proposed approach converges within approximately four gait cycles and achieves 3% error in detecting initial swing events.11 An early version of this work was presented in [1]. A more extensive description of related work and an extended method, including optimization of learning rates, were added to this paper. Further, this paper applies and evaluates the method to a new and much larger gait dataset taken from older adults who each have a variety of medical conditions. Therefore, the experimental protocol was also updated and the results are entirely novel.
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Dagrenat C, Von Hunolstein J, Thebaud L, Marchandot B, Messas N, Greciano S, Tuzin N, Meyer N, Trinh A, Jesel L, Ohlmann P, Morel O. Value of cardiac biomarkers in the early diagnosis of Takotsubo syndrome. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.318] [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: 10/27/2022]
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Abstract
CONTEXT Bone fragility in cerebral palsy (CP) is secondary to a complex interplay of functional, hormonal, and nutritional factors that affect bone remodelling. A greater understanding of bone microarchitectural changes seen in CP should assist therapeutic decision making. OBJECTIVE To examine the relationship between trabecular bone score (TBS), BMD and fractures in adults with CP; the influence of clinical factors and body composition on bone microarchitecture were explored. DESIGN Retrospective cross-sectional study. SETTING AND PARTICIPANTS 43 adults (25 male) with CP of median age 25 years (interquartile range 21.4-33.9) who had evaluable dual-energy X-ray absorptiometry imaging of the lumbar spine from a single tertiary hospital between 2005-March 2018. RESULTS 24/43 (55.8%) of patients had TBS values indicating intermediate or high risk of fracture (<1.31). TBS correlated with areal BMD at the lumbar spine, femoral neck and total body. TBS was significantly associated with arm and leg lean mass, with adjustment for age, gender and height (adjusted R2 = 0.18, p = 0.042 for arm lean mass; adjusted R2 = 0.19, p = 0.036 for leg lean mass). There was no difference in TBS when patients were grouped by fracture status, anticonvulsant use, gonadal status or use of PEG feeding. TBS was lower in non-ambulatory patients compared with ambulatory patients (1.28 vs 1.37, p = 0.019). CONCLUSIONS Abnormal bone microarchitecture, as measured by TBS, was seen in >50% of young adults with CP. TBS correlated with both areal BMD and appendicular lean mass. Maintaining muscle function is likely to be important for bone health in young adults with CP and needs to be confirmed in further studies.
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Affiliation(s)
- A Trinh
- Department of Endocrinology, Monash Health, Clayton, Australia; Hudson Institute of Medical Research, Clayton, Australia; Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Dentistry and Health Sciences, Monash University, Clayton, Australia.
| | - P Wong
- Department of Endocrinology, Monash Health, Clayton, Australia; Hudson Institute of Medical Research, Clayton, Australia
| | - M C Fahey
- Hudson Institute of Medical Research, Clayton, Australia; Departments of Paediatrics, Monash Health and Monash University, Clayton, Australia
| | - P R Ebeling
- Department of Endocrinology, Monash Health, Clayton, Australia; Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Dentistry and Health Sciences, Monash University, Clayton, Australia
| | - P J Fuller
- Department of Endocrinology, Monash Health, Clayton, Australia; Hudson Institute of Medical Research, Clayton, Australia; Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Dentistry and Health Sciences, Monash University, Clayton, Australia
| | - F Milat
- Department of Endocrinology, Monash Health, Clayton, Australia; Hudson Institute of Medical Research, Clayton, Australia; Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Dentistry and Health Sciences, Monash University, Clayton, Australia
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11
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Trinh A, Khamari R, Coiteux V, Joncquel M, Dekiouk S, Laine W, Idziorek T, Quesnel B, Kluza J, Marchetti P. PO-264 Mitochondrial metabolism: a key factor of myeloid leukemic cell response upon exposure to tyrosine kinase inhibitors. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.296] [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] Open
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Rathkopf DE, Smith MR, Ryan CJ, Berry WR, Shore ND, Liu G, Higano CS, Alumkal JJ, Hauke R, Tutrone RF, Saleh M, Chow Maneval E, Thomas S, Ricci DS, Yu MK, de Boer CJ, Trinh A, Kheoh T, Bandekar R, Scher HI, Antonarakis ES. Androgen receptor mutations in patients with castration-resistant prostate cancer treated with apalutamide. Ann Oncol 2018. [PMID: 28633425 DOI: 10.1093/annonc/mdx283] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Mutations in the androgen receptor (AR) ligand-binding domain (LBD), such as F877L and T878A, have been associated with resistance to next-generation AR-directed therapies. ARN-509-001 was a phase I/II study that evaluated apalutamide activity in castration-resistant prostate cancer (CRPC). Here, we evaluated the type and frequency of 11 relevant AR-LBD mutations in apalutamide-treated CRPC patients. Patients and methods Blood samples from men with nonmetastatic CRPC (nmCRPC) and metastatic CRPC (mCRPC) pre- or post-abiraterone acetate and prednisone (AAP) treatment (≥6 months' exposure) were evaluated at baseline and disease progression in trial ARN-509-001. Mutations were detected in circulating tumor DNA using a digital polymerase chain reaction-based method known as BEAMing (beads, emulsification, amplification and magnetics) (Sysmex Inostics' GmbH). Results Of the 97 total patients, 51 had nmCRPC, 25 had AAP-naïve mCRPC, and 21 had post-AAP mCRPC. Ninety-three were assessable for the mutation analysis at baseline and 82 of the 93 at progression. The overall frequency of detected AR mutations at baseline was 7/93 (7.5%) and at progression was 6/82 (7.3%). Three of the 82 (3.7%) mCRPC patients (2 AAP-naïve and 1 post-AAP) acquired AR F877L during apalutamide treatment. At baseline, 3 of the 93 (3.2%) post-AAP patients had detectable AR T878A, which was lost after apalutamide treatment in 1 patient who continued apalutamide treatment for 12 months. Conclusions The overall frequency of detected mutations at baseline (7.5%) and progression (7.3%) using the sensitive BEAMing assay was low, suggesting that, based on this assay, AR-LBD mutations such as F877L and T878A are not common contributors to de novo or acquired resistance to apalutamide. ClinicalTrials.gov identifier NCT01171898.
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Affiliation(s)
- D E Rathkopf
- Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York
| | - M R Smith
- Massachusetts General Hospital and Harvard Medical School, Boston
| | - C J Ryan
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco
| | - W R Berry
- Cancer Centers of North Carolina, Raleigh
| | - N D Shore
- Carolina Urologic Research Center, Myrtle Beach
| | - G Liu
- University of Wisconsin Carbone Cancer Center, Madison
| | - C S Higano
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle
| | - J J Alumkal
- Knight Cancer Institute, Oregon Health & Science University, Portland
| | - R Hauke
- Nebraska Cancer Specialists, Omaha
| | - R F Tutrone
- Chesapeake Urologic Research Associates, Baltimore
| | - M Saleh
- University of Alabama Comprehensive Cancer Center, Birmingham
| | | | - S Thomas
- Janssen Research & Development, Spring House
| | - D S Ricci
- Janssen Research & Development, Spring House
| | - M K Yu
- Janssen Research & Development, Los Angeles
| | - C J de Boer
- Janssen Biologics, B. V., Leiden, the Netherlands
| | - A Trinh
- Janssen Research & Development, Los Angeles
| | - T Kheoh
- Janssen Research & Development, San Diego
| | - R Bandekar
- Janssen Research & Development, Spring House
| | - H I Scher
- Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York
| | - E S Antonarakis
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, USA
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Kibler M, Marchandot B, Messas N, Caspar T, Grunebaum L, Crimizade U, Trinh A, Petit-Eisenmann H, Zeyons F, Von Hunolstein J, Kindo M, Hoang T, Jesel L, Ohlmann P, Morel O. Impact of CT-ADP point-of-care assay on 30-day paravalvular aortic regurgitation and bleeding events following transcatheter aortic valve replacement. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.286] [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: 10/18/2022]
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Fenton C, Al-Ani A, Trinh A, Srinivasan A, Marion K, Hebbard G. Impact of providing patients with copies of their medical correspondence: a randomised controlled study. Intern Med J 2017; 47:68-75. [PMID: 27616436 DOI: 10.1111/imj.13252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 09/01/2016] [Accepted: 09/05/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Australia, correspondence is routinely sent to general practitioners following a specialist consultation. Written communication is an important way to enhance patient experiences and understanding, yet most patients do not receive copies of their medical correspondence. AIMS To determine whether providing clinic correspondence and endoscopy reports to patients leads to improved understanding, satisfaction or anxiety. METHODS This is a prospective, randomised controlled study conducted at an Australian tertiary hospital from October 2013 to February 2015. New adult referrals to the general gastroenterology clinic requiring an urgent endoscopic procedure were eligible for the study. The intervention group received a copy of their clinic correspondence and endoscopy report, while the control group received neither. Participants completed questionnaires, including visual analogue scales and the Hospital Anxiety and Depression Scale, at three time points. Primary outcomes were patient understanding, anxiety and satisfaction. RESULTS A total of 70 participants was included in the study. There was no reduction in anxiety levels (P = 0.52), no increase in understanding (P = 0.73) or any increase in satisfaction (P = 0.33) in participants receiving correspondence. However, 97% of participants indicated that they wished to receive correspondence in the future, and 94% of participants in the correspondence group reported that receiving correspondence had helped them to understand their medical condition. CONCLUSION Patients wish to receive copies of their correspondence and feel it improves their understanding of their medical condition. Although we were unable to demonstrate a measurable reduction in anxiety, increase in understanding or satisfaction, we recommend that patients be offered the choice of receiving copies of their clinic correspondence and endoscopy reports.
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Affiliation(s)
- C Fenton
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - A Al-Ani
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - A Trinh
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - A Srinivasan
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - K Marion
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - G Hebbard
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Marchandot B, Ohlmann P, Jesel L, Kibler M, Messas N, Crimizade U, Trinh A, Petit-Eisenmann H, Morel O, Caspar T. P5234Incremental value of resting 2D and 3D speckle-tracking echocardiography compared to exercise ECG testing to identify coronary artery disease in intermediate risk patients. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sandorfy NQ, Trinh A, Laforgue A, Daudel R. Etude théorique et expérimentale des moments polaires des molécules de la série du dinapthylène. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1949460655] [Citation(s) in RCA: 5] [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: 11/15/2022]
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Trinh A, Wong P, Brown J, Hennel S, Ebeling PR, Fuller PJ, Milat F. Fractures in spina bifida from childhood to young adulthood. Osteoporos Int 2017; 28:399-406. [PMID: 27553445 DOI: 10.1007/s00198-016-3742-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED This study assessed the prevalence and types of fractures in spina bifida and examined risk factors for fracture. Fracture prevalence was highest in childhood and reduced in adolescence and young adulthood. The importance of maintaining mobility is highlighted by the increased risk of fracture in those who are non-ambulatory. INTRODUCTION The aims of this study are to study the prevalence and types of fractures according to age group in spina bifida and examine risk factors associated with fracture. METHODS This is a retrospective cohort study of 146 individuals with spina bifida aged 2 years or older who attended the paediatric or adult spina bifida multidisciplinary clinic at a single tertiary hospital. RESULTS Median age at which first fracture occurred was 7 years (interquartile range 4-13 years). Fracture rates in children (ages 2-10), adolescents (ages 11-18) and adults (age > 18) were 10.9/1000 (95 % confidence interval 5.9-18.3), 5.4/1000 (95 % CI 1.5-13.8) and 2.9/1000 (95 % CI 0.6-8.1) patient years respectively. Childhood fractures predominantly involved the distal femur and femoral shaft; these fractures were rarely seen in adulthood. Non-ambulatory status was associated with a 9.8 times higher risk of fracture compared with ambulatory patients (odds ratio 9.8, p = 0.016, 95 % CI 1.5-63.0). Relative risk of re-fracture was 3.1 (95 % CI 1.4-6.8). Urological intervention with intestinal segments was associated with renal calculi (p = 0.037) but neither was associated with fracture. CONCLUSIONS The risk of fracture is lower in adults compared with children with spina bifida. The predominant childhood fracture affects the distal femur, and immobility is the most significant risk factor for fracture. Clinical factors contributing to fracture risk need to be elucidated to enable selection of patients who require investigation and treatment of osteoporosis.
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Affiliation(s)
- A Trinh
- Department of Endocrinology, Monash Health, 246 Clayton Rd, Clayton, Victoria, 3168, Australia.
- Hudson Institute of Medical Research, Clayton, Melbourne, Australia.
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia.
| | - P Wong
- Department of Endocrinology, Monash Health, 246 Clayton Rd, Clayton, Victoria, 3168, Australia
- Hudson Institute of Medical Research, Clayton, Melbourne, Australia
| | - J Brown
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
- Department of Paediatrics, Monash Health, Melbourne, Australia
| | - S Hennel
- Developmental Paediatrics, Monash Children's, Monash Health, Melbourne, Australia
- Victorian Paediatric Rehabilitation Service, Monash Children's, Monash Health, Melbourne, Australia
| | - P R Ebeling
- Department of Endocrinology, Monash Health, 246 Clayton Rd, Clayton, Victoria, 3168, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - P J Fuller
- Department of Endocrinology, Monash Health, 246 Clayton Rd, Clayton, Victoria, 3168, Australia
- Hudson Institute of Medical Research, Clayton, Melbourne, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - F Milat
- Department of Endocrinology, Monash Health, 246 Clayton Rd, Clayton, Victoria, 3168, Australia
- Hudson Institute of Medical Research, Clayton, Melbourne, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
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Unlu S, Caspar T, Ahmed T, Abdar Esfahani M, Marinov R, Mohamed LAYLA, Chiu DYY, Nogradi AB, Elremisy DRA, Mefriyanni M, Nemes A, Park CS, Fichot M, Petit-Eisenmann H, Samet H, Trinh A, Talha S, Jesel L, El Ghannudi S, Morel O, Ohlmann P, Naiem M, Mazen A, Samy E, Hristova K, Telcharova A, Maghraby HM, Mohamed RM, Green D, Hughes J, Sinha S, Kalra PA, Abidin N, Porpaczy A, Porcsa L, Minier T, Czirjak L, Komocsi A, Faludi R, Issa LM, Deyab RH, Boghdady YM, Soesanto AM, Kalapos A, Domsik P, Oszlanczi M, Orosz A, Torok L, Balogh L, Forster T, Lengyel C, Jeong MH, Ahn HS, Cho JS, Youn HJ. P1294Evaluation of right atrium mechanics and relation with loading conditions by speckle tracking echocardiographyP1295Late detection of left ventricular dysfunction using 2D and 3D speckle-tracking in patients with history of non-severe acute myocarditisP1296The impact of abnormal circadian BP profile on left atrial function by 2D speckle tracking echocardiography and its effect on functional capacity in hypertensive patientsP1297Right heart echocardiographic parameters alterations in asymptomatic breast cancer patients during chemotherapyP1299The Impact of myocardial deformation imaging for assessment of long-life prognosis in young patients with Kawasaki diseasesP1300Early detection of lv systolic dysfunction in asymptomatic patients with rheumatoid arthritis using global longitudinal strain assessmentP1301Cardiovascular risk assessment in haemodialysis patients with preserved left ventricular ejection fraction and left ventricular hypertrophyP1302Echocardiographic determinants of the functional capacity in systemic sclerosis: role of the right heartP1303 Speckle tracking echocardiography assessment of left atrial strain in hypertensive patientsP1304Comparison of global longitudinal strain in rheumatic mitral regurgitation and degenerative mitral regurgitation : does etiology affect?P1305Specific correlations between aortic stiffness and three-dimensional speckle-tracking echocardiography-derived segmental left ventricular strainsP1306Three-dimensional right ventricular strain analysis for the dependency of preload changes. Eur Heart J Cardiovasc Imaging 2016; 17:ii277-ii280. [DOI: 10.1093/ehjci/jew266.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dehant V, Asael D, Baland RM, Baludikay BK, Beghin J, Belza J, Beuthe M, Breuer D, Chernonozhkin S, Claeys P, Cornet Y, Cornet L, Coyette A, Debaille V, Delvigne C, Deproost MH, De WInter N, Duchemin C, El Atrassi F, François C, De Keyser J, Gillmann C, Gloesener E, Goderis S, Hidaka Y, Höning D, Huber M, Hublet G, Javaux EJ, Karatekin Ö, Kodolanyi J, Revilla LL, Maes L, Maggiolo R, Mattielli N, Maurice M, McKibbin S, Morschhauser A, Neumann W, Noack L, Pham LBS, Pittarello L, Plesa AC, Rivoldini A, Robert S, Rosenblatt P, Spohn T, Storme JY, Tosi N, Trinh A, Valdes M, Vandaele AC, Vanhaecke F, Van Hoolst T, Van Roosbroek N, Wilquet V, Yseboodt M. PLANET TOPERS: Planets, Tracing the Transfer, Origin, Preservation, and Evolution of their ReservoirS. ORIGINS LIFE EVOL B 2016; 46:369-384. [PMID: 27337974 DOI: 10.1007/s11084-016-9488-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 01/21/2016] [Indexed: 11/25/2022]
Abstract
The Interuniversity Attraction Pole (IAP) 'PLANET TOPERS' (Planets: Tracing the Transfer, Origin, Preservation, and Evolution of their Reservoirs) addresses the fundamental understanding of the thermal and compositional evolution of the different reservoirs of planetary bodies (core, mantle, crust, atmosphere, hydrosphere, cryosphere, and space) considering interactions and feedback mechanisms. Here we present the first results after 2 years of project work.
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Affiliation(s)
- V Dehant
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium.
| | - D Asael
- Université de Liège (Ulg), 4000, Liège 1, Belgium
| | - R M Baland
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | | | - J Beghin
- Université de Liège (Ulg), 4000, Liège 1, Belgium
| | - J Belza
- Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Universiteit Ghent (Ughent), Ghent, Belgium
| | - M Beuthe
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - D Breuer
- Deutsche Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | | | - Ph Claeys
- Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Y Cornet
- Université de Liège (Ulg), 4000, Liège 1, Belgium
| | - L Cornet
- Université de Liège (Ulg), 4000, Liège 1, Belgium
| | - A Coyette
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - V Debaille
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - C Delvigne
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - M H Deproost
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - N De WInter
- Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - C Duchemin
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - F El Atrassi
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - C François
- Université de Liège (Ulg), 4000, Liège 1, Belgium
| | - J De Keyser
- Belgian Institute for Space Aeronomy (BISA), Brussels, Belgium
| | - C Gillmann
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - E Gloesener
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - S Goderis
- Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Y Hidaka
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - D Höning
- Deutsche Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - M Huber
- Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - G Hublet
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - E J Javaux
- Université de Liège (Ulg), 4000, Liège 1, Belgium
| | - Ö Karatekin
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - J Kodolanyi
- Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - L Maes
- Belgian Institute for Space Aeronomy (BISA), Brussels, Belgium
| | - R Maggiolo
- Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - N Mattielli
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - M Maurice
- Deutsche Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - S McKibbin
- Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - A Morschhauser
- Deutsche Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - W Neumann
- Deutsche Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - L Noack
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - L B S Pham
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - L Pittarello
- Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - A C Plesa
- Deutsche Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - A Rivoldini
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - S Robert
- Belgian Institute for Space Aeronomy (BISA), Brussels, Belgium
| | - P Rosenblatt
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - T Spohn
- Deutsche Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - J -Y Storme
- Université de Liège (Ulg), 4000, Liège 1, Belgium
| | - N Tosi
- Deutsche Zentrum für Luft- und Raumfahrt (DLR), Berlin, Germany
| | - A Trinh
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | - M Valdes
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - A C Vandaele
- Belgian Institute for Space Aeronomy (BISA), Brussels, Belgium
| | | | - T Van Hoolst
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
| | | | - V Wilquet
- Belgian Institute for Space Aeronomy (BISA), Brussels, Belgium
| | - M Yseboodt
- Royal Observatory of Belgium (ROB), 3 Avenue Circulaire, B-1180, Brussels, Belgium
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Trinh A, Wong P, Ebeling PR, Fuller PJ, Milat F. Severe acute phase response after intravenous zoledronic acid in adult patients with cerebral palsy. Intern Med J 2016; 46:506-7. [PMID: 27062209 DOI: 10.1111/imj.13030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 12/20/2015] [Accepted: 12/21/2015] [Indexed: 11/30/2022]
Affiliation(s)
- A Trinh
- Department of Endocrinology, Monash Health, Melbourne, Victoria, Australia.,Hudson Institute of Medical Research, Centre for Endocrinology and Metabolism, Melbourne, Victoria, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
| | - P Wong
- Department of Endocrinology, Monash Health, Melbourne, Victoria, Australia.,Hudson Institute of Medical Research, Centre for Endocrinology and Metabolism, Melbourne, Victoria, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
| | - P R Ebeling
- Department of Endocrinology, Monash Health, Melbourne, Victoria, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
| | - P J Fuller
- Department of Endocrinology, Monash Health, Melbourne, Victoria, Australia.,Hudson Institute of Medical Research, Centre for Endocrinology and Metabolism, Melbourne, Victoria, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
| | - F Milat
- Department of Endocrinology, Monash Health, Melbourne, Victoria, Australia.,Hudson Institute of Medical Research, Centre for Endocrinology and Metabolism, Melbourne, Victoria, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
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Trinh A, Wong P, Fahey MC, Brown J, Churchyard A, Strauss BJ, Ebeling PR, Fuller PJ, Milat F. Musculoskeletal and Endocrine Health in Adults With Cerebral Palsy: New Opportunities for Intervention. J Clin Endocrinol Metab 2016; 101:1190-7. [PMID: 26751195 DOI: 10.1210/jc.2015-3888] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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] [Indexed: 11/19/2022]
Abstract
CONTEXT Cerebral palsy (CP) increases fracture risk through diminished ambulation, nutritional deficiencies, and anticonvulsant medication use. Studies examining bone mineral density (BMD) in adults with CP are limited. OBJECTIVE To examine the relationship between body composition, BMD, and fractures in adults with CP. The effect of functional, nutritional, and endocrine factors on BMD and body composition is also explored. DESIGN Retrospective cross-sectional study. SETTING AND PARTICIPANTS Forty-five adults with CP (mean age, 28.3 ± 11.0 years) who had dual-energy x-ray absorptiometry imaging at a single tertiary hospital between 2005 and 2015. RESULTS Seventeen (38%) had a past history of fragility fracture; 43% had a Z-score of ≤ -2.0 at the lumbar spine (LS) and 41% at the femoral neck (FN). In nonambulatory patients, every one unit decrease in FN Z-score increased the risk of fracture 3.2-fold (95% confidence interval, 1.07-9.70; P = .044). Stepwise linear regression revealed that the Gross Motor Function Classification System was the best predictor of LS Z-score (R(2) = 0.550; β = -0.582; P = .002) and FN Z-score (R(2) = 0.428; β = -0.494; P = .004); 35.7% of the variance in BMD was accounted for by lean tissue mass. Hypogonadism, present in 20% of patients, was associated with reduced lean tissue mass and reduced LS BMD. Lean tissue mass positively correlated with BMD in eugonadal patients, but not in hypogonadal patients. CONCLUSIONS Low BMD and fractures are common in adults with CP. This is the first study to document hypogonadism in adults with CP with detrimental changes in body composition and BMD.
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Affiliation(s)
- A Trinh
- Department of Endocrinology (A.T., P.W., P.R.E., P.J.F., F.M.), Monash Health, 3168 Melbourne, Australia; Hudson Institute of Medical Research (A.T., P.W., M.C.F., P.J.F., F.M.), Clayton 3168, Melbourne, Australia; Department of Medicine (A.T., J.B., A.C., B.J.S., P.R.E., P.J.F., F.M.), Monash University, 3800 Melbourne, Australia; and Department of Paediatrics (M.C.F., J.B.), Monash Health, 3168 Melbourne, Australia
| | - P Wong
- Department of Endocrinology (A.T., P.W., P.R.E., P.J.F., F.M.), Monash Health, 3168 Melbourne, Australia; Hudson Institute of Medical Research (A.T., P.W., M.C.F., P.J.F., F.M.), Clayton 3168, Melbourne, Australia; Department of Medicine (A.T., J.B., A.C., B.J.S., P.R.E., P.J.F., F.M.), Monash University, 3800 Melbourne, Australia; and Department of Paediatrics (M.C.F., J.B.), Monash Health, 3168 Melbourne, Australia
| | - M C Fahey
- Department of Endocrinology (A.T., P.W., P.R.E., P.J.F., F.M.), Monash Health, 3168 Melbourne, Australia; Hudson Institute of Medical Research (A.T., P.W., M.C.F., P.J.F., F.M.), Clayton 3168, Melbourne, Australia; Department of Medicine (A.T., J.B., A.C., B.J.S., P.R.E., P.J.F., F.M.), Monash University, 3800 Melbourne, Australia; and Department of Paediatrics (M.C.F., J.B.), Monash Health, 3168 Melbourne, Australia
| | - J Brown
- Department of Endocrinology (A.T., P.W., P.R.E., P.J.F., F.M.), Monash Health, 3168 Melbourne, Australia; Hudson Institute of Medical Research (A.T., P.W., M.C.F., P.J.F., F.M.), Clayton 3168, Melbourne, Australia; Department of Medicine (A.T., J.B., A.C., B.J.S., P.R.E., P.J.F., F.M.), Monash University, 3800 Melbourne, Australia; and Department of Paediatrics (M.C.F., J.B.), Monash Health, 3168 Melbourne, Australia
| | - A Churchyard
- Department of Endocrinology (A.T., P.W., P.R.E., P.J.F., F.M.), Monash Health, 3168 Melbourne, Australia; Hudson Institute of Medical Research (A.T., P.W., M.C.F., P.J.F., F.M.), Clayton 3168, Melbourne, Australia; Department of Medicine (A.T., J.B., A.C., B.J.S., P.R.E., P.J.F., F.M.), Monash University, 3800 Melbourne, Australia; and Department of Paediatrics (M.C.F., J.B.), Monash Health, 3168 Melbourne, Australia
| | - B J Strauss
- Department of Endocrinology (A.T., P.W., P.R.E., P.J.F., F.M.), Monash Health, 3168 Melbourne, Australia; Hudson Institute of Medical Research (A.T., P.W., M.C.F., P.J.F., F.M.), Clayton 3168, Melbourne, Australia; Department of Medicine (A.T., J.B., A.C., B.J.S., P.R.E., P.J.F., F.M.), Monash University, 3800 Melbourne, Australia; and Department of Paediatrics (M.C.F., J.B.), Monash Health, 3168 Melbourne, Australia
| | - P R Ebeling
- Department of Endocrinology (A.T., P.W., P.R.E., P.J.F., F.M.), Monash Health, 3168 Melbourne, Australia; Hudson Institute of Medical Research (A.T., P.W., M.C.F., P.J.F., F.M.), Clayton 3168, Melbourne, Australia; Department of Medicine (A.T., J.B., A.C., B.J.S., P.R.E., P.J.F., F.M.), Monash University, 3800 Melbourne, Australia; and Department of Paediatrics (M.C.F., J.B.), Monash Health, 3168 Melbourne, Australia
| | - P J Fuller
- Department of Endocrinology (A.T., P.W., P.R.E., P.J.F., F.M.), Monash Health, 3168 Melbourne, Australia; Hudson Institute of Medical Research (A.T., P.W., M.C.F., P.J.F., F.M.), Clayton 3168, Melbourne, Australia; Department of Medicine (A.T., J.B., A.C., B.J.S., P.R.E., P.J.F., F.M.), Monash University, 3800 Melbourne, Australia; and Department of Paediatrics (M.C.F., J.B.), Monash Health, 3168 Melbourne, Australia
| | - F Milat
- Department of Endocrinology (A.T., P.W., P.R.E., P.J.F., F.M.), Monash Health, 3168 Melbourne, Australia; Hudson Institute of Medical Research (A.T., P.W., M.C.F., P.J.F., F.M.), Clayton 3168, Melbourne, Australia; Department of Medicine (A.T., J.B., A.C., B.J.S., P.R.E., P.J.F., F.M.), Monash University, 3800 Melbourne, Australia; and Department of Paediatrics (M.C.F., J.B.), Monash Health, 3168 Melbourne, Australia
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Messas M, Trinh A, Jesel L, Radulescu B, Germain P, Ohlmann P, Bareiss P, Morel O. [Usefulness of diastolic deceleration time assessed by transthoracic Doppler measurement in the detection of sustained microvascular obstruction in STEMI patients treated by primary PTCA]. Ann Cardiol Angeiol (Paris) 2011; 60:119-26. [PMID: 21570057 DOI: 10.1016/j.ancard.2010.12.024] [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] [Received: 07/28/2008] [Accepted: 12/28/2010] [Indexed: 11/25/2022]
Abstract
AIMS To assess the value of coronary flow measurement by transthoracic Doppler technique in the detection of "no-reflow" phenomenon. METHODS Fourteen patients with first anterior wall infarction treated by successful (TIMI3) primary percutaneous angioplasty and left descending coronary artery stenting were investigated. Myocardial perfusion following PCI was assessed by (i) ST-segment resolution, (ii) MRI-detected microvascular obstruction (early hypoenhancement), (iii) coronary flow pattern measurement by transthoracic Doppler technique. RESULTS Sustained impairment of myocardial perfusion following PCI was observed in a large proportion of the cohort (36% by MRI, 43% by ST regression analysis). Patients with a diastolic deceleration time inferior to 482 ms had higher troponin and CK peak value, higher wall motion index score, lower ST resolution and lower LVEF assessed by MRI. The concordance of the three methods was 80%. CONCLUSION The measurement of diastolic deceleration time by transthoracic Doppler technique is a reliable technique to identify microvascular obstruction following PCI in acute anterior STEMI. A DDT inferior to 482 ms is associated with sustained "no-reflow" phenomenon.
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Affiliation(s)
- M Messas
- Pôle d'activité médicochirurgicale des Hôpitaux universitaires de Strasbourg, Nouvel Hôpital Civil, université de Strasbourg, France
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Morel O, Jesel L, Morel N, Nguyen A, Trinh A, Ohlmann P, Imperiale A. Transient left ventricular dysfunction syndrome during anaphylactic shock. Int J Cardiol 2010; 145:501-3. [DOI: 10.1016/j.ijcard.2009.10.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Accepted: 10/17/2009] [Indexed: 10/20/2022]
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Morel O, Jesel L, Cimarelli S, Trinh A, Ohlmann P, Imperiale A. Recurrent form of neurogenic stunned myocardium: Is myocardial adrenergic receptor distribution a dynamic process? Int J Cardiol 2010; 145:237-239. [DOI: 10.1016/j.ijcard.2009.08.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Accepted: 08/19/2009] [Indexed: 10/20/2022]
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Pereira B, Morel O, Blondet C, Grunebaum L, Goichot B, Merrien N, Jesel L, Faure A, Trinh A, Vinzio S, Constantinesco A, Bareiss P. [Value of left atrial dilation in the diagnosis of silent myocardial ischemia in diabetes mellitus patients]. Ann Cardiol Angeiol (Paris) 2008; 57:201-12. [PMID: 18468576 DOI: 10.1016/j.ancard.2008.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2006] [Accepted: 02/15/2008] [Indexed: 12/17/2022]
Abstract
BACKGROUND Accelerated atherothrombosis is a common feature in diabetes mellitus patients (DM), which can be related to abnormalities in vascular cell apoptosis and activation leading to the release of procoagulant microparticles (MPs). In DM patients, we hypothesized that circulating levels of biomarkers involved in atherothrombosis processes as well as cardiac and carotid echocardiography variables could be useful in the detection of silent myocardial diagnosed by myocardial perfusion imaging. METHODS AND RESULTS We investigated, in 55 patients with diabetes (mean age 62+/-10 years) and 15 nondiabetics (46+/-14 years) patients the prevalence of silent myocardial ischemia (SMI) detected by a treadmill exercise or dipyridamole (99m)Tc-sestamibi stress test. Echocardiographic and -carotid variables were obtained using standardized methods. Biomarkers assessing endothelial apoptosis or activation (CD31+-MPs, CD62+-MPs, VCAM-1), inflammatory status (CD11a +/- MPs, MCP-1, CRP), platelet activation (GPIb+/-MPs, CD40-L, P-selectin, GPV) ventricular stretch (BNP) were measured in the plasma. SMI was diagnosed in 23/55 (42%) diabetics patients and in 3/15 (20%) nondiabetics patients. Enhanced inflammatory status and leukocyte damage (CD11a+-MPs) were evidenced in diabetic patients. Within the diabetic population, biomarkers levels of atherothrombosis were not significantly associated to the detection of SMI. In multivariable analyses adjusted for LV hypertophy, left atrial surface (LA) remained independent predictor of silent myocardial ischemia (OR 4.14; IC [1.7-16.13]; P=0.039). CONCLUSIONS In diabetes mellitus patients, LA surface independently predicted silent myocardial ischemia after adjustment for established echocardiographic, and inflammatory risk factors. This simple measure of LA dilation could be helpful in the identification of diabetes mellitus patients at heightened cardiovascular risk.
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Affiliation(s)
- B Pereira
- Fédération de cardiologie des hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France
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Abstract
KEY POINTS Although the cardiovascular consequences of clinical or "overt" dysthyroidism are well known and treatment relatively well established, subclinical dysthyroidism remains a controversial topic, both regarding its cardiovascular effects and the best methods for its management. Subclinical hyperthyroidism is frequent among the elderly, usually associated with multinodular goiter. Although several epidemiologic studies have demonstrated that subclinical hyperthyroidism is associated with an increased risk of atrial fibrillation and high cardiovascular mortality, solid practical data on which management can be based are not currently available. The risks related to subclinical hypothyroidism appear essentially vascular but a conclusive assessment must await further epidemiologic surveys.
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Affiliation(s)
- S Vinzio
- Service de médecine interne et nutrition, Hôpital Hautepierre, av. Molière, 67098 Strasbourg cedex 67, France.
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Geny B, Piquard F, Petit H, Trinh A, Mettauer B, Epailly E, Charpentier A, Chakfe N, Popescu S, Kretz JG, Eisenmann B, Haberey P. Atrial systolic function after heart transplantation. Transplant Proc 1998; 30:2835-6. [PMID: 9745586 DOI: 10.1016/s0041-1345(98)00830-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- B Geny
- Laboratorie d'Explorations Fonctionelles du Système Circularoire, Faculté de Médecine, Strasbourg, France
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28
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Dabernat H, Geslin P, Megraud F, Bégué P, Boulesteix J, Dubreuil C, de La Roque F, Trinh A, Scheimberg A. Effects of cefixime or co-amoxiclav treatment on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae in children with acute otitis media. J Antimicrob Chemother 1998; 41:253-8. [PMID: 9533468 DOI: 10.1093/jac/41.2.253] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
A multicentre, open-label, randomized study was performed in 501 out-patients with acute otitis media, aged 6-36 months, to study the impact of treatment with either cefixime suspension 8 mg/kg/day bd or co-amoxiclav suspension 80 mg/kg/day tds for 10 days on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae. Of 426 patients with nasopharyngeal cultures at entry to the trial, end of treatment and at follow-up visit (35 days after inclusion), significant changes in carriage of S. pneumoniae were observed. The proportion of penicillin-resistant S. pneumoniae was higher in the samples taken at the end of treatment and follow-up than in those taken at inclusion, while the total number of children with this microorganism was lower. The difference at the end of treatment was greater with co-amoxiclav than with cefixime. For H. influenzae the resistance rate remained steady while the number of children with this microorganism decreased. At follow-up there was no significant difference between the two groups in terms of nasopharyngeal positive culture for S. pneumoniae or H. influenzae. Despite these differences, successful clinical responses were similar at the end of treatment and at follow-up.
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Affiliation(s)
- H Dabernat
- Laboratoire Central de Microbiologie, CHU, Hôpital Purpan, Toulouse, France
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29
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Bégué P, Boulesteix J, Mégraud F, Dabernat H, Gestin P, De la Rocque F, Trinh A, Artaz MA. Cefixime versus amoxicilline — acide clavulanique dans le traitement des otites moyennes aigues chez l'enfant : Evaluation de l'efficacite et de la tolerance cliniques. Arch Pediatr 1996. [DOI: 10.1016/0929-693x(96)86354-8] [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: 10/17/2022]
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Pinelli G, Carteaux JP, Trinh A, Kanj H, Aazrami H, Villemot JP. [On the use of the gastroepiploic artery in myocardial revascularization]. Arch Mal Coeur Vaiss 1995; 88:1407-13. [PMID: 8745612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Between 1985 and 1992, the gastroepiploic artery was used for coronary bypass surgery in 80 consecutive patients. Revascularisation was totally arterial in 62.5% of cases, the gastroepiploic being associated with single or double internal mammary artery grafts. The gastroepiploic graft was used to revascularise the inferior myocardial regions. The postoperative morbidity was essentially due to respiratory complications: 6 patients had objective pulmonary complications and 11 patients had relative transient postoperative hypoxia. The early gastrointestinal complications were related to ulceration (5 patients) complicated by haemorrhage in 2 patients. This morbidity was responsible for a significant increase in the period of intensive care. The hospital mortality was 6.2%, observed mainly in the first third of the author's experience and in patients with preoperative poor prognostic factors. These relatively high morbidity and mortality rates have led to a cautious use of the right gastroepiploic artery for coronary bypass surgery in patients over 70 years of age, in those with unstable angina operated as an emergency and in those with associated pathology, especially respiratory problems. The choice of a complex surgical option should not be synonimous with an increased postoperative mortality.
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Affiliation(s)
- G Pinelli
- Service de chirurgie cardiaque et transplantations cardiothoraciques, CHU Nancy-Brabois, Vandoeuvre-lès-Nancy
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31
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Boulesteix J, Bégué P, Dubreuil C, Mégraud F, Dabernat H, Geslin P, de La Rocque F, Trinh A. Acute otitis media in children: a study of nasopharyngeal carriage of potential pathogens and therapeutic efficacy of cefixime and amoxicillin-clavulanate. Infection 1995; 23 Suppl 2:S79-82. [PMID: 8537137 DOI: 10.1007/bf01742989] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We conducted a large, multicenter, randomized, open-label study throughout France comparing the efficacy and safety of cefixime suspension (8 mg/kg/day, b.i.d., for 10 days) versus amoxicillin-clavulanate suspension (80 mg/kg/day, t.i.d., for 10 days) in 510 children (ages 6 to 36 months) with acute otitis media. The most frequent microorganisms colonizing the nasopharynx at the start of treatment were Streptococcus pneumoniae (51.5%), Haemophilus influenzae (45%) and Moraxella catarrhalis (30.2%). Rates of beta-lactamase positivity were 32.1% and 95.3% for H. influenzae and M. catarrhalis, respectively. Decreased susceptibility of S. pneumoniae to penicillin was found in 39.7% of isolates. Clinical efficacy was 87.8% (223/254) for cefixime and 87.0% (215/247) for amoxicillin-clavulanate. At the 5-week follow-up visit, relapse had occurred in 15.7% (31/197) of cefixime-treated patients and in 15.6% (32/205) of those treated with amoxicillin-clavulanate. We conclude that these two regimens are equally effective in acute otitis media in children.
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Affiliation(s)
- J Boulesteix
- Service de Pédiatrie II, Centre Hospitalier Régional et Universitaire de Limoges
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32
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Pinelli G, Carteaux JP, Mertes PM, Civit T, Trinh A, Villemot JP. Mitral valve tumor revealed by stroke. J Heart Valve Dis 1995; 4:199-201. [PMID: 8556184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Valvular tumors are uncommon and usually benign lesions, discovered accidentally or when neurological or cardiological complications occur. We report a case of mitral valve papillary fibroelastoma measuring less than 1 cm and revealed by stroke. Transesophageal echocardiography was the best method to establish the diagnosis as it provided higher discriminative power than the transthoracic echocardiography or nuclear magnetic resonance. The embolic risks justify the surgical treatment of these lesions while anticoagulation therapy can be suggested as a substitute to surgery for the high risk patients.
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Affiliation(s)
- G Pinelli
- Department of Cardiac Surgery, CHU Nancy-Brabois, Nancy, France
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