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Mari S, Lecomte CG, Merlet AN, Audet J, Yassine S, Eddaoui O, Genois G, Nadeau C, Harnie J, Rybak IA, Prilutsky BI, Frigon A. Changes in intra- and interlimb reflexes from hindlimb cutaneous afferents after staggered thoracic lateral hemisections during locomotion in cats. J Physiol 2024. [PMID: 38593215 DOI: 10.1113/jp286151] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/04/2024] [Indexed: 04/11/2024] Open
Abstract
When the foot dorsum contacts an obstacle during locomotion, cutaneous afferents signal central circuits to coordinate muscle activity in the four limbs. Spinal cord injury disrupts these interactions, impairing balance and interlimb coordination. We evoked cutaneous reflexes by electrically stimulating left and right superficial peroneal nerves before and after two thoracic lateral hemisections placed on opposite sides of the cord at 9- to 13-week interval in seven adult cats (4 males and 3 females). We recorded reflex responses in ten hindlimb and five forelimb muscles bilaterally. After the first (right T5-T6) and second (left T10-T11) hemisections, coordination of the fore- and hindlimbs was altered and/or became less consistent. After the second hemisection, cats required balance assistance to perform quadrupedal locomotion. Short-latency reflex responses in homonymous and crossed hindlimb muscles largely remained unaffected after staggered hemisections. However, mid- and long-latency homonymous and crossed responses in both hindlimbs occurred less frequently after staggered hemisections. In forelimb muscles, homolateral and diagonal mid- and long-latency response occurrence significantly decreased after the first and second hemisections. In all four limbs, however, when present, short-, mid- and long-latency responses maintained their phase-dependent modulation. We also observed reduced durations of short-latency inhibitory homonymous responses in left hindlimb extensors early after the first hemisection and delayed short-latency responses in the right ipsilesional hindlimb after the first hemisection. Therefore, changes in cutaneous reflex responses correlated with impaired balance/stability and interlimb coordination during locomotion after spinal cord injury. Restoring reflex transmission could be used as a biomarker to facilitate locomotor recovery. KEY POINTS: Cutaneous afferent inputs coordinate muscle activity in the four limbs during locomotion when the foot dorsum contacts an obstacle. Thoracic spinal cord injury disrupts communication between spinal locomotor centres located at cervical and lumbar levels, impairing balance and limb coordination. We investigated cutaneous reflexes during quadrupedal locomotion by electrically stimulating the superficial peroneal nerve bilaterally, before and after staggered lateral thoracic hemisections of the spinal cord in cats. We showed a loss/reduction of mid- and long-latency responses in all four limbs after staggered hemisections, which correlated with altered coordination of the fore- and hindlimbs and impaired balance. Targeting cutaneous reflex pathways projecting to the four limbs could help develop therapeutic approaches aimed at restoring transmission in ascending and descending spinal pathways.
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Affiliation(s)
- Stephen Mari
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Charly G Lecomte
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Angèle N Merlet
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Johannie Audet
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sirine Yassine
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Oussama Eddaoui
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Gabriel Genois
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Charlène Nadeau
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jonathan Harnie
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Ilya A Rybak
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Boris I Prilutsky
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Alain Frigon
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
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Shen J, Samson N, Lamontagne‐Proulx J, Soulet D, Tremblay Y, Bazin M, Nadeau C, Bouchard S, Praud J, Parent S. Ovine model of congenital chest wall and spine deformity: From birth to 3 months follow-up. JOR Spine 2024; 7:e1295. [PMID: 38222803 PMCID: PMC10782060 DOI: 10.1002/jsp2.1295] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 01/16/2024] Open
Abstract
Background The evolution and treatment of lung alterations related to congenital spine and chest wall deformities (CWD) are poorly understood. Most animal models of CWD created postnatally were not evaluated for respiratory function. The goal of our study was to evaluate the effects of a CWD induced in utero on lung growth and function in an ovine model. Methods A CWD was induced in utero at 70-75 days of gestation in 14 ovine fetuses by resection of the 7th and 8th left ribs. Each non-operated twin fetus was taken as control. Respiratory mechanics was studied postnatally in the first week and at 1, 2, and 3 months. Post-mortem respiratory mechanics and lung histomorphometry were also assessed at 3 months. Results Eight out of 14 CWD lambs (57%) and 14 control lambs survived the postnatal period. One severe and five mild deformities were induced. At birth, inspiratory capacity (25 vs. 32 mL/kg in controls), and dynamic (1.4 vs. 1.8 mL/cmH2O/kg), and static (2.0 vs. 2.5 mL/cmH2O/kg) respiratory system compliances were decreased in CWD lambs. Apart from a slight decrease in inspiratory capacity at 1 month of life, no other differences were observed in respiratory mechanics measured in vivo thereafter. Postmortem measurements found a significant decrease in lung compliance-for each lung and for both lungs taken together-in CWD lambs. No differences in lung histology were detected at 3 months in CWD animals compared to controls. Conclusions Our study is the first to assess the effects of a prenatally induced CWD on lung development and function from birth to 3 months in an ovine model. Our results show no significant differences in lung histomorphometry at 3 months in CWD lambs compared to controls. Resolution at 1 month of the alterations in respiratory mechanics present at birth may be related to the challenge in inducing severe deformities.
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Affiliation(s)
- Jesse Shen
- Centre de recherche du CHU Sainte‐JustineDepartment of SurgeryMontrealQuebecCanada
- University of MontrealDepartment of SurgeryMontrealQuebecCanada
| | - Nathalie Samson
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology‐PhysiologyUniversité de SherbrookeSherbrookeQuebecCanada
| | | | - Denis Soulet
- Axe NeuroscienceCentre de recherche du CHU de QuébecQuebec CityQuebecCanada
- Faculté de pharmacieUniversité LavalQuebec CityQuebecCanada
| | - Yves Tremblay
- Axe Reproduction, santé de la mère et de l'enfantCentre de recherche du CHU de QuébecQuebec CityQuebecCanada
- Centre de Recherche en Reproduction, Développement et Santé Intergénérationnelle (CRDSI)Quebec CityQuebecCanada
- Département d'obstétrique/gynécologie et reproduction, Faculté de médecineUniversité LavalQuebec CityQuebecCanada
| | - Marc Bazin
- Centre de recherche du CHU de QuébecUniversité LavalQuebec CityQuebecCanada
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology‐PhysiologyUniversité de SherbrookeSherbrookeQuebecCanada
| | - Sarah Bouchard
- Centre de recherche du CHU Sainte‐JustineDepartment of SurgeryMontrealQuebecCanada
- University of MontrealDepartment of SurgeryMontrealQuebecCanada
| | - Jean‐Paul Praud
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology‐PhysiologyUniversité de SherbrookeSherbrookeQuebecCanada
| | - Stefan Parent
- Centre de recherche du CHU Sainte‐JustineDepartment of SurgeryMontrealQuebecCanada
- University of MontrealDepartment of SurgeryMontrealQuebecCanada
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Morin C, Simard É, See W, Sage M, Imane R, Nadeau C, Samson N, Lavoie PM, Chabot B, Marouan S, Tremblay S, Praud JP, Micheau P, Fortin-Pellerin É. Total liquid ventilation in an ovine model of extreme prematurity: a randomized study. Pediatr Res 2024; 95:974-980. [PMID: 37833531 DOI: 10.1038/s41390-023-02841-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/16/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND This study aimed at comparing cardiorespiratory stability during total liquid ventilation (TLV)-prior to lung aeration-with conventional mechanical ventilation (CMV) in extremely preterm lambs during the first 6 h of life. METHODS 23 lambs (11 females) were born by c-section at 118-120 days of gestational age (term = 147 days) to receive 6 h of TLV or CMV from birth. Lung samples were collected for RNA and histology analyses. RESULTS The lambs under TLV had higher and more stable arterial oxygen saturation (p = 0.001) and cerebral tissue oxygenation (p = 0.02) than the lambs in the CMV group in the first 10 min of transition to extrauterine life. Although histological assessment of the lungs was similar between the groups, a significant upregulation of IL-1a, IL-6 and IL-8 RNA in the lungs was observed after TLV. CONCLUSIONS Total liquid ventilation allowed for remarkably stable transition to extrauterine life in an extremely preterm lamb model. Refinement of our TLV prototype and ventilation algorithms is underway to address specific challenges in this population, such as minimizing tracheal deformation during the active expiration. IMPACT Total liquid ventilation allows for remarkably stable transition to extrauterine life in an extremely preterm lamb model. Total liquid ventilation is systematically achievable over the first 6 h of life in the extremely premature lamb model. This study provides additional incentive to pursue further investigation of total liquid ventilation as a transition tool for the most extreme preterm neonates.
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Affiliation(s)
- Christophe Morin
- Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Émile Simard
- Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Wendy See
- Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Michaël Sage
- Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Roqaya Imane
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
| | - Charlène Nadeau
- Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Nathalie Samson
- Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Pascal M Lavoie
- Division of Neonatology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Benoît Chabot
- Department of Microbiology and Infectiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sofia Marouan
- Department of Pathology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Sophie Tremblay
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
| | - Jean-Paul Praud
- Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Philippe Micheau
- Department of Mechanical Engineering, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Étienne Fortin-Pellerin
- Department of Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC, Canada.
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Mari S, Lecomte CG, Merlet AN, Audet J, Yassine S, Eddaoui O, Genois G, Nadeau C, Harnie J, Rybak IA, Prilutsky BI, Frigon A. Changes in intra- and interlimb reflexes from hindlimb cutaneous afferents after staggered thoracic lateral hemisections during locomotion in cats. bioRxiv 2023:2023.12.15.571869. [PMID: 38168183 PMCID: PMC10760189 DOI: 10.1101/2023.12.15.571869] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
When the foot dorsum contacts an obstacle during locomotion, cutaneous afferents signal central circuits to coordinate muscle activity in the four limbs. Spinal cord injury disrupts these interactions, impairing balance and interlimb coordination. We evoked cutaneous reflexes by electrically stimulating left and right superficial peroneal nerves before and after two thoracic lateral hemisections placed on opposite sides of the cord at 9-13 weeks interval in seven adult cats (4 males and 3 females). We recorded reflex responses in ten hindlimb and five forelimb muscles bilaterally. After the first (right T5-T6) and second (left T10-T11) hemisections, coordination of the fore- and hindlimbs was altered and/or became less consistent. After the second hemisection, cats required balance assistance to perform quadrupedal locomotion. Short-latency reflex responses in homonymous and crossed hindlimb muscles largely remained unaffected after staggered hemisections. However, mid- and long-latency homonymous and crossed responses in both hindlimbs occurred less frequently after staggered hemisections. In forelimb muscles, homolateral and diagonal mid- and long-latency response occurrence significantly decreased after the first and second hemisections. In all four limbs, however, when present, short-, mid- and long-latency responses maintained their phase-dependent modulation. We also observed reduced durations of short-latency inhibitory homonymous responses in left hindlimb extensors early after the first hemisection and delayed short-latency responses in the right ipsilesional hindlimb after the first hemisection. Therefore, changes in cutaneous reflex responses correlated with impaired balance/stability and interlimb coordination during locomotion after spinal cord injury. Restoring reflex transmission could be used as a biomarker to facilitate locomotor recovery.
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Affiliation(s)
- Stephen Mari
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Charly G. Lecomte
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Angèle N. Merlet
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Johannie Audet
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Sirine Yassine
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Oussama Eddaoui
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Gabriel Genois
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Charlène Nadeau
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Jonathan Harnie
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Ilya A. Rybak
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Boris I. Prilutsky
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Alain Frigon
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
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Elsedawi BF, Samson N, Nadeau C, Charette A, Lehoux A, Fortin-Pellerin É, Praud JP. Effects of Nasal Respiratory Support on Laryngeal and Esophageal Reflexes in Preterm Lambs. Pediatr Res 2023:10.1038/s41390-023-02883-w. [PMID: 37938316 DOI: 10.1038/s41390-023-02883-w] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/27/2023] [Accepted: 10/18/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Significant cardiorespiratory events can be triggered in preterm infants as part of laryngeal chemoreflexes (LCRs) and esophageal reflexes (ERs). We previously showed that nasal continuous positive airway pressure (nCPAP) blunted the cardiorespiratory inhibition induced with LCRs. Therefore, we aimed to compare the effects of nCPAP and high-flow nasal cannulas (HFNC) on the cardiorespiratory events induced during LCRs and ERs. The hypothesis is that nCPAP but not HFNC decreases the cardiorespiratory inhibition observed during LCRs and ERs. METHODS Eleven preterm lambs were instrumented to record respiration, ECG, oxygenation, and states of alertness. LCRs and ERs were induced during non-rapid eye movement sleep in a random order under these conditions: nCPAP 6 cmH2O, HFNC 7 L/min, high-flow nasal cannulas 7 L/min at a tracheal pressure of 6 cmH2O, and no respiratory support. RESULTS nCPAP 6 cmH2O decreased the cardiorespiratory inhibition induced with LCRs, but not with ERs in preterm lambs. This blunting effect was less marked with HFNC 7 L/min, even when the tracheal pressure was maintained at 6 cmH2O. CONCLUSIONS nCPAP might be a treatment for cardiorespiratory events related to LCRs in newborns, either in the context of laryngopharyngeal refluxes or swallowing immaturity. Our preclinical results merit to be confirmed through clinical studies. IMPACT Laryngeal chemoreflexes can be responsible for significant cardiorespiratory inhibition in newborns, especially preterm. Nasal continuous positive airway pressure at 6 cmH2O significantly decreased this cardiorespiratory inhibition. High-flow nasal cannulas at 7 L/min had a lesser effect than nasal continuous positive airway pressure. Esophageal stimulation was responsible for a smaller cardiorespiratory inhibition, which was not significantly modified by nasal continuous positive airway pressure or high-flow nasal cannulas. Nasal continuous positive airway pressure should be tested for its beneficial effect on cardiorespiratory events related to laryngeal chemoreflexes in preterm newborns.
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Affiliation(s)
- Basma F Elsedawi
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, University of Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada
- Department of Human Anatomy and Embryology, Faculty of Medicine, Zagazig University, Zagazig, Sharkia, Arab Republic of Egypt
| | - Nathalie Samson
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, University of Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, University of Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada
| | - Arianne Charette
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, University of Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada
| | - Angélique Lehoux
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, University of Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada
| | - Étienne Fortin-Pellerin
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, University of Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, University of Sherbrooke, Sherbrooke, QC, J1H 5N4, Canada.
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Simard É, Morin C, Coquerel D, Chagnon F, Nadeau C, Samson N, Praud JP, Lesur O, Fortin-Pellerin É. Hemodynamic impacts of apelin-13 in a neonatal lamb model of septic peritonitis. Pediatr Res 2023; 94:129-134. [PMID: 36460738 DOI: 10.1038/s41390-022-02407-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 10/17/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Apelins are potential candidate therapeutic molecules for hemodynamic support. The objective of this study was to assess the hemodynamic impacts of apelin-13 in a neonatal lamb model of septic shock. METHODS Lambs were randomized to receive apelin-13 or normal saline. Septic shock was induced by injecting a fecal slurry into the peritoneal cavity. Lambs underwent volume repletion (30 mL/kg over 1 h) followed by intravenous administration of 5 incremental doses (D) of apelin-13 (D1 = 0.039 to D5 = 19.5 µg/kg/h) or normal saline. RESULTS Following fecal injection, mean arterial pressure (MAP) and cardiac index (CI) dropped in both groups (p < 0.05). The MAP decreased non-significantly from D1 to D5 (p = 0.12) in the saline group, while increasing significantly (p = 0.02) in the apelin group (-12 (-17; 12) vs. +15 (6; 23) % (p = 0.012)). Systemic vascular resistances were higher in the apelin-13 group at D5 compared to the saline group (4337 (3239, 5144) vs. 2532 (2286, 3966) mmHg/min/mL, respectively, p = 0.046). The CI increased non-significantly in the apelin-13 group. CONCLUSION Apelin-13 increased MAP in a neonatal lamb septic shock model. IMPACT Administration of apelin-13 stabilized hemodynamics during the progression of the sepsis induced in this neonatal lamb model. Systemic vascular resistances were higher in the apelin-13 group than in the placebo group. This suggests ontogenic differences in vascular response to apelin-13 and warrants further investigation. This study suggests that apelin-13 could eventually become a candidate for the treatment of neonatal septic shock.
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Affiliation(s)
- Émile Simard
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Christophe Morin
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - David Coquerel
- Department of Medicine and Intensive Care Unit, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédéric Chagnon
- Department of Medicine and Intensive Care Unit, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Charlène Nadeau
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Nathalie Samson
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Paul Praud
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Olivier Lesur
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Medicine and Intensive Care Unit, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Étienne Fortin-Pellerin
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.
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Dubot C, Joly Lobbedez F, Ray Coquard I, Floquet A, Lefevre Arbogast S, Selle F, Berton-Rigaud D, Frank S, De La Motte Rouge T, Kalbacher E, Provansal Gross M, Lortholary A, Orfeuvre H, Alexandre J, Augereau P, Nadeau C, Kurtz J, Grellard JM, Pautier P, Gernier F. 19P Long term sexual disorders among rare ovarian cancer survivors: The national GINECO case-control Vivrovaire Rare Tumors study. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101040] [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: 04/05/2023] Open
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8
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Joly Lobbedez F, Ray-Coquard I, Lefevre Arbogast S, Grellard JM, Clarisse B, Floquet A, Selle F, Berton-Rigaud D, Frank S, De La Motte Rouge T, Kalbacher E, Provansal Gross M, A. lortholary, Orfeuvre H, Alexandre J, Augereau P, Kurtz J, Nadeau C, Pautier P, Gernier F. 535P Long term quality of life after chemotherapy among nonepithelial ovarian cancer survivors: The case-control vivrovaire rare tumours study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.663] [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: 11/16/2022] Open
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9
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Elsedawi BF, Samson N, Nadeau C, Vanhaverbeke K, Nguyen N, Alain C, Fortin-Pellerin E, Praud JP. Corrigendum: Safety of Bottle-Feeding Under Nasal Respiratory Support in Preterm Lambs With and Without Tachypnoea. Front Physiol 2022; 13:854173. [PMID: 35283774 PMCID: PMC8904267 DOI: 10.3389/fphys.2022.854173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/01/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Basma Fathi Elsedawi
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada.,Department of Human Anatomy and Embryology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nathalie Samson
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Kristien Vanhaverbeke
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada.,Laboratory of Experimental Medicine and Pediatrics, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium.,Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Nam Nguyen
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada.,Faculty of Human Medicine, Paracelsus Medical University, Nuremberg, Germany
| | - Charles Alain
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Etienne Fortin-Pellerin
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
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10
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Elsedawi BF, Samson N, Nadeau C, Vanhaverbeke K, Nguyen N, Alain C, Fortin-Pellerin E, Praud JP. Safety of Bottle-Feeding Under Nasal Respiratory Support in Preterm Lambs With and Without Tachypnoea. Front Physiol 2022; 12:785086. [PMID: 35046837 PMCID: PMC8762202 DOI: 10.3389/fphys.2021.785086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/06/2021] [Indexed: 11/19/2022] Open
Abstract
Aim: Convalescing preterm infants often require non-invasive respiratory support, such as nasal continuous positive airway pressure or high-flow nasal cannulas. One challenging milestone for preterm infants is achieving full oral feeding. Some teams fear nasal respiratory support might disrupt sucking–swallowing–breathing coordination and induce severe cardiorespiratory events. The main objective of this study was to assess the safety of oral feeding of preterm lambs on nasal respiratory support, with or without tachypnoea. Methods: Sucking, swallowing and breathing functions, as well as electrocardiogram, oxygen haemoglobin saturation, arterial blood gases and videofluoroscopic swallowing study were recorded in 15 preterm lambs during bottle-feeding. Four randomly ordered conditions were studied: control, nasal continuous positive airway pressure (6 cmH2O), high-flow nasal cannulas (7 L•min–1), and high-flow nasal cannulas at 7 L•min–1 at a tracheal pressure of 6 cmH2O. The recordings were repeated on days 7–8 and 13–14 to assess the effect of maturation. Results: None of the respiratory support impaired the safety or efficiency of oral feeding, even with tachypnoea. No respiratory support systematically impacted sucking–swallowing–breathing coordination, with or without tachypnoea. No effect of maturation was found. Conclusion: This translational physiology study, uniquely conducted in a relevant animal model of preterm infant with respiratory impairment, shows that nasal respiratory support does not impact the safety or efficiency of bottle-feeding or sucking–swallowing–breathing coordination. These results suggest that clinical studies on bottle-feeding in preterm infants under nasal continuous positive airway pressure and/or high-flow nasal cannulas can be safely undertaken.
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Affiliation(s)
- Basma Fathi Elsedawi
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
- Department of Human Anatomy and Embryology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nathalie Samson
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Kristien Vanhaverbeke
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
- Laboratory of Experimental Medicine and Pediatrics, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Nam Nguyen
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
- Faculty of Human Medicine, Paracelsus Medical University, Nuremberg, Germany
| | - Charles Alain
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Etienne Fortin-Pellerin
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Department of Pediatrics, Department of Physiology, University of Sherbrooke, Sherbrooke, QC, Canada
- *Correspondence: Jean-Paul Praud,
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11
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Alain C, Samson N, Nadeau C, Beaudoin JF, Lienhart C, Counil C, Praud JP. Nasal respiratory support and tachypnea and oral feeding in full-term newborn lambs. J Appl Physiol (1985) 2021; 130:1436-1447. [PMID: 33661723 DOI: 10.1152/japplphysiol.00567.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/22/2022] Open
Abstract
Newborn infants with respiratory difficulties frequently require nasal respiratory support such as nasal continuous positive airway pressure (nCPAP) or high-flow nasal cannulae (HFNC). Oral feeding of these infants under nasal respiratory support remains controversial out of fear of aspiration and cardiorespiratory events. The main objective of this study was to evaluate the safety of oral feeding under different types of nasal respiratory support in newborn lambs without or with tachypnea. Eight lambs aged 4-5 days were instrumented to record sucking, swallowing, respiration, ECG, oxygen saturation, and arterial blood gases. Each lamb was given two bottles of 30 mL of milk with a pause of 30 s under videofluoroscopy in four conditions [no respiratory support, nCPAP 6 cmH2O, HFNC 7 L/min, HFNCCPAP (= HFNC 7 L/min + CPAP 6 cmH2O)] administered in random order. The study was conducted in random order over 2 days, with or without standardized tachypnea induced by thoracic compression with a blood pressure cuff. Generalized linear mixed models were used to compare the four nasal respiratory supports in terms of safety (cardiorespiratory events and aspiration), sucking-swallowing-breathing coordination, and efficacy of oral feeding. Results reveal that no nasal respiratory support impaired the safety of oral feeding. Most of the few laryngeal penetrations we observed occurred with HFNCCPAP. Nasal CPAP modified sucking-swallowing-breathing coordination, whereas the efficiency of oral feeding decreased under HFNCCPAP. Results were similar with or without tachypnea. In conclusion, oral feeding under nasal respiratory support is generally safe in a term lamb, even with tachypnea.NEW & NOTEWORTHY The practice of orally feeding newborns suffering from respiratory problems while on nCPAP or HFNC remains controversial for fear of triggering cardiorespiratory events or aspiration pneumonia, or aggravating chronic lung disease. The present results show that bottle-feeding is generally safe in full-term lambs under nasal respiratory support, both without and with tachypnea.
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Affiliation(s)
- Charles Alain
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Nathalie Samson
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean-François Beaudoin
- Centre d'imagerie moléculaire de Sherbrooke (CIMS), Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Camille Lienhart
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Clément Counil
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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12
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Samson N, Nadeau C, Cantin D, Farkouh R, Robinson M, Elnazir P, Geha S, Bussières M, Praud JP. Respiratory activity of the cricopharyngeus muscle in the neonatal period. Respir Physiol Neurobiol 2021; 290:103671. [PMID: 33813048 DOI: 10.1016/j.resp.2021.103671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/23/2020] [Revised: 02/28/2021] [Accepted: 03/30/2021] [Indexed: 11/28/2022]
Abstract
While phasic electrical activity of the cricopharyngeus muscle (EAcp)-the main component of the upper esophageal sphincter-occurs with inspiration and forceful expiration in adults, no such data is available for newborns. In addition, the effect of nasal respiratory support commonly used in newborns is unknown. We aimed to describe the phasic respiratory EAcp and to assess the potential effect of nasal CPAP (nCPAP, 6 cmH2O) or high-flow nasal cannula (HFNC, 7 L/min) in newborn lambs during 6-h recordings. Phasic EAcp was present in 11/17 lambs, including in 32 % (25, 81) [(median (Q1, Q3)] of respiratory cycles in wakefulness, 40 % (27, 70) in NREM sleep, and 10 % (0, 23) in REM sleep. In addition, EAcp was observed only during post-inspiration and/or expiration. Nasal CPAP or HFNC assessed in 7 of the 17 lambs did not have any effect. We conclude that phasic respiratory EAcp occurs in post-inspiration and expiration in newborn lambs.
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Affiliation(s)
- Nathalie Samson
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada
| | - Danny Cantin
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada
| | - Rezkalla Farkouh
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada
| | - Maggy Robinson
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada
| | - Pierre Elnazir
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada
| | - Sameh Geha
- Department of Pathology, Université de Sherbrooke, QC, Canada
| | - Marie Bussières
- Ear, Nose, and Throat Division, Department of Surgery, Université de Sherbrooke, QC, Canada
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada.
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13
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Poudou C, Baffet H, Nadeau C, Rolland AL, Catteau-Jonard S, Robin G. [Benefit-risk balance of hormone replacement therapy: Cancers and mortality. Postmenopausal women management - CNGOF and GEMVi clinical practice guidelines]. ACTA ACUST UNITED AC 2021; 49:462-473. [PMID: 33771739 DOI: 10.1016/j.gofs.2021.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/02/2023]
Abstract
The use of hormone replacement therapy (HRT) for menopausal women has been the subject of much controversy in recent years, particularly concerning the carcinologic risks. The purpose of this review is to evaluate the impact of the use of HRT on the risk of gynecological but also extra-gynecological cancers. The effect of the type and the duration of use of HRT in menopausal women will also be discussed. The beneficial impact of HRT on overall mortality is also an element that will be discussed and must be taken into account when evaluating the benefit-risk balance of HRT for menopausal women.
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Affiliation(s)
- C Poudou
- Service gynécologie obstétrique et médecine de la reproduction, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - H Baffet
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59073 Lille cedex, France; Service d'assistance médicale à la procréation et préservation de la fertilité, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - C Nadeau
- Service gynécologie obstétrique et médecine de la reproduction, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - A-L Rolland
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59073 Lille cedex, France; Service d'assistance médicale à la procréation et préservation de la fertilité, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - S Catteau-Jonard
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59073 Lille cedex, France; Faculté de médecine, université de Lille, 2, avenue Eugène-Avinée, 59120 Loos, France
| | - G Robin
- Service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59073 Lille cedex, France; Faculté de médecine, université de Lille, 2, avenue Eugène-Avinée, 59120 Loos, France.
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14
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Derquin F, Floquet A, Hardy-Bessard AC, Edeline J, Lotz JP, Alexandre J, Pautier P, Angeles MA, Delanoy N, Lefeuvre-Plesse C, Cancel M, Treilleux I, Augereau P, Lavoue V, Kalbacher E, Berton Rigaud D, Selle F, Nadeau C, Gantzer J, Joly F, Guillemet C, Pomel C, Favier L, Abdeddaim C, Venat-Bouvet L, Provansal M, Fabbro M, Kaminsky MC, Lortholary A, Lecuru F, Coquard IR, de La Motte Rouge T. Need for risk-adapted therapy for malignant ovarian germ cell tumors: A large multicenter analysis of germ cell tumors' patients from French TMRG network. Gynecol Oncol 2020; 158:666-672. [PMID: 32624235 DOI: 10.1016/j.ygyno.2020.06.491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/15/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Malignant ovarian germ cell tumors are rare tumors, affecting young women with a generally favorable prognosis. The French reference network for Rare Malignant Gynecological Tumors (TMRG) aims to improve their management. The purpose of this study is to report clinicopathological features and long-term outcomes, to explore prognostic parameters and to help in considering adjuvant strategy for stage I patients. PATIENTS AND METHODS Data from patients with MOGCT registered among 13 of the largest centers of the TMRG network were analyzed. We report clinicopathological features, estimated 5-year event-free survival (5y-EFS) and 5-year overall survival (5y-OS) of MOGCT patients. RESULTS We collected data from 147 patients including 101 (68.7%) FIGO stage I patients. Histology identifies 40 dysgerminomas, 52 immature teratomas, 32 yolk sac tumors, 2 choriocarcinomas and 21 mixed tumors. Surgery was performed in 140 (95.2%) patients and 106 (72.1%) received first line chemotherapy. Twenty-two stage I patients did not receive chemotherapy. Relapse occurred in 24 patients: 13 were exclusively treated with upfront surgery and 11 received surgery and chemotherapy. 5y-EFS was 82% and 5y-OS was 92.4%. Stage I patients who underwent surgery alone had an estimated 5y-EFS of 54.6% and patients receiving adjuvant chemotherapy 94.4% (P < .001). However, no impact on estimated 5y-OS was observed: 96.3% versus 97.8% respectively (P = .62). FIGO stage, complete primary surgery and post-operative alpha fetoprotein level significantly correlated with survival. CONCLUSION Adjuvant chemotherapy does not seem to improve survival in stage I patients. Active surveillance can be proposed for selected patients with a complete surgical staging.
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Affiliation(s)
- F Derquin
- Medical Oncology Department, Centre Hospitaliser Yves Le Foll, Saint Brieuc, France
| | - A Floquet
- Medical Oncology Department, Institut Bergonié, Bordeaux, France
| | | | - J Edeline
- Medical Oncology Department, Centre Eugène Marquis, Rennes, France
| | - J P Lotz
- Medical Oncology Department, Sorbonne University, APHP, Paris, France
| | - J Alexandre
- Medical Oncology Department, Hôpital Cochin, APHP, Paris, France
| | - P Pautier
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France
| | - M A Angeles
- Surgical Oncology Department, Institut Claudius Regaud, Toulouse, France
| | - N Delanoy
- Medical Oncology Department, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | | | - M Cancel
- Medical Oncology Department, Centre Hospitalier Universitaire Bretonneau, Tours, France
| | - I Treilleux
- Medical Oncology Department, Centre Léon Bérard, Lyon, France
| | - P Augereau
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Angers, France
| | - V Lavoue
- Gynecology Department, Centre Hospitalier Universitaire, Rennes, France
| | - E Kalbacher
- Medical Oncology Department, Centre Hospitalier Régional Universitaire, Besançon, France
| | - D Berton Rigaud
- Medical Oncology Department, Institut de Cancérologie de l'Ouest, Nantes, France
| | - F Selle
- Diaconnesses Hospital Group, Paris, France
| | - C Nadeau
- Gynecology Department, CHU de Poitiers, Poitiers, France
| | - J Gantzer
- Medical Oncology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - F Joly
- Medical Oncology Department, Centre François Baclesse, Caen, France
| | - C Guillemet
- Medical Oncology Department, Centre Henri-Becquerel, Rouen, France
| | - C Pomel
- Medical Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - L Favier
- Medical Oncology Department, Centre Georges François Leclerc, Dijon, France
| | - C Abdeddaim
- Medical Oncology Department, Centre Oscar Lambret, Lille, France
| | - L Venat-Bouvet
- Medical Oncology Department, CHU Dupuytren, Limoges, France
| | - M Provansal
- Medical Oncology Department, Institut Paoli Calmettes, Marseille, France
| | - M Fabbro
- Medical Oncology Department, Institut régional du Cancer Montpellier, Montpellier, France
| | - M C Kaminsky
- Medical Oncology Department, Institut de Cancérologie de Lorraine - Alexis Vautrin, Vandoeuvre-Les-Nancy, France
| | - A Lortholary
- Medical Oncology Department, Hôpital Privé du Confluent, Nantes, France
| | - F Lecuru
- Medical Oncology Department, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - I Ray Coquard
- Medical Oncology Department, Centre Léon Bérard, Lyon, France
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15
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Nault S, Creuze V, Al-Omar S, Levasseur A, Nadeau C, Samson N, Imane R, Tremblay S, Carrault G, Pladys P, Praud JP. Cardiorespiratory Alterations in a Newborn Ovine Model of Systemic Inflammation Induced by Lipopolysaccharide Injection. Front Physiol 2020; 11:585. [PMID: 32625107 PMCID: PMC7311791 DOI: 10.3389/fphys.2020.00585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/11/2020] [Indexed: 12/14/2022] Open
Abstract
Although it is well known that neonatal sepsis can induce important alterations in cardiorespiratory control, their detailed early features and the mechanisms involved remain poorly understood. As a first step in resolving this issue, the main goal of this study was to characterize these alterations more extensively by setting up a full-term newborn lamb model of systemic inflammation using lipopolysaccharide (LPS) injection. Two 6-h polysomnographic recordings were performed on two consecutive days on eight full-term lambs: the first after an IV saline injection (control condition, CTRL); the second, after an IV injection of 2.5 μg/kg Escherichia coli LPS 0127:B8 (LPS condition). Rectal temperature, locomotor activity, state of alertness, arterial blood gases, respiratory frequency and heart rate, mean arterial blood pressure, apneas and cardiac decelerations, and heart-rate and respiratory-rate variability (HRV and RRV) were assessed. LPS injection decreased locomotor activity (p = 0.03) and active wakefulness (p = 0.01) compared to the CTRL. In addition, LPS injection led to a biphasic increase in rectal temperature (p = 0.01 at ∼30 and 180 min) and in respiratory frequency and heart rate (p = 0.0005 and 0.005, respectively), and to an increase in cardiac decelerations (p = 0.05). An overall decrease in HRV and RRV was also observed. Interestingly, the novel analysis of the representations of the horizontal and vertical visibility network yielded the most statistically significant alterations in HRV structure, suggesting its potential clinical importance for providing an earlier diagnosis of neonatal bacterial sepsis. A second goal was to assess whether the reflexivity of the autonomic nervous system was altered after LPS injection by studying the cardiorespiratory components of the laryngeal and pulmonary chemoreflexes. No difference was found. Lastly, preliminary results provide proof of principle that brainstem inflammation (increased IL-8 and TNF-α mRNA expression) can be shown 6 h after LPS injection. In conclusion, this full-term lamb model of systemic inflammation reproduces several important aspects of neonatal bacterial sepsis and paves the way for studies in preterm lambs aiming to assess both the effect of prematurity and the central neural mechanisms of cardiorespiratory control alterations observed during neonatal sepsis.
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Affiliation(s)
- Stéphanie Nault
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Sally Al-Omar
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Annabelle Levasseur
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Nathalie Samson
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Roqaya Imane
- CHU Sainte-Justine Research Center, Departments of Neurosciences and Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Sophie Tremblay
- CHU Sainte-Justine Research Center, Departments of Neurosciences and Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Guy Carrault
- Inserm, LTSI - UMR 1099, CHU Rennes, Université Rennes 1, Rennes, France
| | - Patrick Pladys
- Inserm, LTSI - UMR 1099, CHU Rennes, Université Rennes 1, Rennes, France
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
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16
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Simon V, Ngo C, Pujade-Lauraine E, Ferron G, Pomel C, Leblanc E, Nadeau C, Ray-Cocquard I, Lecuru F, Bonsang-Kitzis H. Should We Abandon Systematic Pelvic and Paraaortic Lymphadenectomy in Low-Grade Serous Ovarian Cancer? Ann Surg Oncol 2020; 27:3882-3890. [PMID: 32246309 DOI: 10.1245/s10434-020-08361-5] [Citation(s) in RCA: 5] [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: 03/11/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Low-grade serous ovarian carcinoma (LGSOC) is a rare disease that accounts for 5% of all ovarian cancers and requires surgical complete debulking. To date, the prognostic value of pelvic and paraaortic lymphadenectomy remains unclear in this population. PATIENTS AND METHODS This retrospective cohort of patients with a diagnosis of LGSOC was registered in the Tumeurs Malignes Rares Gynécologiques national network, between January 2000 and July 2017, at 25 centers. All LGSOC were confirmed after pathological review and operated by primary debulking surgery (PDS) or interval debulking surgery after neoadjuvant chemotherapy (NACT-IDS). Primary endpoints were overall survival (OS) and progression-free survival (PFS). RESULTS A total of 126 patients were included, 86.1% were stage III/IV, and 74.6% underwent lymph node dissection (LND). According to the Completeness of Cancer Resection (CCR) score, 83.7% had complete resection. Median OS was 130 months, and median PFS was 41 months. Pelvic and paraaortic LND had no significant impact on OS (p = 0.78) or DFS (p = 0.93), and this was confirmed in subgroups (advanced stages FIGO III/IV, CCR score 0/1 or 2/3, and timing of surgery PDS or NACT-IDS). Histological positive paraaortic lymph nodes had a significant negative impact on PFS in the whole population (HR 2.21, 1.18-4.39, p = 0.02) and in the CC0/CC1 population (HR, 2.28, 1.13-4.59, p = 0.02). CONCLUSIONS Systematic pelvic and paraaortic LND in patients with LGSOC improved neither overall nor PFS. A prospective trial would be necessary to validate these results but would be difficult to conduct due to the rarity of this disease.
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Affiliation(s)
- V Simon
- Gynecologic and Breast Oncologic Surgical Department, Georges Pompidou European Hospital, Paris, France
| | - C Ngo
- Gynecological and Breast Surgery and Cancerology Center, RAMSAY-Générale de Santé, Hôpital Privé des Peupliers, Paris, France
| | - E Pujade-Lauraine
- Medical Oncology Department, Paris Descartes University, Hôpital Hôtel-Dieu, Paris, France.,ARCAGY - GINECO Cooperative Group, Paris, France
| | - G Ferron
- ARCAGY - GINECO Cooperative Group, Paris, France.,Department of Surgical Oncology, Claudius Regaud Institute, IUCT Oncopole, Toulouse, France
| | - C Pomel
- ARCAGY - GINECO Cooperative Group, Paris, France.,Department of Surgical Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | - E Leblanc
- ARCAGY - GINECO Cooperative Group, Paris, France.,Department of Surgical Oncology, Centre Oscar Lambret, Lille Cedex, France
| | - C Nadeau
- ARCAGY - GINECO Cooperative Group, Paris, France.,Department of Surgical Oncology, CHU de Poitiers, Poitiers, France
| | - I Ray-Cocquard
- ARCAGY - GINECO Cooperative Group, Paris, France.,Medical Oncology Department, Centre Leon Berard, Lyon, France
| | - F Lecuru
- ARCAGY - GINECO Cooperative Group, Paris, France.,Breast, Gynecology and Reconstructive Surgical Department, Curie Institute, Paris, France.,Université de Paris, Paris, France
| | - H Bonsang-Kitzis
- Gynecological and Breast Surgery and Cancerology Center, RAMSAY-Générale de Santé, Hôpital Privé des Peupliers, Paris, France. .,ARCAGY - GINECO Cooperative Group, Paris, France.
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17
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Fitzgerald N, Hussain S, Memon S, Gauvreau C, Flanagan W, Nadeau C, Asakawa K, Miller A, Coldman A, Popadiuk C. Evaluating Clinical and Cost Impacts of Achieving 90% HPV Vaccination Rate Against Cervical Cancer in Canada Using the OncoSim Cancer Simulation Model. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.27600] [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
Background: Cervical cancer can be largely prevented through vaccination against the human papillomavirus (HPV). In Canada, HPV vaccination of school-aged girls started in 2008 and has reached an average rate of 67% across the country. However, this rate is below a current national target of 90%. Aim: We project the difference in lifetime clinical outcomes and health system costs of achieving a 90% HPV vaccination rate versus a 67% rate for girls vaccinated in 2015 using the OncoSim-Cervical model. Methods: The OncoSim-Cervical model (version 2.5) is a microsimulation model led by the Canadian Partnership Against Cancer, with model development by Statistics Canada, to evaluate the impacts of cervical cancer interventions in Canada. It has two parts, the first, the HPV Microsimulation Model, simulates the transmission of HPV between males and females including possible modulation by vaccination and herd immunity, and provides projections of HPV infection and prevalence for input to the cervical cancer natural history component in the second part. We simulated two cohorts of 5-10 year old girls in 2015; one receiving HPV vaccination at the rate of 67% and another at 90%. Their relative lifetime cervical cancer outcomes and costs were compared. Assumptions included: 100% efficacy of the HPV vaccine; triennial cytology screening between ages 21 and 65; 90% screening recruitment of age-eligible women with 80% rescreening; and a $500 cost for a 3-dose quadrivalent HPV vaccine regimen. Projected costs were undiscounted and are in 2016 CAD. Results: Compared with the 67%-vaccinated cohort, in the 90%-vaccinated cohort there was a lifetime reduction of 23% in cervical cancer incident cases and 21% in cervical cancer deaths. Lifetime cancer treatment costs decreased by $26 million (23%), and wart treatment costs and precervical cancer costs decreased by $3.2 million (15%) and $45 million (16%) respectively. Lifetime screening costs decreased by $47 million (2%). Conclusion: Achieving a nationally-set target of 90% HPV vaccination in Canadian girls would not only save more lives but would free up funds that could be redirected to other health system needs. Planners could aim for relatively high nation-wide rates of HPV vaccination coverage to enhance their cervical cancer control strategy.
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Affiliation(s)
- N. Fitzgerald
- Canadian Partnership Against Cancer, Toronto, Canada
| | - S. Hussain
- Canadian Partnership Against Cancer, Toronto, Canada
| | - S. Memon
- Canadian Partnership Against Cancer, Toronto, Canada
| | - C. Gauvreau
- Canadian Partnership Against Cancer, Toronto, Canada
| | | | | | | | - A. Miller
- University of Toronto, Toronto, Canada
| | - A. Coldman
- British Columbia Cancer Agency Research Institute, Vancouver, Canada
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Fitzgerald N, Gauvreau C, Memon S, Hussain S, Coldman A, Popadiuk C, Evans W, Wolfson M, Flanagan W, Nadeau C, Asakawa K, Garner R, Miller A. The OncoSim Cancer Simulation Platform: A Tool to Project the Population Effects of Cancer Control Interventions in Canada. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.20300] [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
Background: Cancer control interventions exert their effects over multiple decades. To evaluate diverse and competing opportunities to reduce future cancer burden it is desirable to understand long-term effects prior to any new program implementation or significant change. Internationally, modeling is becoming an accepted source of planning information for decision-makers. Aim: We will describe the construction and use of the OncoSim microsimulation model, which was developed to evaluate cancer control strategies in Canada. Methods: OncoSim is a suite of models (cancers of the lung, colorectum, cervix and breast, plus a composite 32-cancer model) used to address key policy questions and support decision-making. It is led by the Canadian Partnership Against Cancer with model development by Statistics Canada. OncoSim incorporates risk factors, cancer natural history, screening, treatment, survival and end-of-life care. Wherever possible it is informed by Canadian data sources. Models are calibrated to reproduce a range of cancer-specific statistics, e.g., current and historical Canadian cancer-specific incidence and mortality, smoking patterns, and results of screening. The site-specific models have undergone further validation by replicating reported short-term effects of cancer prevention and screening interventions. Users may customize interventions through modifying input parameters. Outputs include incidence, mortality, costs, cost-effectiveness, and resource utilization. Users from the public sector have access at no cost to OncoSim and receive extensive support from a multidisciplinary technical team. The model is continually updated to incorporate emerging knowledge. Results: OncoSim has been used to support cancer control decision-making at the national and provincial/territorial levels. Applications include: national guidelines recommendations for colorectal and lung cancer screening; comparison of cytology vs. HPV based cervical cancer screening; and integration of smoking cessation into low-dose CT lung cancer screening. Conclusion: Validated simulation models such as OncoSim can be a versatile and efficient tool for cancer control planners to evaluate and prioritize cancer control strategies.
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Affiliation(s)
- N. Fitzgerald
- Canadian Partnership Against Cancer, Toronto, Canada
| | - C. Gauvreau
- Canadian Partnership Against Cancer, Toronto, Canada
| | - S. Memon
- Canadian Partnership Against Cancer, Toronto, Canada
| | - S. Hussain
- Canadian Partnership Against Cancer, Toronto, Canada
| | - A. Coldman
- Canadian Partnership Against Cancer, Toronto, Canada
| | - C. Popadiuk
- Canadian Partnership Against Cancer, Toronto, Canada
| | - W. Evans
- Canadian Partnership Against Cancer, Toronto, Canada
| | - M. Wolfson
- Canadian Partnership Against Cancer, Toronto, Canada
| | - W. Flanagan
- Canadian Partnership Against Cancer, Toronto, Canada
| | - C. Nadeau
- Canadian Partnership Against Cancer, Toronto, Canada
| | - K. Asakawa
- Canadian Partnership Against Cancer, Toronto, Canada
| | - R. Garner
- Canadian Partnership Against Cancer, Toronto, Canada
| | - A. Miller
- Canadian Partnership Against Cancer, Toronto, Canada
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19
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Van Wijnendaele R, Nadeau C, Kaszuba M, Snacken J. Voyages pathologiques dans une population de migrants : une étude rétrospective. Encephale 2018; 44:392-393. [DOI: 10.1016/j.encep.2017.10.009] [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] [Received: 06/30/2017] [Revised: 10/05/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
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20
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Cantin D, Djeddi D, Samson N, Nadeau C, Praud JP. Nasal high-frequency oscillatory ventilation inhibits gastroesophageal reflux in the neonatal period. Respir Physiol Neurobiol 2018; 251:28-33. [PMID: 29438810 DOI: 10.1016/j.resp.2018.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 11/19/2022]
Abstract
Nasal high-frequency oscillatory ventilation (nHFOV) in neonates is increasingly considered due to enhanced alveolar ventilation, absence of patient-ventilator asynchrony and lessened ventilator-induced lung injury. Although any type of non-invasive respiratory support can lead to gastric distension via esophageal air passage and thus promote gastroesophageal refluxes (GERs), we have shown that nasal continuous positive airway pressure (CPAP; 6 cmH2O) and intermittent positive pressure ventilation (15/4 cmH2O) conversely inhibit GERs in lambs. The current objective was to test the hypothesis that nHFOV also inhibits GERs compared to spontaneous ventilation without respiratory support. Eight lambs underwent five hours of polysomnographic and esophageal multichannel intraluminal impedance pHmetry recordings to assess GERs and air passage into the esophagus, with and without nHFOV (mean airway pressure = 8 cmH2O, oscillation frequency = 8 Hz, amplitude ≈ 20 cmH2O and I:E = 1:2). Results revealed that GERs were decreased with nHFOV (p = .03), despite an increase in gas-containing swallows (p = .01). In conclusion, similarly to nasal CPAP and intermittent positive pressure ventilation, nHFOV inhibits GERs in newborn lambs.
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Affiliation(s)
- Danny Cantin
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada
| | - Djamal Djeddi
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada; Department of Pediatrics, Université Picardie Jules Verne, Amiens, France
| | - Nathalie Samson
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada.
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Gauvreau CL, Fitzgerald NR, Memon S, Flanagan WM, Nadeau C, Asakawa K, Garner R, Miller AB, Evans WK, Popadiuk CM, Wolfson M, Coldman AJ. The OncoSim model: development and use for better decision-making in Canadian cancer control. ACTA ACUST UNITED AC 2017; 24:401-406. [PMID: 29270052 DOI: 10.3747/co.24.3850] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 12/27/2022]
Abstract
The Canadian Partnership Against Cancer was created in 2007 by the federal government to accelerate cancer control across Canada. Its OncoSim microsimulation model platform, which consists of a suite of specific cancer models, was conceived as a tool to augment conventional resources for population-level policy- and decision-making. The Canadian Partnership Against Cancer manages the OncoSim program, with funding from Health Canada and model development by Statistics Canada. Microsimulation modelling allows for the detailed capture of population heterogeneity and health and demographic history over time. Extensive data from multiple Canadian sources were used as inputs or to validate the model. OncoSim has been validated through expert consultation; assessments of face validity, internal validity, and external validity; and model fit against observed data. The platform comprises three in-depth cancer models (lung, colorectal, cervical), with another in-depth model (breast) and a generalized model (25 cancers) being in development. Unique among models of its class, OncoSim is available online for public sector use free of charge. Users can customize input values and output display, and extensive user support is provided. OncoSim has been used to support decision-making at the national and jurisdictional levels. Although simulation studies are generally not included in hierarchies of evidence, they are integral to informing cancer control policy when clinical studies are not feasible. OncoSim can evaluate complex intervention scenarios for multiple cancers. Canadian decision-makers thus have a powerful tool to assess the costs, benefits, cost-effectiveness, and budgetary effects of cancer control interventions when faced with difficult choices for improvements in population health and resource allocation.
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Affiliation(s)
- C L Gauvreau
- Health Economics, Canadian Partnership Against Cancer, Toronto, ON
| | - N R Fitzgerald
- Health Economics, Canadian Partnership Against Cancer, Toronto, ON
| | - S Memon
- Health Economics, Canadian Partnership Against Cancer, Toronto, ON
| | | | - C Nadeau
- Health Analysis, Statistics Canada, Ottawa, ON
| | - K Asakawa
- Health Analysis, Statistics Canada, Ottawa, ON
| | - R Garner
- Health Analysis, Statistics Canada, Ottawa, ON
| | - A B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - W K Evans
- Department of Oncology, McMaster University, Hamilton, ON
| | - C M Popadiuk
- Faculty of Medicine, Memorial University, St. John's, NL
| | - M Wolfson
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON
| | - A J Coldman
- Cancer Control Research, BC Cancer Research Centre, Vancouver, BC
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22
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Catto-Smith H, Nadeau C, Levillain P, Hainaut E. Présentation verruqueuse d’une tumeur d’Abrikossoff. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.243] [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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23
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Nault S, Samson N, Nadeau C, Djeddi D, Praud JP. Reflex cardiorespiratory events from esophageal origin are heightened by preterm birth. J Appl Physiol (1985) 2017; 123:489-497. [PMID: 28572501 DOI: 10.1152/japplphysiol.00915.2016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 10/17/2016] [Revised: 05/08/2017] [Accepted: 05/24/2017] [Indexed: 12/19/2022] Open
Abstract
The involvement of gastroesophageal refluxes in cardiorespiratory events of preterm infants remains controversial. While a few studies in full-term newborn animals have shown that stimulation of esophageal receptors leads to cardiorespiratory reflexes, the latter remain largely unknown, especially after premature birth. The present study aimed to 1) characterize the cardiorespiratory reflexes originating from esophageal receptors in newborn lambs and 2) test the hypotheses that preterm birth enhances reflex cardiorespiratory inhibition and that C-fibers are involved in these reflexes. Eight full-term lambs and 10 lambs born 14 days prematurely were studied. Following surgical instrumentation, a 6-h polysomnography was performed without sedation to record electrocardiogram, respiratory movements, arterial pressure, laryngeal constrictor muscle activity, state of alertness, and hemoglobin oxygen saturation. Five esophageal stimulations of the upper and/or lower esophagus, including rapid balloon inflation and/or HCl injection, were performed in random order. A second recording was performed in full-term lambs 24 h later, after C-fiber blockade by capsaicin. Results confirmed that esophageal stimulations induced inhibitory cardiorespiratory reflexes combined with protective mechanisms, including laryngeal closure, swallowing, coughing, increased arterial pressure, and arousal. Preterm birth heightened cardiorespiratory inhibition. The strongest cardiorespiratory inhibition was observed following simultaneous stimulation of the lower and upper esophagus. Finally, cardiorespiratory inhibition was decreased after C-fiber blockade. In conclusion, esophageal stimulation induces inhibitory cardiorespiratory reflexes, which are partly mediated by C-fibers and more pronounced in preterm lambs. Clinical relevance of these findings requires further studies, especially in conditions associated with increased cardiorespiratory events, e.g., neonatal infection.NEW & NOTEWORTHY Preterm birth heightens the cardiorespiratory events triggered by esophageal stimulation. The most extensive cardiorespiratory events are induced by simultaneous stimulation of the proximal and distal esophagus.
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Affiliation(s)
- Stéphanie Nault
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Quebec, Canada; and
| | - Nathalie Samson
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Quebec, Canada; and
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Quebec, Canada; and
| | - Djamal Djeddi
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Quebec, Canada; and.,Department of Pediatrics, Université de Picardie Jules Verne, Amiens, France
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Pharmacology-Physiology, Université de Sherbrooke, Quebec, Canada; and
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24
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Samson N, Nadeau C, Vincent L, Cantin D, Praud JP. Effects of Nasal Continuous Positive Airway Pressure and High-Flow Nasal Cannula on Sucking, Swallowing, and Breathing during Bottle-Feeding in Lambs. Front Pediatr 2017; 5:296. [PMID: 29387680 PMCID: PMC5776098 DOI: 10.3389/fped.2017.00296] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/21/2017] [Indexed: 12/02/2022] Open
Abstract
The use of prolonged respiratory support under the form of high-flow nasal cannula (HFNC) or nasal continuous positive airway pressure (nCPAP) is frequent in newborn infants. Introduction of oral feeding under such nasal respiratory support is, however, highly controversial among neonatologists, due to the fear that it could disrupt sucking, swallowing, and breathing coordination and in turn induce cardiorespiratory events. The recent observation of tracheal aspirations during bottle-feeding in preterm infants under nCPAP justifies the use of animal models to perform more comprehensive physiological studies on the subject, in order to gain further insights for clinical studies. The objective of this study was to assess and compare the impact of HFNC and nCPAP on bottle-feeding in newborn lambs, in terms of bottle-feeding efficiency and safety as well as sucking-swallowing-breathing coordination. Eight full-term lambs were instrumented to record sucking, swallowing, and respiration as well as electrocardiogram and oxygenation. Lambs were bottle-fed in a standardized manner during three randomly ordered conditions, namely nCPAP 6 cmH2O, HFNC 7 L/min, and no respiratory support. Results revealed that nCPAP decreased feeding duration [25 vs. 31 s (control) vs. 57 s (HFNC), p = 0.03] and increased the rate of milk transfer [2.4 vs. 1.9 mL/s (control) vs.1.1 mL/s (HFNC), p = 0.03]. No other indices of bottle-feeding safety or sucking-swallowing-breathing coordination were significantly altered by HFNC or nCPAP. In conclusion, our results obtained in full-term newborn lambs suggest that: (i) nCPAP 6 cmH2O, but not HFNC 7 L/min, increases bottle-feeding efficiency; (ii) bottle-feeding is safe under nCPAP 6 cmH2O and HFNC 7 L/min, with no significant alteration in sucking-swallowing-breathing coordination. The present informative and reassuring data in full-term healthy lambs must be complemented by similar studies in preterm lambs, including mild-to-moderate respiratory distress alleviated by respiratory support in order to mimic preterm infants with bronchopulmonary dysplasia and pave the way for clinical studies.
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Affiliation(s)
- Nathalie Samson
- Neonatal Respiratory Research Unit, Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC, Canada.,Neonatal Respiratory Research Unit, Department of Pharmacology - Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC, Canada.,Neonatal Respiratory Research Unit, Department of Pharmacology - Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Laurence Vincent
- Neonatal Respiratory Research Unit, Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC, Canada.,Neonatal Respiratory Research Unit, Department of Pharmacology - Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Danny Cantin
- Neonatal Respiratory Research Unit, Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC, Canada.,Neonatal Respiratory Research Unit, Department of Pharmacology - Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC, Canada.,Neonatal Respiratory Research Unit, Department of Pharmacology - Physiology, Université de Sherbrooke, Sherbrooke, QC, Canada
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Homenauth E, Ghiasi M, Feldman L, Arrouf N, Mallya S, Lacombe J, Pichika SC, Zhao K, Aibibula W, Krishnan R, Kajeguka D, Kaaya R, Protopopoff N, Mosha F, Desrochers R, Watts A, Kulkarni M, Saravu K, Nair S, Mukhopadhyay C, George LS, Pai M, Jiang H, Brown P, Blais L, Lefebvre G, Samoilenko M, Kulkarni M, Jolly A, Roy-Gagnon MH, Sander B, Gauvreau CL, Memon S, Popadiuk C, Flanagan WM, Nadeau C, Coldman AJ, Wolfson MC, Miller AB, Acar E, Cox J, Hamelin AM, McLinden T, Klein MB, Brassard P, Chong M, Martin J. The Canadian Society for Epidemiology and Biostatistics 2016 National Student Conference001INVESTIGATING ECOLOGICAL DETERMINANTS OF MALARIA VECTOR DISTRIBUTION IN RURAL TANZANIA “A MULTI-SCALAR INVESTIGATION”002PREVALENCE AND RISK FACTORS OF TUBERCULOSIS INFECTION AMONG HEALTHCARE TRAINEES IN SOUTH INDIA003SPATIAL MODELLING OF LUNG AND THYROID CANCERS IN UNITED STATES COUNTIES004A MEDIATION ANALYSIS TO ASSESS THE IMPACT OF INHALED CORTICOSTEROIDS (ICSS) DURING PREGNANCY ON BIRTHWEIGHT005MODELLING HUMAN RISK OF WEST NILE VIRUS IN ONTARIO, 2002-2013: INCORPORATING SURVEILLANCE AND ENVIRONMENTAL DATA006EXPLORING THE HEALTH OUTCOMES OF VARIOUS PAN-CANADIAN CERVICAL CANCER SCREENING PROGRAMS USING MICROSIMULATION MODELING007INTEGRATIVE ANALYSIS OF MICRORNA AND GENE EXPRESSION DATA USING SPARSE CANONICAL CORRELATION ANALYSIS008CONDITIONAL DEPENDENCE MODELS UNDER COVARIATE MEASUREMENT ERROR009ASSOCIATION BETWEEN FOOD INSECURITY AND HIV VIRAL SUPPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS010ANTIBIOTICS VERSUS APPENDECTOMY FOR UNCOMPLICATED APPENDICITIS: A GLOBAL HEALTH PERSPECTIVE. Am J Epidemiol 2016. [DOI: 10.1093/aje/kww058] [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: 11/13/2022] Open
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26
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Villeneuve L, Thivolet A, Bakrin N, Mohamed F, Isaac S, Valette PJ, Glehen O, Rousset P, Abba J, Abboud K, Arvieux C, Balagué G, Barrau V, Rejeb H, Bereder JM, Bibeau F, Bouzard D, Brigand C, Carrère S, Carretier M, de Chaisemartin C, Chassang M, Chevallier A, Courvoisier T, Dartigues P, Delroeux D, Desolneux G, Dohan A, Dromain C, Dumont F, Durand-Fontanier S, Elias D, Eveno C, Evrard S, Fay O, Ferron G, Geffroy D, Gilly FN, Fontaine J, Goasguen N, Ghouti L, Goéré D, Guilloit JM, Guyon F, Heyd B, Kaci R, Karoui M, Kianmanesh R, Labbé C, Lacroix J, Lang-Averous G, Laverriere MH, Lefevre J, Lelong B, Leroux A, Dico R, Loi V, Lorimier G, Marchal F, Mariani A, Mariani P, Mariette C, Meeus P, Mery E, Messager M, Msika S, Nadeau C, Ortega-Deballon P, Passot G, Petorin C, Peyrat P, Pezet D, Piessen G, Pirro N, Pocard M, Poizat F, Porcheron J, Pourcher G, Quenet F, Rat P, Regimbeau JM, Rousselot P, Sabbagh C, Svrcek M, Tetreau R, Thibaudeau E, Tuech JJ, Valmary-Degano S, Vaudoyer D, Velasco S, Verriele-Beurrier V, Wernert R, Zinzindohoue F. A new internet tool to report peritoneal malignancy extent. PeRitOneal MalIgnancy Stage Evaluation (PROMISE) application. Eur J Surg Oncol 2016; 42:877-82. [DOI: 10.1016/j.ejso.2016.03.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 03/12/2016] [Accepted: 03/16/2016] [Indexed: 11/17/2022] Open
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Popadiuk C, Gauvreau CL, Bhavsar M, Nadeau C, Asakawa K, Flanagan WM, Wolfson MC, Coldman AJ, Memon S, Fitzgerald N, Lacombe J, Miller AB. Using the Cancer Risk Management Model to evaluate the health and economic impacts of cytology compared with human papillomavirus DNA testing for primary cervical cancer screening in Canada. ACTA ACUST UNITED AC 2016; 23:S56-63. [PMID: 26985148 DOI: 10.3747/co.23.2991] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 11/15/2022]
Abstract
BACKGROUND In Canada, discussion about changing from cytology to human papillomavirus (hpv) dna testing for primary screening in cervical cancer is ongoing. However, the Canadian Task Force on Preventive Health Care has not yet made a recommendation, concluding that the evidence is insufficient. METHODS We used the cervical cancer and hpv transmission models of the Cancer Risk Management Model to study the health and economic outcomes of primary cytology compared with hpv dna testing in 14 screening scenarios with varying screening modalities and intervals. Projected cervical cancer cases, deaths, colposcopies, screens, costs, and incremental cost-effectiveness were evaluated. We performed sensitivity analyses for hpv dna test costs. RESULTS Compared with triennial cytology from age 25, 5-yearly hpv dna screening alone from age 30 resulted in equivalent incident cases and deaths, but 55% (82,000) fewer colposcopies and 43% (1,195,000) fewer screens. At hpv dna screening intervals of 3 years, whether alone or in an age-based sequence with cytology, screening costs are greater, but at intervals of more than 5 years, they are lower. Scenarios on the cost-effectiveness frontier were hpv dna testing alone every 10, 7.5, 5, or 3 years, and triennial cytology starting at age 21 or 25 when combined with hpv dna testing every 3 years. CONCLUSIONS Changing from cytology to hpv dna testing as the primary screening test for cervical cancer would be an acceptable strategy in Canada with respect to incidence, mortality, screening and diagnostic test volumes.
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Affiliation(s)
- C Popadiuk
- Department of Women's Health, Memorial University, St. John's, NL
| | - C L Gauvreau
- Canadian Partnership Against Cancer, Toronto, ON
| | - M Bhavsar
- Canadian Partnership Against Cancer, Toronto, ON
| | | | | | | | | | - A J Coldman
- Canadian Partnership Against Cancer, Toronto, ON
| | - S Memon
- Canadian Partnership Against Cancer, Toronto, ON
| | - N Fitzgerald
- Canadian Partnership Against Cancer, Toronto, ON
| | - J Lacombe
- Canadian Partnership Against Cancer, Toronto, ON
| | - A B Miller
- Dalla Lana School of Public Health, Toronto, ON
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Lavoué V, Fritel X, Antoine M, Beltjens F, Bendifallah S, Boisserie-Lacroix M, Boulanger L, Canlorbe G, Catteau-Jonard S, Chabbert-Buffet N, Chamming's F, Chéreau E, Chopier J, Coutant C, Demetz J, Guilhen N, Fauvet R, Kerdraon O, Laas E, Legendre G, Mathelin C, Nadeau C, Thomassin Naggara I, Ngô C, Ouldamer L, Rafii A, Roedlich MN, Seror J, Séror JY, Touboul C, Uzan C, Daraï E. Tumeurs bénignes du sein : recommandations pour la pratique clinique du Collège national des gynécologues et obstétriciens français (CNGOF) – Texte court. ACTA ACUST UNITED AC 2015; 44:1049-64. [DOI: 10.1016/j.jgyn.2015.09.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 09/18/2015] [Indexed: 11/29/2022]
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Legendre G, Guilhen N, Nadeau C, Brossard A, Fauvet R. [Exploring a non-inflammatory clinical breast mass: Clinical practice guidelines]. ACTA ACUST UNITED AC 2015; 44:904-12. [PMID: 26541562 DOI: 10.1016/j.jgyn.2015.09.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 09/15/2015] [Accepted: 09/18/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of the study was to assess the diagnostic value of physical examination, radiologic explorations and percutaneous procedures of the breast in the exploration of a non-inflammatory palpable mass, in order to propose guidelines. METHOD A systematic literature review was conducted in the Medline and Cochrane library databases. International guidelines in French and English language were also consulted until April 30th 2015. RESULTS Physical examination of a non-inflammatory palpable breast mass is not sufficient to eliminate a breast cancer (LE2). Mammography alone has a sensitivity between 70 and 95% for the diagnosis of breast cancer (LE3). Echography alone has a sensitivity of 98 to 100% for the diagnosis of breast cancer (LE2). The core needle biopsy has a better sensitivity and specificity than the fine-needle aspiration for breast cancer diagnosis (LE2). The association of mammography and 2D echography presents excellent sensitivity and negative predictive value (close to 100 %) to exclude a breast cancer (LE3). A double evaluation using mammography and echography is recommended in the exploration of a non-inflammatory palpable breast mass (grade B).
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Affiliation(s)
- G Legendre
- Service de gynécologie-obstétrique, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 01, France; CESP-Inserm, U1018, équipe 7, genre, santé sexuelle et reproductive, université Paris Sud, 94276 Le Kremlin-Bicêtre, France.
| | - N Guilhen
- Service de gynécologie-obstétrique, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France
| | - C Nadeau
- Service de gynécologie-obstétrique, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France
| | - A Brossard
- Service de gynécologie-obstétrique, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France
| | - R Fauvet
- Service de gynécologie-obstétrique, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 09, France; Inserm U1199, unité « Biologie et thérapies innovantes des cancers localement agressifs » (BioTICLA), université de Caen Basse-Normandie, centre de lutte contre le cancer François-Baclesse, 14076 Caen cedex 05, France
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Coldman AJ, Phillips N, Brisson J, Flanagan W, Wolfson M, Nadeau C, Fitzgerald N, Miller AB. Using the Cancer Risk Management Model to evaluate colorectal cancer screening options for Canada. ACTA ACUST UNITED AC 2015; 22:e41-50. [PMID: 25908920 DOI: 10.3747/co.22.2013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 12/15/2022]
Abstract
BACKGROUND Several screening methods for colorectal cancer (crc) are available, and some have been shown by randomized trials to be effective. In the present study, we used a well-developed population health simulation model to compare the risks and benefits of a variety of screening scenarios. Tests considered were the fecal occult blood test (fobt), the fecal immunochemical test (fit), flexible sigmoidoscopy, and colonoscopy. Outcomes considered included years of life gained, crc cases and deaths prevented, and direct health system costs. METHODS A natural history model of crc was implemented and calibrated to specified targets within the framework of the Cancer Risk Management Model (crmm) from the Canadian Partnership Against Cancer. The crmm-crc permits users to enter their own parameter values or to use program-specified base values. For each of 23 screening scenarios, we used the crmm-crc to run 10 million replicate simulations. RESULTS Using base parameter values and some user-specified values in the crmm-crc, and comparing our screening scenarios with no screening, all screening scenarios were found to reduce the incidence of and mortality from crc. The fobt was the least effective test; it was not associated with lower net cost. Colonoscopy screening was the most effective test; it had net costs comparable to those for several other strategies considered, but required more than 3 times the colonoscopy resources needed by other approaches. After colonoscopy, strategies based on the fit were predicted to be the most effective. In sensitivity analyses performed for the fobt and fit screening strategies, fobt parameter values associated with high-sensitivity formulations were associated with a substantial increase in test effectiveness. The fit was more cost-effective at the 50 ng/mL threshold than at the 100 ng/mL threshold. CONCLUSIONS The crmm-crc provides a sophisticated and flexible environment in which to evaluate crc control options. All screening scenarios considered in this study effectively reduced crc mortality, although sensitivity analyses demonstrated some uncertainty in the magnitude of the improvements. Where possible, local data should be used to reduce uncertainty in the parameters.
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Affiliation(s)
| | - N Phillips
- BC Cancer Research Centre, Vancouver, BC
| | - J Brisson
- Institute de Santé Publique, Quebec City, QC
| | | | | | | | - N Fitzgerald
- Canadian Partnership Against Cancer, Toronto, ON
| | - A B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
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Hadj-Ahmed MA, Samson N, Nadeau C, Boudaa N, Praud JP. Laryngeal muscle activity during nasal high-frequency oscillatory ventilation in nonsedated newborn lambs. Neonatology 2015; 107:199-205. [PMID: 25660143 DOI: 10.1159/000369120] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [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] [Received: 08/18/2014] [Accepted: 10/14/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND We have previously shown that nasal pressure support ventilation (nPSV) can lead to an active inspiratory laryngeal narrowing in lambs. This, in turn, can limit lung ventilation and divert air into the digestive system, with potentially deleterious consequences. On the other hand, nasal high-frequency oscillatory ventilation (nHFOV) is particularly attractive in newborns, especially since, unlike nPSV, it does not require synchronization with the patient's inspiratory efforts. OBJECTIVES The main aim of the present study was to test the hypothesis that glottal constrictor muscle activity (EMG) does not develop during nHFOV. A secondary objective was to study laryngeal EMG during nHFOV-induced central apneas. METHODS Polysomnographic recordings were performed in 7 nonsedated lambs which were ventilated with increasing levels of nPSV and nHFOV at both 4 and 8 Hz, in random order. States of alertness, diaphragm and glottal muscle EMG, SpO2, and respiratory movements were continuously recorded. RESULTS While phasic inspiratory glottal constrictor EMG appeared with increasing nPSV levels in 6 out of 7 lambs, it was never observed with nHFOV. In addition, nHFOV at 4 Hz dramatically inhibited central respiratory drive in 4/7 lambs, with 64-100% of recording time spent in central apnea in 3 lambs. No glottal constrictor EMG was observed during these central apneas. CONCLUSION nHFOV does not induce glottal constrictor muscle EMG in nonsedated newborn lambs, in contrast to nPSV. This may be an additional advantage of nHFOV relative to nPSV.
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Affiliation(s)
- Mohamed Amine Hadj-Ahmed
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, Sherbrooke, Que., Canada
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Bourgoin-Heck M, Specq ML, Samson N, Nadeau C, Prodel M, Corbin F, Praud JP. Effects of Moderate Hyperbilirubinemia on Nutritive Swallowing and Swallowing-Breathing Coordination in Preterm Lambs. Neonatology 2015; 108:42-8. [PMID: 25968232 DOI: 10.1159/000381205] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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] [Received: 10/07/2014] [Accepted: 02/19/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Hyperbilirubinemia (HB) occurs in 90% of preterm newborns. HB induces acute neurological disorders (somnolence, abnormal tone, feeding difficulties, auditory dysfunction) and alterations in respiratory control. These findings suggest brainstem neurotoxicity that could also affect swallowing centers. OBJECTIVE To test the hypothesis that HB impairs nutritive swallowing (NS) and swallowing-breathing coordination. METHODS Two groups of preterm lambs (born 14 days prior to term), namely control (n = 6) and HB (n = 5), were studied. On day 5 of life (D0), moderate HB (150-250 µmol/l) was induced during 17 h in the HB group. Swallowing was assessed via recording of pharyngeal pressure and respiration by respiratory inductance plethysmography and pulse oximetry. The effect of HB on NS was assessed during standardized bottle-feeding. A second recording was performed 48 h after recovery from HB (D3). RESULTS Swallows were less frequent (p = 0.003) and of smaller volume (p = 0.01) in HB lambs while swallowing frequency was decreased (p = 0.004). These differences disappeared after HB normalization. Swallowing-breathing coordination was impaired in HB lambs, with a decrease in percent time with NS burst-related apneas/hypopneas at D0 and D3. Simultaneously, HB lambs tended to experience more severe desaturations (<80%) during bottle-feeding. Finally, following bottle-feeding, the respiratory rate was significantly lower, along with an increased apnea duration in HB lambs. CONCLUSIONS Swallowing and swallowing-breathing coordination are altered by acute moderate HB in preterm lambs. Decreased efficiency at bottle-feeding is accompanied by continuation of breathing during swallow bursts, which may promote lung aspiration.
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Affiliation(s)
- Mélisande Bourgoin-Heck
- Respiratory Physiology Department, CHU de Poitiers, Faculté de Médecine et de Pharmacie, Université de Poitiers, Poitiers, France
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Samson N, Niane L, Nault S, Nadeau C, Praud JP. Laryngeal narrowing during nasal ventilation does not originate from bronchopulmonary C-fibers. Respir Physiol Neurobiol 2014; 202:32-4. [PMID: 25075590 DOI: 10.1016/j.resp.2014.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 07/09/2014] [Revised: 07/21/2014] [Accepted: 07/22/2014] [Indexed: 11/25/2022]
Abstract
We previously showed that nasal pressure support ventilation (nPSV) can lead to active inspiratory laryngeal narrowing, which originates from the stimulation of bronchopulmonary receptors. Among the three major types of bronchopulmonary receptors, which are variably stimulated by lung distension, C-fiber endings are remarkable, given that their stimulation can also trigger laryngeal closure. Taking advantage of our lamb model with blocked C-fibers, we aimed to assess whether bronchopulmonary C-fiber endings are involved in the active inspiratory laryngeal narrowing during nPSV. Nine lambs were surgically instrumented to assess states of alertness, electrical activity of a glottal constrictor (EaTA), respiratory movements and arterial blood gases. Forty-eight hours later, two polysomnographic recordings were performed during nPSV 15/4 cmH2O, before and after C-fiber blockade. During nPSV, blockade of C-fibers did not prevent inspiratory EaTA (present for 74±41% of respiratory cycles vs. 64±35%, p=0.9). We conclude that active inspiratory laryngeal narrowing during nPSV does not originate from bronchopulmonary C-fiber endings.
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Affiliation(s)
- Nathalie Samson
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada J1H 5N4
| | - Lalah Niane
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada J1H 5N4
| | - Stéphanie Nault
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada J1H 5N4
| | - Charlène Nadeau
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada J1H 5N4
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Departments of Pediatrics and Physiology, Université de Sherbrooke, QC, Canada J1H 5N4.
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Bourgoin-Heck M, Specq M, Samson N, Prodel M, Nadeau C, Corbin F, Praud J. SFP CO-67 - Effet d’une hyperbilirubinémie sur la déglutition et la coordination déglutition-respiration chez l’agneau prématuré. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71905-0] [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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Kopec JA, Sayre EC, Fines P, Flanagan WM, Nadeau C, Okhmatovskaia A, Wolfson MC. THU0543 Obesity and Osteoarthritis in Canada: Projections from a Microsimulation Model. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1071] [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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Rossard L, Favreau F, Demars J, Robert R, Nadeau C, Cau J, Thuillier R, Hauet T. Evaluation of early regenerative processes in a preclinical pig model of acute kidney injury. Curr Mol Med 2012; 12:502-505. [PMID: 22364565] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 01/09/2012] [Accepted: 02/02/2012] [Indexed: 05/31/2023]
Abstract
Renal failure due to ischemic injury is a common denominator of various clinical situations in critically ill patients. This study was designed to characterize the TPSO/Cholesterol synthesis and cell division pathways in response to different levels of ischemia. Porcine kidneys were subjected to either 60 min-warm ischemia (WI) or auto-transplanted after cold storage for 24 h at 4°C (CS), or both conditions (WI+CS), pathway activation and function were evaluated at 3 h, 3 and 7 days after reperfusion. CS combined to WI affects renal functions indicating a high degree of injury. During the first week of reperfusion, renal levels of free and esterified cholesterol, major cellular components, increased in CS group with an attenuated production when WI was associated. CS and WI+CS groups exhibited an elevated expression of cell cycle induction markers such as PCNA and stathmin. TSPO expression was highest in groups with the lowest injury, and correlated with kidney outcome, revealing its potential for diagnosis.
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Rossard L, Favreau F, Demars J, Robert R, Nadeau C, Cau J, Thuillier R, Hauet T. Evaluation of Early Regenerative Processes in a Preclinical Pig Model of Acute Kidney Injury. Curr Mol Med 2012. [DOI: 10.2174/156652412800163334] [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: 11/22/2022]
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Rossard L, Favreau F, Demars J, Robert R, Nadeau C, Cau J, Thuillier R, Hauet T. Evaluation of Early Regenerative Processes in a Preclinical Pig Model of Acute Kidney Injury. Curr Mol Med 2012. [DOI: 10.2174/1566524011207040502] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Nadeau C, Guilhen N, Fritel X. [In favour of one-stage surgical treatment of urinary incontinence associated with prolapse]. ACTA ACUST UNITED AC 2011; 39:587-9. [PMID: 21944731 DOI: 10.1016/j.gyobfe.2011.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- C Nadeau
- Service de gynécologie-obstétrique, université de Poitiers, CHU de Poitiers, 2 rue de La-Milétrie, Poitiers cedex, France.
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Fritel X, Fauconnier A, Bader G, Cosson M, Debodinance P, Deffieux X, Denys P, Dompeyre P, Faltin D, Fatton B, Haab F, Hermieux JF, Kerdraon J, Mares P, Mellier G, Michel-Laaengh N, Nadeau C, Robain G, de Tayrac R, Jacquetin B. Diagnostic et prise en charge de l’incontinence urinaire d’effort de la femme adulte. Recommandations pour la pratique clinique du Collège national des gynécologues et obstétriciens français (CNGOF). ACTA ACUST UNITED AC 2010. [DOI: 10.1007/s11608-010-0321-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Albouy-Llaty M, Nadeau C, Descombes E, Pierre F, Migeot V. Évaluation du dépistage périnatal du streptocoque du groupe B, au CHU de Poitiers de 2006 à 2008 à partir de trois bases de données. Rev Epidemiol Sante Publique 2010. [DOI: 10.1016/j.respe.2010.02.068] [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: 10/19/2022] Open
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Nadeau C, Magnin G. [Against systematic lombo-aortic lymphadenectomy in endometrial cancer]. ACTA ACUST UNITED AC 2009; 37:86-9. [PMID: 19117784 DOI: 10.1016/j.gyobfe.2008.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- C Nadeau
- Service de gynécologie-obstétrique, CHU de Poitiers, Poitiers cedex, France
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Nadeau C, Gibelin H, Breheret J, Fieuzal S, Lefort G, Kraimps JL. [Virilizing ovarian tumors in the menopausal patient]. ACTA ACUST UNITED AC 2008; 145:493-5. [PMID: 19106875 DOI: 10.1016/s0021-7697(08)74664-7] [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: 10/21/2022]
Abstract
Virilizing ovarian tumors are rare and can occur at any age. In postmenopausal women, they commonly present with signs of masculinization. These tumors should be suspected in any patient with virilization and high testosterone levels (>1ng/mL). Tumor localization is sometimes difficult. These tumors are usually benign; surgical resection is the accepted treatment. Masculinizing consequences of hormonal secretions may be managed by cosmetologic treatments which should not be overlooked.
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Affiliation(s)
- C Nadeau
- Service de gynécologie obstétrique, CHU - Poitiers.
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Barbeau J, Nadeau C. Dental unit waterline microbiology: a cautionary tale. J Can Dent Assoc 1997; 63:775-9. [PMID: 9401300] [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: 02/05/2023]
Abstract
The question of dental unit waterline contamination now concerns the dental profession on a number of levels and has become part of the landscape in dentistry. Researchers have identified the problem, studied it, and published their results. Official organizations have reacted to the problem by issuing press releases and recommendations. In the mean time, dental companies have jumped into the fray, ensuring a proliferation of products designed to mitigate a problem that certain people feel is imaginary are artificially inflated. Despite the number of publications describing waterline contamination, we still face the challenge of determining whether are picture of the problem is truly accurate. For example, it has become almost customary to use the term contamination when talking about waterlines, even though it is inadequate. In addition, we are moving ahead with water quality standards for dental units at a time when certain fundamental questions remain unanswered. What should we be measuring and what methods should we be using? Do certain disinfection procedures have an opposite effect to the one desired? Finally, the question of health risks linked to the colonization of waterlines has not been adequately addressed by researchers.
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Affiliation(s)
- J Barbeau
- Department of Stomatology, Faculty of Dentistry, University of Montreal
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Fodor JG, Boulet AP, Savard D, Nadeau C, Rakusan K, Chockalingam A, Langer A. The role of diltiazem in treating hypertension and coronary artery disease: new approaches to preventing first events. Can J Cardiol 1997; 13:495-503. [PMID: 9179089] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To review the role of diltiazem in treating and preventing a group of cardiovascular diseases, including painful and silent cardiac ischemia, stroke, nonfatal myocardial infarction and sudden cardiac death, by modulating certain physiological causes that they appear to share. DATA SOURCES A MEDLINE search was conducted for all clinical articles on the use of diltiazem for hypertension and coronary artery disease. When clinical data were not available, basic research findings were reviewed. DATA EXTRACTION AND SYNTHESIS Because many cardiovascular events show a marked daily periodicity--which appears to coincide with circadian peaks in the ability of platelets to aggregate, sympathetic activity, coronary tone, blood pressure, heart rate and hematocrit, and a trough in fibrinolytic activity--the impact of diltizazem on these physiological changes was assessed. CONCLUSIONS Diltiazem influences many of these events by increasing myocardial bloodflow, and reducing myocardial oxygen demand and cardiac workload. However, it differs from other calcium antagonists in its mild negative inotropic and moderate negative dromotropic effects, without apparent stimulation of cardiac performance or contractility. In addition, it inhibits platelet aggregation, decreases catecholamine release, diminishes coronary tone and blocks the vasoconstrictive actions of endothelin-1. This appears to translate into a beneficial effect on ischemia, thrombolysis, arrhythmias, infarct parameters, atherosclerosis and hypertension. Diltiazem has a relatively favourable safety and tolerability profile, and is available in a once-daily dosage form. The most common adverse effects are related to vasodilation (eg, edema and headache), and the most frequent serious adverse event is atrioventricular block, which occurs rarely. In summary, diltiazem appears to be well suited to preventing the first occurrence of cardiovascular events and may even have a role in preventing certain types of secondary events. The data accumulated so far indicate the need for a large scale random clinical trial addressing these outcomes.
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Affiliation(s)
- J G Fodor
- University of Ottawa Heart Institute, University of Ottawa, Ontario.
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Cook RJ, Lawless JF, Nadeau C. Robust tests for treatment comparisons based on recurrent event responses. Biometrics 1996; 52:557-71. [PMID: 8672703] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Robust nonparametric tests are considered for use in longitudinal studies in which the response of interest is a recurrent event. The tests are robust in the sense that they do not rely on distributional assumptions regarding the processes generating the events. The methods we describe are presented in the context of a clinical trial with attention initially directed at the two-sample problem in which a single experimental treatment is compared to a control. We investigate a family of generalized pseudo-score statistics (Lawless and Nadeau, 1995, Technometrics 37, 158-168) in which weight functions may be chosen to generate tests sensitive to various types of departure from the null hypothesis that the mean functions for the treatment and control groups are identical. All tests we consider are evaluated by simulation with respect to the type I error rate and power under a variety of practical scenarios. An application involving data from a kidney transplant study illustrates these procedures. For trials with multiple treatment arms, we generalize these approaches and indicate test statistics appropriate for unstructured alternatives and tests based on linear contrasts of the treatment-specific mean functions. Extensions of this methodology for stratified designs are also indicated.
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Affiliation(s)
- R J Cook
- Department of Statistics and Actuarial Science, University of Waterloo, Canada
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Baird MG, Juneau M, Nadeau C, Clermont P, Chin C, Boulet AA. Efficacy and Safety of Evening Administration of Controlled-Delivery Diltiazem Capsules in Chronic Stable Angina Patients. Am J Ther 1995; 2:401-406. [PMID: 11850684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The safety and efficacy of controlled-delivery (CD) once-a-day formulation of diltiazem administered in the evening, at a dose of 240 mg, was assessed in 37 patients with stable angina pectoris. A double-blind, placebo-controlled, randomized, crossover protocol was used. Following a 4-day washout period, patients entered a 5--7-day single-blind placebo run-in period during which qualification and reproducibility exercise treadmill tests (ETTs) were performed 24 h postdose. Eligible patients were randomized in a double-blind fashion, to either CD diltiazem or to placebo for a 7--10-day treatment period. They then entered a 5--7-day single-blind washout period, after which they received the alternate treatment for another 7 to 10 days. ETTs were performed at the end of each treatment period. Compared to placebo, evening administration of CD diltiazem produced a marked improvement of the time to ETT termination, time to onset of angina, and time to 1 mm ST depression. In addition, the number of angina attacks recorded in patient diaries was reduced compared to placebo. Incidence of adverse events was comparable with CD diltiazem and placebo. We conclude that evening administration of controlled-delivery diltiazem is highly effective and safe in the treatment of stable angina pectoris.
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Affiliation(s)
- M. G. Baird
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
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Gladman DD, Farewell VT, Nadeau C. Clinical indicators of progression in psoriatic arthritis: multivariate relative risk model. J Rheumatol 1995; 22:675-9. [PMID: 7791162] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To identify markers for severe disease in psoriatic arthritis (PsA). METHODS Patients with PsA followed prospectively according to a standard protocol over 14 years were included. Clinical and laboratory assessments of both active inflammation and clinical damage were performed at 6-month intervals according to a standard protocol. The information was entered into a computer database. Progression in damage was defined as transitions between damage states based on the number of damaged joints. Both univariate and multivariate models were developed to identify predictors for progression of damage. RESULTS The best model available, based on patient characteristics at the time of being first seen in the psoriatic arthritis clinic suggests that a high number of effusions and of past medications predicts progression in damage, whereas a low sedimentation rate "protects" from such progression. CONCLUSIONS Evidence of significant inflammation at first visit predicts progression of damage in the future, suggesting that patients with PsA should be offered more aggressive treatment early in the course of their disease.
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Affiliation(s)
- D D Gladman
- University of Toronto Rheumatic Disease Unit, Wellesley Hospital, Toronto, ON, Canada
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