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Sarlon-Bartoli G, Michel Q, Sarlon E, Carcopino-Tusoli M, Suchon P, Soler R, Bartoli MA, Brunet D, Morange P, Charbonnier A. Ultrasound arterial anomalies in patients exposed to nilotinib therapy for chronic myeloid leukemia. J Med Vasc 2021; 46:66-71. [PMID: 33752848 DOI: 10.1016/j.jdmv.2021.02.002] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 02/06/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Patients exposed to nilotinib for chronic myeloid leukemia (CML) appear to be at risk of arterial complication. The prevalence and aspect of ultrasound asymptomatic arterial lesions are unknown. OBJECTIVE To describe prevalence and characteristics of ultrasound arterial anomalies in patients treated with nilotinib for CML. METHODS Patients treated with nilotinib from 2006 to 2015 in the department of the Paoli-Calmettes Institute, Marseille, were included retrospectively. A vascular ultrasound screening was carried out from 2010. The arterial lesions at the first examination were described: plaque and its echogenicity, stenosis or occlusion. A vascular arterial anomaly (VAA) was defined by the presence of a clinical and/or ultrasound anomaly. Patients with or without VAA at initial vascular examination were compared using bivariate and multivariate analysis. RESULTS 74 patients were included (51.4% men, mean age 54.5 years); 25 patients had ultrasound arterial anomalies (33.8%). Carotid bulb was the most involved territory (44%). Arterial anomalies were: 88% plaques, 44%>50% stenosis and 12% occlusion. 72.7% plaques were echolucent or hypoechogenic. A VAA was present in 25 patients with initial vascular evaluation (33.8%). Patients with VAA at baseline were significantly older (64.9 vs 49.3, P<0.001), older at nilotinib initiation (60.8 vs 46.5, P<0.001), with more arterial hypertension (40% vs 12.2%, P=0.01), with more cardiovascular risk factors (P=0.03). In patient with no cardiovascular risk factor 12.5% had VAA (n=24). CONCLUSION Nilotinib seems to be associated to arterial lesions of unstable lipid-like appearance. The most involved arterial territory was the carotid bulb and the most common lesion was echolucent or hypoechogenic plaque. VAA can occur in patients without cardiovascular risk factors. This result encourages us to systematically screen and follow all patients exposed to nilotinib even those without cardiovascular risk factors.
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Affiliation(s)
- G Sarlon-Bartoli
- Unité d'Exploration et de médecine vasculaires, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
| | - Q Michel
- Unité d'Exploration et de médecine vasculaires, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - E Sarlon
- Unité de Santé publique, Centre Hospitalier Intercommunal Gap, 1, place Auguste Muret, 05000 Gap, France
| | - M Carcopino-Tusoli
- Unité d'Exploration et de médecine vasculaires, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - P Suchon
- Service d'hématologie, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France
| | - R Soler
- Service de Chirurgie Vasculaire, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France
| | - M A Bartoli
- Service de Chirurgie Vasculaire, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France
| | - D Brunet
- Unité d'Exploration et de médecine vasculaires, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Service d'hématologie, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France
| | - P Morange
- Service d'hématologie, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France
| | - A Charbonnier
- Unité d'Exploration et de médecine vasculaires, Faculté de Médecine de Marseille, Aix-Marseille Université, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Institut Paoli-Calmettes, département d'Onco-hématologie, 232, boulevard Sainte-Marguerite, BP 156, 13273 Marseille cedex 9, France
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Sarlon E, Duburcq A, Neveu X, Morvan-Duru E, Tremblay R, Rouillon F, Falissard B. Imprisonment, alcohol dependence and risk of delusional disorder: a cross-sectional study. Rev Epidemiol Sante Publique 2012; 60:197-203. [PMID: 22608012 DOI: 10.1016/j.respe.2011.11.001] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 11/13/2011] [Accepted: 11/22/2011] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Compared to the general population, an excess of psychotic illnesses, major depression and dependence disorders among prisoners has been reported. However, the impact of prison on detainees' psychopathology has rarely been studied. OBJECTIVE To determine the mental disorders liable to develop or regress on entry into prison and over time. METHOD Two samples of French prisoners detained in local prisons were interviewed using the same methodology. The first sample consisted of 267 new arrivals. The second was a random sample of 450 prisoners. Diagnoses were assessed using a thorough methodology: each prisoner was interviewed for approximately 2 hours by two clinicians. One of the clinicians used a structured clinical interview, which generates DSM IV diagnoses (MINI plus v 5.0); the second completed the procedure with an open clinical interview. The final DSM IV diagnoses were obtained as a consensus between the two approaches. Multilevel logistic regressions were used to take into account potential confounders. RESULTS Prevalence rates of mental disorders were substantially higher in prison even for the sample of newcomers (major depression disorder: 24.7%, substance dependence: 17.6% and schizophrenia: 4.1%). Alcohol dependence disorder was significantly more frequent in the sample of newcomers (OR 1.84 [1.01-3.51]). No significant difference was evidenced between samples for substance dependence disorder. Psychotic disorders were significantly less frequent at entry into prison, particularly delusional disorder (OR 0.29 [0.08-0.98]). CONCLUSION This study shows the contrasted potential effects of prison on psychopathology: alcohol dependence disorders were significantly more frequent for the newcomers, while the frequency of delusional disorders was lower. This evidence is arguing in favour of the validity of the old concept: prison psychosis. Moreover, prisoners should receive relevant help from clinicians to cope with these disorders.
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Affiliation(s)
- E Sarlon
- Inserm, U669, Maison de Solenn, National Institute of Health and Medical Research, 97, boulevard du Port-Royal, 75679 Paris, France.
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Sarlon-Bartoli G, Boudes A, Buffat C, Bartoli MA, Piercecchi-Marti MD, Sarlon E, Arnaud L, Bennis Y, Thevenin B, Squarcioni C, Nicoli F, Dignat-George F, Sabatier F, Magnan PE. Circulating lipoprotein-associated phospholipase A2 in high-grade carotid stenosis: a new biomarker for predicting unstable plaque. Eur J Vasc Endovasc Surg 2011; 43:154-9. [PMID: 22075154 DOI: 10.1016/j.ejvs.2011.10.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 10/10/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To test plasma levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with high-grade carotid stenosis according to plaque histology. METHODS This cross-sectional single-centre study included patients with ≥70% North American Symptomatic Carotid Endarterectomy Trial (NASCET) carotid stenosis, who were treated surgically. Serum Lp-PLA2 and high-sensitivity C-reactive protein (hs-CRP) were determined on the day of surgery. Histopathological analysis classified carotid plaque as stable or unstable, according to AHA classification. RESULTS Of the 42 patients (mean age 70.4 ± 10.5 years; 67% men), neurological symptoms were present in 16 (38%). Unstable plaques were found in 23 (55%). Median plasma level of Lp-PLA2 was significantly higher in patients with unstable plaque compared to those with stable plaque (222.4 (174.9-437.5) interquartile range (IQR) 63.5 vs. 211.1 (174.9-270.6) IQR 37.2 ng ml(-1); p = 0.02). Moreover, median Lp-PLA2 level were higher in asymptomatic patients with unstable plaque (226.8 ng ml(-1) (174.9-437.5) IQR 76.8) vs. stable plaque (206.9 ng ml(-1) (174.9-270.6) IQR 33.7; p = 0.16). Logistic regression showed that only the neurological symptoms (OR = 30.9 (3.7-244.6); p < 0.001) and the plasma Lp-PLA2 level (OR = 1.7 (1.1-12.3); p = 0.03) were independently associated with unstable carotid plaque as defined by histology. CONCLUSIONS This study showed that circulating Lp-PLA2 was increased in patients with high-grade carotid stenosis and unstable plaque. Lp-PLA2 may be a relevant biomarker to guide for invasive therapy in asymptomatic patients with carotid artery disease.
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Affiliation(s)
- G Sarlon-Bartoli
- Service de Chirurgie Vasculaire, Faculté de Médecine de Marseille, Université de la Méditerranée, Assistance Publique Hôpitaux de Marseille-Hôpital de la Timone, 13005 Marseille, France.
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Amagli F, Sarlon E, Bab-Hamed F, Forestier A, Woerth F. Étude de l’impact de l’activité de l’équipe mobile d’évaluation gériatrique du centre hospitalier de Senlis, France. Rev Epidemiol Sante Publique 2011. [DOI: 10.1016/j.respe.2011.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
METHOD We have calculated all hospital expenses related to treated intracerebral aneurysms for 2005. Catheters, microcatheters, and guidewires as well as coils were included. We have compared these expenses to the payment by activity and fee per service collected for providing these services. RESULTS Payments received covered only a third of the expenses for the supplies used. Three types of expenses are not reimbursed: the guiding material, the coils used but not released, and the latest generation of coils not yet added to the national list of covered devices. These expenses are also not covered by the payment received for the hospital admission. DISCUSSION Endovascular management of intracranial aneurysms has become the treatment of choice over the recent years. This treatment is virtually only available in university hospitals. With the current mode of reimbursement, such treatment generates losses to the hospital. CONCLUSION This example raises the question of financial support for innovative treatments and procedures.
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Affiliation(s)
- C Segouin
- Service de Santé Publique et Economie de la Santé, unité MSI, Groupe Hospitalier Lariboisière-Fernand Widal, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75475 Paris cedex 10, France.
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