1
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Guerin P, Jalal Z, Cueff C, Hascoet S, Bouvaist H, Levy F, Hugues N, Ladouceur M, Malekzadeh-Milani SG, Iriart X, Silini A, Karam N, Iserin L, Le Gloan L, Thambo JB. Percutaneous edge-to-edge repair for systemic tricuspid valve regurgitation in patients with congenital heart disease: the first descriptive cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
In patients with congenital heart diseases (CHD) systemic tricuspid regurgitation (STR) is frequent.
Here, we report our experience with percutaneous edge-to-edge repair (PETER) in a series of 12 CHD patients with STR using the MitraClip system.
Twelve patients (median age = 35 years, 83% males) with severe STR (ccTGA (n=5), asTGA (n=3), SV (n=4)), at high-risk for surgical treatment, gave informed consent for treatment using PETER. The XTR MitraClip device (Abbott, Santa Clara, CA) was used. At baseline, 7/12 patients were in NYHA functional class ≥ III. Standard femoral venous access was successfully used in 10/12 patients. In SV patients, the systemic valve was accessed directly through the right atrium (n=2), after a Fontan conduit puncture (n=1), or after direct atrial surgical access (n=1). In TGA patients, either transseptal (ccTGA patients, n=4) or transbaffle (asTGA patients, n=3) puncture was performed (4).
Mitraclip devices were successfully implanted in 11/12 patients (Figure 1). One procedural complication was reported for a patient with SV in whom a septal leaflet rupture occurred following clip release, leading to severe STR; the patient died from refractory cardiac failure one week later. Peri-procedural complications included one case of left femoral vein injury and one case of atrial flutter treated by catheter ablation. After a median follow-up of 12-months (range 1–25) following device implantation, no death had occurred. The patients had significant reduction in STR (from severe to moderate in 10/11 patients) and clinically improved (10/11 patients were in NYHA class I or II).
To conclude, percutaneous edge-to-edge therapy of STR in CHD patients is feasible, safe and effective to reduce STR and SRV dilatation. This reduction is associated with a significant clinical improvement.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P Guerin
- University Hospital of Nantes - Hospital Guillaume & Rene Laennec , Nantes , France
| | - Z Jalal
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
| | - C Cueff
- University Hospital of Nantes - Hospital Guillaume & Rene Laennec , Nantes , France
| | - S Hascoet
- Surgical Centre Marie Lannelongue, Departmentof Pediatric and Adult Congenital cardiology , Le Plessis Robinson , France
| | - H Bouvaist
- University Hospital of Grenoble, Interventional Cardiology , Grenoble , France
| | - F Levy
- Cardio-Thoracic Center of Monaco, Interventional Cardiology , Monaco , Monaco
| | - N Hugues
- Cardio-Thoracic Center of Monaco, Interventional Cardiology , Monaco , Monaco
| | - M Ladouceur
- Hopital Europeen Georges Pompidou- University Paris Descartes, Department of Cardiology, Adult Congenital Heart Disease Unit , Paris , France
| | - S G Malekzadeh-Milani
- Hopital Europeen Georges Pompidou- University Paris Descartes, Department of Cardiology, Adult Congenital Heart Disease Unit , Paris , France
| | - X Iriart
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
| | - A Silini
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
| | - N Karam
- Georges Pompidou APHP Site of Paris Ouest University Hospital, Department of Cardiology , Paris , France
| | - L Iserin
- Hopital Europeen Georges Pompidou- University Paris Descartes, Department of Cardiology, Adult Congenital Heart Disease Unit , Paris , France
| | - L Le Gloan
- Hospital G.R. Laennec - University Hospital Centre of Nantes, Adult Congenital Heart Disease Unit , St Herblain , France
| | - J B Thambo
- Haut-Leveque Hospital - University Hospital Centre, Department of Pediatric and Adult Congenital cardiology , Pessac , France
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2
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Roberts G, Lenroot R, Overs B, Fullerton J, Leung V, Ridgway K, Stuart A, Frankland A, Levy F, Hadzi-Pavlovic D, Breakspear M, Mitchell PB. Accelerated cortical thinning and volume reduction over time in young people at high genetic risk for bipolar disorder. Psychol Med 2022; 52:1344-1355. [PMID: 32892764 DOI: 10.1017/s0033291720003153] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is a familial psychiatric disorder associated with frontotemporal and subcortical brain abnormalities. It is unclear whether such abnormalities are present in relatives without BD, and little is known about structural brain trajectories in those at risk. METHOD Neuroimaging was conducted at baseline and at 2-year follow-up interval in 90 high-risk individuals with a first-degree BD relative (HR), and 56 participants with no family history of mental illness who could have non-BD diagnoses. All 146 subjects were aged 12-30 years at baseline. We examined longitudinal change in gray and white matter volume, cortical thickness, and surface area in the frontotemporal cortex and subcortical regions. RESULTS Compared to controls, HR participants showed accelerated cortical thinning and volume reduction in right lateralised frontal regions, including the inferior frontal gyrus, lateral orbitofrontal cortex, frontal pole and rostral middle frontal gyrus. Independent of time, the HR group had greater cortical thickness in the left caudal anterior cingulate cortex, larger volume in the right medial orbitofrontal cortex and greater area of right accumbens, compared to controls. This pattern was evident even in those without the new onset of psychopathology during the inter-scan interval. CONCLUSIONS This study suggests that differences previously observed in BD are developing prior to the onset of the disorder. The pattern of pathological acceleration of cortical thinning is likely consistent with a disturbance of molecular mechanisms responsible for normal cortical thinning. We also demonstrate that neuroanatomical differences in HR individuals may be progressive in some regions and stable in others.
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Affiliation(s)
- G Roberts
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - R Lenroot
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medicine, University of New Mexico, Albuquerque, New Mexico
| | - B Overs
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - J Fullerton
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - V Leung
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - K Ridgway
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - A Stuart
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - A Frankland
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - F Levy
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Prince of Wales Hospital, Randwick, NSW, Australia
| | - D Hadzi-Pavlovic
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - M Breakspear
- School of psychology, University of Newcastle, Callaghan, NSW, Australia
| | - P B Mitchell
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
- Prince of Wales Hospital, Randwick, NSW, Australia
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3
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Altes A, Levy F, Iacuzio L, Dumortier H, Toledano M, Tartar J, Tribouilloy C, Marechaux S. Comparison of mitral regurgitant volume assessment between proximal flow convergence and volumetric methods in patients with significant primary mitral regurgitation. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background. Discrepancies have been observed between transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (MRI) severity grading in primary mitral regurgitation (MR).
Purpose. To compare mitral regurgitant volume (RV) obtained by the proximal flow convergence method (PISA) method by TTE and by volumetric methods (TTE and MRI), and study the relationship between LV size and RV obtained by either the PISA or volumetric methods.
Methods and results. 188 patients from 2 heart valve clinics with at least moderate-to-severe primary MR due to prolapse in sinus rhythm who underwent evaluation with TTE and MRI were included. RV was estimated by either PISA or volumetric methods (Left ventricular [LV] stroke volume minus systolic aortic outflow volume)) by either MRI (MRI-RV) or TTE (TTE-RV)). PISA-RV and either MRI-RV or TTE-RV weakly correlated (r = 0.29 and 0.30,p < 0.001). On multivariable analysis, LV end-diastolic volume (LVEDV) and bileaflet prolapse independently correlated with the magnitude of the difference between PISA and volumetric methods. While PISA-RV and LVEDV were unrelated, MRI-RV and TTE-RV strongly correlated with LVEDV (r = 0.66 and 0.68,p < 0.001). In contrast, LVEDV and regurgitant fraction (RF = RV/LVEDV) either with TTE or MRI were poorly related (r = 0.17,p = 0.02 and r = 0.12,p = 0.10).
Conclusion. RV estimated by the PISA and volumetric methods are not comparable. The expected proportional relationship between volumetric RV and LV size, which is not observed with PISA-RV suggests the inaccuracy of PISA-RV. Given that RV by volumetric methods depends on LV size, determination of a unique RV threshold for severe MR is challenging. Calculation of RF may overcome this limitation. Abstract Figure. RV assessed by PISA or volumetric method Abstract Figure. Illustrative example
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Affiliation(s)
- A Altes
- Lille Catholic University, Lille, France
| | - F Levy
- Cardio-Thoracic Center of Monaco, Monaco, Monaco
| | - L Iacuzio
- Cardio-Thoracic Center of Monaco, Monaco, Monaco
| | | | - M Toledano
- Lille Catholic University, Lille, France
| | - J Tartar
- Lille Catholic University, Lille, France
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4
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Levy F, Iacuzio L, Marechaux S, Tribouilloy C, Eker A. Influence of prolapse volume in myxomatous mitral valve prolapse. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.097] [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]
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5
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Altes A, Thellier N, Bohbot Y, Ringle A, Levy F, Castel A, Delelis F, Mailliet A, Tribouilloy C, Marechaux S. Clinical significance of the ratio of acceleration time to ejection time in severe aortic stenosis. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.024] [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]
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6
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Levy F, Iacuzio L, Civaia F, Wautot F, Eker A. Influence of Prolapse Volume in Myxomatous Mitral Valve Prolapse. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.014] [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: 11/30/2022]
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7
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Bohbot Y, Rusinaru D, Belkhir K, Altes A, Levy F, Marechaux S, Sarano M, Tribouilloy C. Impact of sex on management and survival in aortic stenosis. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.157] [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: 11/25/2022]
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8
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Bohbot Y, Rusinaru D, Belkhir K, Altes A, Delpierre Q, Serbout S, Levy F, Marechaux S, Sarano M, Tribouilloy C. Impact of sex on management and survival in aortic stenosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Increasing attention has been paid to differences between the sexes in recent studies, but only a few have focused on such differences in aortic stenosis (AS).
Purpose
We sought to evaluate the differences between genders in AS outcomes and management.
Methods
We included 2429 patients (51.5% men; 49.5% women) with severe AS. Median follow-up was 42.0 (21–78) months.
Results
Women were older (p<0.001), more often symptomatic (p=0.007), and presented with smaller aortic valve area (p<0.001), and greater ejection fraction (p<0.001) than men. Despite that women have a longer life expectancy than men in the general population, estimated five-year survival of patients with severe AS was lower for women compared to men (62±2% versus 69±1% respectively, p<0.001). The 5-year survival was lower compared to expected survival, especially for women (62±2% vs. 71% for women and 69±1% vs. 71% for men). The cumulative 5-years incidence of AVR was 79±2% for men, and only 70±2% for women (p<0.001) and, being male was independently predictive of AVR (OR: 1.49 [1.18–1.97]; p=0.011). After propensity matching, when both genders were comparable in terms of characteristics and management (AVR), women, as expected due to their higher life expectancy than men, had better 5-year survival than men (69±2% vs. 62±2%; p=0.023).
Conclusion
Women with severe AS present at a more advance stage of the disease, at older ages with more symptoms, and incur higher mortality than men. This excess mortality is related to a combination of late diagnosis and a less frequent and later referral for AVR than in men. This justifies appropriate measures to improve the situation and to ensure that both sexes receive equivalent care.
Figure 1. (A) Survival curves. (B) Surgery incidence.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Bohbot
- University Hospital of Amiens, Amiens, France
| | - D Rusinaru
- University Hospital of Amiens, Amiens, France
| | - K Belkhir
- University Hospital of Amiens, Amiens, France
| | - A Altes
- Lille Catholic University, Lille, France
| | - Q Delpierre
- University Hospital of Amiens, Amiens, France
| | - S Serbout
- University Hospital of Amiens, Amiens, France
| | - F Levy
- Cardio-Thoracic Center of Monaco, Monaco, Monaco
| | - S Marechaux
- University Hospital of Amiens, Amiens, France
| | - M Sarano
- Mayo Clinic, Rochester, United States of America
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9
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Roberts G, Perry A, Lord A, Frankland A, Leung V, Holmes-Preston E, Levy F, Lenroot RK, Mitchell PB, Breakspear M. Structural dysconnectivity of key cognitive and emotional hubs in young people at high genetic risk for bipolar disorder. Mol Psychiatry 2018; 23:413-421. [PMID: 27994220 PMCID: PMC5794888 DOI: 10.1038/mp.2016.216] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/30/2016] [Accepted: 10/04/2016] [Indexed: 01/01/2023]
Abstract
Emerging evidence suggests that psychiatric disorders are associated with disturbances in structural brain networks. Little is known, however, about brain networks in those at high risk (HR) of bipolar disorder (BD), with such disturbances carrying substantial predictive and etiological value. Whole-brain tractography was performed on diffusion-weighted images acquired from 84 unaffected HR individuals with at least one first-degree relative with BD, 38 young patients with BD and 96 matched controls (CNs) with no family history of mental illness. We studied structural connectivity differences between these groups, with a focus on highly connected hubs and networks involving emotional centres. HR participants showed lower structural connectivity in two lateralised sub-networks centred on bilateral inferior frontal gyri and left insular cortex, as well as increased connectivity in a right lateralised limbic sub-network compared with CN subjects. BD was associated with weaker connectivity in a small right-sided sub-network involving connections between fronto-temporal and temporal areas. Although these sub-networks preferentially involved structural hubs, the integrity of the highly connected structural backbone was preserved in both groups. Weaker structural brain networks involving key emotional centres occur in young people at genetic risk of BD and those with established BD. In contrast to other psychiatric disorders such as schizophrenia, the structural core of the brain remains intact, despite the local involvement of network hubs. These results add to our understanding of the neurobiological correlates of BD and provide predictions for outcomes in young people at high genetic risk for BD.
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Affiliation(s)
- G Roberts
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - A Perry
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia,Metro North Mental Health Service, Brisbane, QLD, Australia,Centre for Healthy Brain Ageing, Randwick, NSW, Australia
| | - A Lord
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - A Frankland
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - V Leung
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - E Holmes-Preston
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - F Levy
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Prince of Wales Hospital, Randwick, NSW, Australia
| | - R K Lenroot
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia
| | - P B Mitchell
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia,Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia,Prince of Wales Hospital, Randwick, NSW, Australia
| | - M Breakspear
- Program of Mental Health Research, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia,Metro North Mental Health Service, Brisbane, QLD, Australia,Systems Neuroscience Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, QLD, Australia. E-mail:
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10
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Ringlé A, Tribouilloy C, Truffier A, Bohbot Y, Menet A, Castel A, Delelis F, Ennezat P, Levy F, Vincentelli A, Rusinaru D, Maréchaux S. Impact of ejection dynamics parameters on outcome in patients with aortic stenosis. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Ringlé A, Castel A, Le Goffic C, Delelis F, Binda C, Bohbot Y, Ennezat P, Guerbaai R, Levy F, Vincentelli A, Graux P, Tribouilloy C, Maréchaux S. Frequency of paradoxical low flow low gradient severe aortic stenosis: critical impact of aortic flow misalignment and pressure recovery phenomenon. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30030-7] [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: 11/30/2022]
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12
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Bohbot Y, Levy F, Sanhadji K, Rusinaru D, Ringle A, Delpierre Q, Marechaux S, Tribouilloy C. Impact of Pulmonary Hypertension on Long-Term Outcome in Patients with Severe Aortic Stenosis. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30008-3] [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: 11/17/2022]
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13
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Bohbot Y, Levy F, Sanhadji K, Maréchaux S, Rusinaru D, Delpierre Q, Tribouilloy C. Impact of Pulmonary Pressure on Long Term Outcome in Patients with Aortic Stenosis. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30536-0] [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: 10/19/2022]
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14
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Hawi Z, Cummins TDR, Tong J, Arcos-Burgos M, Zhao Q, Matthews N, Newman DP, Johnson B, Vance A, Heussler HS, Levy F, Easteal S, Wray NR, Kenny E, Morris D, Kent L, Gill M, Bellgrove MA. Rare DNA variants in the brain-derived neurotrophic factor gene increase risk for attention-deficit hyperactivity disorder: a next-generation sequencing study. Mol Psychiatry 2017; 22:580-584. [PMID: 27457811 DOI: 10.1038/mp.2016.117] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 10/27/2015] [Revised: 04/14/2016] [Accepted: 05/06/2016] [Indexed: 12/26/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a prevalent and highly heritable disorder of childhood with negative lifetime outcomes. Although candidate gene and genome-wide association studies have identified promising common variant signals, these explain only a fraction of the heritability of ADHD. The observation that rare structural variants confer substantial risk to psychiatric disorders suggests that rare variants might explain a portion of the missing heritability for ADHD. Here we believe we performed the first large-scale next-generation targeted sequencing study of ADHD in 152 child and adolescent cases and 188 controls across an a priori set of 117 genes. A multi-marker gene-level analysis of rare (<1% frequency) single-nucleotide variants (SNVs) revealed that the gene encoding brain-derived neurotrophic factor (BDNF) was associated with ADHD at Bonferroni corrected levels. Sanger sequencing confirmed the existence of all novel rare BDNF variants. Our results implicate BDNF as a genetic risk factor for ADHD, potentially by virtue of its critical role in neurodevelopment and synaptic plasticity.
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Affiliation(s)
- Z Hawi
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences (MICCN), Monash University, Melbourne, VIC, Australia
| | - T D R Cummins
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences (MICCN), Monash University, Melbourne, VIC, Australia
| | - J Tong
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences (MICCN), Monash University, Melbourne, VIC, Australia
| | - M Arcos-Burgos
- John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - Q Zhao
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - N Matthews
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - D P Newman
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences (MICCN), Monash University, Melbourne, VIC, Australia
| | - B Johnson
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences (MICCN), Monash University, Melbourne, VIC, Australia
| | - A Vance
- Academic Child Psychiatry Unit, Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, VIC, Australia
| | - H S Heussler
- Mater Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - F Levy
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,Child and Family East, Prince of Wales Hospital, Randwick, NSW, Australia
| | - S Easteal
- John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - N R Wray
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - E Kenny
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - D Morris
- Department of Biochemistry, National University of Ireland Galway, Galway, Ireland
| | - L Kent
- School of Medicine, University of St Andrews, St Andrews, Scotland, UK
| | - M Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - M A Bellgrove
- School of Psychological Sciences and Monash Institute for Cognitive and Clinical Neurosciences (MICCN), Monash University, Melbourne, VIC, Australia.,Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
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15
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Terra A, Dommerc C, Levy F, Eker A. Right partial pericardial agenesis: An unusual case discovered during a heart surgery. Egypt Heart J 2016. [DOI: 10.1016/j.ehj.2015.09.001] [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: 11/30/2022] Open
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16
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Abstract
This review addresses the pathophysiology of hemorrhagic shock, a condition produced by rapid and significant loss of intravascular volume, which may lead to hemodynamic instability, decreases in oxygen delivery, decreased tissue perfusion, cellular hypoxia, organ damage, and death. The initial neuroendocrine response is mainly a sympathetic activation. Haemorrhagic shock is associated altered microcirculatory permeability and visceral injury. It is also responsible for a complex inflammatory response associated with hemostasis alteration.
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Affiliation(s)
- R Copotoiu
- Service d'anesthésie-réanimation chirurgicale, hôpitaux universitaires de Strasbourg, nouvel hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France
| | - E Cinca
- Service d'anesthésie-réanimation chirurgicale, hôpitaux universitaires de Strasbourg, nouvel hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France
| | - O Collange
- Service d'anesthésie-réanimation chirurgicale, hôpitaux universitaires de Strasbourg, nouvel hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France
| | - F Levy
- Service d'anesthésie-réanimation chirurgicale, hôpitaux universitaires de Strasbourg, nouvel hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France
| | - P-M Mertes
- Service d'anesthésie-réanimation chirurgicale, hôpitaux universitaires de Strasbourg, nouvel hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
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Roberts G, Wen W, Frankland A, Perich T, Holmes-Preston E, Levy F, Lenroot RK, Hadzi-Pavlovic D, Nurnberger JI, Breakspear M, Mitchell PB. Interhemispheric white matter integrity in young people with bipolar disorder and at high genetic risk. Psychol Med 2016; 46:2385-2396. [PMID: 27291060 DOI: 10.1017/s0033291716001161] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND White matter (WM) impairments have been reported in patients with bipolar disorder (BD) and those at high familial risk of developing BD. However, the distribution of these impairments has not been well characterized. Few studies have examined WM integrity in young people early in the course of illness and in individuals at familial risk who have not yet passed the peak age of onset. METHOD WM integrity was examined in 63 BD subjects, 150 high-risk (HR) individuals and 111 participants with no family history of mental illness (CON). All subjects were aged 12 to 30 years. RESULTS This young BD group had significantly lower fractional anisotropy within the genu of the corpus callosum (CC) compared with the CON and HR groups. Moreover, the abnormality in the genu of the CC was also present in HR participants with recurrent major depressive disorder (MDD) (n = 16) compared with CON participants. CONCLUSIONS Our findings provide important validation of interhemispheric abnormalities in BD patients. The novel finding in HR subjects with recurrent MDD - a group at particular risk of future hypo/manic episodes - suggests that this may potentially represent a trait marker for BD, though this will need to be confirmed in longitudinal follow-up studies.
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Affiliation(s)
- G Roberts
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - W Wen
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - A Frankland
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - T Perich
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - E Holmes-Preston
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - F Levy
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - R K Lenroot
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - D Hadzi-Pavlovic
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - J I Nurnberger
- Department of Psychiatry,Indiana University School of Medicine,Indianapolis, IN,USA
| | - M Breakspear
- Division of Mental Health Research,Queensland Institute of Medical Research,Brisbane,QLD,Australia
| | - P B Mitchell
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
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Roberts G, Lenroot R, Frankland A, Yeung PK, Gale N, Wright A, Lau P, Levy F, Wen W, Mitchell PB. Abnormalities in left inferior frontal gyral thickness and parahippocampal gyral volume in young people at high genetic risk for bipolar disorder. Psychol Med 2016; 46:2083-2096. [PMID: 27067698 DOI: 10.1017/s0033291716000507] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Fronto-limbic structural brain abnormalities have been reported in patients with bipolar disorder (BD), but findings in individuals at increased genetic risk of developing BD have been inconsistent. We conducted a study in adolescents and young adults (12-30 years) comparing measures of fronto-limbic cortical and subcortical brain structure between individuals at increased familial risk of BD (at risk; AR), subjects with BD and controls (CON). We separately examined cortical volume, thickness and surface area as these have distinct neurodevelopmental origins and thus may reflect differential effects of genetic risk. METHOD We compared fronto-limbic measures of grey and white matter volume, cortical thickness and surface area in 72 unaffected-risk individuals with at least one first-degree relative with bipolar disorder (AR), 38 BD subjects and 72 participants with no family history of mental illness (CON). RESULTS The AR group had significantly reduced cortical thickness in the left pars orbitalis of the inferior frontal gyrus (IFG) compared with the CON group, and significantly increased left parahippocampal gyral volume compared with those with BD. CONCLUSIONS The finding of reduced cortical thickness of the left pars orbitalis in AR subjects is consistent with other evidence supporting the IFG as a key region associated with genetic liability for BD. The greater volume of the left parahippocampal gyrus in those at high risk is in line with some prior reports of regional increases in grey matter volume in at-risk subjects. Assessing multiple complementary morphometric measures may assist in the better understanding of abnormal developmental processes in BD.
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Affiliation(s)
- G Roberts
- School of Psychiatry, University of New South Wales,Sydney,Australia
| | - R Lenroot
- School of Psychiatry, University of New South Wales,Sydney,Australia
| | - A Frankland
- School of Psychiatry, University of New South Wales,Sydney,Australia
| | - P K Yeung
- Neuroscience Research Australia,Sydney,Australia
| | - N Gale
- School of Psychiatry, University of New South Wales,Sydney,Australia
| | - A Wright
- School of Psychiatry, University of New South Wales,Sydney,Australia
| | - P Lau
- School of Psychiatry, University of New South Wales,Sydney,Australia
| | - F Levy
- School of Psychiatry, University of New South Wales,Sydney,Australia
| | - W Wen
- School of Psychiatry, University of New South Wales,Sydney,Australia
| | - P B Mitchell
- School of Psychiatry, University of New South Wales,Sydney,Australia
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McCormack C, Green MJ, Rowland JE, Roberts G, Frankland A, Hadzi-Pavlovic D, Joslyn C, Lau P, Wright A, Levy F, Lenroot RK, Mitchell PB. Neuropsychological and social cognitive function in young people at genetic risk of bipolar disorder. Psychol Med 2016; 46:745-758. [PMID: 26621494 DOI: 10.1017/s0033291715002147] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Impairments in key neuropsychological domains (e.g. working memory, attention) and social cognitive deficits have been implicated as intermediate (endo) phenotypes for bipolar disorder (BD), and should therefore be evident in unaffected relatives. METHOD Neurocognitive and social cognitive ability was examined in 99 young people (age range 16-30 years) with a biological parent or sibling diagnosed with the disorder [thus deemed to be at risk (AR) of developing BD], compared with 78 healthy control (HC) subjects, and 52 people with a confirmed diagnosis of BD. RESULTS Only verbal intelligence and affective response inhibition were significantly impaired in AR relative to HC participants; the BD participants showed significant deficits in attention tasks compared with HCs. Neither AR nor BD patients showed impairments in general intellectual ability, working memory, visuospatial or language ability, relative to HC participants. Analysis of BD-I and BD-II cases separately revealed deficits in attention and immediate memory in BD-I patients (only), relative to HCs. Only the BD (but not AR) participants showed impaired emotion recognition, relative to HCs. CONCLUSIONS Selective cognitive deficits in the capacity to inhibit negative affective information, and general verbal ability may be intermediate markers of risk for BD; however, the extent and severity of impairment in this sample was less pronounced than has been reported in previous studies of older family members and BD cases. These findings highlight distinctions in the cognitive profiles of AR and BD participants, and provide limited support for progressive cognitive decline in association with illness development in BD.
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Affiliation(s)
- C McCormack
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - M J Green
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - J E Rowland
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - G Roberts
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - A Frankland
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - D Hadzi-Pavlovic
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - C Joslyn
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - P Lau
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - A Wright
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - F Levy
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - R K Lenroot
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
| | - P B Mitchell
- School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
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Haas E, Steib A, Levy F, Somme S, Mendel I, Mertes PM. Allo-immunisation anti-érythrocytaire post-transfusionnelle : analyse et suivi immunologique de patients receveurs de concentres érythrocytaires en Alsace durant la période 2003–2013. Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Krestjyaninov M, Gimaev R, Razin V, Halaph H, Shameeva O, Galli E, Oger E, Levery M, Mabo P, Donal E, Rodriguez Munoz D, Carbonell Sanroman A, Moya Mur J, Lazaro Rivera C, Fernandez Santos S, Rincon Diaz L, Casas Rojo E, Jimenez Nacher J, Fernandez-Golfin C, Zamorano Gomez J, Shamsheva D, Zaletova T, Parkhomenko O, Bogdanov A, Simova I, Katova T, Galderisi M, Pauncheva B, Ozawa K, Funabashi N, Takaoka H, Kobayashi Y, Moatemri F, Messaoudi Y, Mahdhaoui A, Bouraoui H, Hajri S, Jeridi G, Souza C, Nascimento C, Cordovil I, Belem L, Horcades R, Sahate A, Pereira S, Benchimol-Barbosa P, Barros C, Weitzel L, Altin C, Sade L, Gezmis E, Ozen N, Muderrisoglu H, Voilliot D, Magne J, Dulgheru R, Kou S, Henri C, Caballero L, De Sousa C, Sprynger M, Pierard L, Lancellotti P, Miglioranza M, Mihaila S, Muraru D, Cucchini U, Cecchetto A, Cavalli G, Romeo G, Iliceto S, Badano L, Brecht A, Wageloehner T, Oertelt-Prigione S, Seeland U, Ruecke M, Baumann G, Regitz-Zagrosek V, Stangl V, Knebel F, Khanna R, Raghuwanshi A, Kapoor A, Tewari S, Garg N, Kumar S, Goel P, Altin C, Sade L, Gezmis E, Ozen N, Duzceker O, Muderrisoglu H, Petre I, Tautu O, Onciul S, Iancovici S, Zamfir D, Onut R, Dorobantu M, Jashari F, Ibrahimi P, Johansson E, Gronlund C, Bajraktari G, Wester P, Henein M, Torbas O, Sirenko Y, Radchenko G, Page M, Gerber B, Pasquet A, Pouleur A, Vancreynest D, Vanoverschelde J, Wieczorek J, Wieczorek P, Mizia M, Gieszczyk-Strozik K, Sikora-Puz A, Lasota B, Mizia-Stec K, Coisne A, Levy F, Malaquin D, Richardson M, Quere J, Montaigne D, Tribouilloy C, Miskowiec D, Wierzbowska-Drabik K, Wejner-Mik P, Michalski B, Wdowiak-Okrojek K, Szymczyk E, Kasprzak J, Lipiec P, Grossi F, Oddo A, Pieri F, Cordisco A, Zucchini M, Mori F, Gensini G. Club 35 Poster session 1: Wednesday 3 December 2014, 09:00-16:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tchoulfian P, Donatini F, Levy F, Dussaigne A, Ferret P, Pernot J. Direct imaging of p-n junction in core-shell GaN wires. Nano Lett 2014; 14:3491-8. [PMID: 24837761 DOI: 10.1021/nl5010493] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
While core-shell wire-based devices offer a promising path toward improved optoelectronic applications, their development is hampered by the present uncertainty about essential semiconductor properties along the three-dimensional (3D) buried p-n junction. Thanks to a cross-sectional approach, scanning electron beam probing techniques were employed here to obtain a nanoscale spatially resolved analysis of GaN core-shell wire p-n junctions grown by catalyst-free metal-organic vapor phase epitaxy on GaN and Si substrates. Both electron beam induced current (EBIC) and secondary electron voltage constrast (VC) were demonstrated to delineate the radial and axial junction existing in the 3D structure. The Mg dopant activation process in p-GaN shell was dynamically controlled by the ebeam exposure conditions and visualized thanks to EBIC mapping. EBIC measurements were shown to yield local minority carrier/exciton diffusion lengths on the p-side (∼57 nm) and the n-side (∼15 nm) as well as depletion width in the range 40-50 nm. Under reverse bias conditions, VC imaging provided electrostatic potential maps in the vicinity of the 3D junction from which acceptor Na and donor Nd doping levels were locally determined to be Na = 3 × 10(18) cm(-3) and Nd = 3.5 × 10(18) cm(-3) in both the axial and the radial junction. Results from EBIC and VC are in good agreement. This nanoscale approach provides essential guidance to the further development of core-shell wire devices.
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Masurel-Paulet A, Kalscheuer VM, Lebrun N, Hu H, Levy F, Thauvin-Robinet C, Darmency-Stamboul V, El Chehadeh S, Thevenon J, Chancenotte S, Ruffier-Bourdet M, Bonnet M, Pinoit JM, Huet F, Desportes V, Chelly J, Faivre L. Expanding the clinical phenotype of patients with a ZDHHC9 mutation. Am J Med Genet A 2013; 164A:789-95. [PMID: 24357419 DOI: 10.1002/ajmg.a.36348] [Citation(s) in RCA: 23] [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] [Received: 04/19/2013] [Accepted: 10/09/2013] [Indexed: 11/12/2022]
Abstract
In 2007, 250 families with X-linked intellectual disability (XLID) were screened for mutations in genes on the X-chromosome, and in 4 of these families, mutations in the ZDHHC9 gene were identified. The ID was either isolated or associated with a marfanoid habitus. ZDHHC9 encodes a palmitoyl transferase that catalyzes the posttranslational modification of NRAS and HRAS. Since this first description, no additional patient with a ZDHHC9 mutation has been reported in the literature. Here, we describe a large family in which we identified a novel pathogenic ZDHHC9 nonsense mutation (p.Arg298*) by parallel sequencing of all X-chromosome exons. The mutation cosegregated with the clinical phenotype in this family. An 18-year-old patient and his 40-year-old maternal uncle were evaluated. Clinical examination showed normal growth parameters, lingual fasciculation, limited extension of the elbows and metacarpophalangeal joints, and acrocyanosis. There was neither facial dysmorphism nor marfanoid habitus. Brain MRI detected a dysplastic corpus callosum. Neuropsychological testing showed mild intellectual disability. They both displayed generalized anxiety disorder, and the younger patient also suffered from significant behavior impairment that required attention or treatment. Speech evaluation detected satisfactory spoken language since both were able to provide information and to understand conversations of everyday life. Occupational therapy examination showed impaired visual-spatial and visual-motor performance with poor drawing/graphic skills. These manifestations are not specific enough to guide ZDHHC9 screening in patients with ID, and emphasize the value of next generation sequencing for making a molecular diagnosis and genetic counseling in families with XLID.
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Affiliation(s)
- Alice Masurel-Paulet
- Centre de Génétique et Centre de Référence Anomalies du développement et Syndromes Malformatifs, Hôpital d'Enfants, CHU, Dijon, France
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Thomas PA, Berbis J, Falcoz PE, Le Pimpec-Barthes F, Bernard A, Jougon J, Porte H, Alifano M, Dahan M, Alauzen M, Andro JF, Aubert M, Avaro JP, Azorin J, Bagan P, Bellenot F, Blin V, Boitet P, Bordigoni L, Borrelly J, Brichon PY, Cardot G, Carrie JM, Clement F, Corbi P, Debaert M, Debrueres B, Dubrez J, Ducrocq X, Dujon A, Dumont P, Fernoux P, Filaire M, Frassinetti E, Frey G, Gossot D, Grosdidier G, Guibert B, Hagry O, Jaillard S, Jarry JM, Kaczmarek D, Laborde Y, Lenot B, Levy F, Lombart L, Marcade E, Marcade JP, Marzelle J, Massard G, Mazeres F, Mensier E, Metois D, Michaud J, Paris E, Mondine P, Monteau M, Moreau JM, Mouroux J, Mugniot A, Mulsant P, Naffaa N, Neveu P, Pavy G, Peillon C, Pons F, Porte H, Regnard JF, Riquet M, Looyeh BS, Thomas P, Tiffet O, Tremblay B, Valla J, Velly JF, Wack B, Wagner JD, Woelffe D. National perioperative outcomes of pulmonary lobectomy for cancer: the influence of nutritional status. Eur J Cardiothorac Surg 2013; 45:652-9; discussion 659. [DOI: 10.1093/ejcts/ezt452] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Levy F, Mouchabac S, Peretti CS. [Etiopathogeny of the delusion of pregnancy using a literature review: Role of hyperprolactinemia and application of the theory of abductive inference]. Encephale 2013; 40:154-9. [PMID: 23830681 DOI: 10.1016/j.encep.2013.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 02/04/2013] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Delusions of pregnancy are not well known. The delusion of pregnancy is defined as the belief of being pregnant despite factual evidence to the contrary. The clinical picture is heterogeneous (duration, mechanisms, topics and pre-existing psychiatric disorders). Several causes have been proposed to explain the occurrence of the delusions of pregnancy: cenesthetic theory, hyperprolactinemia, polydipsia and psychodynamic conflicts. Hyperprolactinemia is an interesting hypothesis (physiologic increase during pregnancy and similar manifestations in the course of gestation). The abductive inference theory is a probabilistic model that can clarify the role of hyperprolactinemia in the delusions of pregnancy. The purpose of this paper is to study the role of hyperprolactinemia in the delusions of pregnancy using a literature review. The abductive inference model is used to specify the etiopathogeny of this pathology. METHODS A research in Medline, Sudoc, BIUM and PSYLINK using the following key words "delusional pregnancy" or "delusion of pregnancy" and "hyperprolactinemia" was conducted. RESULTS Three articles (case reports) about delusions of pregnancy associated with hyperprolactinemia were found. The cases have some similitudes. First of all, they have similar chronology: delusion appears at the same time as hyperprolactinemia and resolves with biological normalization. Secondly, hyperprolactinemia is always caused by a neuroleptic (haloperidol, olanzapine, risperidone). Concerning pre-existing disorders, a psychiatric pathology for each case was found (schizophrenia, schizo-affective disorder and bipolar disorder). Chronology, reproductivity and reversibility are strong arguments to involve hyperprolactinemia in the delusions of pregnancy (Bradford Hill criteria). Furthermore, this association is biologically plausible: physiologic increase during pregnancy (gestational signal), similar symptoms to those during pregnancy and the role in parental behavior (parental signal). Nevertheless, not everyone with hyperprolactinemia will develop a delusion of pregnancy; the interaction is more complex (non linear); the theory of abductive inference clarifies this relationship. THEORY OF ABDUCTIVE INFERENCE Abductive inference is a probabilistic model whose goal is to explain the occurrence of delusional beliefs. The first factor is the abnormal data. The second factor is the cognitive process (abductive inference), which uses Bayes' theorem to select the most likely hypothesis to explain the abnormal data. In the delusion of pregnancy, abnormal data is the hyperprolactinemia, signal of gestation without pregnancy. Hypotheses in order to explain this signal are then produced (pregnancy or no pregnancy). In the second part, probabilities associated with each hypothesis, given the hyperprolactinemia, are compared. Since hyperprolactinemia is a gestational signal, the pregnancy hypothesis is most likely. Probabilities associated with each hypothesis without taking hyperprolactinemia into account are compared (prior probability). Since any element of reality indicates a pregnancy, the absence of pregnancy is most likely. In the last step, the posterior probability is calculated using the first two comparisons. The probability associated with the pregnancy hypothesis (taking into account hyperprolactinemia) is relatively higher than the probability associated with the no-pregnancy hypothesis (without taking into account hyperprolactinemia). So, the posterior probability associated with the pregnancy hypothesis is more likely than the posterior probability associated with the no-pregnancy hypothesis. Thus, the subject believes in a pregnancy. CONCLUSION The research and the treatment of hyperprolactinemia must be conducted when faced with a delusion of pregnancy.
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Affiliation(s)
- F Levy
- Département de psychiatrie et psychologie médicale, CHU Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
| | - S Mouchabac
- Département de psychiatrie et psychologie médicale, CHU Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - C S Peretti
- Département de psychiatrie et psychologie médicale, CHU Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
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Levy F, Abouth S, Renard C, Szymanski C, Malaquin D, Leborgne L, Tribouilloy C. Assessment of myocardial viability after acute myocardial infarction by global longitudinal 2d strain at rest and during low dose dobutamine stress echocardiography: Comparison with cardiac magnetic resonance imaging. Arch Cardiovasc Dis 2013. [DOI: 10.1016/j.acvd.2013.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Thevenon J, Callier P, Andrieux J, Delobel B, David A, Sukno S, Minot D, Mosca Anne L, Marle N, Sanlaville D, Bonnet M, Masurel-Paulet A, Levy F, Gaunt L, Farrell S, Le Caignec C, Toutain A, Carmignac V, Mugneret F, Clayton-Smith J, Thauvin-Robinet C, Faivre L. 12p13.33 microdeletion including ELKS/ERC1, a new locus associated with childhood apraxia of speech. Eur J Hum Genet 2013; 21:82-8. [PMID: 22713806 PMCID: PMC3522191 DOI: 10.1038/ejhg.2012.116] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 04/27/2012] [Accepted: 05/01/2012] [Indexed: 11/10/2022] Open
Abstract
Speech sound disorders are heterogeneous conditions, and sporadic and familial cases have been described. However, monogenic inheritance explains only a small proportion of such disorders, in particular in cases with childhood apraxia of speech (CAS). Deletions of <5 Mb involving the 12p13.33 locus is one of the least commonly deleted subtelomeric regions. Only four patients have been reported with such a deletion diagnosed with fluorescence in situ hybridisation telomere analysis or array CGH. To further delineate this rare microdeletional syndrome, a French collaboration together with a search in the Decipher database allowed us to gather nine new patients with a 12p13.33 subtelomeric or interstitial rearrangement identified by array CGH. Speech delay was found in all patients, which could be defined as CAS when patients had been evaluated by a speech therapist (5/9 patients). Intellectual deficiency was found in 5/9 patients only, and often associated with psychiatric manifestations of various severity. Two such deletions were inherited from an apparently healthy parent, but reevaluation revealed abnormal speech production at least in childhood, suggesting variable expressivity. The ELKS/ERC1 gene, which encodes for a synaptic factor, is found in the smallest region of overlap. These results reinforce the hypothesis that deletions of the 12p13.33 locus may be responsible for variable phenotypes including CAS associated with neurobehavioural troubles and that the presence of CAS justifies a genetic work-up.
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Affiliation(s)
- Julien Thevenon
- Centre de Génétique et Centre de Référence «Anomalies du Développement et Syndromes Malformatifs», Hôpital d'Enfants, CHU Dijon, Dijon, France
| | | | - Joris Andrieux
- Cytogénétique, Hôpital Jeanne de Flandre, CHRU de Lille, Lille, France
| | - Bruno Delobel
- Centre de Cytogénétique Chromosomique, Hôpital Saint Vincent de Paul, Groupe Hospitalier de l'Institut Catholique Lillois, Faculté Libre de Médecine, Lille, France
| | - Albert David
- Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - Sylvie Sukno
- Service de Neuropédiatrie, Hôpital Saint Vincent de Paul, Groupe Hospitalier de l'Institut Catholique Lillois, Faculté Libre de Médecine, Lille, France
| | - Delphine Minot
- Centre de Génétique et Centre de Référence «Anomalies du Développement et Syndromes Malformatifs», Hôpital d'Enfants, CHU Dijon, Dijon, France
| | | | | | - Damien Sanlaville
- Laboratoire de Cytogénétique, CBPE, Hospices Civils de Lyon, Bron, France
| | - Marlène Bonnet
- Centre de Référence des Troubles du Langage et des Apprentissages, Hôpital d'Enfants, CHU de Dijon, Dijon, France
| | - Alice Masurel-Paulet
- Centre de Génétique et Centre de Référence «Anomalies du Développement et Syndromes Malformatifs», Hôpital d'Enfants, CHU Dijon, Dijon, France
| | - Fabienne Levy
- Centre de Référence des Troubles du Langage et des Apprentissages, Hôpital d'Enfants, CHU de Dijon, Dijon, France
| | - Lorraine Gaunt
- Genetic Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Biomedical Research Centre, St Mary's Hospital, Manchester, UK
| | - Sandra Farrell
- Genetic Medicine, Credit Valley Hospital, Mississauga, Ontario, Canada
| | - Cédric Le Caignec
- Service de Génétique Médicale, CHU Nantes, Nantes, France
- INSERM, UMR_S915, l'institut du thorax, Nantes, France
| | | | | | | | - Jill Clayton-Smith
- Genetic Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Biomedical Research Centre, St Mary's Hospital, Manchester, UK
| | - Christel Thauvin-Robinet
- Centre de Génétique et Centre de Référence «Anomalies du Développement et Syndromes Malformatifs», Hôpital d'Enfants, CHU Dijon, Dijon, France
- Equipe GAD, Université de Bourgogne, Faculté de Médecine, Dijon, France
| | - Laurence Faivre
- Centre de Génétique et Centre de Référence «Anomalies du Développement et Syndromes Malformatifs», Hôpital d'Enfants, CHU Dijon, Dijon, France
- Equipe GAD, Université de Bourgogne, Faculté de Médecine, Dijon, France
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Bavencove AL, Tourbot G, Garcia J, Désières Y, Gilet P, Levy F, André B, Gayral B, Daudin B, Dang LS. Submicrometre resolved optical characterization of green nanowire-based light emitting diodes. Nanotechnology 2011; 22:345705. [PMID: 21795769 DOI: 10.1088/0957-4484/22/34/345705] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The electroluminescent properties of InGaN/GaN nanowire-based light emitting diodes (LEDs) are studied at different resolution scales. Axial one-dimensional heterostructures were grown by plasma-assisted molecular beam epitaxy (PAMBE) directly on a silicon (111) substrate and consist of the following sequentially deposited layers: n-type GaN, three undoped InGaN/GaN quantum wells, p-type AlGaN electron blocking layer and p-type GaN. From the macroscopic point of view, the devices emit light in the green spectral range (around 550 nm) under electrical injection. At 100 mA DC current, a 1 mm2 chip that integrates around 10(7) nanowires emits an output power on the order of 10 µW. However, the emission of the nanowire-based LED shows a spotty and polychromatic emission. By using a confocal microscope, we have been able to improve the spatial resolution of the optical characterizations down to the submicrometre scale that can be assessed to a single nanowire. Detailed μ-electroluminescent characterization (emission wavelength and output power) over a representative number of single nanowires provides new insights into the vertically integrated nanowire-based LED operation. By combining both μ-electroluminescent and μ-photoluminescent excitation, we have experimentally shown that electrical injection failure is the major source of losses in these nanowire-based LEDs.
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Affiliation(s)
- A L Bavencove
- CEA-LETI, MINATEC Campus, 17 avenue des Martyrs, 38054 Grenoble Cedex 9, France
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Tribouilloy C, Rusinaru D, Szymanski C, Mezghani S, Fournier A, Levy F, Peltier M, Ben Ammar A, Carmi D, Remadi JP, Caus T, Touati G. Predicting left ventricular dysfunction after valve repair for mitral regurgitation due to leaflet prolapse: additive value of left ventricular end-systolic dimension to ejection fraction. European Journal of Echocardiography 2011; 12:702-10. [DOI: 10.1093/ejechocard/jer128] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Levy F, Luc Monin J, Rusinaru D, Petit-Eisenmann H, Lelguen C, Chauvel C, Adams C, Metz D, Leleu F, Gueret P, Tribouilloy C. Valvuloarterial impedance does not improve risk stratification in low-ejection fraction, low-gradient aortic stenosis: results from a multicentre study. European Journal of Echocardiography 2011; 12:358-63. [DOI: 10.1093/ejechocard/jer022] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Germain AL, Meimoun P, Elmkies F, Benali T, Levy F, Boulanger J, Zemir H, Clerc J, Luycx-Bore A, Tribouilloy C. Determinants of non-invasive coronary flow reserve in severe aortic stenosis. Arch Cardiovasc Dis 2011. [DOI: 10.1016/j.acvd.2011.03.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dilworth C, Goldsack S, Goldschmidt-Clermont Y, Levy F. XCIV. The magnetic deflection of fast charged particles in the photographic emulsion. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/14786445008561037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Noll E, Levy F, Waller C, Wiesel ML, Steib A. [Bedside pretransfusion compatibility testing fiability with cold agglutinins during cardiopulmonary bypass associated hypothermia for cardiac surgery]. ACTA ACUST UNITED AC 2010; 29:579-81. [PMID: 20609554 DOI: 10.1016/j.annfar.2010.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 05/10/2010] [Indexed: 11/29/2022]
Abstract
This case report is an example of a bedside pretransfusion compatibility testing issue. An 81-years-old woman was admitted in the operating room for aortic valve replacement under cardiopulmonary bypass. A conflict occurred during the bedside pretransfusion compatibility testing between the results of the patient and the packed red blood cells. Afterwards, the patient was diagnosed with cold agglutinins. It might have produced false positive results with the anti-A and anti-B reagents.
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Affiliation(s)
- E Noll
- Service d'anesthésie, réanimation chirurgicale, Samu-Smur Nouvel Hôpital Civil de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
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Izquierdo Ortiz MJ, Levy F, Abaigar P, Carrasco ML, Ruiz A, Torres G. [Acute kidney transplant failure from de novo AA amyloidosis in a patient with pyoderma gangrenosum]. Nefrologia 2010; 30:482-484. [PMID: 20651898 DOI: 10.3265/nefrologia.pre2010.may.10389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
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35
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A.Viala, Nicot T, Levy F, Vacheron MN. À propos d’un cas de syndrome de Usher suivi en psychiatrie : intérêt du diagnostic somatique pour la prise en charge psychiatrique. Encephale 2009; 35:286-91. [DOI: 10.1016/j.encep.2008.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 04/11/2008] [Indexed: 11/26/2022]
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36
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Levy F, Anderson P, Ekren T. Absorption and side-effects after peroral administration of sustained release iron tablets. Ferro-Retard compared with Ferronicum and Duroferon Duretter. Acta Med Scand 2009; 204:303-10. [PMID: 358765 DOI: 10.1111/j.0954-6820.1978.tb08444.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Study I. In 13 iron deficient patients the absorption from 100 mg ferrous sulphate (Ferro-Retard) after 3 and 5 hours was comparable to the absorption from 176 mg ferrous gluconate in rapidly disintegrating tablets (Ferronicum). Study II. (a) The serum iron elevation in 14 blood donors with normal Hb after administration of ferrous sulphate (100 mg Fe2+) in Ferro-Retard or Duroferon Duretter seemed to be equal when tested on the 4th day after donation of 450 ml blood. (b) The iron absorption, measured by the elevation of serum iron 5 and 8 hours after administration of sustained release tablets, proved to be better on the 11th and especially on the 16th day than on the 4th day after donation. Study III (side-effects). In a study on 113 subjects the total number of complaints was unusually high both before and after administration of placebo, rapidly disintegrating and sustained release ferrous sulphate tablets. The selection of participants and other methodological factors have probably been of importance. Hence, comparisons between different studies of side-effects should always be carried out with caution.
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Mahjoub H, Levy F, Cassol M, Meimoun P, Peltier M, Rusinaru D, Tribouilloy C. Effects of age on pulmonary artery systolic pressure at rest and during exercise in normal adults. European Journal of Echocardiography 2009; 10:635-40. [DOI: 10.1093/ejechocard/jep024] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Levy F, Camarero Temiño V, Torres Torres G, Hijazi Prieto B. [Plasmapheresis as a co-treatment in acute renal failure secondary to myeloma kidney]. Nefrologia 2009; 29:283-284. [PMID: 19554076 DOI: 10.3265/nefrologia.2009.29.3.4967.en.full] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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Fikri Benbrahim O, Levy F, Santos Barajas J, Carrasco Prado M. [Antiphospholipid syndrome and thrombotic microangiopathy]. Nefrologia 2009; 29:276-277. [PMID: 19554070 DOI: 10.3265/nefrologia.2009.29.3.4875.en.full] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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40
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Quessard A, Barrière P, Levy F, Steib A, Dupeyron P. Luxation de l’articulation temporomandibulaire diagnostiquée au décours d’une anesthésie générale. ACTA ACUST UNITED AC 2008; 27:846-9. [DOI: 10.1016/j.annfar.2008.07.095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Accepted: 07/09/2008] [Indexed: 10/21/2022]
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Gasparov VA, Sheikin I, Levy F, Teyssier J, Santi G. Study of the Fermi surface of ZrB12 using the de Haas-van Alphen effect. Phys Rev Lett 2008; 101:097006. [PMID: 18851644 DOI: 10.1103/physrevlett.101.097006] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Indexed: 05/26/2023]
Abstract
The de Haas-van Alphen (dHvA) effect in the cluster superconductor ZrB12 was studied by magnetic torque measurements in magnetic fields up to 28 T at temperatures down to 0.07 K. The dHvA oscillations due to orbits from the neck sections and "cubic box" of the Fermi surface were detected. The dHvA frequencies as well as the cyclotron effective masses were calculated using the full-potential linear muffin-tin orbitals method within the generalized gradient approximation. A comparison of the experimental and calculated cyclotron mass shows unusually large electron-phonon interaction on the neck (lambdaep=0.95) and box (lambdaep=1.07) sections of the Fermi surface on the Brillouin zone boundaries.
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Affiliation(s)
- V A Gasparov
- Institute of Solid State Physics RAS, Chernogolovka, 142432, Russian Federation
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Abstract
BACKGROUND Professional mixed martial arts (MMA) competition is a full-contact sport that has risen rapidly in popularity in recent years. However, there is limited information regarding the incidence of competition injuries after sanctioning by an athletic commission. METHODS We conducted a retrospective cohort study to examine MMA injury patterns during a 5 year period after sanctioning in the state of Nevada. Data from all regulated MMA competitions during the study period from March 2002 to September 2007 (1270 fight exposures) was obtained. Injury odds ratios were calculated by conditional logistic regression on match outcome, age, weight, and fight experience, using a pair-matched case-control design (n = 464) and by multiple logistic regression on match outcome, age, fight experience, weight, combat minutes, and scheduled rounds. RESULTS During the 635 professional MMA matches, 300 of the 1270 athletes sustained documented injuries with an injury rate of 23.6 per 100 fight participations. Most common reported injuries were lacerations and upper limb injuries. Severe concussion rate was 15.4 per 1000 athlete exposures, or 3% of all matches. No deaths or critical sports-related injuries resulted from any of the regulated matches during the study period. Age, weight and fight experience did not statistically increase the likelihood of injuries after controlling for other covariates. CONCLUSIONS Injury rates in regulated professional MMA competition are similar to other combat sports; the overall risk of critical sports-related injury seems to be low. Additional study is warranted to achieve a better understanding of injury trends and ways to further lower injury risk in MMA.
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Affiliation(s)
- K M Ngai
- Department of Emergency Medicine, The Johns Hopkins Medical University, Baltimore, MD 21209, USA
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Peltier M, Houpe D, Cohen-Solal A, Béguin M, Levy F, Tribouilloy C. Treatment practices in heart failure with preserved left ventricular ejection fraction: A prospective observational study. Int J Cardiol 2007; 118:363-9. [PMID: 17049391 DOI: 10.1016/j.ijcard.2006.07.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Accepted: 07/13/2006] [Indexed: 11/25/2022]
Abstract
BACKGROUND Current guidelines for treatment of patients with heart failure (HF) and preserved left ventricular ejection fraction (LVEF) are empirical. One of the objectives of the ETICS study was to evaluate medical treatment at discharge and after 1 year in patients hospitalised for a first episode of HF in 2000. We report the results concerning treatment of patients with preserved LVEF at discharge and at 1 year. METHODS Two hundred and sixty three consecutive patients (75+/-10 years, 47 males) with LVEF >50% hospitalised for a first episode of HF were prospectively included. Mean LVEF was 63+/-8%. The main aetiology was hypertension (61%) followed by ischaemic heart disease (29%). Atrial fibrillation and diabetes were present in 34% and 27% of cases, respectively. Medical treatment records were complete at discharge and at 1 year after discharge. RESULTS At discharge, as at 1 year after discharge, diuretics were the drugs most commonly prescribed (81% and 78%), followed by ACE inhibitors (49% and 46%), amiodarone (32% and 28%), beta-blockers (27% and 29%), nitrates (28% and 27%), calcium channel blockers (27% and 26%), spironolactone (21% and 25%), cardiac glycosides (19% and 24%), and angiotensin II receptor antagonists (4% and 6%). Once prescribed at hospital discharge, drug prescription rates and daily doses did not change significantly over time. Age did not influence drug prescription rates at discharge or at 1 year, except for the spironolactone prescription rate, which decreased at 1 year in patients > or =75 years of age. At discharge, ACE inhibitor and beta-blocker daily doses were lower in older patients, while, at 1 year, no differences in daily doses of these drugs were observed between patients above and below the age of 75 years. CONCLUSION Loops diuretics are largely prescribed in HF with preserved LVEF, followed by ACE inhibitors. Future large multicentre trials are required to define the background standard treatment in addition to treatment of aetiological factors.
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Affiliation(s)
- M Peltier
- INSERM, ERI 12, South Hospital, Amiens, France
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Ding R, Jung J, Kirsch T, Levy F, McCarthy M. Characteristics and Short-Term Recidivism Rates of Patients Who Leave the Emergency Department Against Medical Advice. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.1304] [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: 11/10/2022]
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Pribulova Z, Klein T, Marcus J, Marcenat C, Levy F, Park MS, Lee HG, Kang BW, Lee SI, Tajima S, Lee S. Anisotropy of the Sommerfeld coefficient in magnesium diboride single crystals. Phys Rev Lett 2007; 98:137001. [PMID: 17501231 DOI: 10.1103/physrevlett.98.137001] [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] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Indexed: 05/15/2023]
Abstract
The anisotropic field dependence of the Sommerfeld coefficient gamma has been measured down to B-->0 by combining specific heat and Hall probe magnetization measurements in MgB2 single crystals. We find that gamma(B,theta) is the sum of two contributions arising from the sigma and pi band, respectively. We show that gammasigma(B,theta)=B/Bc2(theta) where Bc2(theta)=Bc2ab/sqrt[sin2theta+Gamma2cos2theta] with Gamma approximately 5.4 (theta being the angle between the applied field and the c axis) and gammapi(B,theta)=gammapi(B)=B/Bpi(B). The "critical field" of the pi band Bpi is fully isotropic but field dependent increasing from approximately 0.25 T for B< or =0.1 T up to 3 T approximately Bc2c for B-->3 T. Because of the coupling of the two bands, superconductivity survives in the pi band up to 3 T but is totally destroyed above for any orientation of the field.
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Affiliation(s)
- Z Pribulova
- Institut Néel-CNRS, F-38042 Grenoble Cedex 9, France
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Van Dort M, Walden C, Walker ES, Reynolds SA, Levy F, Sarubbi FA. An outbreak of infections caused by non-typeable Haemophilus influenzae in an extended care facility. J Hosp Infect 2007; 66:59-64. [PMID: 17379356 DOI: 10.1016/j.jhin.2007.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [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: 11/21/2006] [Accepted: 02/01/2007] [Indexed: 11/21/2022]
Abstract
Nosocomial outbreaks of infection due to non-typeable Haemophilus influenzae (NTHi) are rarely described. There are a few published reports that suggest that elderly patients with underlying pulmonary disease are at risk and that person-to-person spread is key to disease transmission. During the summer months of 2005, we documented an outbreak of NTHi infections in a Veterans Affairs nursing home. Thirteen patients developed conjunctivitis or lower respiratory infection involving a beta-lactamase-negative biotype III NTHi isolate, with an indistinguishable SmaI macrorestriction pattern. Patients were elderly males usually with underlying cardiac and pulmonary disease. A case-control study failed to demonstrate any specific significant risk factor for NTHi infection and there was no evidence of spatial clustering of cases within the nursing home. A random throat culture survey involving nursing home patients during the outbreak showed that only one of 19 persons was colonized with NTHi. The outbreak concluded following appropriate treatment and an emphasis on universal and respiratory droplet precautions. All patients recovered and a specific inciting event for the outbreak was never defined. Literature review revealed a spectrum of responses to nosocomial NTHi infections and a lack of consensus regarding the infection control approach towards NTHi outbreaks.
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Affiliation(s)
- M Van Dort
- James H. Quillen Veterans Affairs Medical Center, Mountain Home, Tennessee, USA
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Abstract
No one set of characteristics has been consistently predictive of perioperative mortality and morbidity associated with the Norwood procedure. The purpose of the current study is to further validate a scoring system shown to be predictive of mortality following the Norwood procedure. We performed a retrospective review of all infants with the diagnosis of hypoplastic left heart syndrome (HLHS) who underwent the Norwood procedure at St. Louis Children's Hospital from July 1, 1994, to December 31, 2002. A weighted score for each of six factors comprised the scoring system. The factors included ventricular function, tricuspid regurgitation, ascending aortic diameter, atrial septal defect blood flow characteristics, blood type, and age. A score of > or = 7 points indicated lower reconstructive mortality risk, and a total score of < 7 points indicated a higher mortality risk. A total of 57 patients were analyzed. Twenty-five infants (44%) had a low risk score. These infants had a significantly greater survival at 48 hours compared to infants with a score of < 7 (92 vs 75%, p < 0.05). Infants with a high risk score had a significantly greater relative risk of mortality at 48 hours [OR = 2.04; confidence interval (CI) 1.04-4.00; p = 0.036]. The area under the receiver operating characteristic (ROC) curve is 0.8534 (95% CI, 0.78-0.922). This suggests that the scoring system has a very good degree of discriminatory power in selecting children who did not survive. Based on the results of the ROC, a cutoff score of >7 gives the best sensitivity and specificity for survival. When applied retrospectively, the survival outcomes predicted by our scoring system significantly correlated with actual outcomes. This supports the conclusion that a specific population of HLHS patients may have a higher mortality risk independent of surgical technique and postoperative care based on factors that can be assessed preoperatively.
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Affiliation(s)
- P A Checchia
- Division of Critical Care Medicine, Washington University School of Medicine, St. Louis Children's Hospital, Campus Box 8116, One Children's Place, Suite 5S20, St. Louis, MO, 63110, USA.
- Division of Cardiology, Washington University School of Medicine, St. Louis Children's Hospital, Campus Box 8116, One Children's Place, Suite 5S20, St. Louis, MO, 63110, USA.
| | - J K McGuire
- Division of Critical Care Medicine, Washington University School of Medicine, St. Louis Children's Hospital, Campus Box 8116, One Children's Place, Suite 5S20, St. Louis, MO, 63110, USA
| | - S Morrow
- Department of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis Children's Hospital, Campus Box 8116, One Children's Place, Suite 5S20, St. Louis, MO, 63110, USA
| | - N Daher
- School of Allied Health Professionals, Loma Linda University, Loma Linda, CA, 92350, USA
| | - C Huddleston
- Department of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis Children's Hospital, Campus Box 8116, One Children's Place, Suite 5S20, St. Louis, MO, 63110, USA
| | - F Levy
- Division of Critical Care Medicine, Washington University School of Medicine, St. Louis Children's Hospital, Campus Box 8116, One Children's Place, Suite 5S20, St. Louis, MO, 63110, USA
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Weissrock S, Levy F, Balabaud V, Thiranos JC, Dupeyron JP, Steib A. Intérêt du Mini Mental Test dans le dépistage des troubles cognitifs après chirurgie cardiaque. ACTA ACUST UNITED AC 2005; 24:1255-61. [PMID: 16019185 DOI: 10.1016/j.annfar.2005.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 07/14/2004] [Accepted: 05/16/2005] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Cognitive defects are frequently described after cardiac surgery. They occur in 30 to 79% cases. They might be related to the use of a cardiopulmonary bypass (CPB). They are poorly evaluated in clinical practice. OBJECTIVES To evaluate the usefulness of the Mini Mental State Examination (MMSE) to screen patients scheduled for cardiac surgery. STUDY DESIGN Prospective, open study. PATIENTS AND METHODS 100 consecutive patients undergoing coronary artery bypass or valvular replacement under CPB were enrolled in the study. The MMSE was performed the day before surgery and five days later. Patients exhiting a postoperative defect> or =4 points were compared to those without changes or with improved results. RESULTS 73 patients completed both tests. The mean score decreased postoperatively in 12 patients (15%). They were older (70+/-8 years), had longer CBP durations (128+/-50 min) and the lowest temperatures (30 degrees C+/-3) compared to the other patients. At the opposite, five patients (9%) improved their scores. CONCLUSION These results entourage to carry out a more strict follow-up for the oldest patients in cardiac surgery. The MMSE could be systematically integrated to the pre and postoperative screening. The detection of cognitive dysfunction should lead to address the patient to a geriatrician for a prolonged follow-up.
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Affiliation(s)
- S Weissrock
- Département d'anesthésiologie, hôpital civil, 1, route de l'Hôpital, 67091 Strasbourg cedex, France.
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Skulberg KR, Skyberg K, Kruse K, Eduard W, Levy F, Kongerud J, Djupesland P. The effects of intervention with local electrostatic air cleaners on airborne dust and the health of office employees. Indoor Air 2005; 15:152-159. [PMID: 15865615 DOI: 10.1111/j.1600-0668.2005.00331.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
UNLABELLED The aim of this intervention study was to identify any health improvements in the upper and lower airways of office workers after the installation of local electrostatic air cleaners. Eighty persons with airways symptoms were recruited and randomly assigned to an intervention or control group. Half of the air cleaners had a non-functioning electrostatic unit. Both participants and field researchers were blinded to the group status. Subjective symptoms were recorded using a questionnaire, and indexes calculated for general, irritation and skin symptoms. Objective respiratory health indicators were recorded, with acoustic rhinometry and peak expiratory flow (PEF) meters. In the intervention group there was a decrease in mean dust concentration from 65 to 35 microg/m(3), and a reduction from 57 to 47 microg/m(3) in the control group (P < 0.05 for difference in decline). The reduction was observed for all particles sizes. The irritation and general symptom indices decreased in both groups, but there was no improvement in the intervention group, compared with the control group. Median PEF increased 3 ml/s in the intervention group, and decreased 4 ml/s in the control group. The adjusted odds ratio for an increase above the 70th percentile was 5.7 (95% CI 1.0-32). PRACTICAL IMPLICATIONS Electrostatic air cleaners can reduce the dust concentration effectively in the office environment. Small, medium and large sized particles can be reduced by approximately 50%, relatively most effectively for the respirable particles. However, the air cleaners tested in this study produced an annoying fan noise. Cleaning efficiency and noise data should be given consideration before installation. This experimental field study suggests that office workers with airways symptoms may benefit from installation of local electrostatic air cleaners.
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Affiliation(s)
- K R Skulberg
- National Institute of Occupational Health, Oslo, Norway.
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Abstract
OBJECTIVES This study was designed to evaluate the influence of age and denture use on the size of arches and residual ridges in edentulous patients. DESIGN At two nursing homes, maxillary and mandibular stone casts of 302 fully edentulous patients were utilized to measure the size of the arches and residual ridges, according to age and use of complete dentures. Age cohorts were divided into three groups; 60-69, 70-79, and 80-89 years old. Two hundred and forty-nine denture wearers used complete dentures for at least 2 years before examinations. Fifty-three non-denture users had never worn removable prostheses. Chi-square analysis (p<0.05) was used to establish the possible relations between the linear values and the size indexes of the ridges and arches and the two examined parameters: age and denture wear. RESULTS Young old patients possessed edentulous structures that were not significantly larger than elderly old patients in both the maxilla and the mandible. Non-denture users had significantly bigger arches and ridges in both edentulous jaws than denture users. CONCLUSIONS Young old, non-denture users tended to have bigger residual edentulous tissues compared to elderly old patients who used complete dentures.
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