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Martinez JG, De Sousa J, Dompnier A, Martins-Oliveira M, Israel CW, Teijeira E, Rubin JM, Sebag F, Martino M, Michel Y, Marques P. Efficacy and safety of novel left ventricular pacing leads: 1-year analysis of the NAVIGATOR trial. Open Heart 2024; 11:e002517. [PMID: 38316493 PMCID: PMC10860098 DOI: 10.1136/openhrt-2023-002517] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/03/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVES Assess safety and performance of novel quadripolar preshaped left ventricular (LV) leads: NAVIGO 4LV 2D ('S shaped') and NAVIGO 4LV ARC ('U shaped'). METHODS Patients indicated for cardiac resynchronisation therapy were enrolled in a multicentre, prospective, controlled study (NAVIGATOR, NCT03279484). Patients were implanted with either a NAVIGO 4LV 2D or ARC lead, and assessed at 10 weeks, 6, 12 and 24 months post-implant. Co-primary safety and performance endpoints were assessed at 10 weeks. Safety endpoint was the patients' rate free from lead-related complications. Performance endpoint was the rate of patients with successful lead performance, defined as LV pacing threshold ≤2.5 V at 0.5 ms on at least one pacing vector, and the absence of phrenic nerve stimulation at the final programmed configuration. Lead-related complications and electrical parameters were monitored throughout study. RESULTS A NAVIGO 4LV lead was successfully implanted in 211 out of 217 patients (97.2%). The safety endpoint was met, with 100% and 96.1% of patients free from complications for NAVIGO 4LV 2D and ARC, respectively. The performance endpoint was met with 98.1% and 98.9% of patients with a successful lead performance for NAVIGO 4LV 2D and ARC, respectively. Over 12 months, the global complication-free rate for both leads was 97.1% (95% CI: 93.71% to 98.70%), with a mean pacing capture threshold of 1.23 V±0.73 V and a mean impedance of 951 Ω±300.1 Ω. CONCLUSION A high implantation success rate and low complication rate was reported for the novel NAVIGO 4LV 2D and ARC leads, along with successful performance up to 12 months.
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Affiliation(s)
- Juan Gabriel Martinez
- Hospital General Universitario Dr.Balmis. Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | | | | | | | | | | | | | | | | | - Yann Michel
- Microport CRM, Clamart, Île-de-France, France
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Mahmoudi K, Galea R, Elhadad S, Temperli F, Sebag F, Gräni C, Rezine Z, Roten L, Landolff Q, Brugger N, Masri A, Räber L, Amabile N. Computed Tomography Scan Evidence for Left Atrial Appendage Short-Term Remodeling Following Percutaneous Occlusion: Impact of Device Oversizing. J Am Heart Assoc 2023; 12:e030037. [PMID: 37609989 PMCID: PMC10547351 DOI: 10.1161/jaha.123.030037] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/11/2023] [Indexed: 08/24/2023]
Abstract
Background The interrelationships between left atrial appendage (LAA) dimensions and device following implantation are unknown. We aimed to analyze the impact of Watchman device implantation on LAA dimensions following its percutaneous closure and potential predictors of remodeling. Methods and Results All consecutive LAA closure procedures performed at 2 centers between November 2017 and December 2020 were included in the WATCH-DUAL (Watchman 2.5 Versus Watchman FLX in a Dual-Center Left Atrial Appendage Closure Cohort) registry. This study included patients who had pre- and postintervention computed tomography scan analysis. The LAA and device dimensions were measured in a centralized core lab by 3-dimensional computed tomography scan reconstruction methods, focusing on the device landing zone. This analysis included 104 patients (age, 76.0 [range, 72.0-83.0] years; 72% men; 53% Watchman FLX; 47% Watchman 2.5). The baseline characteristics were comparable between Watchman 2.5 and Watchman FLX groups, except for the higher use of oversizing in the latter group. The median delay for computed tomography control was 49 (range, 43-64) days. The landing zone area (median, 446 [range, 363-523] versus 290 [222-366] mm2; P<0.001) and minimal diameter (median, 23.0 [range, 20.7-24.8] versus 16.7 [14.7-19.4] mm; P<0.001) significantly increased after implantation. The absolute (median, 157 [range, 98-220] versus 85 [18-148] mm2, P<0.001) and relative (median, 50% [range, 32%-79%] versus 26% [4%-50%]; P<0.001) increases in landing zone area were more pronounced in patients with oversized device. Baseline LAA dimensions were smaller, landing zone eccentricity larger, and oversized device more frequent in patients with significant overexpansion compared with the others. Conclusions LAA dimensions increased at the site of the Watchman prosthesis after implantation, suggesting a local positive remodeling after the procedure. This phenomenon was more pronounced in the case of oversized devices.
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Affiliation(s)
- Khalil Mahmoudi
- Cardiology DepartmentInstitut Mutualiste MontsourisParisFrance
| | - Roberto Galea
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | - Simon Elhadad
- Cardiology Department, Centre Hospitalier Marne la Vallée, JossignyFrance
| | - Fabrice Temperli
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | - Frederic Sebag
- Cardiology DepartmentInstitut Mutualiste MontsourisParisFrance
| | - Christoph Gräni
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | - Zhor Rezine
- Cardiology Department, Centre Hospitalier Marne la Vallée, JossignyFrance
| | - Laurent Roten
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | | | - Nicolas Brugger
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | - Alaa Masri
- Cardiology DepartmentInstitut Mutualiste MontsourisParisFrance
| | - Lorenz Räber
- Cardiology Department, Inselspital, Bern University HospitalUniversity of BernSwitzerland
| | - Nicolas Amabile
- Cardiology DepartmentInstitut Mutualiste MontsourisParisFrance
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3
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Benali K, Barre V, Hermida A, Milhem A, Philibert S, Boveda S, Bars C, Anselme F, Maille B, André C, Behaghel A, Moubarak G, Clémenty N, Da Costa A, Arnaud M, Venier S, Sebag F, Jesel L, Macle L, Martins R. Atrial fibrillation recurrences despite durable pulmonary vein isolation: Characteristics, management and outcomes, the PARTY-PVI study. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.177] [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: 12/31/2022]
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4
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Ouvrard E, Mestier LD, Boursier C, Lachachi B, Sahakian N, Chevalier E, Mikail N, Carullo J, Bando-Delaunay A, Walter T, Malouf GG, Addeo P, Poncet G, Sebag F, Lebtahi R, Goichot B, Taïeb D, Imperiale A. 18F-DOPA PET/CT at the Forefront of Initial or Presurgical Evaluation of Small-Intestine Neuroendocrine Tumors. J Nucl Med 2022; 63:1865-1870. [PMID: 35589408 DOI: 10.2967/jnumed.122.263984] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/27/2022] [Indexed: 01/11/2023] Open
Abstract
Our objective was to compare the respective value of 68Ga-DOTATOC and 18F-DOPA PET/CT for initial staging or presurgical work-up of patients with small-intestine neuroendocrine tumors (SiNETs). Methods: This was a retrospective, multicenter, noninterventional investigation involving 53 non-surgically treated SiNET patients who underwent both 68Ga-DOTATOC and 18F-DOPA PET/CT within a 6-mo interval without surgical intervention or therapeutic change between the 2 PET/CT studies. Percentage detection rate was calculated according to per-region and per-lesion analyses. Sensitivity for primary tumor detection was assessed in 37 surgically treated patients, taking surgical results (76 SiNETs) as the diagnostic gold standard. Results: 68Ga-DOTATOC PET/CT and 18F-DOPA PET/CT individually identified at least 1 primary SiNET in 92% (34/37) of the patients. Intestinal tumor multifocality was confirmed by histology in 8 patients. 68Ga-DOTATOC and 18F-DOPA PET/CT were concordantly positive for tumor multifocality in 5 patients, discordantly positive in 2 patients, and concordantly negative in 1 patient. The detection rate for subdiaphragmatic nodal metastases on per-region-based analysis was 91% and 98% for 68Ga-DOTATOC and 18F-DOPA PET/CT, respectively (P = 0.18). 18F-DOPA PET/CT detected a higher number of abnormal subdiaphragmatic nodes (P = 0.009). Regarding mesenteric nodes only, 18F-DOPA PET/CT detected more positive regions (P = 0.005) and nodal lesions (P = 0.003) than 68Ga-DOTATOC PET/CT, including nodes at the origin of mesenteric vessels. For detection of distant metastases, 68Ga-DOTATOC and 18F-DOPA PET/CT performed equally well on a per-region-based analysis. As compared with 68Ga-DOTATOC, 18F-DOPA PET/CT detected more hepatic (P < 0.001), peritoneal (P < 0.001), and lung metastases (P < 0.001). Conclusion: 18F-DOPA PET/CT detected more lesions than 68Ga-DOTATOC PET/CT in the studied patients. The respective roles of the two should be discussed in terms of disease staging and treatment selection.
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Affiliation(s)
- Eric Ouvrard
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Louis De Mestier
- Department of Pancreatology and Digestive Oncology, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, and INSERM U1149, Centre of Research in Inflammation, Paris, France
| | | | | | - Nicolas Sahakian
- Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, France
| | | | - Nidaa Mikail
- Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, Paris, France
| | - Josefina Carullo
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France.,Nuclear Medicine, Sanatorio Allende S.A., Cordoba, Argentina
| | - Aurélie Bando-Delaunay
- Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, Paris, France
| | - Thomas Walter
- Medical Oncology, Edouard Herriot Hospital, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Gabriel G Malouf
- Oncology, Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | - Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Hospitals of Strasbourg, Strasbourg, France
| | - Gilles Poncet
- Digestive and Oncologic Surgery, Edouard-Herriot University Hospital, Claude-Bernard Lyon 1 University, Lyon, France
| | - Frederic Sebag
- Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseille, France
| | - Rachida Lebtahi
- Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, Paris, France
| | - Bernard Goichot
- Diabetes and Metabolic Disorders, Internal Medicine, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - David Taïeb
- Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, France.,European Center for Research in Medical Imaging, Aix-Marseille University, Marseille, France; and
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France; .,Molecular Imaging-DRHIM, IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France
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Menegaux F, Baud G, Chereau N, Christou N, Deguelte S, Frey S, Guérin C, Marciniak C, Paladino NC, Brunaud L, Caiazzo R, Donatini G, Gaujoux S, Goudet P, Hartl D, Lifante JC, Mathonnet M, Mirallié E, Najah H, Sebag F, Trésallet C, Pattou F. SFE-AFCE-SFMN 2022 consensus on the management of thyroid nodules: Surgical treatment. Ann Endocrinol (Paris) 2022; 83:415-422. [PMID: 36309207 DOI: 10.1016/j.ando.2022.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a condition that is a frequent reason for consultation in endocrinology. In more than 90% of cases, patients are euthyroid, with benign non-progressive nodules that do not warrant specific treatment. The clinician's objective is to detect malignant thyroid nodules at risk of recurrence and death, toxic nodules responsible for hyperthyroidism or compressive nodules warranting treatment. The diagnosis and treatment of thyroid nodules requires close collaboration between endocrinologists, nuclear medicine physicians and surgeons, but also involves other specialists. Therefore, this consensus statement was established jointly by 3 societies: the French Society of Endocrinology (SFE), French-speaking Association of Endocrine Surgery (AFCE) and French Society of Nuclear Medicine (SFMN); the various working groups included experts from other specialties (pathologists, radiologists, pediatricians, biologists, etc.). This section deals with the surgical management of thyroid nodules.
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Affiliation(s)
- Fabrice Menegaux
- Service de Chirurgie Générale, Viscérale et Endocrinienne, GH Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France.
| | - Gregory Baud
- Service de Chirurgie Générale et Endocrinienne, CHRU de Lille, Université de Lille, Lille, France
| | - Nathalie Chereau
- Service de Chirurgie Générale, Viscérale et Endocrinienne, GH Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France
| | - Niki Christou
- Service de Chirurgie Digestive, Endocrinienne et Générale, CHU de Limoges, Limoges, France
| | - Sophie Deguelte
- Service de Chirurgie Digestive et Endocrinienne, Hôpital Robert-Debré, Université de Champagne Ardennes, Reims, France
| | - Samuel Frey
- Service de Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, CHU de Nantes, Université de Nantes, Nantes, France
| | - Carole Guérin
- Service de chirurgie Générale, Endocrinienne et Métabolique, CHU La Conception, AP-HM, Aix Marseille Université, Marseille, France
| | - Camille Marciniak
- Service de Chirurgie Générale et Endocrinienne, CHRU de Lille, Université de Lille, Lille, France
| | - Nunzia Cinzia Paladino
- Service de chirurgie Générale, Endocrinienne et Métabolique, CHU La Conception, AP-HM, Aix Marseille Université, Marseille, France
| | - Laurent Brunaud
- Département de Chirurgie Viscérale, Métabolique et Cancérologique, Université de Lorraine, CHRU Nancy, Hôpital Brabois Adultes, Vandœuvre les Nancy, France
| | - Robert Caiazzo
- Service de Chirurgie Générale et Endocrinienne, CHRU de Lille, Université de Lille, Lille, France
| | - Gianluca Donatini
- Service de Chirurgie Viscérale et Endocrinienne, CHU-Poitiers, Poitiers Université, Poitiers, France
| | - Sebastien Gaujoux
- Service de Chirurgie Générale, Viscérale et Endocrinienne, GH Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France
| | - Pierre Goudet
- Département de Chirurgie Générale et Endocrinienne, CHU de Dijon, Université de Bourgogne, Dijon, France
| | - Dana Hartl
- Département d'Anesthésie, de Chirurgie et de Radiologie Interventionnelle, Unité de Chirurgie Thyroïdienne, Institut Gustave Roussy, Villejuif, France
| | - Jean-Christophe Lifante
- Service de Chirurgie Endocrinienne, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Muriel Mathonnet
- Service de Chirurgie Digestive, Endocrinienne et Générale, CHU de Limoges, Limoges, France
| | - Eric Mirallié
- Service de Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, CHU de Nantes, Université de Nantes, Nantes, France
| | - Haythem Najah
- Service de Chirurgie Digestive et Endocrinienne, Hôpital Haut Lévêque, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Frederic Sebag
- Service de chirurgie Générale, Endocrinienne et Métabolique, CHU La Conception, AP-HM, Aix Marseille Université, Marseille, France
| | - Christophe Trésallet
- Service de Chirurgie Digestive, Bariatrique et Endocrinienne, HU Paris Seine-Saint-Denis, AP-HP, Hôpital Avicenne, Bobigny, France
| | - Francois Pattou
- Service de Chirurgie Générale et Endocrinienne, CHRU de Lille, Université de Lille, Lille, France
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Galea R, Mahmoudi K, Gräni C, Elhadad S, Huber AT, Heg D, Siontis GCM, Brugger N, Sebag F, Windecker S, Valgimigli M, Landolff Q, Roten L, Amabile N, Räber L. Watchman FLX vs. Watchman 2.5 in a Dual-Center Left Atrial Appendage Closure Cohort: the WATCH-DUAL study. Europace 2022; 24:1441-1450. [PMID: 35253840 DOI: 10.1093/europace/euac021] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS No studies have compared Watchman 2.5 (W2.5) with Watchman FLX (FLX) devices to date. We aimed at comparing the FLX with W2.5 devices with respect to clinical outcomes, left atrial appendage (LAA) sealing properties and device-related thrombus (DRT). METHODS AND RESULTS All consecutive left atrial appendage closure (LAAC) procedures performed at two European centres between November 2017 and February 2021 were included. Procedure-related complications and net adverse cardiovascular events (NACE) at 6 months after LAAC were recorded. At 45-day computed tomography (CT) follow-up, intra- (IDL) and peri- (PDL) device leak, residual patent neck area (RPNA), and DRT were assessed by a Corelab. Out of 144 LAAC consecutive procedures, 71 and 73 interventions were performed using W2.5 and FLX devices, respectively. There were no differences in terms of procedure-related complications (4.2% vs. 2.7%, P = 0.626). At 45-day CT, the FLX was associated with lower frequency of IDL [21.3% vs. 40.0%; P = 0.032; odds ratio (OR): 0.375; 95% confidence interval (CI): 0.160-0.876; P = 0.024], similar rate of PDL (29.5% vs. 42.0%; P = 0.170), and smaller RPNA [6 (0-36) vs. 40 (6-115) mm2; P = 0.001; OR: 0.240; 95% CI: 0.100-0.577; P = 0.001] compared with the W2.5 group. At 45 days, rate of DRT as detected by CT and/or transoesophageal echocardiography (TOE), was higher with W2.5 (6.0% vs. 0%, P = 0.045). At 6-month follow-up, NACE did not differ between groups. CONCLUSIONS In this cohort of consecutive LAACs, FLX as compared to W2.5, was associated with similar procedure-related complications and 6-month NACE, but with improved LAA neck coverage, and lower IDL and DRT.
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Affiliation(s)
- Roberto Galea
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - Khalil Mahmoudi
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - Simon Elhadad
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France.,Cardiology Department, Jossigny, France
| | - Adrian T Huber
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - Dik Heg
- Clinical Trials Unit, University of Bern, Bern, Switzerland
| | - George C M Siontis
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - Nicolas Brugger
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - Frederic Sebag
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Stephan Windecker
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - Marco Valgimigli
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland.,Cardiocentro Ticino, Institute and Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Quentin Landolff
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Laurent Roten
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - Nicolas Amabile
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Lorenz Räber
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
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7
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Mahmoudi K, Galea R, Elhadad S, Rezine LZ, Sebag F, Landolff Q, Raber L, Amabile N. Left atrial appendage remodeling following percutaneous closure with WATCHMAN 2.5 and FLX: insights from the WATCH-DUAL registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2237] [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: 11/13/2022] Open
Abstract
Abstract
Background
Percutaneous left atrial appendage closure (LAAC) has emerged as a valid option for prevention of thromboembolic events in patients with non-valvular atrial fibrillation and contraindications for oral anticoagulation. The most recent devices have been created to improve the intervention efficiency and to allow the procedure in a wider range of anatomies. The new-generation Watchman FLX (WMFLX) features a new design but its in vivo performances have not been compared to the previous WATCHMAN 2.5 (WM2.5) prosthesis. Hence, the data regarding conformability, compression and device-related LAA remodeling are scarce.
Purpose
To compare the anatomical results of WM2.5 and WMFLX implantation and impact on LAA dimensions.
Methods
This study included LAAC patients from the WATCH-DUAL registry who benefited from a pre- and post-intervention CT scan. The WATCH-DUAL study was a dual center observational study including all the LAAC procedures prospectively collected in local registries from two high-volume centres between November 2017 and December 2020. The LAA and device dimensions were measured in a centralized core lab by 3D CT scan reconstruction methods, focusing on the device landing zone (LZ/defined as the cross section of the appendage that was perpendicular to its axis and connected the circumflex artery to a point 1 to 2 cm inside the LAA).
Results
This analysis included n=107 patients (n=58 WMFLX, n=49 WM2.5). The patients clinical profiles didn't differ, except for a higher proportion of coronary artery disease in WM2.5 group. The LAA dimensions were comparable between groups. There was a significantly higher proportion of chickenwing shapes in the WMFLX patients. The mean device baseline diameter was in the WMFLX compared to the WM2.5 patients (28.8±0.5 vs. 25.7±0.4 mm, p<0.001).
The median delay for CT control was 48 (43–62) days. The LZ area (451 (363–521) vs. 366 (260–459) mm2, p<0.001) and minimal diameter (23.0 (20.7–24.8) vs. 18.7 (15.9–21.8) mm, p<0.001) significantly increased after implantation among patients. The LZ area increase absolute value and percentage were 101 (18–151) mm2 and 28 (4–54) % respectively. The LZ dimensions increase was more pronounced in the WMFLX group: these patients exhibited post LAAC larger LZ area and dimensions compared to the WM2.5 cases. The LAA eccentricity was reduced after implantation: the ratio LZ maximal/LZ minimal diameter significantly decreased for all patients (r=1.28 (1.18–1.40) vs. 1.06 (1.05–1.09), p<0.001). Comparable results were observed in WMFLX and WM2.5 patients.
A multivariable regression analysis demonstrated that baseline LAA length, baseline LZ eccentricity and WM FLX use were independent predictors of LAA remodeling/dimensions increase.
Conclusion
LAA dimensions increased over time at the site of WM prosthesis implantation suggesting a local positive appendage remodeling after procedure. This phenomenon appears to be more pronounced with the WMFLX device.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Mahmoudi
- Institut Mutualiste Montsouris, Paris, France
| | - R Galea
- Inselspital - University of Bern, Bern, Switzerland
| | - S Elhadad
- JOSSIGNY SITE OF GHEF MARNE LA VALLEE, Jossigny, France
| | - L Z Rezine
- JOSSIGNY SITE OF GHEF MARNE LA VALLEE, Jossigny, France
| | - F Sebag
- Institut Mutualiste Montsouris, Paris, France
| | - Q Landolff
- Institut Mutualiste Montsouris, Paris, France
| | - L Raber
- Inselspital - University of Bern, Bern, Switzerland
| | - N Amabile
- Institut Mutualiste Montsouris, Paris, France
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8
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Hindié E, Schwartz P, Avram AM, Imperiale A, Sebag F, Taïeb D. Primary Hyperparathyroidism: Defining the Appropriate Preoperative Imaging Algorithm. J Nucl Med 2021; 62:3S-12S. [PMID: 34230072 DOI: 10.2967/jnumed.120.245993] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/21/2020] [Indexed: 11/16/2022] Open
Abstract
Primary hyperparathyroidism is a common and potentially debilitating endocrine disorder for which surgery is the only curative treatment. Preoperative imaging is always recommended, even in cases of conventional bilateral neck exploration, with a recognized role for 99mTc-sestamibi scintigraphy in depicting ectopic parathyroid lesions. Scintigraphy can also play a major role in guiding a targeted, minimally invasive parathyroidectomy. However, the ability to recognize multiple-gland disease (MGD) varies greatly depending on the imaging protocol used. Preoperative diagnosis of MGD is important to reduce the risks of conversion to bilateral surgery or failure. In this article we discuss imaging strategies before first surgery as well as in the case of repeat surgery for persistent or recurrent primary hyperparathyroidism. We describe a preferred algorithm and alternative options. Dual-tracer 99mTc-sestamibi/123I subtraction scanning plus neck ultrasound is the preferred first-line option. This approach should improve MGD detection and patient selection for minimally invasive parathyroidectomy. Second-line imaging procedures in case of negative or discordant first-line imaging results are presented. High detection rates can be obtained with 18F-fluorocholine PET/CT or with 4-dimensional CT. The risk of false-positive results should be kept in mind, however. Adding a contrast-enhanced arterial-phase CT acquisition to conventional 18F-fluorocholine PET/CT can be a way to improve accuracy. We also briefly discuss other localization procedures, including 11C-methionine PET/CT, MRI, ultrasound-guided fine-needle aspiration, and selective venous sampling for parathyroid hormone measurement.
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Affiliation(s)
- Elif Hindié
- Department of Nuclear Medicine, University Hospitals of Bordeaux, TRAIL, University of Bordeaux, Bordeaux, France;
| | - Paul Schwartz
- Department of Nuclear Medicine, University Hospitals of Bordeaux, TRAIL, University of Bordeaux, Bordeaux, France
| | - Anca M Avram
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, University of Strasbourg, IPHC, Strasbourg, France
| | - Frederic Sebag
- Endocrine Surgery, La Timone Hospital, Aix-Marseille University, Marseille, France; and
| | - David Taïeb
- Nuclear Medicine, La Timone Hospital, CERIMED, Aix-Marseille University, Marseille, France
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9
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Baboudjian M, Mhatli M, Bourouina A, Gondran-Tellier B, Anastay V, Perez L, Proye P, Lavieille JP, Duchateau F, Agostini A, Wazne Y, Sebag F, Foletti JM, Chossegros C, Raoult D, Touati J, Chagnaud C, Michel J, Bertrand B, Giovanni A, Radulesco T, Sartor C, Fournier PE, Lechevallier E. Is minor surgery safe during the COVID-19 pandemic? A multi-disciplinary study. PLoS One 2021; 16:e0251122. [PMID: 33974628 PMCID: PMC8112651 DOI: 10.1371/journal.pone.0251122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/20/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND To assess the risk of postoperative SARS-CoV-2 infection during the COVID-19 pandemic. METHODS The CONCEPTION study was a cohort, multidisciplinary study conducted at Conception University Hospital, in France, from March 17th to May 11th, 2020. Our study included all adult patients who underwent minor surgery in one of the seven surgical departments of our hospital: urology, digestive, plastic, gynecological, otolaryngology, gynecology or maxillofacial surgery. Preoperative self-isolation, clinical assessment using a standardized questionnaire, physical examination, nasopharyngeal RT-PCR and chest CT scan performed the day before surgery were part of our active prevention strategy. The main outcome was the occurrence of a SARS-CoV-2 infection within 21 days following surgery. The COVID-19 status of patients after discharge was updated during the postoperative consultation and to ensure the accuracy of data, all patients were contacted again by telephone. RESULTS A total of 551 patients from six different specialized surgical Departments in our tertiary care center were enrolled in our study. More than 99% (546/551) of included patients underwent a complete preoperative Covid-19 screening including RT-PCR testing and chest CT scan upon admission to the Hospital. All RT-PCR tests were negative and in 12 cases (2.2%), preoperative chest CT scans detected pulmonary lesions consistent with the diagnosis criteria for COVID-19. No scheduled surgery was postponed. One patient (0.2%) developed a SARS-CoV-2 infection 20 days after a renal transplantation. No readmission or COVID-19 -related death within 30 days from surgery was recorded. CONCLUSIONS Minor surgery remained safe in the COVID-19 Era, as long as all appropriate protective measures were implemented. These data could be useful to public Health Authorities in order to improve surgical patient flow during a pandemic.
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Affiliation(s)
- Michael Baboudjian
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France
| | - Mehdi Mhatli
- Department of Otorhinolaryngology- Head & Neck Surgery, APHM, Aix-Marseille University, Conception University Hospital, Marseilles, France.,Department of Head and Neck Surgery, Conception University Hospital, Aix-Marseille University, Marseilles, France
| | - Adel Bourouina
- Department of Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseilles, France
| | - Bastien Gondran-Tellier
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France
| | - Vassili Anastay
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France
| | - Lea Perez
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France
| | - Pauline Proye
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France
| | - Jean-Pierre Lavieille
- Department of Head and Neck Surgery, Conception University Hospital, Aix-Marseille University, Marseilles, France
| | - Fanny Duchateau
- Department of Obstetrics and Gynecology, Conception Hospital, Marseilles, France
| | - Aubert Agostini
- Department of Obstetrics and Gynecology, Conception Hospital, Marseilles, France
| | - Yann Wazne
- Department of Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseilles, France
| | - Frederic Sebag
- Department of Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseilles, France
| | - Jean-Marc Foletti
- Department of Oral and maxillofacial Surgery, Aix Marseille University, APHM, IFSTTAR, LBA, Conception University Hospital, Marseilles, France
| | - Cyrille Chossegros
- Department of Oral and maxillofacial Surgery, Aix Marseille University, APHM, IFSTTAR, LBA, Conception University Hospital, Marseilles, France
| | - Didier Raoult
- Aix-Marseille University, IRD, AP-HM, IHU Méditerranée Infectious Disease Research Institute, Marseilles, France
| | - Julian Touati
- Department of Radiology, Conception University Hospital, APHM, Marseilles, France
| | - Christophe Chagnaud
- Department of Radiology, Conception University Hospital, APHM, Marseilles, France
| | - Justin Michel
- Department of Otorhinolaryngology- Head & Neck Surgery, APHM, Aix-Marseille University, Conception University Hospital, Marseilles, France
| | - Baptiste Bertrand
- Department of Plastic Surgery, Conception University Hospital, APHM, Marseilles, France
| | - Antoine Giovanni
- Department of Otorhinolaryngology- Head & Neck Surgery, APHM, Aix-Marseille University, Conception University Hospital, Marseilles, France
| | - Thomas Radulesco
- Department of Otorhinolaryngology- Head & Neck Surgery, APHM, Aix-Marseille University, Conception University Hospital, Marseilles, France
| | - Catherine Sartor
- Operational Hospital Hygiene Team, Conception University Hospital, Marseilles, France
| | - Pierre-Edouard Fournier
- Aix-Marseille University, IRD, AP-HM, IHU Méditerranée Infectious Disease Research Institute, Marseilles, France
| | - Eric Lechevallier
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseilles, France
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10
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Owens PW, McVeigh TP, Miller N, Guerin C, Sebag F, Quill D, Bell M, Kerin MJ, Lowery AJ. FOXE1 polymorphism rs965513 predisposes to thyroid cancer in a European cohort. Endocr Oncol 2021; 1:1-8. [PMID: 37435181 PMCID: PMC10265543 DOI: 10.1530/eo-21-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 07/13/2023]
Abstract
Objective FOXE1 is an intronless gene on chromosome 9 which plays a significant role in thyroid morphogenesis. Mutations in FOXE1 are associated with thyroid phenotypes including congenital hypothyroidism, thyroid dysgenesis and thyroid cancer. This study aims to investigate the frequency and impact of a SNP (rs965513, G>A) at 9q22.23 in a Western European cohort of patients with differentiated thyroid cancer(DTC), compared to controls. Design This is a candidate gene case control study. Methods 277 patients with histologically confirmed DTC were recruited from tertiary referral centres in Ireland and France. 309 cancer-free controls were recruited from the community. DNA was extracted from buccal swabs or whole blood of control subjects and patients with DTC. Allelic and genotypic frequencies among patients were compared with controls, to assess the risk for disease conferred by homozygous and heterozygous carriers compared to WT genotypes. Genotyping was performed using Taqman-based PCR. Results 277 patients with confirmed DTC and 309 non-cancer controls were genotyped for the variant (rs965513). The frequency of the minor allele among cases was 0.45 compared to 0.34 among controls. The genotypic odds ratio for heterozygotes was 1.66 (CI 1.16-2.39, P =0.00555), increasing to 2.93 (CI 1.70-5.05, P =0.00007) for rare homozygotes. All subjects were in Hardy-Weinberg equilibrium (±χ2, P =0.09, P =0.07 respectively). Conclusions This FOXE1 polymorphism is a low penetrance variant associated with DTC susceptibility in this cohort. The minor allele was identified among patients with thyroid cancer significantly more frequently than controls. An allele dosage effect was observed, with rare homozygous genotypes conferring greater risk than heterozygotes.
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Affiliation(s)
- Patrick W Owens
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland, Galway, Ireland
| | | | - Nicola Miller
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland, Galway, Ireland
| | - Carole Guerin
- Department of Endocrine Surgery Centre hospitalo-universitaire de La Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Frederic Sebag
- Department of Endocrine Surgery Centre hospitalo-universitaire de La Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Denis Quill
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland, Galway, Ireland
| | - Marcia Bell
- Department of Endocrinology, School of Medicine, National University of Ireland, Galway, Ireland
| | - Michael J Kerin
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland, Galway, Ireland
| | - Aoife J Lowery
- Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, National University of Ireland, Galway, Ireland
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11
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Lepillier A, Solimene F, De Ruvo E, Scaglione M, Anselmino M, Sebag F, Pecora D, Gallagher M, Rillo M, Stabile G. Reproducibility of pulmonary vein isolation guided by the ablation index: One-year outcome of the AIR registry. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Pasteur-Rousseau A, Sebag F. [Cardiac CT-Scan: Utility for the management of chest pain, cardiovascular screening and before atrial fibrillation ablation procedure]. Ann Cardiol Angeiol (Paris) 2020; 69:276-288. [PMID: 33071021 DOI: 10.1016/j.ancard.2020.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/18/2020] [Indexed: 01/22/2023]
Abstract
Cardiac CT-scan is recommended for sorting patients presenting with stable or acute chest pain with low to intermediate risk of coronary artery disease (CAD). Recent studies have shown its reliability for diagnosing CAD in high-risk patients, notably those with acute coronary syndrome (ACS) without ST-elevation. Coronary CT-scan also represents a great opportunity for the screening of atherosclerosis in patients at risk and allows a better prevention of coronary artery disease by introduction of preventive treatments in patients with abnormal coronary CT-scan, especially statins. It is useful for the follow-up of patients who underwent a coronary arteries revascularization with either stents or bypasses. Coronary arteries calcium scoring appears to be an independent predictive factor of cardiovascular and total mortality and its use is recommended for stratifying the cardiovascular risk. However, its interpretation remains unobvious and the patient management is poorly improved by the results. Anyway, if the score is above zero, atherosclerosis is present and therefore a lipid lowering treatment should be discussed. Cardiac CT-scan has become the Gold Standard exam before an aortic valve replacement, for the measurement of the aortic root notably, allowing the best prothesis selection. Before atrial fibrillation ablation procedure by pulmonary vein isolation, the cardiac CT-scan allows a 3-D visualization of the two atria, especially the left atrium, and rules out any suspicion of cardiac thrombus. It allows the research of an anomalous pulmonary venous connection. The 3-D support will also enable the operator to navigate in the heart during the ablation procedure.
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Affiliation(s)
- A Pasteur-Rousseau
- Institut Cœur Paris Centre, clinique Turin, Clinique internationale du Parc Monceau, clinique Floréal, 31, rue du Petit-Musc, 75004 Paris, France.
| | - F Sebag
- Institut mutualiste Montsouris, Clinique Turin, Paris, France.
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13
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Sebag F, Galea R, Lepillier A, Moubarak G, Darmon A, Raber L, Amabile N. TCT CONNECT-444 Feasibility and Safety of Left Atrial Appendage (LAA) Occlusion in Presence of LAA Thrombus: The TRAPEUR Registry (Thrombus Trapping European Registry). J Am Coll Cardiol 2020. [DOI: 10.1016/j.jacc.2020.09.472] [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: 11/25/2022]
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14
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Amodru V, Taieb D, Guerin C, Romanet P, Paladino N, Brue T, Cuny T, Barlier A, Sebag F, Castinetti F. MEN2-related pheochromocytoma: current state of knowledge, specific characteristics in MEN2B, and perspectives. Endocrine 2020; 69:496-503. [PMID: 32388798 DOI: 10.1007/s12020-020-02332-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 04/25/2020] [Indexed: 12/19/2022]
Abstract
Multiple endocrine neoplasia type 2 (MEN2) is a rare hereditary syndrome due to mutations of the proto-oncogene REarranged during Transfection (RET), defined by the association of medullary thyroid carcinoma (MTC) in almost 100% cases, and pheochromocytoma in roughly 50% (primary hyperparathyroidism can be seen in 10-20% of patients with MEN2A). Early thyroidectomy and the efficacy of novel tyrosine kinase inhibitors modified the natural history of MTC, with possibilities of cure or long-term control. The second main compound, pheochromocytoma, is reported with a variable penetrance, from 10 to 80% cases, depending on the mutation of RET. Pheochromocytoma constitutes the main disease to screen in patients with RET mutations. Pheochromocytoma clinical and biochemical diagnosis, as well as the way to treat it are thus crucial. This review will thus focus on the epidemiological specificities of MEN2-related pheochromocytoma, the genotype/phenotype relationship, the modern imaging modalities necessary to confirm the diagnosis in this hereditary context, as well as the optimal management and the possibilities of adrenal sparing surgery. Additional information will include the natural history of MEN2B-pheochromocytoma, the rare cases of malignant pheochromocytoma, and the factors that could modify the penetrance between individuals carrying the same mutation, especially in the same family.
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Affiliation(s)
- Vincent Amodru
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - David Taieb
- Department of Nuclear Medicine, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Carole Guerin
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Pauline Romanet
- Department of Molecular Biology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Nunzia Paladino
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Thierry Brue
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Thomas Cuny
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Anne Barlier
- Department of Molecular Biology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Frederic Sebag
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Frederic Castinetti
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France.
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15
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Amodru V, Taieb D, Guerin C, Romanet P, Paladino N, Brue T, Cuny T, Barlier A, Sebag F, Castinetti F. Correction to: MEN2-related pheochromocytoma: current state of knowledge, specific characteristics in MEN2B, and perspectives. Endocrine 2020; 69:695. [PMID: 32488836 DOI: 10.1007/s12020-020-02365-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Vincent Amodru
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - David Taieb
- Department of Nuclear Medicine, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Carole Guerin
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Pauline Romanet
- Department of Molecular Biology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Nunzia Paladino
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Thierry Brue
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Thomas Cuny
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Anne Barlier
- Department of Molecular Biology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Frederic Sebag
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Frederic Castinetti
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France.
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16
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Amodru V, Taieb D, Guerin C, Romanet P, Paladino N, Brue T, Cuny T, Barlier A, Sebag F, Castinetti F. Correction to: MEN2-related pheochromocytoma: current state of knowledge, specific characteristics in MEN2B, and perspectives. Endocrine 2020:10.1007/s12020-020-02408-z. [PMID: 32666384 DOI: 10.1007/s12020-020-02408-z] [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: 11/25/2022]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Vincent Amodru
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - David Taieb
- Department of Nuclear Medicine, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Carole Guerin
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Pauline Romanet
- Department of Molecular Biology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Nunzia Paladino
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Thierry Brue
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Thomas Cuny
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Anne Barlier
- Department of Molecular Biology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Frederic Sebag
- Department of Endocrine Surgery, Aix-Marseille University, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - Frederic Castinetti
- Department of Endocrinology, Aix-Marseille University, INSERM U1251, Endo-ERN Reference Center for Rare Genetic Tumor Syndromes, Assistance Publique-Hopitaux de Marseille, Marseille, France.
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17
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Landolff Q, Sebag F, Costanzo A, Honton B, Amabile N. Covered Stent Implantation for Treatment of Iliac Vein Rupture During Percutaneous Left Atrial Appendage Occlusion. JACC Case Rep 2020; 2:894-897. [PMID: 34317376 PMCID: PMC8302053 DOI: 10.1016/j.jaccas.2020.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/26/2020] [Accepted: 05/05/2020] [Indexed: 06/13/2023]
Abstract
An 82-year-old woman who experienced an iatrogenic external iliac vein perforation during a left atrial appendage occlusion procedure was successfully treated by endovascular graft implantation. We report the short- and long-term outcomes of the procedure. (Level of Difficulty: Advanced.).
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Affiliation(s)
- Quentin Landolff
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Frederic Sebag
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Alessandro Costanzo
- Department of Vascular Surgery, Institut Mutualiste Montsouris, Paris, France
| | - Benjamin Honton
- Department of Interventional Cardiology, Clinique Pasteur, Toulouse, France
| | - Nicolas Amabile
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
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18
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Porterfield C, Wystrach A, Rossi P, Rillo M, Sebag F, Dorszewski A, Gora P, Nilsson K. P1023Comparison of gap identification using three technologies for confirmation of pulmonary vein isolation. Europace 2020. [DOI: 10.1093/europace/euaa162.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation. Tools and techniques used for confirmation of PVI vary greatly, and it is unclear whether the use of any particular combination of tools and techniques provides greater sensitivity for identifying gaps periprocedurally. A high-density mapping catheter enabling simultaneous recording of adjacent bipolar EGMs in two directions is now available in multiple geographies, and it has been suggested that this technology may provide improved sensitivity for gap identification.
Purpose
To identify trends in the incidence of gaps identified in de novo PVI lines using three diagnostic catheter technologies, which may be suggestive of improved sensitivity for gap identification.
Methods
Self-reported procedural data was prospectively collected in de novo atrial fibrillation ablation cases utilizing one of three technologies to confirm PVI: 10-pole circular mapping catheter (CMC10), 20-pole circular mapping catheter (CMC20), and Advisor HD Grid catheter (HD Grid). Techniques for PVI confirmation were analyzed for each group, and the incidence and location of gaps identified by each technology was quantified.
Results
Data was collected in 99 cases across 11 centers in Europe and the United States. PVI was confirmed via entrance and/or exit block in all cases. CMC10 was utilized in 30 cases, CMC20 in 36, and HD Grid in 33. Use of adenosine varied across groups (CMC10: 6.7%; CMC20: 86.1%; HD Grid: 41.7%), as did application of a waiting period (CMC10: 96.7%; CMC20: 2.8%; HD Grid: 11.1%). Gaps were identified in in 36.7%, 38.9%, and 81.8% of cases using CMC10, CMC20, and HD Grid, respectively. HD Grid identified significantly more gaps than the other two technologies (p = 0.015), identifying an average of 49.0% and 139.1% more gaps per patient than CMC20 and CMC10, respectively (HD Grid: 2.15/patient; CMC20: 1.44/patient; CMC10: 0.9/patient). The location and incidence of gaps identified by each technology is shown in Figure 1.
Conclusions
Significantly more gaps were identified by the Advisor HD Grid catheter, as compared to a 10-pole or 20-pole circular mapping catheter. While this does not represent a direct comparison of the sensitivity for identification of gaps across these three technologies, and results could be impacted by other factors (e.g., operator, ablation technique, PVI confirmation technique, etc.), the strong trend toward an increased number of gaps identified with the HD Grid is striking. This may warrant further study including direct comparison of gap identification across technologies, and the resulting impact on long-term clinical outcomes when these additional gaps are ablated during the index procedure.
Abstract Figure.
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Affiliation(s)
- C Porterfield
- French Hospital, San Luis Obispo, CA, United States of America
| | - A Wystrach
- Sozialstiftung Klinikum Bamberg, Bamberg, Germany
| | - P Rossi
- S. Giovanni Calibita FateBeneFratelli – Isola Tiberina, Rome, Italy
| | - M Rillo
- Casa di Cura Villa Verde, Taranto, Italy
| | - F Sebag
- Institut Mutualiste Montsouris, Departement de Cardiologie, Paris, France
| | - A Dorszewski
- Evangelisches Krankenhaus Dinslaken, Dinslaken, Germany
| | - P Gora
- Abbott, Minneapolis, United States of America
| | - K Nilsson
- Piedmont Athens Regional Medical Center, Athens, GA, United States of America
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19
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Amabile N, Bagdadi I, Armero S, Elhadad S, Sebag F, Landolff Q, Saby L, Mechulan A, Boulanger CM, Caussin C. Impact of left atrial appendage closure on circulating microvesicles levels: The MICROPLUG study. Int J Cardiol 2020; 307:24-30. [PMID: 31668659 DOI: 10.1016/j.ijcard.2019.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 09/05/2019] [Accepted: 10/14/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Left atrial appendage occlusion (LAAO) has emerged as a valid alternative to oral anticoagulation therapy for the prevention of systemic embolism in patients with non-valvular atrial fibrillation (NVAF). Microvesicles (MVs) are shed-membrane particles generated during various cellular types activation/apoptosis that carry out diverse biological effects. LAA has been suspected to be a potential source of MVs during AF, but the effects its occlusion on circulating MVs levels are unknown. METHODS N = 25 LAAO and n = 25 control patients who underwent coronary angiography were included. Blood samples were drawn before and 48 h after procedure for all. A third sample was collected 6 weeks after procedure in LAAO patients. In N = 10 extra patients, samples were collected from right atrium, LAA and pulmonary vein during LAAO procedure. Circulating AnnV + procoagulant, endothelial, platelets, red blood cells/RBC and leukocytes derived-MVs were measured using flow cytometry methods. RESULTS In the LAAO group, AnnV+, platelets, RBC, and leukocytes MVs were significantly increased following intervention, whereas only AnnV + MVs levels significantly rose in controls. The 6-w analysis showed that RBC-MVs and AnnV + MVs levels were still significantly elevated compared to baseline values in LAAO patients. The in-site analysis revealed that leukocytes and CD62e + endothelial-MVs were significantly higher in left atrial appendage compared to pulmonary vein, suggesting a local increased production. No major adverse event was observed in any patient post procedural course. CONCLUSIONS LAAO impacts circulating MVs and might create mild pro-coagulant status and potential erythrocytes activation due to the device healing during the first weeks following intervention.
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Affiliation(s)
- Nicolas Amabile
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France.
| | - Imane Bagdadi
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | | | - Simon Elhadad
- Department of Cardiology, CH Marne La Vallée, Jossigny, France
| | - Frederic Sebag
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Quentin Landolff
- Department of Cardiology, Institut Mutualiste Montsouris, Paris, France
| | - Ludivine Saby
- Department of Cardiology, Hôpital Européen, Marseille, France
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20
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Stabile G, Lepillier A, De Ruvo E, Scaglione M, Anselmino M, Sebag F, Pecora D, Gallagher M, Rillo M, Viola G, Rossi L, De Santis V, Landolina M, Castro A, Grimaldi M, Badenco N, Del Greco M, De Simone A, Pisanò E, Abbey S, Lamberti F, Pani A, Zucchelli G, Sgarito G, Dugo D, Bertaglia E, Strisciuglio T, Solimene F. Reproducibility of pulmonary vein isolation guided by the ablation index: 1-year outcome of the AIR registry. J Cardiovasc Electrophysiol 2020; 31:1694-1701. [PMID: 32369225 DOI: 10.1111/jce.14531] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Ablation index (AI) is a new lesion quality marker that has been demonstrated to allow a high single-procedure arrhythmia-free survival in single-center studies. This prospective, multi-center study was designed to evaluate the reproducibility of pulmonary vein (PV) isolation guided by the AI. METHODS A total of 490 consecutive patients with paroxysmal (80.4%) and persistent AF underwent first time PV isolation and were divided in four study groups according to operator's preference in choosing the ablation catheter (a contact force (ST) or contact force surround flow (STSF) catheter) and the AI setting (330-450 or 380-500 at anterior wall or posterior wall, respectively). RESULTS At 12 months a high rate of freedom from AF recurrences was observed in patients with both paroxysmal and persistent AF (91% vs 83.3%; P = .039). There was no difference in the rate of AF recurrence among the four study groups (4.5% in group ST330-450, 12.2% in group ST 380-500, 14.9% in group STSF330-450, 9.4% in group STSF380-500; P = .083). Recurrence was also similar between patients treated with a ST (8%) or STSF catheter (12.1%; P = .2), and within patients targeting an AI settings of 330 to 450 (10.9%) or 380 to 500 (10.3%; P = .64). In patients with paroxysmal AF, there was no difference (P = .12) in the 1-year freedom from AF recurrence among 14 operators that performed ≥10 ablation procedure. CONCLUSIONS An ablation protocol respecting strict criteria for contiguity and quality lesion resulted in high rate of 1-year freedom from AF recurrence, irrespective of the ablation catheters, AI settings, and operator.
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Affiliation(s)
- Giuseppe Stabile
- Clinica Montevergine, Mercogliano, Avellino, Italy.,Clinica San Michele, Maddaloni, Caserta, Italy.,Anthea Hospital, Bari, Italy
| | | | | | | | - Matteo Anselmino
- Department of Medical Sciences, A. O. U. Citta della Salute e della Scienza di Torino, University of Turin, Italy
| | | | | | | | | | | | - Luca Rossi
- Ospedale Civili Guglielmo da Saliceto, Piacenza, Italy
| | | | | | | | - Massimo Grimaldi
- Ospedale Regionale Miulli, Acquaviva delle Fonti, Metropolitan City of Bari, Italy
| | | | | | | | | | - Salim Abbey
- Hôpital Privé Du Confluent (HPCN), Nantes, France
| | | | | | | | | | - Daniela Dugo
- AUO Policlinico Vittorio Emanuele, Catania, Italy
| | - Emanuele Bertaglia
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, Padua, Italy
| | - Teresa Strisciuglio
- Clinica Montevergine, Mercogliano, Avellino, Italy.,Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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21
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Baud G, Brunaud L, Lifante JC, Tresallet C, Sebag F, Bizard JP, Mathonnet M, Menegaux F, Caiazzo R, Mirallié E, Pattou F. Endocrine surgery during and after the COVID-19 epidemic: Expert guidelines from AFCE. J Visc Surg 2020; 157:S43-S49. [PMID: 32448761 PMCID: PMC7190473 DOI: 10.1016/j.jviscsurg.2020.04.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The COVID-19 pandemic commands a major reorganisation of the entire French healthcare system. In France, general rules have been issued nationally and implemented by each healthcare centre, both public and private, throughout France. Guidelines drafted by an expert group led by the French-speaking Association of Endocrine Surgery (AFCE) propose specific surgical management principles for thyroid, parathyroid, endocrine pancreas and adrenal surgery during and after the COVID-19 epidemic.
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Affiliation(s)
- G Baud
- Chirurgie générale et endocrinienne, CHU de Lille, 59000 Lille, France
| | - L Brunaud
- Chirurgie viscérale, métabolique et cancérologique (CVMC), CHRU de Nancy, 54511 Vandœuvre-lès-Nancy, France
| | - J-C Lifante
- Chirurgie digestive, oncologique et endocrinienne, CHU de Lyon, 69310 Pierre-Bénite, France
| | - C Tresallet
- Chirurgie viscérale et digestive, AP-HP, hôpital Avicenne, 93000 Bobigny, France
| | - F Sebag
- Chirurgie générale et endocrinienne, AP-HM, La Conception, 13005 Marseille, France
| | - J-P Bizard
- Chirurgie endocrinienne et viscérale, hôpital privé Arras-les-Bonnettes, 62000 Arras, France
| | - M Mathonnet
- Chirurgie digestive et endocrinienne, CHU de Limoges, 87000 Limoges, France
| | - F Menegaux
- Chirurgie générale digestive et endocrinienne, AP-HP, hôpital Pitié-Salpêtrière, Sorbonne université, 75013 Paris, France
| | - R Caiazzo
- Chirurgie générale et endocrinienne, CHU de Lille, 59000 Lille, France
| | - E Mirallié
- Chirurgie cancérologique, digestive et endocrinienne (CCDE), CHU de Nantes, 44093 Nantes, France
| | - F Pattou
- Chirurgie générale et endocrinienne, CHU de Lille, 59000 Lille, France.
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22
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Baud G, Brunaud L, Lifante JC, Tresallet C, Sebag F, Bizard JP, Mathonnet M, Menegaux F, Caiazzo R, Mirallié É, Pattou F. [Endocrine surgery during and after the COVID-19 epidemic: Guidelines from AFCE]. ACTA ACUST UNITED AC 2020; 157:S44-S51. [PMID: 32355510 PMCID: PMC7190492 DOI: 10.1016/j.jchirv.2020.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
La pandémie de COVID-19 impose une réorganisation majeure de l’ensemble de notre système de soins. En France, des règles générales ont été diffusées au niveau national et sont déclinées par chaque établissement, public comme privé, sur l’ensemble du territoire. Ces recommandations, rédigées par un groupe d’experts sous l’égide de l’Association francophone de chirurgie endocrinienne (AFCE), ont pour objectif de proposer des principes spécifiques de prise en charge chirurgicale au cours et au décours de l’épidémie de COVID- 19, pour les pathologies chirurgicales de la thyroïde, des parathyroïdes, du pancréas endocrine, et des surrénales.
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Affiliation(s)
- G Baud
- Chirurgie générale et endocrinienne, CHU de Lille, 59000 Lille, France
| | - L Brunaud
- Chirurgie viscérale, métabolique et cancérologique (CVMC), CHRU de Nancy, 54511 Vandœuvre-lès-Nancy, France
| | - J C Lifante
- Chirurgie digestive, oncologique et endocrinienne, CHU de Lyon, 69310 Pierre-Bénite, France
| | - C Tresallet
- Chirurgie digestive, bariatrique et endocrinienne, AP-HP, Hôpital Avicenne, université Sorbonne Paris Nord, 93000 Bobigny, France
| | - F Sebag
- Chirurgie générale et endocrinienne, AP-HM, La Conception, 13005 Marseille, France
| | - J P Bizard
- Chirurgie endocrinienne et viscérale, hôpital privé Arras-lès-Bonnettes, 62000 Arras, France
| | - M Mathonnet
- Chirurgie digestive et endocrinienne, CHU de Limoges, 87000 Limoges, France
| | - F Menegaux
- Chirurgie générale digestive et endocrinienne, Sorbonne université, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - R Caiazzo
- Chirurgie générale et endocrinienne, CHU de Lille, 59000 Lille, France
| | - É Mirallié
- Chirurgie cancérologique, digestive et endocrinienne (CCDE), CHU de Nantes, 44093 Nantes, France
| | - F Pattou
- Chirurgie générale et endocrinienne, CHU de Lille, 59000 Lille, France
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23
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Castinetti F, Barlier A, Sebag F, Taieb D. Diagnostic des phéochromocytomes et paragangliomes. ONCOLOGIE 2020. [DOI: 10.3166/onco-2019-0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Les phéochromocytomes et les paragangliomes sont des tumeurs rares responsables d’une surmorbidité et d’une surmortalité. Au cours de ces 20 dernières années, de nombreuses avancées ont permis de mieux les caractériser sur le plan phénotypique (via l’imagerie métabolique) et génotypique (avec la mise en évidence de nombreux gènes de prédisposition). La prise en charge d’un phéochromocytome ou d’un paragangliome nécessite désormais le recours à un centre expert dès la phase diagnostique. L’objectif de cette revue est de souligner les principales caractéristiques de ces tumeurs, et ce, afin de sensibiliser le clinicien aux différentes étapes permettant d’aboutir à une prise en charge optimale.
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24
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Amabile N, Bagdadi I, Armero S, Elhadad S, Sebag F, Saby L, Mammhoudi K, Mechulan A, Landolff Q, Caussin C, Boulanger CM. P3725Impact of left atrial appendage closure on circulating microvesicles levels: the MICROPLUG study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0579] [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: 11/12/2022] Open
Abstract
Abstract
Background
Percutaneous left atrial appendage occlusion (LAAO) has emerged as a valid alternative to oral anticoagulation therapy for the prevention of systemic embolism in patients with non-valvular atrial fibrillation (AF). Microvesicles (MVs) are shed-membrane particles generated during various cellular types activation/ apoptosis that carry out diverse biological effects, including procoagulant effects. Left atrial appendage has been suspected to be a potential source of MVs during AF, but the effects of LAAO on MVs production and circulating levels are unknown.The aim of this work study was to assess the variations of circulating MVs levels following LAAO.
Methods
The study includedn=25 LAAO patients and n=25 control patients who underwent coronary angiography. LAAO and control patients were treated by clopidogrel+ aspirin loading doses before procedures. Blood samples were drawn before antiplatelets therapy & 2 days after for all. A third sample was collected 6 weeks after procedure in LAAO patients. In N=10 extra patients, blood samples were collected from right atrium, left appendage and pulmonary vein during LAAO procedure. Circulating procoagulant (AnnV+), endothelial (CD62e+), platelets (CD41+), red blood cells/RBC (CD235+), leukocytes (CD11+) derived-MVs were measured using flow cytometry methods.
Results
Control and LAAO groups baseline characteristics were comparable, except for the higher age & incidence of previous stroke and lower incidence of coronary artery disease in LAAO patients. Baseline levels of the different microvesicles were comparable in both groups. In the LAAO group, we observed a significant increase of AnnV+ MVs (4355 [1712–8478] vs. 1798 [1006–2759] ev/μL, p=0.001), platelets (1615 [833–4772] vs. 802 [358–1376] ev/, p=0.005), RBC (207 [85–708] vs. 35 [5–84] ev/μL, p<0.001), and leukocytes MVs (1368 [783–2319] vs. 1067 [827–1564] ev/μL, p=0.02) following intervention, whereas only AnnV+ MVs levels significantly rose in controls (3701 [2043–7017] vs. 1506 [1033–4899] ev/μL, p=0.03). The 6-w analysis showed that RBC-MVs (55 [8–182 ev/μL]and AnnV+ MVs levels (2468 [1813–5576 ev/μL]were still significantly increased compared to baseline values in LAAO patients (p<0.05). The in-site analysis revealed that leukocyte MVs and CD62e+ endothelial-MVs were significantly higher in left atrial appendage compared to pulmonary vein (respectively 430 [26–700 vs. 161 [0–426] and 344 [22–723] vs. 200 [120–326] ev/μL, p<0.05), suggesting a local increased production. No major adverse ischemic or bleeding event was observed in any patient post procedural course.
Conclusions
LAAO impact circulating MVs and could create mild pro-coagulant status, inflammation and potential erythrocytes activation due to device presence during the first 6 weeks following intervention. These results suggest that careful attention should be paid in the anti-platelet/anti-coagulant therapy in the post procedural course.
Acknowledgement/Funding
This work was funded by a research grant from the French Society of Cardiology and a research grant from St Jude/Abbott
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Affiliation(s)
- N Amabile
- Institut Mutualiste Montsouris, Department of Cardiology, Paris, France
| | - I Bagdadi
- Institut Mutualiste Montsouris, Department of Cardiology, Paris, France
| | - S Armero
- Hôpital Européen Marseille, Marseille, France
| | - S Elhadad
- CH Marne la Vallée, Jossigny, France
| | - F Sebag
- Institut Mutualiste Montsouris, Department of Cardiology, Paris, France
| | - L Saby
- Hôpital Européen Marseille, Marseille, France
| | - K Mammhoudi
- Institut Mutualiste Montsouris, Department of Cardiology, Paris, France
| | - A Mechulan
- CHP Clairval, Department of Cardiology, Marseille, France
| | - Q Landolff
- Institut Mutualiste Montsouris, Department of Cardiology, Paris, France
| | - C Caussin
- Institut Mutualiste Montsouris, Department of Cardiology, Paris, France
| | - C M Boulanger
- Paris Cardiovascular Research Center (PARCC), Paris, France
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25
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Mahmoudi K, Elhadad S, Landolf Q, Sebag F, Rezine LZ, Paul JF, Caussin C, Amabile N. TCT-374 Residual Left Atrial Appendage Patency Identified by Early Computed Tomography Analysis Following Percutaneous Occlusion: Prevalence and Impact on Outcome. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.461] [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: 11/25/2022]
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26
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Amodru V, Taieb D, Guerin C, Paladino NC, Brue TY, Sebag F, Castinetti F. Large Adrenal Incidentalomas Require a Dedicated Diagnostic Procedure. Endocr Pract 2019; 25:669-677. [DOI: 10.4158/ep-2018-0616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Castinetti F, Waguespack SG, Machens A, Uchino S, Hasse-Lazar K, Sanso G, Else T, Dvorakova S, Qi XP, Elisei R, Maia AL, Glod J, Lourenço DM, Valdes N, Mathiesen J, Wohllk N, Bandgar TR, Drui D, Korbonits M, Druce MR, Brain C, Kurzawinski T, Patocs A, Bugalho MJ, Lacroix A, Caron P, Fainstein-Day P, Borson Chazot F, Klein M, Links TP, Letizia C, Fugazzola L, Chabre O, Canu L, Cohen R, Tabarin A, Spehar Uroic A, Maiter D, Laboureau S, Mian C, Peczkowska M, Sebag F, Brue T, Mirebeau-Prunier D, Leclerc L, Bausch B, Berdelou A, Sukurai A, Vlcek P, Krajewska J, Barontini M, Vaz Ferreira Vargas C, Valerio L, Ceolin L, Akshintala S, Hoff A, Godballe C, Jarzab B, Jimenez C, Eng C, Imai T, Schlumberger M, Grubbs E, Dralle H, Neumann HP, Baudin E. Natural history, treatment, and long-term follow up of patients with multiple endocrine neoplasia type 2B: an international, multicentre, retrospective study. Lancet Diabetes Endocrinol 2019; 7:213-220. [PMID: 30660595 PMCID: PMC8132299 DOI: 10.1016/s2213-8587(18)30336-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/16/2018] [Accepted: 11/16/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Multiple endocrine neoplasia type 2B is a rare syndrome caused mainly by Met918Thr germline RET mutation, and characterised by medullary thyroid carcinoma, phaeochromocytoma, and extra-endocrine features. Data are scarce on the natural history of multiple endocrine neoplasia type 2B. We aimed to advance understanding of the phenotype and natural history of multiple endocrine neoplasia type 2B, to increase awareness and improve detection. METHODS This study was a retrospective, multicentre, international study in patients carrying the Met918Thr RET variant with no age restrictions. The study was done with registry data from 48 centres globally. Data from patients followed-up from 1970 to 2016 were retrieved from May 1, 2016, to May 31, 2018. Our primary objectives were to determine overall survival, and medullary thyroid carcinoma-specific survival based on whether the patient had undergone early thyroidectomy before the age of 1 year. We also assessed remission of medullary thyroid carcinoma, incidence and treatment of phaeochromocytoma, and the penetrance of extra-endocrine features. FINDINGS 345 patients were included, of whom 338 (98%) had a thyroidectomy. 71 patients (21%) of the total cohort died at a median age of 25 years (range <1-59). Thyroidectomy was done before the age of 1 year in 20 patients, which led to long-term remission (ie, undetectable calcitonin level) in 15 (83%) of 18 individuals (2 patients died of causes unrelated to medullary thyroid carcinoma). Medullary thyroid carcinoma-specific survival curves did not show any significant difference between patients who had thyroidectomy before or after 1 year (comparison of survival curves by log-rank test: p=0·2; hazard ratio 0·35; 95% CI 0.07-1.74). However, there was a significant difference in remission status between patients who underwent thyroidectomy before and after the age of 1 year (p<0·0001). There was a significant difference in remission status between patients who underwent thyroidectomy before and after the age of 1 year (p<0·0001). In the other 318 patients who underwent thyroidectomy after 1 year of age, biochemical and structural remission was obtained in 47 (15%) of 318 individuals. Bilateral phaeochromocytoma was diagnosed in 156 (50%) of 313 patients by 28 years of age. Adrenal-sparing surgery was done in 31 patients: three (10%) of 31 patients had long-term recurrence, while normal adrenal function was obtained in 16 (62%) patients. All patients with available data (n=287) had at least one extra-endocrine feature, including 106 (56%) of 190 patients showing marfanoid body habitus, mucosal neuromas, and gastrointestinal signs. INTERPRETATION Thyroidectomy done at no later than 1 year of age is associated with a high probability of cure. The reality is that the majority of children with the syndrome will be diagnosed after this recommended age. Adrenal-sparing surgery is feasible in multiple endocrine neoplasia type 2B and affords a good chance for normal adrenal function. To improve the prognosis of such patients, it is imperative that every health-care provider be aware of the extra-endocrine signs and the natural history of this rare syndrome. The implications of this research include increasing awareness of the extra-endocrine symptoms and also recommendations for thyroidectomy before the age of 1 year. FUNDING None.
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Affiliation(s)
- Frederic Castinetti
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale, Marseille Medical Genetics, Marseille, France; Assistance Publique-Hôpitaux de Marseille, Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l'hypophyse, Marseille, France.
| | - Steven G Waguespack
- Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andreas Machens
- Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Shinya Uchino
- Noguchi Thyroid Clinic and Hospital Foundation, Beppu, Japan
| | - Kornelia Hasse-Lazar
- Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Institute, Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Gabriella Sanso
- Centro de Investigaciones Endocrinológicas, "Dr César Bergadá", Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Tobias Else
- Division of Metabolism, Endocrinology, & Diabetes, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Sarka Dvorakova
- Department of Molecular Endocrinology, Institute of Endocrinology, Prague, Czech Republic
| | - Xiao Ping Qi
- Departments of Oncologic and Urologic Surgery, The 117th People's Liberation Army Hospital, People's Liberation Army Hangzhou Clinical College, Anhui Medical University, Hangzhou, China
| | - Rossella Elisei
- Department of Endocrinology, University Hospital, Pisa, Italy
| | - Ana Luisa Maia
- Thyroid Section, Endocrinology Division, Hospital de Cliínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - John Glod
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Delmar Muniz Lourenço
- Endocrine Genetics Unit, Endocrinology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil; Endocrine Oncology Division, Institute of Cancer of the State of São Paulo, Faculty of Medicine of the University of São Paulo, São Paulo, Brazil
| | - Nuria Valdes
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias, Oviedo, Spain; Unit of Endocrinology, Nutrition, Diabetes and Obesity, Institute of Sanitary Research of Asturias, Oviedo, Spain
| | - Jes Mathiesen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Nelson Wohllk
- Endocrine Section, Universidad de Chile, Hospital del Salvador, Santiago de Chile, Santiago, Chile
| | - Tushar R Bandgar
- Department of Endocrinology, Seth G S Medical College, King Edward Memorial Hospital, Parel, Mumbai, India
| | - Delphine Drui
- L'Institut du thorax, Department of Endocrinology, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Marta Korbonits
- Department of Endocrinology, St Bartholomew's Hospital, London, UK; London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Maralyn R Druce
- Department of Endocrinology, St Bartholomew's Hospital, London, UK; London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Caroline Brain
- Division of Endocrine Surgery, University College Hospital and Great Ormond Street Hospital, London, United Kingdom
| | - Tom Kurzawinski
- Division of Endocrine Surgery, University College Hospital and Great Ormond Street Hospital, London, United Kingdom
| | - Atila Patocs
- Hungarian Academy of Sciences and Semmelweis University, HSA-SE "Lendület" Hereditary Endocrine Tumour Research Group, Budapest, Hungary
| | - Maria Joao Bugalho
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Universitário Lisboa Norte-Hospital Santa Maria, Lisboa, Portugal; Centro Académico de Medicina de Lisboa, Universidade Lisboa, Lisboa, Portugal
| | - Andre Lacroix
- Endocrine Division, Department of Medicine, Centre Hospitalier de l'Universite í de Montréal, Montreal, QC, Canada
| | - Philippe Caron
- Centre Hospitalier Universitaire de Toulouse, Hôpital Larrey, Service d'Endocrinologie, Maladies métaboliques, Nutrition, Toulouse, France
| | - Patricia Fainstein-Day
- Endocrine and Nuclear Medicine Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Francoise Borson Chazot
- Hospices Civils de Lyon, Fédération d'Endocrinologie, Université Claude Bernard Lyon 1, Lyon, France
| | - Marc Klein
- Department of Endocrinology, University Hospital, Nancy, France
| | - Thera P Links
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Claudio Letizia
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - Laura Fugazzola
- Division of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Auxologico Italiano, University of Milan, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Olivier Chabre
- Centre Hospitalier Universitaire de Grenoble, Hôpital Albert Michallon, Service d'Endocrinologie-Diabétologie-Nutrition, Grenoble, France
| | - Letizia Canu
- Department of Experimental and Clinical Biomedical Sciences, Endocrinology Unit, University of Florence, Florence, Italy
| | - Regis Cohen
- Endocrinologie et Métabolismes, Centre Hospitalier de Saint Denis, Saint-Denis, France
| | - Antoine Tabarin
- Centre Hospitalier Universitaire de Bordeaux, Hôpital du Haut Lévêque, Service d'Endocrinologie-Diabétologie et Maladies Métaboliques, Pessac, France
| | - Anita Spehar Uroic
- Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dominique Maiter
- Service d'Endocrinologie et Nutrition, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Brussels, Belgium
| | - Sandrine Laboureau
- Department of Endocrinology, Diabetes and Nutrition, Reference Centre of Rare Thyroid Disease, Hospital of Angers, Angers, France
| | - Caterina Mian
- Operative Unit of the Endocrinology, Department of Medicine, University of Padua, Padua, Italy
| | | | - Frederic Sebag
- Department of Endocrine Surgery, La Conception Hospital, Marseille, France
| | - Thierry Brue
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale, Marseille Medical Genetics, Marseille, France; Assistance Publique-Hôpitaux de Marseille, Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l'hypophyse, Marseille, France
| | | | - Laurence Leclerc
- Centre Hospitalier Régional Universitaire de Lille, Hopital Huriez, Service d'Endocrinologie, Lille, France
| | - Birke Bausch
- Section for Preventive Medicine, Department of Nephrology and General Medicine, Freiburg, Germany
| | - Amandine Berdelou
- Endocrine Oncology, Institut Gustave Roussy Ecole Doctorale de Cancerologie, Villejuif, France
| | - Akihiro Sukurai
- Department of Medical Genetics and Genomics, Sapporo Medical University School of Medicine, Chuo-ku, Sapporo, Hokkaido, Japan
| | - Petr Vlcek
- Department of Nuclear Medicine and Endocrinology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Motol University Hospital, Prague, Czech Republic
| | - Jolanta Krajewska
- Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Institute, Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Marta Barontini
- Centro de Investigaciones Endocrinológicas, "Dr César Bergadá", Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Carla Vaz Ferreira Vargas
- Thyroid Section, Endocrinology Division, Hospital de Cliínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Laura Valerio
- Department of Endocrinology, University Hospital, Pisa, Italy
| | - Lucieli Ceolin
- Thyroid Section, Endocrinology Division, Hospital de Cliínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Srivandana Akshintala
- Department of Pediatrics, New York University Langone Medical Center, New York, NY, USA
| | - Ana Hoff
- Endocrine Genetics Unit, Endocrinology Division, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil; Endocrine Oncology Division, Institute of Cancer of the State of São Paulo, Faculty of Medicine of the University of São Paulo, São Paulo, Brazil
| | - Christian Godballe
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Barbara Jarzab
- Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Institute, Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Camilo Jimenez
- Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charis Eng
- Genomic Medicine Institute, Lerner Research Institute and Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tsuneo Imai
- Department of Breast and Endocrine Surgery, National Hospital Organization Higashinagoya National Hospital, Nagoya, Japan
| | - Martin Schlumberger
- Endocrine Oncology, Institut Gustave Roussy Ecole Doctorale de Cancerologie, Villejuif, France
| | - Elizabeth Grubbs
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Henning Dralle
- Section of Endocrine Surgery, Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Essen, Germany
| | - Hartmut P Neumann
- Section for Preventive Medicine, Department of Nephrology and General Medicine, Freiburg, Germany
| | - Eric Baudin
- Endocrine Oncology, Institut Gustave Roussy Ecole Doctorale de Cancerologie, Villejuif, France
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Bannani S, Christou N, Guérin C, Hamy A, Sebag F, Mathonnet M, Guillot P, Caillard C, Blanchard C, Mirallié E. Effect of parathyroidectomy on quality of life and non-specific symptoms in normocalcaemic primary hyperparathyroidism. Br J Surg 2018; 105:223-229. [PMID: 29405278 DOI: 10.1002/bjs.10739] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/16/2017] [Accepted: 09/29/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Normocalcaemic primary hyperparathyroidism (NcPHPT) is a new clinical entity being diagnosed increasingly among patients with mild primary hyperparathyroidism (PHPT). The aim of this study was to evaluate quality of life and non-specific symptoms before and after parathyroidectomy in patients with NcPHPT compared with those with hypercalcaemic mild PHPT (Hc-m-PHPT). METHODS This was a prospective multicentre study of patients with mild PHPT from four university hospitals. Patients were evaluated before operation, and 3, 6 and 12 months after surgery for quality of life using the SF-36-v2® questionnaire, as well as for 25 non-specific symptoms. RESULTS Before operation, the only statistically significant difference between the NcPHPT and Hc-m-PHPT groups was in the mean(s.d.) blood calcium level (2·54 versus 2·73 mmol; P < 0·001). At 1 year after surgery, the blood calcium level had improved significantly in both groups, with no significant difference between them. Quality of life improved significantly in each group compared with its preoperative score, with regard to the physical component summary (P = 0·040 and P = 0·016 respectively), whereas the mental component summary improved significantly in the Hc-m-PHPT group only (P = 0·043). Only two non-specific symptoms improved significantly in the NcPHPT group compared with nine in the Hc-m-PHPT group. CONCLUSION Parathyroidectomy mildly improves quality of life and some non-specific symptoms in patients with NcPHPT.
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Affiliation(s)
- S Bannani
- Clinique de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France
| | - N Christou
- Service de Chirurgie Digestive, Générale et Endocrinienne, CHU Limoges, Limoges, France
| | - C Guérin
- Service de Chirurgie Générale, Endocrinienne et Métabolique, CHU Marseille, Marseille, France
| | - A Hamy
- Service de Chirurgie Viscérale, CHU Angers, Angers, France
| | - F Sebag
- Service de Chirurgie Générale, Endocrinienne et Métabolique, CHU Marseille, Marseille, France
| | - M Mathonnet
- Service de Chirurgie Digestive, Générale et Endocrinienne, CHU Limoges, Limoges, France
| | - P Guillot
- Service de Rhumatologie, Hôtel Dieu, Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France
| | - C Caillard
- Clinique de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France
| | - C Blanchard
- Clinique de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France
| | - E Mirallié
- Clinique de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France
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Abstract
Left atrial appendage occlusion (LAAO) is an alternative option to oral anticoagulation therapy in patients with non-valvular atrial fibrillation. According to French regulations, this procedure is currently reserved for patients with formal contraindications to VKA and direct thrombin inhibitors. LAAO procedures reduce ischemic and stroke risks compared to no treatment and also reduce bleeding events compared to VKA therapy in eligible patients. The peri-procedural complications risk has been reported to be limited in the different series published so far. Although elderly patients (>75 years) have either higher ischemic and bleeding risk than younger subjects, they hardly benefit from optimal anticoagulation. Thus, these subjects might greatly benefit from LAAO. Published studies reported excellent feasibility and efficiency of LAAO procedure in elderly patients. Yet there is a trend towards a higher incidence of peri-procedural complications (including tamponade), long-term safety is excellent and comparable to what is observed in patients<75 years. Therefore, interventional percutaneous LAAO is an attractive strategy in elderly patients with atrial fibrillation that should be incorporated in a multidisciplinary management.
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Affiliation(s)
- N Amabile
- Service de cardiologie, institut mutualiste Montsouris, 75014 Paris, France.
| | - S Elhadad
- Service de cardiologie, CH Marne la Vallée, 77600 Jossigny, France
| | - C Roig
- Service de cardiologie, institut mutualiste Montsouris, 75014 Paris, France
| | - F Sebag
- Service de cardiologie, institut mutualiste Montsouris, 75014 Paris, France
| | - P Charles
- Service de médecine interne, institut mutualiste Montsouris, 75014 Paris, France
| | - C Caussin
- Service de cardiologie, institut mutualiste Montsouris, 75014 Paris, France
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Vermalle M, Alessandrini M, Graillon T, Paladino NC, Baumstarck K, Sebag F, Dufour H, Brue T, Castinetti F. Lack of functional remission in Cushing's syndrome. Endocrine 2018; 61:518-525. [PMID: 30019306 DOI: 10.1007/s12020-018-1664-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/25/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Hypercortisolism leads to severe clinical consequences persisting after the onset of remission. These physical sequelae of cortisol exposure are known to profoundly impact the patient's quality of life. As psychological factors may be correlated with this quality of life, our objective was to determine the specific weight of psychological determinants of quality of life in patients in remission from hypercortisolism. PATIENTS AND METHODS In an observational study, 63 patients with hypercortisolism in remission were asked to complete exhaustive self-administered questionnaires including quality of life (WHOQoL-BREF and Cushing QoL), depression, anxiety, self-esteem, body image, and coping scales. Multivariate analyses were performed. Psychological variables relevant to the model were: anxiety, depression, self-esteem, body image, and positive thinking dimension of the Brief-COPE. Cortisol deficiency was defined as a potential confounder. RESULTS The median time since remission was 3 years. Patients had significantly lower quality of life and body satisfaction score than the French population and patients with chronic diseases. Depression significantly impaired all WHOQoL and Cushing QoL domains. A low body satisfaction score significantly impaired social relationships quality of life score. In total, 42.9% of patients still needed working arrangements, 19% had disability or cessation of work. CONCLUSION Patients in biological remission of hypercortisolism can rarely be considered as functionally cured: this is evidenced by altered quality of life, working arrangements, and chronic depression. A multidisciplinary management of these patients is thus mandatory on a long-term basis.
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Affiliation(s)
- M Vermalle
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Department of Endocrinology, Hôpital de la Conception, Assistance Publique - Hôpitaux de Marseille (AP-HM), Centre de Référence des Maladies Rares Hypophysaires HYPO 13005, Marseille, France
| | | | - T Graillon
- Department of endocrine surgery, La Conception Hospital, Marseille, France
| | - N C Paladino
- Department of Neurosurgery, La Timone Hospital, Marseille, France
| | | | - F Sebag
- Department of Neurosurgery, La Timone Hospital, Marseille, France
| | - H Dufour
- Department of endocrine surgery, La Conception Hospital, Marseille, France
| | - T Brue
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Department of Endocrinology, Hôpital de la Conception, Assistance Publique - Hôpitaux de Marseille (AP-HM), Centre de Référence des Maladies Rares Hypophysaires HYPO 13005, Marseille, France
| | - F Castinetti
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France.
- Department of Endocrinology, Hôpital de la Conception, Assistance Publique - Hôpitaux de Marseille (AP-HM), Centre de Référence des Maladies Rares Hypophysaires HYPO 13005, Marseille, France.
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Guerin C, Romanet P, Taieb D, Brue T, Lacroix A, Sebag F, Barlier A, Castinetti F. Looking beyond the thyroid: advances in the understanding of pheochromocytoma and hyperparathyroidism phenotypes in MEN2 and of non-MEN2 familial forms. Endocr Relat Cancer 2018; 25:T15-T28. [PMID: 28874394 DOI: 10.1530/erc-17-0266] [Citation(s) in RCA: 18] [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] [Received: 08/30/2017] [Accepted: 09/04/2017] [Indexed: 12/14/2022]
Abstract
Over the last years, the knowledge of MEN2 and non-MEN2 familial forms of pheochromocytoma (PHEO) has increased. In MEN2, PHEO is the second most frequent disease: the penetrance and age at diagnosis depend on the mutation of RET Given the prevalence of bilateral PHEO (50% by age 50), adrenal sparing surgery, aimed at sparing a part of the adrenal cortex to avoid adrenal insufficiency, should be systematically considered in patients with bilateral PHEO. Non-MEN2 familial forms of PHEO now include more than 20 genes: however, only small phenotypic series have been reported, suggesting that phenotypic features of isolated hereditary PHEO must be better explored, and follow-up series are needed to better understand the outcome of patients carrying mutations of these genes. The first part of this review will mainly focus on these points. In the second part, a focus will be given on MEN2 and non-MEN2 familial forms of hyperparathyroidism (HPTH). Again, the management of MEN2 HPTH should be aimed at curing the disease while preserving an optimal quality of life by a tailored parathyroidectomy. The phenotypes and outcome of MEN1-, MEN4- and HRPT2-related HPTH are briefly described, with a focus on the most recent literature data and is compared with familial hypocalciuric hypercalcemia.
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Affiliation(s)
- Carole Guerin
- Department of Endocrine SurgeryAix Marseille University, Assistance Publique Hopitaux de Marseille, La Conception Hospital, Marseille, France
| | - Pauline Romanet
- Department of Molecular BiologyAix Marseille University, CNRS UMR 7286, Assistance Publique Hopitaux de Marseille, La Conception Hospital, Marseille, France
| | - David Taieb
- Department of Nuclear MedicineAix Marseille University, Assistance Publique Hopitaux de Marseille, La Timone Hospital, Marseille, France
| | - Thierry Brue
- Department of EndocrinologyAix Marseille University, CNRS UMR7286, Assistance Publique Hopitaux de Marseille, La Conception Hospital, Marseille, France
| | - André Lacroix
- Endocrine DivisionDepartment of Medicine, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Frederic Sebag
- Department of Endocrine SurgeryAix Marseille University, Assistance Publique Hopitaux de Marseille, La Conception Hospital, Marseille, France
| | - Anne Barlier
- Department of Molecular BiologyAix Marseille University, CNRS UMR 7286, Assistance Publique Hopitaux de Marseille, La Conception Hospital, Marseille, France
| | - Frederic Castinetti
- Department of EndocrinologyAix Marseille University, CNRS UMR7286, Assistance Publique Hopitaux de Marseille, La Conception Hospital, Marseille, France
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Mirallié É, Caillard C, Pattou F, Brunaud L, Hamy A, Dahan M, Prades M, Mathonnet M, Landecy G, Dernis HP, Lifante JC, Sebag F, Jegoux F, Babin E, Bizon A, Espitalier F, Durand-Zaleski I, Volteau C, Blanchard C. Does intraoperative neuromonitoring of recurrent nerves have an impact on the postoperative palsy rate? Results of a prospective multicenter study. Surgery 2017; 163:124-129. [PMID: 29128183 DOI: 10.1016/j.surg.2017.03.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/07/2017] [Accepted: 03/29/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND The impact of intraoperative neuromonitoring on recurrent laryngeal nerve palsy remains debated. Our aim was to evaluate the potential protective effect of intraoperative neuromonitoring on recurrent laryngeal nerve during total thyroidectomy. METHODS This was a prospective, multicenter French national study. The use of intraoperative neuromonitoring was left at the surgeons' choice. Postoperative laryngoscopy was performed systematically at day 1 to 2 after operation and at 6 months in case of postoperative recurrent laryngeal nerve palsy. Univariate and multivariate analyses and propensity score (sensitivity analysis) were performed to compare recurrent laryngeal nerve palsy rates between patients operated with or without intraoperative neuromonitoring. RESULTS Among 1,328 patients included (females 79.9%, median age 51.2 years, median body mass index 25.6 kg/m2), 807 (60.8%) underwent intraoperative neuromonitoring. Postoperative abnormal vocal cord mobility was diagnosed in 131 patients (9.92%), including 69 (8.6%) and 62 (12.1%) in the intraoperative neuromonitoring and nonintraoperative neuromonitoring groups, respectively. Intraoperative neuromonitoring was associated with a lesser rate of recurrent laryngeal nerve palsy in univariate analysis (odds ratio = 0.68, 95% confidence interval, 0.47; 0.98, P = .04) but not in multivariate analysis (oddsratio = 0.74, 95% confidence interval, 0.47; 1.17, P = .19), or when using a propensity score (odds ratio = 0.76, 95% confidence interval, 0.53; 1.07, P = .11). There was no difference in the rates of definitive recurrent laryngeal nerve palsy (0.8% and 1.3% in intraoperative neuromonitoring and non-intraoperative neuromonitoring groups respectively, P = .39). The sensitivity, specificity, and positive and negative predictive values of intraoperative neuromonitoring for detecting abnormal postoperative vocal cord mobility were 29%, 98%, 61%, and 94%, respectively. CONCLUSION The use of intraoperative neuromonitoring does not decrease postoperative recurrent laryngeal nerve palsy rate. Due to its high specificity, however, intraoperative neuromonitoring is useful to predict normal vocal cord mobility. From the CHU de Nantes,a Clinique de Chirurgie Digestive et Endocrinienne, Nantes, France; CHU Lille, Université de Lille,b Chirurgie Générale et Endocrinienne, Lille, France; CHU Nancy-Hôpital de Brabois,c Service de Chirurgie Digestive, Hépato-Biliaire, et Endocrinienne, Nancy, France; CHU Angers,d Chirurgie Digestive et Endocrinienne, Angers, France; CHU de Toulouse-Hôpital Larrey,e Chirurgie Thoracique, Pôle Voies Respiratoires, Toulouse; CHU Saint-Etienne-Hôpital Nord,f ORL et Chirurgie Cervico-Faciale et Plastique, Saint-Etienne, France; CHU de Limoges-Hôpital Dupuytren,g Chirurgie Digestive, Générale et Endocrinienne, Limoges, France; CHU de Besançon-Hôpital Jean Minjoz,h Chirurgie Digestive, Besançon, France; Centre Hospitalier du Mans,i Service ORL et Chirurgie Cervico-Faciale, Le Mans, France; Centre Hospitalier Lyon-Sud,j Chirurgie Générale, Endocrinienne, Digestive et Thoracique, Pierre Bénite, France; AP-HM-Hôpital de La Conception,k Chirurgie Générale, Marseille, France; CHU de Rennes-Hôpital Pontchaillou,l Service ORL et Chirurgie Maxillo-Faciale, Rennes, France; CHU de Caen,m ORL et Chirurgie Cervico-Faciale, Caen, France; CHU d'Angers,n ORL et Chirurgie Cervico-Faciale, Angers, France; CHU de Nantes,o Service ORL, Nantes, France; AP HP URCEco île-de-France,p hôpital de l'Hôtel-Dieu, Paris, France; DRCI, département Promotion,q Nantes, France.
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Affiliation(s)
- Éric Mirallié
- CHU de Nantes, Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Nantes, France.
| | - Cécile Caillard
- CHU de Nantes, Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Nantes, France
| | - François Pattou
- CHU Lille, Université de Lille, Chirurgie Générale et Endocrinienne, Lille, France
| | - Laurent Brunaud
- CHU Nancy - Hôpital de Brabois, Service de Chirurgie Digestive, Hépato-Biliaire et Endocrinienne, Nancy, France
| | - Antoine Hamy
- CHU Angers, Chirurgie Digestive et Endocrinienne, Angers, France
| | - Marcel Dahan
- CHU de Toulouse - Hôpital Larrey, Chirurgie Thoracique, Pôle Voies Respiratoires, Toulouse, France
| | - Michel Prades
- CHU Saint-Etienne - Hôpital Nord, ORL et Chirurgie Cervico-Faciale et Plastique, Saint-Etienne, France
| | - Muriel Mathonnet
- CHU de Limoges - Hôpital Dupuytren, Chirurgie Digestive, Générale et Endocrinienne, Limoges, France
| | - Gérard Landecy
- CHU de Besançon - Hôpital Jean Minjoz, Chirurgie Digestive, Besançon, France
| | - Henri-Pierre Dernis
- Centre Hospitalier du Mans, Service ORL et Chirurgie Cervico-Faciale, Le Mans, France
| | - Jean-Christophe Lifante
- Centre Hospitalier Lyon-Sud, Chirurgie Générale, Endocrinienne, Digestive et Thoracique, Pierre Bénite, France
| | - Frederic Sebag
- AP-HM - Hôpital de La Conception, Chirurgie Générale, Marseille, France
| | - Franck Jegoux
- CHU de Rennes - Hôpital Pontchaillou, Service ORL et Chirurgie Maxillo-Faciale, Rennes, France
| | - Emmanuel Babin
- CHU de Caen, ORL et Chirurgie Cervico-Faciale, Caen, France
| | - Alain Bizon
- CHU d'Angers, ORL et Chirurgie Cervico-Faciale, Angers, France
| | | | | | | | - Claire Blanchard
- CHU de Nantes, Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Nantes, France
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McVeigh TP, Mulligan RJ, McVeigh UM, Owens PW, Miller N, Bell M, Sebag F, Guerin C, Quill DS, Weidhaas JB, Kerin MJ, Lowery AJ. Investigating the association of rs2910164 with cancer predisposition in an Irish cohort. Endocr Connect 2017; 6:614-624. [PMID: 28899898 PMCID: PMC5640569 DOI: 10.1530/ec-17-0196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 09/12/2017] [Indexed: 01/05/2023]
Abstract
INTRODUCTION MicroRNAs (miRNAs) are small noncoding RNA molecules that exert post-transcriptional effects on gene expression by binding with cis-regulatory regions in target messenger RNA (mRNA). Polymorphisms in genes encoding miRNAs or in miRNA-mRNA binding sites confer deleterious epigenetic effects on cancer risk. miR-146a has a role in inflammation and may have a role as a tumour suppressor. The polymorphism rs2910164 in the MIR146A gene encoding pre-miR-146a has been implicated in several inflammatory pathologies, including cancers of the breast and thyroid, although evidence for the associations has been conflicting in different populations. We aimed to further investigate the association of this variant with these two cancers in an Irish cohort. METHODS The study group comprised patients with breast cancer (BC), patients with differentiated thyroid cancer (DTC) and unaffected controls. Germline DNA was extracted from blood or from saliva collected using the DNA Genotek Oragene 575 collection kit, using crystallisation precipitation, and genotyped using TaqMan-based PCR. Data were analysed using SPSS, v22. RESULTS The total study group included 1516 participants. This comprised 1386 Irish participants; 724 unaffected individuals (controls), 523 patients with breast cancer (BC), 136 patients with differentiated thyroid cancer (DTC) and three patients with dual primary breast and thyroid cancer. An additional cohort of 130 patients with DTC from the South of France was also genotyped for the variant. The variant was detected with a minor allele frequency (MAF) of 0.19 in controls, 0.22 in BC and 0.27 and 0.26 in DTC cases from Ireland and France, respectively. The variant was not significantly associated with BC (per allele odds ratio = 1.20 (0.98-1.46), P = 0.07), but was associated with DTC in Irish patients (per allele OR = 1.59 (1.18-2.14), P = 0.002). CONCLUSION The rs2910164 variant in MIR146A is significantly associated with DTC, but is not significantly associated with BC in this cohort.
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Affiliation(s)
- T P McVeigh
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - R J Mulligan
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - U M McVeigh
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - P W Owens
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - N Miller
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - M Bell
- Department of EndocrinologySchool of Medicine, NUI Galway, Galway, Ireland
| | - F Sebag
- Department of Endocrine Surgery Centre hospitalo-universitaire de La ConceptionAssistance Publique Hôpitaux de Marseille, Marseille, France
- Aix-Marseille UniversitéFaculté de Médecine, Marseille, France
| | - C Guerin
- Department of Endocrine Surgery Centre hospitalo-universitaire de La ConceptionAssistance Publique Hôpitaux de Marseille, Marseille, France
- Aix-Marseille UniversitéFaculté de Médecine, Marseille, France
| | - D S Quill
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - J B Weidhaas
- David Geffen School of MedicineUniversity of California, Los Angeles, USA
| | - M J Kerin
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
| | - A J Lowery
- Discipline of SurgeryLambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland
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Zerdoud S, Leboulleux S, Clerc J, Leenhardt L, Bournaud C, Al Ghuzlan A, Keller I, Bardet S, Giraudet AL, Groussin L, Sebag F, Garrel R, Lamy PJ, Toubert ME, Mirallié É, Hindié E, Taïeb D. Traitement par iode 131 des cancers thyroïdiens différenciés : recommandations 2017 des sociétés françaises SFMN/SFE/SFP/SFBC/AFCE/SFORL. Médecine Nucléaire 2017. [DOI: 10.1016/j.mednuc.2017.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Claridge S, Sebag F, Behar J, Porter B, Jackson T, Sieniewicz B, Gould J, Webb J, Chen Z, O'Neill M, Gill J, Leclercq C, Rinaldi C. 96Cost effectiveness of a risk-stratified approach to cardiac resynchronisation therapy defibrillators at the time of generator change. Europace 2017. [DOI: 10.1093/europace/eux283.091] [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: 11/12/2022] Open
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Castinetti F, Maia AL, Peczkowska M, Barontini M, Hasse-Lazar K, Links TP, Toledo RA, Dvorakova S, Mian C, Bugalho MJ, Zovato S, Alevizaki M, Kvachenyuk A, Bausch B, Loli P, Bergmann SR, Patocs A, Pfeifer M, Costa JB, von Dobschuetz E, Letizia C, Valk G, Barczynski M, Czetwertynska M, Plukker JTM, Sartorato P, Zelinka T, Vlcek P, Yaremchuk S, Weryha G, Canu L, Wohllk N, Sebag F, Walz MK, Eng C, Neumann HPH. The penetrance of MEN2 pheochromocytoma is not only determined by RET mutations. Endocr Relat Cancer 2017. [PMID: 28649091 DOI: 10.1530/erc-17-0189] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Frederic Castinetti
- Department of Endocrinology Aix Marseille UniversityCNRS UMR7286 La Conception Hospital, Hopitaux de Marseille, Marseille, France
| | - Ana Luiza Maia
- Thyroid SectionEndocrinology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Marta Barontini
- Center for Endocrinological InvestigationsHospital de Ninos R Gutierrez, Buenos Aires, Argentina
| | - Kornelia Hasse-Lazar
- Department of Nuclear Medicine and Endocrine OncologyMaria Sklodowska Curie Memorial Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Thera P Links
- Department of EndocrinologyUniversity Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Rodrigo A Toledo
- Department of EndocrinologyUniversity of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Sarka Dvorakova
- Department of Molecular EndocrinologyInstitute of Endocrinology, Prague, Czech Republic
| | - Caterina Mian
- Operative Unit of the Endocrinology Department of Medicine (DIMED)University of Padova, Padova, Italy
| | | | - Stefania Zovato
- Department of Medicine (DIMED)University of Padova, Padova, Italy
| | - Maria Alevizaki
- Endocrine Unit Evgenideion Hospital and Department of Medical TherapeuticsAlexandra Hospital, Athens University School of Medicine, Athens, Greece
| | | | - Birke Bausch
- 2nd Department of MedicineUniversity Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - Paola Loli
- Department of EndocrinologyOspedale Niguarda Cà Granda, Milan, Italy
| | - Simona R Bergmann
- Division of Endocrinology and DiabetologyFaculty of Medicine, Philipps University of Marburg, Marburg, Germany
| | - Attila Patocs
- Molecular Medicine Research GroupHSA-SE 'Lendület' Hereditary Endocrine Tumor Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Marija Pfeifer
- Department of EndocrinologyUniversity Medical Center Ljubljana, Ljubljana, Slovenia
| | - Josefina Biarnes Costa
- Hospital Universitari de GironaGerencia Territorial Girona, Institut Català de la Salut, Girona, Spain
| | - Ernst von Dobschuetz
- Department of Visceral SurgeryUniversity Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - Claudio Letizia
- Department of Internal Medicine and Medical SpecialtiesUniversity La Sapienza, Rome, Italy
| | - Gerlof Valk
- Department of Internal MedicineUniversity Medical Centre Utrecht, Utrecht, Netherlands
| | - Marcin Barczynski
- Department of Endocrine SurgeryThird Chair of General Surgery, Jagiellonian University, Medical College, Krakow, Poland
| | - Malgorzata Czetwertynska
- Department of EndocrinologyMaria Sklodowska Curie Memorial Center and Institute of Oncology, Warsaw, Poland
| | - John T M Plukker
- Department of SurgeryUniversity Medical Centre, Groningen, Netherlands
| | - Paola Sartorato
- Department of Internal MedicineGeneral Hospital, Montebelluna, Treviso, Italy
| | - Tomas Zelinka
- 3rd Department of MedicineDepartment of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Petr Vlcek
- Department of Nuclear Medicine and EndocrinologySecond Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Georges Weryha
- Department of EndocrinologyUniversity Hospital, Nancy, France
| | - Letizia Canu
- Department of Experimental and Clinical Biomedical SciencesEndocrinology Unit, University of Florence, Florence, Italy
| | - Nelson Wohllk
- Endocrine SectionUniversidad de Chile, Hospital del Salvador, Santiago de Chile, Chile
| | - Frederic Sebag
- Department of Endocrine SurgeryAix-Marseille University, La Conception Hospital, Marseille, France
| | - Martin K Walz
- Department of Surgery and Center of Minimally Invasive SurgeryKliniken Essen-Mitte, Essen, Germany
| | - Charis Eng
- Genomic Medicine InstituteLerner Research Institute and Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Hartmut P H Neumann
- Section for Preventive MedicineDepartment of Nephrology and General Medicine, University Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
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Moreddu E, Baumstarck-Barrau K, Gabriel S, Fakhry N, Sebag F, Mundler O, Chossegros C, Taïeb D. Incidence of salivary side effects after radioiodine treatment using a new specifically-designed questionnaire. Br J Oral Maxillofac Surg 2017; 55:609-612. [DOI: 10.1016/j.bjoms.2017.03.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/28/2017] [Indexed: 11/16/2022]
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Daher R, Lifante JC, Voirin N, Peix JL, Colin C, Kraimps JL, Menegaux F, Pattou F, Sebag F, Touzet S, Bourdy S, Duclos A. Is it possible to limit the risks of thyroid surgery? Ann Endocrinol (Paris) 2016; 76:1S16-26. [PMID: 26826478 DOI: 10.1016/s0003-4266(16)30010-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Inferior laryngeal nerve (ILN) palsy and hypocalcemia remain the two most frequent major complications after thyroid surgery. Their occurrences may be explained by the influence of factors related to the patient, the surgical procedure, thyroid pathology, or the surgeon's technique. This study aims To assess whether systematically following a rigorous surgical technique during thyroidectomy affects postoperative complications and long-term patient recovery. METHODS We conducted a multicenter, cross-sectional study of prospectively collected data in five high-volume referral centers enrolling all patients who underwent thyroid surgery between April 2008 and December 2009. Inferior laryngeal nerve (ILN) palsy and hypocalcemia were systematically assessed during hospitalization based on objective criteria. A six-month follow-up was conducted in cases of early complications. Multivariate regression models were computed to quantify their relationship with potential risk factors. RESULTS A total of 3574 thyroid procedures were completed. Non-visualization of the ILN during dissection and a large thyroid mass were major risk factors for permanent ILN palsy (OR, 4.17 and 2.61, p<0.01) and persistent complications after initial injury (OR, 4.17 and 2.42, p<0.05). The presence of thyroiditis on the surgical specimen was an independent risk factor for permanent hypoparathyroidism and poor recovery after initial dysfunction (OR, 1.76 and 1.88, p<0.05). CONCLUSIONS Thorough meticulous technique in thyroid surgery is a determinant of ILN function but fails to prevent persistent hypoparathyroidism.
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Affiliation(s)
- R Daher
- Hospices civils de Lyon, Centre hospitalier Lyon-Sud, Service de chirurgie générale et endocrinienne, Pierre-Bénite, F-69495, France
| | - J-C Lifante
- Hospices civils de Lyon, Centre hospitalier Lyon-Sud, Service de chirurgie générale et endocrinienne, Pierre-Bénite, F-69495, France.
| | - N Voirin
- Hospices civils de Lyon, Hôpital Édouard-Herriot, Service d'hygiène, épidémiologie et prévention, Lyon, F-6943, France; Université de Lyon 1, Laboratoire de biométrie et biologie évolutive, Lyon, F-69373, France; CNRS, UMR 5558, Laboratoire de biométrie et biologie évolutive, Lyon, F-69373, France
| | - J-L Peix
- Hospices civils de Lyon, Centre hospitalier Lyon-Sud, Service de chirurgie générale et endocrinienne, Pierre-Bénite, F-69495, France
| | - C Colin
- Hospices civils de Lyon, Pôle information médicale évaluation recherche, Lyon, F-69003; Université de Lyon, EA Santé-Individu-Société 4129, Lyon, F-69002, France
| | - J-L Kraimps
- Department of Endocrine Surgery, Poitiers University, Jean-Bernard Hospital, 86021-Poitiers, France
| | - F Menegaux
- Assistance publique-Hôpitaux de Paris, Hôpital la Pitié-Salpêtrière, Service de chirurgie générale, viscérale et endocrinienne, Paris, France
| | - F Pattou
- CHRU de Lille, Chirurgie générale et endocrinienne, Lille, 59000, France; Université Lille-Nord de France, INSERM, UMR 859, Lille, 59000, France
| | - F Sebag
- Assistance publique-Hôpitaux de Marseille, CHU la Timone-Adulte, France
| | - S Touzet
- Hospices civils de Lyon, Pôle information médicale évaluation recherche, Lyon, F-69003; Université de Lyon, EA Santé-Individu-Société 4129, Lyon, F-69002, France
| | - S Bourdy
- Hospices civils de Lyon, Pôle information médicale évaluation recherche, Lyon, F-69003; Université de Lyon, EA Santé-Individu-Société 4129, Lyon, F-69002, France
| | - A Duclos
- Hospices civils de Lyon, Pôle information médicale évaluation recherche, Lyon, F-69003; Center for Surgery and Public Health, Brigham and Women's Hospital - Harvard Medical School, Boston, MA, USA; Université de Lyon, EA Santé-Individu-Société 4129, Lyon, F-69002, France
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Abstract
INTRODUCTION Oligometastatic cancer prognosis is distinct from polymetastatic cancer prognosis and surgery can improve survival. The objective of this study was to assess the role of adrenalectomy and to look for prognostic or predictive factors for the treatment of patients with oligometastatic solid tumors and adrenal metastasis. MATERIAL AND METHODS Patients with oligometastatic solid tumors undergoing adrenalectomy were selected. Clinical data were retrieved from electronic patients records. Progression-free survival (PFS), overall survival (OS) and clinical outcomes were assessed. RESULTS Forty patients were analyzed. Median PFS was 7.4 months and PFS was longer for metachronous versus synchronous adrenal metastasis (10.8 versus 4.5 months; P=0.008). Median OS was 22.8 months and OS was better with laparoscopic adrenalectomy versus open adrenalectomy (24.4 versus 11.2 months; P=0.05). DISCUSSION Adrenalectomy part of the treatment plan of oligometastatic solid tumors but patients have to be selected. Surgery might be indicated for metachronous metastasis when laparoscopic adrenalectomy is possible.
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Affiliation(s)
- P Tomasini
- Aix Marseille university, Assistance publique-Hôpitaux de Marseille, multidisciplinary oncology & therapeutic innovations department, 13015 Marseille, France; Aix Marseille university, Inserm U911 CRO2, 13005 Marseille, France.
| | - M-E Garcia
- Aix Marseille university, Assistance publique-Hôpitaux de Marseille, multidisciplinary oncology & therapeutic innovations department, 13015 Marseille, France
| | - L Greillier
- Aix Marseille university, Assistance publique-Hôpitaux de Marseille, multidisciplinary oncology & therapeutic innovations department, 13015 Marseille, France; Aix Marseille university, Inserm U911 CRO2, 13005 Marseille, France
| | - C Paladino
- Aix Marseille university, Assistance publique-Hôpitaux de Marseille, endocrine surgery department, 13005 Marseille, France
| | - F Sebag
- Aix Marseille university, Assistance publique-Hôpitaux de Marseille, endocrine surgery department, 13005 Marseille, France
| | - F Barlesi
- Aix Marseille university, Assistance publique-Hôpitaux de Marseille, multidisciplinary oncology & therapeutic innovations department, 13015 Marseille, France; Aix Marseille university, Inserm U911 CRO2, 13005 Marseille, France
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Vanbrugghe C, Lowery AJ, Golffier C, Taieb D, Sebag F. Adrenocortical carcinoma surgery-surgical extent and approach. Langenbecks Arch Surg 2016; 401:991-997. [PMID: 27412357 DOI: 10.1007/s00423-016-1462-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 11/13/2015] [Accepted: 06/08/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Adequate tumour resection is the gold standard of care for adrenocortical carcinoma (ACC). However, the optimal surgical strategy remains debatable. In our opinion, the extent of surgery (adequate tumour resection) is the primary concern, rather than the surgical approach (laparoscopic or open). We propose that both surgical approaches have a role in the management of ACC provided the extent of resection is selected based on patient and tumour characteristics and accurate pre-operative investigations. METHODS A review of 25 curative intent resections for ACC between 2002 and 2013 was done. Group A (16 patients-64 %) included all patients who underwent planned radical adrenalectomy without any other resection and group B (9 patients-36 %) included all patients who underwent a planned extensive resection based on pre-operative investigations. RESULTS Of 471 adrenalectomies, 25 were performed for ACC with curative intent. Tumours were significantly larger in group B with mean size of 119.6 versus 62.4 mm in group A (p = 0.002). Tumours in group B also had higher WEISS scores (mean score 7 vs 5.2, p = 0.033) and almost always required multi-organ resection. The recurrence rate was 37.5 % (n = 6) for group A and 44.4 % for group B (n = 4), p = 1.00. Poor prognosis was associated with significantly higher WEISS scores (p = 0.016) and a trend towards more advanced ENSAT disease stage (p = 0.06). Estimated overall survival was 74.17 months (group A 67.3 vs group B 70.1, p = 0.244). CONCLUSIONS Accurate pre-operative staging is critical to select a tailored surgical strategy. Multi-organ resection remains the preferred approach for large and potentially invasive ACC. Some patients presenting with smaller ACC may benefit from a more extensive resection.
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Affiliation(s)
- C Vanbrugghe
- Department of Endocrine Surgery, La Conception University Hospital, 176, boulevard Baille, 13006, Marseille, France.
| | - A J Lowery
- Department of Endocrine Surgery, La Conception University Hospital, 176, boulevard Baille, 13006, Marseille, France
| | - C Golffier
- Department of Endocrine Surgery, La Conception University Hospital, 176, boulevard Baille, 13006, Marseille, France
| | - D Taieb
- Department of Nuclear Medicine, La Timone University Hospital, 264, rue Saint-Pierre, 13005, Marseille, France
| | - F Sebag
- Department of Endocrine Surgery, La Conception University Hospital, 176, boulevard Baille, 13006, Marseille, France
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Devèze A, Sebag F, Pili S, Henry JF. Parathyroid Adenoma Disclosed by a Massive Cervical Hematoma. Otolaryngol Head Neck Surg 2016; 134:710-2. [PMID: 16564403 DOI: 10.1016/j.otohns.2005.03.075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2004] [Revised: 01/05/2005] [Accepted: 03/09/2005] [Indexed: 11/20/2022]
Affiliation(s)
- A Devèze
- Department of Otolaryngology-Head and Neck Surgery, North University Hospital, Marseille, France.
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Gurrado A, Bellantone R, Cavallaro G, Citton M, Constantinides V, Conzo G, Di Meo G, Docimo G, Franco IF, Iacobone M, Lombardi CP, Materazzi G, Minuto M, Palazzo F, Pasculli A, Raffaelli M, Sebag F, Tolone S, Miccoli P, Testini M. Can Total Thyroidectomy Be Safely Performed by Residents?: A Comparative Retrospective Multicenter Study. Medicine (Baltimore) 2016; 95:e3241. [PMID: 27057861 PMCID: PMC4998777 DOI: 10.1097/md.0000000000003241] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This retrospective comparative multicenter study aims to analyze the impact on patient outcomes of total thyroidectomy (TT) performed by resident surgeons (RS) with close supervision and assistance of attending surgeons (AS).All patients who underwent TT between 2009 and 2013 in 10 Units of endocrine surgery (8 in Italy, 1 in France, and 1 in UK) were evaluated. Demographic data, preoperative diagnosis, extension of goiter, type of surgical access, surgical approach, operative time, use and duration of drain, length of hospitalization, histology, and postoperative complications were recorded. Patients were divided into 3 groups: A, when treated by an AS assisted by an RS; B and C, when treated by a junior and a senior RS, respectively, assisted by an AS.The 8908 patients (mean age 51.1 ± 13.6 years), with 6602 (74.1%) females were enrolled. Group A counted 7092 (79.6%) patients, Group B 261 (2.9%) and Group C 1555 (17.5%). Operative time was significantly greater (P < 0.001) in B (101.3 ± 43.0 min) vs A (71.8 ± 27.6 min) and C (81.2 ± 29.9 min). Duration of drain was significantly lower (P < 0.001) in A (47.4 ± 13.2 h) vs C (56.4 ± 16.5 h), and in B (42.8 ± 14.9 h) vs A and C. Length of hospitalization was significantly longer (P < 0.001) in C (3.8 ± 1.8 days) vs B (2.4 ± 1.0 days) and A (2.6 ± 1.5 days). No mortality occurred. Overall postoperative morbidity was 22.3%: it was significantly higher in B vs A (29.5% vs 22.3%; odds ratio [OR] 1.46, 95% confidence interval [CI] 1.11-1.92, P = 0.006) and C (21.3%; OR 1.55, 95% CI 1.15-2.07, P = 0.003). No differences were found for recurrent laryngeal nerve palsy, hypoparathyroidism, hemorrhage, and wound infection. The adjusted ORs in multivariate analysis showed that overall morbidity remained significantly associated with Group B vs A (OR 1.48, 95% CI 1.12-1.96, P = 0.005) and vs C (OR 1.60, 95% CI 1.19-2.17, P = 0.002), while no difference was observed in Group A vs B + C.TT can be safely performed by residents correctly supervised. Innovative gradual training in dedicated high-volume hospitals should be proposed in order to allow adequate autonomy for the RS and safeguard patient outcome.
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Affiliation(s)
- Angela Gurrado
- From the Department of Biomedical Sciences and Human Oncology (AG, GDM, AP, MT), University Medical School of Bari, Bari; Department of Surgery (RB, CPL, MR), University Medical School "Cattolica del Sacro Cuore," Rome; Department of Medical and Surgical Sciences and Biotechnologies (GC), University Medical School "La Sapienza," Rome; Department of Surgery (MC, MI), Oncology and Gastroenterology, University of Padova, Padova; Department of Anesthesiology (GC, GD, ST), Surgical and Emergency Sciences, Second University of Naples, Naples; Department of Surgical (GM, PM), Medical, Molecular Pathology, Critical Area, University Medical School of Pisa, Pisa; Department of Surgical Sciences (MM), University Medical School of Genoa, Genoa, Italy; Department of Thyroid and Endocrine Surgery (VC, FP), Imperial College London, London, UK; and Department of General and Endocrine Surgery (IFF, FS), Hôpital de la Timone, Marseille, France
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Abstract
Therapeutic options available for the treatment of Cushing's syndrome (CS) have expanded over the last 5 years. For instance, the efficient management of severe hypercortisolism using a combination of fast-acting steroidogenesis inhibitors has been reported. Recent publications on the long-term efficacy of drugs or radiation techniques have also demonstrated low toxicity. These data should encourage endocrinologists to reconsider the place of bilateral adrenalectomy in patients with ACTH-dependent aetiologies of CS; similarly, the indication of bilateral adrenalectomy is reassessed in primary bilateral macronodular adrenal hyperplasia. The objective of this review is to compare the efficacy and side effects of the various therapeutic options of hypercortisolism with those of bilateral adrenalectomy, in order to better define its indications in the 21st century.
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Affiliation(s)
- Carole Guerin
- Aix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrine Surgery, La Conception Hospital, Marseille, FranceAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Nuclear Medicine, La Timone Hospital, Marseille, FranceDepartment of Nuclear MedicineThyroid and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona and Lugano, SwitzerlandAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrinology, La Conception Hospital, 147 Boulevard Baille, 13005 Marseille, FranceEndocrine DivisionDepartment of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - David Taieb
- Aix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrine Surgery, La Conception Hospital, Marseille, FranceAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Nuclear Medicine, La Timone Hospital, Marseille, FranceDepartment of Nuclear MedicineThyroid and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona and Lugano, SwitzerlandAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrinology, La Conception Hospital, 147 Boulevard Baille, 13005 Marseille, FranceEndocrine DivisionDepartment of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - Giorgio Treglia
- Aix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrine Surgery, La Conception Hospital, Marseille, FranceAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Nuclear Medicine, La Timone Hospital, Marseille, FranceDepartment of Nuclear MedicineThyroid and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona and Lugano, SwitzerlandAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrinology, La Conception Hospital, 147 Boulevard Baille, 13005 Marseille, FranceEndocrine DivisionDepartment of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - Thierry Brue
- Aix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrine Surgery, La Conception Hospital, Marseille, FranceAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Nuclear Medicine, La Timone Hospital, Marseille, FranceDepartment of Nuclear MedicineThyroid and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona and Lugano, SwitzerlandAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrinology, La Conception Hospital, 147 Boulevard Baille, 13005 Marseille, FranceEndocrine DivisionDepartment of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - André Lacroix
- Aix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrine Surgery, La Conception Hospital, Marseille, FranceAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Nuclear Medicine, La Timone Hospital, Marseille, FranceDepartment of Nuclear MedicineThyroid and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona and Lugano, SwitzerlandAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrinology, La Conception Hospital, 147 Boulevard Baille, 13005 Marseille, FranceEndocrine DivisionDepartment of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - Frederic Sebag
- Aix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrine Surgery, La Conception Hospital, Marseille, FranceAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Nuclear Medicine, La Timone Hospital, Marseille, FranceDepartment of Nuclear MedicineThyroid and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona and Lugano, SwitzerlandAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrinology, La Conception Hospital, 147 Boulevard Baille, 13005 Marseille, FranceEndocrine DivisionDepartment of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - Frederic Castinetti
- Aix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrine Surgery, La Conception Hospital, Marseille, FranceAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Nuclear Medicine, La Timone Hospital, Marseille, FranceDepartment of Nuclear MedicineThyroid and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona and Lugano, SwitzerlandAix-Marseille UniversityAssistance Publique Hopitaux de Marseille, Department of Endocrinology, La Conception Hospital, 147 Boulevard Baille, 13005 Marseille, FranceEndocrine DivisionDepartment of Medicine, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
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Sebag F, Ernande L, Mignot N, Lellouche N. 0324: Prognostic value of epicardial-endocardial gradient measured by echocardiography to predict Cardiac Resynchronization Therapy (CRT) response. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30221-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Castinetti F, Taieb D, Henry JF, Walz M, Guerin C, Brue T, Conte-Devolx B, Neumann HPH, Sebag F. MANAGEMENT OF ENDOCRINE DISEASE: Outcome of adrenal sparing surgery in heritable pheochromocytoma. Eur J Endocrinol 2016; 174:R9-18. [PMID: 26297495 DOI: 10.1530/eje-15-0549] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [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: 06/04/2015] [Accepted: 08/21/2015] [Indexed: 11/08/2022]
Abstract
The management of hereditary pheochromocytoma has drastically evolved in the last 20 years. Bilateral pheochromocytoma does not increase mortality in MEN2 or von Hippel-Lindau (VHL) mutation carriers who are followed regularly, but these mutations induce major morbidities if total bilateral adrenalectomy is performed. Cortical sparing adrenal surgery may be proposed to avoid definitive adrenal insufficiency. The surgical goal is to leave sufficient cortical tissue to avoid glucocorticoid replacement therapy. This approach was achieved by the progressive experience of minimally invasive surgery via the transperitoneal or retroperitoneal route. Cortical sparing adrenal surgery exhibits <5% significant recurrence after 10 years of follow-up and normal glucocorticoid function in more than 50% of the cases. Therefore, cortical sparing adrenal surgery should be systematically considered in the management of all patients with MEN2 or VHL hereditary pheochromocytoma. Hereditary pheochromocytoma is a rare disease, and a randomized trial comparing cortical sparing vs classical adrenalectomy is probably not possible. This lack of data most likely explains why cortical sparing surgery has not been adopted in most expert centers that perform at least 20 procedures per year for the treatment of this disease. This review examined recent data to provide insight into the technique, its indications, and the results and subsequent follow-up in the management of patients with hereditary pheochromocytoma with a special emphasis on MEN2.
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Affiliation(s)
- F Castinetti
- Department of EndocrinologyLa Conception HospitalDepartment of Nuclear MedicineLa Timone HospitalDepartment of Endocrine SurgeryLa Conception Hospital, Assistance Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, FranceDepartment of SurgeryCenter of Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, GermanySection for Preventive MedicineDepartment of Nephrology and General Medicine, University Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - D Taieb
- Department of EndocrinologyLa Conception HospitalDepartment of Nuclear MedicineLa Timone HospitalDepartment of Endocrine SurgeryLa Conception Hospital, Assistance Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, FranceDepartment of SurgeryCenter of Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, GermanySection for Preventive MedicineDepartment of Nephrology and General Medicine, University Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - J F Henry
- Department of EndocrinologyLa Conception HospitalDepartment of Nuclear MedicineLa Timone HospitalDepartment of Endocrine SurgeryLa Conception Hospital, Assistance Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, FranceDepartment of SurgeryCenter of Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, GermanySection for Preventive MedicineDepartment of Nephrology and General Medicine, University Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - M Walz
- Department of EndocrinologyLa Conception HospitalDepartment of Nuclear MedicineLa Timone HospitalDepartment of Endocrine SurgeryLa Conception Hospital, Assistance Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, FranceDepartment of SurgeryCenter of Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, GermanySection for Preventive MedicineDepartment of Nephrology and General Medicine, University Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - C Guerin
- Department of EndocrinologyLa Conception HospitalDepartment of Nuclear MedicineLa Timone HospitalDepartment of Endocrine SurgeryLa Conception Hospital, Assistance Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, FranceDepartment of SurgeryCenter of Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, GermanySection for Preventive MedicineDepartment of Nephrology and General Medicine, University Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - T Brue
- Department of EndocrinologyLa Conception HospitalDepartment of Nuclear MedicineLa Timone HospitalDepartment of Endocrine SurgeryLa Conception Hospital, Assistance Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, FranceDepartment of SurgeryCenter of Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, GermanySection for Preventive MedicineDepartment of Nephrology and General Medicine, University Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - B Conte-Devolx
- Department of EndocrinologyLa Conception HospitalDepartment of Nuclear MedicineLa Timone HospitalDepartment of Endocrine SurgeryLa Conception Hospital, Assistance Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, FranceDepartment of SurgeryCenter of Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, GermanySection for Preventive MedicineDepartment of Nephrology and General Medicine, University Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - H P H Neumann
- Department of EndocrinologyLa Conception HospitalDepartment of Nuclear MedicineLa Timone HospitalDepartment of Endocrine SurgeryLa Conception Hospital, Assistance Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, FranceDepartment of SurgeryCenter of Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, GermanySection for Preventive MedicineDepartment of Nephrology and General Medicine, University Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - F Sebag
- Department of EndocrinologyLa Conception HospitalDepartment of Nuclear MedicineLa Timone HospitalDepartment of Endocrine SurgeryLa Conception Hospital, Assistance Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, FranceDepartment of SurgeryCenter of Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, GermanySection for Preventive MedicineDepartment of Nephrology and General Medicine, University Medical Centre, Albert Ludwigs University of Freiburg, Freiburg, Germany
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Nielsen HM, How-Kit A, Guerin C, Castinetti F, Vollan HKM, De Micco C, Daunay A, Taieb D, Van Loo P, Besse C, Kristensen VN, Hansen LL, Barlier A, Sebag F, Tost J. Copy number variations alter methylation and parallel IGF2 overexpression in adrenal tumors. Endocr Relat Cancer 2015; 22:953-67. [PMID: 26400872 PMCID: PMC4621769 DOI: 10.1530/erc-15-0086] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2015] [Indexed: 12/14/2022]
Abstract
Overexpression of insulin growth factor 2 (IGF2) is a hallmark of adrenocortical carcinomas and pheochromocytomas. Previous studies investigating the IGF2/H19 locus have mainly focused on a single molecular level such as genomic alterations or altered DNA methylation levels and the causal changes underlying IGF2 overexpression are still not fully established. In the current study, we analyzed 62 tumors of the adrenal gland from patients with Conn's adenoma (CA, n=12), pheochromocytomas (PCC, n=10), adrenocortical benign tumors (ACBT, n=20), and adrenocortical carcinomas (ACC, n=20). Gene expression, somatic copy number variation of chr11p15.5, and DNA methylation status of three differential methylated regions of the IGF2/H19 locus including the H19 imprinting control region were integratively analyzed. IGF2 overexpression was found in 85% of the ACCs and 100% of the PCCs compared to 23% observed in CAs and ACBTs. Copy number aberrations of chr11p15.5 were abundant in both PCCs and ACCs but while PCCs retained a diploid state, ACCs were frequently tetraploid (7/19). Loss of either a single allele or loss of two alleles of the same parental origin in tetraploid samples resulted in a uniparental disomy-like genotype. These copy number changes correlated with hypermethylation of the H19 ICR suggesting that the lost alleles were the unmethylated maternal alleles. Our data provide conclusive evidence that loss of the maternal allele correlates with IGF2 overexpression in adrenal tumors and that hypermethylation of the H19 ICR is a consequence thereof.
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Affiliation(s)
- Helene Myrtue Nielsen
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty
| | - Alexandre How-Kit
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
| | - Carole Guerin
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
| | - Frederic Castinetti
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
| | - Hans Kristian Moen Vollan
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty
| | - Catherine De Micco
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
| | - Antoine Daunay
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
| | - David Taieb
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
| | - Peter Van Loo
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty
| | - Celine Besse
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
| | - Vessela N Kristensen
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty
| | - Lise Lotte Hansen
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
| | - Anne Barlier
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
| | - Frederic Sebag
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
| | - Jörg Tost
- Laboratory for Functional GenomicsFondation Jean Dausset - Centre d'Etude du Polymorphisme Humain (CEPH), Paris, FranceInstitute of BiomedicineAarhus University, Aarhus, DenmarkEndocrine and Metabolic Surgery DepartmentAP-HM La Conception, Marseille, FranceDepartment of EndocrinologyAP-HM La Timone, Marseille, FranceDepartment of GeneticsInstitute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, NorwayDivision of SurgeryTransplantation and Cancer Medicine, Department of Oncology, Oslo University Hospital, Oslo, NorwayThe K G Jebsen Center for Breast Cancer ResearchInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayPathology DepartmentAP-HM La Timone, Marseille, FranceNuclear Endocrine Imaging and Treatment DepartmentAP-HM La Timone, Marseille, FranceCancer Research UKLondon Research Institute, London, UKDepartment of Human GeneticsUniversity of Leuven, Leuven, BelgiumGenotyping FacilitiesCentre National de Génotypage, CEA-Institut de Génomique, Evry, FranceDepartment of Clinical Molecular Biology (EpiGen)University of Oslo, Ahus, Lokerod, NorwayLaboratory of Molecular BiologyAP-HM La Conception and CRN2M, Aix-Marseille University, Marseille, FranceLaboratory for Epigenetics and EnvironmentCentre National de Génotypage, CEA-Institut de Génomique, Evry, France
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McVeigh TP, Owens PW, Mulligan R, Miller N, Guerin C, Sebag F, Quill D, Bell M, Lowery AJ, Weidhaas JB, Kerin MJ. 22. Investigating the role of polymorphism rs2910164 in mir146a in cancer predisposition. Eur J Surg Oncol 2015. [DOI: 10.1016/j.ejso.2015.08.098] [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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Sebag F, Lellouche N, Rinaldi A, Wright M. 0435: Arrhythmic outcome after CRT-D device replacement. Archives of Cardiovascular Diseases Supplements 2015. [DOI: 10.1016/s1878-6480(15)71663-0] [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: 11/16/2022]
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Sebag F, Lellouche N, Dubois Randé JL, Gueret P, Luc Monin J. 0436: Prevalence and clinical impact of QRS duration in patients with low-flow/low-gradient aortic stenosis due to left ventricular systolic dysfunction. Archives of Cardiovascular Diseases Supplements 2015. [DOI: 10.1016/s1878-6480(15)71651-4] [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: 10/24/2022]
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Menegaux F, Chéreau N, Peix JL, Christou N, Lifante JC, Paladino N, Sebag F, Ghander C, Trésallet C, Mathonnet M. Management of adrenal incidentaloma. J Visc Surg 2014; 151:355-64. [DOI: 10.1016/j.jviscsurg.2014.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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