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Raymond J, Gentric JC, Magro E, Nico L, Bacchus E, Klink R, Cognard C, Januel AC, Sabatier JF, Iancu D, Weill A, Roy D, Bojanowski MW, Chaalala C, Barreau X, Jecko V, Papagiannaki C, Derrey S, Shotar E, Cornu P, Eker OF, Pelissou-Guyotat I, Piotin M, Aldea S, Beaujeux R, Proust F, Anxionnat R, Costalat V, Corre ML, Gauvrit JY, Morandi X, Brunel H, Roche PH, Graillon T, Chabert E, Herbreteau D, Desal H, Trystram D, Barbier C, Gaberel T, Nguyen TN, Viard G, Gevry G, Darsaut TE, _ _, _ _, Raymond J, Roy D, Weill A, Iancu D, Bojanowski MW, Chaalala C, Darsaut TE, O’Kelly CJ, Chow MMC, Findlay JM, Rempel JL, Fahed R, Lesiuk H, Drake B, Santos MD, Gentric JC, Nonent M, Ognard J, El-Aouni MC, Magro E, Seizeur R, Timsit S, Pradier O, Desal H, Boursier R, Thillays F, Roualdes V, Piotin M, Blanc R, Aldea S, Cognard C, Januel AC, Sabatier JF, Calviere L, Gauvrit JY, Raoult H, Eugene F, Bras AL, Ferre JC, Paya C, Morandi X, Lecouillard I, Nouhaud E, Ronziere T, Trystram D, Naggara O, Rodriguez-Regent C, Kerleroux B, Barbier C, Gaberel T, Emery E, Touze E, Papagiannaki C, Derrey S, Eker OF, Riva R, Pellisou-Guyotat I, Guyotat J, Berhouma M, Dumot C, Biondi A, Thines L, Bougaci N, Charbonnier G, Bracard S, Anxionnat R, Gory B, Civit T, Bernier-Chastagner V, Barreau X, Marnat G, Jecko V, Penchet G, Gimbert E, Huchet A, Herbreteau D, Boulouis G, Bibi R, Ifergan H, Janot K, Velut S, Brunel H, Roche PH, Graillon T, Peyriere H, Kaya JM, Touta A, Troude L, Boissonneau S, Clarençon F, Shotar E, Sourour N, Lenck S, Premat K, Boch AL, Cornu P, Nouet A, Costalat V, Bonafe A, Dargazanli C, Gascou G, Lefevre PH, Riquelme C, Corre ML, Beaujeux R, Pop R, Proust F, Cebula H, Ollivier I, Spatola G, Spell L, Chalumeau V, Gallas S, Ikka L, Mihalea C, Ozanne A, Caroff J, Chabert E, Mounayer C, Rouchaud A, Caire F, Ricolfi F, Thouant P, Cao C, Mourier KL, Farah W, Nguyen TN, Abdalkader M, Huynh T, Tawk RG, Carlson AP, Silva LAO, Froio NDL, Silva GS, Mont’Alverne FJA, Martins JL, Mendes GN, Miranda RR. Endovascular treatment of brain arteriovenous malformations: clinical outcomes of patients included in the registry of a pragmatic randomized trial. J Neurosurg 2022; 138:1393-1402. [PMID: 37132535 DOI: 10.3171/2022.9.jns22987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
The role of endovascular treatment in the management of patients with brain arteriovenous malformations (AVMs) remains uncertain. AVM embolization can be offered as stand-alone curative therapy or prior to surgery or stereotactic radiosurgery (SRS) (pre-embolization). The Treatment of Brain AVMs Study (TOBAS) is an all-inclusive pragmatic study that comprises two randomized trials and multiple registries.
METHODS
Results from the TOBAS curative and pre-embolization registries are reported. The primary outcome for this report is death or dependency (modified Rankin Scale [mRS] score > 2) at last follow-up. Secondary outcomes include angiographic results, perioperative serious adverse events (SAEs), and permanent treatment-related complications leading to an mRS score > 2.
RESULTS
From June 2014 to May 2021, 1010 patients were recruited in TOBAS. Embolization was chosen as the primary curative treatment for 116 patients and pre-embolization prior to surgery or SRS for 92 patients. Clinical and angiographic outcomes were available in 106 (91%) of 116 and 77 (84%) of 92 patients, respectively. In the curative embolization registry, 70% of AVMs were ruptured, and 62% were low-grade AVMs (Spetzler-Martin grade I or II), while the pre-embolization registry had 70% ruptured AVMs and 58% low-grade AVMs. The primary outcome of death or disability (mRS score > 2) occurred in 15 (14%, 95% CI 8%–22%) of the 106 patients in the curative embolization registry (4 [12%, 95% CI 5%–28%] of 32 unruptured AVMs and 11 [15%, 95% CI 8%–25%] of 74 ruptured AVMs) and 9 (12%, 95% CI 6%–21%) of the 77 patients in the pre-embolization registry (4 [17%, 95% CI 7%–37%] of 23 unruptured AVMs and 5 [9%, 95% CI 4%–20%] of 54 ruptured AVMs) at 2 years. Embolization alone was confirmed to occlude the AVM in 32 (30%, 95% CI 21%–40%) of the 106 curative attempts and in 9 (12%, 95% CI 6%–21%) of 77 patients in the pre-embolization registry. SAEs occurred in 28 of the 106 attempted curative patients (26%, 95% CI 18%–35%, including 21 new symptomatic hemorrhages [20%, 95% CI 13%–29%]). Five of the new hemorrhages were in previously unruptured AVMs (n = 32; 16%, 95% CI 5%–33%). Of the 77 pre-embolization patients, 18 had SAEs (23%, 95% CI 15%–34%), including 12 new symptomatic hemorrhages [16%, 95% CI 9%–26%]). Three of the hemorrhages were in previously unruptured AVMs (3/23; 13%, 95% CI 3%–34%).
CONCLUSIONS
Embolization as a curative treatment for brain AVMs was often incomplete. Hemorrhagic complications were frequent, even when the specified intent was pre-embolization before surgery or SRS. Because the role of endovascular treatment remains uncertain, it should preferably, when possible, be offered in the context of a randomized trial.
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Affiliation(s)
- Jean Raymond
- Department of Radiology, Service of Neuroradiology, Centre hospitalier de l’Université de Montréal (CHUM), and CHUM Research Centre, Montréal, Québec, Canada
| | | | - Elsa Magro
- Department of Neurosurgery, CHU Cavale Blanche, INSERM UMR 1101 LaTIM, Brest, France
| | - Lorena Nico
- Department of Radiology, CHU Saint-Etienne, France
| | - Emma Bacchus
- Division of Neurosurgery, Department of Surgery, University of Alberta Hospital, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada
| | - Ruby Klink
- Department of Radiology, Service of Neuroradiology, Centre hospitalier de l’Université de Montréal (CHUM), and CHUM Research Centre, Montréal, Québec, Canada
| | | | | | - Jean-François Sabatier
- Neurosurgery, Pierre-Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - Daniela Iancu
- Department of Radiology, Service of Neuroradiology, Centre hospitalier de l’Université de Montréal (CHUM), and CHUM Research Centre, Montréal, Québec, Canada
| | - Alain Weill
- Department of Radiology, Service of Neuroradiology, Centre hospitalier de l’Université de Montréal (CHUM), and CHUM Research Centre, Montréal, Québec, Canada
| | - Daniel Roy
- Department of Radiology, Service of Neuroradiology, Centre hospitalier de l’Université de Montréal (CHUM), and CHUM Research Centre, Montréal, Québec, Canada
| | - Michel W. Bojanowski
- Department of Surgery, Division of Neurosurgery, Centre hospitalier de l’Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Chiraz Chaalala
- Department of Surgery, Division of Neurosurgery, Centre hospitalier de l’Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Xavier Barreau
- Neuroradiology Department, Pellegrin Hospital Group, CHU Bordeaux, France
| | - Vincent Jecko
- Neurosurgery Department A, Pellegrin Hospital Group, CHU Bordeaux, France
| | | | - Stéphane Derrey
- Neurosurgery, Charles Nicolle Hospital, Rouen Normandy University Hospital, Rouen, France
| | | | - Philippe Cornu
- Neurosurgery, Mercy Salpetriere Hospital AP-HP, Paris, France
| | | | | | | | - Sorin Aldea
- Neurosurgery, Adolphe de Rothschild Foundation Hospital, Paris, France
| | | | - François Proust
- Neurosurgery, Strasbourg University Hospitals, Strasbourg, France
| | - René Anxionnat
- Interventional Neuroradiology Department, University of Lorraine, Laboratory IADI INSERM U1254, CHRU Nancy, France
| | | | | | | | | | - Hervé Brunel
- Departments of Interventional Neuroradiology and
| | | | | | - Emmanuel Chabert
- Interventional Neuroradiology Department, CHU Clermont-Ferrand, France
| | - Denis Herbreteau
- Interventional Neuroradiology Department, Bretonneau Hospital, Tours, France
| | - Hubert Desal
- Interventional Neuroradiology Department, CHU de Nantes, France
| | - Denis Trystram
- Interventional Neuroradiology Department, University of Paris, INSERM U1266, IPNP, GHU Paris, France
- Psychiatry and Neurosciences, Sainte-Anne Hospital, Paris, France
| | | | | | - Thanh N. Nguyen
- Departments of Radiology,
- Neurology, and
- Neurosurgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts; and
| | | | - Guylaine Gevry
- Department of Radiology, Service of Neuroradiology, Centre hospitalier de l’Université de Montréal (CHUM), and CHUM Research Centre, Montréal, Québec, Canada
| | - Tim E. Darsaut
- Division of Neurosurgery, Department of Surgery, University of Alberta Hospital, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada
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Boissonneau S, Tsiaremby M, Peyriere H, Graillon T, Farah K, Fuentes S, Dufour H. Post-operative complications in cranial and spine neurosurgery: a prospective observational study. J Neurosurg Sci 2021; 67:157-167. [PMID: 33709657 DOI: 10.23736/s0390-5616.21.05083-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Post-operative complications do occur in all neurosurgical departments, but the way they are defined, and their true incidence vary a lot. The aim of the present study is to objectively assess the morbidity and mortality related to all neurosurgical procedures performed in our department and provide insight on their main causes and identify key factors to reduce their incidence. METHODS Data were retrieved from a prospectively-maintained database regarding all patients undergoing a cranial or spinal neurosurgical procedure between November 2016 and April 2016 in the neurosurgical department in Timone University Hospital (APHMMarseille). Patients undergoing a functional, pediatric or interventional neuroradiological procedures were not included. RESULTS The medical records of a total number of 963 patients were analyzed. A postoperative complication occurred in 208 patients (21.6%) including 115 (26.6%) in the cranial surgery group and 93 (17.5%) in the spinal surgery group. A complication occurred 1.5 more frequently in the cranial than in the spinal surgery group. Cranial surgery is 1.5 times more at risk of complications than spinal surgery (p=0.007). Preoperative comorbidities (ASA score > 3 to 4) were significantly associated with the occurrence of complications (p<.001). In the cranial group, procedures performed in an emergency setting were 1.8 times more at risk of complications than scheduled surgeries (p<.001). Conversely, in the spine group, scheduled surgeries were 1.4 times less at risk than emergency procedures (p=0.04). The main complication in both groups was found to be post-operative infection, with an incidence of 9.3% and 11.1% for cranial and spinal surgery respectively. Post-operative mortality reached 4.9% and 1.7% and the average length of stay was 12 and 11 days respectively. CONCLUSIONS The incidence of complication in our series was found to be relatively high with predominantly infection as the main cause of postoperative complications. Reinforcing good practice measures at every step should help to significantly decrease our complication rate.
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Affiliation(s)
- Sebastien Boissonneau
- Department of Neurosurgery, Aix-Marseille Université, APHM, CHU Timone, Marseille, France - .,Inserm, INS, Institute of Neurosciences of Systems, Aix Marseille University, Marseille, France -
| | - Marc Tsiaremby
- Neurosurgical Unit, CHU Joseph Ravoahangy Andrianavalona, Ampefiloha, Antananarivo, Madagascar
| | - Hadrien Peyriere
- Department of Neurosurgery, Aix-Marseille Université, APHM, CHU Timone, Marseille, France
| | - Thomas Graillon
- Department of Neurosurgery, Aix-Marseille Université, APHM, CHU Timone, Marseille, France.,Aix-Marseille University, INSERM, MMG, Marseille, France
| | - Kaissar Farah
- Department of Neurosurgery, Aix-Marseille Université, APHM, CHU Timone, Marseille, France
| | - Stephane Fuentes
- Department of Neurosurgery, Aix-Marseille Université, APHM, CHU Timone, Marseille, France
| | - Henry Dufour
- Department of Neurosurgery, Aix-Marseille Université, APHM, CHU Timone, Marseille, France.,Aix-Marseille University, INSERM, MMG, Marseille, France
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Farah K, Peyriere H, Graillon T, Prost S, Dufour H, Blondel B, Fuentes S. Minimally invasive posterior fixation and anterior debridement-fusion for thoracolumbar spondylodiscitis: A 40-case series and review of the literature. Neurochirurgie 2019; 66:24-28. [PMID: 31836488 DOI: 10.1016/j.neuchi.2019.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/20/2019] [Accepted: 10/26/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Pyogenic spondylodiscitis is a rare disease, but incidence is increasing. Reported failure rates following conservative management range from 12% to 18%. The purpose of this study was to determine the safety and efficacy of posterior percutaneous pedicle screw fixation combined with anterior debridement and fusion (ADF) for infective spondylodiscitis in the thoracic and/or lumbar spine. METHODS The retrospective study cohort comprised all patients without neurological deficit who underwent minimally invasive posterior and anterior surgery between April 2008 and April 2016 for thoracic and/or lumbar spondylodiscitis. RESULTS Forty patients were eligible (16 female: 40%). The lumbar region was affected in 31 cases (77.5%). Source of infection was identified in only 22 cases (55%) and bacteriological identification was obtained in 32 cases (80%). Mean hospital stay was 14.8 days (range, 6-39 days). Complete recovery was achieved in 39 patients (97.5%) at 3 months' follow-up. Mean preoperative local kyphosis angle was 16.1o, versus 14o at 1-year (P>0.05). 36 patients (90%) had at least 1 year's follow-up, and fusion was obtained for all these cases. CONCLUSION Two-stage minimally invasive surgery is effective and safe for the treatment of single or two-level thoracolumbar spondylodiscitis. It could be an alternative to conventional open surgery or conservative treatment.
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Affiliation(s)
- K Farah
- Department of neurosurgery, La Timone university hospital, AP-HM, 13005 Marseille, France; Spine Unit, La Timone university hospital, AP-HM, Marseille, France.
| | - H Peyriere
- Department of neurosurgery, La Timone university hospital, AP-HM, 13005 Marseille, France; Spine Unit, La Timone university hospital, AP-HM, Marseille, France
| | - T Graillon
- Department of neurosurgery, La Timone university hospital, AP-HM, 13005 Marseille, France; Spine Unit, La Timone university hospital, AP-HM, Marseille, France
| | - S Prost
- Department of orthopedic surgery, La Timone university hospital, AP-HM, Marseille, France; Spine Unit, La Timone university hospital, AP-HM, Marseille, France
| | - H Dufour
- Department of neurosurgery, La Timone university hospital, AP-HM, 13005 Marseille, France; Spine Unit, La Timone university hospital, AP-HM, Marseille, France
| | - B Blondel
- Department of orthopedic surgery, La Timone university hospital, AP-HM, Marseille, France; Spine Unit, La Timone university hospital, AP-HM, Marseille, France
| | - S Fuentes
- Department of neurosurgery, La Timone university hospital, AP-HM, 13005 Marseille, France; Spine Unit, La Timone university hospital, AP-HM, Marseille, France
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Batisse A, Eiden C, Le Boisselier R, Tournebize J, Boucher A, Fauconneau B, Deheul S, Fouilhé N, Frauger E, Peyriere H, Djezzar S, Richard N, Monzon E. New psychoactive substances: French addictovigilance data between 2009 and 2017. Toxicologie Analytique et Clinique 2019. [DOI: 10.1016/j.toxac.2019.03.057] [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: 10/26/2022]
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Jacquet JM, Donnadieu-Rigole H, Peries M, Makinson A, Nagot N, Reynes J, Peyriere H. Implementing screening, brief intervention and referral to treatment in a French cohort of people living with HIV: a pilot study. HIV Med 2019; 20:286-290. [PMID: 30706622 DOI: 10.1111/hiv.12709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Screening, brief intervention and referral to treatment (SBIRT) is an evidence-based practice used to identify, reduce and prevent problematic use and abuse of, and dependence on, tobacco, alcohol and psychoactive substances. To date, the pertinence of this practice among people living with HIV (PLHIV) is unknown. In this pilot study, we aimed to assess the acceptability of SBIRT in a cohort of HIV-infected out-patients who were asked about their consumption of alcohol, tobacco and psychoactive substances. METHODS A monocentric study was performed at the University Hospital of Montpellier. In a 6-month period, 20 trained physicians screened for the consumption of alcohol [using the Alcohol Use Disorders Identification Test (AUDIT)], tobacco (using the Short Fagerstrom Test) and psychoactive substances [using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) V3.0] via an auto-questionnaire and proposed a brief intervention to patients with misusage. RESULTS One thousand and eighteen PLHIV completed the questionnaire, and 861 [84.6%; 95% confidence interval (CI) 82.2-86.7%] PLHIV returned it to the physician. Among the latter, 650 patients wished to discuss the answers with their physician (75.5%; 95% CI 72.5-78.3%), and brief interventions were realized in 405 patients (62.3%). CONCLUSIONS SBIRT is a simple screening and harm reduction tool that is well accepted by PLHIV in out-patient clinics. This method could be implemented in routine HIV care to screen and manage patients systematically for harmful substance use.
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Affiliation(s)
- J-M Jacquet
- Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France.,Department of Addictology, Nimes University Hospital, Nimes, France
| | - H Donnadieu-Rigole
- Department of Addictology, Montpellier University Hospital, Montpellier, France
| | - M Peries
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM UMR1058, CHU Montpellier, Montpellier, France
| | - A Makinson
- Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France.,INSERM U1175/IRD UMI 233, Montpellier University, Montpellier, France
| | - N Nagot
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM UMR1058, CHU Montpellier, Montpellier, France
| | - J Reynes
- Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France.,INSERM U1175/IRD UMI 233, Montpellier University, Montpellier, France
| | - H Peyriere
- Pathogenesis and Control of Chronic Infections, Montpellier University, INSERM UMR1058, CHU Montpellier, Montpellier, France.,INSERM U1175/IRD UMI 233, Montpellier University, Montpellier, France
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Peyron PA, Eiden C, Delage M, Peyriere H, Mathieu O, Baccino E. Intoxication létale au GHB suite à une prise massive de gammabutyrolactone (GBL). Toxicologie Analytique et Clinique 2017. [DOI: 10.1016/j.toxac.2017.03.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Peyriere H, Graillon T, Pesenti S, Tropiano P, Blondel B, Fuentes S. Surgical management of post-traumatic atlantoaxial rotatory fixation due to C2 facet fracture: 5 clinical cases. Orthop Traumatol Surg Res 2017; 103:67-70. [PMID: 27871970 DOI: 10.1016/j.otsr.2016.09.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 12/24/2015] [Revised: 07/19/2016] [Accepted: 09/05/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE Report the results of surgical treatment of post-traumatic atlantoaxial rotatory fixation (AARF) due to C2 articular facet fracture in adults. MATERIAL AND METHODS The records of five patients treated since 2009 for AARF due to a C2 articular facet fracture were analyzed retrospectively. Three women and two men with an average age of 60 years (27-82) were included, one of whom initially had neurological deficits. In all cases, the surgical strategy consisted of posterior fixation: Harms-type in four cases and trans-articular with hooks in one case. RESULTS Dislocations due to fracture of the C2 articular facet are rare in adults; various treatment strategies have been described. In our experience, posterior screw fixation leads to satisfactory clinical and radiological outcomes. Fusion is not necessary in these cases because the dislocation is related to an asymmetric fracture without ligament damage. CONCLUSION Posterior fixation provides satisfactory reduction of these injuries and leads to satisfactory bone union. This surgical treatment can be performed early on after the trauma and is an interesting alternative to conservative treatment.
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Affiliation(s)
- H Peyriere
- Unité de chirurgie du rachis, université Aix-Marseille, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - T Graillon
- Unité de chirurgie du rachis, université Aix-Marseille, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - S Pesenti
- Unité de chirurgie du rachis, université Aix-Marseille, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - P Tropiano
- Unité de chirurgie du rachis, université Aix-Marseille, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - B Blondel
- Unité de chirurgie du rachis, université Aix-Marseille, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - S Fuentes
- Unité de chirurgie du rachis, université Aix-Marseille, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille, France.
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Badiou S, Cournil A, Toubal S, Bargnoux AS, Dupuy AM, Fernandez C, Peyriere H, Reynes J, Cristol JP. Long term reference change value of creatinine in HIV-positive patients with anti-retroviral therapy: A new tool in clinical practice. Clin Biochem 2015; 48:622-4. [PMID: 25601234 DOI: 10.1016/j.clinbiochem.2015.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/30/2014] [Accepted: 01/07/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND The use of reference change value (RCV) instead of reference interval emerged as an alternative approach for longitudinal interpretation of biological marker. Follow-up of creatinine variation in HIV-positive adults remains a challenge in order to prevent renal complications. OBJECTIVES To determine the long term RCV of creatinine in HIV-positive adults receiving anti-retroviral therapy (ART) according to the use of tenofovir or ritonavir. DESIGN AND METHODS Longitudinal study of 24 months that include 124 HIV-positive patients followed in HIV outpatient unit. Plasma creatinine was measured at 0, 6, 12 and 24 months in order to calculate the RCV. RESULTS In the whole group, a 24-month RCV of creatinine was 22.5%. Whatever the ART, the index of individuality was <0.6. Significantly higher RCV of creatinine was observed in patients receiving the association tenofovir and ritonavir (28%) compared to the patients receiving i) tenofovir without ritonavir (21.9%), ii) no tenofovir but ritonavir (22.2%), and iii) no tenofovir and no ritonavir (19.7%). CONCLUSIONS The low value of index of individuality pinpointed that RCV should be used to identify critical change in serial creatinine results in HIV-positive adults. RCV of creatinine under ART was around 20% but reached 28% in case of association of tenofovir and ritonavir.
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Affiliation(s)
- S Badiou
- Department of Biochemistry, Montpellier University Hospital, Montpellier, France; UMR 204 NUTRIPASS, Universités Montpellier I/II, Montpellier, France
| | - A Cournil
- UMI 233, IRD Inst Res Devt, Université Montpellier I, Montpellier, France
| | - S Toubal
- Department of Biochemistry, Montpellier University Hospital, Montpellier, France
| | - A S Bargnoux
- Department of Biochemistry, Montpellier University Hospital, Montpellier, France
| | - A M Dupuy
- Department of Biochemistry, Montpellier University Hospital, Montpellier, France
| | - C Fernandez
- Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France
| | - H Peyriere
- UMI 233, IRD Inst Res Devt, Université Montpellier I, Montpellier, France
| | - J Reynes
- UMI 233, IRD Inst Res Devt, Université Montpellier I, Montpellier, France; Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France
| | - J P Cristol
- Department of Biochemistry, Montpellier University Hospital, Montpellier, France; UMR 204 NUTRIPASS, Universités Montpellier I/II, Montpellier, France.
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Scavarda D, Peyriere H, Pech-Gourg G, Trébuchon A, Milh M, Villeneuve N, Bartolomei F, Guye M, Girard N, Lena G. Évaluation d’une méthodologie simplifiée d’implantation d’électrodes profondes d’enregistrement de l’EEG (SEEG), assistée par ordinateur, sans cadre et avec un bras à biopsie non robotisé chez des enfants présentant une épilepsie réfractaire : bilan de la première année d’utilisation. Neurochirurgie 2012. [DOI: 10.1016/j.neuchi.2012.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Peyriere H, Hillaire-Buys D, Dereure O, Meunier L, Blayac J. Muco-cutaneous pigmentation and photosensitization induced by minocycline hydrochloride. J DERMATOL TREAT 2009. [DOI: 10.3109/09546639909056011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Peyriere H, Poiree M, Cociglio M, Margueritte G, Hansel S, Hillaire-Buys D. Reversal of neurologic disturbances related to high-dose methotrexate by aminophylline. Med Pediatr Oncol 2001; 36:662-4. [PMID: 11344503 DOI: 10.1002/mpo.1149] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- H Peyriere
- Service de Pharmacologie Médicale, Hôpital St. Charles, CHU Montpellier, 34295 Montpellier Cedex 5, France.
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Mohty M, Peyriere H, Guinet C, Hillaire-Buys D, Blayac JP, Rossi JF. Carboxypeptidase G2 rescue in delayed methotrexate elimination in renal failure. Leuk Lymphoma 2000; 37:441-3. [PMID: 10752997 DOI: 10.3109/10428190009089446] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report here the case of a 68-year-old woman who presented severe renal failure following the first cycle of high dose methotrexate (HDMTX) for the treatment of a cerebral malignant lymphoma. Before HDMTX administration, serum creatinine value was normal and three days after HDMTX, it reached 457 micromol/L. Leucovorin rescue, hemodialysis and cholestyramine did not increase MTX clearance. Because of the persistence of renal failure, and the high risk of important hematological side-effects associated with high MTX plasma levels, the patient received carboxypeptidase G2 (CPDG2). This allowed MTX plasma levels to decrease by 80% in 15 minutes. No side effects were observed and renal function normalized rapidly. In some patients, when high-dose leucovorin associated with hemodialysis and cholestyramine are unable to restore normal MTX clearance, CPDG2 should be considered because it may represent a safe and efficient alternative for the management of MTX intoxication.
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Affiliation(s)
- M Mohty
- Hematology and Medical Oncology Department, Hôpital Lapeyronie, Montpellier, France
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Peyriere H, Mauboussin JM, Rouanet I, Rouveroux P, Hillaire-Buys D, Balmes P. Frozen shoulder in HIV patients treated with indinavir: report of three cases. AIDS 1999; 13:2305-6. [PMID: 10563718 DOI: 10.1097/00002030-199911120-00015] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Peyriere H, Mauboussin JM, Rouanet I, Merle C, Sotto A, Arnaud A, Hillaire-Buys D, Balmes P. Report of gynecomastia in five male patients during antiretroviral therapy for HIV infection. AIDS 1999; 13:2167-9. [PMID: 10546872 DOI: 10.1097/00002030-199910220-00022] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Peyriere H, Hillaire-Buys D, Pons M, Navarre C, Davy JM, Blayac JP. [Acute pericarditis after vaccination against hepatitis B: a rare effect to be known]. Rev Med Interne 1997; 18:675-6. [PMID: 9365747 DOI: 10.1016/s0248-8663(97)82474-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Abstract
The pharmacokinetics of teicoplanin infused for 30 min at a dose of 6 mg kg-1 was studied in 11 infected patients under continuous arterio-venous haemofiltration (CAVH). Serum teicoplanin levels were assayed by h.p.l.c. over 24 h. After 0.5 h, i.e. at the end of the infusion, the mean plasma concentration was 49.6 +/- 15.1 mg l-1. At the last sampling time (24 h), the mean concentration was 2.6 +/- 1.0 mg l-1. The concentration of teicoplanin was determined in the haemofiltrates. The percentage of the administered dose recovered in the haemofiltrate was low: less than 1% for seven patients, between 1.8 and 3.7% for three patients and 7% for one patient. CAVH patients should be given teicoplanin using the same dosage regimens as previously described for patients with renal impairment.
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Affiliation(s)
- D Hillaire-Buys
- Laboratoire de Pharmacologie, Faculté de Médecine, Hôpital Arnaud de Villeneuve, Montpellier, France
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