1
|
Renaud A, Jirka A, Durant C, Connault J, Espitia O, Takoudju C, Agard C. [Gastrointestinal tract involvement in systemic sclerosis]. Rev Med Interne 2023; 44:410-422. [PMID: 37270380 DOI: 10.1016/j.revmed.2023.05.003] [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] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 04/17/2023] [Accepted: 05/08/2023] [Indexed: 06/05/2023]
Abstract
Gastrointestinal tract involvement in systemic sclerosis concerns more than 90% of patients but is of heterogeneous clinical expression. It can involve the entire intestinal tract and be responsible for multifactorial malnutrition, which is frequent in this disease. It is a major source of deterioration in the quality of life and can even be life-threatening. Management is complex and multidisciplinary, ranging from simple hygienic and dietary measures, to specialized endoscopic or surgical interventional procedures, also including medical treatments, particularly proton pump inhibitors and prokinetics, with potential side effects. Ongoing research for new diagnostic and therapeutic tools promises to improve the management and prognosis of these patients.
Collapse
Affiliation(s)
- A Renaud
- Service de médecine interne, Nantes université, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - A Jirka
- Service d'hépato-gastro-entérologie, Nantes université, CHU de Nantes, 44000 Nantes, France
| | - C Durant
- Service de médecine interne, Nantes université, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - J Connault
- Service de médecine interne, Nantes université, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - O Espitia
- Service de médecine interne, Nantes université, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - C Takoudju
- Service d'hépato-gastro-entérologie, Nantes université, CHU de Nantes, 44000 Nantes, France
| | - C Agard
- Service de médecine interne, Nantes université, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| |
Collapse
|
2
|
Trefond L, Frances C, Costedoat-Chalumeau N, Piette JC, Haroche J, Sailler L, Assaad S, Viallard JF, Jego P, Hot A, Connault J, Galempoix JM, Aslangul E, Limal N, Bonnet F, Faguer S, Chosidow O, Deligny C, Lifermann F, Maria ATJ, Pereira B, Aumaitre O, André M. Aseptic Abscess Syndrome: Clinical Characteristics, Associated Diseases, and up to 30 Years’ Evolution Data on a 71-Patient Series. J Clin Med 2022; 11:jcm11133669. [PMID: 35806955 PMCID: PMC9267245 DOI: 10.3390/jcm11133669] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 12/05/2022] Open
Abstract
Aseptic abscess (AA) syndrome is a rare type of inflammatory disorder involving polymorphonuclear neutrophils (PMNs), often associated with inflammatory bowel disease (IBD). This study sought to describe the clinical characteristics and evolution of this syndrome in a large cohort. We included all patients included in the French AA syndrome register from 1999 to 2020. All patients fulfilled the criteria outlined by André et al. in 2007. Seventy-one patients were included, 37 of which were men (52.1%), of a mean age of 34.5 ± 17 years. The abscesses were located in the spleen (71.8%), lymph nodes (50.7%), skin (29.5%), liver (28.1%), lung (22.5), and rarer locations (brain, genitals, kidneys, ENT, muscles, or breasts). Of all the patients, 59% presented with an associated disease, primarily IBD (42%). They were treated with colchicine (28.1%), corticosteroids (85.9%), immunosuppressants (61.9%), and biologics (32.3%). A relapse was observed in 62% of cases, mostly in the same organ. Upon multivariate analysis, factors associated with the risk of relapse were: prescription of colchicine (HR 0.52; 95% CI [0.28–0.97]; p = 0.042), associated IBD (HR 0.57; 95% CI [0.32–0.99]; p = 0.047), and hepatic or skin abscesses at diagnosis (HR 2.14; 95% CI [1.35–3.40]; p = 0.001 and HR 1.78; 95% CI [1.07–2.93]; p = 0.024, respectively). No deaths occurred related to this disease. This large retrospective cohort study with long follow up showed that AA syndrome is a relapsing systemic disease that can evolve on its own or be the precursor of an underlying disease, such as IBD. Of all the available treatments, colchicine appeared to be protective against relapse.
Collapse
Affiliation(s)
- Ludovic Trefond
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (O.A.); (M.A.)
- M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne, 63000 Clermont-Ferrand, France
- Correspondence:
| | - Camille Frances
- Faculté de Médecine, AP-HP, Service de Dermatologie et Allergologie, Hôpital Tenon, Sorbonne Université, 75252 Paris, France;
| | - Nathalie Costedoat-Chalumeau
- APHP, Service de Médecine Interne, Centre de Référence des Maladies Auto-Immunes Systémiques Rares d’Ile de France, Hôpital Cochin, 27 rue du Faubourg St-Jacques, CEDEX 14, 75679 Paris, France;
- INSERM U 1153, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Université de Paris, 75006 Paris, France
| | - Jean-Charles Piette
- Service de Médecine Interne, AP-HP Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France;
| | - Julien Haroche
- Assistance Publique–Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié–Salpêtrière (GHPS), French National Reference Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Sorbonne Université, 75252 Paris, France;
| | - Laurent Sailler
- Internal Medicine Department, CHU de Toulouse—Hôpital Purpan, 31300 Toulouse, France;
| | | | - Jean-François Viallard
- Hôpital Haut-Lévêque, CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Université de BORDEAUX, 5 Avenue de Magellan, 33604 Pessac, France;
| | - Patrick Jego
- Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, Inserm, EHESP, University of Rennes, 35000 Rennes, France;
- Department of Internal Medicine, Rennes University Hospital, 35203 Rennes, France
| | - Arnaud Hot
- Service de Médecine Interne, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69437 Lyon, France;
| | - Jerome Connault
- Department of Internal and Vascular Medicine, CHU de Nantes, 44000 Nantes, France;
| | | | - Elisabeth Aslangul
- Service de Médecine Interne, Hôpital Louis-Mourier, Assistance Publique-Hôpitaux de Paris, 92701 Colombes, France;
- UPD5, Université Paris-Descartes, rue de l’École-de-Médecine, 75006 Paris, France
| | - Nicolas Limal
- Département de Médecine Interne, Hôpital Henri Mondor, APHP Université Paris-Est Créteil, 94010 Créteil, France;
| | - Fabrice Bonnet
- Department of Internal Medicine and Infectious Diseases, Bordeaux University Hospital, Saint André Hospital, 33000 Bordeaux, France;
| | - Stanislas Faguer
- Département de Néphrologie et Transplantation d’Organes, Centre de Référence des Maladies Rénales Rares, CHU de Toulouse, 31000 Toulouse, France;
| | - Olivier Chosidow
- Department of Dermatology, APHP, Hôpital Henri-Mondor, 94010 Créteil, France;
- Research Group Dynamic, EA7380, Faculté de Santé de Créteil, Ecole Nationale Vétérinaire d’Alfort, USC ANSES, Université Paris-Est Créteil, 94010 Créteil, France
| | - Christophe Deligny
- Service de Médecine Interne, CHU de Fort de France, 97200 Fort de France, France;
| | | | | | - Bruno Pereira
- Biostatistics Unit (DRCI), University Hospital Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Olivier Aumaitre
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (O.A.); (M.A.)
- M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Marc André
- Médecine Interne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (O.A.); (M.A.)
- M2iSH, UMR 1071 Inserm, INRA USC 2018, University of Clermont Auvergne, 63000 Clermont-Ferrand, France
| | | |
Collapse
|
3
|
Crosnier C, Dufrost V, Audrain M, Hemont C, Agard C, Connault J, Artifoni M, Fouassier M, Hamidou M, Guédon A, Zuily S, Espitia O. Syndrome des antiphospholipides après 65 ans : étude comparative rétrospective des caractéristiques clinicobiologiques et des récidives thrombotiques. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
4
|
Guittet M, Lamirault G, Connault J, Durant C, Hamidou M, Wargny M, Le Bras M, Winer N, Artifoni M. [Evaluation of a woman's care program after pre-eclampsia]. Rev Med Interne 2021; 42:154-161. [PMID: 33485699 DOI: 10.1016/j.revmed.2020.12.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 11/30/2020] [Accepted: 12/24/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The medical treatment of preeclampsia is well structured in its acute phase but the required follow-up with patients in post-partum is discussed. However, preeclampsia is associated with an increased risk of cardiovascular morbi-mortality in the long term. In order to optimize the post-partum treatment, a care program has been developed for these patients in the city of Nantes, France. This includes a check-up of the cardiovascular risks at a day hospital. Our study presents the first results of this program. METHODS The study included 134 patients who were diagnosed with preeclampsia between October 2016 and January 2019 in the Nantes area, France, and took part in the program within the year following their childbirth. A descriptive analysis was first carried out and then a multivariate logistic regression model was used to investigate the risk factors for persistent high blood pressure after preeclampsia. RESULTS The study detected 28 cases of persistent hypertension (20.9%), 34 cases of obesity (25.3%) and 1 case of diabetes. Hypertension was predominantly diastolic, mild and sometimes masked (35.7%). In a third of the cases (32.1%), the hypertension was secondary. High blood pressure was found to be more frequent in older patients (OR: 2.26; 95% CI: 1.25-4.11, p=0.072), patients from sub-Saharan Africa (OR: 11.52; 95% CI: 2.67-49.86, p=0.01) and multiparous patients (OR: 7.82; 95% CI: 1.15-53.21, p=0.035). CONCLUSION The study confirmed that this care program enables an earlier detection and therefore treatment of the cardiovascular risk factors of these young women.
Collapse
Affiliation(s)
- M Guittet
- CHU Nantes, Médecine interne Nantes, France.
| | - G Lamirault
- Université de Nantes, CHU Nantes, CNRS, Inserm, l'institut du thorax, 44000 Nantes, France.
| | - J Connault
- CHU Nantes, Médecine interne Nantes, France.
| | - C Durant
- CHU Nantes, Médecine interne Nantes, France.
| | - M Hamidou
- CHU Nantes, Médecine interne Nantes, France.
| | - M Wargny
- CHU Nantes, Santé publique Nantes, France.
| | - M Le Bras
- CHU Nantes, Endocrinologie Nantes, France
| | - N Winer
- CHU Nantes, Gynéco-obstetricologie Nantes, France.
| | - M Artifoni
- CHU Nantes, Médecine interne Nantes, France.
| |
Collapse
|
5
|
Trefond L, Frances C, Nathalie C, Piette J, Assaad S, Sailler L, Viallard J, Jego P, Connault J, Galempoix J, Aumaître O, Andre M. Syndrome des abcès aseptiques : série française de 71 patients. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
6
|
Mekinian A, Saadoun D, Vicaut E, Thietart S, Lioger B, Jego P, Bleibtreu A, Limal N, Connault J, Gottenberg JE, Lhorte P, Bertola JP, Delforge J, Ferreira-Maldent N, Perlat A, Talib Z, Vautier M, Savey L, Quiere I, Cacoub P, Fain O. Tocilizumab in treatment-naïve patients with Takayasu arteritis: TOCITAKA French prospective multicenter open-labeled trial. Arthritis Res Ther 2020; 22:218. [PMID: 32943098 PMCID: PMC7500024 DOI: 10.1186/s13075-020-02311-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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] [Received: 06/22/2020] [Accepted: 09/04/2020] [Indexed: 02/03/2023] Open
Abstract
Objectives To assess long-term efficacy of tocilizumab in treatment-naive patients with Takayasu arteritis (TAK). Methods Prospective open-labeled trial in naïve patients with TAK who received steroids at the dose of 0.7 mg/kg/day and 7 infusions of 8 mg/kg/month of tocilizumab. The primary endpoint was the number of patients who discontinued steroids after 7 infusions of tocilizumab. Secondary endpoints included disease activity and the number of relapses during 18-month follow-up. Results Thirteen patients with TAK were included, with a median age of 32 years [19–45] and 12 (92%) females. Six (54%) patients met the primary end-point. A significant decrease of disease activity was observed after 6 months of tocilizumab therapy: decrease of median NIH scale (3 [3, 4] at baseline, versus 1 [0–2] after 6 months; p < 0.001), ITAS-2010 score (5 [2–7] versus 3 [0–8]; p = 0.002), and ITAS-A score (7 [4–10] versus 4 [1–15]; p = 0.0001)]. During the 12-month follow-up after tocilizumab discontinuation, a relapse occurred among 5 patients (45%) out of 11 in which achieved remission after 6 months of tocilizumab. Conclusion Tocilizumab seems an effective steroid sparing therapy in TAK, but maintenance therapy is necessary. Trial registration ClinicalTrials.gov NCT02101333. Registered on 02 April 2014.
Collapse
Affiliation(s)
- Arsene Mekinian
- Sorbonne Universités AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Faculté de Médecine Sorbonne Université, F-75012, Paris, France.
| | - David Saadoun
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, National center for Autoimmune Systemic rare disease ; National center for Autoinflammatory diseases and amyloidosis, Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), INSERM, UMR_S 959, F-75013, Paris, France.,CNRS, FRE3632, F-75005, Paris, France.,CNRS, F-75013, Paris, France
| | - Eric Vicaut
- Unité de Recherche Clinique Saint-Louis-Lariboisière, APHP, Hôpital Saint Louis, Paris, France
| | - Sara Thietart
- Sorbonne Universités AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Faculté de Médecine Sorbonne Université, F-75012, Paris, France
| | | | - Patrick Jego
- Service de Médecine Interne, CHU Rennes, Rennes, France
| | - Alexandre Bleibtreu
- AP-HP, service de médecine interne, Hôpital Jean Verdier, Faculté de Paris 13, 93000, Paris, France
| | - Nicolas Limal
- AP-HP, service de médecine interne, Hôpital Mondor, Université Paris Est-Créteil (UPEC), Paris, France
| | | | - Jacques-Eric Gottenberg
- Inserm UMR_1109, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France.,Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Pauline Lhorte
- Service de Médecine Interne et vasculaire, CHU Montpellier, Montpellier, France
| | | | - Juliette Delforge
- AP-HP, service de médecine interne, Hôpital Jean Verdier, Faculté de Paris 13, 93000, Paris, France
| | | | | | - Zohra Talib
- Unité de Recherche Clinique Saint-Louis-Lariboisière, APHP, Hôpital Saint Louis, Paris, France
| | - Matthieu Vautier
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, National center for Autoimmune Systemic rare disease ; National center for Autoinflammatory diseases and amyloidosis, Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), INSERM, UMR_S 959, F-75013, Paris, France.,CNRS, FRE3632, F-75005, Paris, France.,CNRS, F-75013, Paris, France
| | - Léa Savey
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, National center for Autoimmune Systemic rare disease ; National center for Autoinflammatory diseases and amyloidosis, Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), INSERM, UMR_S 959, F-75013, Paris, France.,CNRS, FRE3632, F-75005, Paris, France.,CNRS, F-75013, Paris, France
| | - Isabelle Quiere
- Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Patrice Cacoub
- Sorbonne Universités AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Médecine Interne et Immunologie Clinique, National center for Autoimmune Systemic rare disease ; National center for Autoinflammatory diseases and amyloidosis, Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), INSERM, UMR_S 959, F-75013, Paris, France.,CNRS, FRE3632, F-75005, Paris, France.,CNRS, F-75013, Paris, France
| | - Olivier Fain
- Sorbonne Universités AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DMU 3iD), Faculté de Médecine Sorbonne Université, F-75012, Paris, France
| | | |
Collapse
|
7
|
Denis Le Seve J, Gourraud Vercel C, Connault J, Artifoni M. [Update on cholesterol crystal embolism]. Rev Med Interne 2020; 41:250-257. [PMID: 32088097 DOI: 10.1016/j.revmed.2020.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 12/19/2019] [Accepted: 02/01/2020] [Indexed: 10/25/2022]
Abstract
Cholesterol crystal embolism is a systemic pathology associated with diffuse atherosclerosis. Pathophysiology corresponds to tissue necro-inflammation secondary to arteriolar occlusion associated with microembolism from atherosclerotic plaques of large diameter arteries. The clinical presentation is heterogeneous and polymorphic. Multiple organs may be the targets, but preferential damage is skin, kidneys and digestive system. It is a serious pathology, underdiagnosed, with a poor prognosis. The risk factors for developing the disease remain the same risk factors as atheroma. The factors favouring migration of microembolism remain mainly vascular interventional procedures; easy to diagnose, they oppose spontaneous embolic migrations or secondary to the introduction of antithrombotic treatment, whose diagnosis is more difficult and the prognosis more severe. The diagnosis of the disease remains mostly a diagnosis of elimination and often refers to a bundle of clinical, biological, morphological and histologic arguments. The treatment is poorly codified and the subject of few publications. It will favour both symptomatic treatment (and mainly that of pain) and complications (high blood pressure, renal insufficiency). The aetiological support remains less consensual. The treatment of atherosclerotic plaques consists, of course, in the correction of classical cardiovascular risk factors, the introduction of a statin. It will be discussed in the implementation of surgery or angioplasty to exclude potentially responsible atherosclerotic lesions. Eviction of antithrombotic therapy should be considered in terms of the benefit-risk balance, but often in favour of maintaining it. Finally, other treatments may be proposed in a case-by-case basis, such as oral or intravenous corticosteroid therapy, colchicine or LDL aphaeresis.
Collapse
Affiliation(s)
- J Denis Le Seve
- Service de médecine interne-vasculaire, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
| | - C Gourraud Vercel
- Service de néphrologie et immunologie clinique, centre hospitalier universitaire de Nantes, 30, boulevard Jean-Monnet, immeuble Jean-Monnet, 44093 Nantes cedex 1, France
| | - J Connault
- Service de médecine interne-vasculaire, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - M Artifoni
- Service de médecine interne-vasculaire, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| |
Collapse
|
8
|
Rafii H, Frère C, Benzidia I, Crichi B, Andre T, Assenat E, Bournet B, Carpentier A, Connault J, Doucet L, Durant C, Emmerich J, Gris JC, Hij A, Le Hello C, Madelaine I, Messas E, Ndour A, Villiers S, Marjanovic Z, Ait Abdallah N, Yannoutsos A, Farge D. Management of cancer-related thrombosis in the era of direct oral anticoagulants: A comprehensive review of the 2019 ITAC-CME clinical practice guidelines. On behalf of the Groupe Francophone Thrombose et Cancer (GFTC). J Med Vasc 2020; 45:28-40. [PMID: 32057323 DOI: 10.1016/j.jdmv.2019.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
Venous thromboembolism (VTE) is a common disease complication in cancer patients and the second cause of death after cancer progression. VTE management and prophylaxis are critical in cancer patients, but effective therapy can be challenging because these patients are at higher risk of VTE recurrence and bleeding under anticoagulant treatment. Numerous published studies report inconsistent implementation of existing evidence-based clinical practice guidelines (CPG), including underutilization of thromboprophylaxis, and wide variability in clinical practice patterns across different countries and various practitioners. This review aims to summarize the 2019 ITAC-CME evidence-based CPGs for treatment and prophylaxis of cancer-related VTE, which include recommendations on the use of direct oral anticoagulants specifically in cancer patients. The guidelines underscore the gravity of developing VTE in cancer and recommend the best approaches for treating and preventing cancer-associated VTE, while minimizing unnecessary or over-treatment. Greater adherence to the 2019 ITAC guidelines could substantially decrease the burden of VTE and improve survival of cancer patients.
Collapse
Affiliation(s)
- H Rafii
- Eurocord, Équipe 3 EA3518, hôpital Saint-Louis, Université de Paris, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - C Frère
- Inserm UMRS_1166, Department of Haematology, hôpital Pitié-Salpêtrière, Université de Paris, Sorbonne Paris-Cité, AP-HP, Paris, France
| | - I Benzidia
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - B Crichi
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - T Andre
- Hôpital Saint-Antoine, AP-HP, Paris, France
| | - E Assenat
- Montpellier school of Medicine, Saint-Eloi University Hospital, Montpellier, France
| | - B Bournet
- Hôpital Rangueil, CHU de Toulouse, Toulouse, France
| | | | | | - L Doucet
- Hôpital Saint-Louis, AP-HP, Paris, France
| | | | | | | | - A Hij
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - C Le Hello
- CHU Saint-Étienne, Saint-Étienne, France
| | | | - E Messas
- Hôpital Européen Georges-Pompidou, AP-HP, Paris, France
| | - A Ndour
- Hôpital Saint-Louis, AP-HP, Paris, France
| | - S Villiers
- Hôpital Saint-Louis, AP-HP, Paris, France
| | | | - N Ait Abdallah
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | | | - D Farge
- Internal Medicine (UF04), Équipe 3 EA 3518, Autoimmune and Vascular Disease Unit, Saint-Louis Hospital, Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, AP-HP, Sorbonne Paris-Cité, Paris, France; Department of Medicine, McGill University, Montreal, QC, Canada
| |
Collapse
|
9
|
Agard C, Bonnard G, Samson M, de Moreuil C, Lavigne C, Jégo P, Connault J, Artifoni M, Le Gallou T, Landron C, Roblot P, Magnant J, Belizna C, Maillot F, Diot E, Néel A, Hamidou M, Espitia O. Giant cell arteritis-related aortitis with positive or negative temporal artery biopsy: a French multicentre study. Scand J Rheumatol 2019; 48:474-481. [PMID: 31766965 DOI: 10.1080/03009742.2019.1661011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: To compare the clinical presentation and outcome of giant cell arteritis (GCA)-related aortitis according to the results of temporal artery biopsy (TAB).Method: Patients with GCA-related aortitis diagnosed between 2000 and 2017, who underwent TAB, were retrospectively included from a French multicentre database. They all met at least three American College of Rheumatology criteria for the diagnosis of GCA. Aortitis was defined by aortic wall thickening > 2 mm on computed tomography scan and/or an aortic aneurysm, associated with an inflammatory syndrome. Patients were divided into two groups [positive and negative TAB (TAB+, TAB-)], which were compared regarding aortic imaging characteristics and aortic events, at aortitis diagnosis and during follow-up.Results: We included 56 patients with TAB+ (70%) and 24 with TAB- (30%). At aortitis diagnosis, patients with TAB- were significantly younger than those with TAB+ (67.7 ± 9 vs 72.3 ± 7 years, p = 0.022). Initial clinical signs of GCA, inflammatory parameters, and glucocorticoid therapy were similar in both groups. Coronary artery disease and/or lower limb peripheral arterial disease was more frequent in TAB- patients (25% vs 5.3%, p = 0.018). Aortic wall thickness and type of aortic involvement were not significantly different between groups. Diffuse arterial involvement from the aortic arch was more frequent in TAB- patients (29.1 vs 8.9%, p = 0.03). There were no differences between the groups regarding overall, aneurism-free, relapse-free, and aortic event-free survival.Conclusion: Among patients with GCA-related aortitis, those with TAB- are characterized by younger age and increased frequency of diffuse arterial involvement from the aortic arch compared to those with TAB+, without significant differences in terms of prognosis.
Collapse
Affiliation(s)
- C Agard
- Department of Internal Medicine, University Hospital of Nantes, Nantes University, Nantes, France
| | - G Bonnard
- Department of Internal Medicine, University Hospital of Nantes, Nantes University, Nantes, France
| | - M Samson
- Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, University of Burgundy, Dijon, France
| | - C de Moreuil
- Department of Internal Medicine, University Hospital of Brest, University of Bretagne Occidentale, Brest, France
| | - C Lavigne
- Department of Internal Medicine, University Hospital of Angers, Angers, France
| | - P Jégo
- Department of Internal Medicine, University Hospital of Rennes, Rennes University, Rennes, France
| | - J Connault
- Department of Internal Medicine, University Hospital of Nantes, Nantes University, Nantes, France
| | - M Artifoni
- Department of Internal Medicine, University Hospital of Nantes, Nantes University, Nantes, France
| | - T Le Gallou
- Department of Internal Medicine, University Hospital of Rennes, Rennes University, Rennes, France
| | - C Landron
- Department of Internal Medicine, University Hospital of Poitiers, Poitiers University, Poitiers, France
| | - P Roblot
- Department of Internal Medicine, University Hospital of Poitiers, Poitiers University, Poitiers, France
| | - J Magnant
- Department of Internal Medicine, University Hospital of Tours, Tours University, Tours, France
| | - C Belizna
- Department of Internal Medicine, University Hospital of Angers, Angers, France
| | - F Maillot
- Department of Internal Medicine, University Hospital of Tours, Tours University, Tours, France
| | - E Diot
- Department of Internal Medicine, University Hospital of Tours, Tours University, Tours, France
| | - A Néel
- Department of Internal Medicine, University Hospital of Nantes, Nantes University, Nantes, France
| | - M Hamidou
- Department of Internal Medicine, University Hospital of Nantes, Nantes University, Nantes, France
| | - O Espitia
- Department of Internal Medicine, University Hospital of Nantes, Nantes University, Nantes, France
| |
Collapse
|
10
|
de Mornac D, Agard C, Hamidou M, Hardouin J, Connault J, Espitia-Thibault A, Graveleau J, Perrin F, Espitia O. Facteurs de risque d’événement vasculaire compliquant une artérite à cellules géantes : étude de cohorte rétrospective chez 254 patients ayant eu une évaluation vasculaire par imagerie au diagnostic. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
11
|
Lecouffe-Desprets M, Graveleau J, Artifoni M, Connault J, Agard C, Pottier P, Hamidou M, Néel A. [Hemolytic disorders and venous thrombosis: An update]. Rev Med Interne 2019; 40:232-237. [PMID: 30773236 DOI: 10.1016/j.revmed.2018.10.387] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 05/03/2018] [Revised: 10/04/2018] [Accepted: 10/18/2018] [Indexed: 01/05/2023]
Abstract
Many factors can contribute to the risk of venous thrombosis observed in hemolytic diseases. Some mechanisms are related to hemolysis by itself, while others seem more specific to each disease. Despite recent advances in the quantification of this risk and in understanding its physiopathology, the association of hemolysis with venous thrombosis is often unknown. The purpose of this general review is to clarify the main pro-thrombotic mechanisms during hemolysis and to synthesize the clinical data currently available. We will focus on the main types of hemolytic pathologies encountered in current practice, namely paroxysmal nocturnal hemoglobinuria, hemoglobinopathies, auto-immune hemolytic anemia and thrombotic microangiopathies.
Collapse
Affiliation(s)
- M Lecouffe-Desprets
- Service de médecine interne, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France
| | - J Graveleau
- Service de médecine interne, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France
| | - M Artifoni
- Service de médecine interne, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France
| | - J Connault
- Service de médecine interne, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France
| | - C Agard
- Service de médecine interne, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France
| | - P Pottier
- Service de médecine interne, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France
| | - M Hamidou
- Service de médecine interne, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France
| | - A Néel
- Service de médecine interne, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
| |
Collapse
|
12
|
Drouin L, Pistorius MA, Lafforgue A, N’Gohou C, Richard A, Connault J, Espitia O. Épidémiologie des thromboses veineuses des membres supérieurs : étude rétrospective de 160 thromboses aiguës. Rev Med Interne 2019; 40:9-15. [DOI: 10.1016/j.revmed.2018.07.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/09/2018] [Accepted: 07/18/2018] [Indexed: 12/01/2022]
|
13
|
Espitia O, Raimbeau A, Connault J, Gautier G, Goueffic Y, Plissonneau P, Artifoni M, Durant C, Didier Q, Maurel B, Pistorius M, Agard C. Ischémies digitales : présentation clinique, étiologies et suivi à long terme. Une cohorte de 323 patients. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.325] [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: 11/29/2022]
|
14
|
Achille A, Journeau L, Espitia O, Connault J, Espitia-Thibault A, Durant C, Perrin F, Pistorius MA, Néel A, Hamidou M, Agard C. Sclérodermie systémique de révélation tardive : étude rétrospective de 27 patients diagnostiqués après l’âge de 70 ans. Ann Dermatol Venereol 2018; 145:166-172. [DOI: 10.1016/j.annder.2017.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/26/2017] [Accepted: 10/31/2017] [Indexed: 11/30/2022]
|
15
|
Génin V, Caristan A, Ledamany A, Horeau-Langlard D, Connault J, Durant C, Agard C. Treprostinil dans l’hypertension artérielle pulmonaire associée à la sclérodermie systémique : expérience monocentrique chez 11 patients. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
16
|
Benzidia I, Connault J, Solanilla A, Michon-Pasturel U, Jamelot M, Nguessan MK, Hij A, Le Maignan C, Farge D, Frère C. [New international guidelines for curative treatment and prophylaxis for venous thromboembolism (VTE) in cancer patients and the dedicated smartphone application]. J Med Vasc 2017; 42:375-383. [PMID: 29203044 DOI: 10.1016/j.jdmv.2017.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 09/17/2017] [Indexed: 06/07/2023]
Abstract
Venous thromboembolism (VTE) is a frequent and serious complication in cancer patients, and the second leading cause of death in this setting. Cancer patients are also more likely to present recurrent VTE and major bleeding while taking anticoagulants. Management of VTE in these patients is always challenging and remains suboptimal worldwide. In 2013, the International Initiative on Thrombosis and Cancer (ITAC-CME) released international guidelines for the treatment and prophylaxis of VTE and central venous catheter-associated thrombosis, based on a systematic review of the literature ranked according to the Grading of Recommendations Assessment, Development, and Evaluation scale. An update of these ITAC-CME consensus guidelines, including the use of direct oral anticoagulants, was recently published. In this review, we summarize these updated guidelines. Better adherence to the international guidelines, involving an adequate educational and active implementation strategies, will substantially decrease the burden of VTE and allow to increase survival in cancer patients.
Collapse
Affiliation(s)
- I Benzidia
- UF04 maladies auto-immunes et pathologie vasculaire, service de médecine interne, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - J Connault
- Service de médecine interne, CHU de Nantes, 44000 Nantes, France
| | - A Solanilla
- Service de médecine vasculaire, hôpital Saint-André, 33076 Bordeaux, France
| | - U Michon-Pasturel
- Service de médecine vasculaire, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - M Jamelot
- Service d'oncologie médicale, centre Henri-Becquerel, rue d'Amiens, 76000 Rouen, France
| | - M K Nguessan
- Département de médecine interne et gériatrie, centre hospitalier universitaire de Treichville, université Félix Houphouet Boigny d'Abidjan, Abidjan, Côte d'Ivoire
| | - A Hij
- UF04 maladies auto-immunes et pathologie vasculaire, service de médecine interne, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - C Le Maignan
- Service d'oncologie médicale, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - D Farge
- UF04 maladies auto-immunes et pathologie vasculaire, service de médecine interne, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - C Frère
- Service d'hématologie biologique, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
| |
Collapse
|
17
|
Bonnard G, Espitia O, Connault J, De Moreuil C, Le Gallou T, Landron C, Lavigne C, Belizna C, Néel A, Serfaty J, Hamidou M, Agard C. Aortite au cours de l’artérite à cellules géantes à biopsie de l’artère temporale positive ou négative : étude multicentrique comparative de 80 patients. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.095] [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]
|
18
|
Affiliation(s)
- Olivier Espitia
- Department of Internal Medicine, University Hospital of Nantes, Nantes, France
| | - Jerome Connault
- Department of Internal Medicine, University Hospital of Nantes, Nantes, France
| | - Mohamed A Hamidou
- Department of Internal Medicine, University Hospital of Nantes, Nantes, France
| |
Collapse
|
19
|
Castillo JM, Agard C, Artifoni M, Brisseau JM, Connault J, Durant C, Espitia O, Masseau A, Neel A, Perrin F, Pistorius MA, Planchon B, Ponge T, Hamidou M, Pottier P. Évaluation qualitative et quantitative d’un service d’assistance téléphonique de médecine interne dédié à l’aide diagnostique et thérapeutique de pathologies relevant du champ de la médecine générale. Rev Med Interne 2016; 37:321-6. [DOI: 10.1016/j.revmed.2015.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 07/27/2015] [Accepted: 07/29/2015] [Indexed: 10/23/2022]
|
20
|
Guillet A, Connault J, Perrot P, Perret C, Herbreteau D, Berton M, Caron V, Aubert H, Stalder JF, Maruani A, Barbarot S. Early symptoms and long-term clinical outcomes of distal limb's cutaneous arterio-venous malformations: a retrospective multicentre study of 19 adult patients. J Eur Acad Dermatol Venereol 2015; 30:36-40. [PMID: 25631621 DOI: 10.1111/jdv.12961] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/09/2014] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Cutaneous arterio-venous malformations (AVM) are high-flow vascular malformations made up of a direct link between arteries and veins without intermediary capillary space. 'Distal limb's AVM', which mean involving hands or feet, are rare and their functional prognosis is often poor. Little is known about their early clinical symptoms. The objectives of this study were to identify early clinical symptoms of distal limb's cutaneous AVMs and to determine their long-term clinical outcome. METHODS A retrospective study was carried out including adult patients who had distal limb's AVM, who were followed up between January 2000 and November 2013 in two regional tertiary care centres. The information was collected from patients' clinical records and completed by a structured telephone questionnaire. RESULTS Nineteen patients were included in the study: four (21%) with foot AVM and 15 (79%) with hand AVM. The first clinical symptoms were as follows: swelling (47%), pain (47%), one or several venous dilatations (37%) and rarely abnormal skin colour, hyperthermia and pulsating sensation. The median diagnosis delay was 9 years after the onset of first manifestations. Amongst the 17 patients who underwent a treatment, 53% had embolotherapy session(s), 12% surgery and 35% had both. After an average follow-up of 57.6 months, 31% of the 13 patients contacted who were receiving treatment were in complete remission; 31% had partial remission; 15% had relapse after initial improvement and 23% had treatment failure. Overall, 74% of patients had a serious development of the AVM: 37% had digital or hand amputation, and 42% remained symptomatic and/or unstable. CONCLUSION This study suggests that initial manifestations of distal limb's AVMs are discreet and non-specific, leading to a diagnosis delay of about 10 years, with poor prognosis. Doctors should evoke the diagnosis earlier, when these symptoms are shown: pain and/or swelling, sometimes with a large vein.
Collapse
Affiliation(s)
- A Guillet
- Service de dermatologie, CHU Hôtel Dieu, Nantes, France
| | - J Connault
- Service de médecine interne, CHU Hôtel Dieu, Nantes, France
| | - P Perrot
- Service de chirurgie plastique, CHU Hôtel Dieu, Nantes, France
| | - C Perret
- Service de radiologie, CHU Hôtel Dieu, Nantes, France
| | | | - M Berton
- Service de Dermatologie, Unité de Dermatologie Pédiatrique, CHRU de Tours, France
| | - V Caron
- Service de dermatologie, CHU Hôtel Dieu, Nantes, France
| | - H Aubert
- Service de dermatologie, CHU Hôtel Dieu, Nantes, France
| | - J-F Stalder
- Service de dermatologie, CHU Hôtel Dieu, Nantes, France
| | - A Maruani
- Service de Dermatologie, Unité de Dermatologie Pédiatrique, CHRU de Tours, France
| | - S Barbarot
- Service de dermatologie, CHU Hôtel Dieu, Nantes, France
| |
Collapse
|
21
|
Lestang E, Caristan A, Néel A, Graveleau J, Duhamel E, Masseau A, Connault J, Maisonneuve H, Le Gouill S, Blin N, Touzeau C, Moreau P, Hamidou M. Lenalidomide as frontline therapy in polyneuropathy, organomegaly, endocrinopathy, monoclonal protein and skin changes syndrome: a retrospective case series of eight patients. Leuk Lymphoma 2015; 56:1895-6. [PMID: 25347429 DOI: 10.3109/10428194.2014.974595] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Elsa Lestang
- Service de médecine interne, Centre Hospitalier Universitaire (CHU) Nantes , France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Semin-Pelletier B, Cazet L, Bourigault C, Juvin ME, Boutoille D, Raffi F, Hourmant M, Blancho G, Agard C, Connault J, Corvec S, Caillon J, Batard E, Lepelletier D. Challenges of controlling a large outbreak of OXA-48 carbapenemase-producing Klebsiella pneumoniae in a French university hospital. J Hosp Infect 2015; 89:248-53. [PMID: 25601745 DOI: 10.1016/j.jhin.2014.11.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 10/31/2014] [Accepted: 11/17/2014] [Indexed: 10/24/2022]
Abstract
A large outbreak of OXA-48 carbapenemase-producing Klebsiella pneumoniae at Nantes University Hospital was investigated. The index case had no history of travel or hospitalization abroad and had been hospitalized in the internal medicine department for more than one month when the epidemic strain was isolated from a urine sample in June 2013. Seventy-two secondary cases were detected by weekly screening for gastrointestinal colonization during the two phases of the outbreak from June to October 2013 (33 cases) and from November 2013 to August 2014 (39 cases). Spread of the epidemic strain was attributed to the proximity of, and staff movement between, the infectious diseases (32 cases) and the internal medicine (26 cases) departments; 14 secondary cases were also observed in the renal transplant department following the transfer of an exposed patient from the infectious diseases department. Most of the patients (90%) were colonized and no death was linked to the epidemic strain. More than 3000 contact patients were reviewed and 6000 rectal swabs were performed. Initial control measures failed to control the outbreak owing to the late detection of the index case. The late implementation of three successive cohort units, the large number of transfers between wards, and the frequent readmission of cases contributed to the incomplete success of control measures.
Collapse
Affiliation(s)
- B Semin-Pelletier
- Bacteriology and Hygiene Department, Nantes University Hospital, Nantes, France
| | - L Cazet
- Bacteriology and Hygiene Department, Nantes University Hospital, Nantes, France
| | - C Bourigault
- Bacteriology and Hygiene Department, Nantes University Hospital, Nantes, France
| | - M E Juvin
- Bacteriology and Hygiene Department, Nantes University Hospital, Nantes, France
| | - D Boutoille
- Infectious Diseases Department, Nantes University Hospital, Nantes, France; University of Nantes, EA 3826, UFR Medicine School, Nantes, France
| | - F Raffi
- Infectious Diseases Department, Nantes University Hospital, Nantes, France
| | - M Hourmant
- Renal Transplant Department, Nantes University Hospital, Nantes, France
| | - G Blancho
- Renal Transplant Department, Nantes University Hospital, Nantes, France
| | - C Agard
- Internal Medicine Department, Nantes University Hospital, Nantes, France
| | - J Connault
- Renal Transplant Department, Nantes University Hospital, Nantes, France
| | - S Corvec
- Bacteriology and Hygiene Department, Nantes University Hospital, Nantes, France; University of Nantes, EA 3826, UFR Medicine School, Nantes, France
| | - J Caillon
- Bacteriology and Hygiene Department, Nantes University Hospital, Nantes, France; University of Nantes, EA 3826, UFR Medicine School, Nantes, France
| | - E Batard
- University of Nantes, EA 3826, UFR Medicine School, Nantes, France; Emergency Department, Nantes University Hospital, Nantes, France
| | - D Lepelletier
- Bacteriology and Hygiene Department, Nantes University Hospital, Nantes, France; University of Nantes, EA 3826, UFR Medicine School, Nantes, France.
| |
Collapse
|
23
|
Humbert J, Roussey-Kesler G, Guerin P, LeFrançois T, Connault J, Chenouard A, Warin-Fresse K, Salomon R, Bruel A, Allain-Launay E. Diagnostic and medical strategy for renovascular hypertension: report from a monocentric pediatric cohort. Eur J Pediatr 2015; 174:23-32. [PMID: 24953377 DOI: 10.1007/s00431-014-2355-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 12/20/2013] [Revised: 05/20/2014] [Accepted: 05/29/2014] [Indexed: 11/26/2022]
Abstract
UNLABELLED Renovascular hypertension accounts for 5-10 % of hypertension cases in children; there is currently no consensus on treatment. Here, we report on our clinical experience with this disease and outline the different pathways in which to investigate it. We report retrospectively on ten children diagnosed with renovascular hypertension at the University Hospital of Nantes from 2001 to 2012. The main findings were obtained by fortuitous screening of children aged 2 months to 14 years old with neurofibromatosis (n = 2) and fibromuscular dysplasia (n = 8). The hypertension was always severe yet asymptomatic. Lesions were complicated in nine out of ten cases and included bilateral, multiple, mid-aortic syndrome and aneurysm. Doppler ultrasound associated with computed tomography allowed for a precise diagnosis in seven out of ten cases. Where ambiguities persisted, they were highlighted by arteriography, the gold standard investigation. Medical treatment was insufficient, leading to invasive procedures in nine out of ten children: 2 nephrectomies, 2 autotransplantations, and 21 repetitive percutaneous transluminal angioplasties. After invasive procedures, blood pressure control improved in four cases and was resolved in three. CONCLUSION Arteriography remains to be the gold standard technique for renovascular hypertension in children and can be combined with angioplasty when medical treatment is rendered obsolete. The role of computed tomography is controversial. Despite the heterogeneity of the children studied, we present a general medical and therapeutic management pathway for the treatment of this disease.
Collapse
Affiliation(s)
- J Humbert
- Pediatric Nephrology Department, University Hospital of Nantes, Nantes, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Caristan A, Connault J, Letocart V, Pistorius M, Hamidou M, Artifoni M. Tamponnade révélatrice d’une maladie de Horton. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.175] [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]
|
25
|
Guillet A, Maruani A, Berton M, Herbreteau P, Perret C, Connault J, Perrot P, Aubert H, Caron V, Stalder JF, Barbarot S. Signes cliniques précoces et pronostic à long terme des malformations artério-veineuses cutanées distales de membre : étude rétrospective multicentrique de 19 patients. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.164] [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: 12/01/2022]
|
26
|
Espitia O, Le Gallou T, Magnant J, Lavigne C, Connault J, De Moreuil C, Maisonneuve H, Moreau P, Poinsignon Y, Belizna C, Hamidou M, Agard C. Étude rétrospective multicentrique de 94 cas d’aortites, comparant les aortites associées à l’artérite à cellules géantes aux aortites idiopathiques. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.113] [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]
|
27
|
Achille A, Espitia O, Perrin F, Durant C, Masseau A, Ponge T, Connault J, Néel A, Hamidou M, Agard C. Sclérodermie systémique du sujet âgé : étude rétrospective de 27 patients diagnostiqués après 70ans. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
28
|
Lestang E, Caristan A, Graveleau J, Masseau A, Néel A, Connault J, Godmer P, Maisonneuve H, Blin N, Touzeau C, Moreau P, Hamidou M. Lénalidomide en première ligne dans le traitement du POEMS syndrome. À propos de 8 observations. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.031] [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: 11/15/2022]
|
29
|
Artifoni M, Ternisien C, Durant C, Pistorius M, Hamidou M, Connault J. Évaluation qualitative des recherches d’antiphospholipides et devenir des patients suspects de SAPL au CHU de Nantes. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.048] [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]
|
30
|
Boureau AS, Lescalie F, Cassagnau E, Clairand R, Connault J. [Localized purpura revealing vascular prosthetic graft infection]. ACTA ACUST UNITED AC 2013; 38:276-9. [PMID: 23746928 DOI: 10.1016/j.jmv.2013.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 04/21/2013] [Indexed: 11/16/2022]
Abstract
Prosthetic graft infection after vascular reconstruction is a rare but serious complication. We report a case of infection occurring late after implantation of an iliofemoral prosthetic vascular graft. The Staphylococcus aureus infection was revealed by vascular purpura localized on the right leg 7 years after implantation of a vascular prosthesis. This case illustrates an uncommonly late clinical manifestation presenting as an acute infection 7 years after the primary operation. In this situation, the presentation differs from early infection, which generally occurs within the first four postoperative months. Diagnosis and treatment remain a difficult challenge because prosthetic graft infection is a potentially life-threatening complication. Morbidity and mortality rates are high. Here we detail specific aspects of the clinical and radiological presentation.
Collapse
Affiliation(s)
- A S Boureau
- Service de médecine vasculaire, CHU de Nantes, 44000 Nantes, France.
| | | | | | | | | |
Collapse
|
31
|
Espitia O, Néel A, Leux C, Connault J, Ponge T, Dupas B, Barrier JH, Hamidou M, Agard C. FRI0220 Aortic involvement at onset impacts long term outcome in giant cell arteritis: A 12 years follow-up study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
Artifoni M, Chemel M, Connault J, Loussouarn D, Graveleau J, Hamidou M, Durant C. Nécroses digitales inaugurales d’une maladie de Horton : une présentation atypique d’une maladie fréquente. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.109] [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]
|
33
|
Gaborit B, Graveleau J, Pouteau LM, Connault J, Fakhouri F, Néel A, Masseau A, Hamidou M. PRES et myélite du cône terminal successifs lors d’une poussée lupique. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.152] [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]
|
34
|
Hervier B, Meyer A, Stanciu R, Mathian A, Devilliers H, Arlet P, Hatron PY, Connault J, Amoura Z, Hamidou M, Hachulla E, Benveniste O. Prévalence des néoplasies au cours du syndrome des antisynthétases. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
35
|
Sevestre MA, Belizna C, Durant C, Vedrine L, Desruennes E, Debourdeau P, Bonnet I, Pernod G, Stoppa AM, Berremili T, Connault J, Kriegel I, Mahe I, Camuset J, Barrellier MT, Gerotzafias G, Cajfinger F, Terriat B, Bosson JL, Farge D. Compliance of recommendations with French clinical practice in the management of thromboembolism in patients with cancer: The CARMEN study. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.1580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1580 Background: Long-term treatment with low-molecular-weight heparin (LMWH) is recommended for treatment of venous thromboembolism (VTE) in cancer patients. Few data are available on compliance in this population. Our study measured whether the management of VTE in patients with cancer was consistent with French recommendations. Methods: Compliance with recommendations (CR+) was analysed according to malignancy and VTE from a 500-patient cross-sectional observational study run between May and October 2010. CR+ was defined as the compliance to initial 10-day treatment followed by long-term LMWH for at least 3 months, avoiding LMWH in patients with renal insufficiency (SRI). All inpatients with a diagnosis of cancer and VTE of less than 6 months were included in the study. Results: Of 500 patients included in 47 centers, 242 (49%) were male, 81 (18%) had local (T+), 83 (18%) had loco-regional (N+) and 287 (64%) had metastatic malignancies. Malignancies were gastro-intestinal (25%), gynaecologic (23%), pulmonary (21%), haematological (14%), urologic (10%) or other (8%). Twelve patients had SRI. Overall, treatment was CR+ in 289/500 patients (58% [95% CI 53%-62%]). Out of 12 patients with SRI only 3 (25%) were treated long-term with vitamin K antagonists (VKA), as usually recommended. Tumour site influenced CR+ (p=0.02). Treatment for haematological malignancy was poorly compliant with recommendations (32%) while patients with lung malignancy had the best compliance (68%). TNM stage and VTE location had no influence on treatment compliance. Conclusions: In French practice, treatment of cancer-related VTE is CR+ in 58% of cases. TNM stage and VTE location do not influence compliance which remains insufficient, especially in patients with haematological malignancy. [Table: see text]
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Francis Cajfinger
- Medical Oncology Department, AP-HP, Salpetriere Hospital, University Paris VI, Paris, France
| | | | | | | | | |
Collapse
|
36
|
Mekinian A, Neel A, Sibilia J, Cohen P, Connault J, Lambert M, Federici L, Berthier S, Fiessinger JN, Godeau B, Marie I, Guillevin L, Hamidou M, Fain O. Efficacy and tolerance of infliximab in refractory Takayasu arteritis: French multicentre study. Rheumatology (Oxford) 2012; 51:882-6. [DOI: 10.1093/rheumatology/ker380] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
37
|
Connault J, Masseau A, Audrain M, Durant C, Agard C, Néel A, Pottier P, Planchon B, Hamidou M. Étude monocentrique rétrospective de 59 patients porteurs du syndrome des antiphospholipides (SAPL) : dépistage et correction des facteurs de risque cardiovasculaire lors des SAPL primaires et secondaires. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.340] [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: 11/29/2022]
|
38
|
Connault J, Graveleau J, Dupas D, Néel A, Normand M, Planchon B, Hamidou M. Un phénomène de Raynaud d’allure professionnelle qui cache un diagnostic difficile. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
39
|
Néel A, Sevin-Allouet M, Guillon B, Hello M, Graveleau J, Connault J, Auffray-Calvier E, Hamidou M. Vasculopathie cérébrale génétique par mutation COL4A1 découverte chez une sexagénaire initialement suspecte de vascularite du système nerveux central. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.107] [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: 11/24/2022]
|
40
|
Perrin F, Connault J, Ponge T, Agard C. Le sildénafil en relais de l’iloprost pour le traitement curatif des ulcères digitaux sclérodermiques ? Expérience chez deux patients. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.03.226] [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: 11/29/2022]
|
41
|
Connault J, Durant C, Pottier P, Josnin M, Hello M, Ponge T, Planchon B, Hamidou M. Expression clinique vasculaire sévère et précoce de la mutation homozygote MTHFR chez 3 patientes tabagiques. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.03.302] [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: 10/28/2022]
|
42
|
Khatchatourian L, Decrocq C, Connault J, Ponge T, Mussini J, Hamidou M, Agard C. La myosite interstitielle des mollets, mode de révélation d’une maladie de Crohn. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
43
|
Connault J, Durant C, Graveleau J, Clairand R, Planchon B, Hamidou M. Infarctus rénal d’origine cardio-embolique inaugural d’une maladie de Behçet. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.260] [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: 12/01/2022]
|
44
|
Lefebvre M, Néel A, Perret C, Hamidou M, Connault J. Prise en charge des thrombophlébites septiques fongiques : intérêt de la thrombectomie endovasculaire en complément du traitement antifongique. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
45
|
Agard C, Espitia O, Connault J, Dos Sanros A, Azema L, Ponge T, Barrier JH, Hamidou M. Une nouvelle entité anatomoclinique : l’artériopathie inflammatoire anévrismale diffuse à polynucléaires neutrophiles. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
46
|
Graveleau J, Connault J, Durant C, Masseau A, Delaunay J, Hamidou M. RS3PE révélant une leucémie myélomonocytaire chronique. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.163] [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]
|
47
|
Artifoni M, Durant C, Talarmin JP, Connault J, Blin N, Planchon B. Infection à Mycobacterium chelonae révélant une myélodysplasie. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.188] [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]
|
48
|
Le Jeune S, Hermouet S, Planchon B, Pistorius MA, Masliah C, Letessier E, Connault J, Durant C, Mourad JJ, Hamidou M. Spécificités cliniques, biologiques et d’imagerie des thromboses veineuses digestives associées aux syndromes myéloprolifératifs : résultats d’une étude rétrospective de 86 cas. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.148] [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: 10/20/2022]
|
49
|
Connault J, Durant C, Hervier B, Andreu M, Godmer P, Brisseau J, Hamidou M, Amoura Z, Haroche J. Manifestations vasculaires et VEGF au cours du Poems syndrome : à propos de 10 cas. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
50
|
Durant C, Arnaud L, Hervier B, Connault J, Haroche J, Masseau A, Amoura Z, Hamidou M. Artérite pulmonaire au cours de la maladie de Takayasu. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.019] [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: 10/20/2022]
|