1
|
Loffroy R, Quirantes A, Guillen K, Mazit A, Comby PO, Aho-Glélé LS, Chevallier O. Prostate artery embolization using n-butyl cyanoacrylate glue for symptomatic benign prostatic hyperplasia: A six-month outcome analysis in 103 patients. Diagn Interv Imaging 2024; 105:129-136. [PMID: 38161141 DOI: 10.1016/j.diii.2023.12.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE The purpose of this study was to assess the feasibility, safety, and 6-month outcomes of prostate artery embolization (PAE) using N-butyl-cyanoacrylate (NBCA) glue as the only embolic agent in patients with benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms. MATERIALS AND METHODS Patients with BPH-related lower urinary tract symptoms who were treated by PAE using methacryloxysulfolane-NBCA mixed with ethiodized oil (1:8 ratio) between September 2018 and January 2023 were retrospectively included. Vascular mapping was made using cone-beam computed tomography angiography. PAEs were performed as an outpatient procedure, under local anaesthesia. Outcomes were assessed at six months using the International Prostate Symptoms Score (IPSS) and associated quality-of-life score (IPSS-QoL), prostate-specific antigen (PSA) level, prostate volume, and International Index of Erectile Function form 5 (IIEF5). RESULTS A total of 103 men with a mean age of 68.4 ± 6 (standard deviation [SD]) years were included. Technical success rate was 100%. The mean fluoroscopy time was 26.4 ± 12.5 (SD) min and the median radiation dose was 23 980 mGy·cm (Q1, Q3: 16 770, 38 450). Compared to baseline, statistically significant improvements were observed at six months for the IPSS (8.9 ± 6.2 [SD] vs. 20.2 ± 6.5 [SD]; P = 0.01), IPSS-QoL (2.1 ± 1.4 [SD] vs. 5.1 ± 0.9 [SD]; P = 0.01), PSA level (3.6 ± 3.2 [SD] ng/mL vs. 4.8 ± 4.2 [SD] ng/mL; P = 0.0001), and prostate volume (78.6 ± 43.5 [SD] mL vs. 119.1 ± 65.7 [SD] mL; P = 0.01). Minor adverse events developed in 19/103 (18.4%) patients. No major complications occurred. Compared to baseline, the IIEF5 did not change significantly at six months (15.3 ± 6.8 [SD] vs. 15.8 ± 6.8 [SD]; P = 0.078). CONCLUSION PAE with NBCA is a feasible and safe method that provides good outcomes at six months in patients with BPH-related lower urinary tract symptoms. This method deserves further evaluation in randomized trials with longer follow-up.
Collapse
Affiliation(s)
- Romaric Loffroy
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 210000 Dijon, France.
| | - Alexis Quirantes
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France
| | - Kévin Guillen
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 210000 Dijon, France
| | - Amin Mazit
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France
| | - Pierre-Olivier Comby
- ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 210000 Dijon, France; Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 21079 Dijon, France
| | - Ludwig Serge Aho-Glélé
- Department of Epidemiology, Statistics and Clinical Research, François-Mitterrand University Hospital, 21079 Dijon, France
| | - Olivier Chevallier
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 21079 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 210000 Dijon, France
| |
Collapse
|
2
|
Cali J, Chevallier O, Guillen K, Latournerie M, Mazit A, Aho-Glélé LS, Loffroy R. Selective Arterial Embolization of Ruptured Hepatocellular Carcinoma with N-Butyl Cyanoacrylate and Lipiodol: Safety, Efficacy, and Short-Term Outcomes. J Pers Med 2023; 13:1581. [PMID: 38003896 PMCID: PMC10672353 DOI: 10.3390/jpm13111581] [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: 10/08/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
The rupture of hepatocellular carcinoma (rHCC) is uncommon but causes sudden life-threatening bleeding. Selective transarterial embolization (STAE) is an effective bleeding-control option. The optimal embolic agent is unknown, and data on the use of cyanoacrylate glue are lacking. The objective of this study was to report the outcomes of cyanoacrylate-lipiodol embolization for rHCC. We retrospectively reviewed the files of the 16 patients (14 males; mean age, 72 years) who underwent emergency cyanoacrylate-lipiodol STAE at a single center in 2012-2023 for spontaneous rHCC. All 16 patients had subcapsular HCC and abundant hemoperitoneum. The technical success rate was 94% (15/16). Day 30 mortality was 19%; the three patients who died had severe hemodynamic instability at admission; one death was due to rebleeding. Liver enzyme levels returned to baseline by day 30. No rebleeding was recorded during the median follow-up of 454 days in the 10 patients who were alive with available data after day 30. Larger prospective studies with the collection of longer-term outcomes are needed to assess our results supporting the safety and effectiveness of cyanoacrylate-lipiodol STAE for rHCC. Randomized trials comparing this mixture to other embolic agents should be performed.
Collapse
Affiliation(s)
- Jory Cali
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21000 Dijon, France; (J.C.); (O.C.); (A.M.)
| | - Olivier Chevallier
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21000 Dijon, France; (J.C.); (O.C.); (A.M.)
- ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 9 Avenue Alain Savary, 21000 Dijon, France
| | - Kévin Guillen
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21000 Dijon, France; (J.C.); (O.C.); (A.M.)
- ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 9 Avenue Alain Savary, 21000 Dijon, France
| | - Marianne Latournerie
- Department of Gastroenterology and Hepatology, Francois-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21000 Dijon, France;
| | - Amin Mazit
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21000 Dijon, France; (J.C.); (O.C.); (A.M.)
| | - Ludwig Serge Aho-Glélé
- Department of Epidemiology, Statistics and Clinical Research, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21000 Dijon, France;
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21000 Dijon, France; (J.C.); (O.C.); (A.M.)
- ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 9 Avenue Alain Savary, 21000 Dijon, France
| |
Collapse
|
3
|
Guillen K, Thony F, Del Giudice C, Goyault G, David A, Douane F, Le Bras Y, Monnin-Bares V, Heautot JF, Rousseau H, Martinelli T, Thouveny F, Barral PA, Le Pennec V, Chabrot P, Rogopoulos A, Aho-Glélé LS, Sapoval M, Rodière M, Chevallier O, Falvo N, Loffroy R. Patient-Reported Outcomes of Endovascular Treatment of Post-Thrombotic Syndrome: Ancillary Study of a French Cohort. Diagnostics (Basel) 2023; 13:2357. [PMID: 37510101 PMCID: PMC10378457 DOI: 10.3390/diagnostics13142357] [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: 06/13/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
Excellent outcomes of angioplasty/stenting for the post-thrombotic syndrome (PTS) have been reported, notably regarding objective criteria in the vast French SFICV cohort. Differences may exist between patient-reported and objective outcomes. We investigated this possibility by using validated scales because significative correlations are discordant in the literature between patency and patient-reported characteristics. Patient-reported outcomes seem to be a more consistent tool than radiologic patency for the diagnosis and follow-up of patients displaying PTS. We retrospectively reviewed the Villalta scale and 20-item ChronIc Venous dIsease quality-of-life Questionnaire (CIVIQ-20) scores recorded after endovascular stenting for PTS at 14 centres in France in 2009-2019. We also collected patency rates, pre-operative post-thrombotic lesion severity, and the extent of stenting. We performed multivariate analyses to identify factors independently associated with improvements in each of the two scores. The 539 patients, including 324 women and 235 men, had a mean age of 44.7 years. The mean Villalta scale improvement was 7.0 ± 4.7 (p < 0.0001) and correlated with the thrombosis sequelae grade and time from thrombosis to stenting. The CIVIQ-20 score was available for 298 patients; the mean improvement was 19.2 ± 14.8 (p < 0.0001) and correlated with bilateral stenting, single thrombosis recurrence, and single stented segment. The objective gains demonstrated in earlier work after stenting were accompanied by patient-reported improvements. The factors associated with these improvements differed between the Villalta scale and the CIVIQ-20 score. These results proved that clinical follow-up with validated scores is gainful in patients treated for PTS thanks to a mini-invasive procedure.
Collapse
Affiliation(s)
- Kévin Guillen
- Department of Interventional Radiology, CHU Dijon, 21000 Dijon, France
| | - Frédéric Thony
- Department of Interventional Radiology, CHU Grenoble, 38000 Grenoble, France
| | - Costantino Del Giudice
- Interventional Radiology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014 Paris, France
| | - Gilles Goyault
- Department of Vascular and Oncological Interventional Radiology, Institut Cardiovasculaire de Strasbourg (ICS), Clinique Rhena, 67000 Strasbourg, France
| | - Arthur David
- Department of Interventional Radiology, CHU Nantes, 44000 Nantes, France
| | - Frédéric Douane
- Department of Interventional Radiology, CHU Nantes, 44000 Nantes, France
| | - Yann Le Bras
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076 Bordeaux, France
| | - Valérie Monnin-Bares
- Department of Imaging and Interventional Radiology, Montpellier University Hospital (CHU), 34000 Montpellier, France
| | | | - Hervé Rousseau
- Cardiac Imaging Centre, Toulouse University Hospital, 31000 Toulouse, France
| | - Thomas Martinelli
- Department of Medical Imaging and Radiology, Valence Hospital, 179 bd Maréchal Juin, 26953 Valence, France
| | | | - Pierre-Antoine Barral
- Department of Radiology, La Timone Hospital, Assistance Publique des Hôpitaux de Marseille, 13000 Marseille, France
| | - Vincent Le Pennec
- Department of Interventional and Diagnostic Imaging, University Hospital of Caen, Avenue de la Côte de Nacre, 14033 Caen, France
| | - Pascal Chabrot
- Department of Vascular Radiology, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, Place Henri Dunant, 63000 Clermont-Ferrand, France
| | - André Rogopoulos
- Department of Radiology, Institut Arnault Tzanck, 06700 Saint-Laurent du Var, France
| | - Ludwig Serge Aho-Glélé
- Department of Epidemiology, Statistics and Clinical Research, Hôpital Universitaire François-Mitterrand, 21079 Dijon, France
| | - Marc Sapoval
- Vascular and Oncological Interventional Radiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, 75015 Paris, France
| | - Mathieu Rodière
- Department of Interventional Radiology, CHU Grenoble, 38000 Grenoble, France
| | | | - Nicolas Falvo
- Department of Interventional Radiology, CHU Dijon, 21000 Dijon, France
| | - Romaric Loffroy
- Department of Interventional Radiology, CHU Dijon, 21000 Dijon, France
| |
Collapse
|
4
|
Bénet T, Amour S, Valette M, Saadatian-Elahi M, Aho-Glélé LS, Berthelot P, Denis MA, Grando J, Landelle C, Astruc K, Paris A, Pillet S, Lina B, Vanhems P. Incidence of Asymptomatic and Symptomatic Influenza Among Healthcare Workers: A Multicenter Prospective Cohort Study. Clin Infect Dis 2021; 72:e311-e318. [PMID: 32750120 DOI: 10.1093/cid/ciaa1109] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/03/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Influenza is an important cause of viral hospital-acquired infection involving patients, healthcare workers (HCW), and visitors. The frequency of asymptomatic influenza among HCW with possible subsequent transmission is poorly described. The objective is to determine the cumulative incidence of asymptomatic, paucisymptomatic, and symptomatic influenza among HCW. METHOD A multicenter prospective cohort study was done in 5 French university hospitals, including 289 HCW during the 2016-2017 influenza season. HCW had 3 physical examinations (time [T] 0, before epidemic onset; T.1, before epidemic peak; T.2, T.3, after epidemic peak). A blood sample was taken each time for influenza serology and a nasal swab was collected at T1 and T2 for influenza detection by polymerase chain reaction (PCR). Positive influenza was defined as either a positive influenza PCR, and/or virus-specific seroconversion against influenza A, the only circulating virus, with no vaccination record during follow-up. Symptoms were self-reported daily between T1 and T2. Cumulative incidence of influenza was stratified by clinical presentation per 100 HCW. RESULTS Of the 289 HCW included, 278 (96%) completed the entire follow-up. Overall, 62 HCW had evidence of influenza of whom 46.8% were asymptomatic, 41.9% were paucisymptomatic, and 11.3% were symptomatic. Cumulative influenza incidence was 22.3% (95% confidence interval [CI]: 17.4%-27.2%). Cumulative incidence of asymptomatic influenza was 5.8% (95% CI: 3.3%-9.2%), 13.7% (95% CI: 9.9%-18.2%) for paucisymptomatic influenza, and 2.9% (95% CI: 1.3%-5.5%) for symptomatic influenza. CONCLUSIONS Asymptomatic and paucisymptomatic influenza were frequent among HCW, representing 47% and 42% of the influenza burden, respectively. These findings highlight the importance of systematic implementation of infection control measures among HCW regardless of respiratory symptoms from preventing nosocomial transmission of influenza. CLINICAL TRIALS REGISTRATION NCT02868658.
Collapse
Affiliation(s)
- Thomas Bénet
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France.,Équipe Épidémiologie et Santé Internationale, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Sélilah Amour
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Martine Valette
- Centre National de Référence des Infections Respiratoires, Région Sud.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Mitra Saadatian-Elahi
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | | | - Philippe Berthelot
- Unité de Gestion du Risque Infectieux, Service d'Infectiologie, CHU de Saint-Etienne, Saint-Etienne, France.,Laboratoire des Agents Infectieux et Hygiène, CHU de Saint-Etienne, Saint-Etienne, France
| | - Marie-Agnès Denis
- Service de médecine et santé au travail, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France.,Ifsttar, UMRESTTE, UMR T_9405 Univ Lyon, Université Claude Bernard Lyon1, Lyon, France
| | - Jacqueline Grando
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Caroline Landelle
- Service d'hygiène hospitalière, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France
| | - Karine Astruc
- Service d'Epidémiologie et d'Hygiène Hospitalière, CHU de Dijon, Dijon, France
| | - Adeline Paris
- Centre d'Investigation Clinique, Inserm CIC1406, CHU de Grenoble Alpes, Grenoble, France
| | - Sylvie Pillet
- Laboratoire des Agents Infectieux et Hygiène, CHU de Saint-Etienne, Saint-Etienne, France
| | - Bruno Lina
- Centre National de Référence des Infections Respiratoires, Région Sud.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Lyon center, France
| | - Philippe Vanhems
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France.,Équipe Épidémiologie et Santé Internationale, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Lyon center, France
| | | |
Collapse
|
5
|
Mariet AS, Giroud M, Benzenine E, Cottenet J, Roussot A, Aho-Glélé LS, Tubert-Bitter P, Béjot Y, Quantin C. Hospitalizations for Stroke in France During the COVID-19 Pandemic Before, During, and After the National Lockdown. Stroke 2021; 52:1362-1369. [PMID: 33626900 DOI: 10.1161/strokeaha.120.032312] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND PURPOSE In France, the entire population was put under a total lockdown from March 17 to May 11, 2020 during the peak of the coronavirus disease 2019 (COVID-19) pandemic. Whether the lockdown had consequences on the management of medical emergencies such as stroke and transient ischemic attack (TIA) has yet to be fully evaluated. This article describes hospitalization rates for acute stroke in 2 French regions that experienced contrasting rates of COVID-19 infection, before, during, and after the nationwide lockdown (January to June 2020). METHODS All patients admitted for acute stroke/TIA into all public and private hospitals of the 2 study regions were included. Data were retrieved from the National Hospitalization Database (PMSI). In the most affected region (Grand-Est), the hospitalization rates observed in April 2020 were compared with the rates in the same period in the least affected region (Occitanie) and in the 3 prior years (2017-2019). RESULTS There was a significant decline in hospitalization rates for stroke/TIA within the region most affected by COVID-19 during the month of April 2020 compared with previous years, while no significant change was seen in the least affected region. After lockdown, we observed a fast rebound in the rate of hospitalization for stroke/TIA in the most affected region, contrasting with a slower rebound in the least affected region. In both regions, patients with COVID-19 stroke more frequently had ischemic stroke, a nonsignificant greater prevalence of diabetes, they were less frequently admitted to stroke units, and mortality was higher than in patients without COVID-19. CONCLUSIONS Our results demonstrates a significant drop in stroke/TIA hospitalizations and a fast recovery after the end of the French lockdown in the most affected region, while the least affected region saw a nonsignificant drop in stroke/TIA hospitalizations and a slow recovery. These results and recommendations could be used by the health authorities to prepare for future challenges.
Collapse
Affiliation(s)
- Anne-Sophie Mariet
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France (A.-S.M., E.B., J.C., A.R., C.Q.).,Inserm, CIC 1432, Dijon, France (A.-S.M., C.Q.).,Dijon University Hospital, Clinical Investigation Center, clinical epidemiology/clinical trials unit, France (A.-S.M., C.Q.)
| | - Maurice Giroud
- Dijon Stroke Registry - EA7460 (Pathophysiology and Epidemiology of Cerebro-Cardio-Vascular Diseases), University of Burgundy - UBFC (M.G., Y.B.), University Hospital of Dijon, Bourgogne, France
| | - Eric Benzenine
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France (A.-S.M., E.B., J.C., A.R., C.Q.)
| | - Jonathan Cottenet
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France (A.-S.M., E.B., J.C., A.R., C.Q.)
| | - Adrien Roussot
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France (A.-S.M., E.B., J.C., A.R., C.Q.)
| | - Ludwig Serge Aho-Glélé
- Department of Epidemiology and Hospital Hygiene (L.S.A.-G.), University Hospital of Dijon, Bourgogne, France
| | - Pascale Tubert-Bitter
- Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France (P.T.-B., C.Q.)
| | - Yannick Béjot
- Dijon Stroke Registry - EA7460 (Pathophysiology and Epidemiology of Cerebro-Cardio-Vascular Diseases), University of Burgundy - UBFC (M.G., Y.B.), University Hospital of Dijon, Bourgogne, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France (A.-S.M., E.B., J.C., A.R., C.Q.).,Inserm, CIC 1432, Dijon, France (A.-S.M., C.Q.).,Dijon University Hospital, Clinical Investigation Center, clinical epidemiology/clinical trials unit, France (A.-S.M., C.Q.).,Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France (P.T.-B., C.Q.)
| |
Collapse
|
6
|
Ognard J, Demany N, Mesrar J, Aho-Glélé LS, Saraux A, Ben Salem D. Mapping the medullar adiposity of lumbar spine in MRI: A feasibility study. Heliyon 2021; 7:e05992. [PMID: 33506138 PMCID: PMC7814159 DOI: 10.1016/j.heliyon.2021.e05992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 11/01/2020] [Accepted: 01/12/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE The bone medullar adiposity is a marker of bone quality to the point that there is a need to investigate the factors which influence or not the density and distribution of this fat in the spine, especially at the lumbar level. The purpose was to test the feasibility of a Dixon three-point technique and investigate the vertebral marrow fat distribution. MATERIAL AND METHODS A sagittal sequence Iterative Decomposition of Water and Fat with Echo Asymmetry and Least-squares Estimation (IDEAL) IQ was performed on the lumbar spine of 46 subjects who were not suffering from any bone disease (21 women and 25 men, aged 18-77 years). Medulla adiposity was determined directly from the measurement of the fat fraction in each vertebral body (T12 to S1) obtained on the fat cartography automatically generated by the IDEAL sequence. RESULTS Average vertebral fat fraction was 36.48% (SD 12.82), with a tendency to increase with age and to higher values among men. We observed a craniocaudal gradient of the fat fraction (β = 1.37; p < 0,001; SD 0.11) increasing with age in the lumbar spine from T12 to L5. Through multivariate analysis, this gradient was adjusted for sex, weight and height of the subjects. CONCLUSION This feasibility study shows the existence of a physiological craniocaudal gradient of vertebral medullar adiposity from T12 to L5. This gradient increases with age but it is independent of sex or BMI. The IDEAL sequence allows quick and reproducible measurement of the spine vertebral medullar adiposity.
Collapse
Affiliation(s)
- Julien Ognard
- Service d'Imagerie Médicale, CHRU de Brest, Boulevard Tanguy-Prigent, 29609 Brest, France
- Laboratoire de Traitement de l'information Médicale—LaTIM (Inserm, U1101), 5, Avenue Foch, 29200 Brest cedex, France
| | - Nicolas Demany
- Service d'Imagerie Médicale, CHRU de Brest, Boulevard Tanguy-Prigent, 29609 Brest, France
| | - Jawad Mesrar
- Service d'Imagerie Médicale, CHRU de Brest, Boulevard Tanguy-Prigent, 29609 Brest, France
| | | | - Alain Saraux
- Service de Rhumatologie, CHRU de Brest, Boulevard Tanguy-Prigent, 29609 Brest, France
| | - Douraied Ben Salem
- Service d'Imagerie Médicale, CHRU de Brest, Boulevard Tanguy-Prigent, 29609 Brest, France
- Laboratoire de Traitement de l'information Médicale—LaTIM (Inserm, U1101), 5, Avenue Foch, 29200 Brest cedex, France
| |
Collapse
|
7
|
Comte A, Bour JB, Darniot M, Pitoiset C, Aho-Glélé LS, Manoha C. Epidemiological characteristics and clinical outcomes of human rhinovirus infections in a hospitalized population. Severity is independently linked to RSV coinfection and comorbidities. J Clin Virol 2020; 125:104290. [PMID: 32135487 DOI: 10.1016/j.jcv.2020.104290] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/21/2019] [Accepted: 02/17/2020] [Indexed: 11/29/2022]
Abstract
Human rhinovirus (hRV) is a predominant respiratory viral pathogen. The determinants that lead to adverse clinical outcomes in hospitalized patients are unclear. Our objective was to analyze the epidemiological and clinical characteristics of hRV infections in a hospitalized population and to compare non-severe and severe infections. The study was based on data from all patients with a respiratory episode admitted to Hospital from October 2015 to September 2016. During the study period, out of 2465 respiratory episodes, 434 were detected positive for hRV. Most of the coinfections involved the respiratory syncytial virus (RSV) and very few influenza viruses. A possible interference between rhinovirus and influenza virus is suggested. Airway involvement was present in a large part of hRV infections with 28.4 % (n = 48/169) of bronchiolitis and 3.6 % (n = 6/169) of bronchitis. One third of patients had at least one of the following severity criteria: need for oxygen therapy, hospitalization ≥ 5 days, and admission to the ICU. On multivariate analysis, a respiratory co-infection with RSV and the presence of a chronic respiratory disease (including a history of asthma) were shown to be independent risk factors for the onset of a severe infection in patients ≤ 2 years old. In a case control study based on 70 patients, hRV-A was the predominant lineage, followed closely by hRV-C. High viral load or viral genotypes were not associated with severe infection.
Collapse
Affiliation(s)
- Anthony Comte
- Virology Laboratory, University Hospital, Dijon, France
| | | | | | | | | | | |
Collapse
|
8
|
Darniot M, Pitoiset C, Millière L, Aho-Glélé LS, Florentin E, Bour JB, Manoha C. Different meteorological parameters influence metapneumovirus and respiratory syncytial virus activity. J Clin Virol 2018; 104:77-82. [DOI: 10.1016/j.jcv.2018.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/02/2018] [Accepted: 05/04/2018] [Indexed: 10/17/2022]
|
9
|
Lefebvre A, Bertrand X, Quantin C, Vanhems P, Lucet JC, Nuemi G, Astruc K, Chavanet P, Aho-Glélé LS. Association between Pseudomonas aeruginosa positive water samples and healthcare-associated cases: nine-year study at one university hospital. J Hosp Infect 2016; 96:238-243. [PMID: 28189270 DOI: 10.1016/j.jhin.2016.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/08/2016] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To study the association between the results of water samples and Pseudomonas aeruginosa healthcare-associated cases in a French university hospital. METHODS Generalized Estimating Equations were used on complete case and imputed datasets. The spatial unit was the building and the time unit was the quarter. RESULTS For the period 2004-2013, 2932 water samples were studied; 17% were positive for P. aeruginosa. A higher incidence of P. aeruginosa cases was associated with a higher proportion of positive water samples (P=0.056 in complete case analysis and P=0.031 with the imputed dataset). The association was no longer observed when haematology and intensive care units were excluded, but was significant in analyses of data concerning intensive care units alone (P<0.001). CONCLUSION This study suggests that water outlet contamination in hospitals can lead to an increase in healthcare-associated P. aeruginosa cases in wards dealing with susceptible patients, but does not play a significant role in other wards.
Collapse
Affiliation(s)
- A Lefebvre
- Service d'épidémiologie et hygiène hospitalières, CHU Dijon, France; Laboratoire Microbiologie Environnementale et Risques Sanitaires, Dijon, France.
| | - X Bertrand
- Université Paris Diderot, Paris, France; Service d'hygiène, CHU Besançon, France
| | - C Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comté University, Dijon, France; INSERM, CIC 1432, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon, France; Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
| | - P Vanhems
- Service d'Hygiène Hospitalière, Epidémiologie et Prévention, groupe hospitalier Edouard Herriot, Lyon, France
| | - J-C Lucet
- Equipe d'épidémiologie et santé publique, Université Claude Bernard, Lyon, France; UHLIN, groupe hospitalier Bichat - Claude Bernard, HUPNVS, AP-HP, Paris, France
| | - G Nuemi
- Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comté University, Dijon, France; INSERM, CIC 1432, Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon, France
| | - K Astruc
- Service d'épidémiologie et hygiène hospitalières, CHU Dijon, France
| | - P Chavanet
- Laboratoire Chrono-environnement, UMR CNRS 6249, Université de Franche-Comté, Besançon, France; Département de maladies infectieuses, CHU Dijon, France
| | - L S Aho-Glélé
- Service d'épidémiologie et hygiène hospitalières, CHU Dijon, France
| |
Collapse
|
10
|
Lefebvre A, Manoha C, Bour JB, Abbas R, Fournel I, Tiv M, Pothier P, Astruc K, Aho-Glélé LS. Human metapneumovirus in patients hospitalized with acute respiratory infections: A meta-analysis. J Clin Virol 2016; 81:68-77. [PMID: 27337518 PMCID: PMC7106388 DOI: 10.1016/j.jcv.2016.05.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/26/2016] [Accepted: 05/30/2016] [Indexed: 12/31/2022]
Abstract
This meta-analysis aimed to estimate the prevalence of human metapneumovirus (hMPV) infections in patients hospitalized for acute respiratory infection (ARI) and to study factors associated with this prevalence. Medline and ScienceDirect databases were searched for prospective observational studies that screened hospitalized patients with ARI for hMPV by RT-PCR, with data available at December 27, 2014. The risk of bias was assessed regarding participation rate, definition of ARI, description of diagnostic technique, method of inclusion identical for all subjects, standardized and identical sampling method for all subjects, analysis performed according to the relevant subgroups, and presentation of data sources. Random-effect meta-analysis with arcsine transformation and meta-regressions was used. In the 75 articles included, the prevalence of hMPV among hospitalized ARI was 6.24% (95% CI 5.25-7.30). An effect of the duration of the inclusion period was observed (p=0.0114), with a higher prevalence of hMPV in studies conducted during periods of 7-11 months (10.56%, 95% CI 5.97-16.27) or complete years (7.55%, 95% CI 5.90-9.38) than in periods of 6 months or less (5.36%, 95% CI 4.29-6.54). A significant increase in the incidence with increasing distance from the equator was observed (p=0.0384). hMPV should be taken into account as a possible etiology in hospitalized ARI.
Collapse
Affiliation(s)
- Annick Lefebvre
- Epidemiology and infection control unit, Dijon University Hospital, France.
| | | | | | - Rachid Abbas
- Epidemiology and infection control unit, Dijon University Hospital, France
| | - Isabelle Fournel
- Epidemiology and infection control unit, Dijon University Hospital, France
| | - Michel Tiv
- Epidemiology and infection control unit, Dijon University Hospital, France
| | | | - Karine Astruc
- Epidemiology and infection control unit, Dijon University Hospital, France
| | | |
Collapse
|
11
|
Lefebvre A, Bertrand X, Vanhems P, Lucet JC, Chavanet P, Astruc K, Thouverez M, Quantin C, Aho-Glélé LS. Detection of Temporal Clusters of Healthcare-Associated Infections or Colonizations with Pseudomonas aeruginosa in Two Hospitals: Comparison of SaTScan and WHONET Software Packages. PLoS One 2015; 10:e0139920. [PMID: 26448036 PMCID: PMC4598114 DOI: 10.1371/journal.pone.0139920] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 09/18/2015] [Indexed: 11/25/2022] Open
Abstract
The identification of temporal clusters of healthcare-associated colonizations or infections is a challenge in infection control. WHONET software is available to achieve these objectives using laboratory databases of hospitals but it has never been compared with SaTScan regarding its detection performance. This study provided the opportunity to evaluate the performance of WHONET software in comparison with SaTScan software as a reference to detect clusters of Pseudomonas aeruginosa. A retrospective study was conducted in two French university hospitals. Cases of P. aeruginosa colonizations or infections occurring between 1st January 2005 and 30th April 2014 in the first hospital were analyzed overall and by medical ward/care unit. Poisson temporal and space-time permutation models were used. Analyses were repeated for the second hospital on data from 1st July 2007 to 31st December 2013 to validate WHONET software (in comparison with SaTScan) in another setting. During the study period, 3,946 isolates of P. aeruginosa were recovered from 2,996 patients in the first hospital. The incidence rate was 89.8 per 100,000 patient-days (95% CI [87.0; 92.6]). Several clusters were observed overall and at the unit level and some of these were detected whatever the method used. WHONET results were consistent with the analyses that took patient-days and temporal trends into account in both hospitals. Because it is more flexible and easier to use than SaTScan, WHONET software seems to be a useful tool for the prospective surveillance of hospital data although it does not take populations at risk into account.
Collapse
Affiliation(s)
- Annick Lefebvre
- Hospital Epidemiology and Infection Control Department, Dijon University Hospital, Dijon, France
- Laboratory of Environmental Microbiology and Health Risks, University of Burgundy, Dijon, France
| | - Xavier Bertrand
- Infection Control Department, CHU Besançon, Besançon, France
- Chrono-environment Laboratory, UMR CNRS 6249, University of Franche-Comté, Besançon, France
| | - Philippe Vanhems
- Infection Control, Epidemiology and Prevention Department, Hospital Group Edouard Herriot, Lyon, France
- Epidemiology and Public Health Team, Claude Bernard University, Lyon, France
| | - Jean-Christophe Lucet
- UHLIN, Hospital Group Bichat—Claude Bernard, HUPNVS, AP-HP, Paris, France
- Paris Diderot University, Paris 7, Paris, France
| | - Pascal Chavanet
- Laboratory of Environmental Microbiology and Health Risks, University of Burgundy, Dijon, France
- Infectious Diseases Department, Dijon University Hospital, Dijon, France
| | - Karine Astruc
- Hospital Epidemiology and Infection Control Department, Dijon University Hospital, Dijon, France
| | | | - Catherine Quantin
- Biostatistics and Medical Information Department, Dijon University Hospital, Dijon, France
- Epidemiology Department—EA 4184, University of Burgundy, Dijon, France
| | - Ludwig Serge Aho-Glélé
- Hospital Epidemiology and Infection Control Department, Dijon University Hospital, Dijon, France
| |
Collapse
|
12
|
Lefebvre A, Laporte S, Faure S, Tiv M, Chavanet P, Belpois-Duchamp C, Astruc K, Aho-Glélé LS. Information concerning multidrug-resistant bacterial colonization or infection in the medical transfer letter. Med Mal Infect 2015; 45:286-92. [PMID: 26123765 DOI: 10.1016/j.medmal.2015.05.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 04/07/2015] [Accepted: 05/22/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the proportion of transfer letters that contained information relative to infection or colonization by multidrug-resistant (MDR) bacteria and factors associated with the presence of that information. PATIENTS AND METHODS Patients for whom at least one of these selected MDR bacteria (methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Enterobacteriaceae, or MDR Pseudomonas aeruginosa) was isolated during their hospitalization and who were transferred to another health care facility between 2009 and 2012 were included. Information of the MDR bacterium and the mention of isolation precautions were evaluated in the electronic medical record. RESULTS Information (mention of MDR bacterium or isolation precaution) was present in 57% [52; 65] of records. Full information (genus and species, concept of MDR bacterium and mention of isolation precaution) was found in 20% [16; 25]. The presence of a dedicated item in the standard medical discharge letter was associated with more frequent information. Less information was retrieved with P. aeruginosa cases than with the other 2 MDR bacteria. CONCLUSION The presence of the information has improved, but it is still insufficiently reported. Measures to improve information are needed. Indeed, information on MDR bacterial colonization or infection is the first step for isolation precautions. An item could be added to all standard medical discharge letters. An item could also be added to the indicators used to assess quality and safety in healthcare facilities.
Collapse
Affiliation(s)
- A Lefebvre
- Infection control unit, Dijon University Hospital, 21800 Dijon, France.
| | - S Laporte
- Infection control unit, Dijon University Hospital, 21800 Dijon, France
| | - S Faure
- Infection control unit, Dijon University Hospital, 21800 Dijon, France
| | - M Tiv
- Infection control unit, Dijon University Hospital, 21800 Dijon, France
| | - P Chavanet
- Department of infectious diseases, Dijon University Hospital, 21800 Dijon, France
| | - C Belpois-Duchamp
- Infection control unit, Dijon University Hospital, 21800 Dijon, France
| | - K Astruc
- Infection control unit, Dijon University Hospital, 21800 Dijon, France
| | - L S Aho-Glélé
- Infection control unit, Dijon University Hospital, 21800 Dijon, France
| |
Collapse
|