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O'Dor SL, Zagaroli JS, Belisle RM, Hamel MA, Downer OM, Homayoun S, Williams KA. The COVID-19 pandemic and children with PANS/PANDAS: an evaluation of symptom severity, telehealth, and vaccination hesitancy. Child Psychiatry Hum Dev 2024; 55:327-335. [PMID: 35930178 PMCID: PMC9361990 DOI: 10.1007/s10578-022-01401-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/25/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
Abstract
The current study assessed the impact of the COVID-19 pandemic on children with PANS/PANDAS, a condition characterized by sudden-onset obsessive-compulsive, tic, or restrictive eating symptoms following infection. We conducted an anonymous survey between February and June 2021 of 254 self-reported caregivers of minors with PANS/PANDAS. Caregivers answered questions regarding PANS/PANDAS symptoms, telehealth care, and intention to vaccinate their child against COVID-19. PANS/PANDAS symptoms during COVID-19 infections were assessed when applicable. Children's OCD symptoms and coercive behaviors towards caregivers, along with the caregivers' mental health, relationship satisfaction, and burden, were assessed using standardized questionnaires. A majority of respondents endorsed a negative impact on their child's friendships, relationships with extended family, hobbies, and academic skills due to the pandemic. Children with suspected or diagnosed COVID-19 experienced new or worsened psychiatric symptoms, particularly mood lability, OCD, and anxiety. Telehealth care was the preferred treatment modality if the child had mild symptoms of PANS/PANDAS. A majority of caregivers reported high levels of relationship dissatisfaction and caregiver burden. As expected, these data suggest an overall negative impact of the COVID-19 pandemic on children with PANS/PANDAS and their caregivers.
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Affiliation(s)
- Sarah L O'Dor
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
- Yawkey Outpatient Center, Massachusetts General Hospital, Suite 6A, 55 Fruit St, 02114, Boston, MA, USA.
| | - J S Zagaroli
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - R M Belisle
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - M A Hamel
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - O M Downer
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - S Homayoun
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - K A Williams
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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2
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Deschênes-Simard X, Richard C, Galland L, Blais F, Desilets A, Malo J, Cvetkovic L, Belkaid W, Elkrief A, Gagné A, Hamel MA, Orain M, Joubert P, Ghiringhelli F, Routy B, Blais N. Venous thrombotic events in patients treated with immune checkpoint inhibitors for non-small cell lung cancer: A retrospective multicentric cohort study. Thromb Res 2021; 205:29-39. [PMID: 34246011 DOI: 10.1016/j.thromres.2021.06.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 02/20/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Venous thrombotic events (VTEs) are a frequent complication of non-small cell lung cancer (NSCLC) and are associated with increased morbidity. Immune checkpoint inhibitors (ICIs) are revolutionizing the management of NSCLC, but little is known about their impact on thrombosis. This study aims to define the incidence and clinical relevance of VTEs in NSCLC patients receiving these treatments. METHODS A retrospective multicentric cohort study including 593 patients from three centers in Canada and France was performed. The cumulative incidence of VTEs after ICIs was estimated using competing risk analysis, and the association of these events with survival and response to treatment was determined. Finally, univariate and multivariate tests were performed to identify VTE risk factors. RESULTS The cumulative incidence of VTEs in the cohort was 14.8% (95% CI = 7.4-22.2%) for an incidence rate of 76.5 (95% CI = 59.9-97.8) thrombosis per 1000 person-years, with most thromboses occurring rapidly after treatment initiation. VTEs were not correlated with overall survival, progression-free survival, or objective response to ICIs. Age ˂ 65 years old (HR = 2.00; 95% CI = 1.11-3.59) and tumors with PD-L1 1-49% (HR = 3.36; 95% CI = 1.19-9.50) or PD-L1 ≥ 50% (HR = 3.22; 95% CI = 1.21-8.57) were associated with more VTEs after 12 months of ICI initiation. Also, a delay of less than 12 months from diagnosis to the first ICI treatment (HR = 2.06; 95% CI = 1.09-3.89) and active smoking (HR = 2.00; 95% CI = 1.12-3.58) are probable risk factors of VTEs. CONCLUSION This study suggests that the incidence of VTEs in NSCLC patients treated with ICIs is comparable to what is reported in other cohorts of patients treated with chemotherapy. In our cohort, VTEs were not associated with a decreased survival or response to therapy. Patient age < 65 and tumors with PD-L1 ≥ 1% were associated with a higher risk of VTEs under ICIs.
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Affiliation(s)
- Xavier Deschênes-Simard
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Corentin Richard
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Loïck Galland
- Dijon Bourgogne University Hospital, 2 Boul. du Maréchal de Lattre de Tassigny, 21000 Dijon, France
| | - Florence Blais
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), 2725 Sainte-Foy Road, Quebec City, Quebec G1V 4G5, Canada
| | - Antoine Desilets
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Julie Malo
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Lena Cvetkovic
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Wiam Belkaid
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Arielle Elkrief
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Andréanne Gagné
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), 2725 Sainte-Foy Road, Quebec City, Quebec G1V 4G5, Canada
| | - Marc-André Hamel
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), 2725 Sainte-Foy Road, Quebec City, Quebec G1V 4G5, Canada
| | - Michèle Orain
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), 2725 Sainte-Foy Road, Quebec City, Quebec G1V 4G5, Canada
| | - Philippe Joubert
- Quebec Heart and Lung Institute Research Centre (CRIUCPQ), 2725 Sainte-Foy Road, Quebec City, Quebec G1V 4G5, Canada
| | - François Ghiringhelli
- Dijon Bourgogne University Hospital, 2 Boul. du Maréchal de Lattre de Tassigny, 21000 Dijon, France
| | - Bertrand Routy
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada
| | - Normand Blais
- University of Montreal Research Center (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Hematology-Oncology Division, University of Montreal Health Centre (CHUM), 1000 Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada.
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Sazonova O, Manem V, Béland C, Hamel MA, Lacasse Y, Lévesque MH, Orain M, Joubert D, Provencher S, Simonyan D, Joubert P. Development and Validation of Diffuse Idiopathic Pulmonary Neuroendocrine Hyperplasia Diagnostic Criteria. JTO Clin Res Rep 2020; 1:100078. [PMID: 34589957 PMCID: PMC8474376 DOI: 10.1016/j.jtocrr.2020.100078] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/28/2020] [Accepted: 07/17/2020] [Indexed: 12/01/2022] Open
Abstract
Introduction Diffuse idiopathic pulmonary neuroendocrine hyperplasia (DIPNECH) is a rare condition that is likely underdiagnosed owing to the lack of established and validated diagnostic criteria. These clinical guidelines are empirical and created on the basis of a limited number of studies. This study was designed to validate the existing criteria and to identify new clinical parameters that can accurately diagnose DIPNECH. Methods Patients with DIPNECH were identified from a cohort that underwent surgical lung resection for pulmonary carcinoids. The study cohort included a total of 105 consecutive cases with neuroendocrine lesions. Initial diagnostic predictors of DIPNECH were selected from the literature. We employed univariate and multivariate models to evaluate the association of clinical, pathologic, radiologic variables with the likelihood of DIPNECH. Results Univariate analysis identified age, sex, chronic obstructive pulmonary disease diagnosis, obstructive abnormalities, pulmonary nodules, mosaicism, absolute numbers of pulmonary neuroendocrine lesions (PNELs), and the number of tumorlets as significant DIPNECH predictors (for p < 0.05). After adjustment for sampling variations, the ratio of the total number of PNELs to the number of bronchioles was found to be considerably higher in DIPNECH category. Multivariate analysis identified the total number of PNELs and multiple pulmonary nodules (>10) as independent predictors of DIPNECH. The performance of our criteria revealed an accuracy of 76% in detecting DIPNECH cases. Conclusions We proposed a set of diagnostic criteria for DIPNECH on the basis of an expert-panel approach integrating pathological features, radiology, and clinical data. Our findings will help identify DIPNECH patients, without a pathological confirmation of a neuroendocrine lesion. Before the implementation of these criteria in clinical practice, they require further validation in multi-institutional cohorts.
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Affiliation(s)
- Olga Sazonova
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute) Research Center, Laval University, Québec, Canada
| | - Venkata Manem
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute) Research Center, Laval University, Québec, Canada
| | - Chloé Béland
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute) Research Center, Laval University, Québec, Canada
| | - Marc-André Hamel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute) Research Center, Laval University, Québec, Canada
| | - Yves Lacasse
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute) Research Center, Laval University, Québec, Canada.,Department of Medicine, Université Laval, Québec, Canada
| | - Marie-Hélène Lévesque
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute) Research Center, Laval University, Québec, Canada
| | - Michèle Orain
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute) Research Center, Laval University, Québec, Canada
| | - David Joubert
- Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
| | - Steeve Provencher
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute) Research Center, Laval University, Québec, Canada.,Department of Medicine, Université Laval, Québec, Canada
| | - David Simonyan
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute) Research Center, Laval University, Québec, Canada
| | - Philippe Joubert
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Québec Heart and Lung Institute) Research Center, Laval University, Québec, Canada.,Department of Molecular Biology, Medical Biochemistry, and Pathology, Université Laval, Québec, Canada
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Fumet JD, Richard C, Ledys F, Klopfenstein Q, Joubert P, Routy B, Truntzer C, Gagné A, Hamel MA, Guimaraes CF, Coudert B, Arnould L, Favier L, Lagrange A, Ladoire S, Saintigny P, Ortiz-Cuaran S, Perol M, Foucher P, Hofman P, Ilie M, Chevrier S, Boidot R, Derangere V, Ghiringhelli F. Correction: Prognostic and predictive role of CD8 and PD-L1 determination in lung tumor tissue of patients under anti-PD-1 therapy. Br J Cancer 2019; 121:283. [PMID: 31235866 PMCID: PMC6738095 DOI: 10.1038/s41416-019-0512-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Jean-David Fumet
- Department of Medical Oncology, Center GF Leclerc, Dijon, France.,Research Platform in Biological Oncology, Dijon, France.,GIMI Genetic and Immunology Medical Institute, Dijon, France.,University of Burgundy-Franche Comté, Dijon, France
| | - Corentin Richard
- Research Platform in Biological Oncology, Dijon, France.,GIMI Genetic and Immunology Medical Institute, Dijon, France.,University of Burgundy-Franche Comté, Dijon, France
| | - Fanny Ledys
- Research Platform in Biological Oncology, Dijon, France.,GIMI Genetic and Immunology Medical Institute, Dijon, France.,University of Burgundy-Franche Comté, Dijon, France
| | - Quentin Klopfenstein
- Research Platform in Biological Oncology, Dijon, France.,GIMI Genetic and Immunology Medical Institute, Dijon, France
| | - Philippe Joubert
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, QC, Canada
| | - Bertrand Routy
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.,Hematology-Oncology Division, Department of Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Caroline Truntzer
- Research Platform in Biological Oncology, Dijon, France.,GIMI Genetic and Immunology Medical Institute, Dijon, France
| | - Andréanne Gagné
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, QC, Canada
| | - Marc-André Hamel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, QC, Canada
| | - Camila Figueiredo Guimaraes
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, QC, Canada
| | - Bruno Coudert
- Department of Medical Oncology, Center GF Leclerc, Dijon, France
| | | | - Laure Favier
- Department of Medical Oncology, Center GF Leclerc, Dijon, France
| | - Aurélie Lagrange
- Department of Medical Oncology, Center GF Leclerc, Dijon, France
| | - Sylvain Ladoire
- Department of Medical Oncology, Center GF Leclerc, Dijon, France.,University of Burgundy-Franche Comté, Dijon, France
| | - Pierre Saintigny
- Department of Medical Oncology, Center Leon Berard, Lyon, France
| | | | - Maurice Perol
- Department of Medical Oncology, Center Leon Berard, Lyon, France
| | - Pascal Foucher
- Department of Thoracic Oncology, Dijon University Hospital, Dijon, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Nice University Hospital, Université Côte d'Azur, Nice, France.,Hospital-Integrated Biobank (BB-0033-00025), FHU OncoAge, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - Marius Ilie
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Nice University Hospital, Université Côte d'Azur, Nice, France.,Hospital-Integrated Biobank (BB-0033-00025), FHU OncoAge, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - Sandy Chevrier
- Research Platform in Biological Oncology, Dijon, France.,GIMI Genetic and Immunology Medical Institute, Dijon, France
| | - Romain Boidot
- Research Platform in Biological Oncology, Dijon, France.,GIMI Genetic and Immunology Medical Institute, Dijon, France
| | - Valentin Derangere
- Research Platform in Biological Oncology, Dijon, France.,GIMI Genetic and Immunology Medical Institute, Dijon, France
| | - François Ghiringhelli
- Department of Medical Oncology, Center GF Leclerc, Dijon, France. .,Research Platform in Biological Oncology, Dijon, France. .,GIMI Genetic and Immunology Medical Institute, Dijon, France. .,University of Burgundy-Franche Comté, Dijon, France. .,INSERM UMR1231, Dijon, France.
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McCurdy DE, Hamel MA. The use of 226Ra as a quality control check source for the beta-gamma coincidence counting of 131I. Health Phys 1981; 40:561-564. [PMID: 7228709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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