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Debono B, Perez A, Lonjon G, Hamel O, Dandine JB, Dupuy M, Dutertre G, Braticevic C, Latorzeff I, Amelot A. Enhancing the referral process for surgical management of spinal metastases: insights from a 12-year, bi-institutional study of 533 patients. Front Oncol 2024; 14:1301305. [PMID: 38352892 PMCID: PMC10861661 DOI: 10.3389/fonc.2024.1301305] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Delayed surgical management of spinal metastases (SMs) can have detrimental effects on patient survival and quality of life, leading to pain and potential neurological impairment. This study aimed to assess the impact of delayed referral for SMs on clinical outcomes by analyzing patients managed in emergency situations. Methods We retrospectively reviewed the data of all patients admitted on either emergency or elective basis who underwent surgery for the treatment of neoplastic spine lesions at our two institutions (tertiary referral neurosurgical units) between January 2008 and December 2019. Results We analyzed 210 elective (EGp) and 323 emergency patients (UGp); emergencies increased significantly over the 12-year period, with a Friday peak (39.3%) and frequent neurological impairment (61.6% vs. 20%). Among the UGp patients, 186 (7.5%) had a previously monitored primitive cancer, including 102 (31.6%) with known SMs. On admission, 71 of the 102 (69.9%) patients presented with neurological deficits. UGp patients were more likely to undergo a single decompression without fixation. Outcomes at the 3-month follow-up were significantly worse for UGp patients ([very] poor, 29.2 vs. 13.8%), and the median overall survival for UGp patients was statistically lower. Risk factors for patients with SM undergoing emergency management included short delay between onset of symptoms and first contact with a spine surgeon, and an initial motor deficit. Conclusion Many patients with previously identified metastases, including those with neurological deficits, are urgently referred. Optimization is needed in the oncology pathway, and all stakeholders must be made aware of the factors contributing to the improvement in the clinical and radiological identification of potential complications affecting patient survival and quality of life.
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Affiliation(s)
- Bertrand Debono
- Department of Neurosurgery, Paris-Versailles Spine Center, Hôpital privé de Versailles, Versailles, France
| | - Alexis Perez
- Department of Neurosurgery, Clinique de l’Union, Toulouse, France
| | - Guillaume Lonjon
- Department of Orthopedic Surgery, Orthosud, Clinique St-Jean-Sud de France, Santé Cite Group, Montpellier Metropole, France
| | - Olivier Hamel
- Department of Neurosurgery, Clinique des Cédres, Toulouse, France
| | | | - Martin Dupuy
- Department of Neurosurgery, Clinique de l’Union, Toulouse, France
| | - Guillaume Dutertre
- Institut Curie, Paris Sciences et Lettres (PSL) Research University, Surgical Oncology Department, Paris, France
| | - Cécile Braticevic
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Igor Latorzeff
- Department of Radiotherapy, Groupe ONCORAD Garonne, Clinique Pasteur, Toulouse, France
| | - Aymeric Amelot
- Department of Neurosurgery, Hopital Bretonneau, Tours, France
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Hountondji L, Palassin P, Faure S, Iltache S, Dupuy M, Pageaux G, Faillie J, Lesage C, Negre E, Assenat E, Rullier P, Rivet V, Quantin X, Meunier L, Maria A. Hépatites auto-immunes induites par inhibiteurs de checkpoints : étude observationnelle CHILI. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.256] [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]
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Dupuy M, Saba J, Codiat R, Derumeaux G, Alassaad L, Abou Chakra L, Odouard S, Deux J, Guillet H, Savale L, De Luna G, Bartolucci P, D’humières T. Echocardiographic determinants of ventricular arrhythmia in sickle cell disease. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dupuy M, Saba J, Codiat R, Derumeaux G, Alassaad L, Abou Chakra L, Odouard S, Deux J, Guillet H, Savale L, De Luna G, Bartolucci P, D'Humieres T. Echocardiographic determinants of ventricular arrhythmia in sickle cell disease adults. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Unexplained sudden death remains one of the leading causes of death in sickle cell disease (SCD) adults. Ventricular arrhythmia is a well-known risk factor for sudden death but its prevalence and determinants in the context of SCD remain understudied.
Purpose
The aim of this study was to identify echocardiographic predictors of ventricular arrhythmia in SCD.
Methods
From January 2019 to March 2021, consecutive adult patients with SCD referred to ambulatory cardiology department for possible cardiac involvement were prospectively included (Drepacoeur cohort). All patients that had 24-hour ECG monitoring (24h-holter) and thransthoracic echocardiography (TTE) on the same day were analysed in this study. The primary end point was the occurrence of ventricular arrhythmia, defined as sustained or non-sustained ventricular tachycardia (VT), more than 500 premature ventricular contractions (PVC) on 24h-holter, or history of VT ablation.
Results
Overall, 90 patients were included and 54 (60%) were analysed. Mean age was 47.6±11.6 years (range 21–69), 53% were male. Heart function was mainly preserved with a mean left ventricular ejection fraction (LVEF) of 57.9±4.9% and a mean global longitudinal strain (GLS) of −18±2.8%. Mean tricuspid regurgitation velocity was 2.6±0.4m/s.
Ventricular arrhythmia was observed in 13 (24.1%) patients (4 non-sustained VT [range 4–121 consecutive PVC], 9 with more than 500 PVC [range 500–13000 PVC/24h] and 1 history of VT ablation). Regarding echocardiographic parameters, ventricular arrhythmia was associated with lower GLS (−15.8±1.8% vs. −19±2.7%, P<0,001), lower tricuspid annular plane systolic excursion (TAPSE, 23±5.7mm vs. 26.9±4.6mm, P=0,02) and more dilated right ventricle assessed by tricuspid annulus diameter (38.2±6.1mm vs. 34.2±4.5mm, P=0,02). In multivariate analysis, GLS was independently associated with ventricular arrhythmia (OR=2,1 CI95% [1,3; 3,3], P=0,004) with a moderate exponential correlation with PVC load on 24h-holter (R=0,5, P<0,001). Interestingly, ventricular arrhythmia was not associated with corrected QT interval nor with age or hemoglobin serum level.
Conclusion
In SCD adults with preserved LVEF, GLS was the only independent echocardiographic predictor of ventricular arrhythmia.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Dupuy
- Henri Mondor University Hospital Chenevier APHP, Physiology Department, FHU SENEC, Creteil, France
| | - J Saba
- Henri Mondor University Hospital Chenevier APHP, Physiology Department, FHU SENEC, Creteil, France
| | - R Codiat
- Henri Mondor University Hospital Chenevier APHP, Physiology Department, FHU SENEC, Creteil, France
| | - G Derumeaux
- Henri Mondor University Hospital Chenevier APHP, Physiology Department, FHU SENEC, Creteil, France
| | - L Alassaad
- Henri Mondor University Hospital Chenevier APHP, Physiology Department, FHU SENEC, Creteil, France
| | - L Abou Chakra
- Henri Mondor University Hospital Chenevier APHP, Physiology Department, FHU SENEC, Creteil, France
| | - S Odouard
- Henri Mondor University Hospital Chenevier APHP, Physiology Department, FHU SENEC, Creteil, France
| | - J.F Deux
- Henri Mondor University Hospital Chenevier APHP, Department of Radiology, FHU SENEC, Creteil, France
| | - H Guillet
- Henri Mondor University Hospital Chenevier APHP, Sickle Cell Referral Center – UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, Creteil, France
| | - L Savale
- Bicêtre University Hospital, Assistance Publique Hôpitaux de Paris, Department of Pneumology, Kremlin-Bicêtre, France
| | - G De Luna
- Henri Mondor University Hospital Chenevier APHP, Sickle Cell Referral Center – UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, Creteil, France
| | - P Bartolucci
- Henri Mondor University Hospital Chenevier APHP, Sickle Cell Referral Center – UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, UPEC, Creteil, France
| | - T D'Humieres
- Henri Mondor University Hospital Chenevier APHP, Physiology Department, FHU SENEC, Creteil, France
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Hollingsworth R, Palmu A, Pepin S, Dupuy M, Shrestha A, Jokinen J, Syrjänen R, Nealon J, Samson S, De Bruijn I. Effectiveness of the quadrivalent high-dose influenza vaccine for prevention of cardiovascular and respiratory events in people aged 65 years and above: Rationale and design of a real-world pragmatic randomized clinical trial. Am Heart J 2021; 237:54-61. [PMID: 33722585 DOI: 10.1016/j.ahj.2021.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/03/2020] [Accepted: 03/09/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Influenza has been an acknowledged cause of respiratory disease for decades. However, considerable related, and often unappreciated, disease burden stems from cardiovascular complications, exacerbations of underlying medical conditions and secondary respiratory complications, with the highest burden in the elderly. This novel study combines the gold standard method of a randomized controlled trial with real-world data collection through national registries, to assess the relative effectiveness of high-dose (QIV-HD) vs standard-dose quadrivalent influenza vaccine (QIV-SD) in preventing cardio-respiratory hospitalizations in a large cohort of adults aged ≥65 years. METHODS AND RESULTS This trial (NCT04137887) is a Phase III/IV, modified double-blinded, randomized, registry-based trial, conducted by the Finnish Institute for Health and Welfare (THL). Participants (n>120 000) are being enrolled over multiple influenza seasons and randomized (1:1) to receive QIV-HD or QIV-SD. Participant follow-up is based on data collection up to 11 months post-vaccination using Finnish national health registries. The primary objective is to demonstrate the relative superior effectiveness of QIV-HD over QIV-SD in preventing cardio-respiratory hospitalizations up to 6 months post-vaccination. Safety will be assessed using automated online tools throughout the study, with causality assessed using statistical and probabilistic methods; serious adverse reactions and adverse events of special interest will be investigated individually. CONCLUSION This large, real-world, randomized study will provide valuable insight into the contribution of influenza in causing severe cardio-respiratory events, and the role of vaccination with QIV-HD in reducing these outcomes compared to the current standard of care. FUNDING Sanofi Pasteur.
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Affiliation(s)
| | - Arto Palmu
- Finnish Institute for Health and Welfare, Tampere, Finland
| | - Stephanie Pepin
- Global Clinical Sciences, Sanofi Pasteur, Marcy L'Etoile, France.
| | - Martin Dupuy
- Biostatistics Sciences, Sanofi Pasteur, Marcy L'Etoile, France
| | - Anju Shrestha
- Global Pharmacovigilance, Sanofi Pasteur, Swiftwater, PA
| | - Jukka Jokinen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ritva Syrjänen
- Finnish Institute for Health and Welfare, Tampere, Finland
| | - Joshua Nealon
- Vaccines Epidemiology and Modelling, Sanofi Pasteur, Lyon, France
| | | | - Iris De Bruijn
- Global Clinical Sciences, Sanofi Pasteur, Marcy L'Etoile, France
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d'Astorg H, Szadkowski M, Vieira TD, Dauzac C, Lonjon N, Bougeard R, Litrico S, Dupuy M. Management of Incidental Durotomy: Results from a Nationwide Survey Conducted by the French Society of Spine Surgery. World Neurosurg 2020; 143:e188-e192. [PMID: 32711151 DOI: 10.1016/j.wneu.2020.07.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/15/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To obtain real-life data on the most common practices used for management of incidental durotomy (ID) in France. METHODS Data were collected from spinal surgeons using a practice-based online questionnaire. The survey comprised 31 questions on the current management of ID in France. The primary outcome was the identification of areas of consensus and uncertainty on ID follow-up. RESULTS A total of 217 surgeons (mainly orthopaedic surgeons and neurosurgeons) completed the questionnaire and were included in the analysis. There was a consensus on ID repair with 94.5% of the surgeons considering that an ID should always be repaired, if repairable, and 97.2% performing a repair if an ID occurred. The most popular techniques were simple suture or locked continuous suture (48.3% vs. 57.8% of surgeons). Nonrepairable IDs were more likely to be treated with surgical sealants than with an endogenous graft (84.9% vs. 75.5%). Almost two thirds of surgeons (71.6%) who adapted their standard postoperative protocol after an ID recommended bed rest in the supine position. Among these, 48.8% recommended 24 hours of bed rest, while 53.5% recommended 48 hours of bed rest. The surgeons considered that the main risk factors for ID were revision surgery (98.6%), patient's age (46.8%), surgeon's exhaustion (46.3%), and patient's weight (21.3%). CONCLUSIONS This nationwide survey reflects the lack of a standardized management protocol for ID. Practices among surgeons remain very heterogeneous. Further consensus studies are required to develop a standard management protocol for ID.
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Affiliation(s)
- Henri d'Astorg
- Centre Orthopédique Santy, Lyon, France; Hopital Privé Jean, Mermoz, Ramsay-Générale de Santé, Lyon, France
| | - Marc Szadkowski
- Centre Orthopédique Santy, Lyon, France; Hopital Privé Jean, Mermoz, Ramsay-Générale de Santé, Lyon, France
| | - Thais Dutra Vieira
- Centre Orthopédique Santy, Lyon, France; Hopital Privé Jean, Mermoz, Ramsay-Générale de Santé, Lyon, France.
| | - Cyril Dauzac
- Centre du Rachis, Clinique du Dos, Neuilly sur Seine, France
| | - Nicolas Lonjon
- Department of Neurosurgery, Gui de Chauliac Hospital Montpellier, Montpellier, France; Mécanismes Moléculaires dans les Démences Neurodégénératives, University of Montpellier, Montpellier, France; Ecole Pratique des Hautes Études, Institut National de la Santé et de la Recherche Médicale U1198, Montpellier, France
| | - Renaud Bougeard
- Service de Neurochirurgie, Clinique du Val d'Ouest, Ecully, France
| | - Stephane Litrico
- Service de Neurochirurgie, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur, Nice, France
| | - Martin Dupuy
- Service de Neurochirurgie, Clinique de l'Union, Saint-Jean, France
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Ojeda J, Arredondo JL, Salcedo P, Paredes-Paredes M, Dupuy M, Petit C, Chabanon AL, Rivas E, Gurunathan S, De Bruijn I, Pepin S. Immunogenicity and safety of a multi-dose quadrivalent inactivated influenza vaccine in individuals aged 6 months to 17 years: a randomized phase III trial. Hum Vaccin Immunother 2020; 16:1380-1384. [PMID: 31810418 PMCID: PMC7482911 DOI: 10.1080/21645515.2019.1697595] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Annual vaccination is the most effective way to prevent seasonal influenza. Influenza vaccines in multi-dose vial (MDV) formats can facilitate timely vaccination of large populations by reducing per-dose costs and cold storage requirements compared to single-dose pre-filled syringe (PFS) formats. MDV vaccines require thiomersal or another preservative to prevent microbial contamination. We conducted a randomized, open-label trial in 302 healthy subjects aged 6 months to 17 years to evaluate the immunogenicity and safety of a quadrivalent influenza vaccine (QIV) in a thiomersal-containing MDV format compared to the licensed thiomersal-free PFS format. Subjects were randomly assigned in a 1:1 ratio to receive the MDV (n = 153) or PFS (n = 149) format. Post-vaccination hemagglutination inhibition titers for all four vaccine strains were ≥4.9-fold higher than baseline titers with no difference in magnitude between the MDV and PFS groups. Seroconversion rates per strain were also comparable between the two groups. There were no differences in reactogenicity or safety between the two vaccine formats. These results showed that the MDV format of QIV was as safe and immunogenic as the PFS format in infants, children, and adolescents. These findings support the use of MDV QIV as a resource-saving alternative for seasonal influenza vaccination.
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Affiliation(s)
- Joyce Ojeda
- Global Clinical Science, Sanofi Pasteur , Mexico City, Mexico
| | - José Luis Arredondo
- Instituto Nacional de Pediatría, Unidad de Investigación Clínica , Mexico City, Mexico
| | - Perla Salcedo
- Hospital General de Ecatepec "Las Américas", Fraccionamiento las Américas , Ecatepec de Morelos, Mexico
| | | | - Martin Dupuy
- Global Biostatistical Sciences, Sanofi Pasteur , Marcy l'Étoile, France
| | - Celine Petit
- Global Clinical Immunology, Sanofi Pasteur , Marcy l'Étoile, France
| | | | - Enrique Rivas
- Global Clinical Sciences, Sanofi Pasteur , Mexico City, Mexico
| | | | - Iris De Bruijn
- Global Clinical Sciences, Sanofi Pasteur , Marcy l'Étoile, France
| | - Stephanie Pepin
- Global Clinical Sciences, Sanofi Pasteur , Marcy l'Étoile, France
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de Germay S, Lafaurie M, Dupuy M, de Germay B. Meningiomas after cyproterone acetate exposure: Case reports in twin sisters. Therapie 2020; 76:255-257. [PMID: 32418729 DOI: 10.1016/j.therap.2020.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/20/2020] [Accepted: 02/25/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Sibylle de Germay
- Service de pharmacologie médicale et clinique, centre de pharmacovigilance, pharmacoépidémiologie et d'informations sur le médicament, centre hospitalier universitaire, faculté de médecine, 31000 Toulouse, France; UMR 1027 INSERM pharmacoépidémiologie, université Paul Sabatier Toulouse III, 31000 Toulouse, France.
| | - Margaux Lafaurie
- Service de pharmacologie médicale et clinique, centre de pharmacovigilance, pharmacoépidémiologie et d'informations sur le médicament, centre hospitalier universitaire, faculté de médecine, 31000 Toulouse, France; UMR 1027 INSERM pharmacoépidémiologie, université Paul Sabatier Toulouse III, 31000 Toulouse, France
| | - Martin Dupuy
- Service de neurochirurgie, clinique de l'Union, 31240 Saint-Jean, France
| | - Benoît de Germay
- Service de neurochirurgie, clinique de l'Union, 31240 Saint-Jean, France
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Tauziède-Espariat A, Pagès M, Roux A, Siegfried A, Uro-Coste E, Nicaise Y, Sevely A, Gambart M, Boetto S, Dupuy M, Richard P, Perbet R, Vinchon M, Caron S, Andreiuolo F, Gareton A, Lechapt E, Chrétien F, Puget S, Grill J, Boddaert N, Varlet P. Pediatric methylation class HGNET-MN1: unresolved issues with terminology and grading. Acta Neuropathol Commun 2019; 7:176. [PMID: 31707996 PMCID: PMC6842469 DOI: 10.1186/s40478-019-0834-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 10/25/2019] [Indexed: 12/13/2022] Open
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El Guerche-Séblain C, Moureau A, Schiffler C, Dupuy M, Pepin S, Samson SI, Vanhems P, Schellevis F. Epidemiology and burden of influenza in healthy children aged 6 to 35 months: analysis of data from the placebo arm of a phase III efficacy trial. BMC Infect Dis 2019; 19:308. [PMID: 30947693 PMCID: PMC6449994 DOI: 10.1186/s12879-019-3920-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/19/2019] [Indexed: 11/10/2022] Open
Abstract
Background Despite World Health Organization recommendations, in many countries young children are not targeted for influenza vaccination. To help inform influenza vaccination policy, we examined the occurrence and burden of influenza in healthy children aged 6 to 35 months using data from a recent phase III placebo-controlled influenza vaccine trial conducted in countries in the Northern and Southern Hemispheres. Methods This was an analysis of data from participants included in the placebo arm of a phase III clinical trial in healthy children aged 6 to 35 months (EudraCT no. 2013–001231-51). Included children had never been vaccinated for influenza and were observed for one influenza season. Outcome measures included the occurrence of influenza-like illness (ILI), laboratory-confirmed influenza, virus types/subtypes, severe symptoms and complications of confirmed influenza, and healthcare use associated with confirmed influenza. Results Data from 2210 participants were analysed. ILI was reported for 811 participants (36.7%). Of these, 255 participants (31.4%) had 263 virologically confirmed episodes of influenza. The overall influenza attack rate was 11.5%. The most common influenza virus detected was A(H3N2) (40.7%), followed by B/Yamagata (23.6%), A(H1N1) (18.6%), and B/Victoria (8.0%). Grade 3 fever was reported in 24.3% of confirmed episodes, acute lower respiratory infection in 8.7%, acute otitis media in 6.1%, and pneumonia in 1.9%. In most influenza episodes (93.2%), antipyretics, analgesics, or non-steroidal anti-inflammatory drugs were taken. Antibiotics were prescribed for 41.4% of influenza episodes. More than half of the influenza episodes (57.0%) resulted in outpatient visits. Influenza resulted in overnight hospitalisation in 1.1% of episodes. Conclusions Influenza is associated with a significant burden of disease in healthy children. This analysis also revealed that antibiotics continue to be frequently used for young children with influenza. Trial registration EudraCT no. 2013–001231-51. Electronic supplementary material The online version of this article (10.1186/s12879-019-3920-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Annick Moureau
- Global Clinical Biostatistics Department, Sanofi Pasteur, Marcy l'Étoile, France
| | | | - Martin Dupuy
- Global Biostatistics Department, Sanofi Pasteur, Marcy l'Étoile, France
| | - Stephanie Pepin
- Global Clinical Sciences, Sanofi Pasteur, Marcy l'Étoile, France
| | | | - Philippe Vanhems
- Epidemiology and International Health Team, Emergent Pathogens Laboratory, Fondation Mérieux, International Center for Research in Infectiology, National Institute of Health and Medical Research, U1111, National Center of Scientific Research, Mixed Scientific Unit 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - François Schellevis
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands.,Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
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Pepin S, Samson SI, Alvarez FP, Dupuy M, Gresset-Bourgeois V, De Bruijn I. Impact of a quadrivalent inactivated influenza vaccine on influenza-associated complications and health care use in children aged 6 to 35 months: Analysis of data from a phase III trial in the Northern and Southern Hemispheres. Vaccine 2019; 37:1885-1888. [PMID: 30745147 DOI: 10.1016/j.vaccine.2019.01.059] [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: 07/09/2018] [Revised: 01/14/2019] [Accepted: 01/22/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND A multi-season phase III trial conducted in the Northern and Southern Hemispheres demonstrated the efficacy of a quadrivalent split-virion inactivated influenza vaccine (IIV4) in children 6-35 months of age. METHODS Data collected during the phase III trial were analysed to examine the vaccine efficacy (VE) of IIV4 in preventing laboratory-confirmed influenza in age subgroups and to determine the relative risk for IIV4 vs. placebo for severe outcomes, healthcare use, and parental absenteeism from work associated with laboratory-confirmed influenza. RESULTS VE (95% confidence interval [CI]) to prevent laboratory-confirmed influenza due to any A or B strain was 54.76% (40.24-66.03%) for participants aged 6-23 months and 46.91% (23.57-63.53%) for participants aged 24-35 months. VE (95% CI) to prevent laboratory-confirmed influenza due to vaccine-similar strains was 74.51% (53.55-86.91%) for participants aged 6-23 months and 59.78% (19.11-81.25%) for participants aged 24-35 months. Compared to placebo, IIV4 reduced the risk (95% CI) by 31.28% (8.96-89.34%) for acute otitis media, 21.76% (6.46-58.51%) for acute lower respiratory infection, 40.80% (29.62-55.59%) for healthcare medical visits, 29.71% (11.66-67.23%) for parent absenteeism from work, and 39.20% (26.89-56.24%) for antibiotic use. CONCLUSION In children aged 6-35 months, vaccination with IIV4 reduces severe outcomes of influenza as well as the associated burden for their parents and the healthcare system. In addition, vaccination with IIV4 is effective at preventing against influenza in children aged 6-23 and 24-35 months. TRIAL REGISTRATION EudraCT no. 2013-001231-51.
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Affiliation(s)
- Stephanie Pepin
- Sanofi Pasteur, 1541 Avenue Marcel Merieux, 69820 Marcy-l'Étoile, France.
| | | | | | - Martin Dupuy
- Sanofi Pasteur, 1541 Avenue Marcel Merieux, 69820 Marcy-l'Étoile, France.
| | | | - Iris De Bruijn
- Sanofi Pasteur, 1541 Avenue Marcel Merieux, 69820 Marcy-l'Étoile, France.
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Pepin S, Dupuy M, Borja-Tabora CFC, Montellano M, Bravo L, Santos J, de Castro JA, Rivera-Medina DM, Cutland C, Ariza M, Diez-Domingo J, Gonzalez CD, Martinón-Torres F, Papadopoulou-Alataki E, Theodoriadou M, Kazek-Duret MP, Gurunathan S, De Bruijn I. Efficacy, immunogenicity, and safety of a quadrivalent inactivated influenza vaccine in children aged 6–35 months: A multi-season randomised placebo-controlled trial in the Northern and Southern Hemispheres. Vaccine 2019; 37:1876-1884. [DOI: 10.1016/j.vaccine.2018.11.074] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/09/2018] [Accepted: 11/26/2018] [Indexed: 11/27/2022]
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Di Scala G, Dupuy M, Guillaud E, Doat E, Barse E, Dillhareguy B, Jean FAM, Audiffren M, Cazalets JR, Chanraud S. Efficiency of Sensorimotor Networks: Posture and Gait in Young and Older Adults. Exp Aging Res 2019; 45:41-56. [PMID: 30633644 DOI: 10.1080/0361073x.2018.1560108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background/Study context: Posture and gait are complex sensorimotor functions affected by age. These difficulties are particularly apparent when performing cognitively demanding tasks. Characterizing the functional organization of brain networks involved in these associations remains a challenge because of the incompatibility of brain imagery techniques with gross body movements. The present study aimed at testing whether resting-state functional connectivity of sensorimotor networks is associated with posture and gait performance recorded offline, in young and older adults. METHODS Young (n = 12, mean = 24.1 y/o) and older (n = 14, mean = 65.6 y/o) healthy adults were tested for stability of their posture and gait. Four hours later, anatomical and functional brain imaging data were collected with Magnetic Resonance Imaging (MRI). Bilateral precentral and postcentral gyri were used as seeds in a graph theory analysis focused on global and local efficiency. The possible association between these data and posture and gait performance was examined. RESULTS Both samples presented similar sensorimotor graphs, but with different global and local efficiencies (small world properties). The association between the networks' graph measures and posture and gait performance also differed across groups: local efficiency was correlated with gait stability in challenging conditions in older adults, but not in young adults. CONCLUSION This exploratory study suggests that combining analyses of functional networks and offline body movement may provide important information about motor function. In older adults, the association between graph properties of the sensorimotor network and gait performance in challenging conditions may be indicative of compensatory processes. Prospective studies involving more subjects with a larger age range are warranted.
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Affiliation(s)
- G Di Scala
- a Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Université de Bordeaux, CNRS-UMR 5287 , Bordeaux , France
| | - M Dupuy
- a Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Université de Bordeaux, CNRS-UMR 5287 , Bordeaux , France
| | - E Guillaud
- a Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Université de Bordeaux, CNRS-UMR 5287 , Bordeaux , France
| | - E Doat
- a Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Université de Bordeaux, CNRS-UMR 5287 , Bordeaux , France
| | - E Barse
- b École Pratique des Hautes Études (EPHE), PSL Research University , Paris , France
| | - B Dillhareguy
- a Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Université de Bordeaux, CNRS-UMR 5287 , Bordeaux , France
| | - F A M Jean
- c Centre Hospitalier Charles Perrens , Bordeaux , France
| | - M Audiffren
- d Centre de Recherches sur la Cognition et l'Apprentissage (CeRCA), CNRS-UMR 7295, Université de Poitiers, Université François Rabelais de Tours , Poitiers , France
| | - J R Cazalets
- a Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Université de Bordeaux, CNRS-UMR 5287 , Bordeaux , France
| | - S Chanraud
- a Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Université de Bordeaux, CNRS-UMR 5287 , Bordeaux , France.,b École Pratique des Hautes Études (EPHE), PSL Research University , Paris , France
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Vigne C, Dupuy M, Richetin A, Guy B, Jackson N, Bonaparte M, Hu B, Saville M, Chansinghakul D, Noriega F, Plennevaux E. Integrated immunogenicity analysis of a tetravalent dengue vaccine up to 4 y after vaccination. Hum Vaccin Immunother 2017; 13:2004-2016. [PMID: 28598256 PMCID: PMC5612045 DOI: 10.1080/21645515.2017.1333211] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 03/03/2017] [Revised: 04/28/2017] [Accepted: 05/17/2017] [Indexed: 11/09/2022] Open
Abstract
Two large pivotal phase III studies demonstrated the efficacy of the tetravalent dengue vaccine (CYD-TDV; Dengvaxia®, Sanofi Pasteur) against all dengue serotypes. Here we present an unprecedented integrated summary of the immunogenicity of CYD-TDV to identify the parameters driving the neutralizing humoral immune response and evolution over time. We summarized the immunogenicity profiles of a 3-dose schedule of CYD-TDV administered 6 months apart across 10 phase II and 6 phase III trials undertaken in dengue endemic and non-endemic countries. Dengue neutralizing antibody titers in sera were determined at centralized laboratories using the 50% plaque reduction neutralization test (PRNT50) at baseline, 28 d after the third dose, and annually thereafter for up to 4 y after the third dose in some studies. CYD-TDV elicits neutralizing antibody responses against all 4 dengue serotypes; geometric mean titers (GMTs) increased from baseline to post-dose 3. GMTs were influenced by several parameters including age, baseline dengue seropositivity and region. In the 2 pivotal studies, GMTs decreased initially during the first 2 y post-dose 3 but appear to stabilize or slightly increase again in the third year. GMTs persisted 1.2-3.2-fold higher than baseline levels for up to 4 y post-dose 3 in other studies undertaken in dengue endemic countries. Our integrated analysis captures the fullness of the CYD-TDV immunogenicity profile across studies, age groups and regions; by presenting the available data in this way general trends and substantial outliers within each grouping can be easily identified. CYD-TDV elicits neutralizing antibody responses against all dengue serotypes, with differences by age and endemicity, which persist above baseline levels in endemic countries.
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Affiliation(s)
- Claire Vigne
- Research & Development, Sanofi Pasteur, Marcy l'Etoile, France
| | - Martin Dupuy
- Research & Development, Sanofi Pasteur, Marcy l'Etoile, France
| | - Aline Richetin
- Research & Development, Sanofi Pasteur, Marcy l'Etoile, France
| | - Bruno Guy
- Research & Development, Sanofi Pasteur, Marcy l'Etoile, France
| | | | - Matthew Bonaparte
- Global Clinical Immunology Department, Sanofi Pasteur, Swiftwater, PA, USA
| | - Branda Hu
- Global Clinical Immunology Department, Sanofi Pasteur, Swiftwater, PA, USA
| | | | | | | | - Eric Plennevaux
- Research & Development, Sanofi Pasteur, Marcy l'Etoile, France
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Dupuy M, Da Silva M, Mrozek S, Sol J, de Bonnecaze G, Chaput B. A negative pressure wound therapy for complex infected cranial defects overlying dura mater: An effective and safe procedure. J Plast Reconstr Aesthet Surg 2017; 70:1311-1314. [DOI: 10.1016/j.bjps.2017.06.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/27/2017] [Accepted: 06/25/2017] [Indexed: 11/28/2022]
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Salles N, Lafargue A, Barateau M, Caubet C, Dupuy M, Prigent A, Libert K. IMPACT OF TELEMEDICINE ON CARE IMPROVEMENT IN NURSING HOMES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N. Salles
- University Hospital, Bordeaux, France
| | | | | | - C. Caubet
- University Hospital, Bordeaux, France
| | - M. Dupuy
- University Hospital, Bordeaux, France
| | | | - K. Libert
- University Hospital, Bordeaux, France
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Saluja T, Palkar S, Misra P, Gupta M, Venugopal P, Sood AK, Dhati RM, Shetty A, Dhaded SM, Agarkhedkar S, Choudhury A, Kumar R, Balasubramanian S, Babji S, Adhikary L, Dupuy M, Chadha SM, Desai F, Kukian D, Patnaik BN, Dhingra MS. Live attenuated tetravalent (G1-G4) bovine-human reassortant rotavirus vaccine (BRV-TV): Randomized, controlled phase III study in Indian infants. Vaccine 2017; 35:3575-3581. [PMID: 28536027 DOI: 10.1016/j.vaccine.2017.05.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/09/2017] [Accepted: 05/07/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Rotavirus remains the leading cause of diarrhoea among children <5years. We assessed immunogenic non-inferiority of a tetravalent bovine-human reassortant rotavirus vaccine (BRV-TV) over the licensed human-bovine pentavalent rotavirus vaccine RV5. METHODS Phase III single-blind study (parents blinded) in healthy infants randomized (1:1) to receive three doses of BRV-TV or RV5 at 6-8, 10-12, and 14-16weeks of age. All concomitantly received a licensed diphtheria, tetanus, pertussis, hepatitis B, Haemophilus influenzae type b conjugate vaccine (DTwP-HepB-Hib) and oral polio vaccine (OPV). Immunogenic non-inferiority was evaluated in terms of the inter-group difference in anti-rotavirus serum IgA seroresponse (primary endpoint), and seroprotection/seroresponse rates to DTwP-HepB-Hib and OPV vaccines. Seroresponse was defined as a ≥4-fold increase in titers from baseline to D28 post-dose 3. Non-inferiority was declared if the difference between groups (based on the lower limit of the 95% confidence interval [CI]) was above -10%. Each subject was evaluated for solicited adverse events 7days and unsolicited & serious adverse events 28days following each dose of vaccination. RESULTS Of 1195 infants screened, 1182 were randomized (590 to BRV-TV; 592 to RV5). Non-inferiority for rotavirus serum IgA seroresponse was not established: BRV-TV, 47.1% (95%CI: 42.8; 51.5) versus RV5, 61.2% (95%CI: 56.8; 65.5); difference between groups, -14.08% (95%CI: -20.4; -7.98). Serum IgA geometric mean concentrations at D28 post-dose 3 were 28.4 and 50.1U/ml in BRV-TV and RV5 groups, respectively. For all DTwP-HepB-Hib and OPV antigens, seroprotection/seroresponse was elicited in both groups and the -10% non-inferiority criterion between groups was met. There were 16 serious adverse events, 10 in BRV-TV group and 6 in RV5 group; none were classified as vaccine related. Both groups had similar vaccine safety profiles. CONCLUSION BRV-TV was immunogenic but did not meet immunogenic non-inferiority criteria to RV5 when administered concomitantly with routine pediatric antigens in infants.
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Affiliation(s)
- Tarun Saluja
- Shantha Biotechnics Pvt. Ltd., Hyderabad, India.
| | - Sonali Palkar
- Bharati Vidyapeeth Deemed University Medical College, Pune, India
| | - Puneet Misra
- All India Institute of Medical Sciences, New Delhi, India
| | - Madhu Gupta
- Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | | | | | | | | | | | - Sharad Agarkhedkar
- Padmashree Dr. D. Y. Patil Medical College & Research Center, Pune, India
| | | | - Ramesh Kumar
- Pt. Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Sundaram Balasubramanian
- Kanchi Kamakoti Child Trust Hospital & The Child Trust Medical Research Foundation, Chennai, India
| | - Sudhir Babji
- Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | | | - Forum Desai
- Shantha Biotechnics Pvt. Ltd., Hyderabad, India
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Sil A, Ravi MD, Patnaik BN, Dhingra MS, Dupuy M, Gandhi DJ, Dhaded SM, Dubey AP, Kundu R, Lalwani SK, Chhatwal J, Mathew LG, Gupta M, Sharma SD, Bavdekar SB, Rout SP, Jayanth MV, D'Cor NA, Mangarule SA, Ravinuthala S, Reddy E J. Effect of prophylactic or therapeutic administration of paracetamol on immune response to DTwP-HepB-Hib combination vaccine in Indian infants. Vaccine 2017; 35:2999-3006. [PMID: 28449972 DOI: 10.1016/j.vaccine.2017.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 03/04/2017] [Accepted: 03/06/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Vaccination is considered as the most cost effective method for preventing infectious diseases. Low grade fever is a known adverse effect of vaccination. In India, it is a common clinical practice to prescribe paracetamol either prophylactically or therapeutically to manage fever. Some studies have shown that paracetamol interferes with antibody responses following immunization. This manuscript reports the outcome of a post hoc analysis of data from a clinical trial of a pentavalent vaccine in Indian infants where paracetamol was not used or was used either as prophylaxis or for treatment of fever. METHODS Pre and post vaccine antibody levels against Diphtheria, Tetanus, Pertussis, Hepatitis B, Haemophilus influenzae type B were assessed in no paracetamol and paracetamol groups. The paracetamol group was further divided into prophylactic and treatment groups. RESULTS Similar rates of seroprotection/seroresponse for anti-D, anti-T, anti-wP, anti-PT, anti-HBs and anti-PRP were observed in all the groups. There was no clear tendency for difference in percentage seroprotection/seroresponse and geometric mean (GM) titers in any of the groups. CONCLUSION The study found no evidence that paracetamol usage either as prophylactic or for treatment impact immunological responses to DTwP-HepB-Hib combination vaccine. [Clinical trial registry of India (study registration number CTRI/2012/08/002872)].
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Affiliation(s)
- Arijit Sil
- Shantha Biotechnics Private Limited - A Sanofi Company, Hyderabad, India.
| | | | - Badri N Patnaik
- Shantha Biotechnics Private Limited - A Sanofi Company, Hyderabad, India
| | | | | | - Dulari J Gandhi
- Dept. of Pediatrics, SBKS MI & RC, Sumandeep Vidyapeeth, Vadodara, India
| | - Sangappa M Dhaded
- Dept. of Pediatrics, KLE University's, Jawaharlal Nehru Medical College, Belagavi, India
| | - Anand P Dubey
- Dept. of Pediatrics, Maulana Azad Medical College, Delhi, India
| | - Ritabrata Kundu
- Dept. of Pediatrics, Institute of Child Health, Kolkata, India
| | - Sanjay K Lalwani
- Dept. of Pediatrics, Bharati Vidyapeeth Deemed University Medical College, Pune, India
| | - Jugesh Chhatwal
- Dept. of Pediatrics, Christian Medical College, Ludhiana, India
| | - Leni G Mathew
- Dept. of Pediatrics, Christian Medical College, Vellore, India
| | - Madhu Gupta
- Dept. of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Shiv D Sharma
- Dept. of Pediatrics, Sawai Man Singh Medical College, Jaipur, India
| | - Sandeep B Bavdekar
- Dept. of Pediatrics, Topiwala National Medical College and BYL Nair Ch. Hospital, Mumbai, India
| | - Soumya P Rout
- Shantha Biotechnics Private Limited - A Sanofi Company, Hyderabad, India
| | - Midde V Jayanth
- Shantha Biotechnics Private Limited - A Sanofi Company, Hyderabad, India
| | - Naveena A D'Cor
- Shantha Biotechnics Private Limited - A Sanofi Company, Hyderabad, India
| | | | - Suresh Ravinuthala
- Shantha Biotechnics Private Limited - A Sanofi Company, Hyderabad, India
| | - Jagadeesh Reddy E
- Shantha Biotechnics Private Limited - A Sanofi Company, Hyderabad, India
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Assenat E, Fouchardiere C, Mollevi C, Samalin E, Portales F, Desseigne F, Carenco C, Dupuy M, Lopez-Martinez E, Fiess C, Mazard T, Ychou M. Gabrinox: A phase I-II of nab-paclitaxel plus gemcitabine followed by folfirinox in metastatic pancreatic adenocarcinoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dupuy M, Silva M, Salmon B, Grunenwald S, Caron P. Posttraumatic Stress Disorder and Pituitary Surgery: A Pilot Study. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1592446] [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: 10/21/2022]
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Lagos R, Hoffenbach A, Scemama M, Dupuy M, Schodel F, Hessel L, Levine M. Lot-to-Lot Consistency of a Combined Hexavalent Diptheria-Tentanus-Acellular-Pertussis, Hepatitis B, Inactivated Polio and Haemophilus b Conjugate Vaccine, Adminstered to Healthy Chilean Infants at 2, 4 and 6 Months of Age. Human Vaccines 2014; 1:112-7. [PMID: 17012870 DOI: 10.4161/hv.1.3.1848] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To assess the safety, immunogenicity and lot consistency of a liquid hexavalent combined vaccine (DTaP-IPV-PRP approximately T-HBs, HEXAVAC) (Sanofi-Pasteur MSD, France) administered to infants at two, four and six months of age. METHODS A total of 1028 infants were vaccinated with one of three vaccine lots, in a randomized, double-blind fashion. Equivalence testing was used to compare post-vaccination seroprotection/seroconversion rates and geometric mean titers (GMTs) for each antigen between the three lots. Blood samples were drawn before vaccination and one month after the third dose. Local and systemic adverse events were monitored for three days following each injection. RESULTS Equivalence between lots was demonstrated for all antigens, on post-dose 3 seroprotection/seroconversion rates and GMTs. Reported rates of local and systemic adverse events tended to increase with subsequent doses. Altogether, 11.8% of the infants reported at least one adverse local event (mainly redness and induration/swelling) after the first dose and 36.1% after the third dose. Systemic adverse events (mainly irritability and fever) were reported by 39.2% of the infants after the first dose and by 57.5% after the third one. CONCLUSION Three separate lots of the liquid hexavalent combined vaccine induced consistently protective antibody responses against all antigens. These results and the well established clinical tolerability of this combined vaccine make it suitable for primary immunization of infants at two, four and six months of age.
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Cazabat L, Dupuy M, Boulin A, Bernier M, Baussart B, Foubert L, Raffin-Sanson ML, Caron P, Bertherat J, Gaillard S. Silent, but not unseen: multimicrocystic aspect on T2-weighted MRI in silent corticotroph adenomas. Clin Endocrinol (Oxf) 2014; 81:566-72. [PMID: 24601912 DOI: 10.1111/cen.12443] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [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: 09/24/2013] [Revised: 01/21/2014] [Accepted: 02/24/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Silent corticotroph adenomas (SCAs) present as nonfunctional pituitary tumours in routine pre-operative evaluation. The objective of this study was to evaluate the diagnostic accuracy of MRI T2-weighted sequences for detecting the corticotroph subtype pre-operatively. DESIGN The pre-operative T2-weighted MRI sequences were retrospectively evaluated in patients with SCA and two control groups: clinically manifest corticotroph macroadenomas (CSMs) and nonfunctional gonadotroph macroadenomas (NFGMs). All were selected from a registry of 1096 patients in whom transsphenoidal surgery was performed in the same tertiary reference centre. T2-weighted MRI sequences were independently classified by one senior endocrinologist and one senior radiologist who were blinded to the clinical and histological features. PATIENTS Seventeen patients with SCA, 14 with CSM and 60 with NFGM were included in this study. MEASUREMENTS Pituitary MRI with T2-weighted sequences. Two aspects were retained: multiple microcysts (MMs) and the absence of microcysts. Hormonal data included plasma prolactin, IGF-1, testosterone or oestradiol, LH, FT4, TSH, morning plasma cortisol and an ACTH-stimulation test, when available. RESULTS Multiple microcysts were present in 76% (13/17) of SCAs, 21% (3/14) of CSMs and 5% (3/60) of NFGMs. The presence of MMs in clinically nonfunctioning macroadenomas had a sensitivity of 76% and a specificity of 95% for predicting SCA. CONCLUSION The presence of MMs in T2-weighted MRI is a good diagnostic tool to suggest the corticotroph subtype in an apparently nonfunctional pituitary tumour.
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Affiliation(s)
- Laure Cazabat
- Department of Endocrinology, CHU Ambroise Pare, Assistance Publique Hôpitaux de Paris, Boulogne, France; EA 2493, Versailles Saint Quentin University, Montigny-le-Bretonneux, France
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Dupuy M, Cazabat C, Boulin B, Bernier B, Baussart B, Foubert F, Raffin-Sanson R, Caron C, Bertherat B, Gaillard G. Silent, but not Unseen: Multimicrocystic Aspect on T2-Weighted MRI in Silent Corticotroph Adenomas. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1384058] [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]
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Lubrano V, Dupuy M, Chaynes P, Sol J, Leobon B. A Swine Model to Teach Keyhole Approaches for the Anterior and Posterior Fossa. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1384126] [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]
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Dupuy M, Chaput B, Da Silva M, Mrozek S, Fowo S, Sol J. Strategy in Front of Complex Infected Cranial Defects Overlying Dura Mater. Feasibility and Safety of Negative Pressure Wound Therapy. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1384002] [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]
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Dupuy M, Boetto S, Jalbert F, Sol J. Surgery for Spheno-orbital Meningiomas: Should Orbital Walls Have to Be Reconstructed? Skull Base Surg 2014. [DOI: 10.1055/s-0034-1383994] [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]
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Mrozek S, Dupuy M, Hoarau L, Lourtet J, Martin-Blondel G, Geeraerts T. Brain empyema due to Ochrobactrum anthropi. Med Mal Infect 2014; 44:128-9. [PMID: 24534092 DOI: 10.1016/j.medmal.2014.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 01/03/2014] [Accepted: 01/15/2014] [Indexed: 10/25/2022]
Affiliation(s)
- S Mrozek
- Service d'anesthésie-réanimation, équipe d'accueil « modélisation de l'agression tissulaire et nociceptive », université Paul-Sabatier, centre hospitalier universitaire de Toulouse, 31000 Toulouse, France.
| | - M Dupuy
- Service de neurochirurgie, université Paul-Sabatier, centre hospitalier universitaire de Toulouse, 31000 Toulouse, France
| | - L Hoarau
- Service d'anesthésie-réanimation, équipe d'accueil « modélisation de l'agression tissulaire et nociceptive », université Paul-Sabatier, centre hospitalier universitaire de Toulouse, 31000 Toulouse, France
| | - J Lourtet
- Service de microbiologie, université Paul-Sabatier, centre hospitalier universitaire de Toulouse, 31000 Toulouse, France
| | - G Martin-Blondel
- Service de maladies infectieuses et tropicales, centre hospitalier universitaire de Toulouse, 31000 Toulouse, France
| | - T Geeraerts
- Service d'anesthésie-réanimation, équipe d'accueil « modélisation de l'agression tissulaire et nociceptive », université Paul-Sabatier, centre hospitalier universitaire de Toulouse, 31000 Toulouse, France
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Dupuy M, Chaput B, Mrozek S, Fowo S, Sol JC. Intérêt du VAC® dans les pertes de substances complexes infectées en chirurgie crânienne. Neurochirurgie 2013. [DOI: 10.1016/j.neuchi.2013.10.005] [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: 10/25/2022]
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Plas B, Bonneville F, Dupuy M, Sol JC, Chaynes P. Bilateral ophthalmic origin of the middle meningeal artery. Neurochirurgie 2013; 59:183-6. [PMID: 24176432 DOI: 10.1016/j.neuchi.2013.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 07/21/2013] [Accepted: 08/04/2013] [Indexed: 10/26/2022]
Abstract
The origin of the middle meningeal artery (MMA) may vary although it can arise from the ophthalmic artery (OA) with a 0.5% prevalence. We report the exceptional bilateral asymmetric origin from the OAs that has not previously been reported in the literature. Surgeons should be aware of this variation as it could be crucial in the setting of an endovascular approach for meningeal lesions, as in our observation. A 50-year-old male underwent a preoperative cerebral digital subtracted angiography that incidentally revealed MMAs arising from the OA on both sides. In fact, the origin was asymmetric because it was complete on the right side with the anterior and posterior branches of the MMA arising from the OA, whereas it was partial on the left side, with only the anterior branch arising from the OA. The CT scan showed the absence of the foramen spinosum only on the right side. This paper discusses the unique anatomic variation in the light of MMA embryology and its different origins. Knowledge of this variation may have a practical impact in cases of cerebral embolization.
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Affiliation(s)
- B Plas
- Service de neurochirurgie, CHU Rangueil, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex, France.
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Chollet C, Ehlinger V, Dupuy M, Guitard C, Leautier D, Jouret B, Arnaud C, Tauber M. Prévalence du surpoids chez le jeune enfant : analyse des données des bilans de santé à 3-4 ans en Haute-Garonne. Arch Pediatr 2013; 20:1187-1192. [PMID: 24090670 DOI: 10.1016/j.arcped.2013.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 07/17/2013] [Accepted: 08/13/2013] [Indexed: 11/15/2022]
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Selves A, Ruiz S, Crognier L, Conil JM, Bonneville F, Georges B, Dupuy M, Fourcade O, Geeraerts T. L’aspirine et ses dangers : syndrome de Reye chez un adulte jeune. ACTA ACUST UNITED AC 2013; 32:814-6. [DOI: 10.1016/j.annfar.2013.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 08/20/2013] [Indexed: 11/26/2022]
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Dupuy M, Cazabat L, Boulin A, Bernier M, Baussart B, Foubert L, Kouadri A, Raffin-Sanson ML, Caron P, Bertherat J, Gaillard S. « Silencieux mais pas invisibles » – Intérêt des séquences T2 pour le dépistage des adénomes corticotropes silencieux. Neurochirurgie 2012. [DOI: 10.1016/j.neuchi.2012.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
INTRODUCTION The nature of neuropsychological mechanisms underlying the clinical picture of obsessions and compulsions has not been clearly determined. A number of studies has emphasized the role of cognitive deficits, but diversity of methodology and overlapping of clinical sub-groups have not established a specific cognitive functioning of these patients. The studies carried out on executive functions have, however, helped to identify the important role that both inhibition and cognitive flexibility play in obsessive-compulsive (OC) symptoms. Most of them have found that a deficit of inhibition and alteration of cognitive flexibility could explain inflexibility and repetitive thoughts and actions typical of all types of OC disorders. The aim of the paper is to present the published data supporting the hypothesis of a specific role played by a deficit of inhibition and cognitive inflexibility. In the first, theoretical part, we present the neuropsychological approach emphasizing inhibition and lack of flexibility as a promising explanation of the functioning of OC disorders. In the second part, we will present studies using various measurements of inhibition and the results of which, therefore, support this hypothesis. ARGUMENTS AND DISCUSSION On the theoretical level, it is the model of attention that was used in explaining the OCD hypothesis. In the model of attention control of action, described by Norman, Shallice and Burgess, three systems were emphasized: one that takes care of routine actions, and the second that takes over the first in situations where automatic activities must stop in order to establish an attention control and therefore inhibit automatic responses. When selection of everyday and automatic activities is not sufficient to accomplish a task, it is the third system, that of cognitive control, which takes over. This supervisory attentional system operates in non-routine and ambiguous activities. The cognitive control is charged with detecting potential or emitted cognitive errors and resolving ambiguous situations. Neurocognitive studies show that cingular anterior cortex and prefrontal lateral cortex are engaged in ambiguous and conflicting situations. These two regions are considered essential for inhibition of routine actions, adjustment to change and, more generally, for an efficient and flexible behaviour. Repetitive nature of verification rituals in OCD could be explained in terms of lack of relationship between two systems, leaving in action the one that regulates automatic activities. Therefore, the rituals are considered to be under particular influence of the system which, being in charge of automatic actions, has a deficit in disengagement. Another model of attention, described by Posner, gives a further explanation of OCD. Mental inhibition has the capacity to treat information, either by applying strategies to control it (i.e. trying not to remember an unpleasant event) or leaving it to automatic control (i.e. incapacity to experience an emotion in relation to a particular event). In this way, the effort to suppress an intrusive thought is considered as controlled and deliberate cognitive treatment of emotionally charged information. In OCD, in the context of heightened anxiety, the assumed negative valence of information would influence habitual suppression of thought during controlled treatment. As a result, controlled efforts to suppress obsessions in emotionally stressful situations, would lead to the production of repetitive thoughts, as controlled treatment of information has failed in this action. On a clinical and experimental level, these studies have led to a better understanding and conceptualization of OCD. In spite of some conflicting results, there are concordant data in favour of hypotheses of the role of sub-cortical and frontal regions and their function in inhibition/desinhibition implied in the onset and maintenance of OCD. Functional neuroimagery anomalies are also in favour of the role of sub-cortical-frontal region in clinical manifestations of OCD. They are often associated with low performance in cognitive tasks, especially those implying frontal functions, which are, in turn, dependent on a necessary level of attention in order to guide or inhibit motor and cognitive programs.
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Affiliation(s)
- M Dupuy
- LPPS EA 4057, IUPDP, université Paris Descartes, 75014 Paris, France.
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Lonjaret L, Geeraerts T, Albucher JF, Dugert E, Gigaud M, Dupuy M, Fourcade O, Cognard C. Early encephalic toxicity after inadvertent intrathecal injection of low osmolar contrast medium. Neuroradiol J 2012; 25:222-4. [PMID: 24028919 DOI: 10.1177/197140091202500212] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 02/08/2012] [Indexed: 11/17/2022] Open
Abstract
Only nonionic contrast media are allowed for intrathecal use because of their lower neurotoxicity. In case of inadvertent intrathecal administration of an ionic contrast medium, the typical following syndrome is called ascending tonic clonic seizure syndrome. We describe the case of a 61-year-old woman with low back pain who underwent myelography. Ioxaglate, a water-soluble ionic low osmolar contrast medium was accidentally injected intrathecally. She first presented encephalic signs of neurotoxicity, followed by opisthotonic spasms and respiratory distress. In our case, ioxaglate is a low osmolar agent, leading to early encephalic toxicity (preceding medullary signs), because of its cephalic migration. The patient was successfully treated by sedation, anticonvulsant therapy and fluid hydration. Intrathecal administration of an ionic contrast medium is clearly contraindicated. In case of inadvertent injection of a low osmolar product, encephalic signs are seen first.
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Affiliation(s)
- L Lonjaret
- Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Paul Sabatier; Toulouse, France -
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Dupuy M, Bonneville F, Grunenwald S, Breibach F, Delisle MB, Chaynes P, Sol JC, Caron P. Primary sellar neuroblastoma. A new case and review of literature. Ann Endocrinol (Paris) 2012; 73:216-21. [PMID: 22497798 DOI: 10.1016/j.ando.2012.02.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 02/15/2012] [Indexed: 11/29/2022]
Abstract
The primary intracranial development of olfactory neuroblastomas, outside olfactory epithelium, is rare. We report a case of primary sellar neuroblastoma without any aggressive histopathological features, managed solely surgically without adjuvant therapy, with good outcomes at 3 years. Primary sellar neuroblastomas mostly occur in women in the 4th decade with a context of a non-secreting pituitary tumour. Diagnosis is made on histopathological examination (small cells, fibrillary intercellular background, strong immunoreactivity for neurons markers, negative immunoreactivity for anterior pituitary hormones). Management is based on surgery. Adjuvant treatment is not consensual, largely depends on patient's conditions and aggressive histopathological features.
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Affiliation(s)
- Martin Dupuy
- Service de neurochirurgie, centre hospitalo-universitaire Rangueil, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex, France.
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Dupuy M, Gigaud M, Grunenwald S, Uro-Coste E, Delisle M. Neuroblastome primitif pituitaire. Neurochirurgie 2010. [DOI: 10.1016/j.neuchi.2010.10.123] [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: 11/13/2022]
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Van der Vliet D, Pepin S, Lambert M, Fauchoux N, Donazzolo Y, Dupuy M, Dakowski C, Denis M. Similar immunogenicity of the A/H1N1 2009 pandemic influenza strain when used as a monovalent or a trivalent vaccine. Hum Vaccin 2010; 6:823-8. [PMID: 20935517 DOI: 10.4161/hv.6.10.13600] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The WHO recommended including the A (H1N1) 2009 pandemic strain in the influenza vaccines for use in the 2010-2011 northern hemisphere (NH) influenza season. The immunogenicity and safety of the trivalent split inactivated vaccine (Vaxigrip®) NH 2010-2011 formulation was compared to that observed for the corresponding non-adjuvanted monovalent A (H1N1) pandemic vaccine (Panenza®), when tested in similar populations of adult and elderly volunteers. METHODS The monovalent vaccine was evaluated in two clinical trials, conducted respectively in both adult and elderly subjects and in a population of adults. The trivalent vaccine was evaluated in a clinical study that enrolled both adult and elderly subjects. Antibody titers were measured in serum samples drawn at day 0 (before vaccination) and 21 days after one vaccine injection using the same hemagglutination inhibition (HI) assay method. The occurrence of adverse events was reported up to 21 days after vaccination. RESULTS Before immunization in the three studies, most of the volunteers had antibody titers below seroprotective levels against the pandemic A(H1N1) 2009 virus. After vaccination, in each trial and in each age group, high seroprotection rates, GMT ratios and seroconversion rates were observed. Seroprotection rates after administration of the monovalent vaccine reached 93% and 98% in the adult groups, and 83.7% in the elderly group. After administration of the trivalent vaccine, seroprotection rates of 92.2% and 81.3% were obtained respectively in the adult and the elderly groups. No related serious adverse events and no safety signals were detected either with the monovalent or trivalent vaccine. CONCLUSION Comparable immunogenicity profiles were observed in three clinical trials of the pandemic A(H1N1) 2009 strain when formulated either as a monovalent or as a component of a seasonal trivalent vaccine.
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Dupuy M. Home and leisure accidents observatory: a new French data source. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.823] [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]
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Scarone P, Lepeintre JF, Bennis S, Aldea S, Dupuy M, Gaillard S. Two-Levels Mini-Open Transforaminal Lumbar Interbody Fusion: Technical Note. ACTA ACUST UNITED AC 2010; 52:275-80. [DOI: 10.1055/s-0029-1239586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
OBJECT Although endoscopic third ventriculostomy (ETV) has been accepted as a procedure of choice for the treatment of obstructive hydrocephalus, the outcome of this treatment remains controversial with regard to age, cause, and long-term follow-up results. The goal of this study was to assess the risk of failure associated with these factors in a retrospective cohort study. METHODS Between 1999 and 2007, 368 ETVs were performed in 350 patients (165 patients < 18 years of age) with hydrocephalus at the University Hospital of Toulouse. Failure of ETV was defined as cases requiring any subsequent surgical procedure for CSF diversion or death related to hydrocephalus management. RESULTS Tumors (53%), primary aqueductal stenosis (18%), and intracranial hemorrhage (13%) were the most common causes of hydrocephalus. The median follow-up period was 47 months (range 6-106 months), and the overall success rate was 68.5% (252 of the 368 procedures). Patients < 6 months of age had a 5-fold increased risk of ETV failure than older patients (adjusted hazard ratio [HRa] 5.0; 95% CI 2.4-10.4; p < 0.001). Hemorrhage-related (HRa 4.0; 95% CI 1.9-8.5; p < 0.001) and idiopathic chronic hydrocephalus (HRa 6.3, 95% CI 2.5-15.0, p < 0.001) had a higher risk of failure than other causes. Most failures (97%) occurred within 2 months of the initial procedure. The overall morbidity rate was 10%, although most complications were minor. Finally, the introduction of ETV in the authors' department reduced the number of shunt insertions and hospital admissions for shunt failures by half and was a source of cost savings. CONCLUSIONS Endoscopic third ventriculostomy is a safe procedure and an effective treatment option for hydrocephalus. Factors indicating potential poor ETV outcome seem to be very young children and hemorrhage-related and chronic hydrocephalus in adults.
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Affiliation(s)
- Oumar Sacko
- Service de Neurochirurgie, Centres Hospitalo-Universitaires de Toulouse, Toulouse, France
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Cognard C, Dupuy M, Januel AC, Tall P, Viguier A, Albucher JF, Fabre N, Schmidt E, Larrue V, Chollet F, Lagarrigue J. Hypertensions intracrâniennes bénignes : indication, technique et résultats du stenting des sinus latéraux. Neurochirurgie 2009. [DOI: 10.1016/j.neuchi.2009.08.030] [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: 11/27/2022]
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Sorin A, Lepeintre JF, Scarone P, Dupuy M, Kouadri A, Gaillard S. Odontoïdectomie par voie endoscopique endonasale. Expérience avec une nouvelle technique neurochirurgicale. Neurochirurgie 2009. [DOI: 10.1016/j.neuchi.2009.08.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dupuy M, Marcheix B, Grunenwald E, Dickson Z, Cron C, Chauveau D. [Mitral regurgitation associated with Wegener's granulomatosis]. Ann Cardiol Angeiol (Paris) 2009; 58:180-182. [PMID: 19457464 DOI: 10.1016/j.ancard.2009.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2009] [Accepted: 02/20/2009] [Indexed: 05/27/2023]
Abstract
BACKGROUND Wegener's granulomatosis (WG) is a granulomatous disease that can affect many organ systems. The most frequently involved organs include the upper and lower respiratory tract as well as the kidney. Cardiac involvement is rare. METHODS We report the case of a patient with grade 4 mitral insufficiency associated with severe WG. RESULTS Surgical analysis of the mitral valve revealed perforation of the anterior leaflet without evidence of endocarditis. Pathological examination of the anterior mitral leaflet revealed myxoid degeneration nodules and bacteriological examination was negative. As the perforated lesion was very close to the free margin of the anterior leaflet, valve replacement appeared a reasonable surgical option in a poor surgical candidate. Six months after the operation, the patient is doing well. CONCLUSION Wegener's granulomatosis is an autoimmune necrotizing vasculitis that can affect many organ systems. Cardiac involvement is rare. Heart in his globality can be affected by WG in many different ways. Cardiac valvular involvement in WG is rare. The aortic valve seems to be more frequently affected. Cardiologic investigations should have an important place at diagnosis and supervision.
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Affiliation(s)
- M Dupuy
- Service de Chirurgie Cardiovasculaire, Centre Hospitalo-Universitaire de Rangueil, Toulouse Cedex, France
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Rodesch G, Gaillard S, Guedin P, Boulin A, Condette–Auliac S, Aldea S, Scarone P, Lepeintre IF, Dupuy M. Anévrysmes intracrâniens partiellement thrombosés (vasculopathie anévrysmale disséquante chronique) : symptômes, évolution et prise en charge thérapeutique. À propos d’une série de 14 cas consécutifs. Neurochirurgie 2008. [DOI: 10.1016/j.neuchi.2008.08.072] [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: 10/21/2022]
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Rodesch G, Guedin P, Gaillard S, Aldea S, Scarone P, Lepeintre JF, Boulin A, Condette-Auliac S, Dupuy M. Prise en charge thérapeutique de shunts intracrâniens duraux à drainage leptoméningé. À propos de 53 patients consécutifs. Intérêt du traitement endovasculaire à la colle acrylique. Neurochirurgie 2008. [DOI: 10.1016/j.neuchi.2008.08.015] [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]
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Stojanov S, Liese JG, Belohradsky BH, Vandermeulen C, Hoppenbrouwers K, Van der Wielen M, Van Damme P, Georges B, Dupuy M, Scemama M, Watson M, Fiquet A, Stek JE, Golm GT, Schödel FP, Kuter BJ. Administration of hepatitis A vaccine at 6 and 12 months of age concomitantly with hexavalent (DTaP-IPV-PRP approximately T-HBs) combination vaccine. Vaccine 2007; 25:7549-58. [PMID: 17905486 DOI: 10.1016/j.vaccine.2007.08.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Revised: 08/10/2007] [Accepted: 08/15/2007] [Indexed: 11/24/2022]
Abstract
BACKGROUND Administration of two doses of hepatitis A (HA) vaccine to children > or = 2 years of age has been shown to be protective. The present study assessed whether HA vaccine can be administered as early as 6 months of age and whether it can be administered concomitantly with a hexavalent (HV) vaccine at this age. METHODS In an open label, randomized, parallel group study, the liquid HV vaccine (HEXAVAC) (diphtheria, tetanus, 2-component acellular pertussis, inactivated poliomyelitis vaccine, Haemophilus influenzae type b conjugated to tetanus protein and hepatitis B) was administered at 2, 4, 6, and 12 months of age to all children. HA vaccine (VAQTA) was given at 7 and 13 months in the separate administration group (Group 1) and at 6 and 12 months in the concomitant administration group (Group 2). Serum samples were obtained at 2, 7, 12, and 14 months in Group 1 and at 2, 7, 12, and 13 months in Group 2. The primary immunogenicity outcomes were the seroconversion rates for HA 1 month after the second dose of HA vaccine in initially seronegative subjects, and the seroconversion rates for each HV antigen 1 month after the third dose of the HV vaccine (both at 7 months of age). RESULTS HA seropositivity rates 1 month after the second dose were 100% in both groups, regardless of initial serostatus. The responses to each HV antigen 1 month after the third dose were similar in both groups. The vaccines were generally well tolerated in both groups regardless of vaccine(s) administered. CONCLUSIONS A schedule of two doses of HA vaccine, 6 months apart beginning at 6 months of age is highly immunogenic and well tolerated when administered alone or concomitantly with HV vaccine at 6 and 12 months of age.
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Affiliation(s)
- S Stojanov
- University Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
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Baussart B, Lepeintre JF, Condette-Auliac S, Dupuy M, Gaillard S. Localisation trigéminale d'un germinome intracrânien primitif. À propos d'un cas. Neurochirurgie 2007; 53:43-6. [PMID: 17337016 DOI: 10.1016/j.neuchi.2006.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2006] [Accepted: 11/24/2006] [Indexed: 12/01/2022]
Abstract
A 22-year-old man presented headache, asthenia, body weight loss and trigeminal hypoesthesia worsening quickly. Radiological analysis showed an enhanced lesion that originated from the cavernous sinus and extended into the Meckel cave, owing to the fifth cranial nerve's course. The lesion was explored by a temporo-pterional approach and was partially removed. On the basis of histological analysis and negativity of tumor marker levels in serum and cerebrospinal fluid (alpha-fetoprotein alpha, human beta-chorionic gonadotropin), a primitive non-secreting intracranial germinoma was diagnosed. Under combined chemotherapy (carboplatine, ifosfamide, etoposide) followed by focal fractionated radiotherapy delivering 40 Gy to the initial tumor volume, the outcome was excellent. Five years later, the patient was in complete clinical and radiological remission. Primitive intracranial germinomas are rare malignant tumors involving mainly pineal and hypothalamic regions. We report a case of intracranial trigeminal nerve germinoma. To the best of our knowledge, no case of primitive germinoma was previously described in this location. Aspects of diagnosis and treatment are discussed in the light of previous publishing data.
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Affiliation(s)
- B Baussart
- Service de neurochirurgie, hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
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Decroisette C, Ndikumwenayo F, Gazaille V, Dupuy M, Monteil J, Melloni B, Bonnaud F. Traitement palliatif des douleurs osseuses métastatiques du cancer pulmonaire par samarium 153-EDTMP: à propos de 8 cas. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72268-9] [Citation(s) in RCA: 6] [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] [Indexed: 11/24/2022]
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Gelbert F, Boulin A, Condette-Auliac S, Dupuy M, Visot A, Rodesch G. P-22 Tumeur fibreuse solitaire à localization cérébro-méningée. À propos de 2 cas. J Neuroradiol 2004. [DOI: 10.1016/s0150-9861(04)96951-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pierot L, Condette-Auliac S, Piette AM, Boulin A, Graveleau P, Dupuy M. Thromboembolic events after endovascular treatment of unruptured intracranial aneurysms in two patients with antiphospholipid-antibody syndrome. Neuroradiology 2002; 44:355-7. [PMID: 11914815 DOI: 10.1007/s00234-001-0727-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2001] [Accepted: 10/02/2001] [Indexed: 10/27/2022]
Abstract
Antiphospholipid antibodies (APAs) are circulating immunoglobulins associated with a hypercoagulable state. The antiphospholipid syndrome combines APAs and clinical manifestations, including arterial or venous thromboses and/or recurrent spontaneous fetal loss. The main risk incurred by endovascular treatment of intracranial aneurysms is the occurrence of thromboembolic events. We report two cases of patients with antiphospholipid syndrome who developed thromboembolic complications after the endovascular treatment of unruptured intracranial aneurysms.
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Affiliation(s)
- L Pierot
- Service de Radiologie, Hôpital Maison Blanche, Reims, France.
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