1
|
Lévesque H, Viallard JF, Houivet E, Bonnotte B, Voisin S, Le Cam-Duchez V, Maillot F, Lambert M, Liozon E, Hervier B, Fain O, Guillet B, Schmidt J, Luca LE, Ebbo M, Ferreira-Maldent N, Babuty A, Sailler L, Duffau P, Barbay V, Audia S, Benichou J, Graveleau J, Benhamou Y. Cyclophosphamide vs rituximab for eradicating inhibitors in acquired hemophilia A: A randomized trial in 108 patients. Thromb Res 2024; 237:79-87. [PMID: 38555718 DOI: 10.1016/j.thromres.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Acquired hemophilia A (AHA) is a rare autoimmune disorder due to autoantibodies against Factor VIII, with a high mortality risk. Treatments aim to control bleeding and eradicate antibodies by immunosuppression. International recommendations rely on registers and international expert panels. METHODS CREHA, an open-label randomized trial, compared the efficacy and safety of cyclophosphamide and rituximab in association with steroids in patients with newly diagnosed AHA. Participants were treated with 1 mg/kg prednisone daily and randomly assigned to receive either 1.5-2 mg/kg/day cyclophosphamide orally for 6 weeks, or 375 mg/m2 rituximab once weekly for 4 weeks. The primary endpoint was complete remission over 18 months. Secondary endpoints included time to achieve complete remission, relapse occurrence, mortality, infections and bleeding, and severe adverse events. RESULTS Recruitment was interrupted because of new treatment recommendations after 108 patients included (58 cyclophosphamide, 50 rituximab). After 18 months, 39 cyclophosphamide patients (67.2 %) and 31 rituximab patients (62.0 %) were in complete remission (OR 1.26; 95 % CI, 0.57 to 2.78). In the poor prognosis group (FVIII < 1 IU/dL, inhibitor titer > 20 BU mL-1), significantly more remissions were observed with cyclophosphamide (22 patients, 78.6 %) than with rituximab (12 patients, 48.0 %; p = 0.02). Relapse rates, deaths, severe infections, and bleeding were similar in the 2 groups. In patients with severe infection, cumulative doses of steroids were significantly higher than in patients without infection (p = 0.03). CONCLUSION Cyclophosphamide and rituximab showed similar efficacy and safety. As first line, cyclophosphamide seems preferable, especially in poor prognosis patients, as administered orally and less expensive. FUNDING French Ministry of Health. CLINICALTRIALS gov number: NCT01808911.
Collapse
Affiliation(s)
- H Lévesque
- Normandie Univ, UNIROUEN, U 1096, CHU Rouen, Department of Internal Medicine, F-76000 Rouen, France.
| | - J F Viallard
- Service de Médecine Interne et Maladies Infectieuses Hôpital Haut-Lévêque, CHU Bordeaux, 5 avenue de Magellan, 33604 Pessac, France
| | - E Houivet
- Department of Biostatistics, CHU Rouen, F-76031 Rouen, France
| | - B Bonnotte
- Service de médecine interne et immunologie clinique, CHU Dijon-Bourgogne, Université de Dijon, F-21079 Dijon, France
| | - S Voisin
- Department of Internal Medicine, CHU Toulouse, F-31059 Toulouse. France
| | - V Le Cam-Duchez
- Normandie Univ, UNIROUEN, Hématologie biologique, F-76031 Rouen, France
| | - F Maillot
- Département de Médecine Interne et immunologie clinique, CHRU Tours, Université de Tours, F-37044 Tours, France
| | - M Lambert
- CHU Lille, Département de Médecine Interne et d'Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares Nord et Nord-Ouest de France (CeRAINO), European Reerence Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNECT), F-59000 Lille, France
| | - E Liozon
- Department of Internal Medicine, Dupuytren Hospital, F-87000 Limoges, France
| | - B Hervier
- Service de Médecine Interne, Hôpital Saint-Louis, APHP, 75010 Paris & INSERM UMR-S 976, Human Immunology, Pathophysiology, Immunotherapy, Saint-Louis Research Institute, F-75000 Paris, France
| | - O Fain
- Sorbonne Université, APHP, Service de Médecine Interne-DMU i3, Hôpital Saint-Antoine, Paris F-75000, France
| | - B Guillet
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR-S 1085, F-35000 Rennes, France
| | - J Schmidt
- Department of Internal Medicine, Amiens University Hospital, F-80000 Amiens, France
| | - L E Luca
- Department of Internal Medicine, Poitiers University Hospital, F-86000 Poitiers, France
| | - M Ebbo
- Service de Médecine Interne, Hôpital La Timone, CHU Marseille, Aix-Marseille Université, F-13000 Marseille, France
| | - N Ferreira-Maldent
- Département de Médecine Interne et immunologie clinique, CHRU Tours, Université de Tours, F-37044 Tours, France
| | - A Babuty
- Service d'Hématologie Biologique, CRC-MHC, CHU de Nantes, Nantes Cedex 1, France
| | - L Sailler
- Department of Internal Medicine, CHU Toulouse, F-31059 Toulouse. France
| | - P Duffau
- Service de Médecine Interne-Immunologie Clinique Hôpital Saint-André, CHU Bordeaux, 1 rue Jean Burguet, 33075 Bordeaux, France
| | - V Barbay
- Normandie Univ, UNIROUEN, Hématologie biologique, F-76031 Rouen, France
| | - S Audia
- Service de médecine interne et immunologie clinique, CHU Dijon-Bourgogne, Université de Dijon, F-21079 Dijon, France
| | - J Benichou
- Department of Biostatistics, CHU Rouen and CESP UMR 1018, University of Rouen and University Paris-Saclay, F-76031 Rouen, France
| | - J Graveleau
- Nantes Université, CHU Nantes, Service de Médecine Interne, Nantes, France
| | - Y Benhamou
- Normandie Univ, UNIROUEN, U 1096, CHU Rouen, Department of Internal Medicine, F-76000 Rouen, France
| |
Collapse
|
2
|
Chekar CK, Brewster L, Lambert M, Patel T. Gender, flexibility and workforce in the NHS: A qualitative study. Int J Health Plann Manage 2024; 39:740-756. [PMID: 38321952 DOI: 10.1002/hpm.3784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/11/2024] [Accepted: 02/01/2024] [Indexed: 02/08/2024] Open
Abstract
Data from the General Medical Council show that the number of female doctors registered to practise in the UK continues to grow at a faster rate than the number of male doctors. Our research critically discusses the impact of this gender-based shift, considering how models of medical training are still ill-suited to supporting equity and inclusivity within the workforce, with particular impacts for women despite this gender shift. Drawing on data from our research project Mapping underdoctored areas: the impact of medical training pathways on NHS workforce distribution and health inequalities, this paper explores the experiences of doctors working in the NHS, considering how policies around workforce and beyond have impacted people's willingness and ability to continue in their chosen career path. There is clear evidence that women are underrepresented in some specialties such as surgery, and at different career stages including in senior leadership roles, and our research focuses on the structural factors that contribute to reinforcing these under-representations. Medical education and training are known to be formative points in doctors' lives, with long-lasting impacts for NHS service provision. By understanding in detail how these pathways inadvertently shape where doctors live and work, we will be able to consider how best to change existing systems to provide patients with timely and appropriate access to healthcare. We take a cross-disciplinary theoretical approach, bringing historical, spatiotemporal and sociological insights to healthcare problems. Here, we draw on our first 50 interviews with practising doctors employed in the NHS in areas that struggle to recruit and retain doctors, and explore the gendered nature of career biographies. We also pay attention to the ways in which doctors carve their own career pathways out of, or despite of, personal and professional disruptions.
Collapse
Affiliation(s)
| | - Liz Brewster
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Michael Lambert
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Tasneem Patel
- Lancaster Medical School, Lancaster University, Lancaster, UK
| |
Collapse
|
3
|
Ratti N, Ly KH, Dumonteil S, François M, Sailler L, Lambert M, Hot A, Gondran G, Palat S, Bezanahary H, Desvaux E, Aslanbekova N, Parreau S, Fauchais AL, Sève P, Liozon E. Recurrent (or episodic) fever of unknown origin (FUO) as a variant subgroup of classical FUO: a French Multicenter Retrospective study of 170 patients. Clin Med (Lond) 2024:100202. [PMID: 38642612 DOI: 10.1016/j.clinme.2024.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/23/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Recurrent-FUO (fever of unknown origin) is a rare subtype of FUO for which diagnostic procedures are ill-defined and outcome data are lacking. METHODS We performed a retrospective multicentre study of patients with recurrent-FUO between 1995 and 2018. By multivariate analysis, we identified epidemiological, clinical, and prognostic variables independently associated with final diagnosis and mortality. RESULTS Of 170 patients, 74 (44%) had a final diagnosis. Being ≥ 65 years of age (OR=5.2; p<0.001), contributory history (OR=10.4; p < 0.001), and abnormal clinical examination (OR=4.0; p=0.015) independently increased the likelihood of reaching a diagnosis, whereas lymph node and/or spleen enlargement decreased it (OR = 0.2; p=0.004). The overall prognosis was good; 58% of patients recovered (70% of those with a diagnosis). Twelve (7%) patients died; patients without a diagnosis had a fatality rate of 2%. Being ≥ 65 years of age (OR = 41.3; p < 0.001) and presence of skin signs (OR = 9.5; p = 0.005) significantly increased the risk of death. CONCLUSION This study extends the known yield of recurrent-FUO and highlights the importance of repeated complete clinical examinations to discover potential diagnostic clues during follow- up. Moreover, their overall prognosis is excellent.
Collapse
Affiliation(s)
- N Ratti
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren)
| | - K H Ly
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren)
| | - S Dumonteil
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren).
| | - M François
- Departments of Internal Medicine, University Hospitals of Lyon Sud (Pierre-Bénite)
| | - L Sailler
- Departments of Internal Medicine, University Hospitals of Toulouse (Purpan)
| | - M Lambert
- Departments of Internal Medicine, University Hospitals of Lille (Claude Huriez)
| | - A Hot
- Departments of Internal Medicine, University Hospitals of Lyon (Édouard Herriot)
| | - G Gondran
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren)
| | - S Palat
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren)
| | - H Bezanahary
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren)
| | - E Desvaux
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren)
| | - N Aslanbekova
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren)
| | - S Parreau
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren)
| | - A L Fauchais
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren)
| | - P Sève
- Departments of Internal Medicine, University Hospitals of Lyon (La Croix-Rousse)
| | - E Liozon
- Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren)
| |
Collapse
|
4
|
Lambert M, Rezaie M, Jeannin M, Sina N, Mahyar Z, Marks L. The oral health situation and treatment need of schoolchildren Afghanistan: a cross-sectional study. Eur J Paediatr Dent 2024; 25:1. [PMID: 38329026 DOI: 10.23804/ejpd.2024.1902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
AIM The present study explores the treatment need for dental caries in schoolchildren in Herat, Afghanistan. METHODS A convenience sample of 13 schools were selected for the study. All schools were located in the urban areas near Herat and were selected through allocation by the Ministry of Health, which also approved the study protocol. In the schools, classes were allocated by the principal of the school. All the children in the allocated classes were included in the survey. Data collection was performed in the school setting by trained Afghan dentist examiners. To measure caries experience, DMFT/dmft scores were used, counting the number of decayed (measured at both white spot (D≥1) and cavitation level (D≥3), according to WHO criteria), missing and filled teeth. CONCLUSION Dental caries is a considerable oral health problem in the study population. The present sample has a high proportion of untreated carious lesions and a very low level of restorative care. Moreover, significant differences were shown in relation to gender and age groups. The present survey results confirm the need for professional operative and preventive oral health care in this region.
Collapse
Affiliation(s)
- M Lambert
- ELOHA (Equal Lifelong Oral Health for All) research group, Dental Public Health, Oral Health Sciences, Ghent University, Belgium
| | - M Rezaie
- ELOHA (Equal Lifelong Oral Health for All) research group, Dental Public Health, Oral Health Sciences, Ghent University, Belgium
| | - M Jeannin
- ELOHA (Equal Lifelong Oral Health for All) research group, Dental Public Health, Oral Health Sciences, Ghent University, Belgium
| | - N Sina
- University of Herat, Faculty of Stomatology, Herat, Afghanistan
| | - Z Mahyar
- University of Herat, Faculty of Stomatology, Herat, Afghanistan
| | - L Marks
- Faculty of Medicine & Health Sciences, University of Antwerp, Belgium - Department of Cranio-Maxillofacial Surgery - Special Care in Dentistry, Antwerp University Hospital, Antwerp, Belgium
| |
Collapse
|
5
|
den Hollander S, Lambert M, Davidow D, Jones B, Hendricks S. Relationships of Contact Technique in Training and Matches With Performance and Injury Outcomes in Male Rugby Union. Int J Sports Physiol Perform 2023; 18:982-995. [PMID: 37536673 DOI: 10.1123/ijspp.2023-0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/20/2023] [Accepted: 06/01/2023] [Indexed: 08/05/2023]
Abstract
The aims of this study were 3-fold: (1) to compare technical proficiency scores between training and matches for tackling, ball-carrying, and rucking outcomes; (2) to determine the relationship between technique in training and technique in matches for tackling, ball carrying, and rucking; and (3) to determine how contact technique (in training and matches) relates to match performance and injury outcomes. Twenty-four male players from an amateur rugby union club participated in the study. At the beginning of the season, players' contact technique proficiency was assessed in a training drill. Contact technique in matches was assessed during 14 competitive matches. The technique proficiency was assessed using standardized criteria, and the outcomes of each tackle, ball carry, and ruck were recorded. In training and matches, positive performance outcomes were associated with higher contact technique proficiency scores. For instance, in both settings, tackle technique was significantly lower in missed tackles when compared to effective and ineffective tackles. Players' contact technique scores in matches also had a positive effect on their tackle performance in matches. Ball-carry technique was associated with tackle breaks in matches (P < .05, r2 = .31). In training and match environments, tackler, ball-carrier, and ruck technique scores were significantly associated with effective tackles, ball carries, and rucks. Despite the relationship between technical proficiency scores and performance, there were small to moderately higher scores in training compared with matches. The current study highlights the importance of contact skill training, in different environments and conditions, to ensure that skills developed in training are transferred to match performance.
Collapse
Affiliation(s)
- Steve den Hollander
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town,South Africa
- UXI Sport, Cape Town,South Africa
| | - Michael Lambert
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town,South Africa
| | - Demi Davidow
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town,South Africa
| | - Ben Jones
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town,South Africa
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds,United Kingdom
- Leeds Rhinos Rugby League Club, Leeds,United Kingdom
- England Performance Unit, Rugby Football League, Leeds,United Kingdom
- Premiership Rugby, London,United Kingdom
| | - Sharief Hendricks
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town,South Africa
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds,United Kingdom
| |
Collapse
|
6
|
Amoura Z, Bader-Meunier B, Bal Dit Sollier C, Belot A, Benhamou Y, Bezanahary H, Cohen F, Costedoat-Chalumeau N, Darnige L, Drouet L, Elefant E, Harroche A, Lambert M, Martin T, Martin-Toutain I, Mathian A, Mekinian A, Pineton De Chambrun M, de Pontual L, Wahl D, Yelnik C, Zuily S. French National Diagnostic and Care Protocol for antiphospholipid syndrome in adults and children. Rev Med Interne 2023; 44:495-520. [PMID: 37735010 DOI: 10.1016/j.revmed.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/23/2023]
Abstract
Antiphospholipid syndrome (APS) is a chronic autoimmune disease involving vascular thrombosis and/or obstetric morbidity and persistent antibodies to phospholipids or certain phospholipid-associated proteins. It is a rare condition in adults and even rarer in children. The diagnosis of APS can be facilitated by the use of classification criteria based on a combination of clinical and biological features. APS may be rapidly progressive with multiple, often synchronous thromboses, resulting in life-threatening multiple organ failure. This form is known as "catastrophic antiphospholipid syndrome" (CAPS). It may be primary or associated with systemic lupus erythematosus (associated APS) and in very rare cases with other systemic autoimmune diseases. General practitioners and paediatricians may encounter APS in patients with one or more vascular thromboses. Because APS is so rare and difficult to diagnosis (risk of overdiagnosis) any suspected case should be confirmed rapidly and sometimes urgently by an APS specialist. First-line treatment of thrombotic events in APS includes heparin followed by long-term anticoagulation with a VKA, usually warfarin. Except in the specific case of stroke, anticoagulants should be started as early as possible. Any temporary discontinuation of anticoagulants is associated with a high risk of thrombosis in APS. A reference/competence centre specialised in autoimmune diseases must be urgently consulted for the therapeutic management of CAPS.
Collapse
Affiliation(s)
- Z Amoura
- Department of Internal Medicine, Institut E3M, CIMI-Paris, Faculty of medicine, National Reference Centre of Systemic Lupus, antiphospholipid syndrome, and other autoimmune diseases, Sorbonne University, AP-HP, Pitié Salpêtrière, boulevard de l'Hôpital, 75013 Paris, France.
| | - B Bader-Meunier
- Laboratory of Immunogenetics of Paediatric Autoimmune Diseases, Institute Imagine, University Paris Cité, Paris, France
| | - C Bal Dit Sollier
- Thrombosis and atherosclerosis research unit, vessels and blood institute (IVS), anticoagulation clinic (CREATIF), Lariboisière hospital, AP-HP, 75010 Paris, France
| | - A Belot
- Department of Pediatric Nephrology, Rheumatology, Dermatology, Reference Centre for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), hôpital femme mère enfant, CHU de Lyon, Bron, France
| | - Y Benhamou
- National Reference Centre of MicroAngiopathies Thrombotic, Paris, France; Department of Internal Medicine, University Hospital of Rouen, Normandie University, Rouen, France
| | - H Bezanahary
- Department of Internal Medicine and Clinical Immunology, centre hospitalier universitaire de Limoges, Limoges, France
| | - F Cohen
- Department of Internal Medicine, Institut E3M, CIMI-Paris, Faculty of medicine, National Reference Centre of Systemic Lupus, antiphospholipid syndrome, and other autoimmune diseases, Sorbonne University, AP-HP, Pitié Salpêtrière, boulevard de l'Hôpital, 75013 Paris, France
| | - N Costedoat-Chalumeau
- Department of Internal Medicine, Referral Centre for Rare Autoimmune and Systemic Diseases of Île-de-France, AP-HP, Cochin Hospital, Paris, France; Centre for Epidemiology and Statistics, Institut national de la santé et de la recherche médicale, French National Institute for Agricultural Research, University Paris Cité, Paris, France
| | - L Darnige
- Biological Hematology Department, Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, Inserm, UMR-S1140, Innovative Therapies in Haemostasis, Paris, France
| | - L Drouet
- Thrombosis and atherosclerosis research unit, vessels and blood institute (IVS), anticoagulation clinic (CREATIF), Lariboisière hospital, AP-HP, 75010 Paris, France
| | - E Elefant
- Reference Center for Teratogenic Agents, hôpital Armand-Trousseau centre de référence sur les agents tératogènes, Île-de-France, Paris, France
| | - A Harroche
- Department of Hematology, Haemophilia Treatment Centre, University Hospital Necker Enfants Malades, Paris, France
| | - M Lambert
- Department of Internal Medicine and Clinical immunology, Reference Centre of Autoimmune Systemic Rare Diseases Of North And North-West of France (CeRAINO), U1167 RID-AGE, Lille University, Inserm, University hospital of Lille, 59000 Lille, France
| | - T Martin
- Department of Internal Medicine and Clinical Immunology, Strasbourg University Hospital, Strasbourg, France
| | - I Martin-Toutain
- Resource and Competence Centre for Haemorrhagic Diseases, Hospital Center of Versailles André-Mignot, Le Chesnay, France
| | - A Mathian
- Department of Internal Medicine, Institut E3M, CIMI-Paris, Faculty of medicine, National Reference Centre of Systemic Lupus, antiphospholipid syndrome, and other autoimmune diseases, Sorbonne University, AP-HP, Pitié Salpêtrière, boulevard de l'Hôpital, 75013 Paris, France
| | - A Mekinian
- Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy (DMU i3), Saint-Antoine Hospital, Sorbonne University, AP-HP, 75012 Paris, France
| | - M Pineton De Chambrun
- Department of Internal Medicine, Institut E3M, CIMI-Paris, Faculty of medicine, National Reference Centre of Systemic Lupus, antiphospholipid syndrome, and other autoimmune diseases, Sorbonne University, AP-HP, Pitié Salpêtrière, boulevard de l'Hôpital, 75013 Paris, France
| | - L de Pontual
- Department of Paediatrics, Jean-Verdier Hospital, AP-HP, HUPSSD, 93140 Bondy, France
| | - D Wahl
- Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy, Nancy, France
| | - C Yelnik
- Department of Internal Medicine and Clinical immunology, Reference Centre of Autoimmune Systemic Rare Diseases Of North And North-West of France (CeRAINO), U1167 RID-AGE, Lille University, Inserm, University hospital of Lille, 59000 Lille, France
| | - S Zuily
- Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy, Nancy, France
| |
Collapse
|
7
|
Davidow D, Smith M, Ross T, Laura James G, Paul L, Lambert M, Jones B, Hendricks S. Mental Fatigue Impairs Tackling Technique in Amateur Rugby Union Players. Int J Sports Physiol Perform 2023; 18:960-967. [PMID: 37463669 DOI: 10.1123/ijspp.2023-0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To test the effects of mental fatigue (MF) on tackling technique on the dominant and nondominant shoulders in rugby union. METHODS Twenty male amateur rugby union players and a total of 953 tackles were analyzed. A randomized crossover counterbalanced design was used across a non-MF (control) and an MF condition. During each condition, each player performed 24 tackles, divided into 4 sets of 6 tackles (3 tackles on each shoulder). In the MF condition, players performed the Stroop Task between each set of tackles. A video recording of each tackle was used to evaluate each player's technical proficiency. A score of 1 point was awarded if a specific technique was performed correctly, and 0 point was given if not. The total score, measured in arbitrary units (AU) out of 11, represents the player's overall tackling proficiency. RESULTS Overall, players displayed a significantly lower technical proficiency score in the MF condition compared to control (set 2: control 7.30 [7.04-7.57] AU vs MF 6.91 [6.70-7.12] AU, P = .009, effect size (ES) = 0.30 small and set 3: control 7.34 [7.11-7.57] AU vs MF 6.88 [6.66-7.11] AU, P = .002, ES = 0.37 small). For the nondominant shoulder, players had a significantly lower technical proficiency score during the MF condition at set 2 (control 7.05 [6.68-7.41] AU vs MF 6.69 [6.42-6.96] AU, P = .047, ES = 0.29 small) and set 3 (control 7.14 [6.83-7.45] AU vs MF 6.61 [6.35-6.87] AU, P = .007, ES = 0.49 small). CONCLUSIONS MF can diminish a player's overall tackling proficiency, especially when tackling on the nondominant shoulder. The physiological mechanism for this finding may be impaired executive function and suboptimal functioning of neural signals and pathways, which result in less skillful coordination of movement. To further understand and explain MF-induced physiological changes in tackling, the feasibility of monitoring brain activity (such as electroencephalogram) and neuromuscular function (such as electromyogram) needs to be investigated. The findings from this study may also contribute to the development of more effective tackle training programs for injury prevention and performance.
Collapse
Affiliation(s)
- Demi Davidow
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of South Africa, Cape Town,South Africa
| | - Mitchell Smith
- Discipline of Exercise and Sports Science, College of Engineering, Science and Environment, University of Newcastle, Ourimbah, NSW,Australia
- Active Living Research Program, Hunter Medical Research Institute, Ourimbah, NSW,Australia
| | - Tayla Ross
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of South Africa, Cape Town,South Africa
| | - Gwyneth Laura James
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of South Africa, Cape Town,South Africa
| | - Lara Paul
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of South Africa, Cape Town,South Africa
| | - Michael Lambert
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of South Africa, Cape Town,South Africa
| | - Ben Jones
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of South Africa, Cape Town,South Africa
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds,United Kingdom
- Leeds Rhinos Rugby League Club, Leeds,United Kingdom
- England Performance Unit, Rugby Football League, Leeds,United Kingdom
- Premiership Rugby, London,United Kingdom
| | - Sharief Hendricks
- Division of Physiological Sciences and Health Through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of South Africa, Cape Town,South Africa
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds,United Kingdom
| |
Collapse
|
8
|
Penet T, Pokeerbux MR, Morell-Dubois S, Sanges S, Maillard H, Ledoult E, Lambert M, Yelnik C, Sobanski V, Launay D, Hachulla E, Farhat MM. Atteintes coronariennes et artérite a cellules géantes : à propos de 2 cas et revue de la littérature. Rev Med Interne 2023; 44:394-401. [PMID: 37088663 DOI: 10.1016/j.revmed.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Coronaritis is a rare but serious complication of giant-cell arteritis (GCA), with an estimated prevalence of less than 1%, however difficult to establish, and of early onset. METHODS We describe 2 cases of GCA presenting with coronaritis and present a review of the literature on this complication. RESULTS The first patient presented with stable angina on common trunk coronaritis with ostial stenosis. Corticosteroid combined with tocilizumab from the outset resulted in improvement. Angioplasty was performed at 6months with good outcome. The second patient presented with asymptomatic tritruncular ostial coronaritis. Corticosteroid allowed clinic-biological improvement of GCA. Two years later, he presented relapse with an acute coronary syndrome, with favorable evolution after angioplasty, increase of corticosteroids and addition of tocilizumab. CONCLUSION Patients presented were successfully treated with corticosteroids combined with tocilizumab and angioplasty of their coronary stenoses. Efficacy of tocilizumab in GCA has not been evaluated especially on coronaritis due to the rarity of this complication. Our experience and the cases reported in the literature suggest good results of angioplasty in this indication. Studies with long-term follow-up will be necessary to evaluate the risk of restenosis.
Collapse
Affiliation(s)
- T Penet
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - M R Pokeerbux
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - S Morell-Dubois
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - S Sanges
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - H Maillard
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - E Ledoult
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - M Lambert
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - C Yelnik
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - V Sobanski
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - D Launay
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - E Hachulla
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - M M Farhat
- University Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France; Inserm, 59000 Lille, France; Service de médecine interne et immunologie clinique, CHU de Lille, Centre de référence des maladies autoimmunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), 59000 Lille, France; Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France.
| |
Collapse
|
9
|
Jäckel D, Willert A, Brose A, Leopold K, Nischk D, Senner S, Pogarell O, Sachenbacher S, Lambert M, Rohenkohl A, Kling-Lourenco P, Rüsch N, Bermpohl F, Schouler-Ocak M, Disselhof V, Skorupa U, Bechdolf A. Correction: Enhancing educational and vocational recovery in adolescents and young adults with early psychosis through Supported Employment and Education (SEEearly): study protocol for a multicenter randomized controlled trial. Trials 2023; 24:476. [PMID: 37491354 PMCID: PMC10369747 DOI: 10.1186/s13063-023-07524-5] [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: 07/27/2023] Open
Affiliation(s)
- D Jäckel
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité UniversitätsmedizinBerlin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban and Vivantes Klinikum Im Friedrichshain, Berlin, Germany
| | - A Willert
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité UniversitätsmedizinBerlin, Berlin, Germany.
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban and Vivantes Klinikum Im Friedrichshain, Berlin, Germany.
| | - A Brose
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban and Vivantes Klinikum Im Friedrichshain, Berlin, Germany
| | - K Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban and Vivantes Klinikum Im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - D Nischk
- Department of Social Psychiatry, Zentrum Für Psychiatrie, Reichenau, Germany
| | - S Senner
- Department of Social Psychiatry, Zentrum Für Psychiatrie, Reichenau, Germany
| | - O Pogarell
- Department of Psychiatry and Psychother- Apy, University Hospital, LMU Munich, Munich, Germany
| | - S Sachenbacher
- Department of Psychiatry and Psychother- Apy, University Hospital, LMU Munich, Munich, Germany
| | - M Lambert
- Department of Psy- Chiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Rohenkohl
- Department of Psy- Chiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Kling-Lourenco
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - N Rüsch
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - F Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité UniversitätsmedizinBerlin, Berlin, Germany
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - M Schouler-Ocak
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité UniversitätsmedizinBerlin, Berlin, Germany
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - V Disselhof
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban and Vivantes Klinikum Im Friedrichshain, Berlin, Germany
| | - U Skorupa
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban and Vivantes Klinikum Im Friedrichshain, Berlin, Germany
| | - A Bechdolf
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité UniversitätsmedizinBerlin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban and Vivantes Klinikum Im Friedrichshain, Berlin, Germany
| |
Collapse
|
10
|
Jäckel D, Willert A, Brose A, Leopold K, Nischk D, Senner S, Pogarell O, Sachenbacher S, Lambert M, Rohenkohl A, Kling-Lourenco P, Rüsch N, Bermpohl F, Schouler-Ocak M, Disselhoff V, Skorupa U, Bechdolf A. Enhancing educational and vocational recovery in adolescents and young adults with early psychosis through Supported Employment and Education (SEEearly): study protocol for a multicenter randomized controlled trial. Trials 2023; 24:440. [PMID: 37400899 PMCID: PMC10316586 DOI: 10.1186/s13063-023-07462-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/13/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Psychotic disorders often develop a chronic course with devastating consequences for individuals, families, and societies. Early intervention programs for people in the first 5 years after the initial psychotic episode (early psychosis) can significantly improve the outcome and are therefore strongly recommended in national and international guidelines. However, most early intervention programs still focus on improving symptoms and relapse prevention, rather than targeting educational and vocational recovery. The aim of the present study is to explore the effects of Supported Employment and Education (SEE) following the Individual Placement and Support (IPS) model in people with early psychosis. METHODS The SEEearly trial compares treatment as usual (TAU) plus SEE to TAU alone in outpatient psychiatric settings. The study is a six-site, two-arm, single-blinded, superiority randomized controlled trial (RCT). Participants are randomly assigned (1:1) to the intervention or control group. Aiming to recruit 184 participants, with an assumed drop-out rate of 22%, we will be able to detect a 24% difference in the main outcome of employment/education with 90% power. We make assessments at baseline and at 6- and 12-month follow-ups. Outcome data on employment/education, medication, and current psychiatric treatment is obtained monthly through phone based short assessments. The primary outcome is steady participation for at least 50% of the 12-month follow-up in competitive employment and/or mainstream education. Secondary employment outcomes capture length of employment/education, time to first employment/education, monthly wages/educational attainment, and social return on investment (SROI). Secondary non-employment outcomes include subjective quality of life, psychopathology, substance use, relapse, hospitalization, and functional impairment. To be eligible, participants must be between 16 and 35 years, fulfill diagnostic criteria for early psychosis, and be interested in competitive employment and/or mainstream education. DISCUSSION In SEEearly, we hypothesize that participants with psychosis, who receive TAU plus SEE, present with better primary and secondary outcomes than participants, who receive TAU alone. Positive results of this study will justify SEE as an evidence-based strategy for clinical routine treatment in people with early psychosis. TRIAL REGISTRATION SEEearly was registered nationally and internationally in the German Clinical Trials Register (DRKS; identifier: DRKS00029660) on October 14, 2022.
Collapse
Affiliation(s)
- D Jäckel
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - A Willert
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany.
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany.
| | - A Brose
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - K Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - D Nischk
- Department of Social Psychiatry, Zentrum für Psychiatrie, Reichenau, Germany
| | - S Senner
- Department of Social Psychiatry, Zentrum für Psychiatrie, Reichenau, Germany
| | - O Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - S Sachenbacher
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Lambert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Rohenkohl
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Kling-Lourenco
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - N Rüsch
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - F Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - M Schouler-Ocak
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Psychiatric University Clinic of Charité at St. Hedwig Hospital, Berlin, Germany
| | - V Disselhoff
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - U Skorupa
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - A Bechdolf
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany
| |
Collapse
|
11
|
Le Levreur B, Frantz S, Lambert M, Chansel-Debordeaux L, Bernard V, Carriere J, Verdy G, Hocke C. [No improvement in live birth rate after luteal phase support by GnRH agonist]. Gynecol Obstet Fertil Senol 2023; 51:249-255. [PMID: 36871830 DOI: 10.1016/j.gofs.2023.02.005] [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] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/20/2023] [Accepted: 02/18/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES To evaluate the impact of adding a GnRH agonist (GnRH-a) in luteal phase support (LPS) on live birth rates in IVF/ICSI in antagonist protocols. METHODS In total, 341 IVF/ICSI attempts are analyzed in this retrospective study. Patients were divided into two groups: A f: LPS with progesterone alone (179 attempts) between March 2019 and May 2020; B: LPS with progesterone and an injection of triptorelin (GnRH-a) 0.1mg 6 days after oocyte retrieval (162 attempts) between June 2020 and June 2021. The primary outcome was live birth rate. The secondary outcomes were miscarriage rate, pregnancy rate and ovarian hyperstimulation syndrome rate. RESULTS The baseline characteristic are identical between the two groups except the infertility duration (longer in the group B). There was no significant difference between the two groups in live birth rate (24.1% versus 21.2%), pregnancy rate (33.3% versus 28.1%), miscarriage rate (4.9% versus 3.4%) and no increase the SHSO rate. The multivariate regression analysis after adjustment for age, ovarian reserve and infertility duration did not reveal a significant difference in live birth rate between the two groups. CONCLUSION In this study, the results showed no statistically significant association with the single injection of a GnRH-a in addition to progesterone on live birth rate in luteal phase support.
Collapse
Affiliation(s)
- B Le Levreur
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
| | - S Frantz
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - M Lambert
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - L Chansel-Debordeaux
- Service de biologie de la reproduction-CECOS, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - V Bernard
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - J Carriere
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - G Verdy
- Pôle santé publique, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - C Hocke
- Service de gynécologie et de médecine de la reproduction, CHU de Bordeaux, centre Aliénor d'Aquitaine, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| |
Collapse
|
12
|
Jarman RD, Colclough A, McDermott C, Bøtker M, Knudsen L, Harris T, Albaroudi B, Albaroudi O, Haddad M, Darke R, Berry E, Breslin T, Fitzpatrick G, Flanagan L, Olusanya O, Craver D, Omar A, Simpson T, Cherian N, Dore M, Prosen G, Kay S, Villén-Villegas T, Gargani L, Carley S, Woo M, Dupriez F, Hussain A, Via G, Connolly JA, Peck M, Melniker L, Walden A, Attard Biancardi MA, Żmijewska-Kaczor O, Lalande E, Geukens P, McLaughlin R, Olszynski P, Hoffmann B, Chin E, Muhr C, Kim DJ, Mercieca A, Shukla D, Hayward S, Smith M, Gaspari R, Smallwood N, Pes P, Tavazzi G, Corradi F, Lambert M, Morris C, Trauer M, Baker K, Bystrzycki A, Goudie A, Liu R, Rudd L, Dietrich CF, Jenssen C, Sidhu PS. EFSUMB Clinical Practice Guidelines for Point-of-Care Ultrasound: Part One (Common Heart and Pulmonary Applications) SHORT VERSION. Ultraschall Med 2023; 44:36-49. [PMID: 36228630 DOI: 10.1055/a-1882-6116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To evaluate the evidence and produce a summary and recommendations for the most common heart and lung point-of-care ultrasound (PoCUS). METHODS We reviewed 10 clinical domains/questions related to common heart and lung applications of PoCUS. Following review of the evidence, a summary and recommendations were produced, including assigning levels of evidence (LoE) and grading of recommendation, assessment, development, and evaluation (GRADE). 38 international experts, the expert review group (ERG), were invited to review the evidence presented for each question. A level of agreement of over 75 % was required to progress to the next section. The ERG then reviewed and indicated their level of agreement of the summary and recommendation for each question (using a 5-point Likert scale), which was approved in the case of a level of agreement of greater than 75 %. A level of agreement was defined as a summary of "strongly agree" and "agree" on the Likert scale responses. FINDINGS AND RECOMMENDATIONS One question achieved a strong consensus for an assigned LoE of 3 and a weak GRADE recommendation (question 1), the remaining 9 questions achieved broad agreement with an assigned LoE of 4 and a weak GRADE recommendation (question 2), three achieved an LoE of 3 with a weak GRADE recommendation (questions 3-5), three achieved an LoE of 3 with a strong GRADE recommendation (questions 6-8) and the remaining two were assigned an LoE of 2 with a strong GRADE recommendation (questions 9 and 10). CONCLUSION These consensus-derived recommendations should aid clinical practice and highlight areas of further research for PoCUS in acute settings.
Collapse
Affiliation(s)
- Robert David Jarman
- Emergency Department, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom of Great Britain and Northern Ireland
| | - Anna Colclough
- Emergency Medicine, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
| | - Cian McDermott
- Emergency Medicine, Mater Hospital School, Dublin, Ireland
| | - Morten Bøtker
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Prehospital Emergency Medical Services, Central Denmark Region, Viborg, Denmark
| | - Lars Knudsen
- Department of Anaesthesia, Aarhus University Hospital, Aarhus, Denmark
| | - Tim Harris
- Emergency Medicine, Queen Mary University of London, United Kingdom of Great Britain and Northern Ireland
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Omar Albaroudi
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mahmoud Haddad
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Robert Darke
- Emergency Medicine and Intensive Care Medicine, Health Education England North East, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Edward Berry
- Emergency Medicine, Torbay Hospital, Torquay, United Kingdom of Great Britain and Northern Ireland
| | - Tomas Breslin
- Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Ireland
| | | | - Leah Flanagan
- Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Olusegun Olusanya
- Intensive Care Medicine, University College Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Dominic Craver
- Emergency Medicine, The Royal London Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Adhnan Omar
- Respiratory Medicine, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
| | - Thomas Simpson
- Respiratory Medicine, Lewisham and Greenwich NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Nishant Cherian
- Emergency Department, The Alfred Emergency & Trauma Centre, Melbourne, Australia
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom of Great Britain and Northern Ireland
| | - Martin Dore
- Emergency Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Gregor Prosen
- Center for Emergency Medicine, University Medical Centre Maribor, Slovenia
| | - Sharon Kay
- Cardiac Physiology and Echocardiography, The University of Sydney, Australia
| | | | - Luna Gargani
- Cardiology, Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Simon Carley
- Emergency Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain and Northern Ireland
- Emergency Medicine, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Michael Woo
- Emergency Medicine, University of Ottawa, Canada
- Emergency Medicine, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Florence Dupriez
- Emergency Medicine, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Arif Hussain
- Cardiac Critical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Gabriele Via
- Istituto Cardio Centro, EOC, Lugano, Switzerland
| | - James Anthony Connolly
- Emergency Medicine, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Marcus Peck
- Anaesthesia and Intensive Care, Frimley Park Hospital NHS Trust, Frimley, United Kingdom of Great Britain and Northern Ireland
| | - Larry Melniker
- Emergency Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, United States
| | - Andrew Walden
- Acute and Intensive Care Medicine, Royal Berkshire Hospital, Reading, United Kingdom of Great Britain and Northern Ireland
- Acute Medicine and Intensive Care Medicine, University of Oxford, United Kingdom of Great Britain and Northern Ireland
| | | | - Olga Żmijewska-Kaczor
- Emergency Medicine, Royal Cornwall Hospital, Truro, United Kingdom of Great Britain and Northern Ireland
| | - Elizabeth Lalande
- Emergency Medicine, Centre Hospitalier de l'Université Laval, Sainte-Foy, Canada
| | - Paul Geukens
- Intensive Care Medicine, Hopital de Jolimont, Haine-Saint-Paul, Belgium
| | - Russell McLaughlin
- Emergency Medicine, Royal Victoria Hospital, Belfast, United Kingdom of Great Britain and Northern Ireland
- Medical Director, Northern Ireland Ambulance Service, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Paul Olszynski
- Emergency Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Beatrice Hoffmann
- Emergency Department, Harvard Medical School Department of Emergency Medicine Beth Israel Deaconess Medical Center, Boston, United States
| | - Eric Chin
- Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, United States
| | - Christopher Muhr
- Emergency Medicine and Internal Medicine, Capio Sankt Gorans Sjukhus, Stockholm, Sweden
| | - Daniel J Kim
- Emergency Medicine, The University of British Columbia, Vancouver, Canada
- Emergency Medicine, Vancouver General Hospital, Vancouver, Canada
| | | | | | - Simon Hayward
- Physiotherapy, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom of Great Britain and Northern Ireland
| | - Michael Smith
- School of Healthcare Sciences, Cardiff University College of Biomedical and Life Sciences, Cardiff, United Kingdom of Great Britain and Northern Ireland
| | - Romolo Gaspari
- Emergency Medicine, UMass Memorial Medical Center, Worcester, United States
- Emergency Medicine, UMass Medical School, Worcester, United States
| | - Nick Smallwood
- Acute Medicine, East Surrey Hospital, Redhill, United Kingdom of Great Britain and Northern Ireland
| | - Philippe Pes
- Emergency Medicine, University Hospital Centre Nantes, France
| | - Guido Tavazzi
- Anesthesia and Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia Facoltà di Medicina e Chirurgia, Pavia, Italy
| | - Francesco Corradi
- Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
| | - Michael Lambert
- Emergency Medicine, Advocate Christ Medical Center, Oak Lawn, United States
| | - Craig Morris
- Intensive Care, Royal Derby Hospital, Derby, United Kingdom of Great Britain and Northern Ireland
| | - Michael Trauer
- Emergency Medicine, St Thomas' Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Kylie Baker
- Emergency Medicine, Ipswich Hospital, Ipswich, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Australia
| | - Adam Bystrzycki
- Emergency Medicine, The Alfred Emergency & Trauma Centre, Melbourne, Australia
- Department of Epidemiology & Preventive Medicine, Monash University, Clayton, Australia
| | - Adrian Goudie
- Emergency Medicine, Fiona Stanley Hospital, Murdoch, Australia
| | - Rachel Liu
- Emergency Medicine, Yale School of Medicine, New Haven, United States
| | - Lynne Rudd
- General Secretary, European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), London, United Kingdom of Great Britain and Northern Ireland
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Christian Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Germany
| | - Paul S Sidhu
- Radiology, King's College London, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
13
|
Yegen C, Lambert M, Montani D, Humbert M, Planès C, Boncoeur E, Voituron N, Antigny F. La mutation Kcnk3 altère les régulations ventilatoires chémosensibles chez le rat. Rev Mal Respir 2023. [DOI: 10.1016/j.rmr.2022.11.075] [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: 02/18/2023]
|
14
|
Jarman RD, McDermott C, Colclough A, Bøtker M, Knudsen L, Harris T, Albaroudi B, Albaroudi O, Haddad M, Darke R, Berry E, Breslin T, Fitzpatrick G, Flanagan L, Olusanya O, Craver D, Omar A, Simpson T, Cherian N, Dore M, Prosen G, Kay S, Villén-Villegas T, Gargani L, Carley S, Woo M, Dupriez F, Hussain A, Via G, Connolly JA, Peck M, Melniker L, Walden A, Attard Biancardi MA, Żmijewska-Kaczor O, Lalande E, Geukens P, McLaughlin R, Olszynski P, Hoffmann B, Chin E, Muhr C, Kim DJ, Mercieca A, Shukla D, Hayward S, Smith M, Gaspari R, Smallwood N, Pes P, Tavazzi G, Corradi F, Lambert M, Morris C, Trauer M, Baker K, Bystrzycki A, Goudie A, Liu R, Rudd L, Dietrich CF, Jenssen C, Sidhu PS. EFSUMB Clinical Practice Guidelines for Point-of-Care Ultrasound: Part One (Common Heart and Pulmonary Applications) LONG VERSION. Ultraschall Med 2023; 44:e1-e24. [PMID: 36228631 DOI: 10.1055/a-1882-5615] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
AIMS To evaluate the evidence and produce a summary and recommendations for the most common heart and lung applications of point-of-care ultrasound (PoCUS). METHODS We reviewed 10 clinical domains/questions related to common heart and lung applications of PoCUS. Following review of the evidence, a summary and recommendation were produced, including assignment of levels of evidence (LoE) and grading of the recommendation, assessment, development, and evaluation (GRADE). 38 international experts, the expert review group (ERG), were invited to review the evidence presented for each question. A level of agreement of over 75 % was required to progress to the next section. The ERG then reviewed and indicated their level of agreement regarding the summary and recommendation for each question (using a 5-point Likert scale), which was approved if a level of agreement of greater than 75 % was reached. A level of agreement was defined as a summary of "strongly agree" and "agree" on the Likert scale responses. FINDINGS AND RECOMMENDATIONS One question achieved a strong consensus for an assigned LoE of 3 and a weak GRADE recommendation (question 1). The remaining 9 questions achieved broad agreement with one assigned an LoE of 4 and weak GRADE recommendation (question 2), three achieving an LoE of 3 with a weak GRADE recommendation (questions 3-5), three achieved an LoE of 3 with a strong GRADE recommendation (questions 6-8), and the remaining two were assigned an LoE of 2 with a strong GRADE recommendation (questions 9 and 10). CONCLUSION These consensus-derived recommendations should aid clinical practice and highlight areas of further research for PoCUS in acute settings.
Collapse
Affiliation(s)
- Robert David Jarman
- Emergency Department, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom of Great Britain and Northern Ireland
| | - Cian McDermott
- Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Anna Colclough
- Emergency Medicine, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
| | - Morten Bøtker
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Prehospital Emergency Medical Services, Central Denmark Region, Viborg, Denmark
| | - Lars Knudsen
- Department of Anaesthesia, Aarhus University Hospital, Aarhus, Denmark
| | - Tim Harris
- Emergency Medicine, Queen Mary University of London, United Kingdom of Great Britain and Northern Ireland
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Omar Albaroudi
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mahmoud Haddad
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Robert Darke
- Emergency Medicine and Intensive Care Medicine, Health Education England North East, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Edward Berry
- Emergency Medicine, Torbay Hospital, Torquay, United Kingdom of Great Britain and Northern Ireland
| | - Tomas Breslin
- Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Ireland
| | | | - Leah Flanagan
- Emergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Olusegun Olusanya
- Intensive Care Medicine, University College Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Dominic Craver
- Emergency Medicine, The Royal London Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Adhnan Omar
- Respiratory Medicine, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
| | - Thomas Simpson
- Respiratory Medicine, Lewisham and Greenwich NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Nishant Cherian
- Emergency Medicine, The Alfred Emergency & Trauma Centre, Melbourne, Australia
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom of Great Britain and Northern Ireland
| | - Martin Dore
- Emergency Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Gregor Prosen
- Center for Emergency Medicine, University Medical Centre Maribor, Slovenia
| | - Sharon Kay
- Cardiac Physiology and Echocardiography, The University of Sydney, Australia
| | | | - Luna Gargani
- Cardiology, Institute of Clinical Physiology National Research Council, Pisa, Italy
| | - Simon Carley
- Emergency Medicine, Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain and Northern Ireland
- Emergency Medicine, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Michael Woo
- Emergency Medicine, University of Ottawa, Canada
- Emergency Medicine, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Florence Dupriez
- Emergency Medicine, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
| | - Arif Hussain
- Cardiac Critical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Gabriele Via
- Anesthesiology, Intensive Care and Pain Medicine, Istituto Cardiocentro Ticino Ente Ospedaliero Cantonale, Lugano, Switzerland, Pavia, Italy
| | - James Anthony Connolly
- Emergency Medicine, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom of Great Britain and Northern Ireland
| | - Marcus Peck
- Anaesthesia and Intensive Care, Frimley Park Hospital NHS Trust, Frimley, United Kingdom of Great Britain and Northern Ireland
| | - Larry Melniker
- Emergency Medicine, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, United States
| | - Andrew Walden
- Acute and Intensive Care Medicine, Royal Berkshire Hospital, Reading, United Kingdom of Great Britain and Northern Ireland
- Acute Medicine and Intensive Care Medicine, University of Oxford, United Kingdom of Great Britain and Northern Ireland
| | | | - Olga Żmijewska-Kaczor
- Emergency Medicine, Royal Cornwall Hospital, Truro, United Kingdom of Great Britain and Northern Ireland
| | - Elizabeth Lalande
- Emergency Medicine, Centre Hospitalier de l'Université Laval, Sainte-Foy, Canada
| | - Paul Geukens
- Intensive Care Medicine, Hopital de Jolimont, Haine-Saint-Paul, Belgium
| | - Russell McLaughlin
- Emergency Medicine, Royal Victoria Hospital, Belfast, United Kingdom of Great Britain and Northern Ireland
- Medical Director, Northern Ireland Ambulance Service, Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Paul Olszynski
- Emergency Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Beatrice Hoffmann
- Emergency Department, Harvard Medical School Department of Emergency Medicine Beth Israel Deaconess Medical Center, Boston, United States
| | - Eric Chin
- Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, United States
| | - Christopher Muhr
- Emergency Medicine and Internal Medicine, Capio Sankt Gorans Sjukhus, Stockholm, Sweden
| | - Daniel J Kim
- Emergency Medicine, The University of British Columbia, Vancouver, Canada
- Emergency Medicine, Vancouver General Hospital, Vancouver, Canada
| | | | | | - Simon Hayward
- Physiotherapy, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom of Great Britain and Northern Ireland
| | - Michael Smith
- School of Healthcare Sciences, Cardiff University College of Biomedical and Life Sciences, Cardiff, United Kingdom of Great Britain and Northern Ireland
| | - Romolo Gaspari
- Emergency Medicine, UMass Memorial Medical Center, Worcester, United States
- Emergency Medicine, UMass Medical School, Worcester, United States
| | - Nick Smallwood
- Acute Medicine, East Surrey Hospital, Redhill, United Kingdom of Great Britain and Northern Ireland
| | - Philippe Pes
- Emergency Medicine, University Hospital Centre Nantes, France
| | - Guido Tavazzi
- Anesthesia and Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli Studi di Pavia Facoltà di Medicina e Chirurgia, Pavia, Italy
| | - Francesco Corradi
- Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
| | - Michael Lambert
- Emergency Medicine, Advocate Christ Medical Center, Oak Lawn, United States
| | - Craig Morris
- Intensive Care, Royal Derby Hospital, Derby, United Kingdom of Great Britain and Northern Ireland
| | - Michael Trauer
- Emergency Medicine, St Thomas' Hospital, London, United Kingdom of Great Britain and Northern Ireland
| | - Kylie Baker
- Emergency Medicine, Ipswich Hospital, Ipswich, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Australia
| | - Adam Bystrzycki
- Emergency Medicine, The Alfred Emergency & Trauma Centre, Melbourne, Australia
- Department of Epidemiology & Preventive Medicine, Monash University, Clayton, Australia
| | - Adrian Goudie
- Emergency Medicine, Fiona Stanley Hospital, Murdoch, Australia
| | - Rachel Liu
- Emergency Medicine, Yale School of Medicine, New Haven, United States
| | - Lynne Rudd
- General Secretary, European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), London, United Kingdom of Great Britain and Northern Ireland
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Christian Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland Strausberg/ Wriezen, Germany
| | - Paul S Sidhu
- Radiology, King's College London, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
15
|
Lambert M, Litvinov I. 405 Understanding the biologic regulation and impact of Long Interspersed Nuclear Element (LINE-1) retrotransposon reactivation in keratinocytes undergoing phototherapy treatments. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.418] [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: 11/19/2022]
|
16
|
Buchholtz K, Lambert M, Burgess T. The ecological validity of traditional standing and novel bicycle balance and agility tests for predicting performance in mountain bikers. Sports Med Health Sci 2022; 4:287-292. [PMID: 36600968 PMCID: PMC9806695 DOI: 10.1016/j.smhs.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/27/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
Falls are a common mechanism of injury in mountain biking and may be related to a loss of control of the bicycle. Traditionally, the components of bicycle control (balance and agility) are measured in standing and running, which may not reflect the skills required in mountain biking. In this paper, we present the validity of both traditional standing and novel bicycle-specific balance tests in mountain bikers. Twenty-nine male and female participants completed indoor laboratory tests and an outdoor downhill trail. Participants completed single-leg stance balance, Y-balance test, one static and four dynamic bicycle-specific balance tests, a bicycle agility test, and an outdoor downhill trail. Single-leg stance balance and Y-balance tests with eyes open had poor validity when associated with bicycle control. The static (r = -0.57, p = 0.001) and four dynamic bicycle balance tests (r = -0.51 to -0.78, p = 0.005 to 0.0001), and the bicycle agility test (r = 0.87, p < 0.0001) had moderate to strong relationships with the outdoor downhill run. Single-leg stance balance and Y-balance tests with eyes open are not valid measures of performance on a mountain bike, and should not be used to assess these populations. Our novel bicycle balance tests have adequate validity to be used as measures of performance in mountain bikers.
Collapse
Affiliation(s)
- K. Buchholtz
- Health, Physical Activity, Lifestyle, and Sport (HPALS) Research Centre, University of Cape Town, Cape Town, South Africa
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Luxembourg
| | - M. Lambert
- Health, Physical Activity, Lifestyle, and Sport (HPALS) Research Centre, University of Cape Town, Cape Town, South Africa
| | - T.L. Burgess
- Division of Physiotherapy, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa
- Centre for Medical Ethics and Law, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
17
|
Sailler L, Ly K, De Boysson H, Granel B, Samson M, Agard C, Bouillet L, Magnant J, Lambert M, Mekinian A, Tarallo L, Liozon E, Pugnet G, Daumas A, Bonnotte B, Aouba A, Boris B. Phénotypes de l’artérite à cellules géantes et diagnostic de l’aortite chez 1852 patients avant et après 2016 dans 10 CHU français. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
18
|
Stammler R, Nguyen Y, Yelnik C, Le Guern V, Lambert M, Paule R, Mouthon L, Dupré A, Ackermann F, Dufrost V, Godeau B, Leroux G, Benhamou Y, Lazaro E, Daugas E, Bezanahary H, Mekinian A, Piette J, Morel N, Costedoat-Chalumeau N. Facteurs précipitants la survenue d’un syndrome catastrophique des antiphospholipides : étude du rôle du traitement anticoagulant. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
19
|
Villarreal AM, Gantchev J, Lambert M, Litvinov I. 462 Gametocyte Specific Factor 1 contributes to the Th phenotype in Cutaneous T-Cell Lymphomas. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.476] [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: 11/19/2022]
|
20
|
Abou-Jaoude A, Courtes M, Badique L, Elhaj Mahmoud D, Abboud C, Mlih M, Justiniano H, Milbach M, Lambert M, Lemle A, Awan S, Terrand J, Niemeier A, Barbero A, Houard X, Boucher P, Matz RL. ShcA promotes chondrocyte hypertrophic commitment and osteoarthritis in mice through RunX2 nuclear translocation and YAP1 inactivation. Osteoarthritis Cartilage 2022; 30:1365-1375. [PMID: 35840017 DOI: 10.1016/j.joca.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 06/17/2022] [Accepted: 07/05/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Chondrocyte hypertrophic differentiation, a key process in endochondral ossification, is also a feature of osteoarthritis leading to cartilage destruction. Here we investigated the role of the adaptor protein Src homology and Collagen A (ShcA) in chondrocyte differentiation and osteoarthritis. METHODS Mice ablated for ShcA in osteochondroprogenitor cells were generated by crossing mice carrying the Twist2-Cre transgene with ShcAflox/flox mice. Their phenotype (n = 5 to 14 mice per group) was characterized using histology, immuno-histology and western-blot. To identify the signaling mechanisms involved, in vitro experiments were conducted on wild type and ShcA deficient chondrocytes (isolated from n = 4 to 7 littermates) and the chondroprogenitor cell line ATDC5 (n = 4 independent experiments) using western-blot, cell fractionation and confocal microscopy. RESULTS Deletion of ShcA decreases the hypertrophic zone of the growth plate (median between group difference -11.37% [95% confidence interval -17.34 to -8.654]), alters the endochondral ossification process, and leads to dwarfism (3 months old male mice nose-to-anus length -1.48 cm [-1.860 to -1.190]). ShcA promotes ERK1/2 activation, nuclear translocation of RunX2, the master transcription factor for chondrocyte hypertrophy, while maintaining the Runx2 inhibitor, YAP1, in its cytosolic inactive form. This leads to hypertrophic commitment and expression of markers of hypertrophy, such as Collagen X. In addition, loss of ShcA protects from age-related osteoarthritis development in mice (2 years old mice OARSI score -6.67 [-14.25 to -4.000]). CONCLUSION This study reveals ShcA as a new player in the control of chondrocyte hypertrophic differentiation and its deletion slows down osteoarthritis development.
Collapse
Affiliation(s)
- A Abou-Jaoude
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - M Courtes
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - L Badique
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - D Elhaj Mahmoud
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - C Abboud
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - M Mlih
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - H Justiniano
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - M Milbach
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - M Lambert
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - A Lemle
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - S Awan
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - J Terrand
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - A Niemeier
- Department of Biochemistry and Molecular Cell Biology and Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - A Barbero
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - X Houard
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine (CRSA), F-75012 Paris, France.
| | - P Boucher
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| | - R L Matz
- UMR INSERM S_1109 University of Strasbourg, 67000 Strasbourg, France.
| |
Collapse
|
21
|
Brewster L, Lambert M, Shelton C. Who cares where the doctors are? The expectation of mobility and its effect on health outcomes. Sociol Health Illn 2022; 44:1077-1093. [PMID: 35583963 PMCID: PMC9545762 DOI: 10.1111/1467-9566.13480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
Doctors are typically portrayed as active agents in their work lives. However, this paper argues that this construction of agency ignores the effects of the healthcare structures that constrain choice, which in turn affects population health outcomes. Medical training pathways, regional boundaries, and rationalisation all have a long-lasting impact on the provision of healthcare. Using a mobilities lens to examine the movement of doctors, this paper examines how the expectation of movement built into training programmes perpetuates unequal access to healthcare. Long waiting times, poor care quality and lack of preventative care all perpetuate health inequalities; as one of the socio-economic determinants, access to healthcare affects health outcomes.
Collapse
Affiliation(s)
- Liz Brewster
- Lancaster Medical School, Health Innovation One, Sir John Fisher Drive, Lancaster UniversityLancasterUK
| | - Michael Lambert
- Department of SociologyLancaster UniversityBowland NorthLancasterUK
| | - Cliff Shelton
- Lancaster Medical School, Health Innovation One, Sir John Fisher Drive, Lancaster UniversityLancasterUK
| |
Collapse
|
22
|
Jourde-Chiche N, Costedoat-Chalumeau N, Baumstarck K, Bouillet L, Burtey S, Caudwell V, Chiche L, Couzi L, Deligny C, Dussol B, Faguer S, Gobert P, Gondran G, Huart A, Hummel A, Kalbacher E, Karras A, Lambert M, Le Guern V, Loubiere S, Maillard H, Maurier F, Pha M, Queyrel V, Sarrot-Reynauld F, Verhelst D, Hachulla E, Amoura Z, Daugas E. OP0280 WEANING OF MAINTENANCE IMMUNOSUPPRESSIVE THERAPY IN LUPUS NEPHRITIS (WIN-Lupus): A MULTICENTER RANDOMIZED CONTROLLED TRIAL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundLupus nephritis (LN) is a frequent complication of systemic lupus erythematosus (SLE). Severe (proliferative) forms of LN are treated with an induction immunosuppressive therapy (IST), followed by a maintenance IST, to target remission and avoid relapses. The optimal duration of maintenance IST for proliferative LN is unknown.ObjectivesThe WIN-Lupus trial tested whether IST discontinuation after 2-3 years in proliferative LN was non-inferior to IST continuation for 2 more years.MethodsWIN-Lupus is an investigator-initiated academic randomized controlled trial, conducted in 28 French centers. Patients on maintenance IST with azathioprine or mycophenolate mofetil for a minimum of 2 years and a maximum of 3 years, and who were taking Hydroxychloroquine, were randomized (1:1) between 2 groups: IST continuation and IST discontinuation. The primary endpoint was the relapse rate of proliferative LN at 24 months. Secondary endpoints were the rate of severe SLE flares, survival without renal relapse or severe flare, adverse events, kidney function, disease activity, corticosteroid exposure, patient-reported outcome and medico-economic impact.ResultsBetween 2011 and 2016, 125 patients were screened and 96 were randomized in the trial: 48 in the IST continuation group, 48 in the IST discontinuation group. In the per-protocol population, a relapse of proliferative LN occurred in 5/40 (10.4%) patients with IST continuation, and in 12/44 (25%) patients with IST discontinuation (difference 14.8%, 95%CI [-1.9; 31.5]). Non-inferiority was not demonstrated for relapse rate. Time to renal relapse did not differ between groups (p=0.092). Severe SLE flares (renal or extra-renal) were less frequent in patients with IST continuation compared to IST discontinuation (5/40 vs 14/44 patients, p=0.035). IST discontinuation was associated with lower health-related costs. Adverse events did not differ between groups.ConclusionNon-inferiority of maintenance IST discontinuation after 2 to 3 years was not demonstrated for renal relapse. IST discontinuation was associated with a higher risk of severe SLE flare.References[1]Moroni G et al. When and how is it possible to stop therapy in patients with lupus nephritis? Clin J Am Soc Nephrol. 2021. CJN.04830421. doi: 10.2215/CJN.04830421.[2]Fanouriakis A et al. 2019 Update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis. Ann Rheum Dis. 2020;79(6):713-723.[3]Jourde-Chiche N et al. Proliferative lupus nephritis treatment: practice survey in nephrology and internal medicine in France. Nephrol Ther. 2014;10(3):170-6.[4]Zen M et al. Immunosuppressive therapy withdrawal after remission achievement in patients with lupus nephritis. Rheumatology (Oxford). 2021;keab373. doi: 10.1093/rheumatology/keab373.[5]Malvar A et al. Kidney biopsy-based management of maintenance immunosuppression is safe and may ameliorate flare rate in lupus nephritis. Kidney Int. 2020;97(1):156-162.AcknowledgementsGroupe Coopératif sur le Lupus Rénal (GCLR)Disclosure of InterestsNoemie JOURDE-CHICHE Speakers bureau: Vifor Pharma, Grant/research support from: Fresenius Medical Care: grant paid to my institution (AP-HM) for the CINEVAS study in ANCA-associated vasculitis, Nathalie Costedoat-Chalumeau Grant/research support from: AP-HP received a research support from ROCHE for the OBILUP trial, Karine Baumstarck: None declared, LAURENCE BOUILLET Speakers bureau: GSK, novartis, biocryst, takeda, behring, Paid instructor for: takeda, novartis, Consultant of: GSK, novartis, biocryst, takeda, behring, blueprint, Grant/research support from: takeda, gsk, sanofi, biocryst, novartis, Stéphane Burtey: None declared, Valerie Caudwell: None declared, Laurent Chiche Speakers bureau: BMS, Paid instructor for: BMS, Lionel Couzi Speakers bureau: Astellas, Chiesi, Novartis, Sandoz, Ostuka, GSK, Biotest, Consultant of: Biotest, Hansa, Novartis, Grant/research support from: Novartis, Astellas, Christophe DELIGNY: None declared, Bertrand Dussol Speakers bureau: Genzyme, Novonordisk, Grant/research support from: Shire, Stanislas Faguer Speakers bureau: Asahi, Vifor Pharma, Sanofi, Consultant of: Abyonyx Pharma, Pierre Gobert: None declared, Guillaume Gondran Speakers bureau: Pfizer, Novartis, Consultant of: Genzyme, Antoine Huart Speakers bureau: Janssen, Paid instructor for: Pfizer, Aurélie Hummel: None declared, Emilie Kalbacher: None declared, Alexandre Karras Speakers bureau: Vifor, GSK, Astra-Zeneca, Roche, Paid instructor for: Vifor, Sanofi, Alexion, Consultant of: Novartis, GSK, Bohringer-Ingelheim, Marc Lambert Speakers bureau: CHUGAI-ROCHE, BAYER, PFIZER, LEOPHARMA, Paid instructor for: CHUGAI-ROCHE, Consultant of: CHUGAI-ROCHE, BAYER, PFIZER, LEOPHARMA, Grant/research support from: CHUGAI-ROCHE, Véronique LE GUERN: None declared, Sandrine Loubiere: None declared, Helene Maillard: None declared, Francois Maurier: None declared, Micheline Pha: None declared, Viviane Queyrel Paid instructor for: GSK, Consultant of: Boehringer Ingelheim, Francoise Sarrot-Reynauld: None declared, David Verhelst: None declared, Eric Hachulla Speakers bureau: Johnson & Johnson, GSK, Roche-Chugai, Consultant of: Johnson & Johnson, Boehringer Ingelheim, Bayer, GSK, Roche-Chugai, Sanofi-Genzyme, Grant/research support from: CSL Behring, GSK, Roche-Chugai and Johnson & Johnson, Zahir Amoura Speakers bureau: GSK, CSL Behring, Consultant of: GSK, Grant/research support from: GSK, Eric Daugas Speakers bureau: GSK, Amgen, Paid instructor for: GSK, Astra Zeneca, Consultant of: GSK, Astra Zeneca, Amgen, Grant/research support from: ROCHE for the OBILUP trial (AP-HP)
Collapse
|
23
|
Mirouse A, Deltour S, Leclerc D, Pouchelon C, Comarmond C, Kahn J, Benhamou Y, Mirault T, Mekinian A, Lambert M, Cacoub P, Biard L, Saadoun D. Accidents cérébraux ischémiques au cours de la maladie de Takayasu. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Yelnik C, Puigrenier S, Lambert M. Négativation des anticorps antiphospholipides et arrêt du traitement anticoagulant au cours du syndrome des antiphospholipides : qu’en penser ? Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.04.033] [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: 11/16/2022]
|
25
|
Geromont C, Lambert M, Bosch A. Swimrun race, athletes, safety and performance: A brief review. Sports Medicine and Health Science 2021; 3:207-211. [PMID: 35783370 PMCID: PMC9219301 DOI: 10.1016/j.smhs.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 11/26/2022] Open
Abstract
Swimrun was established in Sweden in 2006. In competition athletes alternate between running and swimming multiple times. It has grown from only being hosted in Sweden to now being a global sport. The swimrun race exposes athletes to environments that require a unique set of skills. For example, participants have to negotiate ocean currents and waves. The environmental conditions change between the runs and the swims. Athletes may be exposed to hot temperatures when running in wetsuits (25 °C and hotter) and cold water (colder than 16 °C) when swimming. This sudden change in environmental conditions imposes a poorly defined physiological stress on the participants. Research on the demands of swimrun is scarce. More research is needed to improve athlete safety during events. Also, research is needed to provide insight into enhancing training methods and performance.
Collapse
|
26
|
Lambert M, Carlisle S, Cain I, Douse A, Watt L. Publisher Correction: Unexpected involvement of a second rodent species makes impacts of introduced rats more difficult to detect. Sci Rep 2021; 11:21577. [PMID: 34711870 PMCID: PMC8553806 DOI: 10.1038/s41598-021-00572-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- M Lambert
- National Wildlife Management Centre, Animal and Plant Health Agency, Sand Hutton, York, YO41 1LZ, UK. .,Department for Environment, Food, and Rural Affairs, Foss House, 1-2 Peasholme Green, York, YO1 7PX, UK.
| | - S Carlisle
- National Wildlife Management Centre, Animal and Plant Health Agency, Sand Hutton, York, YO41 1LZ, UK.,Department of Life Sciences, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK
| | - I Cain
- NBC Environment, Federation House, 222 Queensferry Rd, Edinburgh, EH4 2BN, UK
| | - A Douse
- NatureScot, Great Glen House, Leachkin Road, Inverness, IV3 8NW, UK
| | - L Watt
- NatureScot, Rum Reserve Office, Isle of Rum, PH43 4RR, UK
| |
Collapse
|
27
|
Lambert M, Carlisle S, Cain I, Douse A, Watt L. Unexpected involvement of a second rodent species makes impacts of introduced rats more difficult to detect. Sci Rep 2021; 11:19805. [PMID: 34611184 PMCID: PMC8492617 DOI: 10.1038/s41598-021-98956-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/06/2021] [Indexed: 11/09/2022] Open
Abstract
Rodent predators are implicated in declines of seabird populations, and removing introduced rats, often, but not always, results in the expected conservation gains. Here we investigated the relationship between small mammal (Norway rat, wood mouse and pygmy shrew) abundance and Manx shearwater breeding success on the island of Rum, Scotland, and tested whether localised rodenticide treatments (to control introduced Norway rats) increased Manx shearwater breeding success. We found that Manx shearwater breeding success was negatively correlated with late summer indices of abundance for rats and mice, but not shrews. On its own, rat activity was a poor predictor of Manx shearwater breeding success. Rat activity increased during the shearwater breeding season in untreated areas but was supressed in areas treated with rodenticides. Levels of mouse (and shrew) activity increased in areas treated with rodenticides (likely in response to lower levels of rat activity) and Manx shearwater breeding success was unchanged in treated areas (p < 0.1). The results suggest that, unexpectedly, negative effects from wood mice can substitute those of Norway rats and that both species contributed to negative impacts on Manx shearwaters. Impacts were intermittent however, and further research is needed to characterise rodent population trends and assess the long-term risks to this seabird colony. The results have implications for conservation practitioners planning rat control programmes on islands where multiple rodent species are present.
Collapse
Affiliation(s)
- M Lambert
- National Wildlife Management Centre, Animal and Plant Health Agency, Sand Hutton, York, YO41 1LZ, UK. .,Department for Environment, Food, and Rural Affairs, Foss House, 1-2 Peasholme Green, York, YO1 7PX, UK.
| | - S Carlisle
- National Wildlife Management Centre, Animal and Plant Health Agency, Sand Hutton, York, YO41 1LZ, UK.,Department of Life Sciences, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK
| | - I Cain
- NBC Environment, Federation House, 222 Queensferry Rd, Edinburgh, EH4 2BN, UK
| | - A Douse
- NatureScot, Great Glen House, Leachkin Road, Inverness, IV3 8NW, UK
| | - L Watt
- NatureScot, Rum Reserve Office, Isle of Rum, PH43 4RR, UK
| |
Collapse
|
28
|
Lambert M, Sabiston CM, Wrosch C, Brunet J. Behavioural, physical, and psychological predictors of cortisol and C-reactive protein in breast cancer survivors: A longitudinal study. Brain Behav Immun Health 2021; 10:100180. [PMID: 34589720 PMCID: PMC8474539 DOI: 10.1016/j.bbih.2020.100180] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/26/2020] [Accepted: 11/28/2020] [Indexed: 12/05/2022] Open
Abstract
Background Breast cancer survivors (BCS) can exhibit a dysregulation of cortisol and elevated C-reactive protein (CRP) levels post-treatment, which increase the risk of diverse health outcomes. Certain behavioural, physical, and psychological variables may help to predict cortisol and CRP levels post-treatment. The aims of this study were to: (1) describe naturally occurring changes in absolute diurnal cortisol and CRP levels over a period of 1.5 years post-treatment among BCS, (2) assess if absolute diurnal cortisol and CRP levels change in tandem, and (3) assess behavioural, physical, and psychological variables as predictors of absolute diurnal cortisol levels and CRP levels. Methods Capillary blood and saliva samples were collected from 201 BCS, on average, 3.5 months post-treatment (T1) and again 3, 6, 9, and 12 months later (T2−T5). At each time point, five saliva samples were collected on two nonconsecutive days: at awakening, 30 min after awakening, 2:00 p.m., 4:00 p.m., and at bedtime. At each time point, participants also completed self-report questionnaires and wore an accelerometer for seven consecutive days. Data were analyzed using multilevel modeling. Results Absolute diurnal cortisol levels did not change significantly over time. CRP levels decreased across time points (Blinear = −0.31, p = .01), though the rate of decrease slowed over time (Bquadratic = 0.05, p = .03). Generally, greater sedentary time predicted higher overall absolute diurnal cortisol levels (B < 0.01, p = .01); whereas higher physical activity (B = −0.004, p < .01), lower body mass index (B = 0.10, p < .01), and lower health- and cancer-related stress (B = 0.24, p = .04) predicted lower overall CRP levels. Also, lower absolute diurnal cortisol levels were evident when participants engaged in more sedentary time, as compared to their own average sedentary time (B = −0.01, p < .01). Conclusions Results offer insight into the nature of change in diurnal cortisol and CRP levels among BCS from treatment completion onwards and offer clinical implications. Helping BCS manage their weight, reduce stress, increase physical activity participation, and decrease sedentary time as soon as possible after treatment may help to reduce physiological dysregulations, thereby lowering the risk of adverse health outcomes in this population. Further research investigating specific intervention parameters such as type, context, frequency, and intensity are warranted for the development of the most optimal interventions.
Collapse
Affiliation(s)
- M Lambert
- School of Psychology, University of Ottawa, ON, Canada
| | - C M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - C Wrosch
- Department of Psychology, Concordia University, Montreal, Canada
| | - J Brunet
- School of Human Kinetics, University of Ottawa, Montpetit Hall, Room 339, Ottawa, ON K1N 6N5, Canada
| |
Collapse
|
29
|
Lambert M, Zhang Y, Spinazzola J, Widrick J, Conner J, Kunkel L. DMD – ANIMAL MODELS. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.120] [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]
|
30
|
Zhang Y, Lambert M, Widrick J, Conner J, Spinazzola J, Kunkel L. PRE-CLINICAL DEVELOPMENTS IN NEUROMUSCULAR DISORDERS. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.392] [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]
|
31
|
Puigrenier S, Yelnick C, Hachulla E, Le Gouellec N, Launay D, Rousselin C, Quéméneur T, Lambert M. Négativation des anti-phospholipides et risque thrombotique : à propos d’une cohorte bi-centrique. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
32
|
Ducrocq Q, Guédon L, Launay D, Terriou L, Morell-Dubois S, Maillard H, Lefèvre G, Sobanski V, Lambert M, Yelnik C, Hachulla E, Farhat M, Garcia Fernandez M, Sanges S. Activités de recours et de recherche d’un service de Médecine Interne : une place pour la télémédecine, au-delà de la pandémie COVID-19 ? Rev Med Interne 2021. [PMCID: PMC8192034 DOI: 10.1016/j.revmed.2021.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction Les services de Médecine Interne mènent une importante activité de recours expert et de recherche, grevée par plusieurs obstacles. L’activité d’avis spécialisés est chronophage, non valorisée, et limitée par l’impossibilité d’échanger simplement les éléments du dossier médical. L’activité de recherche clinique est limitée par la fréquence des visites protocolaires. L’objectif de ce travail est de déterminer si la télémédecine (TLM) peut contribuer à résoudre ces difficultés. Patients et méthodes Concernant l’activité de recours, nous avons demandé aux médecins de déclarer les avis donnés à l’aide d’un formulaire standardisé, afin de déterminer s’ils validaient les critères de téléconsultation (TLC) ou de télé-expertise (TLE). Concernant l’activité de recherche, nous avons remis aux investigateurs et à 50 patients un questionnaire sur l’acceptabilité de TLC protocolaires. Résultats Concernant l’activité de recours, on dénombrait 120 avis (soit 21 h) hebdomadaires, dont 29 % aux patients et 69 % à des médecins. Soixante et un pour cent des avis aux patients validaient les critères de TLC ; 18 % des avis aux médecins ceux de TLE. Concernant l’activité de recherche, 70 % des investigateurs considéraient la fréquence des visites comme limitant les inclusions ; près de la moitié des patients serait favorable au recours à des TLC à la place (40 %) ou en plus (56 %) des visites présentielles. En termes de facturation, la TLM représente un revenu potentiel de 300 € hebdomadaires pour le TLE et 616€ hebdomadaires pour le TLC. Conclusion Si le recours à la TLM comme procédure dégradée au présentiel s’est démocratisé avec la pandémie, les solutions qu’elle apporte aux difficultés rencontrées dans les activités d’avis et de recherche peuvent contribuer à intégrer pleinement son usage dans le suivi standard des patients. Si tel était le cas, on pourrait tout à fait imaginer avec ce budget (47 632 €/an) pouvoir financer un praticien hospitalier supplémentaire à temps partiel.
Collapse
|
33
|
Nyns EJ, Lambert M, Wiaux AL. Comparative Bacterial Degradation of Detergents. TENSIDE SURFACT DET 2021. [DOI: 10.1515/tsd-1969-060404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
34
|
Moschetti L, Dal Pozzolo L, Le Guern V, Morel N, Yelnik CM, Lambert M, Hachulla E, Benhamou Y, Franceschini F, Andreoli L, Costedoat-Chalumeau N, Tincani A. POS0724 GENDER DIFFERENCES IN THROMBOTIC PRIMARY ANTIPHOSPHOLIPID SYNDROME IN A LARGE COHORT OF PATIENTS FROM FOUR EUROPEAN CENTERS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Autoimmune diseases occur more frequently in females and their course and severity can be affected by gender. Antiphospholipid syndrome (APS) is a systemic autoimmune disorder in which antiphospholipid antibodies (aPL) exert a pathogenic role resulting in vascular thrombosis and/or pregnancy morbidities. Data about gender differences in thrombotic APS (t-APS) are still scarce1,2.Objectives:To evaluate the differences in frequency, disease expression and severity between females and males affected by primary t-APS.Methods:Retrospective study enrolling subjects with a formal diagnosis of primary APS (Miyakis 2006) with vascular thrombosis at onset. Women who presented with obstetric events as first aPL-related manifestation were excluded. All the patients were followed from 1967 to 2019 in four European centers: three French centers and one Italian center.Results:The study included 433 patients (68% females, 32% males). Median age at t-APS onset [31 (24-46) vs 41 (29-53) years, p<0.001] and at diagnosis [34 (27-50) vs 46 (34-57) years, p<0.001] was significantly lower in females.The most common presenting manifestations were venous thrombosis (60%) followed by arterial events (37%) and catastrophic APS (3%). Venous events were more frequent in women as compared to men (64% vs 51% p:0.012 OR:1.7 [1.1-2.5]). Sites of venous thrombosis included: limbs (35%), pulmonary (17%), cerebral (3%), portal and inferior cava (2%) and retinal (1%) veins, without gender differences. The arterial events were more frequent among men (43% vs 34% p:0.053). Strokes (27%) and myocardial infarctions (4%) were the most frequent manifestations, followed by thrombosis of limbs (2%), retina (2%) and abdominal organs (1%). Noteworthy, only men presented with visceral ischemia.During the follow-up, new thrombosis occurred in 41% of patients (179/433). 33% out of them had at least two episodes and these occurred especially among males (22% vs 10% p:0.001 OR:2.5 [1.3-4.8]). New events were mostly of the same type, but ⅓ of patients presented a switch from venous to arterial side and viceversa, with no gender differences.Complete aPL profile was available in 357 subjects: 33% had single aPL positivity, 24% double positivity and 43% triple positivity, with no differences between women and men. About 80% of the patients had a concomitant risk factor (RF) for thrombosis. Established cardiovascular RFs were more represented among men as shown in table 1. In women, estrogenic exposure was the main RFs, present in almost 40% of them.Table 1.MALESn= 137FEMALESn= 296POR [IC 95%]Traditional cardiovascular RFs, n (%)Smoke66 (48)81 (27)<0.0012.5 [1.6-3.8]Arterial hypertension59 (43)75 (25)<0.0012.2 [1.5-3.4]Dyslipidemia52 (38)72 (24)0.0041.9 [1.2-2.9]Diabetes16 (12)15 (5)0.0142.5 [1.8-5.1]Obesity13 (10)38 (13)nsOther thrombophilic factors, n (%)Estrogenic stimuli*0116 (39)-Trauma / surgery / immobilization21 (15)32 (11)nsCongenital thrombophilia9/94 (10)33/204 (16)nsData were compared using contingency tables, p value was calculated with Chi-Squared or Fisher exact test. *= hormonal therapy, pregnancy, post-partumConclusion:This gender-oriented analysis of patients with primary t-APS showed that women had the first vascular event at a younger age and mostly on the venous side, while men presented mainly with arterial events, later in life and suffered from more recurrent events. No differences were observed in the distribution of the aPL profile. The different frequency of arterial and venous events in the two groups could be attributed mainly to the presence of additional RFs rather than to biological gender-specific issues. However, it should be underlined that some RFs, such as the use of estrogens or classic cardiovascular RFs, are exclusive or more represented in one gender rather than the other, making it difficult to assess the link of causality between gender and manifestations of t-APS.References:[1]JF de Carvalho. Rheumatol Int. 2011.[2]LJ Jara. Lupus. 2005.Disclosure of Interests:None declared
Collapse
|
35
|
Hocké C, Diaz M, Bernard V, Frantz S, Lambert M, Mathieu C, Grellety-Cherbero M. [Genitourinary menopause syndrome. Postmenopausal women management: CNGOF and GEMVi clinical practice guidelines]. Gynecol Obstet Fertil Senol 2021; 49:394-413. [PMID: 33757926 DOI: 10.1016/j.gofs.2021.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Genitourinary menopause syndrome (SGUM) is defined as a set of symptoms associated with a decrease of estrogen and other sexual steroids during menopause. The main symptoms are vulvovaginal (dryness, burning, itching), sexual (dyspareunia), and urinary (urinary infections, pollakiuria, nycturia, pain, urinary incontinence by urgenturia). SGUM leads to an alteration of the quality of life, and affects especially women's sexuality. OBJECTIVE The objective of this review was to elaborate guidelines for clinical practice regarding the management of SGUM in postmenopausal women, and in particular, in women with a history of breast cancer, treated or not with hormone therapy. MATERIALS AND METHODS A systematic review of the literature on SGUM management was conducted on Pubmed, Medline and Cochrane Library. Recommendations from international scholarly societies were also taken into account: International Menopause Society (IMS) https://www.imsociety.org, The North American Menopause Society (NAMS) https://www.menopause.org, Canadian Menopause Society https://www.sigmamenopause.com, European Menopause and Andropause Society (EMAS) https://www.emas-online.org, International Society for the Study of Women's Sexual Health (ISSWSH) https://www.isswsh.org. RESULTS Vaginal use of lubricants, moisturizers and hyaluronic acid improves the symptoms of SGUM and may be offered to all patients. For postmenopausal women, local estrogen will be preferred to the oral route because of their safety and efficacy on all symptoms of SGUM during low-dose use. Prasterone is a local treatment that can be proposed as an effective alternative for the management of dyspareunia and sexual function disorder. Current data on oral testosterone, tibolone, oral or transdermal DHEA and herbal medicine are currently limited. Ospemifène, which has shown a significant improvement in sexual symptoms, is not currently marketed in France. In the particular case of women with a history of breast cancer, non-hormonal regimens are a first-line therapy. Current data on the risk of breast cancer recurrence when administering low-dose local estrogen are reassuring but do not support a conclusion that this treatment is safe. CONCLUSION SGUM is a common symptom that can affect the quality of life of postmenopausal women. A treatment should be systematically proposed. Local non-hormonal treatment may be offered in all women. Local low-dose estrogen therapy and Prasterone has shown an interest in the management of symptoms. In women before a history of breast cancer, local non-hormonal treatment should be offered first-line. The safety of low-dose local estrogen therapy and Prasterone cannot be established at this time. Other alternatives exist but are not currently recommended in France due to lack of data.
Collapse
Affiliation(s)
- C Hocké
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
| | - M Diaz
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - V Bernard
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - S Frantz
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - M Lambert
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - C Mathieu
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - M Grellety-Cherbero
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| |
Collapse
|
36
|
Harrison A, Gordon-Strachan G, James Bateman C, Trotman H, Olugbuyi O, Lambert M, Ashley D, Griffith A, Samms-Vaughan M. ECD - Pregnancy outcomes of a birth cohort. Are adolescent mothers really at more risk? PSYCHOL HEALTH MED 2021:1-13. [PMID: 33840330 DOI: 10.1080/13548506.2021.1909740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
This sub-study within the JAKIDS longitudinal cohort study compares medical and psychosocial outcomes of pregnancy in younger adolescent mothers (<16 years), older adolescent mothers (16-19 years) and adult mothers (>19 years) in Jamaica. Participants were recruited from July to September 2011 and included 9521 mother-infant dyads; mean maternal age 26.0 years (SD 6.8). Adolescent mothers represented 19.1% (n = 1822) of the sample - 1704 older adolescent mothers (17.9%) and 118 younger adolescent mothers (1.2%). Participants completed interviewer-administered questionnaires regarding their sexual and reproductive health history, feelings about the current pregnancy, and presence of anxious and depressive symptoms. Data on delivery and perinatal and neonatal outcomes were extracted from hospital charts. Younger adolescent mothers were more likely to deliver preterm (p < 0.001) and low birth weight infants (p < 0.001) than older adolescent and adult mothers. Younger adolescent mothers had lower levels of antenatal anxiety regarding the pregnancy and its outcome (p < 0.001) while prevalence of elevated depressive symptoms antenatally (EPDS ≥11) was similar across age groups. Older adolescent mothers with significant depressive symptoms had increased odds of preterm delivery. These findings call for close antenatal monitoring of younger adolescent mothers and highlight the need for psychological services for all mothers.
Collapse
Affiliation(s)
- Abigail Harrison
- Department of Child and Adolescent Health, Faculty of Medical Sciences, UWI, Mona, Jamaica
| | | | - Caryl James Bateman
- Department of Sociology, Psychology and Social Work, Faculty of Social Sciences, UWI, Mona, Jamaica
| | - Helen Trotman
- Department of Child and Adolescent Health, Faculty of Medical Sciences, UWI, Mona, Jamaica
| | - Oluwayomi Olugbuyi
- Department of Child and Adolescent Health, Faculty of Medical Sciences, UWI, Mona, Jamaica
| | | | - Deanna Ashley
- School for Graduate Studies and Research, UWI, Mona, Jamaica
| | - Anona Griffith
- Department of Child and Adolescent Health, Faculty of Medical Sciences, UWI, Mona, Jamaica
| | - Maureen Samms-Vaughan
- Department of Child and Adolescent Health, Faculty of Medical Sciences, UWI, Mona, Jamaica
| |
Collapse
|
37
|
Van Deinse TB, Cuddeback GS, Wilson AB, Edwards D, Lambert M. Variation in Criminogenic Risks by Mental Health Symptom Severity: Implications for Mental Health Services and Research. Psychiatr Q 2021; 92:73-84. [PMID: 32458340 PMCID: PMC7957914 DOI: 10.1007/s11126-020-09782-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although a growing body of literature has demonstrated that justice-involved people with mental illnesses have criminogenic risk factors at similar or elevated rates as compared to justice-involved people without mental illnesses, more information about how criminogenic risks vary by intensity of mental health symptoms is needed. This information is particularly important for probation agencies who supervise the vast majority of justice-involved individuals with mental illnesses and who are increasingly implementing specialty mental health supervision approaches. To this end, this study examines the relationship between criminogenic risk and intensity of self-reported symptoms of mental illnesses among 201,905 individuals on probation from a large southeastern state. Self-report measures of symptoms of mental illnesses were categorized as low, moderate or high and criminogenic risks were compared among the following three groups: (1) those with no or low self-reported symptoms of mental illness; (2) those reporting moderate levels of symptoms; and (3) those reporting high or elevated levels of symptoms. Our findings suggest that the strength of relationships between symptoms of mental illnesses and criminogenic risks varies by type of criminogenic risk. Also, elevated symptoms of mental illness are associated with higher levels of criminogenic risks. More research about interventions that address mental illnesses and criminogenic risks is needed to inform practice and policy.
Collapse
Affiliation(s)
- Tonya B Van Deinse
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB#3550, Chapel Hill, NC, 27599, USA.
| | - Gary S Cuddeback
- School of Social Work, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB#3550, Chapel Hill, NC, 27599, USA
| | - Amy Blank Wilson
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB#3550, Chapel Hill, NC, 27599, USA
| | - Daniel Edwards
- Research, Planning, & Process Improvement, Missouri Department of Corrections, 2729 Plaza Dr., Jefferson City, MO, 65109, USA
| | - Michael Lambert
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB#3550, Chapel Hill, NC, 27599, USA
| |
Collapse
|
38
|
Lambert M, Awan S, Imtiaz A, Alpy F, Tomasetto C, Schaeffer C, Moritz C, Julien-David D, Matz R, Terrand J, Boucher P. WNT5A promotes endosomal cholesterol trafficking to the er and protects against atherosclerosis. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.073] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
39
|
Le Ribeuz H, Boet A, Lambert M, Chung W, Montani D, Humbert M, Antigny F. SUR1/Kir6.2 potassium channel a new actor involved in pulmonary arterial hypertension. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2020.03.039] [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]
|
40
|
Montag C, Brandt L, Lehmann A, De Millas W, Falkai P, Gaebel W, Hasan A, Hellmich M, Janssen B, Juckel G, Karow A, Klosterkötter J, Lambert M, Maier W, Müller H, Pützfeld V, Schneider F, Stützer H, Wobrock T, Vernaleken IB, Wagner M, Heinz A, Bechdolf A, Gallinat J. Cognitive and emotional empathy in individuals at clinical high risk of psychosis. Acta Psychiatr Scand 2020; 142:40-51. [PMID: 32339254 DOI: 10.1111/acps.13178] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Impairments of social cognition are considered core features of schizophrenia and are established predictors of social functioning. However, affective aspects of social cognition including empathy have far less been studied than its cognitive dimensions. The role of empathy in the development of schizophrenia remains largely elusive. METHODS Emotional and cognitive empathy were investigated in large sample of 120 individuals at Clinical High Risk of Psychosis (CHR-P) and compared with 50 patients with schizophrenia and 50 healthy controls. A behavioral empathy assessment, the Multifaceted Empathy Test, was implemented, and associations of empathy with cognition, social functioning, and symptoms were determined. RESULTS Our findings demonstrated significant reductions of emotional empathy in individuals at CHR-P, while cognitive empathy appeared intact. Only individuals with schizophrenia showed significantly reduced scores of cognitive empathy compared to healthy controls and individuals at CHR-P. Individuals at CHR-P were characterized by significantly lower scores of emotional empathy and unspecific arousal for both positive and negative affective valences compared to matched healthy controls and patients with schizophrenia. Results also indicated a correlation of lower scores of emotional empathy and arousal with higher scores of prodromal symptoms. CONCLUSION Findings suggest that the tendency to 'feel with' an interaction partner is reduced in individuals at CHR-P. Altered emotional reactivity may represent an additional, early vulnerability marker, even if cognitive mentalizing is grossly unimpaired in the prodromal stage. Different mechanisms might contribute to reductions of cognitive and emotional empathy in different stages of non-affective psychotic disorders and should be further explored.
Collapse
Affiliation(s)
- C Montag
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - L Brandt
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - A Lehmann
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - W De Millas
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Vivantes Wenckebach-Klinikum, Berlin, Germany
| | - P Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - W Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - A Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Hellmich
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.,Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - B Janssen
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,LVR-Klinik Langenfeld, Langenfeld, Germany
| | - G Juckel
- Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Bochum, Germany
| | - A Karow
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - J Klosterkötter
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - M Lambert
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - W Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - H Müller
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - V Pützfeld
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - F Schneider
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen, Aachen, Germany
| | - H Stützer
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - T Wobrock
- Department of Psychiatry and Psychotherapy, Georg-August-University Goettingen, Goettingen, Germany.,Department of Psychiatry and Psychotherapy, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
| | - I B Vernaleken
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen, Aachen, Germany
| | - M Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - A Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany
| | - A Bechdolf
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Vivantes Klinikum am Urban and Vivantes Klinikum im Friedrichshain, Berlin, Germany.,Faculty of Medicine, University Hospital Cologne, Cologne, Germany.,ORYGEN, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - J Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
41
|
Sanges S, Farhat MM, Assaraf M, Galland J, Rivière E, Roubille C, Lambert M, Yelnik C, Maillard H, Sobanski V, Lefèvre G, Launay D, Morell-Dubois S, Hachulla E. Raising rare disease awareness using red flags, role play simulation and patient educators: results of a novel educational workshop on Raynaud phenomenon and systemic sclerosis. Orphanet J Rare Dis 2020; 15:159. [PMID: 32576213 PMCID: PMC7310378 DOI: 10.1186/s13023-020-01439-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/03/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND As lack of awareness of rare diseases (RDs) among healthcare professionals results in delayed diagnoses, there is a need for a more efficient approach to RD training during academic education. We designed an experimental workshop that used role-play simulation with patient educators and focused on teaching "red flags" that should raise the suspicion of an RD when faced with a patient with frequently encountered symptoms. Our objective was to report our experience, and to assess the improvement in learners' knowledge and the satisfaction levels of the participants. RESULTS The workshop consisted of 2 simulated consultations that both started with the same frequent symptom (Raynaud phenomenon, RP) but led to different diagnoses: a frequent condition (idiopathic RP) and an RD (systemic sclerosis, SSc). In the second simulated consultation, the role of the patient was played by a patient educator with SSc. By juxtaposing 2 seemingly similar situations, the training particularly highlighted the elements that help differentiate SSc from idiopathic RP. When answering a clinical case exam about RP and SSc, students that had participated in the workshop had a higher mean mark than those who had not (14 ± 3.7 vs 9.6 ± 5.5 points out of 20, p = 0.001). Participants mostly felt "very satisfied" with this training (94%), and "more comfortable" about managing idiopathic RP and SSc (100%). They considered the workshop "not very stressful" and "very formative" (both 71%). When asked about the strengths of this training, they mentioned the benefits of being put in an immersive situation, allowing a better acquisition of practical skills and a more interactive exchange with teachers, as well as the confrontation with a real patient, leading to a better retention of semiological findings and associating a relational component with this experience. CONCLUSIONS Through the use of innovative educational methods, such as role-play simulation and patient educators, and by focusing on teaching "red flags", our workshop successfully improved RP and SSc learning in a way that satisfied students. By modifying the workshop's scenarios, its template can readily be applied to other clinical situations, making it an interesting tool to teach other RDs.
Collapse
Affiliation(s)
- S Sanges
- Centre de Simulation PRESAGE, Univ. Lille, UFR Médecine, F-59000, Lille, France. .,Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France. .,Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59037, Lille Cedex, France. .,Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Oust de France (CeRAINO), F-59000, Lille, France. .,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France.
| | - M-M Farhat
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.,Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59037, Lille Cedex, France.,Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Oust de France (CeRAINO), F-59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - M Assaraf
- Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59037, Lille Cedex, France
| | - J Galland
- Service de médecine interne, Hôpital Lariboisière, Assistance Publique - Hôpitaux de Paris, F-75010, Paris, France.,Université de Paris Diderot, F-75010, Paris, France
| | - E Rivière
- Service de médecine interne et maladies infectieuses, CHU de Bordeaux, F-33600, Pessac, France.,Centre de simulation SimBA-S de Bordeaux, CHU de Bordeaux et Université de Bordeaux, F-33000, Bordeaux, France
| | - C Roubille
- Département de médecine interne, CHU de Montpellier, hôpital Lapeyronie, 371, avenue du Doyen Gaston Giraud, F-34295, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Cedex 5, Montpellier, France
| | - M Lambert
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.,Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59037, Lille Cedex, France.,Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Oust de France (CeRAINO), F-59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - C Yelnik
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.,Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59037, Lille Cedex, France.,Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Oust de France (CeRAINO), F-59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - H Maillard
- Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59037, Lille Cedex, France.,Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Oust de France (CeRAINO), F-59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - V Sobanski
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.,Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59037, Lille Cedex, France.,Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Oust de France (CeRAINO), F-59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - G Lefèvre
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France.,CHU Lille, Institut d'Immunologie, F-59000, Lille, France
| | - D Launay
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.,Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59037, Lille Cedex, France.,Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Oust de France (CeRAINO), F-59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - S Morell-Dubois
- Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59037, Lille Cedex, France.,Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Oust de France (CeRAINO), F-59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| | - E Hachulla
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.,Département de Médecine Interne et Immunologie Clinique, CHU Lille, F-59037, Lille Cedex, France.,Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Oust de France (CeRAINO), F-59000, Lille, France.,Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), Lille, France
| |
Collapse
|
42
|
Lambert M, Sabiston CM, Wrosch C, Brunet J. An investigation into socio-demographic-, health-, and cancer-related factors associated with cortisol and C-reactive protein levels in breast cancer survivors: a longitudinal study. Breast Cancer 2020; 27:1096-1106. [PMID: 32488733 DOI: 10.1007/s12282-020-01113-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Breast cancer survivors (BCS) may exhibit dysregulated patterns of cortisol and C-reactive protein (CRP). The aims of this study were to describe BCS' cortisol and CRP levels over a 1-year period after treatment, and assess how levels relate to socio-demographic- (age, education level, marital status), health- (body mass index [BMI] category, menopausal status), and cancer-related factors (cancer stage, chemotherapy exposure, time since diagnosis). METHODS Participants (N = 201) provided data at 3 months post-treatment (T1) and again 3, 6, 9, and 12 months later (T2-T5). At T1, participants completed self-report questionnaires and had their weight and height measured by a trained technician. At T1-T5, they provided five saliva samples at awakening, 30 min after awakening, 2:00 pm, 4:00 pm, and before bedtime on two nonconsecutive days to measure diurnal cortisol, and provided capillary whole blood to measure CRP. Data were analyzed using repeated-measure analyses of variance (ANOVAs) and mixed-design ANOVAs. RESULTS Diurnal cortisol and CRP levels fluctuated over time. In univariate models, older age and post-menopausal status were associated with higher cortisol and CRP levels, higher cancer stage and chemotherapy were associated with lower cortisol levels, and higher BMI category was associated with higher CRP levels. In adjusted models, age was no longer associated with CRP levels and shorter time since diagnosis was significantly associated with higher CRP levels. CONCLUSIONS Socio-demographic-, health-, and cancer-related factors may help identify BCS at risk of physiological dysregulation who need intervention. Identifying modifiable factors associated with cortisol and CRP will inform cancer care interventions.
Collapse
Affiliation(s)
- M Lambert
- School of Psychology, University of Ottawa, Ontario, Canada
| | - C M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - C Wrosch
- Department of Psychology, Concordia University, Montreal, Canada
| | - J Brunet
- School of Human Kinetics, University of Ottawa, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada.
| |
Collapse
|
43
|
Sanges S, Morell-Dubois S, Farhat MM, Assaraf M, Lambert M, Sobanski V, Launay D, Hachlla E. AB1273 TEACHING RARE DISEASES THROUGH ROLE PLAY: RESULTS OF AN EXPERIMENTAL WORKSHOP ON RAYNAUD PHENOMENON. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic autoimmune diseases are mostly taught through theoretical lectures, which do not allow for the acquisition of physical examination skills and semiologic confrontation.Objectives:We report herein the results of a pilot experiment using role-play to teach how to manage patients with Raynaud phenomenon (RP).Methods:We developed a workshop that consisted of two 30-minute OSCE (Objective and Structured Clinical Examination) stations. Students were divided into groups of 4 to 5 persons. On each station, 2 students were actors and 2 were observers. After a short briefing, students played a 15-minute scenario and then had a 15-minute debriefing.The first station simulated the case of a 26-year old woman referred for suspected RP. Students were instructed to perform clinical history taking and physical examination of the patient, formulated relevant diagnosis hypotheses and prescribe any additional necessary exams. Students had to suspect the diagnosis of idiopathic RP. The simulated patient was played by a trained facilitator with expertise on RP.The second station simulated the case of a 56-year-old woman referred for RP complicated by digital ulcers. Students received the same instructions as before. They had to suspect the diagnosis of systemic sclerosis. The patient role was held by a real patient with systemic sclerosis, followed by the physician who was supervising the station, who had received prior training and who agreed to participate in this training.At the end of the workshop, the students had to complete a satisfaction questionnaire.Results:A total of 21 students participated in the workshop and 17 completed the survey. The students were “very satisfied” (Likert 4/4) of this training in 94%. They considered this workshop “not very stressful” (Likert 2/4) and “very formative” (Likert 4/4) in 71%, but “a little short” (Likert 2/4) in 88%. After taking this training, all students felt “a little” (Likert 3/4, 24%) or “much more comfortable” (Likert 4/4, 76%) to manage patients with idiopathic RP; and “a little” (Likert 3/4, 65%) or “much more comfortable” (Likert 4/4, 35%) to manage patients with systemic sclerosis. All would recommend this workshop to other students.When asked about the strengths of this training, the students mentioned the benefits of being put in an immersive situation, which allowed for a better acquisition of practical skills (especially physical examination) and a more interactive exchange with teachers; as well as the confrontation with a real patient, which allowed for a better retention of semiologic findings and associated a relational component to this experience. The main weak points reported were its short duration and the stress induced by being observed during the simulation.Conclusion:This workshop suggests the interest and feasibility on a small group of students of a rare diseases awareness workshop using role-play. The evaluation of its pedagogical efficiency and its generalization on large student promotions are being considered.Acknowledgments:NoneDisclosure of Interests:Sebastien SANGES: None declared, Sandrine Morell-Dubois: None declared, Meryem-Maud Farhat: None declared, Morgane Assaraf: None declared, Marc Lambert: None declared, Vincent Sobanski: None declared, David Launay Grant/research support from: Dr. Launay reports personal fees from Actelion, grants and personal fees from Takeda, grants and personal fees from CSL Behring, outside the submitted work., Eric Hachlla: None declared
Collapse
|
44
|
Vautier M, Dupont A, De Boysson H, Comarmond C, Mirault T, Mekinian A, Lambert M, Ferfar Y, Aouba A, Cacoub P, Resche-Rigon M, Saadoun D. SAT0244 PROGNOSIS OF LARGE VESSEL INVOLVEMENT IN LARGE VESSEL VASCULITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are the two main forms of large vessels vasculitis (LVV). Vessel inflammation leads to aneurysms, wall thickening, stenosis, and, in some cases, complete occlusion of the artery. Due to the wide variation in the course of LVV, predicting outcome is challenging. To our knowledge, data regarding prognosis factors of LVI in LVV patients and comparison of outcome of LVI in GCA and TAK are lacking. An early identification of patients with higher mortality could help to prevent deaths and vascular complications.Objectives:To assess prognosis factors and outcome of large vessel involvement (LVI) in large vessels vasculitis (LVV) patients.Methods:Retrospective multicenter study of characteristics and outcomes of 417 patients with LVI including 299 Takayasu arteritis (TAK) and 118 Giant cell arteritis (GCA-LVI) were analyzed. Logistic regression analysis assessed prognosis factors in LVV patients. Outcome of LVI among TAK and GCA-LVI patients (ischemic complications, aneurysms complications, relapses and revascularization) were assessed.Results:In multivariable analysis, stroke/transient ischemic attack [HR: 3.63 (1.46 - 9.04), p=0.006] was independently associated with vascular complications in LVV. The 10-years aneurysm free survival was significantly lower [67% (48 – 93) vs 89% (84 – 95), p=0.02] in GCA-LVI compare to TAK patients. The 5-years relapse free survival was significantly lower [47% (37 – 60) vs 69% (63 – 75), p<0.001,] in GCA-LVI compare to TAK patients. The 10-years revascularization free survival was significantly lower [55% (48 – 64) vs 76% (59 – 99), p<0.001] in TAK compare to GCA-LVI patients. After a median follow-up of 5 years, 16 (5.4%) TAK and 7 (5.9%) GCA-LVI patients died, mainly of aneurysm (26%) and ischemic complications (26%).Conclusion:This large nationwide cohort of LVI provided prognosis factors of vascular complications in LVV patients. TAK and GCA-LVI have different long-term outcome in term of aneurysm development, relapse and revascularization.Disclosure of Interests:None declared
Collapse
|
45
|
Mertz P, Kleinmann JF, Lambert M, Puéchal X, Martin T, Sibilia J, Arnaud L. AB0510 INFLIXIMAB IS AN EFFECTIVE GLUCOCORTICOID-SPARING TREATMENT FOR TAKAYASU ARTERITIS: RESULTS OF A MULTICENTER OPEN-LABEL PROSPECTIVE STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Approximately half of patients with Takayasu Arteritis (TA) have glucocorticoid (GC)-dependency and require the addition of a second-line immunosuppressive treatment.Objectives:Here, we conducted a multicenter open-label prospective cohort study to assess the efficacy and safety of infliximab originator as a GC-sparing agent in TA.Methods:A temporary recommendation for use for infliximab in refractory TA was approved by the French National Drug Authorities (April 2014). Infliximab was administered to patients in case of disease activity with a NIH score ≥2 despite conventional therapy. Data regarding patient’s clinical, laboratory, imaging and treatments were obtained at baseline, and at each following visit until last visit (October 2017). TA activity was evaluated according to NIH criteria and GC requirement throughout the study.Results:Twenty-three patients were enrolled, including 19 female. The median age at inclusion was 33 years (Interquartile range, IQR: 23-44 years). At baseline, 17 (74%) patients were treated with GCs, at a median dose of 10 mg/day (IQR: 0-21) of prednisone-equivalent. After a median follow-up of 36.9 months (IQR: 10-58.7), improvement of ≥1 NIH criterion of TA activity was achieved for 14/22 (64%) patients. The median GC dose was 8 mg/day (IQR: 7-10) at 6 months; 5 mg/day (IQR: 0-8) at 12 months and 0 mg/day (IQR: 0-5) at 36 months of follow-up. Overall, infliximab originator had a significant GC-sparing effect between baseline and last follow-up (p=0.009).Conclusion:This multicenter open-label cohort study suggests that infliximab originator is an effective GC-sparing treatment for TA refractory to conventional therapy.Disclosure of Interests:None declared
Collapse
|
46
|
Lombard W, Starling L, Wewege L, Lambert M. Changes in countermovement jump performance and subjective readiness-to-train scores following a simulated soccer match. Eur J Sport Sci 2020; 21:647-655. [DOI: 10.1080/17461391.2020.1757764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Wayne Lombard
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lindsay Starling
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Luke Wewege
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Michael Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands
| |
Collapse
|
47
|
Haasen C, Lambert M, Yagdiran O, Krausz M. Psychiatric disorders among migrants in Germany: prevalence in a psychiatric clinic and implications for services and research. Eur Psychiatry 2020; 12:305-10. [DOI: 10.1016/s0924-9338(97)84791-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/1996] [Revised: 12/10/1996] [Indexed: 11/30/2022] Open
Abstract
SummaryPast studies examining the prevalence of psychiatric disorders among migrants have described a higher rate of schizophrenia, whereas the only major German study found a lower rate. Considering the changed composition of migrants today, a new assessment has become necessary. All admission records of migrants to a psychiatric clinic in 1993 and 1994 were assessed for diagnosis, symptomatology and treatment. Two hundred sixty-three migrant admissions, 8.4% of total admissions, were assessed. Of these 41.4% received a diagnosis of a schizophrenic disorder, significantly more than other clinic patients. The mean age at admission was 33.8 years, at onset of illness 28.6 years and at time of migration 20.3 years. Only 7.9% were mentally ill at the time of migration. Of those with psychotic and depressive symptoms at admission, 70% received a diagnosis of a schizophrenic disorder and 78% were treated with antipsychotics. Antidepressants were prescribed only to 47% of those with a diagnosis of a depressive disorder and only 33% of those with depressive and no psychotic symptoms. An underrepresentation of migrants shows differences in the use of psychiatric services. The higher rate of schizophrenia may be due to misdiagnosis, an artifactual effect of underrepresentation of other disorders or an actual higher rate among migrants. The reluctance to use antidepressants underlines the necessity of training, so as not to withhold treatment options due to cultural barriers.
Collapse
|
48
|
Cossin S, Godart A, Lambert M, Lebrun L, Jouhet V. SmartEHR : un moteur de recherche dans un dossier patient informatisé. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.01.119] [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] Open
|
49
|
Karow A, Brettschneider C, Helmut König H, Correll CU, Schöttle D, Lüdecke D, Rohenkohl A, Ruppelt F, Kraft V, Gallinat J, Lambert M. Better care for less money: cost-effectiveness of integrated care in multi-episode patients with severe psychosis. Acta Psychiatr Scand 2020; 141:221-230. [PMID: 31814102 DOI: 10.1111/acps.13139] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare cost-effectiveness of integrated care with therapeutic assertive community treatment (IC-TACT) versus standard care (SC) in multiple-episode psychosis. METHOD Twelve-month IC-TACT in patients with schizophrenia-spectrum and bipolar I disorders were compared with a historical control group. Primary outcomes were entropy-balanced cost-effectiveness based on mental healthcare costs from a payers' perspective and quality-adjusted life years (QALYs) as a measure of health effects during 12-month follow-up. RESULTS At baseline, patients in IC-TACT (n = 214) had significantly higher illness severity and lower functioning than SC (n = 56). Over 12 months, IC-TACT had significantly lower days in inpatient (10.3 ± 20.5 vs. 28.2 ± 44.9; P = 0.005) and day-clinic care (2.6 ± 16.7 vs. 16.4 ± 33.7; P = 0.004) and correspondingly lower costs (€-55 084). Within outpatient care, IC-TACT displayed a higher number of treatment contacts (116.3 ± 45.3 vs. 15.6 ± 6.3) and higher related costs (€+1417). Both resulted in lower total costs in IC-TACT (mean difference = €-13 248 ± 2975, P < 0.001). Adjusted incremental QALYs were significantly higher for IC-TACT versus SC (+0.10 ± 0.37, P = 0.05). The probability of cost-effectiveness of IC-TACT was constantly higher than 99%. CONCLUSION IC-TACT was cost-effective compared with SC. The use of prima facies 'costly' TACT teams is highly recommended to improve outcomes and save total cost for patients with severe psychotic disorders.
Collapse
Affiliation(s)
- A Karow
- Competence Centre for Integrated Care in Mental Disorders, Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C U Correll
- Recognition and Prevention Program, Zucker Hillside Hospital, New York, NY, USA.,Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, New York, NY, USA.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - D Schöttle
- Competence Centre for Integrated Care in Mental Disorders, Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D Lüdecke
- Competence Centre for Integrated Care in Mental Disorders, Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Rohenkohl
- Competence Centre for Integrated Care in Mental Disorders, Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Ruppelt
- Competence Centre for Integrated Care in Mental Disorders, Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - V Kraft
- Competence Centre for Integrated Care in Mental Disorders, Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Gallinat
- Competence Centre for Integrated Care in Mental Disorders, Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Lambert
- Competence Centre for Integrated Care in Mental Disorders, Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
50
|
Vautier M, Dupont A, De Boysson H, Comarmond C, Mirault T, Mekinian A, Lambert M, Ferfar Y, Aouba A, Cacoub P, Resche-Rigon M, Saadoun D. Vascularite des gros vaisseaux : facteurs pronostics et comparaison de l’évolution à long terme de l’artérite gigantocellulaire et de la maladie de Takayasu. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.110] [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]
|