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Laveneziana P, Fossé Q, Bret M, Patout M, Dudoignon B, Llontop C, Morélot-Panzini C, Cayetanot F, Bodineau L, Straus C, Similowski T. Defective exercise-related expiratory muscle recruitment in patients with PHOX2B mutations: A clue to neural determinants of the congenital central hypoventilation syndrome. Pulmonology 2024:S2531-0437(24)00009-6. [PMID: 38403573 DOI: 10.1016/j.pulmoe.2024.01.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/28/2023] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
INTRODUCTION AND OBJECTIVES The human congenital central hypoventilation syndrome (CCHS) is caused by mutations in the PHOX2B (paired-like homeobox 2B) gene. Genetically engineered PHOX2B rodents exhibit defective development of the brainstem retrotrapezoid nucleus (RTN), a carbon dioxide sensitive structure that critically controls expiratory muscle recruitment. This has been linked to a blunted exercise ventilatory response. Whether this can be extrapolated to human CCHS is unknown and represents the objective of this study. MATERIALS AND METHODS Thirteen adult CCHS patients and 13 healthy participants performed an incremental symptom-limited cycle cardiopulmonary exercise test. Responses were analyzed using guideline approaches (ventilation V'E, tidal volume VT, breathing frequency, oxygen consumption, carbon dioxide production) complemented by a breathing pattern analysis (i.e. expiratory and inspiratory reserve volume, ERV and IRV). RESULTS A ventilatory response occurred in both study groups, as follows: V'E and VT increased in CCHS patients until 40 W and then decreased, which was not observed in the healthy participants (p<0.001). In the latter, exercise-related ERV and IRV decreases attested to concomitant expiratory and inspiratory recruitment. In the CCHS patients, inspiratory recruitment occurred but there was no evidence of expiratory recruitment (absence of any ERV decrease, p<0.001). CONCLUSIONS Assuming a similar organization of respiratory rhythmogenesis in humans and rodents, the lack of exercise-related expiratory recruitment observed in our CCHS patients is compatible with a PHOX2B-related defect of a neural structure that would be analogous to the rodents' RTN. Provided corroboration, ERV recruitment could serve as a physiological outcome in studies aiming at correcting breathing control in CCHS.
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Affiliation(s)
- P Laveneziana
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpitaux Pitié-Salpêtrière, Saint-Antoine et Tenon, Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département R3S), F-75013 Paris, France; Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre de Référence Maladies Rares "Syndrome d'Ondine" (Département R3S), F-75013 Paris, France.
| | - Q Fossé
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpitaux Pitié-Salpêtrière, Saint-Antoine et Tenon, Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département R3S), F-75013 Paris, France; Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France
| | - M Bret
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Service de Pneumologie (Département R3S), F-75013 Paris, France
| | - M Patout
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre de Référence Maladies Rares "Syndrome d'Ondine" (Département R3S), F-75013 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), F-75013 Paris, France
| | - B Dudoignon
- Université de Paris, AP-HP, Hôpital Robert Debré, Service de Physiologie Pédiatrique Centre du Sommeil-CRMR Hypoventilations alvéolaires rares, INSERM NeuroDiderot, F-75019 Paris, France
| | - C Llontop
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Service de Pneumologie (Département R3S), F-75013 Paris, France
| | - C Morélot-Panzini
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre de Référence Maladies Rares "Syndrome d'Ondine" (Département R3S), F-75013 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Service de Pneumologie (Département R3S), F-75013 Paris, France
| | - F Cayetanot
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France
| | - L Bodineau
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France
| | - C Straus
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpitaux Pitié-Salpêtrière, Saint-Antoine et Tenon, Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département R3S), F-75013 Paris, France; Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre de Référence Maladies Rares "Syndrome d'Ondine" (Département R3S), F-75013 Paris, France
| | - T Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre de Référence Maladies Rares "Syndrome d'Ondine" (Département R3S), F-75013 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Département R3S, F-75013 Paris, France
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Quintana-Ortega C, Remesal A, Vigara AP, Parrón-Pajares M, Bret M, Alcobendas R, Murias S. Severe Thrombocytopenia as the Main Manifestation of Childhood-Onset Systemic Lupus Erythematosus. Mediterr J Rheumatol 2022; 33:459-464. [PMID: 37034366 PMCID: PMC10075375 DOI: 10.31138/mjr.33.4.459] [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: 08/11/2021] [Revised: 12/21/2021] [Accepted: 01/15/2022] [Indexed: 01/22/2023] Open
Abstract
Thrombocytopenia is a common hematologic abnormality of childhood-onset systemic lupus erythematosus (cSLE). Although in most cases thrombocytopenia is mild, severe thrombocytopenia with bleeding complications might occur, and is further correlated with disease activity and a worse prognosis. We report two female patients with severe thrombocytopenia as the initial manifestation of cSLE, which were successfully treated by intensive immunosuppression including several high-dose methylprednisolone pulses and IV cyclophosphamide. Both patients were initially diagnosed with idiopathic thrombopenic purpura (ITP) refractory to conventional treatment and complicated with haemorrhagic manifestations. For this matter, patients with ITP should be assessed for the presence of ANA, anti-dsDNA antibodies, and complement levels, since they are at high risk to develop cSLE.
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Affiliation(s)
| | - Agustín Remesal
- Paediatric Rheumatology Department, La Paz Children’s Hospital, Madrid, Spain,
| | - Ana Pérez Vigara
- Paediatric Radiology Department, La Paz Children’s Hospital, Madrid, Spain
| | | | - Montserrat Bret
- Paediatric Radiology Department, La Paz Children’s Hospital, Madrid, Spain
| | - Rosa Alcobendas
- Paediatric Rheumatology Department, La Paz Children’s Hospital, Madrid, Spain,
| | - Sara Murias
- Paediatric Rheumatology Department, La Paz Children’s Hospital, Madrid, Spain,
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Martin-Fernandez M, Bravo García-Morato M, Gruber C, Murias Loza S, Malik MNH, Alsohime F, Alakeel A, Valdez R, Buta S, Buda G, Marti MA, Larralde M, Boisson B, Feito Rodriguez M, Qiu X, Chrabieh M, Al Ayed M, Al Muhsen S, Desai JV, Ferre EMN, Rosenzweig SD, Amador-Borrero B, Bravo-Gallego LY, Olmer R, Merkert S, Bret M, Sood AK, Al-Rabiaah A, Temsah MH, Halwani R, Hernandez M, Pessler F, Casanova JL, Bustamante J, Lionakis MS, Bogunovic D. Systemic Type I IFN Inflammation in Human ISG15 Deficiency Leads to Necrotizing Skin Lesions. Cell Rep 2021; 31:107633. [PMID: 32402279 PMCID: PMC7331931 DOI: 10.1016/j.celrep.2020.107633] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/26/2020] [Accepted: 04/21/2020] [Indexed: 01/14/2023] Open
Abstract
Most monogenic disorders have a primary clinical presentation. Inherited ISG15 deficiency, however, has manifested with two distinct presentations to date: susceptibility to mycobacterial disease and intracranial calcifications from hypomorphic interferon-II (IFN-II) production and excessive IFN-I response, respectively. Accordingly, these patients were managed for their infectious and neurologic complications. Herein, we describe five new patients with six novel ISG15 mutations presenting with skin lesions who were managed for dermatologic disease. Cellularly, we denote striking specificity to the IFN-I response, which was previously assumed to be universal. In peripheral blood, myeloid cells display the most robust IFN-I signatures. In the affected skin, IFN-I signaling is observed in the keratinocytes of the epidermis, endothelia, and the monocytes and macrophages of the dermis. These findings define the specific cells causing circulating and dermatologic inflammation and expand the clinical spectrum of ISG15 deficiency to dermatologic presentations as a third phenotype co-dominant to the infectious and neurologic manifestations. Martin-Fernandez et al. report on five patients with inherited ISG15 deficiency, a recently discovered syndrome of type I IFN autoinflammation and mycobacterial susceptibility. This study defines an expanded clinical spectrum that now includes dermatologic disease and pinpoints the specific cell types driving inflammation.
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Affiliation(s)
- Marta Martin-Fernandez
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | - Conor Gruber
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | - Muhammad Nasir Hayat Malik
- Hannover Medical School, 30625 Hannover, Germany; TWINCORE Centre for Experimental and Clinical Infection Research, 30625 Hannover, Germany; Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany; Faculty of Pharmacy, University of Lahore, Lahore, Pakistan
| | - Fahad Alsohime
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alakeel
- King Saud University Medical City, College of Medicine, King Saud University, 12372 Riyadh, Saudi Arabia
| | - Rita Valdez
- Genetic Unit, Militar Hospital "Dr. Cosme Argerich," C1426BOR Buenos Aires, Argentina
| | - Sofija Buta
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Guadalupe Buda
- Department of Biological Chemistry, School of Natural and Exact Sciences, Buenos Aires University, C1428EGA Buenos Aires, Argentina; Institute of Biological Chemistry, School of Natural and Exact Sciences, IQUIBICEN, Buenos Aires University, CONICET, C1428EGA Buenos Aires, Argentina; Bitgenia, C1064AAT, Buenos Aires, Argentina
| | - Marcelo A Marti
- Department of Biological Chemistry, School of Natural and Exact Sciences, Buenos Aires University, C1428EGA Buenos Aires, Argentina; Institute of Biological Chemistry, School of Natural and Exact Sciences, IQUIBICEN, Buenos Aires University, CONICET, C1428EGA Buenos Aires, Argentina; Bitgenia, C1064AAT, Buenos Aires, Argentina
| | - Margarita Larralde
- Service of Pediatric Dermatology, Ramos Mejía Hospital, C1221ADC Buenos Aires, Argentina
| | - Bertrand Boisson
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, U1163, 75015 Paris, France; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA; Paris University, Imagine Institute, INSERM U1163, 75015 Paris, France
| | | | - Xueer Qiu
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maya Chrabieh
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, U1163, 75015 Paris, France; Paris University, Imagine Institute, INSERM U1163, 75015 Paris, France
| | - Mohammed Al Ayed
- Department of Pediatrics, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Saleh Al Muhsen
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jigar V Desai
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20814, USA
| | - Elise M N Ferre
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20814, USA
| | - Sergio D Rosenzweig
- Immunology Service, Department of Laboratory Medicine, National Institutes of Health Clinical Center, Bethesda, MD 20892, USA
| | - Blanca Amador-Borrero
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | - Ruth Olmer
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), REBIRTH-Research Center for Translational and Regenerative Medicine, Hannover Medical School, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), 30625 Hannover, Germany
| | - Sylvia Merkert
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), REBIRTH-Research Center for Translational and Regenerative Medicine, Hannover Medical School, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), 30625 Hannover, Germany
| | | | - Amika K Sood
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC 27599-7310, USA; Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC 27517, USA
| | - Abdulkarim Al-Rabiaah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad Hani Temsah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rabih Halwani
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Michelle Hernandez
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC 27599-7310, USA; Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC 27517, USA
| | - Frank Pessler
- TWINCORE Centre for Experimental and Clinical Infection Research, 30625 Hannover, Germany; Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, U1163, 75015 Paris, France; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA; Paris University, Imagine Institute, INSERM U1163, 75015 Paris, France; Howard Hughes Medical Institute, New York, NY 10065, USA; Pediatric Hematology and Immunology Unit, AP-HP, Necker Hospital for Sick Children, 75015 Paris, France
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, U1163, 75015 Paris, France; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA; Paris University, Imagine Institute, INSERM U1163, 75015 Paris, France; Center for the Study of Primary Immunodeficiencies, AP-HP, Necker Hospital for Sick Children, 75015 Paris, France
| | - Michail S Lionakis
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20814, USA
| | - Dusan Bogunovic
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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Nava FB, Barrial M, Bret M, Muñoz AJ, Serradilla J, Encinas JL, Martínez L, López-Santamaría M, De la Torre CA. [Slipping rib syndrome in paediatrics: report of 4 cases]. Cir Pediatr 2018; 31:192-195. [PMID: 30371032] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM OF THE STUDY The slipping rib syndrome (SRS) is an unknown pathology for the pediatric surgeon due to its low incidence in children. The weakness of the costal ligaments allowing an area of rib hypermobility has been postulated recently as the main etiology. It produces an intermittent pain in the lower thorax or upper abdomen that can affect to the daily activities and can be the origin of unspecific chronic pain. METHODS A retrospective review of patients diagnosed with SRS between october 2012 and march 2017 was performed. Data of demographics, symptoms, imaging studies, surgical findings and long-term follow-up were collected. RESULTS During this period, 4 patients were diagnosed with SRS. Median age at diagnosis was 13 years (12-15 years) with a mean duration of symptoms of 13 months (12-36 months). In 2 patients the SRS was associated with Costal Dysmorphia (CD). The initial diagnosis was clinical with posterior ultrasound confirmation. Resection of the affected cartilages was performed in 3 patients and after a follow-up of 6 months (3-30 months), they all are painless and refer a good cosmetic result. One patient refused the intervention. CONCLUSIONS The SRS is an infrequent cause of thoracic pain with an etiology not well understood. The awareness of this disease and its typical presentation can avoid unnecessary studies. The resection of the affected cartilages is a safe and effective treatment.
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Affiliation(s)
- F B Nava
- Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid
| | - M Barrial
- Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid
| | - M Bret
- Servicio de Radiología Infantil. Hospital Universitario La Paz. Madrid
| | - A J Muñoz
- Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid
| | - J Serradilla
- Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid
| | - J L Encinas
- Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid
| | - L Martínez
- Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid
| | | | - C A De la Torre
- Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid
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Sanchez Recalde A, Oliver JM, Gonzalez AE, Ruiz-Cantador J, Balbacid E, Garcia-Hamilton D, Bret M, Abelleira C, Moreno R, Irazusta J, Gutierrez-Larraya F, Lopez-Sendon JL. 2113Risk factors for excess mortality in adults with coarctation of the aorta. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2113] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - J M Oliver
- University Hospital Gregorio Maranon, Madrid, Spain
| | | | | | - E Balbacid
- University Hospital La Paz, Madrid, Spain
| | | | - M Bret
- University Hospital La Paz, Madrid, Spain
| | | | - R Moreno
- University Hospital La Paz, Madrid, Spain
| | - J Irazusta
- University Hospital La Paz, Madrid, Spain
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Lecina L, García-Guereta L, Bret M. Coartación compleja y subclavia derecha aberrante. Rev Esp Cardiol (Engl Ed) 2017. [DOI: 10.1016/j.recesp.2016.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lecina L, García-Guereta L, Bret M. Complex Coarctation and Anomalous Right Subclavian Artery. Rev Esp Cardiol (Engl Ed) 2017; 70:293. [PMID: 27514625 DOI: 10.1016/j.rec.2016.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 05/27/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Laura Lecina
- Departamento de Cardiología Pediátrica, Hospital Universitario La Paz, Madrid, Spain.
| | - Luis García-Guereta
- Departamento de Cardiología Pediátrica, Hospital Universitario La Paz, Madrid, Spain
| | - Montserrat Bret
- Departamento de Radiología, Hospital Universitario La Paz, Madrid, Spain
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Briend G, Planquette B, Bret M, Legras A, Barthes F, Herrero S, Sanchez O. Monitorage de la pCO2 par voie transcutanée après chirurgie thoracique : étude de faisabilité. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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9
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Aroca Á, Polo L, Bret M, López-Ortego P, González Á, Villagrá F. Drenaje venosa pulmonar anómalo total. Técnicas y resultados. Cirugía Cardiovascular 2014. [DOI: 10.1016/j.circv.2014.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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10
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del Cerro MJ, Sabaté Rotés A, Cartón A, Deiros L, Bret M, Cordeiro M, Verdú C, Barrios MI, Albajara L, Gutierrez-Larraya F. Pulmonary hypertension in bronchopulmonary dysplasia: clinical findings, cardiovascular anomalies and outcomes. Pediatr Pulmonol 2014; 49:49-59. [PMID: 23788443 DOI: 10.1002/ppul.22797] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [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: 10/23/2012] [Accepted: 02/10/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Pulmonary hypertension (PH) worsens the prognosis of bronchopulmonary dysplasia (BPD). The following items have not been fully established for PH in BPD: clinical characterization, incidence of cardiovascular anomalies (CVAs), response to PH treatment, and outcome. STUDY DESIGN A review of clinical records, computed tomography (CT) images and catheterization data of 36 patients with PH-BPD referred to our PH Unit (March 2006 to December 2011) was performed. Twenty-nine patients without major congenital heart defects and with complete follow-up data were included. RESULTS The diagnosis of PH was made at a median age of 4.5 months (IQR 2.4-7.8), with an echocardiography estimated median right ventricular pressure/systemic pressure ratio of 70% (IQR 60-80%). CT scanning was performed in 21 patients and catheterization in 14 patients. CVAs were found in 19 patients (65.5%): aortopulmonary collaterals (n = 9), pulmonary vein stenosis (n = 7), ASD (n = 4), and PDA (n = 9). Hemodynamic data: PVRI 4.3 UW m(2) (2.7-7); PVRI/SVRI 0.44 (0.32-0.8); and transpulmonary gradient 28 mmHg (19-40). At a median follow-up of 35 months (IQR 21-91), 6 patients had undergone shunts closure, 22 received specific PH drugs, 3 spontaneously improved of their PH, and 8 (26%) had died. CONCLUSION PH in BPD is not always a transient condition; it can be diagnosed at later stages and can have a protracted course. The incidence of associated CVAs is high. Prompt diagnosis, detection, and treatment of CVAs, and specific drug therapy can improve the outcome in these patients, although the mortality rate remains high.
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Hernández S, Fernández A, Ramírez M, López S, De la Torre CA, Miguel M, Bret M, Aroca A, Olivares P, Tovar JA. [Correction of the complicated pectus excavatum with extracorporeal circulation (ECC) support]. Cir Pediatr 2011; 24:44-47. [PMID: 23155650] [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: 06/01/2023]
Abstract
INTRODUCTION The most serious complication in surgery of the pectus excavatum is the possible cardiac perforation. After its resolution, it is very likely that the relapse of the excavatum will be more severe due to the intense retrosternal fibrosis generated, involving cardiac structures and fixing them to the sternum. Reintervention requires modifications of the usual techniques and special monitoring due to the increased risk of cardiac and large vessel lesions. We present the case of 2 patients with severe pectus excavatum with a previous attempt for correction with cardiac perforation. CLINICAL CASES Case 1. A 16 year old male with Haller index 9.9, diagnosed of Ehlers-Danlos syndrome and operated on in neonatal period of cardiac disease, with previous attempt for correction using the Ravitch technique that relapsed and cardiac perforation during it. Case 2. An 11 year old girl, with background of diaphragmatic hernia and cardiac perforation on introducing the Nuss bar at 5 years of age, with Haller index 5.5. Both were operated on under ECC with the collaboration of the Cardiac Surgery Service and cardiac adherences were released after median sternotomy. After it, the Nuss bar was introduced and then sternal closure was performed with reinforced steel wires with titanium plates in the anterior and posterior part. DISCUSSION The backgrounds of the cardiac approach complicate the intervention for the correction of the pectus excavatum, with a high risk of cardiac trauma. Counting on the support of the cardiac surgery and the ECC, we achieve an adequate control and prediction of the complications
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Affiliation(s)
- S Hernández
- Servicio de Cirugía Pediátrica, Departamento de Cirugía Pediátrica, Hospital Universitario la Paz, Madrid.
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Viana-Tejedor A, Sánchez-Recalde A, Oliver J, Maté I, Sobrino J, Bret M, López de Sá y Areses E, Lopez Sendon J. Infective endocarditis of unusual location following surgical correction of a complex congenital heart disease. Clin Cardiol 2010; 32:E85-7. [PMID: 19353677 DOI: 10.1002/clc.20382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A 40-year-old woman from Ecuador diagnosed with a complex congenital heart disease was admitted complaining of fever chills, night sweats, and productive cough 6 months after surgical correction of the anomalies. An echocardiography showed vegetations located on the interatrial pericardium patch. To the best of our knowledge, this is the first reported case of postoperative infective endocarditis on this location.
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Affiliation(s)
- Ana Viana-Tejedor
- Department of Cardiology, Hospital La Paz, Paseo de la Casellana, Madrid, Spain
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13
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Vivas D, García-Guereta L, Bret M, Rubio D, Burgueros M, Gil M, Gutiérrez-Larraya F. Images in Cardiovascular Medicine. Hypoplasia of the abdominal aorta and hypomelanosis of ito: "pseudo-cauda equina" imaging. Circulation 2009; 120:2025-6. [PMID: 19917896 DOI: 10.1161/circulationaha.109.898577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- David Vivas
- Department of Pediatric Cardiology, La Paz University Hospital and San Carlos University Hospital, Madrid, Spain.
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Page M, Hayi-Slayman D, Ber CE, Christin F, Baillon JJ, Bret M, Rimmelé T. Utilisation de la coupled plasma filtration adsorption au cours du traitement d'un choc septique. ACTA ACUST UNITED AC 2007; 26:990-3. [DOI: 10.1016/j.annfar.2007.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2006] [Accepted: 09/04/2007] [Indexed: 10/22/2022]
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15
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Chaulier K, Chalumeau S, Ber CE, Bret M, Rimmelé T. [Metabolic acidosis in a context of acute severe asthma]. ACTA ACUST UNITED AC 2007; 26:352-5. [PMID: 17349773 DOI: 10.1016/j.annfar.2007.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2006] [Accepted: 01/12/2007] [Indexed: 11/19/2022]
Abstract
In a context of asthma, lactic acidosis may occur during beta2-agonist therapy. Several cases have been reported during its administration by intravenous and/or inhaled route. This side-effect seems rather unknown and the mechanism for compensation of metabolic acidosis by hyperventilation may worsen dyspnoea and mislead clinicians. Other causes of lactic acidosis such as a major hypoxemia, a cardiovascular collapse or sepsis may also be experienced in this context and must be ruled out before attributing the lactic acidosis to beta2-agonist treatment. We report the case of a 50-year-old man hospitalized for an acute major asthma, who received a salbutamol continuous infusion associated with inhaled terbutaline. A serum lactate level of 13 mmol/l was noted eight hours after the introduction of the bronchodilator treatment. After reducing doses of beta2-agonists, the evolution was favourable, regarding both respiratory and metabolic aspects, with a rapid decrease of the serum lactate level, which finally returned to normal level after 32 hours of hospitalization.
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Affiliation(s)
- K Chaulier
- Département d'anesthésie-réanimation, pavillon P réanimation, hôpital Edouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
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16
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Madrazo M, Pérez Ferrer A, Lahoz A, Bret M. [Remifentanil: bolus doses to induce apnea and bradycardia for coronary arteriography in a pediatric patient]. Rev Esp Anestesiol Reanim 2006; 53:515-6. [PMID: 17125020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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17
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Teplan V, Schück O, Hanzal V, Hajný J, Horácková M, Ryba M, Stanek I, Surel S, Bret M, Stollová M, Sasaková D. [Obesity and progression of chronic renal insufficiency: a Czech long term prospective double-blind randomised multicentre study]. Vnitr Lek 2006; 52:571-6. [PMID: 16871760] [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: 05/11/2023]
Abstract
Obesity represents one of serious risk factors in chronic renal failure patients (CRF). In three years prospective double-blind randomised multicentre study we monitored 66 patients with advanced chronic renal insufficiency, GFR 24.4-37.3 ml/min (0.41 to 0.62 ml/s) and BMI > or = 30 kg/m2 on long term low-protein diet (0.6 P/kg BW/day) and ACEI + ARB. Thirty four randomly selected patients (group I) were treated with keto amino acids, 32 patients in control group (group II) with placebo. During the study period significant decrease of BMI, proteinuria and slowing in progression of renal failure (C(in)) were found. Significant changes were also noted in parameters of albumin and transferrin (p < 0.02), leucin and WQ (p < 0.01 - p < 0.02), glycaemia and HbA1c (p < 0.02), triglycerides (p < 0.01), leptin and ObRe (p < 0.01) and selected parameters of endothelial dysfunction (ET1, p < 0.02, TGFbeta1, p < 0.02). Significantly also decreased PTH value (p < 0.01). Successful treatment of obesity can significantly improve long term prognosis in CRF patients.
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Affiliation(s)
- V Teplan
- Klinika nefrologie, Transplantacní centrum IKEM.
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18
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Pinilla I, Bret M, Cuesta E, Borches D, Oliver JM, Gómez-León N. Role of computed tomography and magnetic resonance imaging in aortobronchial fistula diagnosis following aortic coarctation reparative surgery. Report of two cases. J Cardiovasc Surg (Torino) 2006; 47:221-7. [PMID: 16572098] [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: 05/08/2023]
Abstract
Aortobronchial fistula (ABF) is an uncommon complication of aortic coarctation repair which may occur years after successful coarctation correction. It is invariably fatal if not diagnosed and treated. ABF diagnosis poses a challenge for clinicians and radiologists because of the difficulty in detecting the fistula and the risks associated with some of the diagnostic procedures. Two cases of ABF occurring 1 and 20 years after reparative surgery of aortic coarctation are reported. The advantages and disadvantages of different imaging procedures for the evaluation of patients with suspected ABF are reviewed and the role of computed tomography angiography and magnetic resonance imaging is underlined.
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Affiliation(s)
- I Pinilla
- Department of Radiology, Hospital Universitario La Paz, Madrid, Spain.
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19
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Polanski J, Niedbala H, Musiol R, Podeszwa B, Tabak D, Palka A, Mencel A, Finster J, Mouscadet J, Bret M. 5-Hydroxy-6-Quinaldic Acid as a Novel Molecular Scaffold for HIV-1 Integrase Inhibitors. LETT DRUG DES DISCOV 2006. [DOI: 10.2174/157018006776286934] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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20
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Ber CE, Bret M, Delafosse B, Rimmelé T. [Cardiovascular risk and chronic kidney failure before kidney transplantation. Is coronary angiography essential?]. ACTA ACUST UNITED AC 2005; 25:312-3. [PMID: 16310332 DOI: 10.1016/j.annfar.2005.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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21
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Pérard L, Thomas X, Jaumain H, Theuil G, Bret M, Coronel B, Charrin C, Boulétreau P. T-cell lineage acute lymphoblastic leukemia with chromosome 5 abnormality in a patient with Crohn's disease and lipoid nephrosis. Ann Hematol 2000; 79:222-5. [PMID: 10834511 DOI: 10.1007/s002770050583] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We describe a 17-year-old patient with a documented history of Crohn's disease (CD) and of minimal-change nephrotic syndrome (MCNS) in whom a diagnosis of T-cell acute lymphoblastic leukemia (ALL) was made. The diagnosis of ALL was established by morphological examination of bone-marrow aspirates and confirmed by means of immunophenotypic analysis showing the involvement of T-cell lineage leukemic cells. The lymphoid clone showed a karyotypic abnormality involving the long arm of chromosome 5 in a translocation (5;6). Few cases of CD complicated by ALL have been previously reported. The present one is the first case combining CD and ALL in a patient with a past history of MCNS. This raises the possibility of a relationship among those diseases. The possible mechanisms for such a relationship are discussed here.
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Affiliation(s)
- L Pérard
- Service d'Anesthesie et de Réanimation, Hôpital Edouard Herriot, Lyon, France
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22
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Abstract
The characteristics of acetate-free biofiltration (AFB) are now well documented in patients with chronic renal failure: hemodynamic tolerance, correction of acid-base imbalance, buffer-free dialysate (without acetate) and absence of backfiltration. This hemodialysis technique can be beneficial to patients with acute renal failure (ARF). In our intensive care unit, we prospectively studied 29 patients with isolated ARF or ARF associated with failure of other organs. All eligible patients were randomly assigned to undergo dialysis with bicarbonate hemodialysis (BH) or with (AFB). All used the same high flux biocompatible dialysis membranes. Effectiveness and hemodynamic tolerance of hemodialysis sessions and evolution of patients were analyzed. Correction of metabolic disorders, although better in the AFB group was not statistically different from that in the BH group. Re-equilibration of acid-base balance was also similar, with or without mechanical ventilation. Heparin consumption was significantly higher in the AFB group, with no effect on haemorrhagic complications. Analysis of hypo- and hypertensive episodes, defined as arterial pressure (AP) variations 20% greater than initial pressure, showed no difference in terms of number or degree of AP variation. However, weight loss and the rate of ultrafiltration led to a higher hypotensive risk in the BH group (p < 0.05). Finally, the clinical course and prognosis was similar in both groups. In summary, AFB may be considered as effective a hemodialysis technique as BH in patients with ARF. Weight loss was better tolerated in the AFB group and can be a favorable factor considering the deleterious effect of overhydration in patients admitted to an intensive care unit. This study invites a comparison of longer dialysis session of AFB therapy and continuous hemodiafiltration.
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Affiliation(s)
- M Bret
- Department of Nephrology, Hôpital Edouard Herriot, Lyon, France
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23
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Bret M, Coronel B, Vinot O, Moskovtchenko JF. Brain death management: keystone of transplantation activity. Transplant Proc 1997; 29:2431. [PMID: 9270797 DOI: 10.1016/s0041-1345(97)00436-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M Bret
- Intensive Care Unit, Höpital Ed. Herriot, Lyon, France
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24
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Blanc-Jouvan M, Mercatello A, Duperret S, Coronel B, Bret M, Troncy J, Moskovtchenko JF. Cardiac aspergillosis: importance of transesophageal echocardiography. Intensive Care Med 1996; 22:1462. [PMID: 8986505 DOI: 10.1007/bf01709570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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25
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Colpart JJ, Ramella S, Bret M, Coronel B, Dorez D, Mercatello A, Hadj Aissa A, Moskovtchenko JF. Hypophysis-thyroid axis disturbances in human brain-dead donors. Transplant Proc 1996; 28:171-2. [PMID: 8644162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- J J Colpart
- Etablissement Francais des Greffes, Region 3, Hôpital Ed. Herriot, Lyon, France
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26
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Assouline D, Negrier C, Coguard I, Archimbaud E, Fiere D, Bret M, Bodnar D. Successful systemic thrombolysis of hepatic vein thrombosis in a patient with promyelocytic leukemia treated with all-trans retinoic acid. Am J Hematol 1995; 48:291-2. [PMID: 7717385 DOI: 10.1002/ajh.2830480422] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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27
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Vedrinne JM, Vedrinne C, Dorez D, Bret M, Coronel B, Colpart JJ. Transesophageal echocardiography assessment of heart in brain dead patients before harvesting. Transplant Proc 1995; 27:1655. [PMID: 7725438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- J M Vedrinne
- Intensive Care Unit, Edouard Herriot Hospital, Pr Motin, Lyon, France
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28
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Négrier S, Mercatello A, Bret M, Merrouche Y, Coronel B, Favrot M, Gaspard M, Dorez D, Philip I, Lanier F. Intensive regimen of cytokines with interleukin-2 and interferon alfa-2b in selected patients with metastatic renal carcinoma. J Immunother Emphasis Tumor Immunol 1995; 17:62-8. [PMID: 7728307 DOI: 10.1097/00002371-199501000-00008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We conducted a Phase II trial using an intensive regimen combining interleukin-2 (IL2), interferon-alfa-2b (IFN), and lymphokine-activated killer (LAK) cells. The aim of this study was to evaluate the toxicity and the efficacy of this combination in selected patients with metastatic renal cell carcinoma. Thirty-one assessable patients were treated with at least one cycle of a regimen consisting of 20 x 10(6) IU/day s.c. IFN for 5 days, followed 2 days later by i.v. injections of 24 x 10(6) IU/m2/day IL2 every 8 h together with i.v. bolus of 5 x 10(6) IU/m2/day IFN every 8 h during 5 days. After a 6-day break, during which four leukophereses were performed, this i.v. combination was administered along with the LAK cell reinjections for a maximum of 5 days. Twenty-seven patients underwent the two parts of the first course of treatment; respectively, 42% and 46% of the planned dose of IL2 and IFN were administered. Several severe toxicities were observed including two treatment-related deaths. Significant tumor responses were observed in seven patients, including two complete remissions. Two of these patients remain alive without evidence of disease 36 and 40 months after treatment, respectively. This intensive regimen of IL2 together with IFN and LAK cells cannot be recommended even in selected patients with metastatic renal cell carcinoma. In addition, our results argue against the concept of a dose-response relationship in this setting.
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Affiliation(s)
- S Négrier
- Medical Oncology Department, Centre León Bérard, Lyon, France
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29
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Coronel B, Laurent V, Mercatello A, Bret M, Colon S, Colpart JJ, Moskovtchenko JF. [Can hydroxyethylamidon be used during intensive care of brain-dead organ donors?]. Ann Fr Anesth Reanim 1994; 13:10-6. [PMID: 7522422 DOI: 10.1016/s0750-7658(94)80181-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In France, most of the kidney grafts are obtained from brain dead organ donors. Brain death induces numerous changes, especially in haemodynamic status, requiring the infusion of large volumes of fluid. The aim of this study was to evaluate the effect of hydroxyethyl starch (HES) on the organ donors and the kidney graft function in recipients. We compared two groups of brain dead organ donors and the kidney grafts, differing by the infused solutions: either a combination of HES (Elohes, Biosedra) and 4% human albumin solutions (HES group), or albumin alone in the control group (Albumin group). In the two groups, sex-ratio, age, cause of brain death and duration of therapy were similar. Fluid requirements were identical in the two groups: respectively 2,211 +/- 1,512 mL in the Albumin group vs 2,452 +/- 1,094 mL in the HES group (p = 0.17). However, the volume of albumin was significantly decreased in the HES group: 711 +/- 822 mL (p = 0.0001). Therefore the cost was lower in the latter: 638 +/- 633 vs 1766 +/- 788 FF. The coagulation status was not significantly different between the two groups. Amylasemia was higher in the HES group, but the difference was not significant. In the Albumin group, urinary output increased, but not significantly and creatinemia was decreased: 113.9 +/- 62 vs 131.5 +/- 44 mumol.L-1 (p < 0.05). The two groups of recipients were also similar for sex-ratio, age, kind of graft, cause of the chronic renal failure and ischaemia times.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- B Coronel
- Département d'Anesthésie-Réanimation, Hôpital Edouard-Herriot, Lyon
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Tognet E, Mercatello A, Polo P, Coronel B, Bret M, Archimbaud E, Moskovtchenko JF. Treatment of acute respiratory failure with non-invasive intermittent positive pressure ventilation in haematological patients. Clin Intensive Care 1993; 5:282-8. [PMID: 10150555] [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: 02/11/2023]
Abstract
OBJECTIVE The aim of this study was to assess whether non-invasive positive pressure ventilation delivered intermittently (Ni-IPPV) by means of a facial or nasal mask is beneficial in haematological patients suffering from acute respiratory failure. DESIGN Prospective, open, non-randomised study. SETTING University Hospital, medical intensive care unit. PATIENTS AND METHOD Eighteen haematological patients with acute respiratory failure which occurred before, during or just after therapeutic aplasia were ventilated with Ni-IPPV delivered via an individual nasal mask or a standard facial mask. Non-invasive ventilation was achieved until weaning (success (S)) or intubation (failure (F)). RESULTS Twelve patients were ultimately intubated and died (F group). Seven needed intubation within 3 hours following admission because of the inability of Ni-IPPV to provide adequate ventilation in six patients and after cardiac arrest, probably related to cardiac aspergillosis in one patient. Six patients were not intubated and were discharged alive (S group). Of 11 patients who received Ni-IPPV for more than 3 hours, the respiratory rate decreased significantly (p < 0.05) from 33 +/- 7 breaths/min to 24 +/- 5 breaths/min with Ni-IPPV and the PaO2 increased significantly from 6.6 +/- 1.7 kPa upon admission to 17.7 +/- 5.5 kPa during Ni-IPPV. Mean daily ventilation was 12 +/- 7 hours for a mean duration of 5.5 +/- 4.4 days. Pressure support was used in nine patients and appeared the most efficient ventilation mode of non-invasive ventilation. The duration per day of Ni-IPPV was shorter and PaCO2 values during Ni-IPPV were lower in the S group than in the F group. CONCLUSIONS This technique is able to provide adequate ventilatory support for many haematological patients and allows avoidance of ventilation in some.
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Affiliation(s)
- E Tognet
- Service de réanimation, Hôpital E Herriot, Lyon, France
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Philip T, Negrier S, Lasset C, Coronel B, Bret M, Blay JY, Merrouche Y, Carrie C, Kaemmerlen P, Chauvin F. Patients with metastatic renal carcinoma candidate for immunotherapy with cytokines. Analysis of a single institution study on 181 patients. Br J Cancer 1993; 68:1036-42. [PMID: 8217594 PMCID: PMC1968726 DOI: 10.1038/bjc.1993.476] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
This study was performed with the aim of discovering the characteristics and survival of patients with metastatic renal carcinoma who undergo immunotherapy with an Interleukin 2 based regimen. One hundred and eighty-one patients with metastatic renal carcinoma were referred to our institute from October 1987 until August 1991; 129 were treated with Interleukin 2 with or without Interferon alpha in three successive protocols. Fifty-two patients were not treated with immunotherapy due to the exclusion criteria of the protocols. Sixty-four patients with the same disease who had been referred to our institute before the initiation of this programme (1982, 1987) were also analysed as a control group. The main characteristics of the three different cohorts of patients were analysed and compared with univariate statistical tests; the median survival of the patients was calculated and compared. The referral rate increased from 13 a year to 45 a year while the IL2 trials were being conducted. Patients treated with cytokines have a median survival of 18 months after occurrence of metastases, compared to 6 and 8 months, respectively, in excluded patients and the control group. This parameter is of 15 months when the 181 patients, treated with cytokines or not, are considered. The survival of treated vs excluded patients is significantly different (P < 10(-6); so is the survival of the 181 patients recently included when compared to the historical group (P:10(-5). When the 181 recent patients are compared to the historical control group, a number of differences appear in their characteristics, which prevent us from drawing any conclusion about the role of immunotherapy in the improvement of survival observed. This study clearly evidences the selection of the patients receiving immunotherapy and the modification in referrals of a disease induced by a new available therapy. This emphasises the need for prospective studies in this setting.
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Affiliation(s)
- T Philip
- Medical Oncology Department, Centre Léon Bérard, Lyon, France
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32
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Négrier S, Mercatello A, Coronel B, Lanier F, Merrouche Y, Bret M, Blay JY, Lasset C, Thiesse P, Carrie C. [Treatment with cytokines of metastatic kidney cancer: the Lyon experience]. Bull Cancer 1993; 80:601-9. [PMID: 8204940] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Between October 1987 and June 1992, 244 patients with metastatic renal carcinoma were referred to our Institute. One hundred and sixty-nine were included in immunotherapy protocols. The 40 most recent patients were included in the ongoing multicentric randomised Crecy study. The previous patients were treated with IL2 as a continuous infusion or high doses intravenous IL2 combined with alpha interferon (IFN) or a combination of IL2 and IFN as subcutaneous low doses. Some patients received as rescue treatment a combination of IL2 with Tumor Necrosis Factor (TNF). First line immunotherapy with cytokines gave 14-25% response rates in these patients with 5-10% of complete persistent remissions. The most intensive regimen was responsible for the most severe toxicity as well as the highest response rate. TNF does not appear to be of great concern since its systemic administration induced important limiting toxicities. This work emphasizes the need for prospective studies in order to evaluate the optimal mode and schedule of treatment as well as to investigate the impact of immunotherapy on survival.
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Affiliation(s)
- S Négrier
- Département de médecine carcinologique, Centre Léon-Bérard, Lyon, France
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33
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Négrier S, Mercatello A, Coronel B, Merrouche Y, Bret M, Blay JY, Thiesse P, Clavel M, Moskovtchenko JF, Philip T. [Immunotherapy of metastatic kidney cancer]. Prog Urol 1993; 3:187-94. [PMID: 8508201] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Interleukin 2 (IL2), like Interferon alpha (IFN), is active in metastatic renal cancer, considered to be a chemoresistant cancer. 20 to 30% of objective responses, including 5 to 10% of complete remissions are reported with various protocols of IL2 administration. The considerable toxicity is now well controlled, allowing treatments to be administered in standard wards or even on an outpatient basis by subcutaneous injection. IFN, generally given as long-term treatment, achieved average response rates of between 15 and 20%. Although IL2 and IFN have been granted Product Marketing Authorization in France, the modalities of optimal administration, the place of the combination of IL2-Interferon alpha and the factors predictive of response to treatment still remain unclear.
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Affiliation(s)
- S Négrier
- Département de Médecine Carcinologique, Centre Léon Bérard, Lyon
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Martin X, Lefrancois N, Dawhara M, Bret M, Brunet M, Desmettre O, Garnier JL, Pouteil-Noble C, Dubernard JM. Pancreas transplantation in the uremic patient: a random trial of total pancreas with bladder drainage versus duct obstruction of segmental grafts. Transplant Proc 1993; 25:1182-3. [PMID: 8442080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- X Martin
- Service d'Urologie et Chirurgie de la Transplantation, Hopital E. Herriot, Lyon, France
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Glovannini I, Chiarla C, Boldrini G, Castagneto M, Beards SC, Watt T, Edwards JD, Nightingale P, Boyd O, Mackay J, Lamb G, Grounds RM, Bennett ED, Munerato P, Fracasso A, Fantin D, Bortolussi R, Giaimo F, Santantonio C, Lendinez MJ, Lopez J, Cerdeno V, Monjas A, Arce MA, de Lorenzo AG, de la Casa R, Lind L, Mälstam J, Skoog G, Mathìeu D, Nevìere R, Herengt F, Fleyfel M, Wattel F, Meier-Hellmann A, Hannemann L, Specht M, Schaffartzik W, Heiss-Dunlop W, Hassel H, Reinhart K, Silance PG, Vincent JL, Berlot PG, Berlot G, Silance PG, Zhang H, Smolle KH, Kahn RJ, Riera JASI, López EA, Aznarez SB, Renes E, Martín MJJ, Gándara AMD, Prados J, López PA, Rodriguez JG, Varela JP, Léon A, Raclot P, Cousson J, Biotteau C, Suinat JL, Rendoing J, van der Hoeven JG, Waanders H, Compier EA, Meinders AE, Lindner KH, Schümann W, Pfenninger EG, Ahnefeld FW, Strohmenger H, Brinkmann A, Georgieff M, Verde G, Pallavicini FB, Caramella F, Cassini F, Bichisao G, Ferguson C, Withey F, Coakley J, Crane P, Honovar M, Hinds CJ, von Planta I, Wagner O, Ritz R, Planta MV, Groeneveld ABJ, Thijs LG, de Boer JP, Abbink JJ, Creasey AA, Chang A, Roem D, Eerenberg AJM, Hack CE, Taylor FB, Annane D, Raphaël JC, Gajdos P, Bernardin G, Milhaud D, Pradier C, Matlei M, Donati A, Adrario E, Valente M, Orsetti G, Sambo G, Cola L, Giovannini C, Pietropaoli P, Tran DD, Cuesta MA, Schneider AJ, Wesdorp RIC, D’Orio V, Martinez C, Saad G, Mendes P, Marcelle R, Boulain T, Legras A, Perrotin D, Giniès G, Perrotin D, Geroulanos S, Cakmakci M, Schilling J, Staubach KH, Audibert G, Donner M, Lefèvre JC, Stoltz JF, Laxenaire MC, Russo R, Veschi G, Dellino E, Solca M, Aveni R, Colombo A, Iapichino G, Coronet B, Mercatello A, Bret M, Lefrançois N, Dubernard IM, Moskovtchenko JF. Shock I. Intensive Care Med 1992. [DOI: 10.1007/bf03216352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Tormo C, Calvo R, Ferrandis S, Parra V, Maravall JL, Lacuevo V, Dreyfuss D, Mier L, Leviel F, Lanore JJ, Djedaïni K, Costa F, Paillard M, Del Rio F, Cardenal C, De Castro J, Blesa A, Martín-Benitez J, Hermo B, Suarez R, Martín SF, Le Cacheux P, de Ligny BH, Cardineau E, Ryckelvnck JP, Marggraf G, Schumann V, Doetsch N, Wagner K, Philipp T, Reidemeister JC, Aykaç B, Öz H, Sun S, Bozkurt P, Cotonel B, Mercatello A, HadjAïssa A, Chery C, Pozet N, Clermont N, Bégou C, Tissot E, Fisher LP, Moskovtchenko JF, Laurent V, Coronel B, Bret M, Colon S, Colpart JJ, Woittiez AJJ, Drenth IM, Jamali M, Bollaert PE, Cao T, Bauer P, Kessler M, Lambert H, Larcan A, Rogiere PE, Leeman M, Kahn RJ, Vincent JL, Nagler J, Neels H, Singer M, Screaton G, McNally T, Mackie I, Machin S, Cohen S, Haller M, Schönfelder R, Briegel J, Jauch KW, Zwiebel F, Forst H, Sicignano A, Vesconi S, Bellato V, De Pietri P, Minuto A, Foroni C, Comité C, Caprioli R, Gemignani R, Stefani M, Russo V, Mazzei A, Rusehi R, Pardelli M, Matamis D, Tsagourias M, Melekos T, Bitzani M, Rodini I, Rigos D, Inglis TJJ, Kuteifan K, Martin-Barbaz F, Man NK, Descamps JM, Bosch FH, van Genderen W, van Leusen R, de Boer JP, Creasey AA, Chang A, Roem D, Eerenberg AJM, Brouwer MC, Hack CE, Taylor FB. Kidney. Intensive Care Med 1992. [DOI: 10.1007/bf03216356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Negrier S, Mercatello A, Coronel B, Ravaud A, Merrouche Y, Bret M, Lanier F, Moskovtchenko JF, Philip T. [Treatment of cancer of the kidney with interleukin 2 in adults, the Lyon experience]. J Chir (Paris) 1992; 129:292-6. [PMID: 1474110] [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: 12/27/2022]
Abstract
Like interferon-alpha, interleukin 2 (IL2) is active on metastatic kidney cancers, which are regarded as chemoresistant tumors. Out of 20 to 30% objective responses, 5 to 10% complete remissions are reported with various IL2 delivery schedules. The considerable toxicity is well mastered at present, thus allowing treatment in non-intensive care departments, or even in an ambulatory mode for subcutaneous administration. Even though Interleukin 2 has been authorized for sale in France, optimal mode of administration, the role of the IL2-interferon-alpha combination or the predictive factors of response to treatment still raise many questions.
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Affiliation(s)
- S Negrier
- Département de Médecine Carcinologique, Centre Léon Bérard, Lyon
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Négrier S, Mercatello A, Bret M, Thiesse P, Blay JY, Coronel B, Merrouche Y, Oskam R, Franks CR, Clavel M. Intravenous interleukin-2 in patients over 65 with metastatic renal carcinoma. Br J Cancer 1992; 65:723-6. [PMID: 1586600 PMCID: PMC1977403 DOI: 10.1038/bjc.1992.152] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The present study was designed in order to evaluate the response rate and the toxicity of continuous infusion of Interleukin 2 (IL2) in patients over 65 with metastatic renal cell carcinoma. Twenty-five patients, median age 69 (range 65-77), without any prior systemic anticancer therapy received a continuous infusion of IL2 at a dose of 18 x 10(6) iu m-2 d-1 for 2 periods of 5 days separated by a 6 day break. Toxicity was not different compared with younger patients (e.g. fever, hypotension, rise in creatinine level), except for cardiac toxicity which was of great concern. Despite normal cardiac tests prior to inclusion into the study, abnormalities of the cardiac rhythm ranging from tachycardia to ventricular extrasystoles occurred in 44% of the patients and IL2 cardiac toxicity was responsible for one toxic death. Three objective responses, i.e. one partial and two complete persistent responses, were seen in 22 evaluable patients. Thus, if age does not seem to modify the potential for response to IL2 therapy, cardiac toxicity appears as a limiting factor for intravenous schedules of IL2.
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Affiliation(s)
- S Négrier
- Department of Medical Oncology, Centre L. Bérard, Lyon, France
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Yatim A, Mercatello A, Coronel B, Bret M, Colpart JJ, Moskovtchenko JF, Peyrin JO. 99mTc-HMPAO cerebral scintigraphy in the diagnosis of brain death. Transplant Proc 1991; 23:2491. [PMID: 1926447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- A Yatim
- Service D'exploration Isotopiques, Pavillon P, Hôpital Ed. Herriot, Lyon, France
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Mercatello A, Hadj-Aïssa A, Négrier S, Allaouchiche B, Coronel B, Tognet E, Bret M, Favrot M, Pozet N, Moskovtchenko JF. Acute renal failure with preserved renal plasma flow induced by cancer immunotherapy. Kidney Int 1991; 40:309-14. [PMID: 1942780 DOI: 10.1038/ki.1991.215] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Adoptive immunotherapy in patients with advanced cancer produces significant regression of metastatic disease in selected patients, but it is complicated by severe side effects. Prevention of these complications is still limited because their precise mechanisms remain unknown. For this reason we have investigated renal function and hemodynamic parameters in 16 patients with renal cell carcinoma before and during treatment with a combination of high doses of both recombinant interleukin-2 (rIL2) and recombinant alpha-interferon. After patients had received three injections of combined immunotherapy, there was a decrease in mean blood pressure (-20%), glomerular filtration rate (-25%), urine output (-50%), and fractional sodium excretion (-0.8%). This was associated with an increase in heart rate (+30%), plasma creatinine level (+30%), fractional potassium excretion (+14%) and microalbuminuria (+130%). However, renal plasma flow remained constant. The increment in microalbuminuria may reflect an alteration of glomerular capillary permeability. The reduction in GFR may be accounted either for a decrease in efferent to afferent arteriolar resistance ratio, leading to a decrease in glomerular capillary pressure, or for a decrease in ultrafiltration coefficient, or both. Nonsteroidal antiinflammatory drugs, such as ketoprofen, used to minimize side effects, could considerably worsen renal function and should be avoided in patients treated by rIL2. Our results bring new insights into the pathogenesis of functional acute renal failure and provide a rational basis for the use of vasopressors in the treatment of cytokine-induced acute renal failure.
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Affiliation(s)
- A Mercatello
- Service d'Anesthésie-Réanimation, Hôpital Ed. Herriot, Lyon, France
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Bret M, Broussolle C, Laferrere B, Souquet JC, Orgiazzi J. [Efficacy and tolerance of a non-releasable intragastric balloon in the treatment of morbid obesity]. Presse Med 1990; 19:1153. [PMID: 2141938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Bret M, Souquet JC. [Exclusive semi-elemental enteral nutrition in Crohn disease]. Gastroenterol Clin Biol 1988; 12:501. [PMID: 3136048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Boulétreau P, Bret M, Meunier J, Ray MJ, Chossegros P, Trépo C, Tête R, Brette R. [Effects of a postpituitary extract and lysine vasopressin on portal and systemic hemodynamics in the cirrhotic patient]. Gastroenterol Clin Biol 1984; 8:255-9. [PMID: 6714560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The purpose of this work was to study the hemodynamic effects of a pituitary extract (Post-Hypophyse, Choay, EPH) and of lysine vasopressin (Diapid, Sandoz, VP). Cardiac, pulmonary and liver hemodynamics were measured in 50 cirrhotic patients before and during intravenous infusion (0.45 IU/kg/h) of EPH (24 patients) or VP (26 patients). EPH and VP did not have identical consequences in cardiac output and systemic resistances. EPH significantly increased cardiac output and significantly decreased systemic resistances while VP significantly and increased systemic resistances. Both vasoactive drugs similarly decreased myocardial performances. EPH and VP had a moderate influence on WHV/IVC pressure gradient. This was variable from one patient to another. The decrease of WHV/IVC pressure gradient observed during EPH infusion was mainly related to an increase of IVC pressure. Since the effects of both drugs on WHV/IVC pressure gradient are slight and unpredictable and they exert an important effect on cardiopulmonary hemodynamics, caution should be taken in administering EPH or VP to cirrhotic patients. The clinical use of EPH or VP should be undertaken only when cardiac and liver hemodynamics monitoring are available.
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Abstract
The case of a 31 year old woman with staphylococcal toxic shock syndrome is reported. The usual clinical characteristics were found: it began during a menstrual period, and she presented with a state of shock, a high fever and a cutaneous eruption. Its evolution was marked by pulmonary interstitial oedema and acute renal failure requiring dialysis; the patient recovered but residual renal failure was still present four months later. A Staphylococcus aureus was isolated from vaginal, nasal and tracheal cultures. It produced enterotoxins A and F, which were responsible for the symptoms.
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Bret M, Meunier J, Seranne C, Bouletreau P. [Anesthesia and intensive care in controlled hepatic surgery]. Ann Chir 1983; 37:42-8. [PMID: 6342505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Meunier J, Perrot D, Bret M, Pissere-Meunier J, Bouletreau P, Pasquier J, Carrier H, Berthillier G. [Recurrent paroxysmal myoglobinuria with acute renal insufficiency caused by muscular carnitine (palmitoyltransferase deficiency. A case]. Nouv Presse Med 1982; 11:2767-71. [PMID: 7145668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A 45-year-old man was hospitalized on 3 occasions for recurrent myalgias with paroxysmal myoglobinuria resulting in two episodes of acute renal failure. The second episode was fatal: the patient died of shock and hyperkaliaemia during haemodialysis. The predominant signs and symptoms were muscle pain with functional deficit, signs of renal failure and a rise in serum enzymes. All examinations were negative between attacks. Muscle biopsies showed a major degree of myolysis, and biochemical tests demonstrated severe muscle palmityl transferase deficiency associated with partial deficiency of muscle carnitine. The diagnostic features and physiopathology of the disease are reviewed.
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Perrot D, Bouletreau P, Seranne C, Bret M, Meunier J, Balay C, Adeleine P, Beaudonnet A. [Evaluation of nutritional status in hospital surgical patients (author's transl)]. Nouv Presse Med 1982; 11:1379-83. [PMID: 7079154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The nutritional status of 90 hospital surgical patients was evaluated on admission by simple, easily measured anthropometric and biological indexes. The results indicated that many patients were admitted with malnutrition, the degree of which varied according to the indices utilized. Anthropometric measurements showed that 29 to 35% of the patients had moderate malnutrition and 0 to 18% severe malnutrition, while biological indexes revealed moderate or severe malnutrition in over 50% of the subjects. Changes in indices were assessed in 51 patients during their stay in hospital. There was a significant decrease in all anthropometric indexes (p less than 0.01) and in blood albumin (p less than 1.10(-6)) though not in other biological indexes. Differences in sensitivity between indexes may be due to the fact that they reflect activities in different tissues. Several indexes must therefore be utilized in hospital patients to make detection and monitoring of malnutrition more reliable and to evaluate its various aspects.
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Maison S, Meunier J, Mialon G, Demolin P, Bret M, Bouletreau P, Brette R. [Unusual complication of colonic preparation with mannitol: hypovolemic collapse in a patient treated with beta-blockers]. Gastroenterol Clin Biol 1982; 6:408. [PMID: 6806137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Meunier J, Bret M, Raupp C, Pissère-Meunier J, Bouletreau P, Saubier E. [Use of intravenous nicergoline in the pre- and peroperative management of pheochromocytoma]. Ann Fr Anesth Reanim 1982; 1:535-7. [PMID: 7184350 DOI: 10.1016/s0750-7658(82)80098-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Godin M, Fillastre JP, Bret M. [Treatment of arterial hypertension with prazosin. Long term care]. Nouv Presse Med 1979; 8:3564. [PMID: 120942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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