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Bonnet F, Balkau B, Lambert O, Diawara Y, Combe C, Frimat L, Laville M, Liabeuf S, Massy ZA, Metzger M, Stengel B, Alencar de Pinho N, Fouque D. The number of nephroprotection targets attained is associated with cardiorenal outcomes and mortality in patients with diabetic kidney disease. The CKD-REIN cohort study. Diabetes Obes Metab 2024; 26:1908-1918. [PMID: 38418407 DOI: 10.1111/dom.15507] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 03/01/2024]
Abstract
AIM The risk of cardiorenal events remains high among patients with diabetes and chronic kidney disease (CKD), despite the prescription of recommended treatments. We aimed to determine whether the attainment of a combination of nephroprotection targets at baseline (glycated haemoglobin <7.0%, urinary albumin-creatinine ratio <300 mg/g, blood pressure <130/80 mmHg, renin-angiotensin system inhibition) was associated with better cardiorenal outcomes and lower mortality. MATERIALS AND METHODS From the prospective French CKD-REIN cohort, we studied 1260 patients with diabetes and CKD stages 3-4 (estimated glomerular filtration rate: 15-60 ml/min/1.73 m2); 69% were men, and at inclusion, mean ± SD age: 70 ± 10 years; estimated glomerular filtration rate: 33 ± 11 ml/min/1.73 m2. The median follow-up was 4.9 years. RESULTS In adjusted Cox regression models, the attainment of two nephroprotection targets was consistently associated with a lower risk of cardiorenal events [hazard ratio 0.70 (95% confidence interval 0.57-0.85)], incident kidney failure with replacement therapy [0.58 (0.43-0.77)], four major adverse cardiovascular events (cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure) [0.75 (0.57-0.99)] and all-cause mortality [0.59 (0.42-0.82)] when compared with the attainment of zero or one target. For patients with a urinary albumin-creatinine ratio ≥300 mg/g, those who attained at least two targets had lower hazard ratios for cardiorenal events [0.61 (0.39-0.96)], four major adverse cardiovascular events [0.53 (0.28-0.98)] and all-cause mortality [0.35 (0.17-0.70)] compared with those who failed to attain any targets. CONCLUSIONS These findings suggest that the attainment of a combination of nephroprotection targets is associated with better cardiorenal outcomes and a lower mortality rate in people with diabetic kidney disease.
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Affiliation(s)
- Fabrice Bonnet
- Department of Diabetology, CHU de Rennes, Université de Rennes 1, Rennes, France
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Beverley Balkau
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Oriane Lambert
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Yakhara Diawara
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Christian Combe
- Department of Nephrology, transplantation, dialysis, CHU de Bordeaux, Université de Bordeaux, Bordeaux, France
- Inserm U1026, Biotis, Bordeaux University, France
| | - Luc Frimat
- Department of Nephrology, CHRU de Nancy, Vandoeuvre-lès-Nancy, France
- Inserm CIC 1433, Clinical Epidemiology Unit, Vandoeuvre-lès-Nancy, France
| | | | - Sophie Liabeuf
- Department of Pharmacology, CHU Amiens-Picardie, MP3CV Unit, Université Picardie Jules Verne, Amiens, France
| | - Ziad A Massy
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
- Department of Nephrology, AP-HP, CHU Ambroise Paré, Boulogne-Billancourt, France
| | - Marie Metzger
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Bénédicte Stengel
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Natalia Alencar de Pinho
- Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Inserm U1018, Versailles Saint-Quentin University, Clinical Epidemiology Team, Villejuif, France
| | - Denis Fouque
- Université de Lyon, Lyon, France
- Inserm U1060, CARMEN, Lyon, France
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Marty L, Diawara Y, Rachas A, Grabar S, Costagliola D, Supervie V. Projection of age of individuals living with HIV and time since ART initiation in 2030: estimates for France. J Int AIDS Soc 2022; 25 Suppl 4:e25986. [PMID: 36176023 PMCID: PMC9523002 DOI: 10.1002/jia2.25986] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 08/01/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Thanks to antiretroviral treatment (ART), people living with HIV (PLHIV) are living longer and ageing. However, ageing involves increased risks of co‐morbidities, which also depend on when PLHIV individuals started ART. To tackle the HIV age‐related upcoming challenges, knowledge of the current and future age structure of the HIV population is needed. Here, we forecast the demographic profile of the adult population living with diagnosed HIV (aPLdHIV) in France until 2030, accounting for the impact of the ART initiation period on mortality. Methods We used national data from the French Hospital Database on HIV (ANRS CO4‐FHDH) and a sample of the National Health Data System to, first, characterize the aPLdHIV in 2018 and estimate their mortality rates according to age, sex and ART initiation period. Second, we used national HIV surveillance data to define three scenarios for the numbers of newly diagnosed HIV cases over 2019–2030: 30% decrease in HIV cases (S1), status quo situation (S2) and epidemic elimination (S3). We then combined these data using a matrix model, to project the age structure of aPLdHIV and time since ART initiation. Results In 2018, there was an estimated 161,125 aPLdHIV (33% women), of which 55% were aged 50 or older (50+), 22% aged 60+ and 8% aged 70+. In 2030, the aPLdHIV would grow to 195,246 for S1, 207,972 for S2 and 167,221 for S3. Whatever the scenario, in 2030, the estimated median time since ART initiation would increase and age distribution would shift towards older ages: with 65–72% aPLdHIV aged 50+, 42–48% 60+ and 17–19% 70+. This corresponds to ∼83,400 aPLdHIV (28% women) aged 60+, among which ∼69% started ART more than 20 years ago (i.e. before 2010) and ∼39% ≥30 years ago (i.e. before 2000), and to ∼33,100 aPLdHIV (27% women) aged 70+, among which ∼72% started ART ≥20 years ago and ∼43% ≥30 years ago. Conclusions By 2030, in France, close to 20% of the aPLdHIV will be aged 70+, of which >40% would have started ART more than 30 years ago. These estimates are essential to adapt co‐morbidities screening and anticipate resource provision in the aged care sector.
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Affiliation(s)
- Lise Marty
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Yakhara Diawara
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Antoine Rachas
- Direction de la Stratégie, des Etudes et des Statistiques, CNAM, Paris, France
| | - Sophie Grabar
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital St Antoine, Paris, France
| | - Dominique Costagliola
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Virginie Supervie
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
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Traoré M, Konaté M, Sidibé FM, Koné AC, NDiaye M, Diawara Y, Doumbia B, Sidibé S. [CT Scan Angiography In The Pulmonary Embolism's Diagosis At Radiology And Nuclear Medicine Department In Hôpital Du Point "G"]. Mali Med 2019; 34:7-12. [PMID: 35897249] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of this study was to precise the role of thoracic CT angiography in the diagnosis of pulmonary embolism in our practice. PATIENTS AND METHODS We conduct a prospective eight (8) month study in the radiology department of the Teaching Hospital of Point "G" Seventy seven patients suspected of pulmonary embolism were included. A thoracic CT angiography was performed in emergency after chest X ray for each patient. Pulmonary embolisms were classified according to the Qanadli index. RESULTS The average age of our patients was 52 years old (23 - 85 years). The age group 55-64 was predominant. The clinical probability was low, medium and high respectively in 8,9%, 28,9% and 62,33%. Chest X ray was suspect of embolism in 92,2% (71/77%), thoracic CT angiography was positive in 58,44% (45/77). Embolism was located in a lobar pulmonary artery in 57,78% and the right side was the most concerned. Among the cardiopulmonary consequences, dilatation of the trunk of the pulmonary artery predominated in 42,22% of cases. According to Qanadli index, the severity of pulmonary embolism was moderate (53;33%), severe (35,56%), and massive (11,11%). CONCLUSION CT angiography is in our practice, the best choice in the diagnosis of pulmonary embolism. It allows to confirm the diagnosis, and to precise the topography of pulmonary embolism. In addition, this examination makes it possible the severity specification of the affection.
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Affiliation(s)
- M Traoré
- service de radiologie et médicine nucléaire CHU du Point « G »
| | - M Konaté
- service de radiologie et médicine nucléaire CHU du Point « G »
| | - F M Sidibé
- service d'hématologie et oncologie médicale CHU du Point « G »
| | - A C Koné
- service de radiologie et médicine nucleaire CHU du Point « G »
| | - M NDiaye
- service de radiologie et médicine nucléaire CHU du Point « G »
- centre d'imagerie infirmerie hôpital de Bamako
| | - Y Diawara
- service de radiologie et médicine nucléaire CHU du Point « G »
| | - B Doumbia
- service de radiologie et médicine nucléaire CHU du Point « G »
| | - S Sidibé
- service de radiologie et médicine nucléaire CHU du Point « G »
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Wang CL, Clonts LG, Diawara Y, Hannan BW, Hodges JP. Elimination of ghosting artifacts from wavelength-shifting fiber neutron detectors. Rev Sci Instrum 2013; 84:013308. [PMID: 23387643 DOI: 10.1063/1.4789497] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Misassignment of neutron position (ghosting) produces artifacts which have been observed in wavelength-shifting (WLS) fiber detectors developed for time-of-flight (TOF) neutron powder diffraction. In position-sensitive detectors (PSDs) with WLS fiber encoding, thermal and cold neutrons interact with a monolithic (6)LiF/ZnS:Ag scintillator screen, and scintillation photons are generated and transported through the crossed fibers to photomultipliers (PMTs). The neutron position is determined by photon counts in the PMTs within a preset time window. Ghosting occurs when neutrons hit the group boundaries of two neighboring PMTs for x-position multiplexing, which is modeled as resulting from a long travel length (about 3-5 mm) of a small number of scintillation photons. This model is supported by the change observed in aperture images when the threshold number for photon-pulses was adjusted for neutron event determination. When the threshold number of photon-pulses was set above 10 for each PMT, the ghost peaks in the aperture images and TOF spectra of powder diffraction were strongly suppressed or completely eliminated, and the intrinsic background levels of the WLS detectors were significantly reduced. Our result indicates that WLS fiber detector is a promising alternative for (3)He PSDs for neutron scattering.
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Affiliation(s)
- C L Wang
- Instrument and Source Design Division, Neutron Sciences Directorate, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA.
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Diawara Y, Currie J, Yelon A, Petrova-Koch V, Nikolov A. Temperature Dependence of Stresses and H Desorption in Porous Silicon. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-358-555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTThe mechanical stress induced in as-prepared porous silicon is generally compressive. Upon thermal annealing, the stress shows hysteresis. Isothermal annealing reveals second-order kinetic processes for both the stress and hydrogen effusion. The correlations between the changes in stress and porous silicon composition and structure are discussed.
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Poulin S, Diawara Y, Currie JF, Yelon A, Gujrathi SC, Petrova-Koch V. Preparation and Chemical Investigation of Porous Silicon. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-283-83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACTWe have begun a systematic study of the chemistry of light emitting porous Si (LEPOS) using X-ray photoemission spectroscopy and time-of-flight elastic recoil nuclear scattering. The relation of chemical composition to preparation parameters and its evolution with rapid thermal annealing in N2:H2 and in vacuum were studied. The relation between chemical and photoluminescence properties and stability was investigated. The composition of LEPOS is extremely sensitive to preparation conditions and to subsequent treatment. The concentration of C and F in addition to Si, H and O vary with thermal treatment conditions and with time after preparation. However, preparation under the cleanest possible conditions increase both reproducibility and stability.
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Durst R, Diawara Y, Benning M, Becker B, Sedov V, Wachter G, Kocsis M, Herve C, Farajado P. High-speed readout of microgap X-ray detectors. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308094798] [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: 11/10/2022] Open
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Schierbeek B, Benning M, Diawara Y, Durst R. First results of Åxiom 200, a high-speed, photon-counting X-ray area detector. Acta Crystallogr A 2006. [DOI: 10.1107/s0108767306096802] [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: 11/10/2022] Open
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Durst R, Becker B, Diawara Y, Khazins D, Medved S, Sedev V, Smith K, Thorson T, Wachter G. A new high-speed, photon-counting X-ray area detector. Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305098326] [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: 11/10/2022] Open
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