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Moret A, Madelaine L, Hanna HA, Bernard A, Pagès PB. [Complications after pulmonary segmentectomy: Impact of the surgical approach]. Rev Mal Respir 2023; 40:666-674. [PMID: 37798174 DOI: 10.1016/j.rmr.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 06/14/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Pulmonary segmentectomy is becoming increasingly widespread but remains technically challenging. The aim of this study was to evaluate the impact of the surgical approach applied on postoperative complications after pulmonary segmentectomy. METHODS All patients having undergone pulmonary segmentectomy by thoracotomy, videothoracoscopy or robot-assisted surgery from 1st January 2018 to 31st December 2021 were included. The primary endpoint was the occurrence of postoperative complications. Secondary endpoints were operative time, length of hospital stay, 30-day readmission rate, 30-day and 90-day mortality. RESULTS Two hundred and twenty-three patients were included, 30% (n=67) in the thoracotomy group, 9.4% (n=21) in the videothoracoscopy group and 60.5% (n=135) in the robot-assisted surgery group. There was no difference in the occurrence of postoperative complications according to type of approach (P=0.564), 26.9% of patients (n=60) had at least one postoperative complication. There was no significant difference between the groups in terms of operative time (P=0.385), length of hospital stay (P=0.107), 30 and 90-day mortality (P=0.124 and P=0.249, respectively). Mini-invasive surgery significantly reduced the 30-day readmission rate (P=0.049). CONCLUSION The surgical approach applied does not influence the postoperative complications of pulmonary segmentectomy.
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Affiliation(s)
- A Moret
- Service de chirurgie thoracique, CHU de Dijon, Bocage central, 14, rue Gaffarel, 21079 Dijon, France; Service de chirurgie thoracique, centre hospitalier Métropole Savoie, Chambéry, France
| | - L Madelaine
- Service de chirurgie thoracique, CHU de Dijon, Bocage central, 14, rue Gaffarel, 21079 Dijon, France
| | - H Abou Hanna
- Service de chirurgie thoracique, CHU de Dijon, Bocage central, 14, rue Gaffarel, 21079 Dijon, France
| | - A Bernard
- Service de chirurgie thoracique, CHU de Dijon, Bocage central, 14, rue Gaffarel, 21079 Dijon, France
| | - P-B Pagès
- Service de chirurgie thoracique, CHU de Dijon, Bocage central, 14, rue Gaffarel, 21079 Dijon, France; Inserm, UMR 1231, CHU de Dijon, université de Bourgogne, Dijon, France.
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Moret A, Madelaine L, Cottenet J, Sophie Mariet A, Quantin C, Bernard A, Pagès PB. [Readmissions after lung resection in France: The PMSI database]. Rev Mal Respir 2021; 38:673-680. [PMID: 34175166 DOI: 10.1016/j.rmr.2021.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Readmission within 30 days is an indicator of the quality of care, because it often reflects post-discharge care that is not optimal. The objective of this work is to measure over time on the one hand the readmission rate and on the other hand the number of hospitals with a standardized readmission rate beyond the national average. METHOD All patients with major pulmonary resection for lung cancer in France were extracted from the PMSI national database. Readmission within 30 days was defined as any new hospitalization either in the same hospital or in another establishment. RESULTS From January 1, 2005 to December 31, 2018, 110,603 patients were included. The 30-day all-cause readmissions rate was 24.9% (n=27,540). Patients after pneumonectomy had a readmission rate of 37% (n=4918) and 23% after lobectomy (n=2684) (P<0.0001). For the first period, we counted 10 hospitals with a standardized readmissions rate above the 99.8 limit and 10 hospitals above the 95% limit. For the second period, 8 hospitals had a standardized readmission rate above the 99.8% limit and 11 hospitals above the 95% limit. For the third period, 7 hospitals had a standardized readmission rate above the 99.8% limit and 6 hospitals above the 95% limit. CONCLUSION Readmissions to hospital 30 days after major lung resection for cancer in France declined little during these three periods. Measures to prevent readmissions should be introduced.
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Affiliation(s)
- A Moret
- Service de chirurgie thoracique et cardio-vasculaire, CHU Dijon, Dijon, France
| | - L Madelaine
- Service de chirurgie thoracique et cardio-vasculaire, CHU Dijon, Dijon, France; Inserm UMR 1231, université de Bourgogne, Dijon, France
| | - J Cottenet
- Departement de biostatistique, CHU Bocage, Université de Bourgogne, Dijon, France
| | - A Sophie Mariet
- Departement de biostatistique, CHU Bocage, Université de Bourgogne, Dijon, France
| | - C Quantin
- Departement de biostatistique, CHU Bocage, Université de Bourgogne, Dijon, France; Inserm, CIC 1432, Centre d'investigation clinique, hôpital de Dijon, université de Bourgogne, Dijon, France; Inserm, UVSQ, Institut Pasteur, université Paris-Saclay, Paris, France
| | - A Bernard
- Service de chirurgie thoracique et cardio-vasculaire, CHU Dijon, Dijon, France.
| | - P B Pagès
- Service de chirurgie thoracique et cardio-vasculaire, CHU Dijon, Dijon, France; Inserm UMR 1231, université de Bourgogne, Dijon, France
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Farinazzo E, Ponis G, Zelin E, Errichetti E, Stinco G, Pinzani C, Gambelli A, De Manzini N, Toffoli L, Moret A, Agozzino M, Conforti C, Di Meo N, Schincariol P, Zalaudek I. Cutaneous adverse reactions after m-RNA COVID-19 vaccine: early reports from Northeast Italy. J Eur Acad Dermatol Venereol 2021; 35:e548-e551. [PMID: 34021625 PMCID: PMC8242497 DOI: 10.1111/jdv.17343] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- E Farinazzo
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - G Ponis
- Hospital Pharmacy Unit, Cattinara Hospital, Trieste, Italy
| | - E Zelin
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - E Errichetti
- Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy
| | - G Stinco
- Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy
| | - C Pinzani
- Dermatology and Venereology, Private Practice, Udine, Italy
| | - A Gambelli
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, National Cancer Institute, Aviano, Italy
| | - N De Manzini
- UCO Chirurgia Generale, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - L Toffoli
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - A Moret
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - M Agozzino
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - C Conforti
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - N Di Meo
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - P Schincariol
- Hospital Pharmacy Unit, Cattinara Hospital, Trieste, Italy
| | - I Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
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Kün-Darbois JD, Kahn A, Khonsari RH, Gueutier A, Baldini N, Corre P, Bertin H, Provost M, Lesclous P, Ansidei CM, Majoufre C, Louvrier A, Meyer C, Ammari H, Rougeot A, Moret A, Poisbleau D, Nicot R, Marti-Flich L, Ferri J, Lutz JC, Prevost R, Kimakhe J, Poulet V, Lauwers F, Veyssière A, Bénateau H, Pham Dang N, Barthelemy I, Foletti JM, Chossegros C, Queiros C, Laure B, Paré A, de Boutray M. Significant decrease of facial cellulitis admissions during COVID-19 lockdown in France: A multicentric comparative study. J Stomatol Oral Maxillofac Surg 2021; 123:16-21. [PMID: 33596475 DOI: 10.1016/j.jormas.2021.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/11/2021] [Indexed: 01/01/2023]
Abstract
During the 2020 coronavirus pandemic, a lockdown was imposed in France during the first wave. An apparent decrease in incidence of cellulitis of odontogenic origin was noticed then. This study aimed to compare the incidence of cellulitis during this extraordinary period with the same period in 2018 and 2019, based on retrospective multicentric data. All maxillofacial surgery departments in French public hospitals were contacted. Responders were asked to include all patients admitted for the surgical drainage of a head and neck abscess of odontogenic origin during the first 2020 lockdown period, and in a similar time frame in 2018 and 2019 (control group), based on screening the French diagnostic and therapeutic classification of medical acts. We report a 44% significant nationwide decrease in the incidence of admissions for cellulitis. There were 187 patients in 2020 for 334 and 333 patients in 2018/2019 respectively. The reasons to explain this finding are hypothetical (organizational reasons leading to earlier management, patients' fear to seek for medical management, usual excess in surgical indications or concomitant decrease of non-steroidal anti-inflammatory drugs delivery). Whatever the explanation, it would be of great interest to find it out in order to improve the prevention of cellulitis.
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Affiliation(s)
- J D Kün-Darbois
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France.
| | - A Kahn
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France
| | - R H Khonsari
- Department of Maxillo-facial and Plastic surgery, Necker-Enfants Malades University Hospital, Paris, France
| | - A Gueutier
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France
| | - N Baldini
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France
| | - P Corre
- Department of Oral and Maxillo-facial surgery, Nantes University Hospital, Nantes, France
| | - H Bertin
- Department of Oral and Maxillo-facial surgery, Nantes University Hospital, Nantes, France
| | - M Provost
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France; Department of Oral surgery, Centre de soins dentaires, Nantes University Hospital, Nantes, France
| | - P Lesclous
- Department of Oral surgery, Centre de soins dentaires, Nantes University Hospital, Nantes, France
| | - C M Ansidei
- Department of Maxillo-facial surgery, Bordeaux University Hospital, Bordeaux, France
| | - C Majoufre
- Department of Maxillo-facial surgery, Bordeaux University Hospital, Bordeaux, France
| | - A Louvrier
- Department of Maxillo-facial surgery, Besançon University Hospital, Besançon, France
| | - C Meyer
- Department of Maxillo-facial surgery, Besançon University Hospital, Besançon, France
| | - H Ammari
- Department of Maxillo-facial surgery, Félix Guyon Hospital, La Réunion University Hospital, Saint-Denis, France
| | - A Rougeot
- Department of Maxillo-facial surgery, Félix Guyon Hospital, La Réunion University Hospital, Saint-Denis, France
| | - A Moret
- Department of Maxillo-facial surgery and Stomatology, Aix Hospital Centre, Aix-En-Provence, France
| | - D Poisbleau
- Department of Maxillo-facial surgery and Plastic surgery, Grenobles University Hospital, Grenoble, France
| | - R Nicot
- Department of Oral and Maxillo-facial surgery, Lille University Hospital, Lille, France
| | - L Marti-Flich
- Department of Oral and Maxillo-facial surgery, Angers University Hospital, Angers, France; Department of Oral and Maxillo-facial surgery, Lille University Hospital, Lille, France
| | - J Ferri
- Department of Oral and Maxillo-facial surgery, Lille University Hospital, Lille, France
| | - J C Lutz
- Department of Maxillo-facial surgery and Stomatology, Strasbourg University Hospital, Strasbourg, France
| | - R Prevost
- Department of Maxillo-facial surgery, La Rochelle, Ré, Aunis Hospital, La Rochelle, France
| | - J Kimakhe
- Department of Maxillo-facial surgery and Stomatology, Vendée Hospital Centre, La Roche Sur Yon, France
| | - V Poulet
- Department of Maxillo-facial surgery, Purpan University Hospital, Toulouse, France
| | - F Lauwers
- Department of Maxillo-facial surgery, Purpan University Hospital, Toulouse, France
| | - A Veyssière
- Department of Maxillo-facial and Plastic surgery, Caen University Hospital, Caen, France
| | - H Bénateau
- Department of Maxillo-facial and Plastic surgery, Caen University Hospital, Caen, France
| | - N Pham Dang
- Department of Maxillo-facial and Plastic surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - I Barthelemy
- Department of Maxillo-facial and Plastic surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - J M Foletti
- Department of Maxillo-facial surgery, Marseille University Hospital, Marseille, France
| | - C Chossegros
- Department of Maxillo-facial surgery, Marseille University Hospital, Marseille, France
| | - C Queiros
- Department of Maxillo-facial and Plastic surgery, Tours University Hospital, Tours, France
| | - B Laure
- Department of Maxillo-facial and Plastic surgery, Tours University Hospital, Tours, France
| | - A Paré
- Department of Maxillo-facial and Plastic surgery, Tours University Hospital, Tours, France
| | - M de Boutray
- Department of Maxillo-facial surgery, Gui de Chauliac University Hospital Centre, Montpellier University, Montpellier, France
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Moret A, Charton-Bain MC, Lota I, De Cuttoli JP, Revol P. [Skin shrinkage study for skin oncologic surgery. Clinical study of 79 cases]. ANN CHIR PLAST ESTH 2018; 64:157-164. [PMID: 30509688 DOI: 10.1016/j.anplas.2018.10.005] [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: 09/14/2018] [Accepted: 10/15/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Skin tumors surgery is common and well established. There is discrepancy between recommendations on macroscopic margins to apply and therapeutic decisions taken on histological margins. The purpose of this study is to examine skin shrinkage upon exeresis, then in formalin, to understand the anatomo-clinical discrepancy, which is often found. MATERIAL AND METHODS It was a prospective study, lasting a month, including patients receiving skin surgery. For each tumor, the surgeon carried out 4 margins measurements before and after exeresis ; margins measured again in histology. The evaluation criterion was the difference between preoperative, postoperative and histological margins measurement. These data was weighting according to factors linked to the patient and the tumor. RESULTS Seventy-nine tumors for 61 patients had been studied. The study showed a significant shrinkage between preoperative measurements and postoperative, from 0.4 to 0.6mm. It is correlated with no one tested factors. Significant shrinkage between 0.4 and 0.5mm was also established between preoperative and histological measurements. However, there is a significant augmentation between postoperative and histological measurements. CONCLUSION This last result could be linked to the inflammatory peri-wound skin that surgeon consider as tumoral process so exclude of his margin, while histology could show a healthy area. In front of these results, an expert committee leading a more important study could include histological margins recommendations to the actual clinical recommendations.
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Affiliation(s)
- A Moret
- Service de chirurgie maxillo-faciale, stomatologie, plastique de la face et réparatrice, hôpital d'Aix-en-Provence, avenue des Tamaris, 13616 Aix-en-Provence, France.
| | - M-C Charton-Bain
- Service d'anatomopathologie, hôpital d'Aix-en-Provence, avenue des Tamaris, 13616 Aix-en-Provence, France
| | - I Lota
- Service de dermatologie, hôpital d'Aix-en-Provence, avenue des Tamaris, 13616 Aix-en-Provence, France
| | - J-P De Cuttoli
- Service d'oto-rhino-laryngologie, hôpital d'Aix-en-Provence, avenue des Tamaris, 13616 Aix-en-Provence, France
| | - P Revol
- Service de chirurgie maxillo-faciale, stomatologie, plastique de la face et réparatrice, hôpital d'Aix-en-Provence, avenue des Tamaris, 13616 Aix-en-Provence, France
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6
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Moret A, Paré A, Sury F, Goga D, Laure B. [Posttraumatic enophthalmos correction by bone graft: Why the unpredictable results?]. ANN CHIR PLAST ESTH 2015; 60:276-83. [PMID: 25841767 DOI: 10.1016/j.anplas.2015.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 03/05/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE OF THE STUDY Posttraumatic enophthalmos cause complex cosmetic problems to fix. In order to get better results, we wanted to calculate the volume of parietal bone graft needed to be put in place, know where to place it in orbit and study soft tissues' participation. PATIENTS AND METHOD In a retrospective study, we have calculated on scanner the volume of bone and soft tissue as well as the volume and the location of the graft. We have compared, between two groups ("good result" and "insufficient result"), graft volumes, taking into account differences in bone's volume between the healthy and the traumatized orbit. A comparison of the locations of the graft was also made. We were trying to find out if these factors were involved in the quality of the result. RESULTS Twenty-nine surgeries on 24 patients were analyzed. The average bone's volume of an orbit with enophthalmos was 24.76 cm(3) for 17.12 cm(3) of soft tissue. Retro-lens distance was the most reliable measurement method of enophthalmos (P=0.001). There was a trend to a more substantial over-correction in the group "good result". A significant increase (P=0.0008) of soft tissue volumes in the traumatized orbit was found. CONCLUSION This last result is surprising. Many authors believe that there is a scar retraction of soft tissues. But Kronish et al. showed an increase of the fat density and connective tissue. This, together with the assumption of a weathering of the ligament suspension of the globe, may affect our aesthetic results. MRI, ultrasound and anatomopathological studies would allow a better understanding of the fat, muscle and ligament pathophysiologies of an orbit with enophthalmos.
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Affiliation(s)
- A Moret
- Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France.
| | - A Paré
- Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France
| | - F Sury
- Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France
| | - D Goga
- Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France
| | - B Laure
- Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France
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Aznar JA, Pérez-Alenda S, Jaca M, García-Dasí M, Vila C, Moret A, Querol F, Bonanad S. Home-delivered ultrasound monitoring for home treatment of haemarthrosis in haemophilia A. Haemophilia 2015; 21:e147-e150. [PMID: 25623041 DOI: 10.1111/hae.12622] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2014] [Indexed: 11/28/2022]
Affiliation(s)
- J A Aznar
- Hemostasis and Thrombosis Unit, La Fe University and Polytechnical Hospital, Valencia, Spain; Health Research Institute, La Fe University and Polytechnical Hospital, Valencia, Spain
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Martos L, Ferrando F, Moret A, Navarro Rosales S, Medina P, Bonet E, Mira Y, Vayá A, Cabrera N, Estellés A, Bonanad S, España F. C0123: Combined Deficiency of Protein C, Protein S and Antithrombin in Patients with Mesenteric or Portal Venous Thrombosis with or without Hepatic Cirrhosis. Thromb Res 2014. [DOI: 10.1016/s0049-3848(14)50197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Aznar JA, Moret A, Ibáñez F, Vila C, Cabrera N, Mesa E, Bonanad S. Inhibitor development after switching of FVIII concentrate in multitransfused patients with severe haemophilia A. Haemophilia 2014; 20:624-9. [DOI: 10.1111/hae.12439] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2014] [Indexed: 01/26/2023]
Affiliation(s)
- J. A. Aznar
- Hemostasis and Thrombosis Unit; La Fe University and Polytechnical Hospital; Valencia Spain
- Health Investigation Institute; La Fe University and Polytechnical Hospital; Valencia Spain
| | - A. Moret
- Hemostasis and Thrombosis Unit; La Fe University and Polytechnical Hospital; Valencia Spain
| | - F. Ibáñez
- Hematology Unit; General Hospital of Requena; Requena Spain
| | - C. Vila
- Hemostasis and Thrombosis Unit; La Fe University and Polytechnical Hospital; Valencia Spain
| | - N. Cabrera
- Hemostasis and Thrombosis Unit; La Fe University and Polytechnical Hospital; Valencia Spain
| | - E. Mesa
- Hemostasis and Thrombosis Unit; La Fe University and Polytechnical Hospital; Valencia Spain
| | - S. Bonanad
- Hemostasis and Thrombosis Unit; La Fe University and Polytechnical Hospital; Valencia Spain
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Aznar JA, García-Dasí M, Pérez-Alenda S, Marco A, Jaca M, Moret A, Querol F. Secondary prophylaxis vs. on-demand treatment to improve quality of life in severe adult haemophilia A patients: a prospective study in a single centre. Vox Sang 2013; 106:68-74. [PMID: 23802855 DOI: 10.1111/vox.12066] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 06/04/2013] [Accepted: 06/05/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Retrospective publications show a decrease in the bleeding frequency and an improvement in the quality of life (QoL) in severe adult haemophilia A (SAHA) after switching from the on-demand treatment (DT) to secondary prophylaxis (SP). But there are no prospective studies which demonstrate, using a haemophilia-specific questionnaire, an improvement in the QoL after such treatment change. The main objective of this study is to prospectively compare the QoL and the musculoskeletal assessment after switching from DT to SP in SAHA using the A36 Hemofilia-QoL(®) . As secondary objective, we compare the haemarthrosis frequency and factor VIII consumption in DT and SP during a similar period of time (12 months) after switching. MATERIALS AND METHODS We have designed a prospective study including SAHA who have been under DT and were changed to a protocol, which combines SP (biweekly administration of factor VIII) with individualized physiotherapy programme. RESULTS Twelve months after switching to SP, the QoL was significantly improved (P = 0·005). Musculoskeletal assessment of pathologic irreversible joints and joints with a reversible alteration was generally improved, although in only a few joints, this improvement was statistically significant. Haemarthrosis was strongly reduced (12·60-1·42, P < 0·001). CONCLUSIONS This prospective study has demonstrated a statistically significant improvement in the QoL after 1 year from switching patients from DT to SP. The musculoskeletal assessment after 1 year was maintained similar or slightly improved. When we compared retrospective DT and prospective SP, haemarthrosis where strongly reduced requiring a slight increase in the consumption of factor VIII concentrates.
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Affiliation(s)
- J A Aznar
- Haemostasis and Thrombosis Unit, Haematology and Haemotherapy Service, La Fe University and Polytechnic Hospital, Valencia, Spain
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11
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Cabrera N, Moret A, Caunedo P, Cid AR, Vila V, España F, Aznar JA. Comparison of a new chemiluminescent immunoassay for von Willebrand factor activity with the ristocetin cofactor-induced platelet agglutination method. Haemophilia 2013; 19:920-5. [PMID: 23730809 DOI: 10.1111/hae.12203] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2013] [Indexed: 11/28/2022]
Abstract
Measuring von Willebrand factor (VWF) activity is essential for the diagnosis of von Willebrand disease (VWD). The VWF activity is usually assessed based on measurement of the ristocetin cofactor (VWF:RCo). However, that test is technically challenging and has high intra- and inter-assay variabilities. A new automated chemiluminescent immunoassay VWF activity has recently become commercially available (HemosIL AcuStar von Willebrand Factor Ristocetin Cofactor Activity). The main objective of this study was to evaluate this new method and to compare it with the VWF:RCo assay as the reference method. We studied 91 samples, 18 healthy volunteers samples and 73 samples from patients (VWF:RCo level <50 IU dL(-1) ): 29 type 1 VWD, 13 type 2A, 5 type 2B, 5 type 2M, 3 type 2N, 5 type 3, 4 type 3 under treatment, 5 type 3 carriers and 4 samples with other pathologies. The HemosIL AcuStar VWF:RCo assay was 96% sensitive and 100% specific for detecting VWF abnormalities. The good analytical performance, and the sensitivity and specificity of HemosIL AcuStar VWF:RCo to detect VWF deficiency renders it a suitable method for VWD screening.
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Affiliation(s)
- N Cabrera
- Unidad de Hemostasia y Trombosis, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Lissitchkov T, Matysiak M, Zavilska K, Laguna P, Gercheva L, Antonov A, Moret A, Caunedo P, Aznar JA, Woodward MK, Páez A. Head-to-head comparison of the pharmacokinetic profiles of a high-purity factor IX concentrate (AlphaNine®) and a recombinant factor IX (BeneFIX®) in patients with severe haemophilia B. Haemophilia 2013; 19:674-8. [DOI: 10.1111/hae.12148] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - M. Matysiak
- Department of Hematology and Oncology; Medical University; Warsaw; Poland
| | - K. Zavilska
- Department of Hematology and Internal Medicine; J. Strus Hospital; Poznan; Poland
| | - P. Laguna
- Department of Hematology and Oncology; Medical University; Warsaw; Poland
| | - L. Gercheva
- Department of Hematology; Sveta Marina University Hospital; Varna; Bulgaria
| | - A. Antonov
- Department of Hematology; University Hospital; Medical University; Pleven; Bulgaria
| | - A. Moret
- Department of Hemostasis and Thrombosis; La Fe University Hospital; Valencia; Spain
| | - P. Caunedo
- Department of Hemostasis and Thrombosis; La Fe University Hospital; Valencia; Spain
| | - J. A. Aznar
- Department of Hemostasis and Thrombosis; La Fe University Hospital; Valencia; Spain
| | - M. K. Woodward
- Department of Clinical Trials and Pharmacovigilance; Instituto Grifols S.A.; Parets del Vallès; Barcelona; Spain
| | - A. Páez
- Department of Clinical Trials and Pharmacovigilance; Instituto Grifols S.A.; Parets del Vallès; Barcelona; Spain
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Vila V, Aznar JA, Moret A, Marco A, Navarro S, Vila C, España F. Assessment of the thrombin generation assay in haemophilia: Comparative study between fresh and frozen platelet-rich plasma. Haemophilia 2012; 19:318-21. [DOI: 10.1111/hae.12044] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2012] [Indexed: 11/27/2022]
Affiliation(s)
- V. Vila
- Centro de Investigación; Hospital Universitario y Politécnico La Fe; Valencia; Spain
| | - J. A. Aznar
- Unidad de Hemostasia y Trombosis; Hospital Universitario y Politécnico La Fe; Valencia; Spain
| | - A. Moret
- Unidad de Hemostasia y Trombosis; Hospital Universitario y Politécnico La Fe; Valencia; Spain
| | - A. Marco
- Unidad de Hemostasia y Trombosis; Hospital Universitario y Politécnico La Fe; Valencia; Spain
| | - S. Navarro
- Centro de Investigación; Hospital Universitario y Politécnico La Fe; Valencia; Spain
| | - C. Vila
- Unidad de Hemostasia y Trombosis; Hospital Universitario y Politécnico La Fe; Valencia; Spain
| | - F. España
- Centro de Investigación; Hospital Universitario y Politécnico La Fe; Valencia; Spain
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Grancha S, Ortiz AM, Marañón C, Hampel K, Moret A, Zimmermann B, Jorquera JI, Aznar JA. Kinetics of the interaction between anti-FVIII antibodies and FVIII from therapeutic concentrates, with and without von Willebrand factor, assessed by surface plasmon resonance. Haemophilia 2012; 18:982-9. [DOI: 10.1111/j.1365-2516.2012.02858.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2012] [Indexed: 11/27/2022]
Affiliation(s)
- S. Grancha
- R&D Area; Instituto Grifols S.A; Barcelona; Spain
| | - A. M. Ortiz
- R&D Area; Instituto Grifols S.A; Barcelona; Spain
| | - C. Marañón
- R&D Area; Instituto Grifols S.A; Barcelona; Spain
| | - K. Hampel
- Biaffin GmbH & Co KG; Kassel; Germany
| | - A. Moret
- Hemostasis and Thrombosis Unit; Hospital Universitario La Fe; Valencia; Spain
| | | | | | - J. A. Aznar
- Hemostasis and Thrombosis Unit; Hospital Universitario La Fe; Valencia; Spain
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Aznar JA, Marco A, Jiménez-Yuste V, Fernández-Fontecha E, Pérez R, Soto I, Parra R, Moreno M, Mingot ME, Moret A. Is on-demand treatment effective in patients with severe haemophilia? Haemophilia 2012; 18:738-42. [PMID: 22537601 DOI: 10.1111/j.1365-2516.2012.02806.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
On-demand therapy enables stopping haemorrhages rapidly, reducing joint pain and restoring joint mobility, but does not prevent the beginning and subsequent development of haemophilic arthropathy. The main objective of this study was to identify the clinical and orthopaedic status of severe haemophilic patients with bleeding phenotype receiving on-demand treatment in Spain. We conducted an epidemiological, observational, retrospective study, recruiting 167 patients from 36 centres (92% of them with haemophilia A), median age at enrolment of 35 years. Forty per cent of the patients received a combination of on-demand and short-term prophylaxis regimen; the rest was under on-demand treatment. One hundred and forty-five patients (87%) reported at least one bleeding episode and 22 (13%) of the biologically severe patients had no bleeding phenotype. Seventy-one per cent of the studied population presented established haemophilic arthropathy, reaching 80% if we exclude patients without bleeding phenotype. Forty-three per cent of these patients had one or two joints affected, 28% of them had three or four affected joints, 20% reported five or six affected joints and 9% more than six injured joints. An increase in established haemophilic arthropathy with age was observed. Forty-six patients underwent orthopaedic surgery at least once. These data show that on-demand therapy is not effective in preventing the development of haemophilic arthropathy in severe haemophilic population with bleeding phenotype. Therefore, we suggest that the optimal treatment in these patients should be based on prophylaxis. We recommend analysing the reasons for ending prophylaxis, in case its reinstatement should be necessary.
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Affiliation(s)
- J A Aznar
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe, Valencia.
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Moret A, Fabregat J, Valls P, Calatayud S. [The Proseal laryngeal mask during anesthesia in a patient with Steinert myotonic dystrophy]. Rev Esp Anestesiol Reanim 2006; 53:452-3. [PMID: 17066867] [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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Planelles D, Nagore E, Moret A, Botella-Estrada R, Vila E, Guillén C, Montoro JA. HLA class II polymorphisms in Spanish melanoma patients: homozygosity for HLA-DQA1 locus can be a potential melanoma risk factor. Br J Dermatol 2006; 154:261-6. [PMID: 16433795 DOI: 10.1111/j.1365-2133.2005.06896.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 11/30/2022]
Abstract
BACKGROUND The association of melanoma with HLA class II loci is under extensive debate. Different investigators have found discrepant results due to, at least in part, sample size, patient series heterogeneity, choice of control population and differences in the techniques employed for the detection of HLA antigens and alleles. OBJECTIVES This study was designed to analyse the possible association of melanoma with HLA class II loci with regard to different clinic pathological factors and to investigate other risk factors for melanoma susceptibility, such as HLA homozygosity. PATIENTS AND METHODS HLA-DRB1, -DQA1 and -DQB1 genotyping was performed for 117 eastern Spanish patients presenting with primary melanoma. RESULTS Although there were no significant alterations in the phenotypic frequencies of HLA-DQA1, -DQB1 or -DRB1 alleles in any subgroup of patients when compared with controls, patients exhibited a statistically significant increase in HLA-DQA1 homozygosity rate. This DQA1 homozygosity-specific association was particularly dependent on some features in melanoma patients such as light hair colour, skin type I or II, early age at diagnosis, absence of atypical naevi, or abscence of atypical naevus syndrome phenotype (aetiological fractions about 10-20%). Analysis of homozygosity for single DQA1 alleles showed an increased homozygosity rate for DQA1*0505 and DQA1*0301 in comparison with controls. These DQA1 alleles are in strong linkage disequilibrium with DQB1*0301 in white populations, and DQB1*0301 homozygous individuals were significantly increased in red in or fair-haired patients (relative risk 5.65). CONCLUSIONS Our results indicate that the contribution of HLA class II alleles to primary melanoma incidence is not significant in the Spanish population. However, homozygosity for the HLA-DQA1 locus (and, perhaps, for the HLA-DQB1*0301 allele) might be considered a potential risk factor for developing melanoma depending on the person's genetic background and, perhaps, on certain environmental conditions.
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Affiliation(s)
- D Planelles
- Laboratory of Histocompatibility-Molecular Biology, Centro de Transfusión de la Comunidad Valenciana, Avenida del Cid, 65-A, 46014-Valencia, Spain.
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López-Carbonell M, Moret A, Nadal M. Changes in Cell Ultrastructure and Zeatin Riboside Concentrations in Hedera helix, Pelargonium zonale, Prunus avium, and Rubus ulmifolius Leaves Infected by Fungi. Plant Dis 1998; 82:914-918. [PMID: 30856921 DOI: 10.1094/pdis.1998.82.8.914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Ultrastructural alterations in epidermal and mesophyll cells and variations in endogenous zeatin riboside (ZR) concentrations were studied in leaves of Hedera helix, Pelargonium zonale, Pru-nus avium, and Rubus ulmifolius infected by Colletotrichum trichellum, Puccinia pelargonii-zonalis, Cercospora circumscissa, and Phragmidium violaceum, respectively. Infected tissues showed a marked increase in vesicles, myelin-like structures, and electron-dense bodies associated with plasma membranes. The main changes to the chloroplast included thylakoid swelling and disruption of the chloroplast envelope. The ZR content of the green islands was always higher than that of the yellow, senescent parts of the same leaves; the highest levels of ZR were observed in the green areas of infected Prunus avium (462.2 pmol g-1 fresh weight [FW]) and Rubus ulmifolius (441.6 pmol g-1 FW), followed by Pelargonium zonale (263.8 pmol g-1 FW) and Hedera helix (219.8 pmol g-1 FW); the yellow zones of the same leaves had lower ZR contents (78.3, 73.9, 73.6, and 18.1 pmol g-1 FW, respectively). The green islands had almost the same ZR content as the controls (green healthy leaves). These results suggest a relationship between ultrastructural alterations and ZR content of these plant species (blackberry, cherry, English ivy, geranium) in reacting to this type of biotic stress and could confirm the role of cytokinins as senescence-delaying hormones.
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Affiliation(s)
| | - A Moret
- Associate Professors, Unit of Plant Physiology, Faculty of Biology, University of Barcelona, Avda. Diagonal 645, E-08028 Barcelona, Spain
| | - M Nadal
- Associate Professors, Unit of Plant Physiology, Faculty of Biology, University of Barcelona, Avda. Diagonal 645, E-08028 Barcelona, Spain
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Baumann J, Moret A. RECHERCHES SUR L’ÉTAT BIOLOGIQUE DU BOUT CENTRAL D'UN RAMEAU DU NERF FACIAL, SECTIONNÉ EXPÉRIMENTALEMENT, DANS DIVERSES CONDITIONS, CHEZ LE COBAYE. Tissue Cell 1947. [DOI: 10.1159/000140262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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