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Carsin A, Cornus M, Loundou A, Thiebault G, Vié Le Sage F, Dubus JC. Vaccines and atopic/allergic children: A survey among private paediatricians. Clin Exp Allergy 2018; 48:1235-1237. [DOI: 10.1111/cea.13184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- A. Carsin
- Department of Pediatric Pulmonology and Allergy; Timone Hospital; Marseille France
| | - M. Cornus
- Department of Pediatric Pulmonology and Allergy; Timone Hospital; Marseille France
| | - A. Loundou
- Public Health Department; Aix-Marseille University; Marseille France
| | - G. Thiebault
- Association Française de Pédiatrie Ambulatoire (AFPA); Talence France
| | - F. Vié Le Sage
- Association Française de Pédiatrie Ambulatoire (AFPA); Talence France
| | - J.-C. Dubus
- Department of Pediatric Pulmonology and Allergy; Timone Hospital; Marseille France
- IHU Méditerranée Infection; Aix-Marseille University; IRD 198; MEPHI; Marseille France
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2
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Lelong AG, Mallet S, Le Treut C, Dubus JC, Carsin A, Bosdure E. [Pseudomonas aeruginosa in post-piercing perichondritis: Two case reports]. Arch Pediatr 2017; 24:1235-1240. [PMID: 29174111 DOI: 10.1016/j.arcped.2017.09.007] [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: 12/08/2016] [Revised: 09/11/2017] [Accepted: 09/22/2017] [Indexed: 10/18/2022]
Abstract
The frequency of body piercing has increased in France over the past few years, particularly among teenagers. Piercing can be performed at different sites on the body, especially in the cartilage of the ears. We relate two cases of Pseudomonas aeruginosa chondritis. A 10-year retrospective study at the Marseille University Hospital found no additional pediatric cases. These infectious complications can sometimes be necrotizing. It is therefore important to inform the medical staff on the hygiene measures that need to be respected and the patients on the treatment to follow after the piercing as well as the signs to watch for, possibly indicating chondritis. The esthetic consequences depend on early diagnosis.
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Affiliation(s)
- A-G Lelong
- Unité de médecin infantile, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - S Mallet
- Service de dermatologie, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - C Le Treut
- Fédération d'ORL pédiatrique, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - J-C Dubus
- Unité de médecin infantile, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - A Carsin
- Unité de médecin infantile, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - E Bosdure
- Unité de médecin infantile, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
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Carsin A, Romain T, Ranque S, Reynaud‐Gaubert M, Dubus J, Mège J, Vitte J. Aspergillus fumigatus in cystic fibrosis: An update on immune interactions and molecular diagnostics in allergic bronchopulmonary aspergillosis. Allergy 2017; 72:1632-1642. [PMID: 28513848 DOI: 10.1111/all.13204] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 05/13/2017] [Indexed: 12/13/2022]
Abstract
A wide spectrum of pathological conditions may result from the interaction of Aspergillus fumigatus and the immune system of its human host. Allergic bronchopulmonary aspergillosis is one of the most severe A. fumigatus-related diseases due to possible evolution toward pleuropulmonary fibrosis and respiratory failure. Allergic bronchopulmonary aspergillosis occurs almost exclusively in cystic fibrosis or asthmatic patients. An estimated 8%-10% of patients with cystic fibrosis experience this condition. The diagnosis of allergic bronchopulmonary aspergillosis relies on criteria first established in 1977. Progress in the understanding of host-pathogen interactions in A. fumigatus and patients with cystic fibrosis and the ongoing validation of novel laboratory tools concur to update and improve the diagnosis of allergic bronchopulmonary aspergillosis.
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Affiliation(s)
- A. Carsin
- Aix‐Marseille Univ APHM Hôpital Timone Enfants Pneumo‐pédiatrie Centre de Ressources et de Compétences en Mucoviscidose Marseille France
- Aix‐Marseille Univ INSERM UMR 1067 CNRS UMR 7333 Marseille France
| | - T. Romain
- Aix‐Marseille Univ APHM Hôpital de La Conception Laboratoire d'Immunologie Marseille France
| | - S. Ranque
- Aix‐Marseille Univ APHM Hôpital Timone Laboratoire de Parasitologie Marseille France
- Aix‐Marseille Univ INSERM U1095 CNRS U7278 IRD 198 URMITE Marseille France
| | - M. Reynaud‐Gaubert
- Aix‐Marseille Univ INSERM U1095 CNRS U7278 IRD 198 URMITE Marseille France
- Aix‐Marseille Univ APHM Hôpital Nord Centre de Ressources et de Compétences en Mucoviscidose Marseille France
| | - J.‐C. Dubus
- Aix‐Marseille Univ APHM Hôpital Timone Enfants Pneumo‐pédiatrie Centre de Ressources et de Compétences en Mucoviscidose Marseille France
- Aix‐Marseille Univ INSERM U1095 CNRS U7278 IRD 198 URMITE Marseille France
| | - J.‐L. Mège
- Aix‐Marseille Univ APHM Hôpital de La Conception Laboratoire d'Immunologie Marseille France
- Aix‐Marseille Univ INSERM U1095 CNRS U7278 IRD 198 URMITE Marseille France
| | - J. Vitte
- Aix‐Marseille Univ INSERM UMR 1067 CNRS UMR 7333 Marseille France
- Aix‐Marseille Univ APHM Hôpital de La Conception Laboratoire d'Immunologie Marseille France
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Sonneville R, Ruimy R, Benzonana N, Riffaud L, Carsin A, Tadié JM, Piau C, Revest M, Tattevin P. An update on bacterial brain abscess in immunocompetent patients. Clin Microbiol Infect 2017; 23:614-620. [PMID: 28501669 DOI: 10.1016/j.cmi.2017.05.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [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: 03/24/2017] [Revised: 04/29/2017] [Accepted: 05/01/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND A brain abscess is a focal infection of the brain that begins as a localized area of cerebritis. In immunocompetent patients, bacteria are responsible for >95% of brain abscesses, and enter the brain either through contiguous spread following otitis, sinusitis, neurosurgery, or cranial trauma, or through haematogenous dissemination. AIMS To identify recent advances in the field. SOURCES We searched Medline and Embase for articles published during years 2012-2016, with the keywords 'brain' and 'abscess'. CONTENT The triad of headache, fever and focal neurological deficit is complete in ∼20% of patients on admission. Brain imaging with contrast-preferentially magnetic resonance imaging-is the reference standard for diagnosis, and should be followed by stereotactic aspiration of at least one lesion, before the start of any antimicrobials. Efforts should be made for optimal management of brain abscess samples, for reliable microbiological documentation. Empirical treatment should cover oral streptococci (including milleri group), methicillin-susceptible staphylococci, anaerobes and Enterobacteriaceae. As brain abscesses are frequently polymicrobial, de-escalation based on microbiological results is safe only when aspiration samples have been processed optimally, or when primary diagnosis is endocarditis. Otherwise, many experts advocate for anaerobes coverage even with no documentation, given the sub-optimal sensitivity of current techniques. A 6-week combination of third-generation cephalosporin and metronidazole will cure most cases of community-acquired brain abscess in immunocompetent patients. IMPLICATIONS Significant advances in brain imaging, minimally invasive neurosurgery, molecular biology and antibacterial agents have dramatically improved the prognosis of brain abscess in immunocompetent patients over the last decades.
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Affiliation(s)
- R Sonneville
- Intensive Care Medicine and Infectious Diseases, AP-HP, Bichat Hospital, and UMR1148, LVTS, Sorbonne Paris Cité, INSERM/Paris Diderot University, Paris, France
| | - R Ruimy
- Microbiology, Archet Hospital, Nice Côte d'Azur University, Nice, France
| | - N Benzonana
- Infectious Diseases and Clinical Microbiology, Dr Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - L Riffaud
- Neurosurgery, Pontchaillou University Hospital, Rennes, France
| | - A Carsin
- Radiology, Maison Blanche University Hospital, Reims, France
| | - J-M Tadié
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - C Piau
- Microbiology, Pontchaillou University Hospital, Rennes, France
| | - M Revest
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - P Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France.
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Nattes E, Lejeune S, Carsin A, Borie R, Gibertini I, Balinotti J, Nathan N, Marchand-Adam S, Thumerelle C, Fauroux B, Houdouin V, Delestrain C, Louha M, Couderc R, De Becdelievre A, Fanen P, Funalot B, Crestani B, Deschildre A, Dubus JC, Epaud R. Hétérogénéité de l’atteinte respiratoire associée aux mutations de NK2 homeobox 1. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Arnoux V, Carsin A, Bosdure E, Retornaz K, Chabrol B, Gorincour G, Mancini J, Dabadie A, Dubus JC. Radiographie de thorax et bronchiolite aiguë : des indications en diminution ? Arch Pediatr 2017; 24:10-16. [DOI: 10.1016/j.arcped.2016.10.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 09/23/2016] [Accepted: 10/21/2016] [Indexed: 11/29/2022]
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Orfanos S, Carsin A, Baravalle M, Dubus JC. [Health care providers' knowledge and abilities to use inhalation devices and spacers]. Rev Mal Respir 2016; 34:561-570. [PMID: 27863828 DOI: 10.1016/j.rmr.2016.08.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/17/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Inhaled therapy is the mainstay of asthma treatment due to its local and rapid action. However, its efficiency relies on the teaching of a good inhalation technique by health care providers. We assessed health care providers' knowledge and practical skills in the use of inhalation devices. METHODS An observational multicenter study was conducted in the pulmonology and paediatric wards in Marseille. The departments' common practices, theoretical knowledge and practical skills were assessed through a questionnaire and a demonstration using a spacer device. RESULTS Forty health care providers were interviewed (9 attending physicians, 14 residents, 16 nurses and 1 physiotherapist), in 8 different pulmonology and paediatric wards. A total of 42.5% reported previous training in inhalation device technique. When evaluating theoretical knowledge, we found a mean of 54% correct answers. Attending physicians did significantly better than residents and nurses. With regard to practical skills, we found a mean of 1.12 failed steps out of 7. Here again attending physicians did significantly better than residents and nurses. CONCLUSION Based on the results of our study, we recommend that attending physicians provide training of inhalation technique to nurses and residents, as they did significantly better theoretically and practically.
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Affiliation(s)
- S Orfanos
- Faculté de médecine, Aix Marseille université, 13000 Marseille, France.
| | - A Carsin
- Unité de pneumologie pédiatrique, CHU Timone Enfants, Assistance publique-Hôpitaux de Marseille, 13000 Marseille, France
| | - M Baravalle
- Unité de pneumologie pédiatrique, CHU Timone Enfants, Assistance publique-Hôpitaux de Marseille, 13000 Marseille, France
| | - J-C Dubus
- Unité de pneumologie pédiatrique, CHU Timone Enfants, Assistance publique-Hôpitaux de Marseille, 13000 Marseille, France
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Lejeune S, Carsin A, Hadchouel A, Blanchon S, Mordacq C, Thumerelle C, Deschildre A. Pneumo Pédiatrie : l'asthme de l'enfant. Revue des Maladies Respiratoires Actualités 2016; 8:S43-S53. [PMID: 32288907 PMCID: PMC7140291 DOI: 10.1016/s1877-1203(17)30010-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Lejeune
- CHU de Lille, Unité de pneumologie-allergologie pédiatrique, pôle enfant, hôpital Jeanne de Flandre, 59000 Lille. France
| | - A. Carsin
- Unité de Pneumologie et Allergologie Pédiatrique, Hôpital Timone Enfants, 264, rue Saint Pierre, 13385 Marseille, France
| | - A. Hadchouel
- Service de Pneumologie et Allergologie Pédiatriques, Hôpital Universitaire Necker-Enfants Malades, 149 rue de Sèvres, 75743 Paris Cedex 15, France
| | - S. Blanchon
- Service de Pneumologie et Allergologie Pédiatriques, hôpital des Enfants, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France
| | - C. Mordacq
- CHU de Lille, Unité de pneumologie-allergologie pédiatrique, pôle enfant, hôpital Jeanne de Flandre, 59000 Lille. France
| | - C. Thumerelle
- CHU de Lille, Unité de pneumologie-allergologie pédiatrique, pôle enfant, hôpital Jeanne de Flandre, 59000 Lille. France
| | - A. Deschildre
- CHU de Lille, Unité de pneumologie-allergologie pédiatrique, pôle enfant, hôpital Jeanne de Flandre, 59000 Lille. France
- Auteur correspondant
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Vitte J, Romain T, Carsin A, Gouitaa M, Stremler-Le Bel N, Baravalle-Einaudi M, Cleach I, Reynaud-Gaubert M, Dubus JC, Mège JL. Aspergillus fumigatus components distinguish IgE but not IgG4 profiles between fungal sensitization and allergic broncho-pulmonary aspergillosis. Allergy 2016; 71:1640-1643. [PMID: 27542151 DOI: 10.1111/all.13031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 08/17/2016] [Indexed: 01/11/2023]
Abstract
Aspergillus fumigatus is the causative agent of allergic broncho-pulmonary aspergillosis. Prompt and accurate diagnosis may be difficult to achieve with current clinical and laboratory scores, which do not include immune responses to recombinant A. fumigatus allergens. We measured specific immunoglobulin E and G4 directed to recombinant A. fumigatus allergens in 55 cystic fibrosis patients without allergic broncho-pulmonary aspergillosis but sensitized to A. fumigatus and in nine patients with allergic broncho-pulmonary aspergillosis (two with cystic fibrosis and seven with asthma). IgG4 responses to recombinant A. fumigatus allergens were detected in all patients, but neither prevalence nor levels were different between the two patient groups. On the other hand, both prevalence and levels of IgE responses to Asp f 3, Asp f 4, and Asp f 6 helped distinguish allergic broncho-pulmonary aspergillosis from A. fumigatus sensitization with good negative and positive predictive values.
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Affiliation(s)
- J. Vitte
- Laboratoire d'Immunologie; Hôpital de La Conception; APHM Assistance Publique Hôpitaux de Marseille; Marseille France
- Faculté de Médecine de Marseille; Aix-Marseille University; Marseille France
| | - T. Romain
- Laboratoire d'Immunologie; Hôpital de La Conception; APHM Assistance Publique Hôpitaux de Marseille; Marseille France
| | - A. Carsin
- Faculté de Médecine de Marseille; Aix-Marseille University; Marseille France
- Centre de Ressources et de Compétences en Mucoviscidose; Hôpital Timone Enfants; APHM Assistance Publique Hôpitaux de Marseille; Marseille France
| | - M. Gouitaa
- Service de Pneumologie; Hôpital Nord; APHM Assistance Publique Hôpitaux de Marseille; Marseille France
| | - N. Stremler-Le Bel
- Centre de Ressources et de Compétences en Mucoviscidose; Hôpital Timone Enfants; APHM Assistance Publique Hôpitaux de Marseille; Marseille France
| | - M. Baravalle-Einaudi
- Centre de Ressources et de Compétences en Mucoviscidose; Hôpital Timone Enfants; APHM Assistance Publique Hôpitaux de Marseille; Marseille France
| | - I. Cleach
- Laboratoire d'Immunologie; Hôpital de La Conception; APHM Assistance Publique Hôpitaux de Marseille; Marseille France
| | - M. Reynaud-Gaubert
- Faculté de Médecine de Marseille; Aix-Marseille University; Marseille France
- Centre de Ressources et de Compétences en Mucoviscidose; Hôpital Nord; APHM Assistance Publique Hôpitaux de Marseille; Marseille France
| | - J.-C. Dubus
- Faculté de Médecine de Marseille; Aix-Marseille University; Marseille France
- Centre de Ressources et de Compétences en Mucoviscidose; Hôpital Timone Enfants; APHM Assistance Publique Hôpitaux de Marseille; Marseille France
| | - J.-L. Mège
- Laboratoire d'Immunologie; Hôpital de La Conception; APHM Assistance Publique Hôpitaux de Marseille; Marseille France
- Faculté de Médecine de Marseille; Aix-Marseille University; Marseille France
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Banti T, Carsin A, Chabrol B, Reynaud R, Fabre A. [Infant food diversification. Assessment of practices in relation to French recommendations in pediatricians and pediatric residents in southern France]. Arch Pediatr 2016; 23:1018-1027. [PMID: 27642151 DOI: 10.1016/j.arcped.2016.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 07/05/2016] [Accepted: 07/07/2016] [Indexed: 11/28/2022]
Abstract
Infant food diversification has undergone a rapid succession of good practice recommendations in France, but there has been no assessment of pediatrician practices on food diversification. OBJECTIVE To assess the practices of pediatricians in relation to current recommendations of the French Society of Pediatrics on infant food diversification. METHODS This was an observational study conducted from 1 November 2014 to 31 March 2015. The study population consisted of 97 pediatricians in the Var department and 84 pediatric residents assigned to the University of Aix-Marseille in France. A questionnaire was sent by email or post to determine physician characteristics, food diversification methods in healthy children and those at atopic risk, and how the pediatric consultation was conducted. The expected answers were based on the most recent recommendations of the French Society of Pediatrics published in 2008, updated from 2003. In summary, breastfeeding is recommended up to 6 months. Food diversification can be started between 4 and 6 months in children with no allergy risk. Gluten, honey, legumes and cow's milk are introduced between 4 and 7 months, after 12 months and after 36 months, respectively. In atopic children, food diversification is delayed until after 6 months and the most allergenic foods (nuts, exotic fruits, peanuts, and shellfish) are introduced after the age of 12 months. RESULTS Eighty-four responses were obtained (51%): 50 pediatricians and 34 pediatric residents. Sixteen items were classified depending on whether or not an update after 2003 existed. Over 80% of the physicians responded as recommended for the recently updated items for the age of introduction of "solid food in healthy children", "gluten", "cow's milk protein hydrolysates", and "the time until introduction of cow's milk in the atopic child". At best, 65% of physicians responded in accordance with recommendations for items without a recent update, age of introduction of "cow's milk", "milk desserts", "animal proteins", "fats", "vegetables", "use of a hypoallergenic infant formula", and "breastfeeding extension with atopic child". Pediatric residents had the same responses as pediatricians. Seventy-two physicians did not consider the allergenic status of the children to delay the introduction of the most allergenic foods. The lack of complete updating the introduction of solid foods schedule could explain the differences between pediatrician practices and recommendations. Moreover, old recommendations on allergenic food eviction are still available. CONCLUSION Pediatricians and pediatric residents partially applied the current recommendations on the introduction of solid food.
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Affiliation(s)
- T Banti
- Unité de pédiatrie multidisciplinaire, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - A Carsin
- Unité de pneumologie et médecine infantile, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - B Chabrol
- Unité de pneumologie et médecine infantile, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - R Reynaud
- Unité de pédiatrie multidisciplinaire, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - A Fabre
- Unité de pédiatrie multidisciplinaire, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Banti T, Carsin A, Chabrol B, Fabre A. Diversification alimentaire : l’information disponible sur Internet est-elle en accord avec les recommandations des sociétés savantes ? Arch Pediatr 2016; 23:706-13. [DOI: 10.1016/j.arcped.2016.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 04/25/2016] [Indexed: 11/25/2022]
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12
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Dubus JC, Gachelin E, Baravalle-Einaudi M, Carsin A, Vecellio L. [Asthma: the jungle of holding chambers]. Arch Pediatr 2016; 22:157-8. [PMID: 26112569 DOI: 10.1016/s0929-693x(15)30078-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J-C Dubus
- Unité de pneumo-allergologie pédiatrique, CHU Timone-Enfants, 13385 Marseille Cedex 5, France.
| | - E Gachelin
- Service de pédiatrie, CHU Félix Guyon, Saint Denis, France
| | - M Baravalle-Einaudi
- Unité de pneumo-allergologie pédiatrique, CHU Timone-Enfants, 13385 Marseille Cedex 5, France
| | - A Carsin
- Unité de pneumo-allergologie pédiatrique, CHU Timone-Enfants, 13385 Marseille Cedex 5, France
| | - L Vecellio
- EA6305, CEPR, Faculté de médecine, Université François Rabelais, et DTF-Aerodrug, Faculté de Médecine, Tours, France
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Carsin A, Oudyi M, Dubus JC, De Blic J, De Lagausie P, Chanez P, Gras D. Effet in vitro des corticoïdes inhalés sur l’activation viro-induite des cellules épithéliales bronchiques d’enfants asthmatiques. Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2014.04.011] [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: 11/17/2022]
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Stremler-Le Bel N, Carsin A, Sauvaget E. Complications respiratoires de l’enfant polyhandicapé et leur prise en charge. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71503-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tissot C, Carsin A, Freymond N, Pacheco Y, Devouassoux G. Sarcoidosis complicating anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody biotherapy. Eur Respir J 2012; 41:246-7. [DOI: 10.1183/09031936.00107912] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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16
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Carsin A, Bienvenu J, Pacheco Y, Devouassoux G. [Physiopathology of aspirin intolerant asthma]. Rev Mal Respir 2012; 29:118-27. [PMID: 22405107 DOI: 10.1016/j.rmr.2011.11.014] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 06/01/2011] [Indexed: 12/30/2022]
Abstract
Aspirin-exacerbated respiratory disease (AERD) refers to the development of bronchoconstriction in individuals with asthma following the ingestion of aspirin. AERD affects up to 20 % of adults with asthma. At present, no reliable in vitro test is available to confirm the diagnosis. The confirmation of the diagnosis of AERD therefore depends on the response to challenge testing with aspirin. The pathogenesis of AERD is linked to abnormalities in arachidonic acid metabolism. Prior to exposure to aspirin, respiratory mucosal inflammation is the result of a cell infiltration, an overproduction of leukotrienes, prostaglandins D2, 5-oxo-eicosatetraenoic acid and an underproduction of lipoxins. After aspirin ingestion, patients with AERD synthesize excessive amounts of cysteinyl leukotrienes and prostaglandin metabolites involved in bronchoconstriction. New hypotheses concerning AERD pathogenesis have been added to the initial cyclooxygenase theory. These propose that AERD may be linked to the complement system, adenosine metabolism or angiotensin converting enzyme gene and IgE receptor gene polymorphisms.
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Affiliation(s)
- A Carsin
- Service de pneumologie, centre hospitalier Lyon-Sud, Lyon, France
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Carsin A, Pham-Thi N. [Asthmatic exacerbations: specific features in children]. Rev Mal Respir 2011; 28:1322-8. [PMID: 22152939 PMCID: PMC7135330 DOI: 10.1016/j.rmr.2011.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 03/25/2011] [Indexed: 11/29/2022]
Abstract
L’asthme aurait déjà concerné plus de 10 % des enfants âgés de dix ans. Ce constat mérite une discussion pneumopédiatrique à part entière. Malgré des similitudes entre l’asthme de l’adulte et celui de l’enfant, la population pédiatrique présente certaines spécificités notamment concernant les exacerbations. L’asthme du nourrisson est une entité particulière dont la définition a bénéficié récemment d’une mise à jour officielle. Les étiologies d’exacerbations asthmatiques restent les infections, avec en tête les virus dont le typage joue un rôle pronostique. L’environnement intérieur et extérieur peut aggraver l’asthme, notamment par de fortes concentrations de polluants atmosphériques. Les nutriments semblent jouer un rôle pronostique par le biais de la vitamine D ou de la présence d’allergie alimentaire. La recherche de facteurs prédictifs ou de marqueurs inflammatoires de l’asthme est la clé de voûte pour la maîtrise de ces exacerbations, mais les techniques actuelles ne sont pas encore totalement performantes comme la mesure de l’oxyde nitrique exhalé (eNO), l’étude des crachats/exhalas ou encore de simples questionnaires. La prise en charge précoce et continue avec l’éducation thérapeutique des enfants et de leur famille demeure un outil efficace en termes de prévention de rechute des exacerbations.
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Affiliation(s)
- A Carsin
- Unité de pneumologie pédiatrique, CHU Timone-Enfants, 264 rue Saint-Pierre, Marseille cedex 05, France
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Carsin A, Mely L, Chrestian MA, Devred P, de Lagausie P, Guys JM, Dubus JC. Association of three different congenital malformations in a same pulmonary lobe in a 5-year-old girl. Pediatr Pulmonol 2010; 45:832-5. [PMID: 20652995 DOI: 10.1002/ppul.21068] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report the case of a 5-year-old girl with persistent chest X-ray abnormalities following an episode of pneumonia who has a complex congenital pulmonary malformation comprising of a congenital pulmonary airway malformation, an intralobar sequestration and two bronchogenic cysts, all present within the same lobe. The observation suggests a common embryological origin of these malformations.
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Affiliation(s)
- A Carsin
- Unité de Médecine Infantile, CHU Timone-Enfants and CNRS URMITE 6234, Marseille Cedex 05, France
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Forler J, Carsin A, Arlaud K, Bosdure E, Viard L, Paut O, Camboulives J, Dubus JC. [Respiratory complications of accidental drownings in children]. Arch Pediatr 2009; 17:14-8. [PMID: 19896350 DOI: 10.1016/j.arcped.2009.09.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 09/06/2009] [Accepted: 09/30/2009] [Indexed: 11/30/2022]
Abstract
Accidental drownings are severe and sometimes mortal events in children. Our study aims to better clarify the epidemiology and the respiratory complications of these accidents in our hospital. We led a retrospective study over 10 years concerning the children hospitalized for accidental drowning in our hospital centre. Age at the moment of the accident, sex, history of accident, hospitable care, thoracic imaging and neurological outcome of the children were studied. In total, 83 children were hospitalized (5 years on average, 70% being boys). The drowning especially took place in fresh water (71%), particularly in swimming pools (51.8%). Stages III and IV of drowning concerned 40.9% of the population. The coverage was the following one: admittance in ICU 57.8%, mechanical ventilation 34.9%, oxygen therapy 16.9%, antibiotics 87.9%. A normal chest x-ray was present in 45.7% of the cases. Drowning in fresh water, especially in contaminated fresh water (canal, WC, etc.), induced atelectasis (10.8%), whereas drowning in sea water induced diffuse infiltrates (8.4%). Aspiration pneumonia (33.7%) was present in both cases and a pulmonary oedema (6%) was only noticed during stage IV drowning. The secondary infections were rare (1 case was suspected and another probable). A child presented a secondary acute respiratory distress syndrome (1.2 %). Finally, 7 deaths (8.4%) and 1 case with severe neurological sequelae (1.2%) were noted. Accidental drowning causes important consequences in children. The long-term respiratory outcomes have not been properly studied. Prevention of such accidents is based on parental vigilance during their child's bathe.
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Affiliation(s)
- J Forler
- Unité de pneumologie et médecine infantile, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Carsin A, Bosdure E, Zandotti C, Mancini J, Chabrol B, Dubus JC. Bronchopneumonies sévères chez l’enfant : la sérologie pour le virus d’Epstein-Barr peut-elle égarer ? Arch Pediatr 2008; 15:1667-71. [DOI: 10.1016/j.arcped.2008.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Revised: 07/31/2008] [Accepted: 08/11/2008] [Indexed: 10/21/2022]
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Lesimple T, Neidhard EM, Vignard V, Lefeuvre C, Adamski H, Labarrière N, Carsin A, Monnier D, Collet B, Clapisson G, Birebent B, Philip I, Toujas L, Chokri M, Quillien V. Immunologic and Clinical Effects of Injecting Mature Peptide-Loaded Dendritic Cells by Intralymphatic and Intranodal Routes in Metastatic Melanoma Patients. Clin Cancer Res 2006; 12:7380-8. [PMID: 17189411 DOI: 10.1158/1078-0432.ccr-06-1879] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [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: 11/16/2022]
Abstract
PURPOSE A phase I/II trial was conducted to evaluate clinical and immunologic responses after intralymphatic and intranodal injections of mature dendritic cells. EXPERIMENTAL DESIGN Fourteen patients with a metastatic melanoma received matured dendritic cells, loaded with Melan-A/MART-1 and/or NA17-A peptides and keyhole limpet hemocyanin. The cells were matured overnight with Ribomunyl, a toll-like receptor ligand, and IFN-gamma, which ensured the production of high levels of interleukin-12p70. Dendritic cells were injected at monthly intervals, first into an afferent lymphatic and then twice intranodally. Immunologic responses were monitored by tetramer staining of circulating CD8(+) lymphocytes and delayed-type hypersensitivity tests. RESULTS Dendritic cell vaccination induced delayed-type hypersensitivity reactivity toward NA17-A-pulsed, keyhole limpet hemocyanin-pulsed, and Melan-A-pulsed dendritic cells in 6 of 10, 4 of 11, and 3 of 9 patients, respectively. Four of the 12 patients analyzed by tetramer staining showed a significantly increased frequency of Melan-A-specific T cells, including one patient vaccinated only with NA17-A-pulsed dendritic cells. Furthermore, 2 of the 12 analyzed patients had a significant increase of NA17-A-specific T cells, including one immunized after an optional additional treatment course. No objective clinical response was observed. Two patients were stabilized at 4 and 10 months and three patients are still alive at 30, 39, and 48 months. CONCLUSIONS Injections into the lymphatic system of mature peptide-loaded dendritic cells with potential TH1 polarization capacities did not result in marked clinical results, despite immunologic responses in some patients. This highlights the need to improve our understanding of dendritic cell physiology.
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Lesimple T, Moisan A, Carsin A, Ollivier I, Mousseau M, Meunier B, Leberre C, Collet B, Quillien V, Drenou B, Lefeuvre-Plesse C, Chevrant-Breton J, Toujas L. Injection by various routes of melanoma antigen-associated macrophages: biodistribution and clinical effects. Cancer Immunol Immunother 2003; 52:438-44. [PMID: 12690521 PMCID: PMC11032851 DOI: 10.1007/s00262-003-0390-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2002] [Accepted: 02/13/2003] [Indexed: 11/25/2022]
Abstract
Patients' autologous macrophages (AM) were used as antigen-presenting cells (APC) in a vaccination protocol against malignant melanoma. AM were administered by various routes, including intralymphatic, since these cells did not express CCR7, a molecule required for APC migration to lymph nodes. Seven HLA-A2 patients with metastatic melanoma-two classified as M1 and five as M3-were included in the study. AM were produced from leukapheresis-separated mononuclear cells by 7-day culture with granulocyte-macrophage colony-stimulating factor. After separation by elutriation, AM were frozen in aliquots and subsequently thawed at monthly intervals, exposed to MAGE-3(271-279) peptide and injected subcutaneously into lymph nodes or into one peripheral lymph vessel. Intradermal tests were performed before and after treatment to determine peptide reactivity. No acute toxicity was observed following injection. One M1 patient had a 7-mm induration intradermal reaction response and was stabilized for 64 weeks. The M3 patients did not show any immunological or clinical response. In 11 patients, the biodistribution of 111In-labeled AM was investigated. There was no clear evidence that AM injected intradermally or subcutaneously left the site of injection. After injection into a lymph vessel of the foot region, scintigraphs showed five to ten popliteal and inguinocrural lymph nodes. This appeared to be the most efficient way to administer rapidly and safely large amounts of peptide-loaded APC into lymph nodes.
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Affiliation(s)
- Thierry Lesimple
- Centre Régional de Lutte Contre le Cancer Eugène Marquis, rue de la Bataille Flandres-Dunkerque, CD 44229, 35042 Rennes, France.
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Boucher E, Carsin A, Raoul JL, Marchetti C, Joram F, Kerbrat P. [Massive hepatic necrosis secondary to treatment of hepatocellular carcinoma by percutaneous alcoholization]. Gastroenterol Clin Biol 1998; 22:459-61. [PMID: 9762276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Fatal complications of percutaneous ethanol injection for the treatment of hepatic tumors are rare events. We report a case of massive hepatic necrosis after treatment by percutaneous ethanol injection of a 4 cm diameter hepatocellular carcinoma, which resulted in the death of the patient. The mechanism of this complication was probably an intratumoral aterioportal shunt, which allowed ethanol to spread through the blood vessels.
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Affiliation(s)
- E Boucher
- Centre Régional de Lutte contre le Cancer, Rennes
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Marchetti C, Carsin A, Sorel L, Kerbrat P, Fleury P, Bourguet P. [Axillary lymph node microcalcifications disclosing breast cancer]. J Radiol 1997; 78:457-459. [PMID: 9239353] [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: 05/22/2023]
Abstract
Intra nodal calcifications associate with breast cancer are uncommon. The rare publications always describe malignant microcaocifications in axillary lymph nodes, evolving with the primary breast tumor imaged on mammography. In the reported observation, we observed calcified metastatic neoplasm in axillary nodes, preceding the intramammary lesion.
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Affiliation(s)
- C Marchetti
- Service de Radiologie, Centre Régional de Lutte contre le Cancer, Eugène Marquis, Rennes
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Stines J, Bertrand AF, Cambier L, Carsin A, Collay R, Delignette A, Dilhuydy MH, Hagay C, Humeau F, Kaemmerlen P. [Standards, options and recommendations for a successful practice in radiographic imagery in oncology. National Federation of Centers for the Fight against Cancer]. Bull Cancer 1995; 82:835-46. [PMID: 8535010] [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: 01/31/2023]
Affiliation(s)
- J Stines
- Centre Alexis-Vautrin, Nancy, France
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Carsin A, Journel H, Roussey M, Le Marec B. [Incidence of occult lumbro-sacral spina bifida in parents of children with spina bifida (concerning 80 pairs of parents with affected children)]. J Genet Hum 1986; 34:285-92. [PMID: 3531402] [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: 01/06/2023]
Abstract
Authors examined 80 pairs of parents with affected children with spina-bifida. They compared the incidence of spina-bifida occulta in parents and in 211 controls. The conclusion is: there is no increased incidence of spina-bifida occulta in parents of spina-bifida.
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