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Levochkina M, McQuillan L, Awan N, Barton D, Maczuzak J, Bianchine C, Trombley S, Kotes E, Wiener J, Wagner A, Calcagno J, Maza A, Nierstedt R, Ferimer S, Wagner A. Neutrophil-to-Lymphocyte Ratios and Infections after Traumatic Brain Injury: Associations with Hospital Resource Utilization and Long-Term Outcome. J Clin Med 2021; 10:jcm10194365. [PMID: 34640381 PMCID: PMC8509449 DOI: 10.3390/jcm10194365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 12/30/2022] Open
Abstract
Traumatic brain injury (TBI) induces immune dysfunction that can be captured clinically by an increase in the neutrophil-to-lymphocyte ratio (NLR). However, few studies have characterized the temporal dynamics of NLR post-TBI and its relationship with hospital-acquired infections (HAI), resource utilization, or outcome. We assessed NLR and HAI over the first 21 days post-injury in adults with moderate-to-severe TBI (n = 196) using group-based trajectory (TRAJ), changepoint, and mixed-effects multivariable regression analysis to characterize temporal dynamics. We identified two groups with unique NLR profiles: a high (n = 67) versus a low (n = 129) TRAJ group. High NLR TRAJ had higher rates (76.12% vs. 55.04%, p = 0.004) and earlier time to infection (p = 0.003). In changepoint-derived day 0–5 and 6–20 epochs, low lymphocyte TRAJ, early in recovery, resulted in more frequent HAIs (p = 0.042), subsequently increasing later NLR levels (p ≤ 0.0001). Both high NLR TRAJ and HAIs increased hospital length of stay (LOS) and days on ventilation (p ≤ 0.05 all), while only high NLR TRAJ significantly increased odds of unfavorable six-month outcome as measured by the Glasgow Outcome Scale (GOS) (p = 0.046) in multivariable regression. These findings provide insight into the temporal dynamics and interrelatedness of immune factors which collectively impact susceptibility to infection and greater hospital resource utilization, as well as influence recovery.
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Affiliation(s)
- Marina Levochkina
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
- Department of Infectious Diseases & Microbiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Leah McQuillan
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
| | - Nabil Awan
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - David Barton
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA;
| | - John Maczuzak
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
| | - Claudia Bianchine
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
| | - Shannon Trombley
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
| | - Emma Kotes
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
| | - Joshua Wiener
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
| | - Audrey Wagner
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
| | - Jason Calcagno
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
| | - Andrew Maza
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
| | - Ryan Nierstedt
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
| | - Stephanie Ferimer
- Division of Pediatric Rehabilitation Medicine, Department of Orthopaedics, West Virginia University, Morgantown, WV 26506, USA;
| | - Amy Wagner
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA; (M.L.); (L.M.); (N.A.); (J.M.); (C.B.); (S.T.); (E.K.); (J.W.); (A.W.); (J.C.); (A.M.); (R.N.)
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Correspondence:
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Masson Regnault M, Fraitag S, Lamant L, Maza A, De la Fouchardière A, Tournier E, Lauwers F, Carfagna L, Meyer N, De Berail A, Busam KJ, Lazova R, Mazereeuw-Hautier J. [The role of new molecular tests in the diagnosis of melanoma in a setting of congenital nævus in an infant]. Ann Dermatol Venereol 2020; 147:746-754. [PMID: 32451177 DOI: 10.1016/j.annder.2020.03.006] [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: 09/29/2019] [Revised: 01/14/2020] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Congenital and infantile melanomas are extremely rare. We report a case of a child presenting at birth with a giant congenital nevus complicated by melanoma and on long-term follow-up with exploration using new immunohistochemistry and molecular biology tools. OBSERVATION A new-born girl presented at birth with a large congenital cervico-mandibular tumour with para-pharyngeal extension and underlying osteolysis. At 7 months, histology and immunohistochemistry of the operative specimen revealed nodules with atypical features (mitotic figures, necrosis and positive expression of KI67 and P53 in approximatively 50 % of the melanocytic nuclei). A diagnosis was made of infantile melanoma associated with congenital nevi. Repeated surgery and monitoring (clinical and imaging) were performed. At the age of 7 years, as there was no evidence of metastatic lesions, further analyses were performed on the initial operative specimen. Investigation of transcription factor expression using immunohistochemistry, comparative genomic hybridization and histology-guided mass spectrometry, although suspect, did not in itself support a diagnosis of melanoma. Finally, at the age of 7 years, hepatic and pulmonary metastases were reported. Despite combined immunotherapy with ipilimumab and nivolumab, the child died 5 months later. CONCLUSION This case illustrates the complexity of diagnosis of infantile melanoma and the risk of metastatic involvement long after the initial diagnosis. Diagnosis may be difficult and necessitates expert advice and the application of several recent methods to reach a conclusion and initiate appropriate treatment.
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Affiliation(s)
- M Masson Regnault
- Service de dermatologie, centre de références de maladies rares de la peau et des muqueuses, université Paul-Sabatier, hôpital Larrey, CHU de Toulouse, 24, chemin du Pouvourville, 31400 Toulouse, France; Pathology department, Samaritan Drive, San Jose, États-Unis.
| | - S Fraitag
- Service d'anatomopathologie, groupe hospitalier Necker-Enfants-Malades, AP-HP, Paris, France
| | - L Lamant
- Service d'anatomopathologie, CHU de Toulouse, Toulouse, France
| | - A Maza
- Service de dermatologie, centre de références de maladies rares de la peau et des muqueuses, université Paul-Sabatier, hôpital Larrey, CHU de Toulouse, 24, chemin du Pouvourville, 31400 Toulouse, France
| | | | - E Tournier
- Service d'anatomopathologie, CHU de Lyon, Lyon, France
| | - F Lauwers
- Service de chirurgie maxillo-faciale, CHU Purpan, Toulouse, France
| | - L Carfagna
- Service d'oncodermatologie, institut universitaire du Cancer, Toulouse-Oncopole, CHU de Toulouse, Toulouse, France
| | - N Meyer
- Service d'oncodermatologie, institut universitaire du Cancer, Toulouse-Oncopole, CHU de Toulouse, Toulouse, France
| | - A De Berail
- Service de chirurgie maxillo-faciale, CHU Purpan, Toulouse, France
| | - K J Busam
- Pathology department, Memorial Sloan-Kettering Cancer Center, New York, États-Unis
| | - R Lazova
- Pathology department, Samaritan Drive, San Jose, États-Unis; Service de dermatologie, hôpital Jean-Bernard, CHU de Poitiers, Poitiers, France
| | - J Mazereeuw-Hautier
- Service de dermatologie, centre de références de maladies rares de la peau et des muqueuses, université Paul-Sabatier, hôpital Larrey, CHU de Toulouse, 24, chemin du Pouvourville, 31400 Toulouse, France
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Berti L, Maza A, Wilcox M, Kesinger M. Abstract WP305: Discriminating Hemorrhagic and Ischemic Stroke Using a Novel, Non-Invasive, Point-of-Care Neuromonitoring Platform. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.wp305] [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] [Indexed: 11/16/2022]
Abstract
Study Objectives:
Tissue plasminogen activator (tPA) may improve ischemic stroke outcomes if administered soon after symptom onset. A computed tomography (CT) scan is required to exclude hemorrhagic stroke. The purpose of this study was to evaluate the feasibility of using an experimental, non-invasive, point-of-care electroencephalography (EEG)-based platform to identify hemorrhage in suspected stroke subjects presenting to the emergency department (ED).
Methods:
During a study that took place between May 2018 and July 2019, a sensor was added to the EEG-based platform that was hypothesized could differentiate between hemorrhagic and ischemic stroke. Eligible subjects presented within 24 hours of symptom onset and had a National Institute of Health Stroke Score (NIHSS) greater than 1. The performance of an artificial intelligence (AI) algorithm was assessed using five-fold cross validation.
Results:
Starting in December 2018, 88 subjects were enrolled with the additional sensor. The median (IQR) age was 68 (56 - 78), 56 subjects (64%) were male, and the distribution in terms of ethnicity was 44% white, 38% African American, and 18% non-black latino. There were 14 (16%) intracerebral hemorrhages (ICH) and 52 (59%) ischemic strokes. Median (IQR) time last known well time was 430 (193 - 574) minutes. Performance is shown in Table 1.
Conclusion:
Preliminary results from a small sample are encouraging. More hemorrhagic stroke patients are expected to improve performance.
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Wilcox MR, Berti L, Maza A, Kesinger M. Abstract WP279: Evaluation of a Novel Point-of-care Neuromonitoring Device to Detect Large Vessel Occlusion in Suspected Acute Stroke Patients. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.wp279] [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] [Indexed: 11/16/2022]
Abstract
Study Objectives:
Several prehospital stroke scales have been developed to provide quick and accurate triage to facilitate timely treatment. This study evaluated a portable, experimental EEG device using AI as a tool for detection of acute stroke and large vessel occlusion (LVO) among patients with neurological deficits. Both device performance and feasibility in the emergent setting were assessed.
Methods:
This observational study enrolled a convenience sample of emergency department (ED) patients evaluated for suspected stroke within 24 hours of symptom onset. LVO and stroke status were determined by local neuroradiologists blinded to device output. LVO was defined as an acute occlusion of any of the following arteries: ICA/MCA-(M1 or M2)/vertebral/ basilar. Controls were neurologically normal subjects (NIHSS=0).
Results:
From May 2018 to July 2019, eight urban US stroke centers enrolled 89 subjects being evaluated for stroke. In suspected stroke subjects, 68 had stroke (76%) and 23 had LVO (26%). Mean (± SD) age was 68 (± 14), 36% were female, and the median (IQR) NIH stroke score was 6 (3 - 12) among suspected stroke subjects. The median last known well time was 327 minutes (196 - 577). Device performance for detecting LVO is shown in Table 1. There were no severe adverse events related to use of the device.
Conclusion:
The neuromonitoring device performed well in identifying LVO in patients presenting with suspected stroke. The performance of the neuromonitoring device in the acute setting indicates that it may be able to support prehospital decision making when triaging suspected stroke subjects. Additional studies with larger sample sizes are needed to validate this study’s findings.
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Benzebouchi N, Salomon G, Maza A, Mazereeuw-Hautier J. Calcinose cutanée idiopathique de type milium (3 cas). Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.265] [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: 11/24/2022]
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Battini M, Casassa E, Maza A, Dreyfus I, Mazereeuw-Hautier J. Macules hypochromiques ou achromiques multiples de l’enfant et risque de sclérose tubéreuse de Bourneville. Ann Dermatol Venereol 2018; 145:741-748. [DOI: 10.1016/j.annder.2018.07.005] [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] [Received: 10/30/2017] [Revised: 12/29/2017] [Accepted: 07/04/2018] [Indexed: 11/28/2022]
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Dreyfus I, Maza A, Merlos M, Hélène T, Mazereeuw-Hautier J. Évaluation de l’amélioration de la qualité de vie des patients atteints de maladie de Hailey Hailey ou de Darier après injections de toxine botulique. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.154] [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: 10/27/2022]
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Fradet M, Hegazy S, Bulai-Livideanu C, Hardy J, Godillot C, Godeau M, Touhouche A, Deilhes F, Casassa E, Borjesson C, Albluwi S, Balica S, Maza A, Thomas-Pfaab M, Aquilina C, Gall Y, Chaput B, Paul C, Konstantinou MP. Laser épilatoire alexandrite dans le cadre de la prise en charge de l’hidradénite suppurée. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Salomon G, Maza A, Boulinguez S, Paul C, Lamant L, Tournier E, Mazereeuw-Hautier J, Meyer N. Efficacy of anti-programmed cell death-1 immunotherapy for skin carcinomas and melanoma metastases in a patient with xeroderma pigmentosum. Br J Dermatol 2018; 178:1199-1203. [PMID: 29274233 DOI: 10.1111/bjd.16270] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2017] [Indexed: 12/27/2022]
Abstract
Xeroderma pigmentosum (XP) is an orphan disease of poor prognosis. We report one case of parallel efficacy with anti-programmed cell death-1 (PD-1) antibody on both melanoma and skin carcinoma in a patient with XP. A 17-year-old patient presented with metastatic melanoma and multiple nonmelanoma skin cancers. He was treated with pembrolizumab, a monoclonal anti-PD-1 antibody, at a dose of 2 mg kg-1 , every 3 weeks. Parallel therapeutic efficacy of anti-PD-1 was observed in metastatic melanoma and skin carcinomas, and maintained at week 24. This observation suggests anti-PD-1 may be considered in patients with XP and metastatic melanoma in addition to advanced nonmelanoma skin cancer.
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Affiliation(s)
- G Salomon
- Dermatology, Paul Sabatier-Toulouse III University, Institut Universitaire du Cancer de Toulouse, Toulouse, France.,CHU de Toulouse, Larrey Hospital, Toulouse, France
| | - A Maza
- Dermatology, Paul Sabatier-Toulouse III University, Institut Universitaire du Cancer de Toulouse, Toulouse, France.,CHU de Toulouse, Larrey Hospital, Toulouse, France.,Reference Center for Rare Skin Diseases, Toulouse, France
| | - S Boulinguez
- Dermatology, Paul Sabatier-Toulouse III University, Institut Universitaire du Cancer de Toulouse, Toulouse, France.,CHU de Toulouse, Larrey Hospital, Toulouse, France
| | - C Paul
- Dermatology, Paul Sabatier-Toulouse III University, Institut Universitaire du Cancer de Toulouse, Toulouse, France.,CHU de Toulouse, Larrey Hospital, Toulouse, France
| | - L Lamant
- Pathology, University Cancer Institute of Toulouse, Toulouse, France
| | - E Tournier
- Pathology, University Cancer Institute of Toulouse, Toulouse, France
| | - J Mazereeuw-Hautier
- Dermatology, Paul Sabatier-Toulouse III University, Institut Universitaire du Cancer de Toulouse, Toulouse, France.,CHU de Toulouse, Larrey Hospital, Toulouse, France.,Reference Center for Rare Skin Diseases, Toulouse, France
| | - N Meyer
- Dermatology, Paul Sabatier-Toulouse III University, Institut Universitaire du Cancer de Toulouse, Toulouse, France.,CHU de Toulouse, Larrey Hospital, Toulouse, France
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Masson Regnault M, Maza A, de la Fouchardière A, Tournier E, Lauwers F, Carfagna L, Fraitag-Spinner S, Meyer N, de Berail A, Busam K, Lamant L, Mazereeuw-Hautier J. Nævus congénital géant tumoral : nodules de proliférations ou mélanome ? Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.268] [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: 10/18/2022]
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Severino-Freire M, Maza A, Kuentz P, Rivière JB, Faivre-Olivier L, Brazet E, Vabres P, Mazereeuw-Hautier J. Syndrome Protée avec mutation AKT1 en mosaïque. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Salomon G, Maza A, Boulinguez S, Paul C, Mazereeuw-Hautier J, Meyer N. Anti-PD1 et xeroderma pigmentosum, une activité sur le mélanome et les carcinomes épidermoïdes. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Severino-Freire M, Maza A, Chassaing N, Mazereeuw-Hautier J. Syndrome de Goltz et mosaïque. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Passeron T, Maza A, Fontas E, Toubel G, Vabres P, Livideanu C, Mazer JM, Rossi B, Boukari F, Harmelin Y, Dreyfus I, Mazereeuw-Hautier J, Lacour JP. Treatment of port wine stains with pulsed dye laser and topical timolol: a multicenter randomized controlled trial. Br J Dermatol 2016; 170:1350-3. [PMID: 24641096 DOI: 10.1111/bjd.12772] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND Neoangiogenesis occurs within days following laser treatment of port wine stains (PWS), and plays a central role in treatment failures. Topical use of timolol can significantly reduce the production of vascular endothelial growth factor in vitro, and in animal models. OBJECTIVES The aim of this study was to assess the efficacy of topical timolol in combination with pulsed dye laser (PDL) treatment, compared with PDL alone, for treating PWS. METHODS This was a prospective multicenter controlled trial performed in children with PWS of the face who had not previously received laser treatment. After randomization, one group was treated with PDL alone, and the other with PDL followed by twice daily applications of timolol gel. Three laser sessions were performed at 1-month intervals with fixed parameters. The evaluation was performed on standardized pictures by two independent physicians blinded to the treatment received. The primary endpoint was marked or complete improvement of the PWS [Investigator Global Assessment (IGA) 3 or 4] 1 month after the third session. RESULTS Twenty-two children were included. Two patients were lost to follow-up. There was no difference in the success rate between the two groups (IGA 3 or 4 observed in one of 10 patients and two of 12 patients, for PDL alone, and for PDL associated with topical timolol, respectively; P = 1·0). No side-effect related to the application of topical timolol was observed. CONCLUSIONS The addition of timolol gel for preventing neoangiogenesis failed to significantly improve the efficacy of PDL treatment of PWS.
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Affiliation(s)
- T Passeron
- Department of Dermatology, University Hospital of Nice, Nice, France; INSERM U1065, Team 12, C3M, Nice, France
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Passeron T, Salhi A, Mazer JM, Mazereeuw-Hautier J, Collet-Vilette AM, Labreze C, Céline L, Boon L, Hardy JP, Fayard V, Bulai Livideanu C, Toubel G, Georgescou G, Gral N, Maza A, Lacour JP. Angiomes plan du visage précocement hypertrophiques : étude multicentrique rétrospective. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.097] [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: 10/22/2022]
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Rodrigo V, Maza A, Calatayud J, Bances L, Diaz F, Gimeno M, Carro B. Long-term follow-up of anterior cervical discectomy and fusion with bioabsorbable plates and screws. Clin Neurol Neurosurg 2015; 136:116-21. [DOI: 10.1016/j.clineuro.2015.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 04/02/2015] [Accepted: 04/05/2015] [Indexed: 11/30/2022]
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Gey A, Ezzedine K, Diallo A, Prey S, Dreyfus I, Maza A, Mazereeuw-Hautier J, Taïeb A, Léauté-Labrèze C. Stay in NICU and infantile haemangioma development. J Eur Acad Dermatol Venereol 2015; 29:566-73. [DOI: 10.1111/jdv.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. Gey
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
| | - K. Ezzedine
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
| | - A. Diallo
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
| | - S. Prey
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
| | - I. Dreyfus
- Dermatology Department; Larrey Hospital; Toulouse France
| | - A. Maza
- Dermatology Department; Larrey Hospital; Toulouse France
| | | | - A. Taïeb
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
| | - C. Léauté-Labrèze
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
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Severino M, Paul C, Lamant L, Legendre L, Kirsten N, Maza A, Planat V, Hautier Mazereeuw J, Bulai Livideanu C. Laser vasculaire : un traitement de la sclérose dans la sclérodermie systémique ? Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.182] [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: 10/24/2022]
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Gey A, Prey S, Ezzedine K, Mazereeuw-Hautier J, Maza A, Taïeb A, Léauté-Labrèze C. Influence d’un séjour en réanimation néonatale (RN) sur la survenue et la localisation des hémangiomes infantiles. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.148] [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: 10/26/2022]
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Passeron T, Maza A, Fontas E, Toubel G, Vabres P, Mazer JM, Rossi B, Boukari F, Harmelin Y, Dreyfus I, Mazereeuw-Hautier J, Lacour JP. Traitement des angiomes plans de l’enfant par laser à colorant pulsé et timolol gel. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.044] [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: 10/26/2022]
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Dreyfus I, Maza A, Mazereeuw-Hautier J. Quoi de neuf dans les hémangiomes infantiles ? Arch Pediatr 2013; 20:809-16. [DOI: 10.1016/j.arcped.2013.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 03/21/2013] [Accepted: 03/25/2013] [Indexed: 12/21/2022]
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Mazereeuw-Hautier J, Dreyfus I, Barbarot S, Maza A, Galera I, Bourrat E, Chiaverini C, Ezzedine K, LeRhun A, Taieb C. Élaboration et validation d’un questionnaire de qualité de vie spécifique des ichtyoses héréditaires. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dreyfus I, Bourrat E, Maruani A, Bessis D, Chiavérini C, Bursztejn AC, Chevrant-Breton J, Maza A, Mallet S, Barbarot S, Vabres P, Ezzedine K, Mazereeuw-Hautier J. Facteurs associés à une altération importante de la qualité de vie chez les patients adultes atteints d’ichtyose héréditaire. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.038] [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: 10/27/2022]
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Abbo O, Dubedout S, Ballouhey Q, Maza A, Sevely A, Galinier P. [Asymptomatic neonatal neurocutaneous melanosis]. Arch Pediatr 2012; 19:1319-21. [PMID: 23107087 DOI: 10.1016/j.arcped.2012.09.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 08/23/2012] [Accepted: 09/20/2012] [Indexed: 11/15/2022]
Abstract
Giant congenital nevi in 1% of cases are associated with anomalies of the central nervous system, which are characteristic of neurocutaneous melanosis. When neurocutaneous melanosis becomes symptomatic, it is associated with a poor prognosis. With recommended neonatal screening, asymptomatic neonatal cases are being discovered more frequently. On the basis of this observation, we consider various aspects of this association.
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Affiliation(s)
- O Abbo
- Service de chirurgie viscérale, hôpital des Enfants de Toulouse, CHU de Toulouse, 330, avenue de Grande-Bretagne, TSA 70034, 31059 Toulouse cedex 9, France.
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Maza A, Richard M, Aubin F, Ortonne J, Prey S, Bachelez H, Beylot-Barry M, Bulai-Livideanu C, Lahfa M, Nougué J, Mengual X, Le Moigne M, Lauwers-Cances V, Paul C. Significant delay in the introduction of systemic treatment of moderate to severe psoriasis: a prospective multicentre observational study in outpatients from hospital dermatology departments in France. Br J Dermatol 2012; 167:643-8. [DOI: 10.1111/j.1365-2133.2012.10991.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mazereeuw-Hautier J, Dreyfus I, Barbarot S, Serrentino L, Bourdon-Lanoy E, Ezzedine K, Maza A, Aujoulat I, Le Rhun A. Factors influencing quality of life in patients with inherited ichthyosis: a qualitative study in adults using focus groups. Br J Dermatol 2012; 166:646-8. [DOI: 10.1111/j.1365-2133.2011.10701.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bibas N, Sartor V, Bulai Livideanu C, Bagheri H, Nougué J, Giordano-Labadie F, Maza A, Paul C, Chouini-Lalanne N, Marguery MC. Contact Photoallergy to Isothipendyl Chlorhydrate. Dermatology 2012; 224:289-91. [DOI: 10.1159/000338024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 03/13/2012] [Indexed: 11/19/2022] Open
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Paul C, Maza A, Richard MA, Aubin F, Ortonne J, Prey S, Bachelez H, Beylot_Barry M, Bulai-Livideanu C, Lahfa M, Nougué J, Mengual X, Le Moigne M, Lauwers-Cances V. Existe-t-il un retard à l’utilisation des traitements systémiques dans le psoriasis modéré à sévère ? Ann Dermatol Venereol 2011. [DOI: 10.1016/j.annder.2011.09.173] [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: 11/30/2022]
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Paul C, Gallini A, Maza A, Montaudié H, Sbidian E, Aractingi S, Aubin F, Bachelez H, Cribier B, Joly P, Jullien D, Le Maître M, Misery L, Richard MA, Ortonne JP. Evidence-based recommendations on conventional systemic treatments in psoriasis: systematic review and expert opinion of a panel of dermatologists. J Eur Acad Dermatol Venereol 2011; 25 Suppl 2:2-11. [DOI: 10.1111/j.1468-3083.2011.03990.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Maza A, Montaudié H, Sbidian E, Gallini A, Aractingi S, Aubin F, Bachelez H, Cribier B, Joly P, Jullien D, Le Maître M, Misery L, Richard MA, Ortonne JP, Paul C. Oral cyclosporin in psoriasis: a systematic review on treatment modalities, risk of kidney toxicity and evidence for use in non-plaque psoriasis. J Eur Acad Dermatol Venereol 2011; 25 Suppl 2:19-27. [DOI: 10.1111/j.1468-3083.2011.03992.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Montaudié H, Sbidian E, Paul C, Maza A, Gallini A, Aractingi S, Aubin F, Bachelez H, Cribier B, Joly P, Jullien D, Le Maître M, Misery L, Richard MA, Ortonne JP. Methotrexate in psoriasis: a systematic review of treatment modalities, incidence, risk factors and monitoring of liver toxicity. J Eur Acad Dermatol Venereol 2011; 25 Suppl 2:12-8. [DOI: 10.1111/j.1468-3083.2011.03991.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Sbidian E, Maza A, Montaudié H, Gallini A, Aractingi S, Aubin F, Cribier B, Joly P, Jullien D, Le Maître M, Misery L, Richard MA, Paul C, Ortonne JP, Bachelez H. Efficacy and safety of oral retinoids in different psoriasis subtypes: a systematic literature review. J Eur Acad Dermatol Venereol 2011; 25 Suppl 2:28-33. [DOI: 10.1111/j.1468-3083.2011.03993.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pauwels C, Bulai Livideanu C, Maza A, Lamant L, Paul C. Cytophagic Histiocytic Panniculitis after H1N1 Vaccination: A Case Report and Review of the Cutaneous Side Effects of Influenza Vaccines. Dermatology 2011; 222:217-20. [DOI: 10.1159/000326912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 02/18/2011] [Indexed: 01/09/2023] Open
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Gardinal-Galera I, Bulai Livideanu C, Lamant L, Viraben R, Meyer N, Mazereeuw-Hautier J, Maza A, Prey S, Nespoulous M, Paul C. Joint clinical and pathological review meetings improve patient care: a prospective evaluation in dermatology. J Eur Acad Dermatol Venereol 2010; 25:928-32. [PMID: 21054572 DOI: 10.1111/j.1468-3083.2010.03883.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Joint clinical and pathological review meeting exists in most academic dermatology departments. OBJECTIVE The primary objective of the study was to assess the impact of the joint clinical and pathological review meeting in dermatology on patient care. METHODS Prospective descriptive study over 6 months (May to October 2008) on all clinical cases of dermatology reviewed at the joint clinical and pathological review meeting in our University Hospital. RESULTS A total of 139 cases were reviewed during the 6-month period. In 97 cases (69.8%), the joint clinical and pathological review meeting had a positive impact on final diagnosis and/or on patient management. For 27 cases, a consensus diagnosis different from the initial proposal was established. In 21 cases, the joint clinical and pathological review meeting led to additional investigations or therapeutic proposals. The impact of the joint clinical and pathological review meeting was highest for inflammatory skin diseases. CONCLUSIONS The joint clinical and pathological review meeting is a useful procedure to improve diagnostic accuracy in difficult cases.
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Affiliation(s)
- I Gardinal-Galera
- Department of Dermatology, Paul-Sabatier University, Larrey University Hospital, Toulouse, France
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Lourari S, Herve C, Doffoel-Hantz V, Meyer N, Bulai-Livideanu C, Viraben R, Maza A, Adoue D, Bedane C, Paul C. Bullous and mucous membrane pemphigoid show a mixed response to rituximab: experience in seven patients. J Eur Acad Dermatol Venereol 2010; 25:1238-40. [DOI: 10.1111/j.1468-3083.2010.03889.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Giannitelli M, Maza A, Lahfa M, Meyer N, Livideanu C, Paul C. Iatrogenic adrenal insufficiency associated with calcipotriol-betamethasone topical combination in psoriasis. Clin Exp Dermatol 2010; 35:e167-8. [DOI: 10.1111/j.1365-2230.2009.03770.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Maza A, Gaudy-Marqueste C, Collet-Vilette AM, Joubert F, Richard MA, Grob JJ. [Congenital universal hypertrichosis]. Ann Dermatol Venereol 2009; 136:300-2. [PMID: 19328322 DOI: 10.1016/j.annder.2008.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Accepted: 06/23/2008] [Indexed: 10/21/2022]
Affiliation(s)
- A Maza
- Service de dermatologie, hôpital Sainte-Marguerite, CHU de Marseille, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
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Maza A, Berbis J, Gaudy-Marqueste C, Morand JJ, Berbis P, Grob JJ, Richard MA. Évaluation de l’activité hospitalière de consultation liaison en dermatologie à partir d’une enquête prospective multicentrique au sein d’un CHU français. Ann Dermatol Venereol 2009; 136:241-8. [DOI: 10.1016/j.annder.2008.12.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Accepted: 12/22/2008] [Indexed: 11/16/2022]
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Maza A, Morel F, Pommier S, Vedy S, Lightburn E, Roux L, Patte JH, Meyer F, Morand JJ. [Tubercular fibrosing conjunctivitis associated with facial cutaneous tuberculosis]. Ann Dermatol Venereol 2008; 135:679-81. [PMID: 18929919 DOI: 10.1016/j.annder.2008.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2007] [Accepted: 03/28/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Tuberculous conjunctivitis has been described only rarely during the course of lupus vulgaris. We report a case of hemifacial cutaneous tuberculosis, diagnosed as atypical lupus vulgaris, associated with homolateral fibrosing tuberculous conjunctivitis. PATIENTS AND METHODS An 83-year-old woman presented inflammatory conjunctivitis without bullous involvement in the left eye leading to corneal neovascularisation, symblepharons and ptosis. Erythematous and atrophic papules were seen on the left side of the face. Biopsy of the skin and conjunctiva revealed a tuberculoid granulomatous infiltrate. Bacterial culture and PCR were both positive for Mycobacterium tuberculosis. DISCUSSION This case illustrates the need to consider tuberculosis when faced with an atypical facial eruption and ocular involvement.
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Affiliation(s)
- A Maza
- Service de dermatologie, hôpital militaire Laveran, HIA Laveran, Marseille Armées, Marseille, France
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Maza A, Parra JL, Coderch L, Bosch P. Phosphatidylcholine/cholesterol liposomes as vehicles for anthraquinone disperse dyes in wool dyeing. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1478-4408.1995.tb01673.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Maza A, Parra JL, Manich A, Coderch L. Liposomes in wool dyeing — the stability of dye‐liposome systems and their application to untreated wool fibres. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1478-4408.1992.tb01408.x] [Citation(s) in RCA: 10] [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] [Indexed: 11/30/2022]
Affiliation(s)
- A Maza
- Institute de Tecnologia Quimica y Textil (CSIC) C/Jorge Girona Salgado 18–26, 08034 Barcelona, Spain
| | - J L Parra
- Institute de Tecnologia Quimica y Textil (CSIC) C/Jorge Girona Salgado 18–26, 08034 Barcelona, Spain
| | - A Manich
- Institute de Tecnologia Quimica y Textil (CSIC) C/Jorge Girona Salgado 18–26, 08034 Barcelona, Spain
| | - L Coderch
- Institute de Tecnologia Quimica y Textil (CSIC) C/Jorge Girona Salgado 18–26, 08034 Barcelona, Spain
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Maza A, Coderch L, Serra S, Parra JL. Phosphatidylcholine unilamellar liposomes as vehicles for a 1:2 metal-complex dye in wool dyeing. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1478-4408.1997.tb01891.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Maza A, Renard L, Monestier S, Grob JJ, Richard MA. [Fever with skin rash and polyarthralgia in a genetically black-skinned woman]. Med Trop (Mars) 2008; 68:297-299. [PMID: 18689326] [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: 05/26/2023]
Abstract
Adult onset Still's disease (AOSD) is a systemic disorder characterized by intermittent fever, evanescent rash, polyarthralgia or arthritis, and neutrophilic leucocytoclasis. Appearance of skin rash during fever episodes is the characteristic feature. An atypical form of AOSD with a fixed pigmented skin rash was described in 1994. Prognosis of the atypical form is thought to be more severe than that of the classic form. The purpose of this report is to describe the first case of atypical AOSD in a genetically black-skinned woman. Treatment required administration of high-dose systemic corticosteroids.
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Affiliation(s)
- A Maza
- Service de dermatologie, CHU Sainte Marguerite, Marseille.
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Maza A, Coderch L, Lopez O, Baucells J, Parra JL. Permeability changes in liposomes modeling the stratum corneum lipid composition caused by surfactants. Colloid Polym Sci 1997. [DOI: 10.1007/bf01188949] [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: 11/30/2022]
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Abstract
The influence of partial hepatectomy on the pharmacokinetics of theophylline was determined in rats. The pharmacokinetics of intravenous theophylline was studied in unhepatectomized rats (control group: CG) and in hepatectomized rats (HG) 12 h after 70% hepatectomy. Liver function was monitored in both groups by measurements of total and direct bilirubin, transaminases GOT and GPT, and plasma protein. Seventy per cent hepatectomy caused significant liver dysfunction: transaminase levels (GOT and GPT) increased by 118 and 683%, respectively, and the total and direct bilirubin levels increased by 28.6 and 9.1%, respectively. At the same time, plasma concentrations of theophylline decreased significantly and half-life increased from 4.16 +/- 0.57 h (CG) to 7.08 +/- 0.69 h (HG), as did the distribution volumes values of central (Vc) and peripheral (Vp) compartments (Vc: CG, 0.18 +/- 0.03 L; HG, 0.24 +/- 0.03 L) (Vp: CG, 0.08 +/- 0.05 L; HG, 0.13 +/- 0.05 L). The percentage of theophylline binding to plasma proteins decreased from 44.3% in CG to 33.8% in HG. The theophylline intrinsic clearance (CLint) dropped from 1.35 +/- 0.43 mL/min (CG) to 0.93 +/- 0.10 mL/min (HG)1, which can be attributed to a significant fall in the quantity of hepatic microsomal enzymes. These modifications on the pharmacokinetics of drugs with low hepatic extraction coefficients, such as theophylline, should be considered when dosage regimens during the posthepatectomy hepatic regeneration period are planned.
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Affiliation(s)
- A Maza
- Laboratory of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of the Basque Country, Vitoria, Spain
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Ocharan-Corcuera J, Martínez-Alvarez A, López-Ruiz JA, Maza A, Cabrejas C, Marco A, Rodríguez-Arzadun JA. [Bioenergetic radiographic absorptiometry in hemodialysis]. An Med Interna 1994; 11:224-6. [PMID: 8061136] [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: 01/28/2023]
Abstract
UNLABELLED In order to assess bone loss in uremic renal osteodystrophy (URO), we have measured total and regional mineral bone density (TMBD and RMBD, respectively) by using bioenergetic radiographic absorptiometry (BRA) in a population of patients on hemodialysis (HD). Thirty one patients have been evaluated, with a mean age of 55 and a mean time on hemodialysis of 31 mo. (range 2-120 mo.). Bone absorptiometry consisted of measurement of total body (TMBD) and regional analysis of head, upper limb, lower limb, ribs, pelvis and spine (RMBD). TMBD inversely correlated with alkaline phosphatase and parathyroid hormone levels; it also correlated inversely with age, but only in females. TMBD showed significantly lower values in HD patients than in chronic renal failure patients and controls. All the regional parameters correlated inversely with alkaline phosphatase levels. CONCLUSION BRA is a non invasive method which quantifies TMBD and RMBD with a very low radiologic exposure and correlates adequately with levels of alkaline phosphatase and parathyroid hormone in URO. TMBD measures total cortical bone of the skeleton with good accuracy, RMBD allows a selective analysis of regional bone changes and a evolutive control in these patients, given the nonuniform decrease of mineral density in the skeleton.
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Affiliation(s)
- A. Maza
- Best Foods Research and Engineering Center CPC International, Inc.; Union New Jersey 07083
| | - R. A. Ormsbee
- Best Foods Research and Engineering Center CPC International, Inc.; Union New Jersey 07083
| | - L. R. Strecker
- Best Foods Research and Engineering Center CPC International, Inc.; Union New Jersey 07083
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Garcia MJ, Alonso AC, Maza A, Santos D, Matesanz C, Dominguez-Gil A. Comparison of methods of carbamazepine dosage, individualization in epileptic patients. J Clin Pharm Ther 1988; 13:375-80. [PMID: 3235481 DOI: 10.1111/j.1365-2710.1988.tb00207.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The aim of the present work was to analyse the predictive capacity of different optimization methods for carbamazepine dosage regimens according to population pharmacokinetic parameters and/or serum levels data. Calculations were performed using a multiple non-linear regression program (MULTI 2 BAYES) with two different options: (a) using the ordinary least squares methods and (b) the least squares method based on the Bayesian algorithm. The predictive capacity of the three methods was analysed comparing the serum levels values in patients predicted by each method and those observed later. The performance obtained was poor and even unacceptable when dosage prediction was based on the mean parameters of the population studied (Method A) and when only one data point relating to the serum carbamazepine levels was available (Method B). When two serum levels data were used the standard deviation of the mean prediction error was only clinically acceptable when Bayesian non-linear regression was applied (Method C). When the number of serum levels data points was 3 or 4 the errors were acceptable from a clinical point of view and no significant differences could be found between the use of the simple and Bayesian version at the same level of information.
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Affiliation(s)
- M J Garcia
- Department of Pharmacy, School of Pharmacy, University of Salamanca, Spain
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