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Coinsin B, Lacroix G, Nzamushe JR. Duodenal perforation in giant inguinal hernia. J Visc Surg 2023; 160:158-159. [PMID: 36878836 DOI: 10.1016/j.jviscsurg.2023.01.009] [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: 03/07/2023]
Abstract
Large and complicated hernias are doubly challenging; not only must the hernia be treated according to a degree of severity, but it also necessary to prevent compartment syndrome during reintegration of the viscera. Possible complications range from intestinal necrosis to perforation of the hollow organs. We are presenting the rare case of a duodenal perforation in a man with large strangulated hernia.
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Affiliation(s)
- B Coinsin
- Emergency surgery department, University Lille, CHU, 59000 Lille, France
| | - G Lacroix
- Emergency surgery department, University Lille, CHU, 59000 Lille, France
| | - J R Nzamushe
- Emergency surgery department, University Lille, CHU, 59000 Lille, France.
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2
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Lacroix G, Jeanne M, Martinot V, Pasquesoone L. "Extensive necrosis following extravasation of alkali in the crease of the elbow after voluntary intravenous injection: A case report". ANN CHIR PLAST ESTH 2023; 68:81-85. [PMID: 35902288 DOI: 10.1016/j.anplas.2022.07.002] [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: 05/19/2022] [Revised: 06/28/2022] [Accepted: 07/06/2022] [Indexed: 01/18/2023]
Abstract
Chemical burns are often deep with difficult initial clinical evaluation, especially those due to alkalic agents, which have a strong penetrating power. They therefore require specialized care in a Burn Unit. Self-inflicted burns are infrequent but their management represents a real challenge. We report the case of a 47-year-old referred to our Burn Center for the evaluation of a self-inflicted corrosion with an alkalic agent (soda), injected at the crease of the left elbow. The patient, right handed, was a nurse and had notably a psychiatric history of depressive syndrome. We observed a deep, well-defined necrosis area, associated with intense peri-lesional inflammation and extensive cellulitis. Faced with this unusual clinical appearance for a chemical burn, the patient's questioning was repeated and the patient finally admitted to having injected himself with a basic caustic product intravenously. Surgical treatment was carried out in two stages: debridement with exposure of vascular and neural structures then coverage with a free anterolateral thigh flap. The postoperative consequences were uneventful with a satisfactory functional result. Factitious disorders are underestimated and often misleading. Among factitious disorders, self-inflicted wounds remain a real challenge requiring multidisciplinary management. Many etiologies exist, among which injection of drugs or substances, in any anatomical localization, leading to variable loss of substance. The use of a free flap for acute extravasation is rare but sometimes essential. The anterolateral thigh flap allows good resurfacing on areas with important functional requirements.
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Affiliation(s)
- G Lacroix
- Plastic Surgery and Burn Centre, CHU de Lille, 59000 Lille, France.
| | - M Jeanne
- Anesthesia and Critical Care, Burn Centre, CHU de Lille, 59000 Lille, France; Inserm, CIC 1403 - centre d'investigations cliniques, University of Lille, 59000 Lille, France; ULR 7365, GRITA - groupe de recherche sur les formes injectables et les technologies associées, University of Lille, 59000 Lille, France
| | - V Martinot
- Plastic Surgery and Burn Centre, CHU de Lille, 59000 Lille, France
| | - L Pasquesoone
- Plastic Surgery and Burn Centre, CHU de Lille, 59000 Lille, France
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3
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Lacroix G, Gouyer V, Rocher M, Gottrand F, Desseyn JL. A porous cervical mucus plug leads to preterm birth induced by experimental vaginal infection in mice. iScience 2022; 25:104526. [PMID: 35754724 PMCID: PMC9218384 DOI: 10.1016/j.isci.2022.104526] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/14/2022] [Accepted: 05/29/2022] [Indexed: 11/12/2022] Open
Abstract
During gestation, the cervical mucus plug (CMP) acts to seal the cervical canal. Pilot studies in humans have suggested that a porous CMP may increase the risk of uterine infection and preterm birth. We examined the gel-forming content of the mouse vagina and the CMP. We experimentally infected pregnant mice by intravaginal administration of pathogens related to preterm birth in humans. We found that the epithelium in both the vagina and cervical canal of pregnant mice produced the two gel-forming mucins Muc5b and Muc5ac. The CMP was porous in Muc5b-deficient mice for which intravaginal administration of Escherichia coli O 55 led to the activation of an inflammatory response in the uterus and 100% preterm births. The pathogen was found in the mucus plug and uterus. This study shows that Muc5b is essential for the in vivo barrier function and the prevention of uterine infections during gestation. Muc5b and Muc5ac are the main gel-forming mucins of the mouse vagina and cervical canal During pregnancy, a cervical mucus plug (CMP) is formed and seals the cervical canal Muc5b-deficient CMP is highly porous Inflammation following vaginal infection causes preterm birth in Muc5b-deficient mice
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Affiliation(s)
- Guillaume Lacroix
- University Lille, Inserm, CHU Lille, U1286 - Infinite, 59000 Lille, France
| | - Valérie Gouyer
- University Lille, Inserm, CHU Lille, U1286 - Infinite, 59000 Lille, France
| | - Mylène Rocher
- University Lille, Inserm, CHU Lille, U1286 - Infinite, 59000 Lille, France
| | - Frédéric Gottrand
- University Lille, Inserm, CHU Lille, U1286 - Infinite, 59000 Lille, France
| | - Jean-Luc Desseyn
- University Lille, Inserm, CHU Lille, U1286 - Infinite, 59000 Lille, France
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4
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Lacroix G, Martinot-Duquennoy V, Ngo B, Knipper P, Pasquesoone L. [Not Available]. Ann Burns Fire Disasters 2022; 35:152-159. [PMID: 36381338 PMCID: PMC9416691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/10/2021] [Indexed: 06/16/2023]
Abstract
Armenia and Azerbaijan fought between September and November 2020 in Nagorno-Karabagh. Several surgical missions were scheduled by Assistance Publique- Hôpitaux de Paris to help care for the warinjured Armenians. These missions included the evaluation of Armenian soldiers suspected of having been injured by phosphorus. Facing, during these missions, such infrequent burns, we were interested in their pathophysiology, care and complications. Repeated up-to-date information is necessary in order to better take care of phosphorus burns. Therefore, we conducted a literature review, using PubMed and the Mesh Terms "phosphorus" and "burns", without setting any date limit. The review acknowledges that phosphorus burns are deep, tend to spread and may be the cause of systemic toxicity including hypocalcaemia, which can lead to heart rate disturbance and even death. In the acute phase, burns should be extensively washed with normal saline or water before a mechanical decontamination. One should not use oily dressings, given the liposolubility of phosphorus. Subsequently, one or many debridements are necessary before starting wound coverage, for which any kind of plastic surgery may be used. Phosphorus burns are infrequent but serious. They mainly occur in warfare and should be known by any caregiver acting in this context.
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Affiliation(s)
- G. Lacroix
- Centre de Traitement des Brûlés, CHRU Lille, Université Lille 2, France
| | | | - B. Ngo
- Centre de Traitement des Brûlés, CHRU Lille, Université Lille 2, France
| | - P. Knipper
- Service de Chirurgie Plastique Ambulatoire, Hôpital Cochin - Port Royal, Assistance Publique - Hôpitaux de Paris, Université de Paris, Fran
| | - L. Pasquesoone
- Centre de Traitement des Brûlés, CHRU Lille, Université Lille 2, France
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5
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Carril-Ajuria L, Desnoyer A, Meylan M, Dalban C, Naigeon M, Cassard L, Vano Y, Rioux-Leclercq N, Chouaib S, Beuselinck B, Chabaud S, Barros-Monteiro J, Bougoüin A, Lacroix G, Colina-Moreno I, Tantot F, Boselli L, De Oliveira C, Fridman WH, Escudier B, Sautes-Fridman C, Albiges L, Chaput-Gras N. Baseline circulating unswitched memory B cells and B-cell related soluble factors are associated with overall survival in patients with clear cell renal cell carcinoma treated with nivolumab within the NIVOREN GETUG-AFU 26 study. J Immunother Cancer 2022; 10:jitc-2022-004885. [PMID: 35640928 PMCID: PMC9157347 DOI: 10.1136/jitc-2022-004885] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The phase II NIVOREN GETUG-AFU 26 study reported safety and efficacy of nivolumab in patients with metastatic clear cell renal cell carcinoma (m-ccRCC) in a 'real-world setting'. We conducted a translational-research program to determine whether specific circulating immune-cell populations and/or soluble factors at baseline were predictive of clinical outcomes in patients with m-ccRCC treated with nivolumab within the NIVOREN study. METHODS Absolute numbers of 106 circulating immune-cell populations were prospectively analyzed in patients treated at a single institution within the NIVOREN trial with available fresh-whole-blood, using dry formulation panels for multicolor flow cytometry. In addition, a panel of 14 predefined soluble factors was quantified for each baseline plasma sample using the Meso-Scale-Discovery immunoassay. The remaining patients with available plasma sample were used as a validation cohort for the soluble factor quantification analysis. Tumor immune microenvironment characterization of all patients included in the translational program of the study was available. The association of blood and tissue-based biomarkers, with overall survival (OS), progression-free survival (PFS) and response was analyzed. RESULTS Among the 44 patients, baseline unswitched memory B cells (NSwM B cells) were enriched in responders (p=0.006) and associated with improved OS (HR=0.08, p=0.002) and PFS (HR=0.54, p=0.048). Responders were enriched in circulating T follicular helper (Tfh) (p=0.027) and tertiary lymphoid structures (TLS) (p=0.043). Circulating NSwM B cells positively correlated with Tfh (r=0.70, p<0.001). Circulating NSwM B cells correlated positively with TLS and CD20 +B cells at the tumor center (r=0.59, p=0.044, and r=0.52, p=0.033) and inversely correlated with BCA-1/CXCL13 and BAFF (r=-0.55 and r=-0.42, p<0.001). Tfh cells also inversely correlated with BCA-1/CXCL13 (r=-0.61, p<0.001). IL-6, BCA-1/CXCL13 and BAFF significantly associated with worse OS in the discovery (n=40) and validation cohorts (n=313). CONCLUSION We report the first fresh blood immune-monitoring of patients with m-ccRCC treated with nivolumab. Baseline blood concentration of NSwM B cells was associated to response, PFS and OS in patients with m-ccRCC treated with nivolumab. BCA-1/CXCL13 and BAFF, inversely correlated to NSwM B cells, were both associated with worse OS in discovery and validation cohorts. Our data confirms a role for B cell subsets in the response to immune checkpoint blockade therapy in patients with m-ccRCC. Further studies are needed to confirm these findings.
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Affiliation(s)
- Lucia Carril-Ajuria
- Department of Cancer Medicine, Institut Gustave-Roussy, Villejuif, France.,Laboratory for Immunomonitoring in Oncology, Institut Gustave-Roussy, Villejuif, France
| | - Aude Desnoyer
- Laboratory for Immunomonitoring in Oncology, Institut Gustave-Roussy, Villejuif, France.,Faculté de Pharmacie, Université Paris-Saclay, Chatenay-Malabray, France
| | - Maxime Meylan
- Centre de Recherche des Cordeliers, Inserm UMR S1138, Paris, France
| | - Cécile Dalban
- Department of Biostatistics, Centre Leon Bernard, Lyon, France
| | - Marie Naigeon
- Faculté de Pharmacie, Université Paris-Saclay, Chatenay-Malabray, France.,Laboratoire d'immunomonitoring En Oncologie, Institut Gustave-Roussy, Villejuif, France.,Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicetre, France
| | - Lydie Cassard
- Laboratory for Immunomonitoring in Oncology, Institut Gustave-Roussy, Villejuif, France
| | - Yann Vano
- Centre de Recherche des Cordeliers, Inserm UMR S1138, Paris, France.,Service d'Oncologie Medicale, Hopital Europeen Georges Pompidou, Paris, France
| | - Nathalie Rioux-Leclercq
- Service Anatomie Etcytologie Pathologiques, CHU, Université de Rennes, Universite de Rennes 1, Rennes, France
| | - Salem Chouaib
- Department of Immunology, Gustave Roussy Institute, Villejuif, France
| | | | - Sylvie Chabaud
- Department of Biostatistics, Centre Leon Bernard, Lyon, France
| | | | - Antoine Bougoüin
- Centre de Recherche des Cordeliers, Inserm UMR S1138, Paris, France
| | | | | | | | - Lisa Boselli
- Laboratory for Immunomonitoring in Oncology, Institut Gustave-Roussy, Villejuif, France
| | - Caroline De Oliveira
- Laboratory for Immunomonitoring in Oncology, Institut Gustave-Roussy, Villejuif, France
| | | | - Bernard Escudier
- Department of Cancer Medicine, Institut Gustave-Roussy, Villejuif, France
| | | | - Laurence Albiges
- Department of Cancer Medicine, Institut Gustave-Roussy, Villejuif, France.,Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicetre, France
| | - Nathalie Chaput-Gras
- Laboratory for Immunomonitoring in Oncology, Institut Gustave-Roussy, Villejuif, France .,Faculté de Pharmacie, Université Paris-Saclay, Chatenay-Malabray, France
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Lacroix G, Duquennoy-Martinot V, Guerreschi P. Le muscle buccinateur : une nouvelle cible pour les injections de toxine botulique dans le traitement des séquelles de paralysie faciale. ANN CHIR PLAST ESTH 2022; 67:125-132. [DOI: 10.1016/j.anplas.2022.04.001] [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: 03/16/2022] [Accepted: 04/04/2022] [Indexed: 11/24/2022]
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7
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Meylan M, Petitprez F, Becht E, Bougoüin A, Pupier G, Calvez A, Giglioli I, Verkarre V, Lacroix G, Verneau J, Sun CM, Laurent-Puig P, Vano YA, Elaïdi R, Méjean A, Sanchez-Salas R, Barret E, Cathelineau X, Oudard S, Reynaud CA, de Reyniès A, Sautès-Fridman C, Fridman WH. Tertiary lymphoid structures generate and propagate anti-tumor antibody-producing plasma cells in renal cell cancer. Immunity 2022; 55:527-541.e5. [PMID: 35231421 DOI: 10.1016/j.immuni.2022.02.001] [Citation(s) in RCA: 194] [Impact Index Per Article: 97.0] [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: 05/17/2021] [Revised: 12/09/2021] [Accepted: 02/02/2022] [Indexed: 12/30/2022]
Abstract
The presence of intratumoral tertiary lymphoid structures (TLS) is associated with positive clinical outcomes and responses to immunotherapy in cancer. Here, we used spatial transcriptomics to examine the nature of B cell responses within TLS in renal cell carcinoma (RCC). B cells were enriched in TLS, and therein, we could identify all B cell maturation stages toward plasma cell (PC) formation. B cell repertoire analysis revealed clonal diversification, selection, expansion in TLS, and the presence of fully mature clonotypes at distance. In TLS+ tumors, IgG- and IgA-producing PCs disseminated into the tumor beds along fibroblastic tracks. TLS+ tumors exhibited high frequencies of IgG-producing PCs and IgG-stained and apoptotic malignant cells, suggestive of anti-tumor effector activity. Therapeutic responses and progression-free survival correlated with IgG-stained tumor cells in RCC patients treated with immune checkpoint inhibitors. Thus, intratumoral TLS sustains B cell maturation and antibody production that is associated with response to immunotherapy, potentially via direct anti-tumor effects.
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Affiliation(s)
- Maxime Meylan
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Florent Petitprez
- Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, 75013 Paris, France; MRC Centre for Reproductive Health, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Etienne Becht
- Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, 75013 Paris, France
| | - Antoine Bougoüin
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Guilhem Pupier
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Anne Calvez
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Ilenia Giglioli
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Virginie Verkarre
- Département de pathologie, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris - Paris Centre, 75015 Paris, France; Université de Paris, 75006 Paris, France; PARCC, INSERM, Equipe Labellisée Ligue contre le Cancer, 75015 Paris, France
| | - Guillaume Lacroix
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Johanna Verneau
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Chen-Ming Sun
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, EPIGENETEC, 75006 Paris, France
| | - Yann-Alexandre Vano
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France; Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, 75013 Paris, France; MRC Centre for Reproductive Health, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK; Département d'oncologie médicale, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris - Paris Centre, F-75015 Paris, France; Université de Paris, 75006 Paris, France; PARCC, INSERM, Equipe Labellisée Ligue contre le Cancer, 75015 Paris, France
| | - Reza Elaïdi
- Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, 75015 Paris, France
| | - Arnaud Méjean
- Département d'urologie, Hôpital européen Georges Pompidou, Université de Paris, 75015 Paris, France
| | - Rafaël Sanchez-Salas
- Département d'urologie, Institut Mutualiste Montsouris, Université de Paris, 75014 Paris, France
| | - Eric Barret
- Département d'urologie, Institut Mutualiste Montsouris, Université de Paris, 75014 Paris, France
| | - Xavier Cathelineau
- Département d'urologie, Institut Mutualiste Montsouris, Université de Paris, 75014 Paris, France
| | - Stephane Oudard
- Département d'oncologie médicale, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris - Paris Centre, F-75015 Paris, France; Université de Paris, 75006 Paris, France
| | - Claude-Agnès Reynaud
- Institut Necker Enfants Malades (INEM), INSERM U1151/CNRS UMRS8253, Université de Paris, 75015 Paris, France
| | - Aurélien de Reyniès
- Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, 75013 Paris, France; MRC Centre for Reproductive Health, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK; Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, EPIGENETEC, 75006 Paris, France; Université de Paris, 75006 Paris, France
| | - Catherine Sautès-Fridman
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France
| | - Wolf Herman Fridman
- Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Equipe labellisée Ligue Contre le Cancer, 75006 Paris, France.
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Gantzer J, Davidson G, Vokshi B, Weingertner N, Bougoüin A, Moreira M, Lindner V, Lacroix G, Mascaux C, Chenard MP, Bertucci F, Davidson I, Kurtz JE, Sautès-Fridman C, Fridman WH, Malouf GG. OUP accepted manuscript. Oncologist 2022; 27:501-511. [PMID: 35278076 PMCID: PMC9177113 DOI: 10.1093/oncolo/oyac040] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/14/2022] [Indexed: 11/14/2022] Open
Abstract
Background Thoracic SMARCA4-deficient undifferentiated tumors (SMARCA4-UT) are aggressive neoplasms. Data linking BAF alterations with tumor microenvironment (TME) and efficacy of immune checkpoint inhibitors (ICI) are contradictory. The TME of SMARCA4-UT and their response to ICI are unknown. Materials and Methods Patients diagnosed with SMARCA4-UT in our institution were included. Immunostainings for tertiary lymphoid structures (TLS), immune cell markers, and checkpoints were assessed. Validation was performed using an independent transcriptome dataset including SMARCA4-UT, non–small cell lung cancers (NSCLC) with/without SMARCA4 mutations, and unclassified thoracic sarcomas (UTS). CXCL9 and PD-L1 expressions were assessed in NSCLC and thoracic fibroblast cell lines, with/without SMARCA4 knockdown, treated with/without interferon gamma. Results Nine patients were identified. All samples but one showed no TLS, consistent with an immune desert TME phenotype. Four patients received ICI as part of their treatment, but the only one who responded, had a tumor with a TLS and immune-rich TME. Unsupervised clustering of the validation cohort using immune cell scores identified 2 clusters associated with cell ontogeny and immunity (cluster 1 enriched for NSCLC independently of SMARCA4 status (n = 9/10; P = .001); cluster 2 enriched for SMARCA4-UT (n = 11/12; P = .005) and UTS (n = 5/5; P = .0005). SMARCA4 loss-of-function experiments revealed interferon-induced upregulation of CXCL9 and PD-L1 expression in the NSCLC cell line with no effect on the thoracic fibroblast cell line. Conclusion SMARCA4-UT mainly have an immune desert TME with limited efficacy to ICI. TME of SMARCA4-driven tumors varies according to the cell of origin questioning the interplay between BAF alterations, cell ontogeny and immunity.
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Affiliation(s)
- Justine Gantzer
- Corresponding author: Justine Gantzer, Department of Medical Oncology, Strasbourg-Europe Cancer Institute (ICANS), 17 rue Albert Calmette, 67033 Strasbourg, France. Tel: +33 3 68 76 72 25;
| | - Guillaume Davidson
- Department of Cancer and Functional Genomics, INSERM UMR_S1258, Institute of Genetics and of Molecular and Cellular Biology, Illkirch, France
| | - Bujamin Vokshi
- Department of Cancer and Functional Genomics, INSERM UMR_S1258, Institute of Genetics and of Molecular and Cellular Biology, Illkirch, France
| | - Noëlle Weingertner
- Fédération de Médecine Translationnelle (FMTS), Strasbourg, France
- Department of Pathology, University Hospital, Strasbourg, France
| | - Antoine Bougoüin
- Centre de recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Team 13- Complement, Inflammation and Cancer, Équipe labellisée Ligue contre le cancer, Paris, France
| | - Marco Moreira
- Centre de recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Team 13- Complement, Inflammation and Cancer, Équipe labellisée Ligue contre le cancer, Paris, France
| | - Véronique Lindner
- Fédération de Médecine Translationnelle (FMTS), Strasbourg, France
- Department of Pathology, University Hospital, Strasbourg, France
| | - Guillaume Lacroix
- Centre de recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Team 13- Complement, Inflammation and Cancer, Équipe labellisée Ligue contre le cancer, Paris, France
| | - Céline Mascaux
- Department of Pneumology, University Hospital, Strasbourg, France
- University of Strasbourg, Inserm UMR_S 1113, IRFAC, Laboratory Streinth (STress REsponse and INnovative THerapy against cancer), Strasbourg, France
| | - Marie-Pierre Chenard
- Fédération de Médecine Translationnelle (FMTS), Strasbourg, France
- Department of Pathology, University Hospital, Strasbourg, France
| | - François Bertucci
- Department of Medical Oncology, Cancer Research Center of Marseille (CRCM), INSERM U1068, CNRS UMR7258, Institut Paoli Calmettes, Aix-Marseille University, Marseille, France
| | - Irwin Davidson
- Department of Cancer and Functional Genomics, INSERM UMR_S1258, Institute of Genetics and of Molecular and Cellular Biology, Illkirch, France
| | - Jean-Emmanuel Kurtz
- Department of Medical Oncology, Strasbourg-Europe Cancer Institute (ICANS), Strasbourg, France
- Fédération de Médecine Translationnelle (FMTS), Strasbourg, France
| | - Catherine Sautès-Fridman
- Centre de recherche des Cordeliers, INSERM, Université de Paris, Sorbonne Université, Team 13- Complement, Inflammation and Cancer, Équipe labellisée Ligue contre le cancer, Paris, France
| | | | - Gabriel G Malouf
- Gabriel G. Malouf, Department of Medical Oncology, Strasbourg-Europe Cancer Institute (ICANS), 17 rue Albert Calmette, 67033 Strasbourg, France. Tel: +33 3 68 76 72 17;
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9
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Lacroix G, Boleslawski E, Nzamushe JR. Hepatic compartment syndrome complicating a right laparoscopic nephrectomy and treated by surgical decompression. J Visc Surg 2021; 159:260-263. [PMID: 34774450 DOI: 10.1016/j.jviscsurg.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The hepatic compartment syndrome (HCS) corresponds to compression of the intraparenchymal liver tissue (intrahepatic pressure greater than the portal vein pressure, i.e. >10-15mmHg) caused by a subcapsular or intraparenchymal hematoma of the liver. It can lead to reversal of portal flow and hepatic parenchymal necrosis. We report the case of a patient who underwent a right radical nephrectomy by laparoscopy and who presented with HCS due to a subcapsular hematoma of the liver. Emergency decompression of the liver via laparotomy was performed, which allowed rapid clinical and laboratory improvement.
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Affiliation(s)
- G Lacroix
- Emergency Surgery Department, University Lille, CHU, 59000 Lille, France.
| | - E Boleslawski
- Department of Digestive Surgery and Transplants, University Lille, CHU, 59037 Lille, France
| | - J-R Nzamushe
- Emergency Surgery Department, University Lille, CHU, 59000 Lille, France
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10
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Madiedo-Podvršan S, Zhu F, Cattelin M, Martinez T, Sebillet L, Jellali R, Lacroix G, Vayssade M. Development of a newin vitro device for risk assessment of inhaled xenobiotics: Lung/Liver. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00532-4] [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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11
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Terry S, Dalban C, Rioux Leclercq N, Adam J, Meylan M, Buart S, Bougoüin A, Lespagnol A, Dugay F, Colina Moreno I, Lacroix G, Lorens JB, Gausdal G, Fridman WH, Mami-Chouaib F, Chaput N, Beuselinck B, Chabaud S, Barros Monteiro J, Vano Y, Escudier B, Sautes-Fridman C, Albiges L, Chouaib S. Association of AXL and PD-L1 expression with clinical outcomes in patients with advanced renal cell carcinoma treated with PD-1 blockade. Clin Cancer Res 2021; 27:6749-6760. [PMID: 34407968 DOI: 10.1158/1078-0432.ccr-21-0972] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/26/2021] [Accepted: 08/16/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE A minority of patients currently respond to single agent immune checkpoint blockade (ICB) and strategies to increase response rates are urgently needed. AXL is receptor tyrosine kinase commonly associated with drug-resistance and poor prognosis in many cancer types including in clear-cell renal cell carcinoma (ccRCC). Recent experimental cues in breast, pancreatic and lung cancer models have linked AXL with immune suppression and resistance to antitumor immunity. However, its role in intrinsic and acquired resistance to ICB remains largely unexplored. EXPERIMENTAL DESIGN In this study, tumoral expression of AXL was examined in ccRCC specimens from 316 metastatic patients receiving PD-1 inhibitor, nivolumab, in the GETUG AFU 26 NIVOREN trial after failure of anti-angiogenic therapy. We assessed associations between AXL and patient outcomes following PD-1 blockade, as well as the relationship with various markers including PD-L1, VEGFA, the immune markers CD3, CD8, CD163, CD20, and the mutational status of the tumor suppressor gene VHL Results: Our results show that high AXL expression levels in tumor cells is associated with lower response rates and a trend to shorter progression-free survival following anti-PD-1 treatment. AXL expression was strongly associated with tumor PD-L1 expression, especially in tumors with VHL inactivation. Moreover, patients with tumors displaying concomitant PD-L1 expression and high AXL expression had the worst overall survival. CONCLUSIONS Our findings propose AXL as candidate factor of resistance to PD-1 blockade, and provide compelling support for screening both AXL and PD-L1 expression in the management of advanced ccRCC.
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Affiliation(s)
| | | | | | | | - Maxime Meylan
- Inflammation, complement & cancer, Centre de Recherche des Cordeliers
| | | | - Antoine Bougoüin
- Inflammation, Complement and Cancer, Centre de Recherche des Cordeliers
| | - Alexandra Lespagnol
- Department of Somatic Cancer Genetics, Pontchaillou Hospital, CHU de Rennes, Rennes, France
| | | | | | - Guillaume Lacroix
- Inflammation, Complement and Cancer, Cordeliers Research Center, INSERM UMRS 1138
| | | | | | | | | | | | | | | | | | | | | | - Catherine Sautes-Fridman
- Laboratoire Inflammation, complement et cancer, Centre de Recherche des Cordeliers, Inserm UMRS 1138
| | - Laurence Albiges
- Department of Cancer Medicine, Institut Gustave Roussy, Université Paris Saclay
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12
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Daugan MV, Revel M, Russick J, Dragon-Durey MA, Gaboriaud C, Robe-Rybkine T, Poillerat V, Grunenwald A, Lacroix G, Bougouin A, Meylan M, Verkarre V, Oudard SM, Mejean A, Vano YA, Perkins G, Validire P, Cathelineau X, Sanchez-Salas R, Damotte D, Fremeaux-Bacchi V, Cremer I, Sautès-Fridman C, Fridman WH, Roumenina LT. Complement C1s and C4d as Prognostic Biomarkers in Renal Cancer: Emergence of Noncanonical Functions of C1s. Cancer Immunol Res 2021; 9:891-908. [PMID: 34039653 DOI: 10.1158/2326-6066.cir-20-0532] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 02/05/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022]
Abstract
The complement system plays a complex role in cancer. In clear cell renal cell carcinoma (ccRCC), local production of complement proteins drives tumor progression, but the mechanisms by which they do this are poorly understood. We found that complement activation, as reflected by high plasma C4d or as C4d deposits at the tumor site, was associated with poor prognosis in two cohorts of patients with ccRCC. High expression of the C4-activating enzyme C1s by tumor cells was associated with poor prognosis in three cohorts. Multivariate Cox analysis revealed that the prognostic value of C1s was independent from complement deposits, suggesting the possibility of complement cascade-unrelated, protumoral functions for C1s. Silencing of C1s in cancer cell lines resulted in decreased proliferation and viability of the cells and in increased activation of T cells in in vitro cocultures. Tumors expressing high levels of C1s showed high infiltration of macrophages and T cells. Modification of the tumor cell phenotype and T-cell activation were independent of extracellular C1s levels, suggesting that C1s was acting in an intracellular, noncanonical manner. In conclusion, our data point to C1s playing a dual role in promoting ccRCC progression by triggering complement activation and by modulating the tumor cell phenotype and tumor microenvironment in a complement cascade-independent, noncanonical manner. Overexpression of C1s by tumor cells could be a new escape mechanism to promote tumor progression.See related Spotlight by Magrini and Garlanda, p. 855. See article by Daugan et al., p. 909 (40).
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Affiliation(s)
- Marie V Daugan
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Margot Revel
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Jules Russick
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Marie-Agnès Dragon-Durey
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France.,Université de Paris, Paris, France.,Hôpital Européen Georges-Pompidou, Biological Immunology Department, Assistance Publique Hopitaux de Paris, Paris, France
| | | | - Tania Robe-Rybkine
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Victoria Poillerat
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Anne Grunenwald
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Guillaume Lacroix
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Antoine Bougouin
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Maxime Meylan
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Virginie Verkarre
- Université de Paris, Paris, France.,Hôpital Européen Georges-Pompidou, Pathology Department, Assistance Publique Hopitaux de Paris, Paris, France
| | - Stephane M Oudard
- Université de Paris, Paris, France.,Hôpital Européen Georges-Pompidou, Oncology Department, Assistance Publique Hopitaux de Paris, Paris, France
| | - Arnaud Mejean
- Université de Paris, Paris, France.,Hôpital Européen Georges-Pompidou, Urology Department, Assistance Publique Hopitaux de Paris, Paris, France
| | - Yann A Vano
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France.,Université de Paris, Paris, France.,Hôpital Européen Georges-Pompidou, Oncology Department, Assistance Publique Hopitaux de Paris, Paris, France
| | - Geraldine Perkins
- Hôpital Européen Georges-Pompidou, Gastroenterology and Hepatology Department, Assistance Publique Hopitaux de Paris, Paris, France
| | - Pierre Validire
- Department of Pathology, Institut Mutualiste Montsouris, Paris, France
| | - Xavier Cathelineau
- Université de Paris, Paris, France.,Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | | | - Diane Damotte
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France.,Université de Paris, Paris, France.,Hôpital Cochin, Departments of Pathology and Thoracic Surgery, Assistance Publique Hopitaux de Paris, Paris, France
| | - Veronique Fremeaux-Bacchi
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France.,Hôpital Européen Georges-Pompidou, Biological Immunology Department, Assistance Publique Hopitaux de Paris, Paris, France
| | - Isabelle Cremer
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Catherine Sautès-Fridman
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Wolf H Fridman
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France
| | - Lubka T Roumenina
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France.
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13
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Gantzer J, Davidson G, Vokshi B, Weingertner N, Bougoüin A, Moreira M, Lindner V, Lacroix G, Mascaux C, Chenard MP, Davidson I, Kurtz JE, Sautes-Fridman C, Fridman WH, Malouf G. Immune-desert tumor microenvironment in SMARCA4-deficient thoracic sarcomas with limited efficacy of immune checkpoint inhibitors. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.11552] [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: 11/20/2022] Open
Abstract
11552 Background: SMARCA4-deficient thoracic sarcomas (SDS) are rare and aggressive sarcomas characterized by inactivating SMARCA4 mutations, with no approved treatment to date. Previous data linking SWI/SNF deficiency with tumor immune microenvironment (TME) are contradictory. While an immunogenic microenvironment and efficacy of immune checkpoint inhibitors (ICI) were described in SMARCA4-deficient small cell carcinoma of the ovary, the TME phenotype of SDS is unknown; in addition, response of patients to ICI is lacking. Methods: All consecutive patients diagnosed with SDS between 2016 and 2019 in Strasbourg University Hospital were included and clinical outcomes collected. Immunostainings for immune cell markers, immune checkpoints and tertiary lymphoid structures (TLS) were assessed on available samples. Validation was performed using an independent transcriptomes dataset of SDS (n = 12), not otherwise specified (NOS) non-small cell lung cancer (NSCLC) with/without SMARCA4 mutations (n = 14) and undifferentiated thoracic sarcoma (n = 5). Finally, chemokines (CXL9 and CXCL10) and PD-L1 expressions were assessed in NSCLC and thoracic fibroblast cell lines, treated with/without interferon gamma (IFNG). Results: Nine patients were identified and had all metastatic disease at presentation, with a median overall survival of 1.8 months (0.3-NR). Among them, 4 received ICI as part of their treatment. Out of 11 evaluated tumors samples, all but one case showed no TLS, consistent with an immune desert TME phenotype charted by low densities of CD3+ T-cells, CD8+ T-cells, CD20+ B-cells from one side and high density of CD68+ macrophage-cells from the other side. Conversely, the unique tumor with TLS aggregate showed an immune-rich TME phenotype associated with high mutational tumor burden. While the patient with TLS harboring tumor showed an exceptional long-lasting response, the 3 remaining patients without TLS had progressive disease at best response to ICI. Using an independent cohort, unsupervised clustering using immune cell scores identified two clusters tightly associated with cell ontogeny of cancer subtypes and immunity; while cluster 1 (C1) was enriched for NOS NSCLC independently from SMARCA4 status (n = 9/10; 90%) (p = 0.001), C2 was enriched for SDS (n = 11/12; 91.7%) (p = 0.005) and undifferentiated thoracic sarcomas (n = 5/5; 100%) (p = 0.0005). Finally, SMARCA4 loss of function experiments revealed upregulation of chemokines (CXL9 and CXCL10) and PD-L1 expression in the NSCLC cell line with no effect on thoracic fibroblast cell line. Conclusions: SDS harbor an immune desert TME phenotype with limited efficacy to ICI, similar to other sarcomas. Our data suggest that TME of SMARCA4-driven tumors might vary according to the cell of origin. Further studies are needed to understand the interplay between SWI/SNF mutations, cell ontogeny and immunity.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Celine Mascaux
- Department of Pneumology, Hôpitaux Universitaire de Strasbourg, Strasbourg, France
| | | | | | | | | | | | - Gabriel Malouf
- Department of Medical Oncology, Institut de Cancérologie de Strasbourg (ICANS), Strasbourg, France
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14
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Abstract
PURPOSE OF THE STUDY To determine the statistical indicators aimed at identifying patients for whom ambulatory colectomy could be proposed without additional risk. PATIENTS AND METHODS The medical charts of patients who benefited from scheduled colonic or rectal resection during conventional hospitalization stays between 2018 and 2019 were reviewed. Eligibility for ambulatory colectomy was defined by hospital stay≤4 days and absence of any postoperative complication. Patient characteristics were compared, and the results were modeled in the form of a decision-making tree. The effect of an enhanced recovery after surgery (ERAS) protocol for each sub-group was calculated. RESULTS One hundred and ten (110) patients were selected (41 "eligible" and 69 "non-eligible"). Median age was 73 years (27-95). Nearly 80% of the patients were operated for cancer. In multivariate analysis, age (≥65 years, OR=3.15, CI95%=1.22-8.12), diabetes (OR=3.91, CI95%=1.03-14.8) and indication (sigmoidectomy for diverticulosis, OR=0.21, CI=95%=0.05-0.9) were the only identified independent variables. Likelihood for ambulatory eligibility was 83.3% (<65 years, sigmoidectomy pour diverticulosis, +ERAS=92%-96.9%), 58.3% (<65 years, other indication, +ERAS=63.4%-89.9%), 35.7% (≥65 years without diabetes, +ERAS=40.0%-55.9%) and 8.3% (≥65 years with diabetes, +ERAS=10.0%-20.1%). CONCLUSION Sigmoidectomy for diverticulosis in a patient under 65 years age represents the best indication for ambulatory colectomy, a procedure that must not be proposed to diabetic patients over 65 years of age. In the other cases (<65 years operated in another indication and non-diabetic≥65 years), ambulatory surgery is possible, pending satisfactory application of the ERAS protocol.
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Affiliation(s)
- S Bourgouin
- Department of Digestive and Oncological Surgery, Sainte Anne Military Teaching Hospital, Toulon, France.
| | - T Monchal
- Department of Digestive and Oncological Surgery, Sainte Anne Military Teaching Hospital, Toulon, France
| | - G Schlienger
- Department of Digestive and Oncological Surgery, Sainte Anne Military Teaching Hospital, Toulon, France
| | - L Franck
- Department of Anesthesia and Intensive Care, Sainte Anne Military Teaching Hospital, Toulon, France
| | - G Lacroix
- Department of Anesthesia and Intensive Care, Sainte Anne Military Teaching Hospital, Toulon, France
| | - P Balandraud
- Department of Digestive and Oncological Surgery, Sainte Anne Military Teaching Hospital, Toulon, France; École du Val-de-Grâce, Paris, France
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15
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Abstract
Preterm births are a global health priority that affects 15 million babies every year worldwide. There are no effective prognostic and therapeutic strategies relating to preterm delivery, but uterine infections appear to be a major cause. The vaginal epithelium is covered by the cervicovaginal mucus, which is essential to health because of its direct involvement in reproduction and functions as a selective barrier by sheltering the beneficial lactobacilli while helping to clear pathogens. During pregnancy, the cervical canal is sealed with a cervical mucus plug that prevents the vaginal flora from ascending toward the uterine compartment, which protects the fetus from pathogens. Abnormalities of the cervical mucus plug and bacterial vaginosis are associated with a higher risk of preterm delivery. This review addresses the current understanding of the cervicovaginal mucus and the cervical mucus plug and their interactions with the microbial communities in both the physiological state and bacterial vaginosis, with a focus on gel-forming mucins. We also review the current state of knowledge of gel-forming mucins contained in mouse cervicovaginal mucus and the mouse models used to study bacterial vaginosis.
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16
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Gaudray E, N’ Guyen C, Martin E, Lyochon A, Dagain A, Bordes J, Cordier P, Lacroix G. Efficacy of scalp nerve blocks using ropivacaïne 0,75% associated with intravenous dexamethasone for postoperative pain relief in craniotomies. Clin Neurol Neurosurg 2020; 197:106125. [DOI: 10.1016/j.clineuro.2020.106125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/10/2020] [Accepted: 07/30/2020] [Indexed: 11/24/2022]
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17
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Denis Page B, Carl M, Daniels D, Dominguez F, Essers ML, Hollman PCH, Rico II, Ito Y, Kaiser R, Kempf U, Kittle C, Lacroix G, Lombaert G, Miyata M, Pettipas R, Pocifia R, Willis C, Wong L. Liquid Chromatographic Method for the Determination of Nine Phenolic Antioxidants in Butter Oil: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/76.4.765] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Ten laboratories collaboratively studied a liquid chromatographic (LC) method for the determination of propyl, octyl, and dodecyl gallate (PG, OG, and DG, respectively), 2,4,5-trihydroxybutyrophenone (THBP), ferf-butylhydroquinone (TBHQ), nordihydroguaiaretic acid (NDGA), 2- and 3-tert-butyl-4- hydroxyanisole (BHA), 2,6-di-ferf-butyl-4-hydroxymethylphenol (lonox-100), and 3,5-di-terf-butyl-4- hydroxytoluene (BHT) in butter oil. The 10 samples analyzed were spiked in matched pairs at about 100,50, and 10 μg/g. In the method studied, antioxidants are extracted as in AOAC LC method 983.15, but different LC eluants are used to separate the 9 antioxidants. Results from 1 laboratory were rejected as not valid and were not included in any calculations. For the remaining 9 laboratories, the overall mean recoveries for PG, THBP, TBHQ, NDGA, BHA, OG, lonox, BHT, and DG were 100.9, 97.8,103.4,95.4, 97.4,93.6,95.5,79.0, and 96.2%, respectively. The overall reproducibility relative standard deviations were 8.55,17.4,25.6,14.5,6.60, 9.64,10.8,11.4, and 7.35%, respectively. The method was adopted first action by AOAC International as a modification of AOAC method 983.15.
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Affiliation(s)
- B Denis Page
- Health and Welfare Canada, Health Protection Branch, Food Directorate, Bureau of Chemical Safety, Food Research Division, Ottawa, ON, Kl A 0L2, Canada
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18
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Petitprez F, de Reyniès A, Keung EZ, Chen TWW, Sun CM, Calderaro J, Jeng YM, Hsiao LP, Lacroix L, Bougoüin A, Moreira M, Lacroix G, Natario I, Adam J, Lucchesi C, Laizet YH, Toulmonde M, Burgess MA, Bolejack V, Reinke D, Wani KM, Wang WL, Lazar AJ, Roland CL, Wargo JA, Italiano A, Sautès-Fridman C, Tawbi HA, Fridman WH. B cells are associated with survival and immunotherapy response in sarcoma. Nature 2020; 577:556-560. [PMID: 31942077 DOI: 10.1038/s41586-019-1906-8] [Citation(s) in RCA: 1026] [Impact Index Per Article: 256.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/26/2019] [Indexed: 12/21/2022]
Abstract
Soft-tissue sarcomas represent a heterogeneous group of cancer, with more than 50 histological subtypes1,2. The clinical presentation of patients with different subtypes is often atypical, and responses to therapies such as immune checkpoint blockade vary widely3,4. To explain this clinical variability, here we study gene expression profiles in 608 tumours across subtypes of soft-tissue sarcoma. We establish an immune-based classification on the basis of the composition of the tumour microenvironment and identify five distinct phenotypes: immune-low (A and B), immune-high (D and E), and highly vascularized (C) groups. In situ analysis of an independent validation cohort shows that class E was characterized by the presence of tertiary lymphoid structures that contain T cells and follicular dendritic cells and are particularly rich in B cells. B cells are the strongest prognostic factor even in the context of high or low CD8+ T cells and cytotoxic contents. The class-E group demonstrated improved survival and a high response rate to PD1 blockade with pembrolizumab in a phase 2 clinical trial. Together, this work confirms the immune subtypes in patients with soft-tissue sarcoma, and unravels the potential of B-cell-rich tertiary lymphoid structures to guide clinical decision-making and treatments, which could have broader applications in other diseases.
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Affiliation(s)
- Florent Petitprez
- Team Cancer, Immune Control and Escape, Centre de Recherche des Cordeliers, INSERM, Paris, France
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Paris Cite, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre le Cancer, Paris, France
| | - Aurélien de Reyniès
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre le Cancer, Paris, France
| | - Emily Z Keung
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tom Wei-Wu Chen
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University Cancer Center, Taipei, Taiwan
- Centers of Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Ming Sun
- Team Cancer, Immune Control and Escape, Centre de Recherche des Cordeliers, INSERM, Paris, France
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Paris Cite, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
| | - Julien Calderaro
- Team Cancer, Immune Control and Escape, Centre de Recherche des Cordeliers, INSERM, Paris, France
- Département de Pathologie, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Creteil, France
- Institut Mondor de Recherche Biomédicale, Creteil, France
| | - Yung-Ming Jeng
- Centers of Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan
- Department of Pathology, National Taiwan University, Taipei, Taiwan
| | - Li-Ping Hsiao
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Laetitia Lacroix
- Team Cancer, Immune Control and Escape, Centre de Recherche des Cordeliers, INSERM, Paris, France
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Paris Cite, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
| | - Antoine Bougoüin
- Team Cancer, Immune Control and Escape, Centre de Recherche des Cordeliers, INSERM, Paris, France
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Paris Cite, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
| | - Marco Moreira
- Team Cancer, Immune Control and Escape, Centre de Recherche des Cordeliers, INSERM, Paris, France
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Paris Cite, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
| | - Guillaume Lacroix
- Team Cancer, Immune Control and Escape, Centre de Recherche des Cordeliers, INSERM, Paris, France
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Paris Cite, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
| | - Ivo Natario
- Team Cancer, Immune Control and Escape, Centre de Recherche des Cordeliers, INSERM, Paris, France
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Paris Cite, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
| | - Julien Adam
- Department of Biology and Pathology, Gustave Roussy, Villejuif, France
| | - Carlo Lucchesi
- Institut Bergonié, Bordeaux, France
- Bioinformatics Unit, Institut Bergonié, Bordeaux, France
| | - Yec Han Laizet
- Institut Bergonié, Bordeaux, France
- Bioinformatics Unit, Institut Bergonié, Bordeaux, France
| | - Maud Toulmonde
- Institut Bergonié, Bordeaux, France
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Melissa A Burgess
- Department of Medicine, Divison of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Denise Reinke
- Sarcoma Alliance for Research Through Collaboration, Ann Arbor, MI, USA
| | - Khalid M Wani
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wei-Lien Wang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alexander J Lazar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christina L Roland
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer A Wargo
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Antoine Italiano
- Institut Bergonié, Bordeaux, France
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
- University of Bordeaux, Bordeaux, France
| | - Catherine Sautès-Fridman
- Team Cancer, Immune Control and Escape, Centre de Recherche des Cordeliers, INSERM, Paris, France
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Paris Cite, Paris, France
- Centre de Recherche des Cordeliers, Sorbonne University, Paris, France
| | - Hussein A Tawbi
- Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Wolf H Fridman
- Team Cancer, Immune Control and Escape, Centre de Recherche des Cordeliers, INSERM, Paris, France.
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Paris Cite, Paris, France.
- Centre de Recherche des Cordeliers, Sorbonne University, Paris, France.
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Savard J, Ivers H, Caplette-Gingras A, Morin C, Bouchard S, Lauzon G, Lacroix G. Efficacy of a stepped care approach to offer cognitive-behavioral therapy for insomnia in cancer patients. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.941] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mathais Q, Montcriol A, Cotte J, Gil C, Contargyris C, Lacroix G, Prunet B, Bordes J, Meaudre E. Anesthesia during deployment of a military forward surgical unit in low income countries: A register study of 1547 anesthesia cases. PLoS One 2019; 14:e0223497. [PMID: 31584991 PMCID: PMC6777794 DOI: 10.1371/journal.pone.0223497] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/22/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Military anesthesia meets unique logistical, technical, tactical, and human constraints, but to date limited data have been published on anesthesia management during military operations. OBJECTIVE This study aimed to describe and analyze French anesthetic activity in a deployed military setting. METHODS Between October 2015 and February 2018, all patients managed by Sainte-Anne Military Hospital anesthesiologists deployed in mission were included. Anesthesia management was described and compared with the same surgical procedures in France performed by the same anesthesia team (hernia repair, lower and upper limb surgeries). Demographics, type of surgical procedure, and surgical activity were also described. The primary endpoint was to describe anesthesia management during the deployment of forward surgical teams (FST). The secondary endpoint was to compare anesthesia modalities during FST deployment with those usually used in a military teaching hospital. RESULTS During the study period, 1547 instances of anesthesia were performed by 11 anesthesiologists during 20 missions, totaling 1237 days of deployment in nine different theaters. The majority consisted of regional anesthesia, alone (43.5%) or associated with general anesthesia (21%). Compared with France, there was a statistically significant increase in the use of regional anesthesia in hernia repair, lower and upper limb surgeries during deployment. The majority of patients were civilians as part of medical support to populations. CONCLUSION In the context of an austere environment, the use of regional anesthesia techniques predominated when possible. These results show that the training of military anesthetists must be complete, including anesthesia, intensive care, pediatrics, and regional anesthesia.
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Affiliation(s)
- Quentin Mathais
- Department of Anesthesiology and Intensive care, Military Hospital Sainte-Anne, Toulon, France
- * E-mail:
| | - Ambroise Montcriol
- Department of Anesthesiology and Intensive care, Military Hospital Sainte-Anne, Toulon, France
| | - Jean Cotte
- Department of Anesthesiology and Intensive care, Military Hospital Sainte-Anne, Toulon, France
| | - Céline Gil
- Department of Anesthesiology and Intensive care, Military Hospital Sainte-Anne, Toulon, France
| | - Claire Contargyris
- Department of Anesthesiology and Intensive care, Military Hospital Sainte-Anne, Toulon, France
| | - Guillaume Lacroix
- Department of Anesthesiology and Intensive care, Military Hospital Sainte-Anne, Toulon, France
| | - Bertrand Prunet
- Service Médical de la Brigade des Sapeurs Pompiers de Paris, Paris, France
- French Military Health Service Academy Unit, Ecole du Val-De-Grâce, Paris, France
| | - Julien Bordes
- Department of Anesthesiology and Intensive care, Military Hospital Sainte-Anne, Toulon, France
- French Military Health Service Academy Unit, Ecole du Val-De-Grâce, Paris, France
| | - Eric Meaudre
- Department of Anesthesiology and Intensive care, Military Hospital Sainte-Anne, Toulon, France
- French Military Health Service Academy Unit, Ecole du Val-De-Grâce, Paris, France
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21
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Cardinale M, Esnault P, d'Aranda E, Meaudre E, Lacroix G. Validation of a monitoring matrix for patients with brain injuries. Injury 2019; 50:79-81. [PMID: 30224177 DOI: 10.1016/j.injury.2018.09.016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 09/07/2018] [Accepted: 09/08/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Brain injury is a leading cause of death and disabilities worldwide. The severity of brain damage is of course related to the primary injury. Secondary brain insults are the most powerful determinants of outcome from severe head injury. To improve the outcome, it needs to be well detected to be controlled. The detection of these factors can be difficult among numerous data. The objective of this work was to validate a monitoring matrix to help this screening. We hypothesise that a monitoring matrix will improve the detection rate of factors linked to secondary brain injury (SBI). METHOD We conducted a single-center prospective observational simulation study. We designed a monitoring matrix compiling all the brain insults, intracranial data (ICP, CCP, PtiO2) and systemic data (PaCO2, PaO2, temperature, natremia, hemoglobin). Each caregiver had to analyze the same simulated data with a standard monitoring sheet and with the monitoring matrix. We then compared the detection rate of SBI factors. RESULTS 25 caregivers analyzed a total of 265 matrixes. The monitoring matrix had a sensitivity of 96.5% and a specificity of 99.9% versus 69.9% and 67.8% respectively for the standard monitoring sheet. The detection rate was significantly higher with the monitoring matrix (96.5%) versus the standard monitoring sheet (69.9%), regardless of the caregiver's status. It is also improved among nurses, regardless of their seniority. CONCLUSION The use of this monitoring matrix is simple and inexpensive. The monitoring matrix improves significantly the detection rate of factors linked to secondary brain injury. It also provides homogenization of the detection rate among the physicians and nurses regardless of their experience. Nurses becoming as qualified as physicians, allows earlier detection and therefore a faster treatment.
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Affiliation(s)
- Mickaël Cardinale
- Department of Anesthesiology and Intensive Care, Military Hospital, Hôpital d'Instruction des Armées Sainte-Anne, France.
| | - Pierre Esnault
- Department of Anesthesiology and Intensive Care, Military Hospital, Hôpital d'Instruction des Armées Sainte-Anne, France
| | - Erwan d'Aranda
- Department of Anesthesiology and Intensive Care, Military Hospital, Hôpital d'Instruction des Armées Sainte-Anne, France
| | - Eric Meaudre
- Department of Anesthesiology and Intensive Care, Military Hospital, Hôpital d'Instruction des Armées Sainte-Anne, France
| | - Guillaume Lacroix
- Department of Anesthesiology and Intensive Care, Military Hospital, Hôpital d'Instruction des Armées Sainte-Anne, France
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Gouyer V, Demouveaux B, Lacroix G, Valque H, Gottrand F, Desseyn JL. Non-C-mannosylable mucin CYS domains hindered proper folding and secretion of mucin. Biochem Biophys Res Commun 2018; 506:812-818. [PMID: 30389136 DOI: 10.1016/j.bbrc.2018.10.138] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 10/22/2018] [Indexed: 01/12/2023]
Abstract
The CYS domain occurs in multiple copies in many gel-forming mucins. It is believed that CYS domains can interact with each other in a reversible manner, suggesting a key role of the domain in gel formation. This domain always contains in its amino-terminal sequence the C-mannosylation motif WXXW, but whether the CYS domain is C-mannosylated is debated, and the putative role of C-mannosylation of the domain is unclear. We prepared recombinant CYS domains of the human mucin MUC5B with (WXXW→AXXW) and without a single amino acid mutation and mini-5B mucins made of a large Ser/Thr/Pro region flanked by two CYS domains with the WXXW motif or with the mutated AXXW motif on the first, second or both CYS domains. We found that the single CYS domain and the two CYS domains of mini-5B mucin must be C-mannosylable for the efficient maturation and secretion of the recombinant molecules; otherwise, they are retained in the cell and co-localized with a resident enzyme of the endoplasmic reticulum.
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Affiliation(s)
- Valérie Gouyer
- Inserm, Université de Lille, CHU Lille, LIRIC UMR 995, Lille, France
| | | | - Guillaume Lacroix
- Inserm, Université de Lille, CHU Lille, LIRIC UMR 995, Lille, France
| | - Hélène Valque
- Inserm, Université de Lille, CHU Lille, LIRIC UMR 995, Lille, France
| | - Frédéric Gottrand
- Inserm, Université de Lille, CHU Lille, LIRIC UMR 995, Lille, France
| | - Jean-Luc Desseyn
- Inserm, Université de Lille, CHU Lille, LIRIC UMR 995, Lille, France.
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23
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Desmit X, Thieu V, Billen G, Campuzano F, Dulière V, Garnier J, Lassaletta L, Ménesguen A, Neves R, Pinto L, Silvestre M, Sobrinho JL, Lacroix G. Reducing marine eutrophication may require a paradigmatic change. Sci Total Environ 2018; 635:1444-1466. [PMID: 29710669 DOI: 10.1016/j.scitotenv.2018.04.181] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 04/13/2018] [Accepted: 04/13/2018] [Indexed: 06/08/2023]
Abstract
Marine eutrophication in the North-East Atlantic (NEA) strongly relies on nutrient enrichment at the river outlets, which is linked to human activities and land use in the watersheds. The question is whether human society can reduce its nutrient emissions by changing land use without compromising food security. A new version of Riverstrahler model (pyNuts-Riverstrahler) was designed to estimate the point and diffuse nutrient emissions (N, P, Si) to the rivers depending on land use in the watersheds across a large domain (Western Europe agro-food systems, waste water treatment). The loads from the river model have been used as inputs to three marine ecological models (PCOMS, ECO-MARS3D, MIRO&CO) covering together a large part of the NEA from the Iberian shelf to the Southern North Sea. The modelling of the land-ocean continuum allowed quantifying the impact of changes in land use on marine eutrophication. Pristine conditions were tested to scale the current eutrophication with respect to a "natural background" (sensu WFD), i.e. forested watersheds without any anthropogenic impact. Three scenarios representing potential management options were also tested to propose future perspectives in mitigating eutrophication. This study shows that a significant decrease in nitrogen fluxes from land to sea is possible by adapting human activities in the watersheds, preventing part of the eutrophication symptoms in the NEA rivers and adjacent coastal zones. It is also shown that any significant achievement in that direction would very likely require paradigmatic changes at social, economic and agricultural levels. This requires reshaping the connections between crop production and livestock farming, and between agriculture and local human food consumption. It also involves cultural changes such as less waste production and a shift towards lower-impact and healthier diets where half of the animal products consumption is replaced by vegetal proteins consumption, known as a demitarian diet (http://www.nine-esf.org/node/281/index.html).
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Affiliation(s)
- X Desmit
- RBINS (Royal Belgian Institute of Natural Sciences), Operational Directorate Natural Environment, Brussels, Belgium.
| | - V Thieu
- UMR 7619 METIS, Sorbonne University, CNRS, EPHE, 4 place Jussieu, 75005 Paris, France
| | - G Billen
- UMR 7619 METIS, Sorbonne University, CNRS, EPHE, 4 place Jussieu, 75005 Paris, France
| | - F Campuzano
- MARETEC, Instituto Superior Técnico, Universidade de Lisboa, Portugal
| | - V Dulière
- RBINS (Royal Belgian Institute of Natural Sciences), Operational Directorate Natural Environment, Brussels, Belgium
| | - J Garnier
- UMR 7619 METIS, Sorbonne University, CNRS, EPHE, 4 place Jussieu, 75005 Paris, France
| | - L Lassaletta
- UMR 7619 METIS, Sorbonne University, CNRS, EPHE, 4 place Jussieu, 75005 Paris, France; CEIGRAM/Department of Agricultural Production, Universidad Politecnica de Madrid, Madrid 28040, Spain
| | - A Ménesguen
- IFREMER, Dynamiques de l'Environnement Côtier (DYNECO), Plouzané, France
| | - R Neves
- MARETEC, Instituto Superior Técnico, Universidade de Lisboa, Portugal
| | - L Pinto
- MARETEC, Instituto Superior Técnico, Universidade de Lisboa, Portugal
| | - M Silvestre
- FIRE FR-3020, CNRS, Sorbonne University, 4 place Jussieu, 75005 Paris, France
| | - J L Sobrinho
- MARETEC, Instituto Superior Técnico, Universidade de Lisboa, Portugal
| | - G Lacroix
- RBINS (Royal Belgian Institute of Natural Sciences), Operational Directorate Natural Environment, Brussels, Belgium
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Siaffa R, Bordes J, Vatin L, Prunet B, Vinciguerra D, Meaudre E, Lacroix G. Effectiveness of regional anaesthesia for treatment of facial and hand wounds by emergency physicians: A 9-month prospective study. Anaesth Crit Care Pain Med 2018; 37:577-581. [PMID: 29476939 DOI: 10.1016/j.accpm.2018.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 01/26/2018] [Accepted: 02/16/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We compared the effectiveness of nerve blocks (regional anaesthesia, [RA]) versus local anaesthesia (LA) to treat face and hand wounds. Emergency physicians who had not previously used nerve blocks administered the anaesthesia based on anatomic landmarks. METHODS This prospective observational open study was conducted at a military teaching hospital emergency department (ED) between May 1, 2013 and January 31, 2014. All patients requiring treatment of facial or hand wounds were included. The primary outcome was anaesthesia effectiveness 15minutes post-administration. We also recorded the number of injections sites, injected volume, pain of administration, operator comfort, and complications. Lidocaine anaesthesia without epinephrine was used. RESULTS Of the 1090 treated patients, 617 patients were included in the analysis: 316 with hand wounds and 301 with facial wounds. Overall, 130 wrist blocks and 63 facial blocks were performed. RA effectiveness was comparable to that of LA: for facial wounds, RA=88.9% versus LA=89% (P=0.86); for hand wounds, RA=82.2% versus LA=90.1% (P=0.15). RA groups had significantly fewer injections than the LA groups, and less anesthetic was injected in the facial RA group. The pain of anaesthesia administration and operator comfort was similar. There was no complication during the 9-month data collection period. CONCLUSION Facial and wrist nerve blocks are easy to administer and as efficient as local infiltrations, plus they require fewer injection sites, and, for facial RA, less anesthetic. Their teaching and use should be more widespread in EDs.
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Affiliation(s)
- R Siaffa
- Emergency Department, Sainte-Anne Military Hospital, 2, boulevard Sainte-Anne, 83800 Toulon, France.
| | - J Bordes
- Anaesthesia and Critical Care Department, Sainte-Anne Military Hospital, 2, boulevard Sainte-Anne, 83800 Toulon, France
| | - L Vatin
- ENT Department, Sainte-Anne Military Hospital, 2, boulevard Sainte-Anne, 83800 Toulon, France
| | - B Prunet
- Anaesthesia and Critical Care Department, Sainte-Anne Military Hospital, 2, boulevard Sainte-Anne, 83800 Toulon, France
| | - D Vinciguerra
- Emergency Department, Sainte-Anne Military Hospital, 2, boulevard Sainte-Anne, 83800 Toulon, France
| | - E Meaudre
- Anaesthesia and Critical Care Department, Sainte-Anne Military Hospital, 2, boulevard Sainte-Anne, 83800 Toulon, France
| | - G Lacroix
- Anaesthesia and Critical Care Department, Sainte-Anne Military Hospital, 2, boulevard Sainte-Anne, 83800 Toulon, France
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25
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Beltempo M, Lacroix G, Cabot M, Blais R, Piedboeuf B. Association of nursing overtime, nurse staffing and unit occupancy with medical incidents and outcomes of very preterm infants. J Perinatol 2018; 38:175-180. [PMID: 28933776 DOI: 10.1038/jp.2017.146] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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] [Received: 01/31/2017] [Revised: 07/14/2017] [Accepted: 08/11/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the association of nursing overtime, nursing provision and unit occupancy rate with medical incident rates in the neonatal intensive care unit (NICU) and the risk of mortality or major morbidity among very preterm infants. STUDY DESIGN Single center retrospective cohort study of infants born within 23 to 29 weeks of gestational age or birth weight <1000 g admitted at a 56 bed, level III NICU. Nursing overtime ratios (nursing overtime hours/total nursing hours), nursing provision ratios (nursing hours/recommended nursing hours based on patient dependency categories) and unit occupancy rates were pooled for all shifts during NICU hospitalization of each infant. Log-binomial models assessed their association with the composite outcome (mortality or major morbidity). RESULTS Of the 257 infants that met the inclusion criteria, 131 (51%) developed the composite outcome. In the adjusted multivariable analyses, high (>3.4%) relative to low nursing overtime ratios (⩽3.4%) were not associated with the composite outcome (relative risk (RR): 0.93; 95% confidence interval (CI): 0.86 to 1.02). High nursing provision ratios (>1) were associated with a lower risk of the composite outcome relative to low ones (⩽1) (RR: 0.81; 95% CI: 0.74 to 0.90). NICU occupancy rates were not associated with the composite outcome (RR: 0.98; 95% CI: 0.89 to 1.07, high (>100%) vs low (⩽100%)). Days with high nursing provision ratios (>1) were also associated with lower risk of having medical incidents (RR: 0.91; 95% CI: 0.82 to 0.99). CONCLUSION High nursing provision ratio during NICU hospitalization is associated with a lower risk of a composite adverse outcome in very preterm infants.
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Affiliation(s)
- M Beltempo
- Department of Pediatrics, McGill University Health Centre, Montreal, QC, Canada
| | - G Lacroix
- Department of Economics, Université Laval, Ville de Québec, QC, Canada
| | - M Cabot
- Department of Pediatrics, CHU de Québec and Université Laval, Ville de Québec, QC, Canada
| | - R Blais
- Department of Health Administration, Université de Montreal, Montreal, QC, Canada
| | - B Piedboeuf
- Department of Pediatrics, CHU de Québec and Université Laval, Ville de Québec, QC, Canada
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Papineau E, Lacroix G, Sévigny S, Biron JF, Corneau-Tremblay N, Lemétayer F. Assessing the differential impacts of online, mixed, and offline gambling. International Gambling Studies 2017. [DOI: 10.1080/14459795.2017.1378362] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- E. Papineau
- Institut national de santé publique du Québec, Clinical lecturer, Département de médecine sociale et préventive, Université de Montréal, Montréal, Canada
- Institut de recherche en santé publique, Université de Montréal, Montréal, Canada
| | - G. Lacroix
- Département d’économique, Université Laval, Québec, Canada
| | - S. Sévigny
- Département des fondements et pratiques en éducation, Université Laval, Québec, Canada
| | - J.-F. Biron
- Direction de santé publique, CIUSSS du Centre-Sud de l’île de Montréal, Montréal, Canada
| | | | - F. Lemétayer
- Institut national de santé publique du Québec, Montréal, Canada
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Vanoye C, Lacroix G, Le Gonidec E, Couret A, Benois A, Peigne V. Local-regional anesthesia in the management of stingray stings: Experience of the Bouffard medical-surgical hospital in Djibouti. Med Sante Trop 2017; 27:40-43. [PMID: 28132951 DOI: 10.1684/mst.2016.0638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Stingray injuries are very painful. Systemic analgesics are ineffective, and the use of local-regional anesthesia has been reported. This retrospective descriptive study reviewed all cases of stingray injuries seen at the emergency department of the Bouffard Hospital (Djbouti, Africa) between 2011 and 2014. The study included 35 patients. Most of the injuries (n= 31, 89%) concerned the lower limbs. Median pain intensity was 6 [5-8] on a visual analog scale of 0 (no pain) to 10. The following systemic medications were administered: acetaminophen to 13 (27%) patients, morphine to 8 (23%), and tramadol to 6 (17%). In all, 25 (71%) patients received local-regional anesthesia, 15 (60%) by injections at the ankle. All procedures were successful, and no adverse event was reported. This study reports clinical data about stingray injuries in the Red Sea area and highlights the interest of local-regional anesthesia in their management. Most of the procedures were distal and could be performed by trained emergency physicians.
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28
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Goutorbe P, Montcriol A, Lacroix G, Bordes J, Meaudre E, Souraud JB. Intestinal Necrosis Associated with Orally Administered Calcium Polystyrene Sulfonate Without Sorbitol. Ann Pharmacother 2015; 45:e13. [PMID: 21304040 DOI: 10.1345/aph.1m547] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To describe a case of extensive intestinal necrosis with oral intake of calcium polystyrene sulfonate without sorbitol. CASE SUMMARY A 73-year-old woman was admitted to the emergency department with abdominal pain. Abdominal computed tomography (CT) scan showed widespread dilatation of the bowel. The diagnosis of acute colonic pseudoobstruction was made. On day 3, her serum potassium level rose to 5.6 mEq/L. It was treated with hydrocortisone 100 mg/day and calcium polystyrene sulfonate 15 g/day via nasogastric tube from day 3 to day 6. On day 6, the severe abdominal pain recurred, with abdominal tenderness. CT scan showed pneumoperitoneum and peritoneal effusion. At surgery, 2 lenticular jejunal perforations and an ischemic cecum were found. Microscopic findings indicated that the transmural abscess contained massive inflammatory infiltrate and the cecal mucosa showed ulceration and inflammation with a fibrinous and purulent coating. Small gray-purple or blue angulated crystals were embedded in the cecal and most of the jejunal mucosal ulcers. On day 19, the patient died of multiple organ failure after her third laparotomy. DISCUSSION Ion-exchanging resins are given orally or by retention enema for the treatment of hyperkalemia. The most commonly used and best-established resin is sodium polystyrene sulfonate. However, it is known to promote colonic necrosis when sorbitol is also given or especially in patients with renal failure or postoperative ileus. Calcium polystyrene sulfonate is another ion-exchange resin. There are few reports of adverse effects in the literature. Our case is interesting for 2 reasons: the resin given was calcium polystyrene sulfonate and sorbitol was not used. CONCLUSIONS Like sodium polystyrene sulfonate, calcium polystyrene sulfonate is an ion-exchanging resin that can promote bowel necrosis. We believe that it should not be used with sorbitol or when bowel transit time is slowed.
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Affiliation(s)
- Philippe Goutorbe
- Philippe Goutorbe MD, Clinical Specialist, Head of Department of Intensive Care, Sainte Anne Military Teaching Hospital, Toulon, France
| | - Ambroise Montcriol
- Ambroise Montcriol MD, Clinical Specialist, ICU, Sainte Anne Military Teaching Hospital
| | - Guillaume Lacroix
- Guillaume Lacroix MD, Clinical Specialist, ICU, Sainte Anne Military Teaching Hospital
| | - Julien Bordes
- Julien Bordes MD, Clinical Specialist, ICU, Sainte Anne Military Teaching Hospital
| | - Eric Meaudre
- Eric Meaudre MD, Clinical Specialist, ICU, Sainte Anne Military Teaching Hospital
| | - Jean-Baptiste Souraud
- Jean-Baptiste Souraud MD, Clinical Specialist, Anathomopathology, Sainte Anne Military Teaching Hospital
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Cotte J, Courjon F, Beaume S, Prunet B, Bordes J, N'Guyen C, Contargyris C, Lacroix G, Montcriol A, Kaiser E, Meaudre E. Vittel criteria for severe trauma triage: Characteristics of over-triage. Anaesth Crit Care Pain Med 2015; 35:87-92. [PMID: 26592159 DOI: 10.1016/j.accpm.2015.06.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 02/01/2015] [Revised: 06/26/2015] [Accepted: 06/29/2015] [Indexed: 11/16/2022]
Abstract
AIM Over-triage rates related to the use of Vittel criteria are unknown. We compared severe stable trauma patients with and without significant visceral injuries. STUDY DESIGN A single-centre retrospective analysis of a single-centre prospective cohort. PATIENTS AND METHODS Trauma patients with at least one positive Vittel criterion from June 2010 to January 2012 in a level-1 trauma centre. Initial management included a systematic whole-body scanner. All significant lesions in stable trauma patients were recorded. RESULTS A total of 252 trauma patients were admitted. One hundred and twenty were stable. In this group without vital distress, 72 (60%) had at least one occult lesion, 21 (17.5%) had an isolated orthopaedic injury and 27 (22.5%) had no injury. Thoracic injuries accounted for 44% of visceral injuries, abdominal for 17%, spinal for 16% and cerebral for 15%. Overall, the over-triage rate was 19%. Surgery for significant visceral injury was performed in 13 patients (18%) and arteriography in 4 patients (5.5%). Admission in an intensive care unit was required for 13 patients with occult injuries and for one patient without such a lesion (18% versus 2%, P=0.008). Hospital stays were longer in the group with visceral injuries (4±7 versus 9±8days; P=0.006). CONCLUSION Vittel criteria use in trauma patients induces an acceptable over-triage rate. A large proportion of stable trauma patients have occult lesions. These visceral injuries frequently require special care. These data highlight the imperative need to transport major trauma patients immediately to a dedicated trauma centre and supports whole-body scanner use.
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Affiliation(s)
- Jean Cotte
- Anaesthesia and Intensive Care Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
| | - Fredrik Courjon
- Emergency Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
| | - Sébastien Beaume
- Emergency Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
| | - Bertrand Prunet
- Anaesthesia and Intensive Care Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
| | - Julien Bordes
- Anaesthesia and Intensive Care Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
| | - Cédric N'Guyen
- Anaesthesia and Intensive Care Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
| | - Claire Contargyris
- Anaesthesia and Intensive Care Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
| | - Guillaume Lacroix
- Anaesthesia and Intensive Care Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
| | - Ambroise Montcriol
- Anaesthesia and Intensive Care Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
| | - Eric Kaiser
- Anaesthesia and Intensive Care Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
| | - Eric Meaudre
- Anaesthesia and Intensive Care Department, Sainte-Anne Military Hospital, BP 20545, 83041 Toulon cedex 9, France.
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Esnault P, Prunet B, Cungi PJ, Caubere A, Lacroix G, Bordes J, David JS, Gonzalez JF, Kaiser E. [Thromboelastometric profile of unwashed shed blood after primary knee arthroplasty]. Transfus Clin Biol 2015; 22:30-6. [PMID: 25595822 DOI: 10.1016/j.tracli.2014.12.001] [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: 11/02/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Knee arthroplasty causes significant blood loss. Different blood-saving measures exist like retransfusion of unwashed salvaged blood. Some studies question the quality of this blood and in particular its ability to clot. These studies use "static" coagulation tests reflecting only partially the reality, unlike viscoelastic methods. The main objective of this study was to evaluate the salvaged blood thromboelastometric profile using ROTEM® system and to compare these results with patient venous blood. MATERIALS AND METHODS We performed an observational, prospective, single-center study conducted over 3 months in 2013. Agreement of local ethical committee and patient consent were obtained beforehand. All adult patients who underwent a primary total knee arthroplasty were included. A thromboelastometric profile and standard laboratory tests (hemoglobin, platelets count, PT, aPTT, fibrinogen) were performed in the same time on patient venous blood and on unwashed salvaged blood in the PACU. RESULTS Twenty patients were included. The median duration of surgery was 93 minutes. Thirteen patients (65%) received tranexamic acid during procedure. The median volume of shed blood was 225 mL. Two patients (10%) received a reinfusion. Analysis of shed blood showed a major deficiency of clotting factor in standard biology (PT<10%) and an absence of clot formation in thromboelastometric test (In-tem®, Ex-tem®, Fib-tem® or Ap-tem®). Compared to venous blood, shed blood had significantly lower hemoglobin levels: 8.8 vs 13.5 g/dL (P<0.0001). Allogenic transfusion concerned 5% of patients. DISCUSSION In this work, we confirmed that shed blood was naturally uncoagulable probably due to a multifactorial mechanism involving a major clot factor deficiency and an activation of fibrinolysis.
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Affiliation(s)
- P Esnault
- Département d'anesthésie réanimation, hôpital d'instruction des armées Sainte-Anne, 83000 Toulon, France.
| | - B Prunet
- Département d'anesthésie réanimation, hôpital d'instruction des armées Sainte-Anne, 83000 Toulon, France
| | - P J Cungi
- Département d'anesthésie réanimation, hôpital d'instruction des armées Sainte-Anne, 83000 Toulon, France
| | - A Caubere
- Service de chirurgie orthopédique et traumatologique, hôpital d'instruction des armées Sainte-Anne, 83000 Toulon, France
| | - G Lacroix
- Département d'anesthésie réanimation, hôpital d'instruction des armées Sainte-Anne, 83000 Toulon, France
| | - J Bordes
- Département d'anesthésie réanimation, hôpital d'instruction des armées Sainte-Anne, 83000 Toulon, France
| | - J-S David
- Département d'anesthésie réanimation, hospices civils de Lyon, CHU de Lyon Sud, 69310 Lyon, France
| | - J F Gonzalez
- Service de chirurgie orthopédique et traumatologique, hôpital d'instruction des armées Sainte-Anne, 83000 Toulon, France
| | - E Kaiser
- Département d'anesthésie réanimation, hôpital d'instruction des armées Sainte-Anne, 83000 Toulon, France
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Prunet B, Basely M, D'Aranda E, Cambefort P, Pons F, Cimarelli S, Dagain A, Desse N, Veyrieres JB, Jego C, Lacroix G, Esnault P, Boret H, Goutorbe P, Bussy E, Habib G, Meaudre E. Impairment of cardiac metabolism and sympathetic innervation after aneurysmal subarachnoid hemorrhage: a nuclear medicine imaging study. Crit Care 2014; 18:R131. [PMID: 24964817 PMCID: PMC4230019 DOI: 10.1186/cc13943] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 06/13/2014] [Indexed: 12/11/2022]
Abstract
Introduction Although aneurysmal subarachnoid hemorrhage (SAH) is often complicated by myocardial injury, whether this neurogenic cardiomyopathy is associated with the modification of cardiac metabolism is unknown. This study sought to explore, by positron emission tomography/computed tomography, the presence of altered cardiac glucose metabolism after SAH. Methods During a 16-month period, 30 SAH acute phase patients underwent myocardial 18 F- fluorodesoxyglucose positron emission tomography (18F-FDGPET), 99mTc-tetrofosmin and 123I-meta-iodobenzylguanidine (123I-mIBG) scintigraphy, respectively, assessing glucose metabolism, cardiac perfusion, and sympathetic innervation. Patients with initial abnormalities were followed monthly for two months for 18F-FDG, and six months later for 123I-mIBG. Results In this SAH population, acute cardiac metabolic disturbance was observed in 83% of patients (n = 25), and sympathetic innervation disturbance affected 90% (n = 27). Myocardial perfusion was normal for all patients. The topography and extent of metabolic defects and innervation abnormalities largely overlapped. Follow-up showed rapid improvement of glucose metabolism in one or two months. Normalization of sympathetic innervation was slower; only 27% of patients (n = 8) exhibited normal 123I-mIBG scintigraphy after six months. Presence of initial altered cardiac metabolism was not associated with more unfavorable cardiac or neurological outcomes. Conclusions These findings support the hypothesis of neurogenic myocardial stunning after SAH. In hemodynamically stable acute phase SAH patients, cardiomyopathy is characterized by diffuse and heterogeneous 18F-FDG and 123I-mIBG uptake defect. Trial registration Clinicaltrials.gov NCT01218191. Registered 6 October 2010.
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Beltempo M, Lacroix G, Cabot M, Beauchesne V, Piedboeuf B. 6: Patient Volume and Nursing Overtime Increased Risk of Nosocomial Infection in the NICU. Paediatr Child Health 2014. [DOI: 10.1093/pch/19.6.e35-6] [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: 11/12/2022] Open
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Beltempo M, Lacroix G, Cabot M, Beauchesne V, Piedboeuf B. 34: Nursing Overtime Increases the Risk of Medical Incidents in the NICU. Paediatr Child Health 2014. [DOI: 10.1093/pch/19.6.e35-33] [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: 11/12/2022] Open
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Vandamme SG, Maes GE, Raeymaekers JAM, Cottenie K, Imsland AK, Hellemans B, Lacroix G, Mac Aoidh E, Martinsohn JT, Martínez P, Robbens J, Vilas R, Volckaert FAM. Regional environmental pressure influences population differentiation in turbot (Scophthalmus maximus). Mol Ecol 2014; 23:618-36. [PMID: 24354713 DOI: 10.1111/mec.12628] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [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: 02/18/2013] [Revised: 12/02/2013] [Accepted: 12/08/2013] [Indexed: 01/18/2023]
Abstract
Unravelling the factors shaping the genetic structure of mobile marine species is challenging due to the high potential for gene flow. However, genetic inference can be greatly enhanced by increasing the genomic, geographical or environmental resolution of population genetic studies. Here, we investigated the population structure of turbot (Scophthalmus maximus) by screening 17 random and gene-linked markers in 999 individuals at 290 geographical locations throughout the northeast Atlantic Ocean. A seascape genetics approach with the inclusion of high-resolution oceanographical data was used to quantify the association of genetic variation with spatial, temporal and environmental parameters. Neutral loci identified three subgroups: an Atlantic group, a Baltic Sea group and one on the Irish Shelf. The inclusion of loci putatively under selection suggested an additional break in the North Sea, subdividing southern from northern Atlantic individuals. Environmental and spatial seascape variables correlated marginally with neutral genetic variation, but explained significant proportions (respectively, 8.7% and 10.3%) of adaptive genetic variation. Environmental variables associated with outlier allele frequencies included salinity, temperature, bottom shear stress, dissolved oxygen concentration and depth of the pycnocline. Furthermore, levels of explained adaptive genetic variation differed markedly between basins (3% vs. 12% in the North and Baltic Sea, respectively). We suggest that stable environmental selection pressure contributes to relatively strong local adaptation in the Baltic Sea. Our seascape genetic approach using a large number of sampling locations and associated oceanographical data proved useful for the identification of population units as the basis of management decisions.
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Affiliation(s)
- S G Vandamme
- Institute for Agricultural and Fisheries Research (ILVO), Animal Sciences Unit - Fisheries, Ankerstraat 1, B-8400, Ostend, Belgium; Laboratory of Biodiversity and Evolutionary Genomics, University of Leuven, Charles Deberiotstraat 32, B-3000, Leuven, Belgium
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Bordes J, Lacroix G, Esnault P, Goutorbe P, Cotte J, Dantzer E, Meaudre E. Comparison of the Berlin definition with the American European consensus definition for acute respiratory distress syndrome in burn patients. Burns 2014; 40:562-7. [PMID: 24685349 DOI: 10.1016/j.burns.2014.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 11/24/2013] [Revised: 03/05/2014] [Accepted: 03/06/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Acute respiratory distress syndrome (ARDS) is a leading cause of mortality in burn patients. Smoke inhalation, pneumonia and inflammation process are the major causes of ARDS in burn patients. The American European Consensus Conference (AECC) definition proposed in 1994 has recently been revised by the Berlin definition. Our objective was to describe the epidemiology of ARDS comparing the Berlin definition with the AECC definition in a retrospective cohort of burn patients. METHODS We reviewed admitted burn adult patients for a two year period, and investigated patient who received mechanical ventilation for more than 48 h and in whom pneumonia was diagnosed. RESULTS 40 patients were analyzed. According to the AECC definition, 11 patients met criteria for ALI (27.5%), and 29 patients for ARDS (72.5%). According to the Berlin definition, all patients met criteria for ARDS: 4 (10%) for a severe ARDS, 25 (62.5%) for a moderate ARDS, 11 (27.5%) for a mild ARDS. Inhalation injury was diagnosed in 10 patients (25%). Categorizing patients with the Berlin definition showed statistically significative difference of mortality within the three groups, but not with the AECC definition. CONCLUSION The Berlin definition seems to be more accurate than the AECC definition to assess the severity of ARDS in term of outcome in burn patients. This definition may facilitate prompt recognition of ARDS in burn patients, and promote protective ventilation strategy to a larger number of patients.
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Affiliation(s)
- Julien Bordes
- Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France.
| | | | - Pierre Esnault
- Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France
| | | | - Jean Cotte
- Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France
| | - Eric Dantzer
- Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France
| | - Eric Meaudre
- Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France
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Esnault P, Prunet B, Lacroix G, D'Aranda E, Gaillard Y, Boret H. Instantaneous rigor after fatal pholcodine intoxication. Br J Clin Pharmacol 2014; 77:578-9. [PMID: 23772895 PMCID: PMC4371536 DOI: 10.1111/bcp.12183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 06/04/2013] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | | | | | - Yvan Gaillard
- Toxicological Analysis LaboratoryLa Voulte sur Rhône, France
| | - Henry Boret
- Military Teaching Hospital Sainte AnneToulon, France
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Baudoin Y, Lacroix G, Louge P, Platel JP. An unusual diving accident: a case of delayed presentation of traumatic diaphragmatic rupture. J Emerg Med 2013; 45:e81-2. [PMID: 23849368 DOI: 10.1016/j.jemermed.2013.03.028] [Citation(s) in RCA: 2] [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] [Received: 08/28/2012] [Revised: 02/01/2013] [Accepted: 03/15/2013] [Indexed: 11/24/2022]
Affiliation(s)
- Yoann Baudoin
- Department of Abdominal and Emergency Surgery, Military Teaching Hospital Sainte Anne, Toulon, France
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d’Aranda E, Lacroix G, Cotte J, Cungi PJ, Meaudre E. L’hémodialyse est utile en cas d’intoxication grave au baclofène. ACTA ACUST UNITED AC 2013. [DOI: 10.1051/ata/2013032] [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] [Indexed: 11/15/2022]
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Lacroix G, Prunet B, Bordes J, Cabon-Asencio N, Asencio Y, Gaillard T, Pons S, D'aranda E, Kerebel D, Meaudre E, Goutorbe P. Evaluation of early mini-bronchoalveolar lavage in the diagnosis of health care-associated pneumonia: a prospective study. Crit Care 2013; 17:R24. [PMID: 23383619 PMCID: PMC4056024 DOI: 10.1186/cc12501] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 01/29/2013] [Indexed: 11/10/2022]
Abstract
Introduction Health care-associated pneumonia (HCAP) has been proposed as a new category of respiratory infection to identify patients at risk of multidrug-resistant (MDR) pathogens. The American Thoracic Society's recommendation for HCAP treatment is to use broad-spectrum and multiple antibiotics. However, this strategy may be economically expensive and promote antimicrobial resistance when a multisensitive pathogen is not identified. Methods We prospectively included all patients presenting with HCAP in the emergency department. Blood cultures and fiberoptic bronchoscope-guided distal protected small volume bronchoalveolar lavage (FODP mini-BAL) were performed in each patient. Empirical antibiotic therapy was adapted when microbiological findings were available. The primary objective was to assess whether FODP mini-BAL is more efficient than blood cultures in identifying pathogens with the ratio of identification between both techniques as principal criteria. Results We included 54 patients with HCAP. Pathogens were identified in 46.3% of cases using mini-BAL and in 11.1% of cases using blood cultures (P <0.01). When the patient did not receive antibiotic therapy before the procedure, pathogens were identified in 72.6% of cases using mini-BAL and in 9.5% of cases using blood cultures (P <0.01). We noted multidrug-resistant pathogens in 16% of cases. All bronchoscopic procedures could be performed in patients without complications. Conclusions FODP mini-BAL was more efficient than blood cultures for identifying pathogens in patients presenting with HCAP. When bacteriological identification was obtained, antibiotic therapy was adapted in 100% of cases. See related letter by Sircar et al.,http://ccforum.com/content/17/2/428
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Cotte J, Lacroix G, D'Aranda E, Kaiser E, Meaudre E. [Management of traumatic coagulopathy during long-distance medical evacuation: utility of the Coaguchek(®) XS pro]. Ann Fr Anesth Reanim 2013; 32:122-3. [PMID: 23337339 DOI: 10.1016/j.annfar.2012.11.007] [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] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 11/13/2012] [Indexed: 11/25/2022]
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Cotte J, Prunet B, Esnault P, Lacroix G, D'aranda E, Cungi PJ, Goutorbe P, Dantzer E, Meaudre E. Early onset pneumonia in patients with severely burned face and neck: a 5-year retrospective study. Burns 2013; 39:892-6. [PMID: 23332161 DOI: 10.1016/j.burns.2012.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 12/01/2012] [Accepted: 12/04/2012] [Indexed: 11/18/2022]
Abstract
Patients with face and neck burns (FNBs) often undergo prehospital intubation, or sustain inhalation injury which are risk factors for pneumonia in specific populations. Early onset pneumonia (EOP) might be caused by initial management. The primary goal of this study was to find risk factors for EOP in FNB patients. This is a retrospective, single-center trial. We screened all FNB patients for EOP with the Clinical Pulmonary Infection Score. Pneumonia diagnosis was with culture from a mini broncho-alveolar lavage. Potential risk factors for EOP were recorded. We included 152 patients, EOP was diagnosed in 58 (38.2%). EOP patients had a greater burned surface area median (20±17% vs. 10±17%; p<0.001), were more frequently intubated during prehospital care (65.5% vs. 21.3%; p<0.001), had more abnormal fiberoptic bronchoscopy at admission (58.6% vs. 19.1%; p=0.002) and a lower initial PaO2/FiO2 ratio (median 314±118.6 vs. 365±105.7; p=0.01). Multivariate analysis showed that only prehospital intubation was independently associated with EOP (odds ratio 3.6; 95% confidence interval, 1.34-10). Prehospital intubation appears to be an independent risk factor for EOP in severe burn patients. Assessments of the risk-benefit ratios of intubating and of not intubating those patients are indicated.
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Affiliation(s)
- Jean Cotte
- Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France.
| | - Bertrand Prunet
- Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France
| | - Pierre Esnault
- Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France
| | - Guillaume Lacroix
- Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France
| | - Erwan D'aranda
- Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France
| | - Pierre Julien Cungi
- Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France
| | - Philippe Goutorbe
- Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France
| | - Eric Dantzer
- Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France
| | - Eric Meaudre
- Burn Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France
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Esnault P, Lacroix G, Cotte J, Cungi PJ, D'Aranda E, Prunet B. Is automated peritoneal lavage a better way than an endovascular device to induce mild therapeutic hypothermia after resuscitated cardiac arrest? Crit Care 2013; 17:431. [PMID: 23659681 PMCID: PMC3672757 DOI: 10.1186/cc12603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Esnault P, Lacroix G, Cungi PJ, D'Aranda E, Cotte J, Goutorbe P. Dialysis disequilibrium syndrome in neurointensive care unit: the benefit of intracranial pressure monitoring. Crit Care 2012; 16:472. [PMID: 23280151 PMCID: PMC3672609 DOI: 10.1186/cc11877] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Lacroix G, Pons F, D'Aranda E, Legodec J, Romanat PE, Goutorbe P. High-flow oxygen, a therapeutic bridge while awaiting thrombolysis in pulmonary embolism? Am J Emerg Med 2012; 31:463.e1-2. [PMID: 23159426 DOI: 10.1016/j.ajem.2012.08.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 08/15/2012] [Accepted: 08/15/2012] [Indexed: 12/29/2022] Open
Affiliation(s)
- Guillaume Lacroix
- Department of Anesthesiology and Intensive Care, Teaching military hospital Sainte Anne, Boulevard Sainte Anne; BP 20545; 83041 Cedex 09 Toulon, France.
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Lacroix G. BENEFICIAL EFFECTS OF PEEP ON RESPIRATORY COMPLIANCE MONITORED BY NEWER GENERATION OF ANESTHESIA VENTILATORS IN ANESTHESIZED PATIENTS: RESULTS OF A PROSPECTIVE STUDY. Br J Anaesth 2012. [DOI: 10.1093/bja/el_9474] [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: 11/14/2022] Open
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Lacroix G, Cotte J, Prunet B, Meaudre E. Anesthésie locorégionale de la face aux urgences (partie 2) : blocs infra-orbitaire et mentonnier. Ann Fr Med Urgence 2012. [DOI: 10.1007/s13341-012-0235-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lacroix G, Prunet B, d’Aranda E, Meaudre E. Anesthésie locorégionale de la face aux urgences : blocs supra-orbitaire et supra-trochléaire. Ann Fr Med Urgence 2012. [DOI: 10.1007/s13341-012-0225-6] [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: 10/28/2022]
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Lacroix G, Legodec J, D'Aranda E, Esnault P, Romanat PE, Goutorbe P. Is non-invasive ventilation the best ventilatory support for 'do not intubate' patients? Crit Care 2012; 16:442. [PMID: 22871046 PMCID: PMC3580715 DOI: 10.1186/cc11435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lacroix G, d'Aranda E, Cotte J, Esnault P, Romanat PE, Goutorbe P. Recruitment maneuver after apnea test or continuous positive airway pressure apnea test? Crit Care 2012; 16:445. [PMID: 22979922 PMCID: PMC3580731 DOI: 10.1186/cc11453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Lacroix G, Dagain A, Esnault P, Joubert C, Prunet B. Fever and neck pain in a paraplegic patient: Figure 1. Arch Emerg Med 2012; 29:429. [DOI: 10.1136/emermed-2012-201262] [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: 11/04/2022]
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