1
|
Richard N, Arab-Hocine N, Vannier M, Leblanc-Boubchir R, Pelaquier A, Boruchowicz A, Musikas M, Amil M, Fumery M, Nahon S, Arotcarena R, Gelsi E, Maurin A, Hébuterne X, Savoye G. Efficacy of ferric carboxymaltose on haemoglobin response among older patients with gastrointestinal bleeding: a randomised clinical trial. Age Ageing 2024; 53:afae085. [PMID: 38706390 DOI: 10.1093/ageing/afae085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Acute gastrointestinal bleeding (AGIB) is common in older patients but the use of iron in this context remains understudied. AIMS This study aimed to evaluate prospectively the efficacy of ferric carboxymaltose to treat anaemia in older patients after AGIB. METHODS This randomised double-blinded placebo-controlled clinical trial was conducted in 10 French centres. Eligible patients were 65 years or more, had controlled upper or lower gastrointestinal bleeding and a haemoglobin level of 9-11 g/dl. Patients were randomly assigned, in a 1:1 ratio, to receive either one intravenous iron injection of ferric carboxymaltose or one injection of saline solution. The primary endpoint was the difference in haemoglobin level between day 0 and day 42. Secondary endpoints were treatment-emergent adverse events, serious adverse events, rehospitalisation and improvement of quality of life (QOL) at day 180. RESULTS From January 2013 to January 2017, 59 patients were included. The median age of patients was 81.9 [75.8, 87.3] years. At day 42, a significant difference in haemoglobin level increase was observed (2.49 g/dl in the ferric carboxymaltose group vs. 1.56 g/dl in the placebo group, P = 0.02). At day 180, QOL, measured on European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, improved by 10.5 points in the ferric carboxymaltose group and by 8.2 points in the placebo group (P = 0.56). Rates of adverse events and rehospitalisation were similar in the two groups. CONCLUSIONS Intravenous iron seems safe and effective to treat anaemia in older patients after AGIB and should be considered as a standard-of-care treatment. ClinicalTrials.gov (NCT01690585).
Collapse
Affiliation(s)
- Nicolas Richard
- Department of Gastroenterology, Univ Rouen Normandie, INSERM, ADEN UMR1073, "Nutrition, Inflammation and microbiota-gut-brain axis", CHU Rouen, Rouen F-76000, France
| | - Nadia Arab-Hocine
- Department of Gastroenterology and Clinical Nutrition, CHU of Nice and University Côte d'Azur, Nice, France
| | - Margot Vannier
- Department of Biostatistics, CHU Rouen, Rouen F-76000, France
| | | | - Agnès Pelaquier
- Department of Gastroenterology, Montelimar Hospital, Montelimar, France
| | - Arnaud Boruchowicz
- Department of Gastroenterology, Valenciennes Hospital, Valenciennes, France
| | - Marietta Musikas
- Department of Gastroenterology, Caen University Hospital, Caen, France
| | - Morgane Amil
- Department of Gastroenterology, La Roche Sur Yon Hospital, La Roche Sur Yon, France
| | - Mathurin Fumery
- Department of Gastroenterology, Amiens University and Hospital, Amiens, France
| | - Stéphane Nahon
- Department of Gastroenterology, Le Raincy - Montfermeil Hospital -, Le Raincy, Montfermeil, France
| | | | - Eve Gelsi
- Department of Gastroenterology and Clinical Nutrition, CHU of Nice and University Côte d'Azur, Nice, France
| | - Arnaud Maurin
- Department of Gastroenterology, Le Mans Hospital, Le Mans, France
| | - Xavier Hébuterne
- Department of Gastroenterology and Clinical Nutrition, CHU of Nice and University Côte d'Azur, Nice, France
| | - Guillaume Savoye
- Department of Gastroenterology, Univ Rouen Normandie, INSERM, ADEN UMR1073, "Nutrition, Inflammation and microbiota-gut-brain axis", CHU Rouen, Rouen F-76000, France
| |
Collapse
|
2
|
Chaigneau T, Morello R, Vannier E, Musikas M, Piquet MA, Dupont B. Impact of sarcopenic obesity on predicting the severity of acute pancreatitis. Dig Liver Dis 2023:S1590-8658(23)00217-7. [PMID: 36849286 DOI: 10.1016/j.dld.2023.02.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 02/04/2023] [Accepted: 02/09/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND AND AIMS This work aimed to evaluate the impact of sarcopenia and sarcopenic obesity on the occurrence of severe pancreatitis and to study the performance of anthropometric indices to predict severe forms. METHODS We conducted a single-center retrospective study at Caen University Hospital between 2014 and 2017. Sarcopenia was assessed by measuring the psoas area on an abdominal scan. The psoas area /body mass index ratio reflected sarcopenic obesity. By normalizing the value to the body surface, we obtained an index called sarcopancreatic index, avoiding sex differences in measurements. RESULTS Among 467 included patients, 65 (13.9%) developed severe pancreatitis. The sarcopancreatic index was independently associated with the occurrence of severe pancreatitis (1.455 95% CI [1.028-2.061]; p = 0.035), as was the Visual Analog Scale, creatinine or albumin. The complication rate was not different depending on sarcopancreatic index value. Based on variables independently associated with the occurrence of severe pancreatitis, we constructed a score called Sarcopenia Severity Index. This score presented an area under the receiver operating characteristics curve of 0.84, comparable to the Ranson score (0.87) and superior to body mass index or the sarcopancreatic index to predict a severe form of acute pancreatitis. CONCLUSIONS Sarcopenic obesity seems to be associated with severe acute pancreatitis.
Collapse
Affiliation(s)
- Thomas Chaigneau
- Département d'Hepato-Gastroenterologie et Nutrition, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue Côte de Nacre, 14033 CAEN, France
| | - Remy Morello
- Plateforme de Méthodologie, Normandie Univ, UNICAEN, CHU de Caen Normandie, 14000 CAEN, France
| | - Elise Vannier
- Département d'Hepato-Gastroenterologie et Nutrition, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue Côte de Nacre, 14033 CAEN, France
| | - Marietta Musikas
- Département d'Hepato-Gastroenterologie et Nutrition, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue Côte de Nacre, 14033 CAEN, France
| | - Marie-Astrid Piquet
- Département d'Hepato-Gastroenterologie et Nutrition, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue Côte de Nacre, 14033 CAEN, France
| | - Benoît Dupont
- Département d'Hepato-Gastroenterologie et Nutrition, Normandie Univ, UNICAEN, CHU de Caen Normandie, Avenue Côte de Nacre, 14033 CAEN, France.
| |
Collapse
|
3
|
Walter A, Rudler M, Olivas P, Moga L, Trépo E, Robic MA, Ollivier-Hourmand I, Baiges A, Sutter O, Bouzbib C, Peron JM, Le Pennec V, Ganne-Carrié N, Garcia-Pagán JC, Mallet M, Larrue H, Dao T, Thabut D, Hernández-Gea V, Nault JC, Bureau C, Allaire M, Betancourt F, Garcia‐Criado MA, Magaz M, Métivier S, Musikas M, Reverter E, Ripoll E. Combination of Model for End-Stage Liver Disease and Lactate Predicts Death in Patients Treated With Salvage Transjugular Intrahepatic Portosystemic Shunt for Refractory Variceal Bleeding. Hepatology 2021; 74:2085-2101. [PMID: 34018627 DOI: 10.1002/hep.31913] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 04/19/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Data about the prognosis of salvage transjugular intrahepatic portosystemic shunt (TIPS) using covered stents for refractory variceal bleeding caused by portal hypertension are scarce. We aimed to assess survival and to identify predictors of mortality in these patients. APPROACH AND RESULTS One hundred sixty-four patients with cirrhosis from five centers treated with salvage TIPS between 2007 and 2017 were retrospectively divided into a derivation cohort (83 patients) and a validation cohort (81 patients). Comparisons were performed using the Mann-Whitney and Fischer's exact test. Six-week overall survival (OS) was correlated with variables on the day of the TIPS using Kaplan-Meier curves with log-rank test and univariate/multivariate analyses using the Cox model. Eighty-three patients were included in the derivation cohort (male, 78%; age, 55 years, alcohol-associated cirrhosis, 88%; Model for End-Stage Liver Disease [MELD], 19 [15-27]; arterial lactate, 3.7 mmol/L [2.0-8.3]). Six-week OS rate was 58%. At multivariate analysis, the MELD score (OR, 1.064; 95% CI, 1.005-1.126; P = 0.028) and arterial lactate (OR, 1.063; 95% CI, 1.013-1.114; P = 0.032) were associated with 6-week OS. Six-week OS rates were 100% in patients with arterial lactate ≤2.5 mmol/L and MELD score ≤ 15 and 5% in patients with lactate ≥12 mmol/L and/or MELD score ≥ 30. The 81 patients of the validation cohort had similar MELD and arterial lactate level but lower creatinine level (94 vs 106 µmol/L, P = 0.008); 6-week OS was 67%. Six-week OS rates were 86% in patients with arterial lactate ≤2.5 mmol/L and MELD score ≤ 15 and 10% for patients with lactate ≥12 mmol/L and/or MELD score ≥ 30. In the overall cohort, rebleeding rate was 15.8% at 6 weeks, and the acute-on-chronic liver failure grade (OR, 1.699; 95% CI, 1.056-1.663; P = 0.040) was independently associated with rebleeding. CONCLUSIONS After salvage TIPS, 6-week mortality remains high and can be predicted by MELD score and lactate. Survival rate at 6 weeks was >85% in patients with arterial lactate ≤2.5 mmol/L and MELD score ≤ 15, while mortality was >90% for lactate ≥12 mmol/L and/or MELD score ≥ 30.
Collapse
Affiliation(s)
- Aurélie Walter
- Service d'Hépatologie, Hôpital Avicenne, Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance-publique Hôpitaux de Paris, Université Sorbonne Paris Nord, Bobigny, France
| | - Marika Rudler
- Service d'Hépato-gastro-entérologie, Hôpital de la Pitié-Salpétrière, Hôpitaux universitaires Pitié-Salpétrière-Charles Foix, Assistance-publique Hôpitaux de Paris, Paris, France
| | - Pol Olivas
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucile Moga
- Service d'Hépatologie, Hôpital Beaujon, Hôpitaux universitaires Paris-Nord-Val-de-Seine, Assistance-publique Hôpitaux de Paris, Clichy, France
| | - Eric Trépo
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.,Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Anna Baiges
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Olivier Sutter
- Service de Radiologie, Hôpital Jean Verdier, Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance-publique Hôpitaux de Paris, Bondy, France.,Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'universités et établissements Sorbonne Paris cité, Paris, France
| | - Charlotte Bouzbib
- Service d'Hépato-gastro-entérologie, Hôpital de la Pitié-Salpétrière, Hôpitaux universitaires Pitié-Salpétrière-Charles Foix, Assistance-publique Hôpitaux de Paris, Paris, France.,Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, Unité de soins intensifs d'hépatologie, Service d'hépato-gastroentérologie, Inserm, Centre de recherche Saint-Antoine, Sorbonne université, Groupement hospitalier Pitié-Salpêtrière Charles-Foix, Assistance-publique Hôpitaux de Paris, Paris, France
| | - Jean Marie Peron
- Service d'hépato-gastro-entérologie, CHU Toulouse, Toulouse, France
| | | | - Nathalie Ganne-Carrié
- Service d'Hépatologie, Hôpital Avicenne, Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance-publique Hôpitaux de Paris, Université Sorbonne Paris Nord, Bobigny, France.,Unité mixte de Recherche 1138, Équipe FunGeS, Institut National de la Santé et de la Recherche médicale, Centre de Recherche des Cordeliers, Université de Paris, Paris, France
| | - Juan Carlos Garcia-Pagán
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Maxime Mallet
- Service d'Hépato-gastro-entérologie, Hôpital de la Pitié-Salpétrière, Hôpitaux universitaires Pitié-Salpétrière-Charles Foix, Assistance-publique Hôpitaux de Paris, Paris, France
| | - Hélène Larrue
- Service d'hépato-gastro-entérologie, CHU Toulouse, Toulouse, France
| | - Thong Dao
- Service d'hépato-gastroentérologie et de nutrition, CHU Côte de Nacre, Caen, France
| | - Dominique Thabut
- Service d'Hépato-gastro-entérologie, Hôpital de la Pitié-Salpétrière, Hôpitaux universitaires Pitié-Salpétrière-Charles Foix, Assistance-publique Hôpitaux de Paris, Paris, France.,Unité mixte de Recherche S 938, Institut National de la Santé et de la Recherche médicale/CDR Saint-Antoine & Institute of Cardiometabolism and Nutrition, Paris, France
| | - Virginia Hernández-Gea
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Jean-Charles Nault
- Service d'Hépatologie, Hôpital Avicenne, Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance-publique Hôpitaux de Paris, Université Sorbonne Paris Nord, Bobigny, France.,Unité mixte de Recherche 1138, Équipe FunGeS, Institut National de la Santé et de la Recherche médicale, Centre de Recherche des Cordeliers, Université de Paris, Paris, France
| | | | - Manon Allaire
- Service d'hépato-gastroentérologie et de nutrition, CHU Côte de Nacre, Caen, France.,Unité mixte de Recherche 1149, Centre de Recherche sur l'inflammation, Faculté de Médecine Bichat, Paris, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Tebani A, Sudrié-Arnaud B, Boudabous H, Brassier A, Anty R, Snanoudj S, Abergel A, Abi Warde MT, Bardou-Jacquet E, Belbouab R, Blanchet E, Borderon C, Bronowicki JP, Cariou B, Carette C, Dabbas M, Dranguet H, de Ledinghen V, Ferrières J, Guillaume M, Krempf M, Lacaille F, Larrey D, Leroy V, Musikas M, Nguyen-Khac E, Ouzan D, Perarnau JM, Pilon C, Ratzlu V, Thebaut A, Thevenot T, Tragin I, Triolo V, Vergès B, Vergnaud S, Bekri S. Large-scale screening of lipase acid deficiency in at risk population. Clin Chim Acta 2021; 519:64-69. [PMID: 33857477 DOI: 10.1016/j.cca.2021.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Lysosomal acid lipase deficiency (LALD, OMIM#278000) is a rare lysosomal disorder with an autosomal recessive inheritance. The main clinical manifestations are related to a progressive accumulation of cholesteryl esters, triglycerides or both within the lysosome in different organs such as the liver, spleen, and cardiovascular system. A wide range of clinical severity is associated with LALD including a severe very rare antenatal/neonatal/infantile phenotype named Wolman disease and a late-onset form named cholesteryl ester storage disease (CESD). METHODS This study aimed to investigate a cohort of at-risk patients (4174) presenting with clinical or biological signs consistent with LALD using the assessment of LAL activity on dried blood spots. RESULTS LAL activity was lower than 0.05 nmol/punch/L (cut-off: 0.12) in 19 patients including 13 CESD and 6 Wolman. Molecular study has been conducted in 17 patients and succeeded in identifying 34 mutated alleles. Fourteen unique variants have been characterized, 7 of which are novel. CONCLUSION This study allowed to identify a series of patients and expanded the molecular spectrum knowledge of LALD. Besides, a new screening criteria grid based on the clinical/biological data from our study and the literature has been proposed in order to enhance the diagnosis rate in at risk populations.
Collapse
Affiliation(s)
- Abdellah Tebani
- Normandie Univ, UNIROUEN, INSERM U1245, CHU Rouen, Department of Metabolic Biochemistry, 76000 Rouen, France
| | - Bénédicte Sudrié-Arnaud
- Normandie Univ, UNIROUEN, INSERM U1245, CHU Rouen, Department of Metabolic Biochemistry, 76000 Rouen, France
| | - Hela Boudabous
- Pediatric Department, La Rabta Hospital, Faculty of Medecine of Tunis, University of Tunis El Manar, Jabberi, Jebal Lakhdhar, Tunis, Tunisia
| | - Anais Brassier
- Reference Center of Inherited Metabolic Diseases, Necker Enfants Malades Hospital, Imagine Institute, University Paris Descartes, AP-HP, 75015 Paris, France
| | - Rodolphe Anty
- INSERM, U1065, C3M, Team 8 "Hepatic Complications in Obesity", Nice, France
| | - Sarah Snanoudj
- Normandie Univ, UNIROUEN, INSERM U1245, CHU Rouen, Department of Metabolic Biochemistry, 76000 Rouen, France
| | - Armand Abergel
- Department of Digestive Medicine, CHU Estaing, Clermont-Ferrand, France
| | | | - Edouard Bardou-Jacquet
- Univ Rennes, INSERM, Institut Numecan, Liver Disease Unit, CHU de Rennes, F-35000 Rennes, France
| | - Reda Belbouab
- Pediatric Department, University Hospital Center Mustapha Bacha, 16000 Algiers, Algeria
| | - Eloi Blanchet
- Service Hépatologie-Gastroenterologie, Groupe Hospitalier La Rochelle-Ré-Aunis, La Rochelle, France
| | | | - Jean-Pierre Bronowicki
- Department of Hepato-Gastroenterology, Centre Hospitalo-Universitaire de Nancy, 54000 Nancy, France
| | - Bertrand Cariou
- Université de Nantes, CHU de Nantes, CNRS, INSERM, L'institut du thorax, Department of Endocrinology-Diabetology-Nutrition, F-44000 Nantes, France
| | - Claire Carette
- AP-HP, Department of Nutrition, Centre spécialisé de l'Obesité Hôpital Européen Georges Pompidou, Paris University, Paris, France
| | - Myriam Dabbas
- AP-HP, Nutrition Obesity Unit, Necker Hospital, Paris, France
| | - Hélène Dranguet
- Normandie Univ, UNIROUEN, INSERM U1245, CHU Rouen, Department of Metabolic Biochemistry, 76000 Rouen, France
| | | | - Jean Ferrières
- Department of Cardiology and UMR INSERM 1027, Toulouse University School of Medicine, Toulouse, TSA 50032 31059, France
| | - Maeva Guillaume
- Service d'Hépatologie CHU Toulouse Rangueil, Institut Cardiomet et Université Paul Sabatier, Toulouse, France
| | - Michel Krempf
- Endocrinology, Metabolic Diseases and Nutrition, ELSAN, Clinique Breteché, Nantes, France
| | - Florence Lacaille
- Gastroenterology Hepatology Nutrition Unit, Hôpital Necker-Enfants Malades, Paris, France
| | - Dominique Larrey
- Liver and Transplantation Unit, Montpellier School of Medicine and IRB-INSERM-1183, Montpellier, France
| | - Vincent Leroy
- Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire Grenoble-Alpes, INSERM U1209, Université Grenoble-Alpes, Grenoble, France
| | - Marietta Musikas
- Department of Hepato-Gastroenterology and Nutrition, Caen University Hospital, France
| | - Eric Nguyen-Khac
- Service d'Hépato-Gastroentérologie, Amiens University Hospital, and Equipe Région INSERM 24, University of Picardy, Amiens, France
| | - Denis Ouzan
- Institut Arnaud Tzanck, Service d'Hépatologie, St Laurent du Var, France
| | - Jean-Marc Perarnau
- Service d'Hépato-gastroentérologie, Centre Hospitalo-Universitaire, Tours, France
| | - Carine Pilon
- Normandie Univ, UNIROUEN, INSERM U1245, CHU Rouen, Department of Metabolic Biochemistry, 76000 Rouen, France
| | - Vlad Ratzlu
- Department of Hepatology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hopitaux de Paris, Paris, France; University Pierre et Marie Curie, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris, France
| | - Alice Thebaut
- Pediatric Hepatology & Pediatric Liver Transplant Department, Centre de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques (AVB-CG), Filière de Santé des Maladies Rares du Foie de l'enfant et de l'adulte (FILFOIE), European Reference Network RARE-LIVER, Assistance Publique-Hôpitaux de Paris, Faculty of Medecine Paris-Saclay, CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - Thierry Thevenot
- Centre Hospitalier Universitaire de Besançon, Hôpital Jean Minjoz, Service d'Hépatologie et de Soins Intensifs Digestifs, Besançon, France
| | - Isabelle Tragin
- Normandie Univ, UNIROUEN, INSERM U1245, CHU Rouen, Department of Metabolic Biochemistry, 76000 Rouen, France
| | | | - Bruno Vergès
- Université de Bourgogne, Centre de Recherche INSERM LNC-UMR1231; Service de Diabétologie et Endocrinologie, CHU François Mitterand, BP 77908, Dijon cedex 21079, France
| | - Sabrina Vergnaud
- Department of Biochemistry Toxicology and Pharmacology, Grenoble University Hospital, La Tronche, France
| | - Soumeya Bekri
- Normandie Univ, UNIROUEN, INSERM U1245, CHU Rouen, Department of Metabolic Biochemistry, 76000 Rouen, France.
| |
Collapse
|
5
|
Maugin F, Morello R, Vastel E, Poignavant C, Joubert C, Musikas M, Deberles E, Piquet MA. Saignement après gastrostomie percutanée endoscopique selon le traitement antiagrégant ou anticoagulant : étude observationnelle « dans la vraie vie ». NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
6
|
Lacombe K, Malmezat X, Le Mouel A, Fradin S, Joubert C, Musikas M, Vastel E, Piquet MA. Efficience de la prise en charge nutritionnelle par une Unité transversale de nutrition clinique : bilan de 3 ans d’expérience dans un CHU. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.083] [Citation(s) in RCA: 1] [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: 11/25/2022]
|
7
|
Lacombe K, Roussel LM, Babin E, Beaufils E, Dupont B, Vastel E, Savey V, Vallée M, Musikas M, Piquet MA, Joubert C. P276: Intérêt d’un suivi diététique à domicile pendant et après radiothérapie pour cancer ORL. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70918-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
8
|
Benlian P, Lacaille F, Mary S, Feillet F, Noel E, Eyer D, Gottrand F, Ouzounian S, Musikas M, Peretti N, Boidin-Ceschini L, Willefert M, Levade T, Froissard R, Valayannopoulos V. Cholesteryl ester storage disease: a predominant lipa genotype underlies disease manifestations and progression - A review of 12 french cases. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
9
|
Vallée M, Vastel E, Musikas M, Poignavant C, Piquet M, Joubert C. P174 Quelle est la place du médecin généraliste dans la prise en charge des patients en nutrition entérale à domicile ? NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70506-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
10
|
Baveux R, Vastel E, Lemouel A, Leclerq A, Chedru V, Hecquard C, Piquet M, Musikas M. P150 Quelle est la proportion d’utilisation de nutrition entérale et parentérale dans un CHU ? NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70482-5] [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: 11/29/2022]
|
11
|
Dupont B, Dao T, Joubert C, Dupont-Lucas C, Gloro R, Nguyen-Khac E, Beaujard E, Mathurin P, Vastel E, Musikas M, Ollivier I, Piquet MA. Randomised clinical trial: enteral nutrition does not improve the long-term outcome of alcoholic cirrhotic patients with jaundice. Aliment Pharmacol Ther 2012; 35:1166-74. [PMID: 22452620 DOI: 10.1111/j.1365-2036.2012.05075.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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: 01/17/2012] [Revised: 02/08/2012] [Accepted: 03/05/2012] [Indexed: 12/17/2022]
Abstract
BACKGROUND Malnutrition and jaundice are independent prognostic factors in cirrhosis. AIM To assess the impact of enteral nutrition on the survival of alcoholic cirrhotic patients with jaundice but without acute alcoholic hepatitis. METHODS The study was a multicentre prospective randomised controlled trial comparing effects of enteral nutrition vs. a symptomatic support in patients with alcoholic cirrhosis and jaundice (bilirubin ≥51 µmol/L) but without severe acute alcoholic hepatitis. A total of 99 patients were randomised to receive either the conventional symptomatic treatment (55 patients) or the symptomatic support associated with 35 kcal/Kg/day of enteral nutrition during 4 weeks followed by an oral nutritional support during 2 months (44 patients). Randomisation was stratified on nutritional status. One-year survival curves were compared using the Kaplan-Meier method and Logrank test. RESULTS Populations in both arms were similar. One-year survival was similar in the overall population (27/44 patients (61.4%) in the enteral nutrition arm vs. 36/55 (65.5%) in the control arm; Logrank P = 0.60) and in the subgroup suffering from malnutrition [18/29 patients (62.1%) in the enteral nutrition arm vs. 20/32 (62.5%) in the control arm; Logrank P = 0.99]. There was no statistical difference for bilirubin, prothrombin rate, Child-Pugh score, albumin or nutritional assessment. Complications during treatment (bleeding, encephalopathy, infection) occurred in 23% of patients in the enteral nutrition group (10/44) vs. 16% (9/55) of the control patients (P = 0.59). CONCLUSION Enteral nutrition does not improve the survival and hepatic or nutritional parameters of cirrhotic patients with jaundice.
Collapse
Affiliation(s)
- B Dupont
- Department of Hepato-Gastroenterology and Nutrition, Caen University Hospital, France.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Le Toux AL, Bignon AL, Musikas M, Vastel E, Dupont B, Joubert C, Dao T, Piquet MA. P124 Traitement par nutrition entérale de patients atteints d’hépatite alcoolique aiguë grave non répondeurs aux corticoïdes. Série rétrospective non contrôlée. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70191-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
13
|
Malmezat X, Couster J, Delvincourt M, Fradin S, Roupie E, Vastel E, Le Mouel A, Leclercq A, Joubert C, Musikas M, Piquet MA. P109 Efficacité du dépistage de la dénutrition par l’albuminémie aux urgences. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70176-5] [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: 11/26/2022]
|