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Tasu JP, Herpe G, Damion J, Richer JP, Debeane B, Vionnet M, Rouleau L, Carretier M, Ferru A, Ingrand P, Tougeron D. Irreversible electroporation to bring initially unresectable locally advanced pancreatic adenocarcinoma to surgery: the IRECAP phase II study. Eur Radiol 2024:10.1007/s00330-024-10613-x. [PMID: 38494526 DOI: 10.1007/s00330-024-10613-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/10/2023] [Accepted: 01/08/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES The aim of the IRECAP study was to evaluate the rate of locally advanced pancreas cancer patients (LAPC) who could undergo R0 or R1 surgery after irreversible electroporation (IRE). MATERIALS AND METHODS IRECAP study is a phase II, single-center, open-label, prospective, non-randomized trial registered at clinicaltrials.gov (NCT03105921). Patients with LAPC were first treated by 3-month neo-adjuvant chemotherapy in order to avoid inclusion of either patients with LAPC having become resectable after chemotherapy or patients with rapid disease progression. In cases of stable disease, IRE was performed percutaneously under CT guidance. Surgery was planned between 28 and 90 days after IRE. Tumor specimens were studied to evaluate the resection margins (R0/R1/R2). RESULTS Six men and 11 women were included (median age 61 years, range 37-77 years). No IRE-related death was observed. Ten patients (58%, 10/17) experienced 25 serious adverse events related to IRE. Four patients progressed between IRE and surgery and were excluded from surgery. Thirteen patients were finally operated, six withheld for pancreas resection, three for diffuse peritoneal carcinosis, two for massive vascular entrapment, and one for hepato-cellular carcinoma not diagnosed before surgery. Rate of R1-R0 was 35% (n = 6/17). Median overall survival was 31 months (95% CI; 4-undefined) for the six patients with R0/R1 resection and 21 months (95% CI; 4-25) for the 11 patients without resection or R2 resection (logrank p = 0.044). CONCLUSION After neoadjuvant chemotherapy, IRE could provide R0 or R1 resection in 35% of LAPC, which seems to be associated with higher OS. CLINICAL RELEVANCE STATEMENT After induction chemotherapy, stable locally advanced pancreatic cancers can be treated by irreversible electroporation, which could lead to a secondary 35% rate of R0 or R1 surgical resection which may be associated with a significantly higher overall survival. KEY POINTS • In cases of unresectable LAPC (locally advanced pancreatic cancer), percutaneous irreversible electroporation (pIRE) is feasible (100% success rate of the procedure), but is associated with a 58% rate of grade 3-4 adverse events. • In patients with unresectable LAPC, pIRE could lead 35% of patients to R0-R1 surgical resection. • From IRE, median overall survival was 31 months (95% CI; 4-undefined) for the patients with R0/R1 resection and 21 months (95% CI; 4-25) for the patients without resection or R2 resection (logrank p = 0.044).
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Affiliation(s)
- Jean-Pierre Tasu
- Department of Diagnosis and Interventional Radiology, University Hospital of Poitiers, 86021, Poitiers Cedex, France.
- LaTim, UBO and INSERM 1101, University of Brest, 29000, Brest, France.
| | - Guillaume Herpe
- Department of Diagnosis and Interventional Radiology, University Hospital of Poitiers, 86021, Poitiers Cedex, France
| | - Jérôme Damion
- Department of Pancreatic Surgery, University Hospital of Poitiers, 86021, Poitiers Cedex, France
| | - Jean-Pierre Richer
- Department of Pancreatic Surgery, University Hospital of Poitiers, 86021, Poitiers Cedex, France
| | - Bertrand Debeane
- Department of Anesthesiology, University Hospital of Poitiers, 86021, Poitiers Cedex, France
| | - Mathilde Vionnet
- Department of Diagnosis and Interventional Radiology, University Hospital of Poitiers, 86021, Poitiers Cedex, France
| | - Laetitia Rouleau
- Department of Anesthesiology, University Hospital of Poitiers, 86021, Poitiers Cedex, France
| | - Michel Carretier
- Department of Pancreatic Surgery, University Hospital of Poitiers, 86021, Poitiers Cedex, France
| | - Aurélie Ferru
- Department of Abdominal Oncology, University Hospital of Poitiers, 86021, Poitiers Cedex, France
| | - Pierre Ingrand
- Department of Biostastistic and Epidemiology, University of Poitiers, 86000, Poitiers, France
| | - David Tougeron
- Department of Abdominal Oncology, University Hospital of Poitiers, 86021, Poitiers Cedex, France
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Leveziel N, Marillet S, Braithwaite T, Peto T, Ingrand P, Pardhan S, Bron AM, Jonas JB, Resnikoff S, Julie Anne L, Davis AC, McMahon CM, Bourne RRA. Self-reported dual sensory impairment and related factors: a European population-based cross-sectional survey. Br J Ophthalmol 2024; 108:484-492. [PMID: 36759151 PMCID: PMC10894815 DOI: 10.1136/bjo-2022-321439] [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: 07/18/2022] [Accepted: 01/11/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Data on population-based self-reported dual vision and hearing impairment are sparse in Europe. We aimed to investigate self-reported dual sensory impairment (DSI) in European population. METHODS A standardised questionnaire was used to collect medical and socio-economic data among individuals aged 15 years or more in 29 European countries. Individuals living in collective households or in institutions were excluded from the survey. RESULTS Among 296 677 individuals, the survey included 153 866 respondents aged 50 years old or more. The crude prevalence of DSI was of 7.54% (7.36-7.72). Among individuals aged 60 or more, 9.23% of men and 10.94% of women had DSI. Eastern and southern countries had a higher prevalence of DSI. Multivariable analyses showed that social isolation and poor self-rated health status were associated with DSI with ORs of 2.01 (1.77-2.29) and 2.33 (2.15-2.52), while higher income was associated with lower risk of DSI (OR of 0.83 (0.78-0.89). Considering country-level socioeconomic factors, Human Development Index explained almost 38% of the variance of age-adjusted prevalence of DSI. CONCLUSION There are important differences in terms of prevalence of DSI in Europe, depending on socioeconomic and medical factors. Prevention of DSI does represent an important challenge for maintaining quality of life in elderly population.
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Affiliation(s)
| | - Simon Marillet
- Public Health department, CHU Poitiers, Poitiers, France
| | - Tasanee Braithwaite
- School of Immunology and Microbiology and School of Life Course Sciences, Kings College, London, UK
- The Medical Eye Unit, Guy's and St Thomas' Hospital, London, UK
| | - Tunde Peto
- Centre for Public Health, Faculty of Medicine Health and Life Sciences, Queen's University Belfast, Belfast, Belfast, UK
| | - Pierre Ingrand
- Public health department, University of Poitiers, Poitiers, France
| | - Shahina Pardhan
- Vision and Eye Research Institute (VERI), School of Medicine, Anglia Ruskin University, Cambridge, Cambridgeshire, UK
| | - Alain M Bron
- Ophthalmology, University Hospital Centre Dijon Bourgogne, Dijon, Bourgogne-Franche-Comté, France
| | - Jost B Jonas
- Ophthalmology, Ruprecht Karls University Heidelberg Faculty of Medicine Mannheim, Mannheim, Baden-Württemberg, Germany
| | - Serge Resnikoff
- Brien Holden Vision Institute and SOVS, University of New South Wales, Sydney, New South Wales, Australia
| | - Little Julie Anne
- Centre for Optometry and Vision Science, School of Biomedical Sciences, Biomedical Sciences Research Institute, Ulster University, Coleraine, Belfast, UK
| | | | - Catherine M McMahon
- Hear Center, Macquarie University Faculty of Medicine and Health Sciences, Sydney, New South Wales, Australia
| | - Rupert R A Bourne
- Vision and Eye Research Unit, Anglia Ruskin University Faculty of Science and Technology, Chelmsford, Essex, UK
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Milhem A, Anselme F, Da Costa A, Abbey S, Mansourati J, Bader H, Winum PF, Badenco N, Maury P, Dompnier A, Shah D, Johner N, Taieb J, Bertrand J, Tréguer F, Amelot M, Ingrand P, Allix-Béguec C. ATE Score Diagnostic Accuracy for Predicting the Absence of Intra-Atrial Thrombi Before AF Ablation. JACC Clin Electrophysiol 2023; 9:2550-2557. [PMID: 37804261 DOI: 10.1016/j.jacep.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 08/14/2023] [Accepted: 08/20/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND In a preliminary study in patients hospitalized for catheter ablation of atrial fibrillation (AF), the atrial thrombus exclusion (ATE) score (stroke, hypertension, heart failure, and D-dimers >270 ng/mL) was developed to rule out the diagnosis of intra-atrial thrombus, with a negative predictive value (NPV) of 100%, and to avoid performing transesophageal echocardiography (TEE). OBJECTIVES The present study was designed to prospectively confirm the NPV of the ATE score in an independent population. METHODS Consecutive patients hospitalized for catheter ablation of AF or left atrial tachycardia (LAT) were prospectively enrolled in a multicenter study. D-dimer levels were measured within 48 hours before ablation. An ATE score of 0 was considered predictive of no thrombus. TEE was routinely performed at the beginning or just before the ablation procedure. The primary endpoint was the presence of atrial thrombus diagnosed by TEE. RESULTS The analysis included 3,072 patients (53.3% paroxysmal AF, 36.7% persistent AF, and 10% LAT). A thrombus was detected in 29 patients (0.94%; 95% CI: 0.63%-1.35%), all on appropriate anticoagulant therapy. An ATE score of 0 was observed in 818 patients (26.6%), and the sensitivity, specificity, positive predictive value, and NPV were 93.1%, 26.8%, 1.2%, and 99.8%, respectively. Follow-up of the 2 false negative patients revealed the persistence of chronic organized thrombi. CONCLUSIONS In patients hospitalized for catheter ablation of AF or LAT, the ATE score identifies a population at very low risk for atrial thrombus. In consultation with the patient, the cardiologist may consider not performing a preoperative TEE in case of an ATE score of 0.
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Affiliation(s)
- Antoine Milhem
- Department of Cardiology, CH la Rochelle, La Rochelle, France.
| | | | - Antoine Da Costa
- Department of Cardiology, CHU Saint-Etienne, Saint-Etienne, France
| | - Sélim Abbey
- Department of Cardiology, Nouvelles Cliniques Nantaises, Groupe Confluent, Nantes, France
| | | | | | | | - Nicolas Badenco
- Department of Cardiology, APHP, Hôpital Pitié Salpêtrière, Paris, France; Sorbonne Université, INSERM, UMRS 1166-ICAN, Institute of Cardiometabolism and Nutrition, Paris, France
| | - Philippe Maury
- Department of Cardiology, CHU Toulouse, Toulouse, France
| | | | - Dipen Shah
- Department of Cardiology, University Hospital Geneva, Geneva, Switzerland
| | - Nicolas Johner
- Department of Cardiology, University Hospital Geneva, Geneva, Switzerland
| | - Jérôme Taieb
- Department of Cardiology, CH Pays d'Aix, Aix-en-Provence, France
| | - Julien Bertrand
- Department of Cardiology, CHR Metz-Thionville, Ars-Laquenexy, France
| | | | | | - Pierre Ingrand
- Epidemiology and Biostatistics, INSERM CIC 1402, Université de Poitiers, CHU Poitiers, Poitiers, France
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Evrard C, Ingrand P, Rochelle T, Martel M, Tachon G, Flores N, Randrian V, Ferru A, Haineaux PA, Goujon JM, Karayan-Tapon L, Tougeron D. Circulating tumor DNA in unresectable pancreatic cancer is a strong predictor of first-line treatment efficacy: The KRASCIPANC prospective study. Dig Liver Dis 2023; 55:1562-1572. [PMID: 37308396 DOI: 10.1016/j.dld.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/08/2023] [Accepted: 03/27/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND There is no robust predictor of response to chemotherapy (CT) in unresectable pancreatic adenocarcinomas (UPA). The objective of the KRASCIPANC study was to analyze the kinetics of cell-free DNA (cfDNA)/circulating tumor DNA (ctDNA) as a predictor of response to CT in UPA. METHODS Blood samples were collected just before first CT and at day 28. The primary endpoint was the kinetics of KRAS-mutated ctDNA by digital droplet PCR between D0 and D28 as a predictor of progression-free survival (PFS). RESULTS We analyzed 65 patients with a KRAS-mutated tumor. A high level of cfDNA and KRAS-mutated ctDNA at D0, as well as the presence of KRAS-mutated ctDNA at D28, were strongly associated with lower centralized disease control rate (cDCR), shorter cPFS and OS in multivariate analysis. A score combining cfDNA level at diagnosis ≥ or <30 ng/mL and presence or not of KRAS-mutated ctDNA at D28 was an optimal predictor of cDCR (OR=30.7, IC95% 4.31-218 P=.001), PFS (HR=6.79, IC95% 2.76-16.7, P<.001) and OS (HR=9.98, IC95% 4.14-24.1, P<.001). CONCLUSION A combined score using cfDNA level at diagnosis and KRAS-mutated ctDNA at D28 is strongly associated with patient survival/response to chemotherapy in UPA. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04560270.
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Affiliation(s)
- Camille Evrard
- Medical Oncology Department, Poitiers University Hospital, Poitiers 86000, France; ProDicET, UR 24144, University of Poitiers, Poitiers 86000, France.
| | - Pierre Ingrand
- Department of Statistics, Faculty of Medicine, University of Poitiers, Poitiers 86000, France
| | - Tristan Rochelle
- Cancer Biology Department, Poitiers University Hospital, Poitiers 86000, France
| | - Marine Martel
- Cancer Biology Department, Poitiers University Hospital, Poitiers 86000, France
| | - Gaëlle Tachon
- Cancer Biology Department, Poitiers University Hospital, Poitiers 86000, France; Cancer Biology Department, Centre Léon Bérard, Lyon 69000, France
| | - Nicolas Flores
- Department of Imaging, University Hospital of Poitiers, Poitiers 86000, France
| | - Violaine Randrian
- ProDicET, UR 24144, University of Poitiers, Poitiers 86000, France; Hepato-Gastroenterology Department, Poitiers University Hospital, Poitiers, France
| | - Aurélie Ferru
- Medical Oncology Department, Poitiers University Hospital, Poitiers 86000, France
| | - Paul-Arthur Haineaux
- Hepato-Gastroenterology Department, Poitiers University Hospital, Poitiers, France; Hepato-Gastroenterology Department, Poitiers University Hospital, Châtellerault Hospital, Poitiers 86106, France
| | - Jean-Michel Goujon
- Department of Pathology, Poitiers University Hospital, Poitiers 86000, France
| | - Lucie Karayan-Tapon
- ProDicET, UR 24144, University of Poitiers, Poitiers 86000, France; Cancer Biology Department, Poitiers University Hospital, Poitiers 86000, France
| | - David Tougeron
- ProDicET, UR 24144, University of Poitiers, Poitiers 86000, France; Hepato-Gastroenterology Department, Poitiers University Hospital, Poitiers, France.
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Bironneau V, Ingrand P, Pontier S, Iamandi C, Portel L, Martin F, Mallart A, Lerousseau L, Alfandary D, Levrat V, Portier F, Tamisier R, Goutorbe F, Rabec C, Codron F, Auregan G, Mercy M, Attali V, Soyez F, Launois C, Recart D, Vecchierini MF, Gagnadoux F, Meurice JC. Auto-adjusted versus fixed positive airway pressure in patients with severe OSA: A large randomized controlled trial. Respirology 2023; 28:1069-1077. [PMID: 37587548 DOI: 10.1111/resp.14569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/24/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Continuous positive airway pressure (CPAP) in the treatment of severe obstructive sleep apnoea (OSA) can be used in fixed CPAP or auto-adjusted (APAP) mode. The aim of this prospective randomized controlled clinical study was to evaluate the 3 month-efficacy of CPAP used either in fixed CPAP or APAP mode. METHODS Eight hundred one patients with severe OSA were included in twenty-two French centres. After 7 days during which all patients were treated with APAP to determine the effective pressure level and its variability, 353 and 351 patients were respectively randomized in the fixed CPAP group and APAP group. After 3 months of treatment, 308 patients in each group were analysed. RESULTS There was no difference between the two groups in terms of efficacy whatever the level of efficient pressure and pressure variability (p = 0.41). Exactly, 219 of 308 patients (71.1%) in the fixed CPAP group and 212 of 308 (68.8%) in the APAP group (p = 0.49) demonstrated residual apnoea hypopnoea index (AHI) <10/h and Epworth Score <11. Tolerance and adherence were also identical with a similar effect on quality of life and blood pressure evaluation. CONCLUSION The two CPAP modes, fixed CPAP and APAP, were equally effective and tolerated in severe OSA patients.
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Affiliation(s)
- Vanessa Bironneau
- INSERM CIC 1402, IS-ALIVE Research Group, University of Poitiers, Poitiers, France
- Pneumologie, CHU de Poitiers, Poitiers, France
| | | | | | | | | | | | | | | | | | | | | | - Renaud Tamisier
- Université Grenoble Alpes, Inserm U1300, CHU Grenoble Alpes, Grenoble, France
| | | | | | | | - Guy Auregan
- Pneumologie, Polyclinique de Poitiers, Poitiers, France
| | | | - Valérie Attali
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- Département R3S, Service des Pathologies du Sommeil, AP-HP. Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | | | | | - Didier Recart
- Pneumologie, Cabinet Médical Arnasa, Biarritz, France
| | | | - Frédéric Gagnadoux
- Département de Pneumologie et Médecine du sommeil, CHU d'Angers, Angers, France
| | - Jean-Claude Meurice
- INSERM CIC 1402, IS-ALIVE Research Group, University of Poitiers, Poitiers, France
- Pneumologie, CHU de Poitiers, Poitiers, France
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Julien-Sweerts S, Romo L, Blot E, Ordonneau P, Ingrand P, Gicquel L. CBT program to reduce recidivism risk for road crashes among adolescents and young adults: Results of a randomized controlled study and prospects. Heliyon 2023; 9:e20074. [PMID: 37810130 PMCID: PMC10559812 DOI: 10.1016/j.heliyon.2023.e20074] [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: 02/13/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Road crashes are the first cause of mortality for young adults aged 18-25 years and the human factor contributes to 90-95% of events. The present study was carried out to determine the efficacity of the ECARR2 recurrence prevention program among adolescents and young adults at high risk of having a new traffic crash in the following months. A total of 288 participants having had a traffic crash that required going to the emergency room, at high risk of accident recurrence (ECARR≥5) were randomly allocated to either the intervention group (n = 144) or the control group (n = 144). Results revealed that the risk of recurrence was highest during the first 6 months (66% of recurrences). In per-protocol analysis population, at 6 months after inclusion, the accident recurrence rate was 14.2% ± 3.3% in the intervention group, and 23.5% ± 4.0% in the control group. The intervention had an effect per se, independently of the other predictors (p = 0.020). This effect was mediated by the three interaction variables: BDI, Impulsive Behavior Scale lack of perseverance, and Orientation to Happiness engagement. It was therefore through these dimensions that the intervention had an effect. In conclusion, the ECARR score predicts the risk of recurrence, risk which is the highest during the first 6 months. Finally, results confirm the predictive validity of the ECARR scale. The ECARR score had an effect on the risk of recurrence regardless of group (p = 0.045) and was predictive of recurrence (p = 0.045).A brief psychological intervention such as ECARR2 program, offered to young people ar hight risk of having a new crash, just after the crash, seems to halve the risk of recurrence at 6 months. Future research should improve the brief psychological intervention and its access via a mobile application or few hours in high school or in a driving school given.
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Affiliation(s)
| | - Lucia Romo
- EA 4430 Clipsyd, Paris Nanterre University, Nanterre, France
- Hôpital Universitaire Raymond Poincaré, Garches, France. CESP, U1018 INSERM UPS
| | - Emilie Blot
- Child and Adolescent Psychiatry Department, Laborit Hospital, Poitiers, France
| | - Pauline Ordonneau
- Child and Adolescent Psychiatry Department, Laborit Hospital, Poitiers, France
| | - Pierre Ingrand
- INSERM CIC 1402, University Hospital of Poitiers, University of Poitiers, Poitiers, France
| | - Ludovic Gicquel
- Child and Adolescent Psychiatry Department, Laborit Hospital, Poitiers, France
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Rigoard P, Billot M, Moens M, Goudman L, El-Hajj H, Ingrand P, Ounajim A, Roulaud M, Page P, Babin E, Et Talby M, Dany J, Johnson S, Bataille B, David R, Slavin KV. Evaluation of External Trigeminal Nerve Stimulation to Prevent Cerebral Vasospasm after Subarachnoid Hemorrhage Due to Aneurysmal Rupture: A Randomized, Double-Blind Proof-of-Concept Pilot Trial (TRIVASOSTIM Study). Int J Environ Res Public Health 2023; 20:ijerph20105836. [PMID: 37239562 DOI: 10.3390/ijerph20105836] [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] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/20/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023]
Abstract
Cerebral vasospasm remains the most frequent and devastating complication after subarachnoid aneurysmal hemorrhage because of secondary cerebral ischemia and its sequelae. The underlying pathophysiology involves vasodilator peptide release (such as CGRP) and nitric oxide depletion at the level of the precapillary sphincters of the cerebral (internal carotid artery network) and dural (external carotid artery network) arteries, which are both innervated by craniofacial autonomic afferents and tightly connected to the trigeminal nerve and trigemino-cervical nucleus complex. We hypothesized that trigeminal nerve modulation could influence the cerebral flow of this vascular network through a sympatholytic effect and decrease the occurrence of vasospasm and its consequences. We conducted a prospective double-blind, randomized controlled pilot trial to compare the effect of 10 days of transcutaneous electrical trigeminal nerve stimulation vs. sham stimulation on cerebral infarction occurrence at 3 months. Sixty patients treated for aneurysmal SAH (World Federation of Neurosurgical Societies scale between 1 and 4) were included. We compared the radiological incidence of delayed cerebral ischemia (DCI) on magnetic resonance imaging (MRI) at 3 months in moderate and severe vasospasm patients receiving trigeminal nerve stimulation (TNS group) vs. sham stimulation (sham group). Our primary endpoint (the infarction rate at the 3-month follow-up) did not significantly differ between the two groups (p = 0.99). Vasospasm-related infarctions were present in seven patients (23%) in the TNS group and eight patients (27%) in the sham group. Ultimately, we were not able to show that TNS can decrease the rate of cerebral infarction secondary to vasospasm occurrence. As a result, it would be premature to promote trigeminal system neurostimulation in this context. This concept should be the subject of further research.
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Affiliation(s)
- Philippe Rigoard
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
- Department of Neuro-Spine & Neuromodulation, Poitiers University Hospital, 86000 Poitiers, France
- Pprime Institute UPR 3346, CNRS, ISAE-ENSMA, University of Poitiers, 86360 Chasseneuil-du-Poitou, France
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
- STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
- STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Research Foundation-Flanders (FWO), 1090 Brussels, Belgium
| | - Hassan El-Hajj
- Department of Neuro-Spine & Neuromodulation, Poitiers University Hospital, 86000 Poitiers, France
| | - Pierre Ingrand
- CIC 1402, Clinical Investigation Center, Bio-Statistic and Epidemiology, University of Poitiers, 86021 Poitiers, France
| | - Amine Ounajim
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Manuel Roulaud
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Philippe Page
- Department of Neuro-Spine & Neuromodulation, Poitiers University Hospital, 86000 Poitiers, France
| | - Etienne Babin
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Mohamed Et Talby
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
- Department of Neuro-Spine & Neuromodulation, Poitiers University Hospital, 86000 Poitiers, France
| | - Jonathan Dany
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
- Department of Neuro-Spine & Neuromodulation, Poitiers University Hospital, 86000 Poitiers, France
| | - Simona Johnson
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
| | - Benoit Bataille
- Department of Neuro-Spine & Neuromodulation, Poitiers University Hospital, 86000 Poitiers, France
| | - Romain David
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, France
- Physical and Rehabilitation Medicine Unit, Poitiers University Hospital, University of Poitiers, 86021 Poitiers, France
| | - Konstantin V Slavin
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA
- Neurology Service, Jesse Brown Veterans Administration Medical Center, Chicago, IL 60612, USA
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Ingrand I, Palierne N, Sarrazin P, Desbordes Y, Blanchard C, Ingrand P. Familial colonoscopic screening: how do French general practitioners deal with patients and their high-risk relatives. A qualitative study. Eur J Gen Pract 2022; 28:182-190. [PMID: 35796607 PMCID: PMC9272923 DOI: 10.1080/13814788.2022.2089353] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Screening of colorectal cancer (CRC) can reduce incidence and mortality. First-degree relatives (FDRs) of patients with CRC or advanced adenoma before the age of 65 (index patients) are at increased risk of CRC; however, the guidelines for screening of FDRs by colonoscopy are poorly followed. Objectives The present study, conducted in the context of the COLOR3 interventional study project, aimed to explore the positioning of general practitioners (GPs) in familial CRC screening in France. Methods From February 2020 to April 2021, 35 semi-structured interviews with GPs of index patients and/or their FDRs were conducted by telephone. The full-data transcribed corpus was subjected to horizontal thematic analysis. Results Knowledge and compliance with the guidelines vary greatly between GPs. Although initiating the diagnostic process, GPs do not consider themselves as actors in the flow of information concerning familial risk. Their accompaniment of index patients in this role varies. GPs should overcome barriers to implementing colonoscopic screening for FDRs. They underline the importance of exploring family history, but they lack the time and doubt the reliability of the information given by FDRs. Conclusion Challenges include circumventing gaps in knowledge, adherence to guidelines and improving family history updates. The GPs interviewed suggested personalised guidelines in specialists' reports to initiate information campaigns raising awareness of familial risk, and to enhance coordination between organised screening and familial screening.
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Affiliation(s)
- Isabelle Ingrand
- INSERM CIC 1402, University Hospital of Poitiers, University of Poitiers, Poitiers, France
| | - Nicolas Palierne
- GRESCO (EA 3815), University Hospital of Poitiers, University of Poitiers, Poitiers, France
| | - Pauline Sarrazin
- Department of General Medicine, University of Poitiers, Poitiers, France
| | - Yvan Desbordes
- Department of General Medicine, University of Poitiers, Poitiers, France
| | - Clara Blanchard
- Department of General Medicine, University of Poitiers, Poitiers, France
| | - Pierre Ingrand
- INSERM CIC 1402, University Hospital of Poitiers, University of Poitiers, Poitiers, France
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Nassiri F, Davy G, Wright C, Ingrand P. Artificial Intelligence Software: Can it Improve the MSK Decision Making of Radiographers? A Pilot Study in France. J Med Imaging Radiat Sci 2022. [DOI: 10.1016/j.jmir.2022.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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10
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Tasu JP, Guen RL, Rhouma IB, Guerrab A, Beydoun N, Bergougnoux B, Ingrand P, Herpe G. Accuracy of a CT density threshold enhancement in distinguishing pancreas parenchymal necrosis in cases of acute pancreatitis in the first week. Diagn Interv Imaging 2022; 103:266-272. [PMID: 34991994 DOI: 10.1016/j.diii.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE The purpose of this study was to identify attenuation threshold value on computed tomography (CT) that allowed discriminating between interstitial edematous pancreatitis (IEP) and necrotizing pancreatitis (NP) in patients with acute pancreatitis during the first week of the disease and evaluate interobserver reproducibility for the diagnosis of acute pancreatitis category. MATERIALS AND METHODS Patients with acute pancreatitis who underwent CT examination of the abdomen between March 2015 and December 2019 were retrospectively included. Actual diagnosis of IEP or NP was based on final clinical report, follow-up evaluation, and complications. Six regions of interest were manually placed in the pancreatic gland and peripancreatic fat, and differences in CT attenuation values before contrast injection and during the portal venous phase of enhancement were computed. Performance in the diagnosis of AP category was evaluated using receiver operating characteristic analysis. Interobserver agreement was estimated by the intraclass correlation coefficient (ICC) and Bland Altman analysis was used to estimate reproducibility between pairs of observers. RESULTS Sixty-six patients with NP (46 men, 20 women; mean age, 55 ± 17 [SD] years; age range: 20-89 years) and 70 patients with IEP (39 men, 31 women; mean age, 54 ± 18 [SD] years; age range: 21-87 years) were included. An enhancement value less than 30 Hounsfield units (HU) in the pancreatic gland during the portal phase compared to non-contrast phase, yielded 90.9% sensitivity (60/66; 95% CI: 81.3-96.6), 94.3% specificity (66/70; 95% CI: 86.0-98.4) and an area under curve of 0.958 (95% CI: 0.919-0.996) for the diagnosis of NP versus IEP. Interobserver reproducibility for pancreas enhancement was good using Bland Altman plot and ICC was excellent for pancreatic gland analysis (ICC 0.978; 95% CI: 0.961-0.988) but poor or moderate (ICC ≤0.634) regarding peripancreatic fat necrosis. CONCLUSION By using a pancreas enhancement threshold value of 30 HU, CT is accurate and reproducible for the diagnosis of NP during the first week of the disease.
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Affiliation(s)
- Jean Pierre Tasu
- Department of Diagnostic and Interventional Radiology, University Hospital of Poitiers, 86021 Poitiers, France; LaTim, UBO and INSERM 1101, University of Brest, 29000 Brest, France.
| | - Raphael Le Guen
- Department of Diagnostic and Interventional Radiology, University Hospital of Poitiers, 86021 Poitiers, France
| | - Inès Ben Rhouma
- Department of Diagnostic and Interventional Radiology, University Hospital of Poitiers, 86021 Poitiers, France
| | - Ayoub Guerrab
- Department of Diagnostic and Interventional Radiology, University Hospital of Poitiers, 86021 Poitiers, France
| | - Nadeem Beydoun
- Department of Diagnostic and Interventional Radiology, University Hospital of Poitiers, 86021 Poitiers, France
| | - Brice Bergougnoux
- Department of Diagnostic and Interventional Radiology, University Hospital of Poitiers, 86021 Poitiers, France
| | - Pierre Ingrand
- CIC 1402, Clinical Investigation center, Bio-statistic and epidemiology, University of Poitiers, 86021 Poitiers, France
| | - Guillaume Herpe
- Department of Diagnostic and Interventional Radiology, University Hospital of Poitiers, 86021 Poitiers, France
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11
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Ducloux A, Marillet S, Ingrand P, Bullimore MA, Bourne RRA, Leveziel N. Progression of myopia in teenagers and adults: a nationwide longitudinal study of a prevalent cohort. Br J Ophthalmol 2021; 107:644-649. [PMID: 34937695 PMCID: PMC10176358 DOI: 10.1136/bjophthalmol-2021-319568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 11/12/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The prevalence of myopia is increasing worldwide. The purpose of this study was to evaluate the progression of myopia in teenagers and adults in France. METHODS This nationwide prospective study followed 630 487 myopic adults and teenagers (mean age 43.4 years±18.2, 59.8% of women) between January 2013 and January 2019. Myopia and high myopia were defined as a spherical equivalent less than or equal to -0.50 and -6.00 diopters (D), respectively. Demographic data were collected at first visit and refractive characteristics were collected at each visit. Analysis of short-term progression (first 12 to 26 months postbaseline) was modelled using analysis of variance (ANOVA). Progression of myopia was stratified according to age, gender and spherical equivalent at first visit. RESULTS Higher proportions of progressors were observed in the youngest age groups: 14-15 (18.2 %) and 16-17 years old (13.9 %). In multivariate analysis, after adjustment for over age, spherical equivalent and gender, the mean short-term progression decreased from -0.36 D in the 14-15 years age group to -0.13 D in the 28-29 years age group. Young age and higher myopia at baseline together were strongly associated with the risk of developing high myopia, the 5-year cumulative risk being 76% for youngest teenager with higher myopia status at baseline. CONCLUSION In this large cohort of myopic teenagers and adults, myopia progression was reported in 18.2% and 13.9% of the 14-15 and 16-17 age groups, respectively. The risk to develop high myopia was higher for younger individuals with higher myopia at baseline examination.
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Affiliation(s)
| | - Simon Marillet
- Ophthalmology, CHU Poitiers, Poitiers, France.,Public Health Department, University of Poitiers, Poitiers, Nouvelle-Aquitaine, France
| | - Pierre Ingrand
- Public Health Department, University of Poitiers, Poitiers, Nouvelle-Aquitaine, France
| | - Mark A Bullimore
- Optometry, University of Houston College of Optometry, Houston, Texas, USA
| | - Rupert R A Bourne
- Postgraduate Medical Institute, Anglia Ruskin University Vision and Eye Research Institute, Cambridge, UK
| | - Nicolas Leveziel
- Ophthalmology, CHU Poitiers, Poitiers, France .,Postgraduate Medical Institute, Anglia Ruskin University Vision and Eye Research Institute, Cambridge, UK
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12
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Rouillon M, Laporte C, Ingrand P, Castéra P, Di Patrizio P, Messaadi N, Binder P, Dupouy J. Perceptions, professional responsibility and management experiences of patients with alcohol, tobacco and opioid use disorder by residents in general practice and teaching general practitioners. Eur J Gen Pract 2021; 27:77-82. [PMID: 33978533 PMCID: PMC8118509 DOI: 10.1080/13814788.2021.1917542] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 04/01/2021] [Accepted: 04/01/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Substance use disorders (SUDs) are based on pathophysiological mechanisms common to all psychoactive substances. However, general practitioners (GPs) hold different views depending on the substance in question. OBJECTIVES To determine whether the perceptions that teaching GPs and final-year residents in general practice have of patients with a SUD vary according to the substance involved and explore their professional responsibility and management experiences. METHODS A cross-sectional observational study was carried out by asking residents and teaching GPs from eight faculties of medicine about their perceptions, professional responsibility and management experience of patients with tobacco, alcohol and opioid use disorders, using an online questionnaire between June and September 2017. RESULTS The responses of 238 teaching GPs (mean age 50 years SD 3.5; 58% men) and 327 residents (mean age 28 years SD 9.9; 67% women) were analysed (response rates: 9 and 15% respectively). Tobacco smokers were considered to be more responsible for their acts than the other users. Teaching GPs and residents considered that it was their responsibility to discuss substance use. They did not feel able to manage alcohol and opioid use disorders. Tobacco cessation was mainly managed alone (78%). The results were quite similar among teaching GPs and residents. CONCLUSION The majority of practitioners had no difficulty managing smoking cessation. During the management of alcohol and particularly opioid use disorders, practitioners did not feel competent. The gap between their perceived responsibility and competencies should be addressed by training and promoting collaborative care.
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Affiliation(s)
- Marie Rouillon
- Département Universitaire de Médecine Générale, Université de Toulouse III Paul Sabatier, Faculté de Médecine, Toulouse, France
| | - Catherine Laporte
- Département de Médecine Générale, Faculté de Médecine, Université de Clermont-Ferrand, Clermont-Ferrand, France
- EA 7280 NPsy-Sydo, Faculté de Médecine de Clermont-Ferrand, Université d’Auvergne, Clermont-Ferrand, France
| | - Pierre Ingrand
- Unité d’épidémiologie et de biostatistique de la Faculté de Médecine et de Pharmacie de, l’Université de Poitiers CIC Inserm, Poitiers, France
| | - Philippe Castéra
- Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Bordeaux, Bordeaux, France
| | - Paolo Di Patrizio
- Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Nancy, Nancy, France
| | - Nassir Messaadi
- Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Lille, Lille, France
| | - Philippe Binder
- Département de Médecine Générale, Faculté de Médecine et de Pharmacie, Université de Poitiers, Poitiers, France
| | - Julie Dupouy
- Département Universitaire de Médecine Générale, Université de Toulouse III Paul Sabatier, Faculté de Médecine, Toulouse, France
- Faculté de Médecine, Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France
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13
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de Bisschop C, Caron F, Ingrand P, Bretonneau Q, Dupuy O, Meurice JC. Does branched-chain amino acid supplementation improve pulmonary rehabilitation effect in COPD? Respir Med 2021; 189:106642. [PMID: 34678585 DOI: 10.1016/j.rmed.2021.106642] [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: 06/21/2021] [Revised: 09/03/2021] [Accepted: 10/05/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Muscle wasting is frequent in chronic obstructive lung disease (COPD) and associated with low branched-chain amino acids (BCAA). We hypothesized that BCAA supplementation could potentiate the effect of a pulmonary rehabilitation program (PRP) by inducing muscular change. MATERIALS AND METHODS Sixty COPD patients (GOLD 2-3) were involved in an ambulatory 4-week PRP either with BCAA oral daily supplementation or placebo daily supplementation in a randomized double-blind design. Maximal exercise test including quadriceps oxygenation measurements, functional exercise test, muscle strength, lung function tests, body composition, dyspnea and quality of life were assessed before and after PRP. RESULTS Fifty-four patients (64.9 ± 8.3 years) completed the protocol. In both groups, maximal exercise capacity, functional and muscle performances, quality of life and dyspnea were improved after 4-week PRP (p ≤ 0.01). Changes in muscle oxygenation during the maximal exercise and recovery period were not modified after 4-week PRP in BCAA group. Contrarily, in the placebo group the muscle oxygenation kinetic of recovery was slowed down after PRP. CONCLUSION This study demonstrated that a 4-week PRP with BCAA supplementation is not more beneficial than PRP alone for patients. A longer duration of supplementation or a more precise targeting of patients would need to be investigated to validate an effect on muscle recovery and to demonstrate other beneficial effects.
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Affiliation(s)
| | - Fabrice Caron
- CHU Poitiers, F-86000, Poitiers, France; Centre de Réadaptation Du Moulin Vert, F-86340, Nieuil L'espoir, France
| | - Pierre Ingrand
- Université de Poitiers, CHU Poitiers, INSERM CIC 1402, F-86000, Poitiers, France
| | | | - Olivier Dupuy
- Université de Poitiers, MOVE, F-86000, Poitiers, France
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14
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Evrard C, Ingrand P, Tachon G, Flores N, Rochelle T, Martel M, Randrian V, Ferru A, Haineaux PA, Isambert N, Karayan Tapon L, Tougeron D. 1472P Circulating tumor DNA in unresectable pancreatic cancer is a strong predictor of response to first-line therapy: The KRASCIPANC study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.799] [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] Open
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15
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Leveziel N, Marillet S, Braithwaite T, Peto T, Ingrand P, Pardhan S, Bron AM, Jonas JB, Resnikoff S, Little J, Bourne RR. Self-reported visual difficulties in Europe and related factors: a European population-based cross-sectional survey. Acta Ophthalmol 2021; 99:559-568. [PMID: 33029925 PMCID: PMC8451874 DOI: 10.1111/aos.14643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/15/2020] [Accepted: 09/13/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE There is a relative paucity of self-reported vision problems data in European countries. METHODS In this context, we investigated self-reported vision problems through European Health Interview Survey 2, a cross-sectional European population survey based on a standardized questionnaire including 147 medical, demographic and socioeconomic variables applied to non-institutionalized individuals aged 15 years or more in 28 European countries, in addition to Iceland and Norway. RESULTS The survey included 311 386 individuals (54.18% women), with overall crude prevalence of self-reported vision problems of 2.07% [95% CI; 2.01-2.14]. Among them, 1.70 % [1.61-1.78] of men, 2.41% [2.31-2.51] of women and 4.71% [4.53-4.89] of individuals aged 60 or more reported to have a lot of vision problems or to be not able to see. The frequency of self-reported vision problems was the highest in Eastern European countries with values of 2.43% [2.30-2.56]. In multivariate analyses, limiting long-standing illness, depression, daily smoking, lack of physical activity, lower educational level and social isolation were associated with self-reported vision problems with ORs of 2.66 [2.42-2.92], 2.16 [2.01-2.32], 1.11 [1.01-1.23], 1.31 [1.21-1.42], 1.29 [1.19-1.40] and 1.45 [1.26-1.67], respectively, while higher income was associated with less self-reported vision problems with OR of 0.80 [0.73-0.86]. CONCLUSIONS This study demonstrated inequalities in terms of prevalence of self-reported vision problems in Europe, with higher prevalence in Eastern European countries and among women and older individuals.
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Affiliation(s)
- Nicolas Leveziel
- Vision & Eye Research Institute Anglia Ruskin University Cambridge UK
- CHU Poitiers Poitiers France
- CIC 1402 Poitiers France
- INSERM 1084 Poitiers France
- University of Poitiers Poitiers France
| | | | - Tasanee Braithwaite
- Centre for Patient Reported Outcomes Research and NIHR Birmingham Biomedical Research Centre University of Birmingham Birmingham UK
- Moorfields Eye Hospital London UK
| | - Tunde Peto
- Institute of Clinical Sciences Building A Queen's University Belfast Belfast UK
| | - Pierre Ingrand
- CHU Poitiers Poitiers France
- CIC 1402 Poitiers France
- Epidemiology and biostatistics department Faculty of Medicine University of Poitiers Poitiers France
| | - Shahina Pardhan
- Vision & Eye Research Institute Anglia Ruskin University Cambridge UK
| | - Alain M. Bron
- Department of Ophthalmology University Hospital Dijon France
- Eye and Nutrition Research Group Bourgogne Franche‐Comté University Dijon France
| | - Jost B. Jonas
- Department of Ophthalmology Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Serge Resnikoff
- Brien Holden Vision Institute and SOVSUniversity of New South Wales Sydney NSW Australia
| | - Julie‐Anne Little
- Centre for Optometry & Vision Science Biomedical Sciences Ulster University Coleraine UK
| | - Rupert R.A. Bourne
- Vision & Eye Research Institute Anglia Ruskin University Cambridge UK
- Cambridge Eye Research Centre Department of Ophthalmology Cambridge University Hospitals Cambridge UK
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16
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Beydoun N, Brunner P, De La Torre Y, Herpe G, Guillevin R, Ingrand P, Tasu JP. Effectiveness of CT-guided epidural infiltration of steroids and local anesthetics for acute and chronic herpes zoster neuralgia. Diagn Interv Imaging 2021; 102:525-530. [PMID: 33785313 DOI: 10.1016/j.diii.2021.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/28/2021] [Accepted: 02/18/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the effectiveness and complication rate of computed tomography (CT)-guided epidural injection of steroids and local anesthetics for pain relief in patients with neuralgia due to acute or chronic herpes zoster (HZ). MATERIALS AND METHODS A prospective study was conducted from April 2017 to February 2019 including patients with HZ neuralgia (HZN) at any stage (acute or chronic, the latter being defined as pain lasting more than 3 months and also called post herpetic neuralgia [PHN]). The sensory ganglion of the affected dermatome and/or the affected sensory nerve was targeted under CT-guidance and local injection of a mixture of two vials of methylprednisolone 40mg/mL and 2mL of Lidocaine 1% was performed. Using a visual analogue scale (VAS, 0 to 10), pain was assessed prior to the procedure, and at day 7, 1 month, 3 months and 6 months. Adverse effects were graded according to the Society of Interventional Radiology classification. RESULTS Twenty patients were included. There were 9 men and 11 women with a mean age of 67±13.9 (SD) years (range: 27-83 years). Of these, 14 patients had acute HZN and 6 had PHN. Mean VAS at baseline was 8.1±1.2 (SD) (range: 6-10) with significant decrease (P<0.0001) at day 7 (3.4±3.2 [SD]; range: 0-10), day 30 (3.4±3.2 [SD]; range: 0-9), day 90 (2.9±3.2 [SD]; range: 0-9), and day 180 (2.5±3.1 [SD]; range: 0-9). Infiltrations were significantly more effective on acute HZN than on PHN (P<0.001) and required significantly fewer infiltrations for pain relef (P=0.002). Only one grade A adverse event was reported. CONCLUSION Epidural injection of a mixture of steroids and local anesthetics under CT-guidance is effective on HZN with a persisting effect over 6 months.
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Affiliation(s)
- Nadeem Beydoun
- University Hospital of Poitiers, Department of Radiology, 86021, Poitiers, France
| | | | - Yannick De La Torre
- University Hospital of Poitiers, Department of Radiology, 86021, Poitiers, France
| | - Guillaume Herpe
- University Hospital of Poitiers, Department of Radiology, 86021, Poitiers, France
| | - Remy Guillevin
- University Hospital of Poitiers, Department of Radiology, 86021, Poitiers, France
| | - Pierre Ingrand
- University of Poitiers, Clinical research center, CIC 1402, 86021, Poitiers, France
| | - Jean-Pierre Tasu
- University Hospital of Poitiers, Department of Radiology, 86021, Poitiers, France; LATim, Laboratory of Medical Information Processing-inserm UMR 1101, 29609 Brest cedex, France.
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17
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Tricard D, Marillet S, Ingrand P, Bullimore MA, Bourne RRA, Leveziel N. Progression of myopia in children and teenagers: a nationwide longitudinal study. Br J Ophthalmol 2021; 106:1104-1109. [PMID: 33712479 PMCID: PMC9340031 DOI: 10.1136/bjophthalmol-2020-318256] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 10/20/2020] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 11/05/2022]
Abstract
Background Data on myopia prevalence and progression in European children are sparse. The aim of this work was to evaluate the progression of myopia in children and teenagers in a large prospective study. Methods A prospective study involving a nationwide cohort. Myopia was defined as a spherical equivalent (SE) of ≤ –0.50 diopters (D). Data on refractive error, gender and age were collected in 696 optical centres in France between 2013 and 2019, including 136 333 children (4–17 years old) in the analysis. Progression of myopia was assessed between the first visit and the last visit over up to 6.5 years. Results Mean age was 11.3±3.8 years (55.0% of female). The proportion of children progressing more than –0.50 D per year was higher in age groups 7–9 years and 10–12 years and in children with SE ≤ –4.00 D at first visit, representing 33.1%, 29.4% and 30.0% of these groups, respectively. In multivariate analysis, progression during the first 11–24 months was higher in the 7–9 and 10–12 age groups (–0.43 D and –0.42 D, respectively), for higher SE at baseline (at least –0.33 D for SE ≤ –1 D) and for girls (–0.35 D). Conclusion This is the first French epidemiological study to investigate myopia progression in a large-scale cohort of children. Sex, age groups and myopia severity are associated with differing rates of progression.
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Affiliation(s)
| | | | - Pierre Ingrand
- University of Poitiers, Poitiers, Poitou-Charentes, France
| | | | | | - Nicolas Leveziel
- Ophthalmology, CHU Poitiers, Poitiers, France .,University of Poitiers, Poitiers, Poitou-Charentes, France.,INSERM CIC 1402, Poitiers, France.,INSERM 1084, Poitiers, France
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18
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Arroyo-Anlló EM, Souchaud C, Ingrand P, Chamorro Sánchez J, Melero Ventola A, Gil R. Alexithymia in Alzheimer's Disease. J Clin Med 2020; 10:jcm10010044. [PMID: 33375608 PMCID: PMC7795069 DOI: 10.3390/jcm10010044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/28/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022] Open
Abstract
Alexithymia is widely recognized as the inability to identify and express emotions. It is a construct which consists of four cognitive traits such as difficulty in identifying feelings, describing feelings to others, externally oriented thinking, and limited imaginative capacity. Several studies have linked alexithymia to cognitive functioning, observing greater alexithymia scores associated with poorer cognitive abilities. Despite Alzheimer's disease (AD) being a neurodegenerative pathology characterized by cognitive troubles from the early stages, associated to behavioral and emotional disturbances, very few investigations have studied the alexithymia in AD. These studies have shown that alexithymia scores-assessed with Toronto Alexithymia Scale (TAS)-were greater in AD patients than healthy participants. The objective of the study was to investigate if the alexithymia was present in patients with mild AD. We hypothesized that the AD group would show more alexithymia features than the control group. We evaluated 54 subjects, including 27 patients diagnosed with mild AD and 27 normal healthy controls, using the Shalling Sifneos Psychosomatic Scale (SSPS-R) and a neuropsychological test battery. Using non-parametric statistical analyses-Wilcoxon and Mann-Whitney U tests-we observed that the SSPS-R scores were similar in the AD and control groups. All participants showed SSPS-R scores below to 10 points, which means no-alexithymia. We did not find significant correlations between SSPS-R scores and cognitive variables in both groups (p > 0.22), but we observed a negative association between name abilities and alexithymia, but it does not reach to significance (p = 0.07). However, a significant correlation between SSPS-R score and mood state, assessed using Zerssen Rating Scale, was found in both groups (p = 0.01). Because we did not find a significant difference in the alexithymia assessment between both subject groups, pot hoc analyses were computed for each item of the SSPS-R. We made comparisons of alexithymic responses percentages in each SSPS-R item between AD and control groups, using Fisher's test. We observed that AD patients produced more alexithymic responses in some items of SSPS-R test than the control group, particularly about difficulties to find the words to describe feelings, as well as difficulties of imagination capacity and externally oriented thinking. The present results do not confirm our hypothesis and they do not support the results of previous studies revealing great alexithymia in AD.
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Affiliation(s)
- Eva Mª Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, University of Salamanca, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-629460944
| | - Corinne Souchaud
- Department of Neurology and Neuropsychology, University Hospital, CHU La Milétrie, 86000 Poitiers, France;
| | - Pierre Ingrand
- Department of Biostatistics, University of Poitiers, 86000 Poitiers, France;
| | - Jorge Chamorro Sánchez
- Faculty of Psychology, Pontifical University of Salamanca, 37002 Salamanca, Spain; (J.C.S.); (A.M.V.)
| | - Alejandra Melero Ventola
- Faculty of Psychology, Pontifical University of Salamanca, 37002 Salamanca, Spain; (J.C.S.); (A.M.V.)
| | - Roger Gil
- Department of Neurology, University Hospital, 86000 Poitiers, France;
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Bidegain N, Degand B, Bouleti C, Christiaens L, Tavernier M, Kerforne T, Ingrand P, Garcia R. Severe sleep apnea is associated with atrial fibrillation burden in pacemaker recipients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0480] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
New generation pacemaker allow the assessment day by day of sleep disordered breathing (SDB) based on impedance measurement. A recent study demonstrated that incidence of AF is higher in case of severe SA monitored by pacemaker
Purpose
The aim was to compare the atrial fibrillation (AF) burden between patients with severe and non-severe sleep apnea (SA) detected with pacemakers monitoring (SDB).
Methods
This retrospective study was carried out at our University Hospital. We included all patients with Microport CRM pacemaker implanted from 2013 to 2016 at our university hospital. Exclusion criteria were inactivation of sleep apnea monitoring (SAM), history of sleep apnea, missing data or invalid data. AF burden was assessed according to Fallback mode switch (FMS) duration. Respiratory disturbance index (RDI) was calculated as the average number of events (ventilation pause and reductions) per number of hours of monitoring. Patients with RDI<20/h were compared with patients with RDI≥20/h (considered as severe SA group).
Results
404 patients (mean age = 79.7±10 years; 52.0% men) were included. The most prevalent indication for cardiac pacing was atrioventricular block in 57%. Mean RDI was 18.9 events per hour. 234 (58%) of them had a mean RDI <20 and 170 (42%) had a mean RDI ≥20. Compared to patients with mean RDI<20, those with mean RDI ≥20 were youngers (78.6±10 years Vs 81.8±8 years; p=0.02), were more likely to be male (58.2% Vs 47.5%: p=0.035) and had more heart failure history (28.8% Vs 19.2%: p=0.03). BMI was not different between groups (26.3±5. vs 26.3±4; P=0.33). Mean follow-up was 27 months. Patients with RDI ≥20 had a mean Atrial fibrillation duration longer than patients with RDI <20 (631 min Vs 291 min respectively; p=0.014). RDI was correlated with FMS (r=0.26; p=0.0004). The stroke rate tended to be higher in the RDI ≥20 group (2.1% vs 5.4%) (p=0.12).
Conclusion
Severe SA detected by pacemaker was associated with longer AF duration. We did not find higher occurrence of stroke in the severe SA group.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Bidegain
- University Hospital of Poitiers, Poitiers, France
| | - B Degand
- University Hospital of Poitiers, Poitiers, France
| | - C Bouleti
- University Hospital of Poitiers, Poitiers, France
| | | | - M Tavernier
- University Hospital of Poitiers, Poitiers, France
| | - T Kerforne
- University Hospital of Poitiers, Poitiers, France
| | - P Ingrand
- University Hospital of Poitiers, Poitiers, France
| | - R Garcia
- University Hospital of Poitiers, Poitiers, France
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20
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Poupin P, Bouleti C, Degand B, Paccalin M, Le Gal F, Bureau ML, Alos B, Roumegou P, Christiaens L, Ingrand P, Garcia R. Prognostic value of Charlson Comorbidity Index in the elderly with a cardioverter defibrillator implantation. Int J Cardiol 2020; 314:64-69. [PMID: 32291172 DOI: 10.1016/j.ijcard.2020.03.060] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Elderly patients are often underrepresented in implantable cardioverter defibrillator (ICD) trials, and ICD implantation in patients ≥75 years consequently remains controversial. We aimed to evaluate mortality, appropriate ICD therapy rates and survival gain in an elderly population after risk stratification according to the Charlson Comorbidity Index (CCI). METHODS This monocentric retrospective study included elderly ICD patients ≥75 years. They were subdivided according to their CCI score into 3 categories (0-1, 2-3 or ≥4 points). Elderly patients were matched 1:2 with younger control ICD patients on gender, type of prevention (primary or secondary) and type of device (associated cardiac resynchronization therapy or not). RESULTS Between January 2009 and July 2017, 121 elderly patients (mean age 78 ± 3; 83% male) matched with 242 controls (mean age 66 ± 5) were included. At 5 year follow-up after ICD implantation, overall survival was 78%, 57%, and 29% (P = 0.002) in the elderly with a CCI score of 0-1, 2-3 and ≥4 respectively, and 72% in controls. There was no significant difference regarding ICD appropriate therapy between the 3 subgroups despite a trend towards lower rates of therapy in CCI ≥ 4 points patients (34.2%, 39.7% and 22.8% respectively; P = 0.45). Median potential survival gain after an appropriate therapy was >5, 4.7 and 1.4 years, with a CCI score of 0-1, 2-3 and ≥4 respectively (P = 0.01). CONCLUSION Elderly patients with CCI score ≥ 4 had the lowest survival after ICD implantation and little survival gain in case of appropriate defibrillator therapy. More than age alone, the burden of comorbidities assessed by the CCI could be helpful to better select elderly patients for ICD implantation.
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Affiliation(s)
- Pierre Poupin
- CHU Poitiers, Unité Médico-Chirurgicale Pôle Montmorillon, 2 rue de la Milétrie, F-86021 Poitiers, France
| | - Claire Bouleti
- CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France; Univ Poitiers, Faculté de Médecine et Pharmacie, F-86021 Poitiers, France; INSERM CIC 1402, CHU Poitiers, 2 rue de la Milétrie, F-86021 Poitiers, France
| | - Bruno Degand
- CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France.
| | - Marc Paccalin
- Univ Poitiers, Faculté de Médecine et Pharmacie, F-86021 Poitiers, France; CHU Poitiers, Service de Gériatrie, 2 rue de la Milétrie, F-86021 Poitiers, France.
| | - François Le Gal
- CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France.
| | - Marie-Laure Bureau
- CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France; Univ Poitiers, Faculté de Médecine et Pharmacie, F-86021 Poitiers, France.
| | - Benjamin Alos
- CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France; Univ Poitiers, Faculté de Médecine et Pharmacie, F-86021 Poitiers, France; INSERM CIC 1402, CHU Poitiers, 2 rue de la Milétrie, F-86021 Poitiers, France
| | - Pierre Roumegou
- CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France.
| | - Luc Christiaens
- CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France; Univ Poitiers, Faculté de Médecine et Pharmacie, F-86021 Poitiers, France; INSERM CIC 1402, CHU Poitiers, 2 rue de la Milétrie, F-86021 Poitiers, France.
| | - Pierre Ingrand
- Univ Poitiers, Faculté de Médecine et Pharmacie, F-86021 Poitiers, France; Epidemiology and Biostatistics, INSERM CIC 1402, CHU Poitiers, 2 rue de la Milétrie, F-86021 Poitiers, France.
| | - Rodrigue Garcia
- CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, F-86021 Poitiers, France; Univ Poitiers, Faculté de Médecine et Pharmacie, F-86021 Poitiers, France; INSERM CIC 1402, CHU Poitiers, 2 rue de la Milétrie, F-86021 Poitiers, France.
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21
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Rigoard P, Billot M, Ingrand P, Durand-Zaleski I, Roulaud M, Peruzzi P, Dam Hieu P, Voirin J, Raoul S, Page P, Djian MC, Fontaine D, Lantéri-Minet M, Blond S, Buisset N, Cuny E, Cadenne M, Caire F, Ranoux D, Mertens P, Naous H, Simon E, Emery E, Béraud G, Debiais F, Durand G, Serrie A, Diallo B, Bulsei J, Ounajim A, Nivole K, Duranton S, Naiditch N, Monlezun O, Bataille B. How Should we Use Multicolumn Spinal Cord Stimulation to Optimize Back Pain Spatial Neural Targeting? A Prospective, Multicenter, Randomized, Double-Blind, Controlled Trial (ESTIMET Study). Neuromodulation 2020; 24:86-101. [PMID: 32865344 DOI: 10.1111/ner.13251] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 02/21/2020] [Revised: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent studies have highlighted multicolumn spinal cord stimulation (SCS) efficacy, hypothesizing that optimized spatial neural targeting provided by new-generation SCS lead design or its multicolumn programming abilities could represent an opportunity to better address chronic back pain (BP). OBJECTIVE To compare multicolumn vs. monocolumn programming on clinical outcomes of refractory postoperative chronic BP patients implanted with SCS using multicolumn surgical lead. MATERIALS AND METHODS Twelve centers included 115 patients in a multicenter, randomized, double-blind, controlled trial. After randomization, leads were programmed using only one or several columns. The primary outcome was change in BP visual analogic scale (VAS) at six months. All patients were then programmed using the full potential of the lead up until 12-months follow-up. RESULTS At six months, there was no significant difference in clinical outcomes whether the SCS was programmed using a mono or a multicolumn program. At 12 months, in all patients having been receiving multicolumn SCS for at least six months (n = 97), VAS decreases were significant for global pain (45.1%), leg pain (55.8%), and BP (41.5%) compared with baseline (p < 0.0001). CONCLUSION The ESTIMET study confirms the significant benefit experienced on chronic BP by patients implanted with multicolumn SCS, independently from multicolumn lead programming. These good clinical outcomes might result from the specific architecture of the multicolumn lead, giving the opportunity to select initially the best column on a multicolumn grid and to optimize neural targeting with low-energy requirements. However, involving more columns than one does not appear necessary, once initial spatial targeting of the "sweet spot" has been achieved. Our findings suggest that this spatial concept could also be transposed to cylindrical leads, which have drastically improved their capability to shape the electrical field, and might be combined with temporal resolution using SCS new modalities.
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Affiliation(s)
- Philippe Rigoard
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France.,Department of Neurosurgery, Spine & Neurostimulation Unit, Poitiers University Hospital, Poitiers, France.,UPR 3346, CNRS, P' Institute, Futuroscope, Faculty of Sciences, Poitiers, France
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Pierre Ingrand
- Faculty of Medicine and Pharmacy, Poitiers University Hospital, Poitiers, France
| | | | - Manuel Roulaud
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Philippe Peruzzi
- Department of Neurosurgery, Reims University Hospital, Reims, France
| | - Phong Dam Hieu
- Department of Neurosurgery, Brest University Hospital, Brest, France
| | - Jimmy Voirin
- Department of Neurosurgery, Colmar Hospital, Colmar, France
| | - Sylvie Raoul
- Department of Neurosurgery, Nantes University Hospital, Nantes, France
| | - Philippe Page
- Department of Neurosurgery, Spine & Neurostimulation Unit, Poitiers University Hospital, Poitiers, France
| | | | - Denys Fontaine
- Centre Hospitalier Universitaire de Nice, Department of Neurosurgery, Université Côte d'Azur, Nice, France.,FHU InovPain, Côte Azur University, Nice, France
| | - Michel Lantéri-Minet
- FHU InovPain, Côte Azur University, Nice, France.,Pain Evaluation and Treatment Centre, Nice University Hospital, Nice, France.,INSERM U1107, Neuro-Dol, Trigeminal Pain and Migraine, Auvergne University, Clermont-Ferrand, France
| | - Serge Blond
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | - Nadia Buisset
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | - Emmanuel Cuny
- Department of Neurosurgery, Bordeaux University Hospital, Bordeaux, France
| | - Myriam Cadenne
- Pain Evaluation and Treatment Centre, Bordeaux University Hospital, Bordeaux, France
| | - François Caire
- Department of Neurosurgery, Limoges University Hospital, Limoges, France
| | - Danièle Ranoux
- Pain Evaluation and Treatment Centre, Limoges University Hospital, Limoges, France
| | - Patrick Mertens
- Department of Neurosurgery, Lyon University Hospital, Lyon, France
| | - Hussein Naous
- Department of Neurosurgery, Lyon University Hospital, Lyon, France
| | - Emile Simon
- Department of Neurosurgery, Lyon University Hospital, Lyon, France
| | - Evelyne Emery
- Department of Neurosurgery, Caen University Hospital, Caen, France
| | - Guillaume Béraud
- Internal Medicine/Infectious and Tropical Diseases Department, Poitiers University Hospital, Poitiers, France
| | - Françoise Debiais
- Department of Rheumatology, Poitiers University Hospital, Poitiers, France
| | - Géraldine Durand
- Department of Rheumatology, Poitiers University Hospital, Poitiers, France
| | - Alain Serrie
- Pain Evaluation and Treatment Centre, Lariboisière Hospital, Paris, France
| | - Bakari Diallo
- Pain Evaluation and Treatment Centre, Poitiers University Hospital, Poitiers, France
| | - Julie Bulsei
- Clinical Research Unit in Economics, Hôtel Dieu, Paris, France
| | - Amine Ounajim
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Kevin Nivole
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Sophie Duranton
- Vigilance Department, Clinical Research Direction, Poitiers University Hospital, Poitiers, France
| | - Nicolas Naiditch
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Olivier Monlezun
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Benoit Bataille
- Department of Neurosurgery, Spine & Neurostimulation Unit, Poitiers University Hospital, Poitiers, France
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22
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De Pardieu M, Boucebci S, Herpe G, Fauche C, Velasco S, Ingrand P, Tasu JP. Glioma-grade diagnosis using in-phase and out-of-phase T1-weighted magnetic resonance imaging: A prospective study. Diagn Interv Imaging 2020; 101:451-456. [DOI: 10.1016/j.diii.2020.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/08/2020] [Accepted: 04/14/2020] [Indexed: 12/15/2022]
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De Chateaubriant A, Ingrand P, Gervais E. AB1162 ANTI-TNF BIOSIMILARS: HOW KNOWLEDGE AND BELIEF INFLUENCE PRESCRIPTION. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Biological agents change the management of rheumatic inflammatory disease with improving care but increasing costs. Biosimilars for subcutaneous TNF inhibitors (SC TNFi) are available in France since 2015 and provide the same treatments at lower cost. French health agencies do not legally oblige rheumatologist to first prescribe or switch to biosimilars.Objectives:To assess the knowledge and beliefs of French rheumatologists about biosimilars.Methods:The assessment was developed with a questionnaire consisting of five parts: demographics data, professional practice, theoretical knowledge, beliefs and confidence. The questionnaire was administrated via the website Limesurvey and sent by email to French rheumatologist. A descriptive analysis of the data and associated factors to initiation and switch of biosimilars have been done.Results:One hundred one rheumatologists have participated to the study. 47.1% was less than forty years old. 92% of them have the authorization to prescribe TNFi. 53.2 always prescribed a biosimilars when they prescribed a SC TNFi for the first time and 78.5% in 90% of cases. 30.6% of French rheumatologist never switched to a biosimilars. Those who switch, do it in more than 75% of cases. 96.5%, 87.1% and 91.8% respectively answered that biosimilars are as efficient, as safe and have the same immunogenicity profile compared to originator. The initial biosimilars prescription is associated with a better knowledge about biosimilars. For example, 77.4% of rheumatologist who prescribe in more than 90% of the case, answerNOto the question “biosimilars and originator have to be compared in a phase III study for EACH indications for which originator obtained marketing approval”. Only 31.2% of rheumatologist who prescribed in less than 90% of the case respondNOto this question. This difference was significant p<0.001. The switch to a biosimilars is associated with the beliefs and confidence. For example 25.4% of rheumatologists who switch for biosimilar in more than 75% of the case, answerYESto the question “There is not enough experiences with biosimilar”. 57.7% of rheumatologist who switched in less than 75% of the case respondYESto this question. This difference was significant p<0.003.Conclusion:Despite good knowledge on biosimilars, some French rheumatologists do not switch for these molecules. Our study suggests that this is due to lack of confidence.Acknowledgments:The authors thank French rheumatologist who answer to the questionnaireDisclosure of Interests:Arnaud De Chateaubriant: None declared, Pierre Ingrand: None declared, Elisabeth Gervais Speakers bureau: Novartis, Janssen, Roche, Pfizer, BMS, Abbvie
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24
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Systchenko T, Defossez G, Guidez S, Laurent C, Puyade M, Debiais-Delpech C, Dreyfus B, Machet A, Leleu X, Delwail V, Ingrand P. R-CHOP appears to be the best first-line treatment for second primary diffuse large B cell lymphoma: a cancer registry study. Ann Hematol 2020; 99:1605-1613. [PMID: 32451709 DOI: 10.1007/s00277-020-04100-8] [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: 12/04/2019] [Accepted: 05/19/2020] [Indexed: 11/28/2022]
Abstract
Second primary diffuse large B cell lymphoma (spDLBCL) is defined as a metachronous tumor occurring after a first primary cancer. To date, while R-CHOP is the standard first-line treatment for de novo DLBCL, no available data show that R-CHOP is the optimal treatment for spDLBCL. This exploratory study aimed to investigate treatment of spDLBCL. From 2008 to 2015, the Poitou-Charentes general cancer registry recorded 68 cases of spDLBCL ≤ 80 years old, having received a first-line treatment with either R-CHOP (78%) or other regimens (22%). Patients without R-CHOP have worse overall survival in univariate (HR 2.89 [1.33-6.24], P = 0.007) and multivariate (HR 2.98 [1.34-6.67], P = 0.008) analyses. Patients without R-CHOP more frequently had PS > 1 (67% vs. 28%, P = 0.007) and prior chemotherapy (60% vs. 26%, P = 0.02), which suggests that both of these factors influence a clinician's decision to not use R-CHOP. Prior chemotherapy had no prognostic impact in univariate and multivariate analyses; this result could call into question the risk-benefit balance of not using R-CHOP to prevent toxicity. In our study, one DLBCL out of ten occurred after a first primary cancer, and as regards de novo DLBCL, R-CHOP appeared to be the best first-line treatment. Larger series are needed to confirm these results.
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Affiliation(s)
- T Systchenko
- Poitou-Charentes General Cancer Registry, Université de Poitiers, 6 rue de la Milétrie, 86073, Poitiers Cedex 9, France. .,INSERM CIC 1402, CHU de Poitiers, Poitiers, France. .,Haematology Department, CHU de Poitiers, Poitiers, France.
| | - G Defossez
- Poitou-Charentes General Cancer Registry, Université de Poitiers, 6 rue de la Milétrie, 86073, Poitiers Cedex 9, France.,INSERM CIC 1402, CHU de Poitiers, Poitiers, France
| | - S Guidez
- INSERM CIC 1402, CHU de Poitiers, Poitiers, France.,Haematology Department, CHU de Poitiers, Poitiers, France
| | - C Laurent
- Anatomy-pathology Department, CHU de Toulouse, Réseau Lymphopath, Toulouse, France
| | - M Puyade
- Poitou-Charentes General Cancer Registry, Université de Poitiers, 6 rue de la Milétrie, 86073, Poitiers Cedex 9, France.,INSERM CIC 1402, CHU de Poitiers, Poitiers, France
| | | | - B Dreyfus
- Haematology Department, CHU de Poitiers, Poitiers, France
| | - A Machet
- Haematology Department, CHU de Poitiers, Poitiers, France
| | - X Leleu
- INSERM CIC 1402, CHU de Poitiers, Poitiers, France.,Haematology Department, CHU de Poitiers, Poitiers, France
| | - V Delwail
- INSERM CIC 1402, CHU de Poitiers, Poitiers, France.,Haematology Department, CHU de Poitiers, Poitiers, France
| | - P Ingrand
- Poitou-Charentes General Cancer Registry, Université de Poitiers, 6 rue de la Milétrie, 86073, Poitiers Cedex 9, France.,INSERM CIC 1402, CHU de Poitiers, Poitiers, France
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25
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Narquin S, Ingrand P, Azais I, Delwail V, Vialle R, Boucebci S, Tasu JP. Erratum to “Comparison of whole-body diffusion MRI andconventional radiological assessment in the staging of myeloma” [Diagn. Interv. Imaging. 94 (2013), 629–636]. Diagn Interv Imaging 2020; 101:331. [DOI: 10.1016/j.diii.2019.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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26
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Noventa A, Herpe G, Vesselle G, Guibal A, Velasco S, Chan P, Ingrand P, Boucebci S, Tasu JP. Erratum to “Chart for renal tumor microwave ablation from human study” [Diagn. Interv. Imaging 99 (2018) 609–14]. Diagn Interv Imaging 2020; 101:327. [DOI: 10.1016/j.diii.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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27
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Portet S, Banor T, Bousquet J, Simonneau A, Flores M, Ingrand P, Milin S, Karayan-Tapon L, Bataille B. New Insights into Expression of Hormonal Receptors by Meningiomas. World Neurosurg 2020; 140:e87-e96. [PMID: 32371078 DOI: 10.1016/j.wneu.2020.04.168] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Meningiomas have a female predilection, which is even stronger for spinal than for intracranial meningiomas. The relationship between meningiomas and endogenous or exogenous sex hormones such as cyproterone acetate (CPA) is well documented, yet their underlying mechanism remains unknown. Clarification of the expression profile of hormonal receptors by meningiomas would help us to better understand their hormonal susceptibility. METHODS We used tissue microarray and immunohistochemistry to determine the receptor status of the 3 main sex hormones: androgen (AR), estrogen, and progesterone (PR) in 30 intracranial meningiomas, 30 spinal meningiomas, and 30 meningiomas developed on CPA. RESULTS AR status was positive in 73% of meningiomas in the intracranial group, 87% of meningiomas in the CPA group, and in all meningiomas in the spinal group. Estrogen status was positive in only 7% of meningiomas in the intracranial group and in only 3% of meningiomas in the CPA group but in 30% of meningiomas in the spinal group. PR status was positive in 90% of meningiomas in the intracranial group, in 97% of meningiomas in the CPA group, and in 87% of meningiomas in the spinal group. These specific hormonal receptor statuses based on immunoreactive score were reflected on staining intensities. Furthermore, AR and PR expression was correlated in each group. CONCLUSIONS Our study shows that intracranial meningiomas, spinal meningiomas, and meningiomas developed on CPA express specific hormonal receptor patterns. This result invites the scientific community to review the potential role of AR in the unbalanced sex ratio of meningiomas.
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Affiliation(s)
- Sylvain Portet
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Neurosurgery, University Hospital of Poitiers, Poitiers, France.
| | - Tania Banor
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Neurosurgery, University Hospital of Poitiers, Poitiers, France
| | - Jonathan Bousquet
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Neurosurgery, University Hospital of Poitiers, Poitiers, France
| | - Adrien Simonneau
- Department of Neurosurgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Marie Flores
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Pathology, University Hospital of Poitiers, Poitiers, France
| | - Pierre Ingrand
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Statistics, University Hospital of Poitiers, Poitiers, France
| | - Serge Milin
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Pathology, University Hospital of Poitiers, Poitiers, France
| | - Lucie Karayan-Tapon
- Faculty of Medicine, University of Poitiers, Poitiers, France; INSERM 1084, Experimental and Clinical Neurosciences Laboratory, University of Poitiers, Poitiers, France; Department of Cancer Biology, University Hospital of Poitiers, Poitiers, France
| | - Benoit Bataille
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Neurosurgery, University Hospital of Poitiers, Poitiers, France
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28
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Pladys A, Defossez G, Lemordant P, Lassalle M, Ingrand P, Jacquelinet C, Riou C, Bouzillé G, Van Hille P, Vigneau C, Cuggia M, Bayat S. Cancer risk in dialyzed patients with and without diabetes. Cancer Epidemiol 2020; 65:101689. [PMID: 32126508 DOI: 10.1016/j.canep.2020.101689] [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: 12/13/2019] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The risk of cancer is higher in patients with renal diseases and diabetes compared with the general population. The aim of this study was to assess in dialyzed patients, the association between diabetes and the risk to develop a cancer after dialysis start. METHODS All patients who started dialysis in the French region of Poitou-Charentes between 2008 and 2015 were included. Their baseline characteristics were extracted from the French Renal Epidemiology and Information Network and were linked to data relative to cancer occurrence from the Poitou-Charentes General Cancer Registry using a procedure developed by the INSHARE platform. The association between diabetes and the risk of cancer was assessed using the Fine & Gray model that takes into account the competing risk of death. RESULTS Among the 1634 patients included, 591 (36.2 %) had diabetes and 91 (5.6 %) patients developed a cancer (n = 24 before or at dialysis start, and n = 67 after dialysis start). The risk to develop a cancer after dialysis initiation was lower in dialyzed patients with diabetes than without diabetes (SHR = 0.54; 95 %CI: 0.32-0.91). Moreover, compared with the general population, the cancer risk was higher in dialyzed patients without diabetes, but not in those with diabetes. CONCLUSION The risk of developing a cancer in the region of Poitou-Charentes is higher in dialyzed patients without diabetes than with diabetes.
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Affiliation(s)
- Adélaïde Pladys
- Univ Rennes, EHESP, REPERES (Recherche en pharmaco-épidémiologie et recours aux soins) - EA 7449, F-35000 Rennes, France
| | - Gautier Defossez
- Poitou-Charentes General Cancer Registry, Poitiers University Hospital, University of Poitiers, Poitiers, France; INSERM, CIC1402, Poitiers, France
| | - Pierre Lemordant
- Univ Rennes, CHU Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France
| | - Mathilde Lassalle
- Renal Epidemiology and Information Network (REIN), Biomedicine Agency, La Plaine Saint-Denis, France
| | - Pierre Ingrand
- Poitou-Charentes General Cancer Registry, Poitiers University Hospital, University of Poitiers, Poitiers, France; INSERM, CIC1402, Poitiers, France
| | - Christian Jacquelinet
- Renal Epidemiology and Information Network (REIN), Biomedicine Agency, La Plaine Saint-Denis, France; CESP Centre for Research in Epidemiology and Population Health, Inserm UMRS 1018, Univ Versailles-Saint Quentin, Univ Paris-Saclay, Univ Paris Sud, Villejuif, France.
| | - Christine Riou
- Univ Rennes, CHU Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France
| | - Guillaume Bouzillé
- Univ Rennes, CHU Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France
| | - Pascal Van Hille
- Univ Rennes, CHU Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France
| | - Cécile Vigneau
- University of Rennes 1, INSERM U1085-IRSET, Rennes, France; CHU Pontchaillou, Department of Nephrology, Rennes, France
| | - Marc Cuggia
- Univ Rennes, CHU Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France
| | - Sahar Bayat
- Univ Rennes, EHESP, REPERES (Recherche en pharmaco-épidémiologie et recours aux soins) - EA 7449, F-35000 Rennes, France
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Abstract
Background: Multiple sclerosis (MS) is considered a neurodegenerative disease and an inflammatory demyelinating neuropathology in young population. Procedural memory has been poorly investigated in MS. Objective: We assessed whether the MS group was able to develop a motor-cognitive skill, using a procedural task (PLSC) developed in our laboratory, applying a manual and serial reaction time (RT) paradigm to semantic categorization. Methods: We evaluated 26 MS patients and 26 socio-demographic matched control participants using the PLSC task. Results: Using non-parametric statistical analyses, we observed a significant improvement of semantic categorization RTs with practice (p = 0.002), even with new verbal material to categorize in MS patients (p = 0.006), despite their motor and executive moderate deficits. This same profile of semantic procedural learning in MS was observed in previous studies carried out with Alzheimer’s and Parkinson’s diseases. Moreover, the visual-motor RTs remained stable or slightly improved over the five blocks in both groups, as well as in the AD groups of previous studies. The MS group showed longer visual-motor reaction times than those of the control group (p < 0.042), except in motor initiation aspect (p = 0.064). Both groups showed no significant differences for any type of error. Additionally, disability level and cognitive performances were not associated with the ratio of semantic procedural learning. Conclusion: The present results support the notion that MS patients may be capable of acquiring semantic skill, despite their motor disabilities and executive troubles. This work also addresses the possibilities to improve motor-cognitive skill RTs in neurodegenerative diseases.
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Affiliation(s)
- Eva M Arroyo-Anlló
- Department of Psychobiology, University of Salamanca, Neuroscience Institute of Castilla-León, Spain
| | | | | | - Pierre Ingrand
- Department of Biostatistics, University of Poitiers, Poitiers, France
| | - Jean-Philippe Neau
- Department of Neurology, University Hospital, CHU La Milétrie, Poitiers, France
| | - Roger Gil
- Emeriti Professor of Neurology, University Hospital, Poitiers, France
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Leveziel N, Marillet S, Dufour Q, Lichtwitz O, Bentaleb Y, Pelen F, Ingrand P, Bourne R. Prevalence of macular complications related to myopia - Results of a multicenter evaluation of myopic patients in eye clinics in France. Acta Ophthalmol 2020; 98:e245-e251. [PMID: 31503418 PMCID: PMC7078981 DOI: 10.1111/aos.14246] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 01/23/2019] [Accepted: 08/19/2019] [Indexed: 01/14/2023]
Abstract
PURPOSE Uncorrected refractive errors are the first cause of vision impairment worldwide. High myopia is a frequent cause of sight-threatening chorioretinal complications. The aim of this study was to evaluate the prevalence of macular complications, visual impairment and blindness in patients with myopia. METHODS A cross-sectional multicenter study carried out in French eye clinics mainly dedicated to refractive errors. Myopia severity was defined as mild (-0.5 to -3 D), moderate (-3 to -6 D), high (-6 to -10 D) and very high (more than -10 D). Macular complications related to myopia included lacquer cracks, myopic choroidal neovascularization, chorioretinal atrophy and retinoschisis. The prevalences of macular complications, blindness and vision impairment were estimated with respect to degree of myopia and age. Eligibility criteria were myopia on the left eye of -0.5 D or more. Exclusion criteria included any missing data related to subjective refractive error, age, gender and any history of cataract or refractive surgery. RESULTS Data files from 198 641 myopic individuals with a mean age of 34 years (SD: 15 years) were analysed. The prevalence of mild, moderate, high and very high myopia was, respectively, 65.95%, 26.14%, 6.72% and 1.19%. The prevalence of macular complications in the high and very high myopia groups was 0.5% [0.39-0.64] and 4.27% [3.49-5.17]. The prevalence of blindness or vision impairment was observed in 10.10% [8.91-11.39%] of the very high myopic group. At 60 years old or over, the prevalences of blindness or vision impairment were, respectively, 9.75% [7.91-11.85%] and 25.71% [21.00-30.87%] in the high and very high myopia groups. CONCLUSIONS This multicenter cross-sectional study provides new insights in terms of prevalence of macular complications related to myopia. To our knowledge, this is one of the largest European studies focusing on individuals with myopia, particularly on the macular complications and the functional consequences in relation to myopia.
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Affiliation(s)
- Nicolas Leveziel
- University of PoitiersPoitiersFrance,CHU PoitiersPoitiersFrance,INSERM 1084PoitiersFrance,CIC 1402PoitiersFrance,Vision & Eye Research UnitAnglia Ruskin UniversityCambridgeUK
| | - Simon Marillet
- CHU PoitiersPoitiersFrance,Public Health departmentUniversity of PoitiersPoitiersFrance
| | - Quentin Dufour
- University of PoitiersPoitiersFrance,CHU PoitiersPoitiersFrance
| | | | | | | | - Pierre Ingrand
- CIC 1402PoitiersFrance,Public Health departmentUniversity of PoitiersPoitiersFrance
| | - Rupert Bourne
- Vision & Eye Research UnitAnglia Ruskin UniversityCambridgeUK
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Binder P, Heintz AL, Haller DM, Favre AS, Tudrej B, Ingrand P, Vanderkam P. Detection of adolescent suicidality in primary care: an international utility study of the bullying-insomnia-tobacco-stress test. Early Interv Psychiatry 2020; 14:80-86. [PMID: 31058453 PMCID: PMC7003752 DOI: 10.1111/eip.12828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/30/2019] [Accepted: 04/14/2019] [Indexed: 01/20/2023]
Abstract
AIM General practitioners (GPs) are ideally placed to identify suicidality in adolescents. However, adolescents are often reluctant to confide in their GPs about these problems, and GPs are not comfortable when questioning them about suicide. We previously proposed the BITS test, a set of four opening and four additional questions, to alert doctors about possible suicidality in an adolescent. We validated its use in the identification of suicidality ("frequent suicidal ideation or suicide attempts at one time or another)" in 15-year-old adolescents in a school setting. The objective of the present study was to assess the detection utility of this method in 13-to-18-year-olds in primary care. METHODS We carried out a screening utility study in general practices in 17 French-speaking sites in four countries and three continents. Each GP was instructed to use the bullying, insomnia, tobacco, stress (BITS) test with five to ten 13-to-18-year-old adolescents, consulting consecutively, for any reason. They subsequently asked them questions about their suicidality. RESULTS One hundred and two GPs tested a total of 693 adolescents; 13.0% of the adolescents (girls 15.4%, boys 9.9%) reported suicidality (1.6% known, 11.4% previously unknown). A score of at least 3 on the BITS scale was associated with suicidality (sensitivity: 65.9, specificity: 82.5%). CONCLUSIONS The BITS test is a pragmatic instrument, alerting the GP to an adolescent's previously unknown suicidability, whatever the reason for consultation.
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Affiliation(s)
- Philippe Binder
- Department of General Practice, Faculty of Medicine, Poitiers, France
| | - Anne-Laure Heintz
- Department of General Practice, Faculty of Medicine, Poitiers, France
| | - Dagmar M Haller
- Primary care unit, Faculty of Medicine, Centre Médical Universitaire, University of Geneva, Genève 4, Switzerland.,Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Anne-Sophie Favre
- Department of General Practice, Faculty of Medicine, Poitiers, France
| | - Benoit Tudrej
- Department of General Practice, Faculty of Medicine, Poitiers, France
| | - Pierre Ingrand
- Department of Epidemiology & Biostatistics, INSERM CIC-1402, Faculty of Medicine, Poitiers, France
| | - Paul Vanderkam
- Department of General Practice, Faculty of Medicine, Poitiers, France
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Ingrand I, Defossez G, Lafay-Chebassier C, Chavant F, Ferru A, Ingrand P, Pérault-Pochat MC. Serious adverse effects occurring after chemotherapy: A general cancer registry-based incidence survey. Br J Clin Pharmacol 2020; 86:711-722. [PMID: 31658394 DOI: 10.1111/bcp.14159] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 05/27/2019] [Revised: 09/03/2019] [Accepted: 09/30/2019] [Indexed: 11/30/2022] Open
Abstract
AIMS Pharmaco-epidemiological surveys enable the frequency of serious adverse effects-and also the determining factors of their occurrence and seriousness-to be quantified. Few studies systematically gathering post-chemotherapy adverse effects data have been conducted. The objective was to assess the incidence of post-chemotherapy serious adverse effects on the basis of cancer registry data. METHODS The population was composed of new invasive cancer cases, with the exception of haematopoietic tumours and cutaneous carcinomas. These cancers were identified in 2012 among patients living at the time of diagnosis in a region covered by a general cancer registry and by a French regional pharmacovigilance centre, and treated with neo-adjuvant and/or adjuvant first-intention chemotherapy, followed or not by radiotherapy. The study was based on a sample of 1000 patients from the registry, followed by the collection of serious adverse effects and the required information to constitute a pharmacovigilance file. RESULTS Chemotherapy was associated with a particularly high incidence of serious adverse effects, affecting 44.5% (41.4-47.5%) of the patients. The highest incidence rates were observed when patients were exposed to topo-isomerase II inhibitors such as etoposide and bleomycin (69.2%), vinca-alkaloids (66.7%), topo-isomerase I inhibitors (54.5%) and platinum derivatives (52.0%). The clinical context was also linked to incidence, especially in case of metastases (53.3%) and comorbidities (51.3%). Substantial differences were found according to localisation, with a particularly high incidence in bronchial-pulmonary cancers (59.0%). CONCLUSION The high overall incidence rate of serious adverse effects should motivate a reinforcement of information about drug toxicities and improve knowledge by drawing on patient reporting.
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Affiliation(s)
- Isabelle Ingrand
- Unité d'Epidémiologie et Biostatistique, Registre Général des Cancers Poitou-Charentes; INSERM CIC 1402; Université; CHU de Poitiers, France.,Service de Pharmacologie clinique et Vigilances; Université; CHU de Poitiers, France
| | - Gautier Defossez
- Unité d'Epidémiologie et Biostatistique, Registre Général des Cancers Poitou-Charentes; INSERM CIC 1402; Université; CHU de Poitiers, France
| | - Claire Lafay-Chebassier
- Service de Pharmacologie clinique et Vigilances; Université; CHU de Poitiers, France.,INSERM U1084-LNEC/INSERM CIC 1402; Université; CHU de Poitiers, France
| | - François Chavant
- Service de Pharmacologie clinique et Vigilances; Université; CHU de Poitiers, France
| | - Aurélie Ferru
- Pôle régional de cancérologie; CHU de Poitiers, France
| | - Pierre Ingrand
- Unité d'Epidémiologie et Biostatistique, Registre Général des Cancers Poitou-Charentes; INSERM CIC 1402; Université; CHU de Poitiers, France
| | - Marie-Christine Pérault-Pochat
- Service de Pharmacologie clinique et Vigilances; Université; CHU de Poitiers, France.,INSERM U1084-LNEC/INSERM CIC 1402; Université; CHU de Poitiers, France
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Barin-Le Guellec C, Lafay-Chebassier C, Ingrand I, Tournamille JF, Boudet A, Lanoue MC, Defossez G, Ingrand P, Perault-Pochat MC, Etienne-Grimaldi MC. Toxicities associated with chemotherapy regimens containing a fluoropyrimidine: A real-life evaluation in France. Eur J Cancer 2020; 124:37-46. [PMID: 31715555 DOI: 10.1016/j.ejca.2019.09.028] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 12/14/2022]
Abstract
AIMS Despite fluoropyrimidines (FPs) constituting the main component of the chemotherapy combination protocols in 50% of chemotherapies for solid tumour treatments, incidence data for FP-related toxicity are poorly documented in real life. This study evaluated the number of patients receiving FP-based chemotherapies in France, along with the true incidence of FP-related serious adverse effects (SAEs) before the recent mandatory dihydropyrimidine dehydrogenase (DPD)-screening was introduced by French health authorities, DPD being the rate-limiting enzyme of 5-fluorouracil (5-FU) catabolism. METHODS Exhaustive data on the number of patients treated with FP-based chemotherapy in 2013-2014 were collected in the Centre-Val de Loire region of France. True incidence of SAEs was extracted from a cohort of 513 patients with incident solid tumours receiving first-line FP-based chemotherapy. RESULTS After extrapolation at national level, we estimated that 76,200 patients are currently treated annually with 5FU (53,100 patients, 62% digestive system-related versus 26% breast cancers versus 12% head and neck cancers) or capecitabine (23,100 patients, 45% digestive system-related versus 37% breast cancers versus 18% non-documented). Earlier (in the first two cycles) the SAE incidence rate was 19.3% (95% confidence interval (CI) 16-23%) including one toxic death (0.2%, 95%CI 0-1%). SAE incidence rate was 32.2% (95%CI 28-36%) over the first 6 months of treatment. Incidence of death, life-threatening prognosis or incapacity/disability was 1.4% (95%CI 0.4-2.4%) and 1.6% (95%CI 0.5-2.6%) during first two cycles and first 6 months, respectively. CONCLUSION These data highlight the significant public health issue related to FP toxicity, with around 1200 patients developing FP-related life-threatening prognosis or incapacity/disability annually in France, including 150 toxic deaths. It is hoped that DPD-deficiency screening will reduce such iatrogenic events and eradicate toxic deaths.
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Affiliation(s)
- Chantal Barin-Le Guellec
- Laboratoire de Biochimie et Biologie Moléculaire, Unité de Pharmacogénétique, CHU de Tours, France; INSERM U1248-IPPRIT, Université, CHU de Limoges, France.
| | - Claire Lafay-Chebassier
- Service de Pharmacologie Clinique et Vigilances, Université, CHU de Poitiers, France; INSERM U1084-LNEC/ INSERM CIC 1402, Université, CHU de Poitiers, France
| | - Isabelle Ingrand
- Service de Pharmacologie Clinique et Vigilances, Université, CHU de Poitiers, France; Unité d'Epidémiologie et Biostatistique, Registre Général des Cancers Poitou-Charentes, INSERM CIC 1402, Université, CHU de Poitiers, France
| | | | | | | | - Gautier Defossez
- Unité d'Epidémiologie et Biostatistique, Registre Général des Cancers Poitou-Charentes, INSERM CIC 1402, Université, CHU de Poitiers, France
| | - Pierre Ingrand
- Unité d'Epidémiologie et Biostatistique, Registre Général des Cancers Poitou-Charentes, INSERM CIC 1402, Université, CHU de Poitiers, France
| | - Marie-Christine Perault-Pochat
- Service de Pharmacologie Clinique et Vigilances, Université, CHU de Poitiers, France; INSERM U1084-LNEC/ INSERM CIC 1402, Université, CHU de Poitiers, France
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Vendeuvre T, Monlezun O, Brandet C, Ingrand P, Durand-Zaleski I, Gayet LE, Germaneau A, Khiami F, Roulaud M, Herpe G, Rigoard P. Comparative evaluation of minimally invasive 'tibial tuberoplasty' surgical technique versus conventional open surgery for Schatzker II-III tibial plateau fractures: design of a multicentre, randomised, controlled and blinded trial (TUBERIMPACT study). BMJ Open 2019; 9:e026962. [PMID: 31481365 PMCID: PMC6731842 DOI: 10.1136/bmjopen-2018-026962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Fractures of the tibial plateau are in constant progression. They affect an elderly population suffering from a number of comorbidities, but also a young population increasingly practicing high-risk sports. The conventional open surgical technique used for tibial plateau fractures has several pitfalls: bone and skin devascularisation, increased risks of infection and functional rehabilitation difficulties. Since 2011, Poitiers University Hospital is offering to its patients a new minimally invasive technique for the reduction and stabilisation of tibial plateau fractures, named 'tibial tuberoplasty'. This technique involves expansion of the tibial plateau through inflation using a kyphoplasty balloon, filling of the fracture cavity with cement and percutaneous screw fixation. We designed a study to evaluate the quality of fracture reduction offered by percutaneous tuberoplasty versus conventional open surgery for tibial plateau fracture and its impact on clinical outcome. METHODS AND ANALYSIS This is a multicentre randomised controlled trial comparing two surgical techniques in the treatment of tibial plateau fractures. 140 patients with a Schatzker II or III tibial plateau fracture will be recruited in France. They will be randomised either in tibial tuberoplasty arm or in conventional surgery arm. The primary outcome is the postoperative radiological step-off reduction blindly measured on CT scan (within 48 hours post-op). Additional outcomes include other radiological endpoints, pain, functional abilities, quality of life assessment and health-economic endpoints. Outcomes assessment will be performed at baseline (before surgery), at day 0 (surgery), at 2, 21, 45 days, 3, 6, 12 and 24 months postsurgery. ETHICS AND DISSEMINATION This study has been approved by the ethics committee Ile-De-France X and will be conducted in accordance with current Good Clinical Practice (GCP) guidelines, Declaration of Helsinki and standard operating procedures. The results will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER Clinicaltrial.gov:NCT03444779.
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Affiliation(s)
- Tanguy Vendeuvre
- Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- Prismatics Lab, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- Spine and Neuromodulation Functional Unit, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- ABS Lab, Poitiers University, Poitiers, France
- Institut Pprime, Futuroscope, Poitou-Charentes, France
| | - Olivier Monlezun
- Prismatics Lab, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Claire Brandet
- Prismatics Lab, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Pierre Ingrand
- UFR Medecine et Pharmacie, Universite de Poitiers, Poitiers, France
| | | | - Louis-Etienne Gayet
- Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | | | - Frederic Khiami
- Department of Orthopaedic Surgery and Traumatology, Hopitaux Universitaires Pitie Salpetriere-Charles Foix, Paris, France
| | - Manuel Roulaud
- Prismatics Lab, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Guillaume Herpe
- Department of Radiology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Philippe Rigoard
- Prismatics Lab, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- Spine and Neuromodulation Functional Unit, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- ABS Lab, Poitiers University, Poitiers, France
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Abstract
BACKGROUND Alzheimer's disease may compromise several musical competences, though no clear data is available in the scientific literature. Furthermore, music is capable of communicating basic emotions, but little is known about the emotional aspect of music in patients with Alzheimer's disease. We present a systematic investigation of music processing in relation to extra-musical skills, in particular emotional skills in patients with Alzheimer's disease. METHODS We tested 30 patients with mild or moderate Alzheimer's disease and 30 control subjects. We essentially evaluated (a) musical competences, using the extra-linguistic test, Solfeggio test and the recognition test of musical emotions-elaborated by our research team-and the Seashore test, and (b) emotional capacities using emotional memory and emotional prosody tests-made by our research group. RESULTS We significantly observed lower total results of every test assessing cognitive, emotional and music competences in Alzheimer's disease patients than those in control subjects, but the score of musical emotion recognition test did not reach to a significant difference between the subjects groups. CONCLUSIONS Our findings found a global impairment of music competences in Alzheimer patients with cognitive and emotional troubles. Nevertheless, the performances in the recognition test of musical emotions showed a trend towards a performance difference. We can suggest that Alzheimer's disease currently presents an aphaso-agnoso-apractic-amusia syndrome.
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Affiliation(s)
- Eva M. Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, University of Salamanca, Av. de la Merced s/n 37007, Salamanca, Spain
- Emeriti Professor of Neurology, University Hospital, Poitiers, France
| | - Stéphanie Dauphin
- Department of Neurology Faculty of Medicine, University Hospital, CHU La Milétrie, 2, Rue de la Milétrie, 86021 Poitiers, France
| | - M. Noelle Fargeau
- Department of Neurology Faculty of Medicine, University Hospital, CHU La Milétrie, 2, Rue de la Milétrie, 86021 Poitiers, France
| | - Pierre Ingrand
- Department of Biostatistics Faculty of Medicine, University of Poitiers, 2, Rue de la Milétrie, 86021 Poitiers, France
| | - Roger Gil
- Emeriti Professor of Neurology, University Hospital, Poitiers, France
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De Luca A, Bernardo K, Frasquet-Darrieux M, Christin P, Schiphorst AM, Grand M, Ingrand P, Robins RJ, Hankard R. Maternal obesity does not influence human milk protein 15N natural isotope abundance. Isotopes Environ Health Stud 2019; 55:385-393. [PMID: 31132878 DOI: 10.1080/10256016.2019.1620229] [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] [Received: 11/01/2018] [Accepted: 05/01/2019] [Indexed: 06/09/2023]
Abstract
Obesity increases protein metabolism with a potential effect on nitrogen isotope fractionation. The aim of this study was to test the influence of obesity on human milk extracted protein 15N natural isotope abundance (NIA) at one month post-partum and to compare human milk extracted protein 15N NIA and bulk infant hair 15N NIA. This cross-sectional observational study involved 16 obese mothers (body mass index (BMI) ≥ 30 kg m-2 before pregnancy) matched with 16 normal-weight mothers (18.5 kg m-2 ≤ BMI < 25 kg m-2) for age and pregnancy characteristics. Human milk extracted protein and bulk infant hair 15N NIA were determined by isotope ratio monitoring by mass spectrometry interfaced to an elemental analyser (IRM-EA/MS). No significant difference was found in human milk protein 15N NIA values between obese and normal-weight mothers (8.93 ± 0.48 ‰ vs. 8.95 ± 0.27 ‰). However, human milk protein 15N NIA was significantly lower than bulk infant hair 15N NIA: 8.94 ± 0.38 ‰ vs. 9.66 ± 0.69 ‰, respectively. On the basis of these results, it is concluded that human milk protein 15N NIA measured at one month post-partum is not influenced by maternal obesity. These findings suggest that 15N NIA may be exploited to study metabolism without considering maternal obesity as a confounder.
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Affiliation(s)
- Arnaud De Luca
- a Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1069 , Tours , France
- b Nutrition Unit, University Hospital of Tours , Tours , France
| | - Karine Bernardo
- a Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1069 , Tours , France
- b Nutrition Unit, University Hospital of Tours , Tours , France
| | | | - Patricia Christin
- c Pediatrics and Child Nutrition, University Hospital , Poitiers , France
- d Maternity Ward, General Hospital , Chatellerault , France
| | - Anne-Marie Schiphorst
- e Elucidation of Biosynthesis by Isotopic Spectrometry Group, CEISAM, CNRS-University of Nantes, UMR 6230 , Nantes , France
| | - Mathilde Grand
- e Elucidation of Biosynthesis by Isotopic Spectrometry Group, CEISAM, CNRS-University of Nantes, UMR 6230 , Nantes , France
| | - Pierre Ingrand
- f Institut National de la Santé Et de la Recherche Médicale (INSERM) CIC 1402 , Poitiers , France
- g Institute of Public Health, Poitiers University , Poitiers , France
| | - Richard J Robins
- e Elucidation of Biosynthesis by Isotopic Spectrometry Group, CEISAM, CNRS-University of Nantes, UMR 6230 , Nantes , France
| | - Regis Hankard
- a Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1069 , Tours , France
- b Nutrition Unit, University Hospital of Tours , Tours , France
- h Faculty of Medicine, F Rabelais University , Tours , France
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Madico C, Herpe G, Vesselle G, Boucebci S, Tougeron D, Sylvain C, Ingrand P, Tasu JP. Intra peritoneal abdominal fat area measured from computed tomography is an independent factor of severe acute pancreatitis. Diagn Interv Imaging 2019; 100:421-426. [DOI: 10.1016/j.diii.2019.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/21/2019] [Accepted: 03/10/2019] [Indexed: 01/28/2023]
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Mazé J, Vesselle G, Herpe G, Boucebci S, Silvain C, Ingrand P, Tasu JP. Evaluation of hepatic iron concentration heterogeneities using the MRI R2* mapping method. Eur J Radiol 2019; 116:47-54. [PMID: 31153573 DOI: 10.1016/j.ejrad.2018.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/05/2018] [Accepted: 02/09/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To measure hepatic iron concentration (HIC) heterogeneities using a magnetic resonance R2* mapping method. PATIENTS AND METHODS Ninety-four patients with suspected hepatic iron overload and 10 volunteers were included prospectively. A multi-echo R2* sequence with fat saturation and with three post-processing fitting methods (a single exponential decay model with or without truncation, SED and SEDt, and a constant offset model, COS) was compared to a signal intensity ratio method (SIR), considered as the reference. HIC heterogeneity was evaluated from R2* mapping after placing a ROI on each liver segment. RESULTS A strong linear correlation between SIR and R2* methods using the SEDt and COS models was observed (r = 0.973 and 0.955, respectively). Volunteers and patient liver variabilities, quantified by mean intra-liver standard deviation (SD) were 1.58 μmol/g (mean range 5.06 μmol/g) and 4.73 μmol/g (mean range 19.08 μmol/g), respectively. For the patient group, the highest HIC was observed in the IVth segment. Heterogeneity increased for patients with an HIC > 60 μmol/g (mean intra-liver SD = 13.90 μmol/g; mean range = 50.60 μmol/g). CONCLUSION This study is the first to demonstrate in vivo HIC heterogeneities using whole-liver mapping analysis. These preliminary results require confirmation through further studies, but might be useful in cases of single ROI analysis.
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Affiliation(s)
- Jean Mazé
- Imaging Department, CHU de Poitiers, 2 Rue de la milétrie, 86000 CHU de Poitiers, France
| | - Guillaume Vesselle
- Imaging Department, CHU de Poitiers, 2 Rue de la milétrie, 86000 CHU de Poitiers, France
| | - Guillaume Herpe
- Imaging Department, CHU de Poitiers, 2 Rue de la milétrie, 86000 CHU de Poitiers, France
| | - Samy Boucebci
- Imaging Department, CHU de Poitiers, 2 Rue de la milétrie, 86000 CHU de Poitiers, France
| | - Christine Silvain
- Hepatology Department, CHU de Poitiers, 2 Rue de la milétrie, 86000 CHU de Poitiers, France
| | - Pierre Ingrand
- Inserm U619, CHU de Poitiers et University of Poitiers, Rue de la milétrie, 86000 CHU de Poitiers, France
| | - Jean-Pierre Tasu
- Imaging Department, CHU de Poitiers, 2 Rue de la milétrie, 86000 CHU de Poitiers, France.
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Reygagne E, Du Boisgueheneuc F, Berger A, Ingrand P. Examining the Inter Hemispheric Transfer Time Test: A new computerized cognitive test to incorporate into therapeutic strategy for patients with brain metastases? A pilot study. Clin Transl Radiat Oncol 2019; 16:48-54. [PMID: 30993219 PMCID: PMC6449743 DOI: 10.1016/j.ctro.2018.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/01/2018] [Accepted: 11/17/2018] [Indexed: 01/04/2023] Open
Abstract
IHTTT is a rapid computerised cognitive test. IHTTT is more sensitive than MMSE or FAB to evaluate executive functions. Passing IHTTT could be predictive of progression-free survival. IHTTT could be interesting as a way of better selecting the patients.
Objective To evaluate the computerized Inter Hemispheric Transfer Time Test (IHTTT), a cognitive test designed for the detection of information processing speed impairment in patients undergoing stereotactic radiation therapy for brain metastases. Methods Inclusion criteria: age ≥18 years, brain metastases treated by stereotactic radiotherapy (SRT) with dose schedule: 33 Gy in 3 fractions, solid tumour, ≥70 Karnofsky Performance Status, Mini-Mental State Evaluation (MMSE) ≥ 24, no history of stroke brain injury. Twenty-nine patients were recruited from June 2014 to April 2015. All recruited patients were administered Frontal Assessment Battery at Bedside (FAB), IHTTT and QLQ-C30 quality of life questionnaire before SRT, at one-month, six-month and one-year follow-up. The primary endpoint was Interhemispheric Transfer Index (IHTI). Secondary endpoints included Interhemispheric Transfer Time (IHTT), MMSE, FAB, and quality of life. Results A significant evolution of cognitive function over time was assessed by the IHTTT: IHTT = 720 ± 27 ms at baseline, 728 ± 20 at one month, 736 ± 36 at 6 months, 799 ± 111 at one-year follow-up (p = 0.0010); IHTI = 13.1 ± 31.4, 11.5 ± 24.3, 50.6 ± 57.9, 91.0 ± 59.4 (p < 0.0001). There was also a significant evolution over time for MMSE (p = 0.014) but neither for FAB score nor the quality of life scores. IHTI was strongly related to progression-free survival (p = 0.0091). Conclusion Our results suggest that IHTTT is able to detect the evolution of cognitive function over time. IHTTT could be an interesting sensitive cognitive test to include in evaluation of patients with brain metastases irradiated by SRT.
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Affiliation(s)
| | | | | | - Pierre Ingrand
- INSERM CIC 1402, CHU, Poitiers, France.,Epidemiology and Biostatistics, Poitou-Charentes Cancer Registry, University of Poitiers, France
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Poupin P, Bureau M, Degand B, Le Gal F, Christiaens L, Alos B, Ingrand P, Paccalin M, Garcia R. Implantable Cardioverter Defibrillator in the elderly. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.02.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Milhem A, Ingrand P, Tréguer F, Cesari O, Da Costa A, Pavin D, Rivat P, Badenco N, Abbey S, Zannad N, Winum PF, Mansourati J, Maury P, Bader H, Savouré A, Sacher F, Andronache M, Allix-Béguec C, De Chillou C, Anselme F, Al Arnaout A, Amara W, Amelot M, Bars C, Becoulet L, Bru P, Chevalier P, Darmon JP, Deharo JC, Dompnier A, Duplantier-Duchene C, Extramiana F, Faugier JP, Guenancia C, Horvilleur J, Jourda F, Laurent G, Lellouche N, Magnin Poull I, Piot O, Roux A, Saludas Y, Seitz J, Taieb J. Exclusion of Intra-Atrial Thrombus Diagnosis Using D-Dimer Assay Before Catheter Ablation of Atrial Fibrillation. JACC Clin Electrophysiol 2019; 5:223-230. [DOI: 10.1016/j.jacep.2018.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/20/2018] [Accepted: 09/11/2018] [Indexed: 11/25/2022]
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Palazzo P, Ingrand P, Agius P, Belhadj Chaidi R, Neau JP. Transcranial Doppler to detect right-to-left shunt in cryptogenic acute ischemic stroke. Brain Behav 2019; 9:e01091. [PMID: 30506983 PMCID: PMC6346730 DOI: 10.1002/brb3.1091] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/08/2018] [Accepted: 06/20/2018] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES We aimed to confirm the sensitivity and specificity of contrast transcranial Doppler (cTCD) in the detection of right-to-left shunt (RLS) compared to the current reference standard (i.e., transesophageal echocardiography-TEE) in patients aged <55 years with a cryptogenic acute ischemic stroke (AIS) or high-risk (ABCD2 score ≥4) transient ischemic attack (TIA), and to calculate the real life delay in detecting RLS by cTCD versus TEE in a tertiary care academic stroke center. METHODS Consecutive 16- to 54-year-old patients with AIS or high-risk TIA underwent complete diagnostic workup which included, in case of undetermined etiology, cTCD and TEE. Sensitivity and specificity of cTCD, RLS characteristics, and median delay between the two tests were calculated. RESULTS Of the 98 included patients, 52 (53%) had a cryptogenic cerebrovascular ischemic event, which displayed a 56% prevalence of RLS related to a patent foramen ovale (PFO) mainly with a high-grade shunt. When comparing TCD with "bubble test" to TEE, sensitivity and specificity were both 100%. Median delays from symptom onset to examination were 2 (min-max 1-10) and 21 (min-max 1-60) days, respectively, for cTCD and TEE. No adverse event occurred during or after cTDC examination. CONCLUSIONS Transcranial Doppler with "bubble test" appears as the best screening test for the detection of RLS in young and middle-aged adults with cryptogenic acute cerebral ischemic events to select patients potentially suitable for closure procedure after TEE confirmation.
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Affiliation(s)
- Paola Palazzo
- Department of Neurology, Poitiers University Hospital, Poitiers Cedex, France.,Department of Neurology, S. Giovanni Calibita-Fatebenefratelli Hospital, Rome, Italy
| | - Pierre Ingrand
- Clinical Investigation Center INSERM, Poitiers University Hospital, Poitiers Cedex, France
| | - Pierre Agius
- Department of Neurology, Saint Nazaire Community Hospital, Saint-Nazaire, France
| | - Rafik Belhadj Chaidi
- Department of Vascular Medicine, Poitiers University Hospital, Poitiers Cedex, France
| | - Jean-Philippe Neau
- Department of Neurology, Poitiers University Hospital, Poitiers Cedex, France
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Ingrand I, Gaussot L, Richard E, Drouet G, Moreau F, Ingrand P. [Family risk information for colorectal cancer. Perspectives on the effectiveness of a tailored intervention]. Sante Publique 2019; 2:79-89. [PMID: 32372585 DOI: 10.3917/spub.197.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Information on risk levels is an essential part of the prevention of colorectal cancer (CRC). The objective of this article is to describe a tailored intervention carried out to inform the protagonists about the high risk of CRC due to family history and then to understand, through an interdisciplinary analysis, the mechanisms implemented during the intervention. METHOD A randomized trial design was applied. The primary outcome was the colonoscopy uptake. The intervention concerned firstly the index patients with CRC or adenoma to advise and accompany them in the transmission of information about the elevated risk for their siblings. The siblings received tailored counselling carried out by a preventive nurse, by telephone then by mail. Epidemiological, linguistic and sociological cross-analyzes were carried out to understand the impact of the intervention. RESULTS Colonoscopy rate was 56.3% in the intervention group, 35.4% in the control group (P = 0.0027; 304 siblings). The linguistic analysis of recorded nurse's interventions showed that, following the intervention (N = 59), the prevention themes were better assimilated while they remained vague and questioned in the discourse of the control siblings who had carried out the colonoscopy (N = 8). That was confirmed by the sociological analysis (four families) which also revealed the importance of information received from a health professional and of communication within families. CONCLUSION The study showed the impact of transmission of information to convince siblings at high risk of CRC to carry out colonoscopy.
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Garcia R, Guenancia C, Le Gal F, Rehman M, Tao Kong Man V, Christiaens L, Ingrand P, Degand B. Contractibility sensor signal evolution predicts cardiovascular events in patients with cardiac resynchronization therapy. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mignot S, Fritel X, Loreal M, Binder P, Roux MT, Gicquel L, Ingrand P. Identifying teenage sexual abuse victims by questions on their daily lives. Child Abuse Negl 2018; 85:127-136. [PMID: 30172412 DOI: 10.1016/j.chiabu.2018.07.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/11/2018] [Accepted: 07/22/2018] [Indexed: 06/08/2023]
Abstract
Child sexual abuse (CSA) is an international public health problem. While general practitioners are perhaps ideally positioned to detect CSA, a lack of simple tools and their discomfort in bringing up such a sensitive subject reduce the likelihood of its being brought up and flagged in primary care. However, it may be possible to identify victims of CSA by observing its consequences on student well-being, overall well-being and risk behavior. This study investigate the predictive value of daily life events possibly associated with CSA: relationship difficulties with peers and teachers, autolytic attempts, self-mutilation, low self-esteem, addiction, poor body image, physical and psychological violence, low quality of sleep. We carried out a crosssectional survey involving a representative sample of 1719 15 year-old adolescents enrolled in 192 randomly drawn schools from two French regions. In their classrooms, they filled out a version of the Health Behavior in School-Aged Children international (HBSC) self-questionnaire. Compared to their coevals, these youth were more likely to regularly consume cannabis, OR 4.40 [1.85; 10.48] and to express fear of violence, OR 2.05 [1.28; 3,28]. They were less likely to feel satisfied about their weight, OR 2.24 [1.13; 4.40] and more likely to feel unaccepted by others, OR 1.65 [1.03; 2.65]. The C-index (concordance statistic) taking into account gender, regular cannabis consumption, fear of violence, not having the right weight and not being accepted by others, was 0.79. The C-index also including self mutilation and autolytic attempts was 0.83. Indirect thematic could likewise facilitate detection and identification of CSA.
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Affiliation(s)
- Stéphanie Mignot
- Department of General Practice, University of Poitiers, France: 3 rue de la Milétrie, 86000 Poitiers, France.
| | - Xavier Fritel
- Department of gynecology obstetrics and reproductive medecine, University of Poitiers, France
| | - Marie Loreal
- Department of General Practice, University of Poitiers, France
| | - Philippe Binder
- Department of General Practice, University of Poitiers, France
| | | | - Ludovic Gicquel
- Department of Child Psychiatry, University of Poitiers, France
| | - Pierre Ingrand
- University Institute of Public Health, University of Poitiers, France
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Reygagne E, Berger A, Du Boisgueheneuc F, Ingrand P. Examining Computerized Neurocognitive Screening Test in Predicting Cerebral Progression Free Survival in Patients Undergoing Brain Stereotactic Radiation Therapy for Brain Metastases: A Pilot Study. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ingrand I, Paccalin M, Liuu E, Gil R, Ingrand P. Positive perception of aging is a key predictor of quality-of-life in aging people. PLoS One 2018; 13:e0204044. [PMID: 30281672 PMCID: PMC6169874 DOI: 10.1371/journal.pone.0204044] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 08/31/2018] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE We conducted a cross-sectional survey in France in a cohort over 55 years of age to characterize the impact of psychological dimensions on quality-of-life (QoL). METHODS The predictors of QoL in relation with aging were studied using an adapted quality-of-life model, based on emotional, cognitive and physical symptoms, functional status, and general health perception. Adding psychological dimensions such as self-esteem, psychological distress, perceptions of ageing and coping, was hypothesized to improve the QoL model. Responses were analyzed using structural equation modeling and path analysis. RESULTS The study involved 258 participants, mean age 66.9±7.9 years. Psychological distress and positive perception of aging exhibited the strongest direct impact on QoL (p<0.0001). Psychological distress also appeared to be mediator on QoL for perceived health status, self-esteem and negative perception of aging. Coping centred on emotion exhibited direct impact on self-esteem and so, indirect impact on QoL (p = 0.0002). Perception of personal financial situation (p = 0.0007) and coping centred on social support (p = 0.02) appeared as direct mediators influencing QoL. CONCLUSIONS Psychological dimensions are predictors of QOL and have to be taken into account to maximize the resources with a view to successful aging. Further interventions targeting successful aging should focus on positive perception aging.
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Affiliation(s)
- Isabelle Ingrand
- Pôle Biologie, Pharmacie et Santé Publique, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
- INSERM, CIC 1402, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
| | - Marc Paccalin
- INSERM, CIC 1402, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
- EA3808 Molecular Targets and Therapeutics of Alzheimer’s disease, Université de Poitiers, Poitiers, France
- Pôle de Gériatrie, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
- Centre Mémoire de Ressources et de Recherche, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
| | - Evelyne Liuu
- INSERM, CIC 1402, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
- Pôle de Gériatrie, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
| | - Roger Gil
- Centre Mémoire de Ressources et de Recherche, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
| | - Pierre Ingrand
- Pôle Biologie, Pharmacie et Santé Publique, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
- INSERM, CIC 1402, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France
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Novanta A, Herpe G, Vesselle G, Guibal A, Velasco S, Chan P, Ingrand P, Boucebi S, Tasu JP. Chart for renal tumor microwave ablation from human study. Diagn Interv Imaging 2018; 99:609-614. [DOI: 10.1016/j.diii.2018.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/28/2018] [Accepted: 05/15/2018] [Indexed: 10/28/2022]
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Reygagne E, Berger A, du Boisgueheneuc F, Ingrand P. Évaluation du test de transfert interhémisphérique comme facteur prédictif de survie chez les patients bénéficiant d’une radiothérapie stéréotaxique cérébrale. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lauda-Maillen M, Liuu E, Catroux M, Caupenne A, Priner M, Cazenave-Roblot F, Burucoa C, Ingrand P, Paccalin M. Treatment compliance with European guidelines and prognosis of Clostridium difficile infection according to age. Med Mal Infect 2018; 49:173-179. [PMID: 30266433 DOI: 10.1016/j.medmal.2018.08.001] [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: 05/22/2017] [Revised: 08/18/2017] [Accepted: 08/31/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Age>65 years is associated with the recurrence and poor prognosis of Clostridium difficile infection (CDI). Data on elderly patients (≥75 years) is scarce, and little is known about compliance with European guidelines in terms of specific treatment. We aimed to analyze the treatment and prognosis of CDI in two groups of patients aged<and≥75 years. PATIENTS AND METHODS We performed a prospective survey from May 2014 to April 2015 in a university hospital including all patients presenting with microbiologically confirmed CDI. Sociodemographic and clinical data, treatment of CDI, recurrences (<8 weeks after CDI treatment completion), new episodes, and mortality were recorded. Follow-up was performed until February 2016. RESULTS Overall, 101 patients were included; 45 were aged≥75 years (44.6%). More than two-thirds of CDIs (71/101) were severe. Seven per cent of patients presenting with severe CDI and 10% of patients at increased risk of recurrence received the adequate treatment as per European guidelines. Mean follow-up was 15±4 months (range: 10-22). Among patients aged≥75 years, we observed the same number of recurrences and new episodes of CDI during the follow-up. The 3-month case fatality was significantly higher in the elderly group (P<0.001). The one-year survival rate was 73.2% in younger patients and 45.7% in elderly patients (P=0.0004). CONCLUSION This study confirms the poor prognosis of CDI in elderly patients and highlights the lack of compliance with treatment guidelines.
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Affiliation(s)
- M Lauda-Maillen
- Pôle Medipool, service de maladies infectieuses, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France.
| | - E Liuu
- Pôle de Gériatrie, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France; Inserm, CIC 1402, université de Poitiers, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France
| | - M Catroux
- Pôle Medipool, service de maladies infectieuses, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France
| | - A Caupenne
- Pôle de Gériatrie, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France
| | - M Priner
- Pôle de Gériatrie, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France
| | - F Cazenave-Roblot
- Pôle Medipool, service de maladies infectieuses, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France
| | - C Burucoa
- Laboratoire de bactériologie, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France
| | - P Ingrand
- Biostatistique, pôle biologie, pharmacie et santé publique, université de Poitiers, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France; Inserm, CIC 1402, université de Poitiers, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France
| | - M Paccalin
- Pôle de Gériatrie, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France; Inserm, CIC 1402, université de Poitiers, centre hospitalier universitaire de Poitiers, 86021 Poitiers, France
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