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Barret M, Collier M, Tran VT, Dellagi M, Beeker N. Disease burden of Barrett's esophagus across the Paris metropolitan area. Clin Res Hepatol Gastroenterol 2024; 48:102371. [PMID: 38719146 DOI: 10.1016/j.clinre.2024.102371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 04/25/2024] [Accepted: 05/05/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION The prevalence of Barrett's esophagus (BE) in France is unknown. However, the management of dysplastic BE in expert centers is recommended and reduces the risk of developing invasive adenocarcinoma. Our aim was to determine the burden of BE patients in the Paris Region. METHODS We performed a retrospective study using the data from electronic medical records from the data warehouse of the 39 Greater Paris public hospitals (Entrepôt de données de santé de l' Assistance Publique- Hôpitaux de Paris) for the year 2018, and used natural language processing to search for occurrences of Barrett's esophagus in endoscopy and pathology reports. RESULTS we observed a 2.2 % prevalence of Barrett's esophagus. Patients with Barrett's esophagus were older, more frequently males, with a hiatal hernia, proton pump inhibitor users, and less frequently infected by H. Pylori. Gastro-esophageal reflux symptoms were not more frequently encountered in Barrett's patients. Eleven percent of patients with Barrett's esophagus had dysplasia or adenocarcinoma. DISCUSSION Over 200 000 patients with Barrett's esophagus are expected in the Paris Region, of which 11 % harbor dysplasia or adenocarcinoma. This data should be taken into account to tailor healthcare offer in France.
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Affiliation(s)
- Maximilien Barret
- Department of Gastroenterology and Digestive Oncology, Cochin Hospital, AP-HP.Centre - Université Paris Cité, France; Université de Paris, France.
| | - Mathis Collier
- Clinical Research Unit, Cochin Hospital, Paris, AP-HP.Centre - Université Paris Cité, France
| | - Viet-Thi Tran
- Université de Paris, France; Epidemiology Department, Hôtel Dieu Hospital, Assistance Publique - Hôpitaux de Paris, France
| | - Mourad Dellagi
- Clinical Research Unit, Cochin Hospital, Paris, AP-HP.Centre - Université Paris Cité, France
| | - Nathanael Beeker
- Clinical Research Unit, Cochin Hospital, Paris, AP-HP.Centre - Université Paris Cité, France
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Falcinelli F, Lazzeri L, Tognetti L, Bardelli M, Rubegni P, Russo F. Development of a sebo-psoriasis-like dermatosis: a newly paradoxical reaction due to ixekizumab described with line-field confocal optical coherence tomography. Ital J Dermatol Venerol 2024; 159:197-198. [PMID: 38127319 DOI: 10.23736/s2784-8671.23.07661-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- Francesca Falcinelli
- Unit of Medical, Surgical and Neurological Science, Dermatology Section, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy -
| | - Laura Lazzeri
- Unit of Medical, Surgical and Neurological Science, Dermatology Section, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy
| | - Linda Tognetti
- Unit of Medical, Surgical and Neurological Science, Dermatology Section, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy
| | - Marco Bardelli
- Unit of Rheumatology, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Unit of Medical, Surgical and Neurological Science, Dermatology Section, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy
| | - Filomena Russo
- Unit of Medical, Surgical and Neurological Science, Dermatology Section, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy
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Burisch J, Safroneeva E, Laoun R, Ma C. Lack of Benefit for Early Escalation to Advanced Therapies in Ulcerative Colitis: Critical Appraisal of Current Evidence. J Crohns Colitis 2023; 17:2002-2011. [PMID: 37345930 PMCID: PMC10798867 DOI: 10.1093/ecco-jcc/jjad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Indexed: 06/23/2023]
Abstract
Although ulcerative colitis [UC] shares many common pathways and therapeutic options with Crohn's disease [CD], CD patients are four times more likely to undergo surgery 10 years into their disease in the biological era and are more likely to have extraintestinal manifestations than UC patients. Early treatment in CD has been demonstrated to modify the natural history of the disease and potentially delay surgery. Previous reviews on this topic have borrowed their evidence from CD to make UC-specific recommendations. This review highlights the emergence of UC-specific data from larger cohort studies and a comprehensive individual patient data systemic review and meta-analysis to critically appraise evidence on the utility of early escalation to advanced therapies with respect to short-, medium-, and long-term outcomes. In UC, the utility of the early escalation concept for the purposes of changing the natural history, including reducing colectomy and hospitalizations, is not supported by the available data. Data on targeting clinical, biochemical, endoscopic, and histological outcomes are needed to demonstrate that they are meaningful with regard to achieving reductions in hospitalization and surgery, improving quality of life, and minimizing disability. Analyses of different populations of UC patients, such as those with 'relapsing & remitting' disease or with severe or complicated disease course, are urgently needed. The costs and risk/benefit profile of some of the newer advanced therapies should be carefully considered. In this clinical landscape, it appears premature to advocate an indiscriminate 'one size fits all' approach to escalating to advanced therapies early during the course of UC.
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Affiliation(s)
- Johan Burisch
- Gastro Unit, Medical Division, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark
- Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark
| | - Ekaterina Safroneeva
- Tillotts Pharma AG, Rheinfelden, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Christopher Ma
- Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
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Yagiz B, Lermi N, Coskun BN, Dalkilic E, Kiraz S, Erden A, Ertenli I, Duran E, Bilgin E, Yılmaz R, Ateş A, Tufan A, Küçük H, Mercan R, Cinaklı H, Akar S, Yaşar Bilge NŞ, Kaşifoglu T, Türk SM, Gonullu EO, Bes C, Alpay Kanitez N, Emmungil H, Kalyoncu U, Pehlivan Y. The predictors of paradoxical reactions, especially psoriasis, to biologic therapy-findings from the TReasure database: a 5-year follow-up study. Rheumatology (Oxford) 2023; 62:3962-3967. [PMID: 37354493 DOI: 10.1093/rheumatology/kead318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/27/2023] [Accepted: 05/07/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVES The objectives of this study were to assess the clinical characteristics, predictive factors, and practical algorithms of paradoxical reactions (PRs), specifically paradoxical psoriasis (PP). METHODS The TReasure database is a web-based prospective observational cohort comprised of patients with RA and SpA from 17 centres around Turkey since 2017. A cohort study and a case-control study nestled within the cohort were identified. RESULTS In total, 2867 RA and 5316 SpA patients were evaluated. The first biologic agent was found to have caused PRs in 60% of the 136 patients (1.66%) who developed the PRs. The median time interval between the PRs and biological onset was 12 months (range 1-132 months, mean 21 months). The most common types of PP, constituting 92.6% of PRs, were pustular (60.3%) and palmoplantar (30.9%). Adalimumab (30.9%), infliximab (19%) and etanercept (17.4%) were the most common agents causing the PP. In the treatment of most PP patients (73.2%), switching biologic agents was favoured, with TNF inhibitor (TNFi) chosen in 46.03% and non-TNFi in 26.9% of cases. The three most frequently selected drugs were etanercept (24.6%), secukinumab (9.5%) and adalimumab (8.7%). Only 5.17% of patients who switched to another TNFi showed progression. The odds ratios (s) for SSZ, HCQ, and LEF use were significantly higher in RA controls than in PP patients (P = 0.033, OR = 0.15; P = 0.012, OR = 0.15; and P = 0.015, OR = 0.13, respectively). In the PP group with SpA, the number of smokers was significantly higher (P = 0.003, OR: 2.0, 95% CI: 1.05, 3.81). CONCLUSION Contrary to expectations based on earlier research suggesting that paradoxical reactions develop with the class effect of biological agents, the response of patients who were shifted to another TNFi was favourable.
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Affiliation(s)
- Burcu Yagiz
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Nihal Lermi
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Belkis N Coskun
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Ediz Dalkilic
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludağ University, Bursa, Turkey
| | - Sedat Kiraz
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Abdulsamet Erden
- Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Ihsan Ertenli
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emine Duran
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emre Bilgin
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Recep Yılmaz
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Aşkın Ateş
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Abdurrahman Tufan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Hamit Küçük
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ridvan Mercan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey
| | - Haluk Cinaklı
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, İzmir Kâtip Çelebi University, İzmir, Turkey
| | - Servet Akar
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, İzmir Kâtip Çelebi University, İzmir, Turkey
| | - Nazife Ş Yaşar Bilge
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Timucin Kaşifoglu
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Sümeyye M Türk
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Emel Orge Gonullu
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Cemal Bes
- University of Health Sciences, Department of Rheumatology, Çam and Sakura City Hospital, İstanbul, Turkey
| | - Nilufer Alpay Kanitez
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Koc University, İstanbul, Turkey
| | - Hakan Emmungil
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yavuz Pehlivan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludağ University, Bursa, Turkey
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Romagnuolo M, Moltrasio C, Iannone C, Gattinara M, Cambiaghi S, Marzano AV. Pyoderma gangrenosum following anti-TNF therapy in chronic recurrent multifocal osteomyelitis: drug reaction or cutaneous manifestation of the disease? A critical review on the topic with an emblematic case report. Front Med (Lausanne) 2023; 10:1197273. [PMID: 37324147 PMCID: PMC10264797 DOI: 10.3389/fmed.2023.1197273] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory disease, clinically characterized by chronic and recurrent episodes of osteoarticular inflammation, that generally presents in children and adolescents. From a dermatological point-of-view, CMRO can be associated with skin rashes mainly including psoriasis, palmoplantar pustulosis and acne. Pyoderma gangrenosum (PG) is a rare immune-mediated inflammatory skin disease classified within the spectrum of neutrophilic dermatoses that, in some cases, has been reported as cutaneous manifestation in CMRO patients. This paper presents a 16-year female patient diagnosed with CMRO, who presented PG lesions located on the lower leg, that arose after the administration of the tumour necrosis factor (TNF)-α inhibitor adalimumab. Cases of PG have been reported in patients being treated with certain medications, including TNF-α antagonists, leading to classified them in a setting aptly termed "drug-induced PG." In this paper, we discuss the co-occurrence of PG and CRMO, in the light of recent evidence on the pathogenesis of both diseases and giving ample space to a literature review on drug induced PG. In our case, it is plausible that PG could be considered a cutaneous manifestation of CRMO, although the mechanisms underlying this intriguingly relationship remain to be fully unraveled.
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Affiliation(s)
- Maurizio Romagnuolo
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Iannone
- Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, Italy
| | - Maurizio Gattinara
- Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, University of Milan, Milan, Italy
| | - Stefano Cambiaghi
- Pediatric Dermatology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Öğüt ND. Two paradoxical reactions in a patient with psoriasis and psoriatic arthritis: Adalimumab-induced hidradenitis suppurativa and secukinumab-induced alopecia areata. J Eur Acad Dermatol Venereol 2023; 37:e468-e469. [PMID: 36151938 DOI: 10.1111/jdv.18601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Neslihan Demirel Öğüt
- Department of Dermatology and Venereology, School of Medicine, Uşak University, Uşak, Turkey
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Paul C. The use of large patient databases to improve disease understanding and care. Br J Dermatol 2022; 187:638. [PMID: 36104827 PMCID: PMC9826112 DOI: 10.1111/bjd.21853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
Linked Article:Bataille et al. Br J Dermatol 2022; 187:676–683.
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Affiliation(s)
- Carle Paul
- Department of Dermatology‐AllergologyToulouse University and CHU ToulouseToulouseFrance
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Hennocq Q, Adjed C, Chappuy H, Orliaguet G, Monteil C, Kebir CE, Picard A, Segna E, Beeker N, Khonsari RH. Injuries and child abuse increase during the pandemic over 12942 emergency admissions. Injury 2022; 53:3293-3296. [PMID: 36008172 PMCID: PMC9359596 DOI: 10.1016/j.injury.2022.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 07/10/2022] [Accepted: 08/06/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION A strict lockdown was decided from 17/03/2020 to 11/05/2020 in France in order to tackle the first wave of the COVID19 pandemic. In the Great Paris region, several areas are severely affected by overcrowding, creating difficult conditions for children and their families during a period of nearly two months. The objective was to assess the effects of the 2020 spring lockdown on injuries, child abuse and neglect. MATERIAL AND METHODS The central medical data warehouse was screened for all pediatric admissions at emergency and critical care departments of 20 hospitals, in a cohort of 12942 children. Specific keywords were used to screen for both injuries and child abuse and neglect. RESULTS We found head and neck trauma (1.2% in 2020 vs. 0.7% in 2019, p<0.001), burns (0.6% in 2020 vs. 0.1% in 2019, p < 0.001), lacerations (0.5% in 2020 vs. 0.3% in 2019, p<0.001), fractures (0.5% in 2020 vs. 0.3% in 2019, p<0.017), dog bites (0.1% in 2020 vs. 0.0% in 2019, p<0.001), and child abuse and neglect (18 cases during the 2020 lockdown vs. 24 cases in 2019, p=0.005) were significantly more prevalent during this period than during the same control period in 2019. CONCLUSIONS These results indicate that specific prevention measures are crucial if strict lockdowns are to be decided in the future.
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Affiliation(s)
- Quentin Hennocq
- Service de chirurgie maxillofaciale et chirurgie plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université de Paris, 149 rue de Sèvres, Paris 75015, France.
| | - Célia Adjed
- AP-HP.Centre, Groupe Hospitalier Cochin Port Royal, DMU PRIME, Unité de Recherche Clinique, Paris, France
| | - Hélène Chappuy
- Service des urgences pédiatriques, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Faculté de Médecine, Université de Paris, Paris, France
| | - Gilles Orliaguet
- Service d'anesthésie-réanimation pédiatrique et obstétricale, Hôpital universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Faculté de Médecine, Université de Paris & EA 7323, Pharmacologie et évaluation des thérapeutiques chez l'enfant et la femme enceinte, Université de Paris, Paris, France
| | - Cécile Monteil
- Services des urgences pédiatriques, Hôpital Robert-Debré, Assistance Publique - Hôpitaux de Paris ; Faculté de Médecine, Université de Paris, Paris, France
| | - Claire El Kebir
- Service social, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Faculté de Médecine, Université de Paris, Paris, France
| | - Arnaud Picard
- Service de chirurgie maxillofaciale et chirurgie plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université de Paris, 149 rue de Sèvres, Paris 75015, France
| | - Eleonora Segna
- Service de chirurgie maxillofaciale et chirurgie plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université de Paris, 149 rue de Sèvres, Paris 75015, France
| | - Nathanael Beeker
- AP-HP.Centre, Groupe Hospitalier Cochin Port Royal, DMU PRIME, Unité de Recherche Clinique, Paris, France
| | - Roman Hossein Khonsari
- Service de chirurgie maxillofaciale et chirurgie plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université de Paris, 149 rue de Sèvres, Paris 75015, France
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