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Servais A, Barbeau EJ, Bastin C. Contextual novelty detection and novelty-related memory enhancement in amnestic mild cognitive impairment. Cortex 2024; 172:72-85. [PMID: 38237229 DOI: 10.1016/j.cortex.2023.12.005] [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: 08/04/2023] [Revised: 10/23/2023] [Accepted: 12/03/2023] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Though novelty processing plays a critical role in memory function, little is known about how it influences learning in memory-impaired populations, such as amnestic Mild Cognitive Impairment (aMCI). METHODS 21 aMCI patients and 22 age- and education-matched healthy older participants performed two tasks-(i) an oddball paradigm where fractals that were often repeated (60 % of the stimuli), less frequently repeated (20 %), or novel (presented once each) were shown to assess novelty preference (longer viewing time for novel than familiar stimuli), and (ii) a Von Restorff paradigm assessing novelty-related effects on memory. Participants studied 22 lists of 10 words. Among these lists, 18 contained an isolated word different from the others by its distinctive aspect, here the font size (90-point, 120-point or 150-point against 60-point for non-isolated words). The remaining four were control lists without isolated words. After studying each list, participants freely recalled the maximum words possible. RESULTS For the oddball task, a group-by-stimulus type ANOVA on median viewing times revealed a significant effect of stimulus type, but not of group. Both groups spent more time on novel stimuli. For the Von Restorff task, both aMCI and healthy controls recalled the isolated words (presented in 120-point or 150-point, but not 90-point) better than others (excluding primacy and recency effects). Novelty-related memory benefit-gain factor-was computed as the difference between the recall scores for isolated and other words. A group-by-font size ANOVA on gain factors revealed no group effect, nor interaction, suggesting that aMCI patients benefited from novelty, alike controls. CONCLUSION Novelty preference and the boosting effect of isolation-related novelty on subsequent recall seem preserved despite impaired episodic memory in aMCI patients. This is discussed in the light of contemporary divergent theories regarding the relationship between novelty and memory, as either being independent or parts of a continuum.
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Affiliation(s)
- Anaïs Servais
- Centre de recherche Cerveau et Cognition, CNRS UMR5549, CHU Purpan, Toulouse, France
| | - Emmanuel J Barbeau
- Centre de recherche Cerveau et Cognition, CNRS UMR5549, CHU Purpan, Toulouse, France
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Curot J, Servais A, Barbeau EJ. Intracranial electrical brain stimulation as an approach to studying the (dis)continuum of memory experiential phenomena. Behav Brain Sci 2023; 46:e362. [PMID: 37961784 DOI: 10.1017/s0140525x23000110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Déjà vu and involuntary autobiographical memories (IAM) can be induced by intracranial electric brain stimulation in epileptic patients, sometimes in the same individual. We suggest that there may be different types of IAM which should be taken into account and provide several ideas to test the hypothesis of a continuity between IAM and déjà vu phenomena.
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Affiliation(s)
- Jonathan Curot
- Brain and Cognition Research Center, CerCo, CNRS, UMR 5549, Toulouse, France
- Department of Neurology, Toulouse University Hospital, Toulouse, France
- Faculty of Health, University of Toulouse-Paul Sabatier, Toulouse, France
| | - Anaïs Servais
- Brain and Cognition Research Center, CerCo, CNRS, UMR 5549, Toulouse, France
- Faculty of Health, University of Toulouse-Paul Sabatier, Toulouse, France
| | - Emmanuel J Barbeau
- Brain and Cognition Research Center, CerCo, CNRS, UMR 5549, Toulouse, France
- Faculty of Health, University of Toulouse-Paul Sabatier, Toulouse, France
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Servais A, Hurter C, Barbeau EJ. Attentional switch to memory: An early and critical phase of the cognitive cascade allowing autobiographical memory retrieval. Psychon Bull Rev 2023; 30:1707-1721. [PMID: 37118526 DOI: 10.3758/s13423-023-02270-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Accepted: 03/09/2023] [Indexed: 04/30/2023]
Abstract
Remembering and mentally reliving yesterday's lunch is a typical example of episodic autobiographical memory retrieval. In the present review, we reappraised the complex cascade of cognitive processes involved in memory retrieval, by highlighting one particular phase that has received little interest so far: attentional switch to memory (ASM). As attention cannot be simultaneously directed toward external stimuli and internal memories, there has to be an attentional switch from the external to the internal world in order to initiate memory retrieval. We formulated hypotheses and developed hypothetical models of both the cognitive and brain processes that accompany ASM. We suggest that gaze aversion could serve as an objective temporal marker of the point at which people switch their attention to memory, and highlight several fields (neuropsychology, neuroscience, social cognition, comparative psychology) in which ASM markers could be essential. Our review thus provides a new framework for understanding the early stages of autobiographical memory retrieval.
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Affiliation(s)
- Anaïs Servais
- CerCo, CNRS UMR5549-Université de Toulouse, CHU Purpan, Pavillon Baudot, 31052, Toulouse, France.
- ENAC, 7, avenue Edouard Belin, 31055, Toulouse, France.
| | | | - Emmanuel J Barbeau
- CerCo, CNRS UMR5549-Université de Toulouse, CHU Purpan, Pavillon Baudot, 31052, Toulouse, France
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Servais A, Préa N, Hurter C, Barbeau EJ. Why and when do you look away when trying to remember? Gaze aversion as a marker of the attentional switch to the internal world during memory retrieval. Acta Psychol (Amst) 2023; 240:104041. [PMID: 37774488 DOI: 10.1016/j.actpsy.2023.104041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/05/2022] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 10/01/2023] Open
Abstract
It is common to look away while trying to remember specific information, for example during autobiographical memory retrieval, a behavior referred to as gaze aversion. Given the competition between internal and external attention, gaze aversion is assumed to play a role in visual decoupling, i.e., suppressing environmental distractors during internal tasks. This suggests a link between gaze aversion and the attentional switch from the outside world to a temporary internal mental space that takes place during the initial stage of memory retrieval, but this assumption has never been verified so far. We designed a protocol where 33 participants answered 48 autobiographical questions while their eye movements were recorded with an eye-tracker and a camcorder. Results indicated that gaze aversion occurred early (median 1.09 s) and predominantly during the access phase of memory retrieval-i.e., the moment when the attentional switch is assumed to take place. In addition, gaze aversion lasted a relatively long time (on average 6 s), and was notably decoupled from concurrent head movements. These results support a role of gaze aversion in perceptual decoupling. Gaze aversion was also related to higher retrieval effort and was rare during memories which came spontaneously to mind. This suggests that gaze aversion might be required only when cognitive effort is required to switch the attention toward the internal world to help retrieving hard-to-access memories. Compared to eye vergence, another visual decoupling strategy, the association with the attentional switch seemed specific to gaze aversion. Our results provide for the first time several arguments supporting the hypothesis that gaze aversion is related to the attentional switch from the outside world to memory.
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Affiliation(s)
- Anaïs Servais
- Centre de recherche Cerveau et Cognition (CerCo), UMR5549 (CNRS-UPS), Pavillon Baudot, 31052 Toulouse, France; National Civil Aviation School (ENAC), 7 avenue Edouard Belin, 31055 Toulouse, France.
| | - Noémie Préa
- Centre de recherche Cerveau et Cognition (CerCo), UMR5549 (CNRS-UPS), Pavillon Baudot, 31052 Toulouse, France
| | - Christophe Hurter
- National Civil Aviation School (ENAC), 7 avenue Edouard Belin, 31055 Toulouse, France.
| | - Emmanuel J Barbeau
- Centre de recherche Cerveau et Cognition (CerCo), UMR5549 (CNRS-UPS), Pavillon Baudot, 31052 Toulouse, France.
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Servais A, Hurter C, Barbeau EJ. Gaze direction as a facial cue of memory retrieval state. Front Psychol 2022; 13:1063228. [PMID: 36619020 PMCID: PMC9813397 DOI: 10.3389/fpsyg.2022.1063228] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Gaze direction is a powerful social cue that indicates the direction of attention and can be used to decode others' mental states. When an individual looks at an external object, inferring where their attention is focused from their gaze direction is easy. But when people are immersed in memories, their attention is oriented towards their inner world. Is there any specific gaze direction in this situation, and if so, which one? While trying to remember, a common behavior is gaze aversion, which has mostly been reported as an upward-directed gaze. Our primary aim was to evaluate whether gaze direction plays a role in the inference of the orientation of attention-i.e., external vs. internal-in particular, whether an upward direction is considered as an indicator of attention towards the internal world. Our secondary objective was to explore whether different gaze directions are consistently attributed to different types of internal mental states and, more specifically, memory states (autobiographical or semantic memory retrieval, or working memory). Gaze aversion is assumed to play a role in perceptual decoupling, which is supposed to support internal attention. We therefore also tested whether internal attention was associated with high gaze eccentricity because the mismatch between head and eye direction alters visual acuity. We conducted two large-sample (160-163 participants) online experiments. Participants were asked to choose which mental state-among different internal and external attentional states-they would attribute to faces with gazes oriented in different directions. Participants significantly associated internal attention with an upward-averted gaze across experiments, while external attention was mostly associated with a gaze remaining on the horizontal axis. This shows that gaze direction is robustly used by observers to infer others' mental states. Unexpectedly, internal attentional states were not more associated with gaze eccentricity at high (30°) than low (10°) eccentricity and we found that autobiographical memory retrieval, but not the other memory states, was highly associated with 10° downward gaze. This reveals the possible existence of different types of gaze aversion for different types of memories and opens new perspectives.
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Affiliation(s)
- Anaïs Servais
- Centre de Recherche Cerveau et Cognition (CerCo), CNRS-UPS, UMR5549, Toulouse, France,Ecole Nationale d’Aviation Civile (ENAC), Toulouse, France,*Correspondence: Anaïs Servais,
| | | | - Emmanuel J. Barbeau
- Centre de Recherche Cerveau et Cognition (CerCo), CNRS-UPS, UMR5549, Toulouse, France
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Dao M, Decramer S, Llanas B, Chauveau D, Nobili F, Ranchin B, Rieu P, Knebelmann B, Hummel A, Servais A. Devenir à l’âge adulte des patients suivis pour un syndrome de Lowe. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Servais A, Karras A, Delmas Y, Pouteil Noble C, Choukroun G, Golbin L, Lemoine S, Provot F, Mathian A, Fremeaux-Bacchi V. Analyse du complément chez des patients ayant une microangiopathie thrombotique associée au lupus : identification de variants rares du facteur I. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Servais A, Emma F, Deschenes G, Bertholet Thomas A, Ariceta G, Levtchenko E, Novo R, Sandrine L, Chauveau D, Niaudet P. RaDiCo-ECYSCO, une cohorte européenne dédiée à la cystinose. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.293] [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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Servais A, Gueguen S, Georges D, Aurélia B, Sandrine L, Robert N, Lamia T, Marine R, Serge A, Patrick N. RaDiCo-ECYSCO, une cohorte européenne dédiée à la cystinose. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.147] [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: 11/28/2022]
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Servais A, Bowman S, Lundgren S, Klepser D, Brink H. Preoperative Amiodarone and Primary Graft Dysfunction in Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Bauvois A, Servais A, Blanchard-Laumonnier E, Larrat C, Sautenet B, Merieau E, Maillot F, Bigot A. Intérêt de la microscopie électronique dans la maladie de Fabry. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Robert T, Cambier A, El Kharoui K, Servais A, Rabant M, Peuchmaur M, Hertig A, Deschenes G, Salomon R, Hogan J. Comparaison de la présentation clinique et histologique de la néphropathie à IgA entre les enfants et les adultes. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Gaillard F, Gribouval O, Courbebaisse M, Fournier C, Antignac C, Legendre C, Servais A. Comparaison de la fonction rénale à 1 an entre les donneurs vivants de rein caucasiens et d’origine africaine présentant un génotype APOL1 à faible risque d’insuffisance rénale terminale. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bertholet-Thomas A, Llanas B, Servais A, Bendelac N, Goizet C, Choukroun G, Novo R, Decramer S. [Significance of the urine strip test in case of stunted growth]. Arch Pediatr 2015; 22:756-62. [PMID: 26047745 DOI: 10.1016/j.arcped.2015.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/18/2014] [Accepted: 04/24/2015] [Indexed: 10/23/2022]
Abstract
Observation of stunted growth in children usually leads the general practitioner to refer the patient to endocrinologists or gastroenterologists. In most cases, after a complementary check-up, the diagnosis is made and treatment is initiated. However, certain cases remain undiagnosed, particularly renal etiologies, such as proximal tubulopathy. The urine strip test at the initial check-up would be an easy and inexpensive test to avoid delayed diagnosis. The aim of the present paper is to increase general physicians' and pediatricians' awareness of the significance of questioning the parents and using the urine strip test for any child presenting stunted growth. We report a patient case of a 20-month-old child admitted to the emergency department for severe dehydration. He had displayed stunted growth since the age of 5 months and showed a negative etiologic check-up at 9 months of age. Clinical examination at admission confirmed stunted growth with loss of 2 standard deviations and signs of dehydration with persistent diuresis. Skin paleness, ash-blond hair, and signs of rickets were also observed and the urine strip test showed positive pads for glycosuria and proteinuria. Polyuria and polydipsia were also revealed following parents' questioning, suggesting proximal tubulopathy (Fanconi syndrome). Association of stunted growth, rickets, polyuria and polydipsia, glycosuria (without ketonuria and normal glycemia), and proteinuria suggest nephropathic cystinosis. Ophthalmic examination showed cystine deposits in the cornea. The semiotic diagnosis of nephropathic cystinosis was confirmed by leukocyte cystine concentrations and genetic investigations. This case report clearly illustrates the significance of the urine strip test to easily and quickly concentrate the diagnosis of stunted growth on a renal etiology (glycosuria, proteinuria), especially on proximal tubulopathy for which the most frequent cause is nephropathic cystinosis. Specificity of nephropathic cystinosis treatment is that the age of treatment initiation is crucial and determinant for the prognosis of the disease and the onset of final stage renal failure. Therefore, the urine strip test should be included in the systematic check-up of stunted growth to identify any renal etiology.
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Affiliation(s)
- A Bertholet-Thomas
- Néphrogones, centre de référence des maladies rénales rares, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69500 Bron, France.
| | - B Llanas
- Néphrologie pédiatrique, centre de référence du Sud-Ouest des maladies rénales rares (SORARE), hôpital des Enfants, CHU de Bordeaux, 33076 Bordeaux, France
| | - A Servais
- Service de néphrologie adulte, centre de référence MARRHEA, hôpital Necker-Enfants-Malades, université Paris Descartes, AP-HP, 75015 Paris, France
| | - N Bendelac
- Endocrinologie, diabète et maladies héréditaires du métabolisme, hôpital Femme-Mère-Enfant, hôpitaux de Lyon, 69500 Lyon, France
| | - C Goizet
- Génétique médicale, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France
| | - G Choukroun
- Inserm UMR 1088, service de néphrologie-médecine interne-dialyse-transplantation-réanimation, université de Picardie-Jules-Verne, CHU d'Amiens, 80054 Amiens, France
| | - R Novo
- Néphrologie pédiatrique, hôpital Jeanne-de-Flandre, CHRU de Lille, 59037 Lille cedex, France
| | - S Decramer
- Pédiatrie, néphrologie, médecine interne et hypertension pédiatrique, centre de référence du Sud-Ouest des maladies rénales rares (SORARE), hôpital des Enfants, CHU de Toulouse, 31300 Toulouse, France
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Benhamou Y, Boelle PY, Baudin B, Ederhy S, Gras J, Galicier L, Azoulay E, Provôt F, Maury E, Pène F, Mira JP, Wynckel A, Presne C, Poullin P, Halimi JM, Delmas Y, Kanouni T, Seguin A, Mousson C, Servais A, Bordessoule D, Perez P, Hamidou M, Cohen A, Veyradier A, Coppo P. Cardiac troponin-I on diagnosis predicts early death and refractoriness in acquired thrombotic thrombocytopenic purpura. Experience of the French Thrombotic Microangiopathies Reference Center. J Thromb Haemost 2015; 13:293-302. [PMID: 25403270 DOI: 10.1111/jth.12790] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [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: 08/14/2014] [Indexed: 08/31/2023]
Abstract
BACKGROUND Cardiac involvement is a major cause of mortality in patients with thrombotic thrombocytopenic purpura (TTP). However, diagnosis remains underestimated and delayed, owing to subclinical injuries. Cardiac troponin-I measurement (cTnI) on admission could improve the early diagnosis of cardiac involvement and have prognostic value. OBJECTIVES To assess the predictive value of cTnI in patients with TTP for death or refractoriness. PATIENTS/METHODS The study involved a prospective cohort of adult TTP patients with acquired severe ADAMTS-13 deficiency (< 10%) and included in the registry of the French Reference Center for Thrombotic Microangiopathies. Centralized cTnI measurements were performed on frozen serum on admission. RESULTS Between January 2003 and December 2011, 133 patients with TTP (mean age, 48 ± 17 years) had available cTnI measurements on admission. Thirty-two patients (24%) had clinical and/or electrocardiogram features. Nineteen (14.3%) had cardiac symptoms, mainly congestive heart failure and myocardial infarction. Electrocardiogram changes, mainly repolarization disorders, were present in 13 cases. An increased cTnI level (> 0.1 μg L(-1) ) was present in 78 patients (59%), of whom 46 (59%) had no clinical cardiac involvement. The main outcomes were death (25%) and refractoriness (17%). Age (P = 0.02) and cTnI level (P = 0.002) showed the greatest impact on survival. A cTnI level of > 0.25 μg L(-1) was the only independent factor in predicting death (odds ratio [OR] 2.87; 95% confidence interval [CI] 1.13-7.22; P = 0.024) and/or refractoriness (OR 3.03; 95% CI 1.27-7.3; P = 0.01). CONCLUSIONS A CTnI level of > 0.25 μg L(-1) at presentation in patients with TTP appears to be an independent factor associated with a three-fold increase in the risk of death or refractoriness. Therefore, cTnI level should be considered as a prognostic indicator in patients diagnosed with TTP.
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Affiliation(s)
- Y Benhamou
- Service de Médecine Interne, CHU Charles Nicolle, Rouen, France; Inserm U1096, Rouen, France; Centre de Référence des Microangiopathies Thrombotiques, Hôpital Saint-Antoine, AP-HP, Paris, France
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Servais A, Arnoux JB, Lamy C, Hummel A, Vittoz N, Katerinis I, Bazzaoui V, Dubois S, Broissand C, Husson MC, Berleur MP, Rabier D, Ottolenghi C, Valayannopoulos V, de Lonlay P. Treatment of acute decompensation of maple syrup urine disease in adult patients with a new parenteral amino-acid mixture. J Inherit Metab Dis 2013; 36:939-44. [PMID: 23250513 DOI: 10.1007/s10545-012-9570-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 11/21/2012] [Accepted: 11/26/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acute decompensation of maple syrup urine disease (MSUD) is usually treated by enteral feeding with an amino-acid mixture without leucine (Leu), valine or isoleucine. However, its administration is ineffective in cases of gastric intolerance and some adult patients refuse enteral feeding via a nasogastric tube. We developed a new parenteral amino-acid mixture for patients with MSUD. METHODS Seventeen decompensation episodes in four adult patients with MSUD treated with a parenteral amino-acid mixture (group P) were compared to 18 previous episodes in the same patients treated by enteral feeding (group E). RESULTS The mean Leu concentration at presentation was similar in the groups P and E (1196.9 μmol/L and 1212.2 μmol/L, respectively). The mean decrease in the Leu concentration during the first 3 days of hospitalisation was significantly higher in group P than group E (p = 0.0026); there were no side effects. The mean duration of hospitalisation was similar (4 vs. 4.5 days, p = NS). No patient in group P deteriorated whereas one patient in group E required dialysis. CONCLUSION This new parenteral amino-acid mixture is safe and allows efficient Leu concentration decrease during acute MSUD decompensation episodes in adults. Its use avoids the need for nasogastric tube insertion.
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Affiliation(s)
- A Servais
- Department of Nephrology, Hôpital Necker-Enfants Malades AP-HP, Paris, France,
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Warling O, Guiot J, Ramaut M, Servais A, Lewin M, Louis R. [Clinical case of the month. Idiopathic mediastinal fibrosis]. Rev Med Liege 2013; 68:408-411. [PMID: 24053100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Fibrosing mediastinitis is a rare condition characterized by an excessive growth of dense fibrous tissue within the mediastinum. The etiology of the disease is most often a fungal infection and may in some cases be idiopathic. We present the case of a patient with chronic obstructive pulmonary disease (COPD) suffering from fibrosing mediastinitis of undetermined origin and in whom the diagnosis was established by histopathological analysis after mediastinoscopy.
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Chauvet S, Karras A, Burtey S, Macher MA, Glowacki F, Peraldi MN, Tostivint I, Thervet É, Frémeaux-Bacchi V, Servais A. Traitement des glomérulopathies à dépôts de C3 par mycophénolate mofétil ou rituximab : étude comparative. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2012.07.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Servais A, Brodin-Sartorius A, Pauly P, Daoud S, Niaudet P. Cystinose et grossesse. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2012.07.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Figuères ML, Frémeaux-Bacchi V, Rabant M, Galmiche L, Noël LH, Servais A. Hétérogénéité clinique et histologique de la maladie des dépôts denses : à propos de trois cas atypiques. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2012.07.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Adam J, Bollée G, Kohn W, Servais A, Qamous O, Ceballos-Picot I, Daudon M, Noël L. Diagnostic de déficit en adénine phosphoribosyl transférase (APRT) : il n’est jamais trop tard. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2011.07.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Lequintrec M, Servais A, Ngo S, Dragon-Durey M, Roumenina L, Fremeaux-Bacchi V. Factor H and MCP haplotypes don’t confer susceptibility for C3 glomerulopathy. Mol Immunol 2011. [DOI: 10.1016/j.molimm.2011.06.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kamar N, Guilbeau-Frugier C, Servais A, Tack I, Thervet E, Cointault O, Esposito L, Guitard J, Lavayssiere L, Muscari F, Bureau C, Rostaing L. Kidney histology and function in liver transplant patients. Nephrol Dial Transplant 2011; 26:2355-2361. [DOI: 10.1093/ndt/gfq718] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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24
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Servais A, Meas-Yedid V, Noël LH, Martinez F, Panterne C, Kreis H, Zuber J, Timsit MO, Legendre C, Olivo-Marin JC, Thervet E. Interstitial fibrosis evolution on early sequential screening renal allograft biopsies using quantitative image analysis. Am J Transplant 2011; 11:1456-63. [PMID: 21672152 DOI: 10.1111/j.1600-6143.2011.03594.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Screening renal biopsies (RB) may assess early changes of interstitial fibrosis (IF) after transplantation. The aim of this study was to quantify IF by automatic color image analysis on sequential RB. We analyzed RB performed at day (D) 0, month (M) 3 and M12 from 140 renal transplant recipients with a program of color segmentation imaging. The mean IF score was 19 ± 9% at D0, 27 ± 11% at M3 and 32 ± 11% at M12 with a 8% progression during the first 3 months and 5% between M3 and M12. IF at M3 was correlated with estimated glomerular rate (eGFR) at M3, 12 and 24 (p < 0.02) and IF at M12 with eGFR at M12 and 48 (p < 0.05). Furthermore, IF evolution between D0 and M3 (ΔIFM3-D0) was correlated with eGFR at M24, 36 and 48 (p < 0.03). IF at M12 was significantly associated with male donor gender and tacrolimus dose (p = 0.03). ΔIFM3-D0 was significantly associated with male donor gender, acute rejection episodes (p = 0.04) and diabetes mellitus (p = 0.02). Thus, significant IF is already present before transplantation. IF evolution is more important during the first 3 months and has some predictive ability for change in GFR. Intervention to decrease IF should be applied early, i.e. before 3 months, after transplantation.
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Affiliation(s)
- A Servais
- Department of Nephrology, Assistance publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France.
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Grünfeld JP, Servais A. [Fabry disease and cystinosis, two lysosomal diseases: similarities and differences]. Rev Med Interne 2011; 31 Suppl 2:S226-8. [PMID: 21211669 DOI: 10.1016/s0248-8663(10)70017-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Fabry disease and cystinosis are both lysosomal diseases. Some clinical features (such as renal and corneal involvement) are shared by both diseases whereas many other features are different (mode of inheritance, rate of progression, mechanism of lysosomal storage, therapeutic modalities etc.). Intermediary mechanisms that lead from lysosomal overload to lesions and disease are still incompletely understood.
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Affiliation(s)
- J-P Grünfeld
- Hôpital Necker, Université Paris Descartes, France.
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Servais A, Meas-Yedid V, Toupance O, Lebranchu Y, Thierry A, Moulin B, Etienne I, Presne C, Hurault DLB, Le Pogamp P, Le Meur Y, Glotz D, Hayem C, Olivo Marin JC, Thervet E. Interstitial fibrosis quantification in renal transplant recipients randomized to continue cyclosporine or convert to sirolimus. Am J Transplant 2009; 9:2552-60. [PMID: 19843033 DOI: 10.1111/j.1600-6143.2009.02803.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Conversion from cyclosporine (CsA) to sirolimus at week 12 after kidney transplantation is associated with a significant improvement in renal function. The aim of this analysis was to investigate the effect of this conversion on interstitial fibrosis (IF), a hallmark of chronic allograft injury, in patients taking part in the CONCEPT trial. This multicenter, prospective, trial included 193 renal recipients randomized at week 12 to switch from CsA to sirolimus or to continue CsA, with mycophenolate mofetil. Routine biopsy with automated, quantified assessment of IF by a program of color segmentation was performed at 1 year in 121 patients. At 1 year, renal function was significantly improved in the conversion group as assessed by estimated GFR (MDRD) and measured GFR. Biopsy results, however, showed no between-group difference in percentage of IF. Calculated GFR at 1 year was significantly associated with the percentage of IF (p = 0.004, R(2)= 0.07). By multivariate analysis diabetic patients had more fibrosis than non-diabetic patients. In conclusion, although kidney transplant patients converted from CsA to sirolimus showed significant improvement in renal function, we found no difference of IF on 1-year biopsies.
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Affiliation(s)
- A Servais
- Departments of Nephrology, Assistance publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France.
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Abstract
Drug-induced renal calculi represent 1-2% of all renal calculi. They include two categories: those resulting from the urinary crystallisation of a highly excreted, poorly soluble drug or metabolite, and those due to the metabolic effects of a drug. Indinavir, used in HIV-infected patients, sulfonamides, especially sulfadiazine, and triamterene, which is less prescribed today, are the most frequent. Besides these drugs, about twenty other molecules, among them silicate-containing drugs and some antibiotics have been reported in patients receiving high doses or long-term treatments. Calculi analysis by physical methods such as infrared spectroscopy or x-ray diffraction can demonstrate the presence of the drug or its metabolites inside the calculi. In those calculi due to the metabolic effects of a drug, diagnosis relies on both stone analysis and clinical inquiry. Incidence of such calculi is probably underestimated, especially those due to calcium/vitamin D supplements or carbonic anhydrase inhibitors. Drug-induced calculi occur more often during high-dose or long term treatments, but there are also patient-related risk factors in relation to urine pH, urine output and other parameters, which can provide a basis for preventive treatment of such calculi. A better knowledge of these lithogenic complications of treatments and of solubility characteristics of drugs should reduce the incidence of drug-induced nephrolithiasis, especially in patients with identified risk factors.
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Affiliation(s)
- A Servais
- Service de néphrologie adultes, hôpital Necker, université Paris V, 161, rue de Sèvres, 75015 Paris, France.
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Servais A, Bissery A, Le Coz S, Chatellier G, Duclos JM, Plouin PF. [Pheochromocytoma: 25 years of experience. Report of 199 cases]. Arch Mal Coeur Vaiss 2003; 96:963-6. [PMID: 14653056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The methods for diagnosing pheochromocytoma have progressed in 25 years, so changing the clinical, biological and tumoral presentations. The authors compare the features of 199 patients with pheochromocytoma operated between 1975 and 2001 by quartiles. The frequency and known duration of hypertension, plasma adrenaline, the tumour size and proportion of cases which were malignant from the outset, have decreased over the observation period (p < 0.01). The average age and proportion of familial cases or associated with diabetes or those of asymptomatic patients (with incidentaloma), has not changed significantly. The pheochromocytoma were adrenal (104 right, 60 left, 12 bilateral) or ectopic (23) and 13 were malignant from the outset. Over a median 5 year follow-up, 35 pheochromocytomas recurred either in the benign or malignant forms. Recurrences of tumours of the right adrenal were more common than those of the left adrenal gland (p = 0.03). In conclusion, pheochromocytomas are diagnosed earlier, at a stage when the tumours are smaller and less secreting. The higher incidence and recurrence rate of right adrenal pheochromocytoma remain unexplained.
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Affiliation(s)
- A Servais
- Unité d'hypertension artérielle, Hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75908 Paris
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Servais A, Pestieau SR, Detry O, Honoré P, Belaïche J, Boniver J, Jacquet N. Autoimmune pancreatitis mimicking cancer of the head of pancreas: report of two cases. Acta Gastroenterol Belg 2001; 64:227-30. [PMID: 11475142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Autoimmune pancreatitis has been characterised in 1995, but only a few cases have been published since then, most of them from Japan. This report describes the cases of two Belgian male patients who presented with isolated obstructive jaundice. Radiological imaging studies were highly suggestive of carcinoma of the head of pancreas and both patients underwent uneventful cephalic pancreaticoduodenectomy with portal vein resection. Pathological analysis of the removed tissues suggested an autoimmune process in both cases. Both patients had hyper-gammaglobulinemia and antinuclear antibodies, but failed to show evidence of any other autoimmune disease or cause of chronic pancreatitis. In both cases final diagnosis was autoimmune pancreatitis. Preoperative clinical suspicion of this diagnosis is mandatory and may avoid unnecessary surgery in future cases.
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Affiliation(s)
- A Servais
- Department of Pathology, University Hospital of Liège, Belgium
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Gaspar Y, de Leval J, Servais A, Quatresooz P, Boniver J. [Clinical case of the month. Von Hippel-Lindau disease]. Rev Med Liege 2001; 56:68-71. [PMID: 11294051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
VHL disease is a rare genetical disease with a poor long-term prognosis. Clinical features include retineous angiomas, CNS hemangioblastomas, pheochromocytomas and renal cysts. Renal cysts are bilateral and frequently lead to malignant transformation. Surgical treatment of renal cysts is preferably delayed until a minimum of 3 cm diameter has been reached. Treatment has to be as conservative as possible, knowing that uni- or bilateral nephrectomy often has to be carried out later.
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Affiliation(s)
- Y Gaspar
- Service d'Urologie, Université de Liège
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