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Moret A, Madelaine L, Hanna HA, Bernard A, Pagès PB. [Complications after pulmonary segmentectomy: Impact of the surgical approach]. Rev Mal Respir 2023; 40:666-674. [PMID: 37798174 DOI: 10.1016/j.rmr.2023.06.008] [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: 09/02/2022] [Accepted: 06/14/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Pulmonary segmentectomy is becoming increasingly widespread but remains technically challenging. The aim of this study was to evaluate the impact of the surgical approach applied on postoperative complications after pulmonary segmentectomy. METHODS All patients having undergone pulmonary segmentectomy by thoracotomy, videothoracoscopy or robot-assisted surgery from 1st January 2018 to 31st December 2021 were included. The primary endpoint was the occurrence of postoperative complications. Secondary endpoints were operative time, length of hospital stay, 30-day readmission rate, 30-day and 90-day mortality. RESULTS Two hundred and twenty-three patients were included, 30% (n=67) in the thoracotomy group, 9.4% (n=21) in the videothoracoscopy group and 60.5% (n=135) in the robot-assisted surgery group. There was no difference in the occurrence of postoperative complications according to type of approach (P=0.564), 26.9% of patients (n=60) had at least one postoperative complication. There was no significant difference between the groups in terms of operative time (P=0.385), length of hospital stay (P=0.107), 30 and 90-day mortality (P=0.124 and P=0.249, respectively). Mini-invasive surgery significantly reduced the 30-day readmission rate (P=0.049). CONCLUSION The surgical approach applied does not influence the postoperative complications of pulmonary segmentectomy.
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Affiliation(s)
- A Moret
- Service de chirurgie thoracique, CHU de Dijon, Bocage central, 14, rue Gaffarel, 21079 Dijon, France; Service de chirurgie thoracique, centre hospitalier Métropole Savoie, Chambéry, France
| | - L Madelaine
- Service de chirurgie thoracique, CHU de Dijon, Bocage central, 14, rue Gaffarel, 21079 Dijon, France
| | - H Abou Hanna
- Service de chirurgie thoracique, CHU de Dijon, Bocage central, 14, rue Gaffarel, 21079 Dijon, France
| | - A Bernard
- Service de chirurgie thoracique, CHU de Dijon, Bocage central, 14, rue Gaffarel, 21079 Dijon, France
| | - P-B Pagès
- Service de chirurgie thoracique, CHU de Dijon, Bocage central, 14, rue Gaffarel, 21079 Dijon, France; Inserm, UMR 1231, CHU de Dijon, université de Bourgogne, Dijon, France.
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Braillon A, Bernard A, Leclercq T, Duloquin G, Comby PO, Loffroy R, Midulla M, Ricolfi F, Bejot Y, Guenancia C. Prediction of atrial fibrillation by cardiac imaging added to the acute stroke CT protocol. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.185] [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: 12/31/2022]
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3
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Fuzeau A, Dion F, Angoulvant D, Ivanes F, Genet T, Delhommais A, Vermes E, Pucheux J, Cazeneuve N, Bernard A. Incidence, risk factors and multimodality imaging of post STEMI left ventricular thrombus, a monocentric one-year follow-up study. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.123] [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: 12/31/2022]
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Pezel T, Dreyfus J, Mouhat B, Thebaut C, Audureau E, Bernard A, Lavie Badie Y, Bohbot Y, Fard D, Biere L, Le Ven F, Fauvel C, Donal E, Mansencal N, Coisne A. Efficacy of simulation-based training on transoesophageal echocardiography learning in a multicentre randomised controlled trial: SIMULATOR study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.008] [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: 11/14/2022] Open
Abstract
Abstract
Background
Evidence on the impact of simulation-based training in transesophageal echocardiography (TEE) is scarce.
Purpose
We aimed to assess the efficacy of simulation-based versus traditional teaching on TEE knowledge and skills for cardiology residents.
Methods
Between November 2020 and November 2021, all consecutive cardiology residents inexperienced from TEE were randomised (1:1, n=324) through 42 French University Centers into two groups with or without simulation support (either a simulation group or a traditional group). The coprimary outcomes were the scores in the final theoretical and practical tests 3 months after the training. TEE duration and the feelings of residents were also assessed. An economic analysis was also performed.
Results
While the theoretical and practical test scores were similar between the two groups before the training (respectively P=0.80 and P=0.51), the residents in the simulation group displayed higher theoretical test and practical test scores after the training than those in the traditional group (respectively 47.2±15.6% vs. 38.3±19.8%, P<0.0001 and 74.5±17.7% vs. 59.0±25.1%, P<0.0001). Subgroups analyses showed that the efficacy of the simulation training was even greater when performed at the beginning of residency (P<0.0001). After the training, the duration to perform a complete TEE was significantly lower in the simulation group than in the traditional group (respectively 8.3±1.4 min vs. 9.4±1.2 min, P<0.0001). Finally, residents' feelings were better in the simulation group than in the traditional group across all components (P<0.0001). Compared to the traditional group, the average additional cost per resident of the simulation program was respectively €1,785, €942 or €662 for 20, 40 and 60 residents.
Conclusion
Simulation-based teaching on TEE showed a significant improvement in knowledge, skills, and feelings of cardiology residents as well as a reduction in the duration to complete the examination.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Pezel
- Hospital Lariboisiere , Paris , France
| | - J Dreyfus
- Centre Cardiologique du Nord (CCN) , Saint Denis , France
| | - B Mouhat
- University of Besançon , Besancon , France
| | - C Thebaut
- University Hospital of Limoges , Limoges , France
| | - E Audureau
- Henri-Mondor University Hospital, Unité de Recherche Clinique et Statistiques , Créteil , France
| | - A Bernard
- University of Tours - Faculty of Medicine , Tours , France
| | - Y Lavie Badie
- Toulouse Rangueil University Hospital (CHU) , Toulouse , France
| | - Y Bohbot
- University Hospital of Amiens , Amiens , France
| | - D Fard
- Henri-Mondor University Hospital, Unité de Recherche Clinique et Statistiques , Créteil , France
| | - L Biere
- University Hospital of Angers , Angers , France
| | - F Le Ven
- University Hospital of Brest , Brest , France
| | - C Fauvel
- University Hospital of Rouen , Rouen , France
| | - E Donal
- Hospital Pontchaillou of Rennes , Rennes , France
| | - N Mansencal
- Ambroise Pare Universitary Hospital, Cardiology , Paris , France
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Pialot B, Bernard A, Liebgott H, Varray F. Sensitivity Enhancement Using Chirp Transmission for an Ultrasound Arthroscopic Probe. IEEE Trans Ultrason Ferroelectr Freq Control 2022; 69:2776-2784. [PMID: 35312619 DOI: 10.1109/tuffc.2022.3160880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Meniscal tear in the knee joint is a highly common injury that can require an ablation. However, the success rate of meniscectomy is highly impacted by difficulties in estimating the thin vascularization of the meniscus, which determines the healing capacities of the patient. Indeed, vascularization is estimated using arthroscopic cameras that lack of high sensitivity to blood flow. Here, we propose an ultrasound method for estimating the density of vascularization in the meniscus during surgery. This approach uses an arthroscopic probe driven by ultrafast sequences. To enhance the sensitivity of the method, we propose to use a chirp-coded excitation combined with a mismatched compression filter robust to the attenuation. This chirp approach was compared to a standard ultrafast emission and a Hadamard-coded emission using a flow phantom. The mismatched filter was also compared to a matched filter. Results show that, for a velocity of a few millimeters per second, the mismatched filter gives a 4.4-10.4-dB increase of the signal-to-noise ratio (SNR) compared to the Hadamard emission and a 3.1-6.6-dB increase compared to the matched filter. Such increases are obtained for a loss of axial resolution of 13% when comparing the point spread functions (PSFs) of the mismatched and matched filters. Hence, the mismatched filter allows increasing significantly the probe capacity to detect slow flows at the cost of a small loss in axial resolution. This preliminary study is the first step toward an ultrasensitive ultrasound arthroscopic probe able to assist the surgeon during meniscectomy.
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Berrada-Gomez MP, Roch-Simon P, Bernard A, Rakotomalala S, Bigonne H, Ferret PJ. P22-22 Exposure data of cosmetic products for patients undergoing cancer treatments. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.736] [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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Aprile E, Abe K, Agostini F, Ahmed Maouloud S, Alfonsi M, Althueser L, Angelino E, Angevaare J, Antochi V, Antón Martin D, Arneodo F, Baudis L, Baxter A, Bellagamba L, Bernard A, Biondi R, Bismark A, Brown A, Bruenner S, Bruno G, Budnik R, Capelli C, Cardoso J, Cichon D, Cimmino B, Clark M, Colijn A, Conrad J, Cuenca-García J, Cussonneau J, D’Andrea V, Decowski M, Di Gangi P, Di Pede S, Di Giovanni A, Di Stefano R, Diglio S, Elykov A, Farrell S, Ferella A, Fischer H, Fulgione W, Gaemers P, Gaior R, Galloway M, Gao F, Glade-Beucke R, Grandi L, Grigat J, Higuera A, Hils C, Hoetzsch L, Howlett J, Iacovacci M, Itow Y, Jakob J, Joerg F, Joy A, Kato N, Kavrigin P, Kazama S, Kobayashi M, Koltman G, Kopec A, Landsman H, Lang R, Levinson L, Li I, Li S, Liang S, Lindemann S, Lindner M, Liu K, Lombardi F, Long J, Lopes J, Ma Y, Macolino C, Mahlstedt J, Mancuso A, Manenti L, Manfredini A, Marignetti F, Marrodán Undagoitia T, Martens K, Masbou J, Masson D, Masson E, Mastroianni S, Messina M, Miuchi K, Mizukoshi K, Molinario A, Moriyama S, Morå K, Mosbacher Y, Murra M, Müller J, Ni K, Oberlack U, Paetsch B, Palacio J, Peres R, Pienaar J, Pierre M, Pizzella V, Plante G, Qi J, Qin J, Ramírez García D, Reichard S, Rocchetti A, Rupp N, Sanchez L, dos Santos J, Sarnoff I, Sartorelli G, Schreiner J, Schulte D, Schulze Eißing H, Schumann M, Scotto Lavina L, Selvi M, Semeria F, Shagin P, Shi S, Shockley E, Silva M, Simgen H, Takeda A, Tan PL, Terliuk A, Thers D, Toschi F, Trinchero G, Tunnell C, Tönnies F, Valerius K, Volta G, Wei Y, Weinheimer C, Weiss M, Wenz D, Wittweg C, Wolf T, Xu Z, Yamashita M, Yang L, Ye J, Yuan L, Zavattini G, Zhang Y, Zhong M, Zhu T, Zopounidis J. Emission of single and few electrons in XENON1T and limits on light dark matter. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.022001] [Citation(s) in RCA: 2] [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] [Indexed: 11/07/2022]
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8
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Bernard A, Le May C, Martin JC, Delaby P, Le Bourgot C, Ledoux S, Besnard P. La voie tryptophan/Kynurenine : un nouveau lien entre obésité nutritionnelle, chirurgie bariatrique et perception orosensorielle des lipides. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.150] [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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9
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Pezel T, Bernard A, Lavie-Badie Y, Dreyfus J, Bohbot Y, Fard D, Nguyen L, Biere L, Le Ven F, Canu M, Ribeyrolles S, Mion B, Fauvel C, Ternacle J, Cautela J, Le Tourneau T, Donal E, Lafitte S, Mansencal N, Coisne A. SIMULATOR study: Multicentre randomized study to assess the impact of SIMULation-bAsed Training on transoesophageal echocardiOgraphy leaRning for cardiology residents. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.098] [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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10
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Vallejo Bustamante J, Wu NJ, Fermon C, Pannetier-Lecoeur M, Wakamura T, Watanabe K, Taniguchi T, Pellegrin T, Bernard A, Daddinounou S, Bouchiat V, Guéron S, Ferrier M, Montambaux G, Bouchiat H. Detection of graphene's divergent orbital diamagnetism at the Dirac point. Science 2021; 374:1399-1402. [PMID: 34882473 DOI: 10.1126/science.abf9396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- J Vallejo Bustamante
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France
| | - N J Wu
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France.,Université Paris-Saclay, CNRS, Institut des Sciences Moléculaires d'Orsay, Orsay, France
| | - C Fermon
- SPEC, CEA, CNRS, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | | | - T Wakamura
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France.,NTT Basic Research Laboratories, NTT Corporation, Atsugi, Kanagawa, Japan
| | - K Watanabe
- Research Center for Functional Materials, National Institute for Materials Science, 1-1 Namiki, Tsukuba 305-0044, Japan
| | - T Taniguchi
- International Center for Materials Nanoarchitectonics, National Institute for Materials Science, 1-1 Namiki, Tsukuba 305-0044, Japan
| | - T Pellegrin
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France
| | - A Bernard
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France
| | - S Daddinounou
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France
| | - V Bouchiat
- Néel Institute, CNRS, 38000 Grenoble, France
| | - S Guéron
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France
| | - M Ferrier
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France
| | - G Montambaux
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France
| | - H Bouchiat
- Université Paris-Saclay, CNRS, Laboratoire de Physique des Solides, 91405 Orsay, France
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11
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Fauchier L, Bisson A, Bodin A, Herbert J, Spiesser PH, Pierre B, Clementy N, Babuty D, Bernard A, Lip GYH. All-cause mortality and cardiovascular death in 52091 patients with hypertrophic cardiomyopathy. A nationwide cohort study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1735] [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: 11/12/2022] Open
Abstract
Abstract
Background
Patients with hypertrophic cardiomyopathy (HCM) have high risk of death related to cardiovascular (CV) death. Improvements in risk stratification are needed to help identify those HCM patients at higher risk of all-cause death and cardiovascular death.
Methods
This French longitudinal cohort study from the database covering hospital care from 2010 to 2019 analyzed adultshospitalized with isolated HCM. The overall sample of 52,091 patients was randomly partitioned into derivation (n=26,067) and validation (n=26,024) populations. A logistic regression model was used to construct HCM death and CV-death scores in the derivation sample, which were compared to the Charlson index, Frailty index and CHA2DS2VASc scores using c-indexes and calibration analysis.
Results
In 52,091 patients with isolated HCM, 12,676 (24.0%) died during follow-up of 3.0±2.8 years (median 2.3, interquartile range 0.4–5.0). Rate of all-cause death was 8.10%/year (7.96–8.24) and was 2.76%/year (2.68–2.84) for CV death.Independent predictors of CV death in HCM were older age, diabetes mellitus, heart failure, history of pulmonary edema, atrial fibrillation, ventricular tachycardia or fibrillation, ischemic stroke, while smoking and poor nutrition were associated with better survival (all p<0.05). In addition to these, male sex, vascular disease, alcohol related diagnoses, kidney disease, lung disease, liver disease anemia and cancer were independent predictors of all-cause death. In the derivation cohort, c-indexes for the HCM death score were 0.720 (0.713–0.727) for all-cause death and 0.695 (0.685–0.705) for CV death. For the HCM CV-death score, c-indexes were 0.679 (0.671–0.686) for all-cause death and 0.723 (0.712–0.733) for CV death. Performances were very similar in the validation cohort. Both scores had good calibrations. Charlson and Frailty indexes however had a better clinical usefulness than the HCM death score and HCM CV-death scores for predicting all-cause death. Decision curve analysis for CV death demonstrated that the HCM CV-death score had the best clinical usefulness of all the tested risk scores.
Conclusion
HCM patients have a high risk of all-cause and CV mortality. Independent predictors of CV-mortality in HCM were used to derive and validate a simple risk prediction model (French HCM CV-mortality score) which performed better than clinical scores, Charlson Index and Frailty Index; showing the best clinical usefulness, with good calibration.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- L Fauchier
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bisson
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bodin
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - J Herbert
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - P H Spiesser
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - B Pierre
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - N Clementy
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - D Babuty
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bernard
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - G Y H Lip
- City Hospital, Centre for Cardiovascular Sciences, Birmingham, United Kingdom
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12
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Bernard A, Poupon-Nedelec M, Robichon C, Gommez-Berrada MP, Ferret PJ. Usage patterns of facial cosmetic products in Asia. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00420-3] [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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13
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Levron A, El Chehab H, Agard E, Bernard A, Verrecchia S, Badri Y, Dot C. Impact of estimated total keratometry on the refractive outcomes of the XY1AT toric intraocular lens in cataract surgery. J Fr Ophtalmol 2021; 44:e487-e492. [PMID: 34340885 DOI: 10.1016/j.jfo.2021.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 10/20/2022]
Affiliation(s)
- A Levron
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
| | - H El Chehab
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - E Agard
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - A Bernard
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - S Verrecchia
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - Y Badri
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - C Dot
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France; French Military Health Service Academy of Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
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Moret A, Madelaine L, Cottenet J, Sophie Mariet A, Quantin C, Bernard A, Pagès PB. [Readmissions after lung resection in France: The PMSI database]. Rev Mal Respir 2021; 38:673-680. [PMID: 34175166 DOI: 10.1016/j.rmr.2021.04.009] [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: 10/30/2020] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Readmission within 30 days is an indicator of the quality of care, because it often reflects post-discharge care that is not optimal. The objective of this work is to measure over time on the one hand the readmission rate and on the other hand the number of hospitals with a standardized readmission rate beyond the national average. METHOD All patients with major pulmonary resection for lung cancer in France were extracted from the PMSI national database. Readmission within 30 days was defined as any new hospitalization either in the same hospital or in another establishment. RESULTS From January 1, 2005 to December 31, 2018, 110,603 patients were included. The 30-day all-cause readmissions rate was 24.9% (n=27,540). Patients after pneumonectomy had a readmission rate of 37% (n=4918) and 23% after lobectomy (n=2684) (P<0.0001). For the first period, we counted 10 hospitals with a standardized readmissions rate above the 99.8 limit and 10 hospitals above the 95% limit. For the second period, 8 hospitals had a standardized readmission rate above the 99.8% limit and 11 hospitals above the 95% limit. For the third period, 7 hospitals had a standardized readmission rate above the 99.8% limit and 6 hospitals above the 95% limit. CONCLUSION Readmissions to hospital 30 days after major lung resection for cancer in France declined little during these three periods. Measures to prevent readmissions should be introduced.
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Affiliation(s)
- A Moret
- Service de chirurgie thoracique et cardio-vasculaire, CHU Dijon, Dijon, France
| | - L Madelaine
- Service de chirurgie thoracique et cardio-vasculaire, CHU Dijon, Dijon, France; Inserm UMR 1231, université de Bourgogne, Dijon, France
| | - J Cottenet
- Departement de biostatistique, CHU Bocage, Université de Bourgogne, Dijon, France
| | - A Sophie Mariet
- Departement de biostatistique, CHU Bocage, Université de Bourgogne, Dijon, France
| | - C Quantin
- Departement de biostatistique, CHU Bocage, Université de Bourgogne, Dijon, France; Inserm, CIC 1432, Centre d'investigation clinique, hôpital de Dijon, université de Bourgogne, Dijon, France; Inserm, UVSQ, Institut Pasteur, université Paris-Saclay, Paris, France
| | - A Bernard
- Service de chirurgie thoracique et cardio-vasculaire, CHU Dijon, Dijon, France.
| | - P B Pagès
- Service de chirurgie thoracique et cardio-vasculaire, CHU Dijon, Dijon, France; Inserm UMR 1231, université de Bourgogne, Dijon, France
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Lacout M, David C, Bernard A, Saint Etienne C, Clerc JM, Quilliet L, Dion F, Caze C. prognostic evaluation of patients benefiting from a trans aortic valve replacement according to the type of aortic stenosis. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.057] [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: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Aortic Stenosis (AS) is a common condition in patients over 75 years. Latest ESC recommendations differentiate 4 types of AS according to: Indexed Stroke Volume (SVi), mean gradient and left ventricular ejection fraction (LVEF). The aim of our study is to evaluate prognosis of patients who have had a transcatheter aortic valve replacement (TAVR), in terms of mortality, according to the 4 types of AS.
Methods
This study compares prognosis of 620 patients who had TAVR between January 1, 2015 and December 31, 2018. Patients were classified into 4 groups according to AS type: high gradient; low gradient, low flow, low LVEF; low gradient, low flow, normal LVEF; low gradient, normal flow.
Results
69 patients (11.1%) died within 12 months of the procedure: 49 in the high gradient group (9.4%); 13 in the low gradient, low flow, low LVEF group (47.1%); 1 in the low gradient, low flow, normal LVEF group (5%); 6 in the low gradient, normal flow, normal LVEF group (18.2%). All-cause mortality at one year follow-up is higher in low-gradient, low-flow, altered LVEF group (p = 0.0004) than in other groups. Patients in this group were significantly more often admitted for heart failure than patients in high-gradient group (p = 0.009).
Conclusion
A complete echocardiography evaluation is needed to evaluate AS, its severity and type. Patients in the low gradient, low flow, low LVEF group have an independent risk of mortality at 12 months higher than other groups and are more hospitalized than patients in the high gradient group.
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Affiliation(s)
- M Lacout
- Hospital Pontchaillou of Rennes, cardiology, Rennes, France
| | - C David
- University Hospital Pasteur of Nice, cardiology, Nice, France
| | - A Bernard
- Regional University Hospital Centre TROUSSEAU - CHAMBRAY, cardiology, Chambray Les Tours, France
| | - C Saint Etienne
- Regional University Hospital Centre TROUSSEAU - CHAMBRAY, cardiology, Chambray Les Tours, France
| | - JM Clerc
- Regional University Hospital Centre TROUSSEAU - CHAMBRAY, cardiology, Chambray Les Tours, France
| | - L Quilliet
- Regional University Hospital Centre TROUSSEAU - CHAMBRAY, cardiology, Chambray Les Tours, France
| | - F Dion
- Regional University Hospital Centre TROUSSEAU - CHAMBRAY, cardiology, Chambray Les Tours, France
| | - C Caze
- Regional University Hospital Centre TROUSSEAU - CHAMBRAY, cardiology, Chambray Les Tours, France
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16
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Marchand L, Luyton C, Bernard A. Glucagon-like peptide-1 (GLP-1) receptor agonists in type 2 diabetes and long-term complications: FOCUS on retinopathy. Diabet Med 2021; 38:e14390. [PMID: 32799379 DOI: 10.1111/dme.14390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/16/2020] [Accepted: 08/12/2020] [Indexed: 01/22/2023]
Affiliation(s)
- L Marchand
- Department of Endocrinology and Diabetes, Centre Hospitalier Saint Joseph Saint Luc, Lyon
| | - C Luyton
- Department of Endocrinology and Diabetes, Centre Hospitalier Saint Joseph Saint Luc, Lyon
| | - A Bernard
- Department of Ophthalmology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite
- Department of Ophthalmology, Centre Hospitalier Saint Joseph Saint Luc, Lyon, France
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17
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Bernard A, Leclercq T, Béjot Y, Duloquin G, Comby P, Ricolfi F, Guenancia C. High rate of cardiac thrombus diagnosed by adding cardiac imaging in acute stroke CT protocol. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.196] [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: 10/22/2022]
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18
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Quignon P, da Mata P, Faraj F, Guibert S, Bernard A, Léonardi J, Loundou AD, Vitte J, Charpin D. Altitude healing effect in severe asthmatic children. Respir Med Res 2020; 79:100810. [PMID: 33540154 DOI: 10.1016/j.resmer.2020.100810] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/25/2020] [Accepted: 12/12/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The beneficial effect of a climatic treatment in children with asthma was established quite some time ago, but the mechanism of this beneficial effect has not been fully elucidated. We investigated the role of the cytokines of the TH2 pathway, reactive oxygen species (ROS) and reactive nitrogen species (RNS) over the course of a high-altitude climatic therapy. METHODS A group of 67 children originating from various French towns suffering from uncontrolled severe asthma was sent via their medical specialists, to the Briançon climatic area. They were monitored over the course of an entire school year. During this time, they returned home for 15 days during the Christmas holidays. At each stage, assessment of asthma control, lung function examination (peak flow meter and spirometry), and measurement of exhaled NO, ROS and RNS in exhaled breath condensate (EBC), and the level of cytokines in the plasma of the TH2 pathway were carried out. RESULTS The degree of asthma control improved at high altitude and worsened upon returning home. The average value of the peak expiratory flow also improved during the first 3 months but then worsened upon returning home, while the other spirometric parameters did not change. The level of expired NO and the scores for quality of life underwent a similar change. The level of RNS and ROS in the EBC did not change significantly. Besides, a marked and statistically significant decrease in the level of IL-13 and IL-10 was noted. CONCLUSION The beneficial effect of a climatic stay of children suffering from allergic asthma at altitude appears to be linked with less allergenic stimulation.
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Affiliation(s)
- P Quignon
- CEMBREU, 35, rue Croix de Bretagne, 05100 Briançon, France.
| | - P da Mata
- Instituto Clínico de Alergologia, avenue de Berna No. 30, 4(e) B 1050-042, Lisbon, Portugal.
| | - F Faraj
- Centre Les Jeunes Pousses, 34 A, avenue de la République, 05100 Briançon, France
| | - S Guibert
- Centre Les Hirondelles, 17, rue Maisonnette, 05100 Villar-Saint-Pancrace, France
| | - A Bernard
- Centre La Guisane, rue de la Croix de Bretagne, 05100 Villar-Saint-Pancrace, France
| | - J Léonardi
- Centre La Guisane, rue de la Croix de Bretagne, 05100 Villar-Saint-Pancrace, France
| | - A D Loundou
- Department of Medical Statistics, Aix Marseille University, 27, boulevard Jean-Moulin, 13005 Marseille, France.
| | - J Vitte
- Aix-Marseille University IRD, AP-HM, MEPHI, Immunology Department, 19-21, boulevard Jean-Moulin, 13005 Marseille, France.
| | - D Charpin
- Pulmonology Unit, La Timone Hospital, Aix Marseille University, 264, rue Saint-Pierre, Marseille, France.
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19
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Lantelme P, Bisson A, Lacour T, Herbert J, Ivanes F, Bourguignon T, Quilliet L, Angoulvant D, Harbaoui B, Bonnet M, Bernard A, Babuty D, Saint-Etienne C, Deharo P, Fauchier L. Impact of the timing of coronary revascularization relative to the transcatheter aortic valve implantation procedure: insights from a propensity score analysis based on a nationwide analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2621] [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: 11/14/2022] Open
Abstract
Abstract
Background
The significance and the management of coronary artery disease (CAD) are disputed in patients treated by transcatheter aortic valve implantation (TAVI). In the presence of a significant CAD eligible for percutaneous coronary intervention (PCI), the issue of the timing of PCI relative to TAVI is unsettled. To answer this question, the present study aimed at comparing the short-term and long-term outcome in patients treated by staged PCI within a 90-day time interval before or after TAVI.
Methods
Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients treated with TAVI between 2014 and 2018. Patients treated with PCI in the preceding 90 days before the TAVI procedure (pre-TAVI PCI) or subsequent 90 days after the TAVI procedure (post-TAVI PCI) were included. All-cause mortality, cardiovascular mortality, stroke, myocardial infarction and a combined cardiovascular endpoint were assessed at 30 days after the last procedure (short-term) and during the whole follow-up (long-term). Propensity score matching was used for the analysis of outcomes.
Results
8613 patients met the inclusion criteria with a vast majority of pre-TAVI PCI patients (N=8324) as opposed to post-TAVI PCI (N=229). After propensity score matching, 2 groups of 227 patients with comparable characteristics were obtained. At 30 days, no significant difference was observed for any of the outcome tested with the exception of myocardial infarction more frequent in post-TAVI PCI (OR 2.43 [1.17–5.07]). After a mean [SD] follow-up of 459 [569] days, all outcomes were identical between subgroups. The figure below illustrates the Kaplan Meier curve for all-cause mortality.
Conclusions
Our study based on a French nationwide database shows that PCI is performed pre-TAVI in a majority of cases, with no significant impact on outcome. Deferring PCI after TAVI seems safe and may provide an opportunity to make the decision on more objective parameters while the stenosis has been removed (such as FFR or IFR). In any case, the timing of PCI relative to TAVI does not seem to represent a concern and should be decided on an individual basis.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Lantelme
- Croix-Rousse Hospital - HCL, Lyon, France
| | - A Bisson
- University Hospital of Tours, Cardiology, Tours, France
| | - T Lacour
- University Hospital of Tours, Cardiology, Tours, France
| | - J Herbert
- University Hospital of Tours, Cardiology, Tours, France
| | - F Ivanes
- University Hospital of Tours, Cardiology, Tours, France
| | - T Bourguignon
- University Hospital of Tours, Cardiology, Tours, France
| | - L Quilliet
- University Hospital of Tours, Cardiology, Tours, France
| | - D Angoulvant
- University Hospital of Tours, Cardiology, Tours, France
| | - B Harbaoui
- Croix-Rousse Hospital - HCL, Lyon, France
| | - M Bonnet
- Croix-Rousse Hospital - HCL, Lyon, France
| | - A Bernard
- University Hospital of Tours, Cardiology, Tours, France
| | - D Babuty
- University Hospital of Tours, Cardiology, Tours, France
| | | | - P Deharo
- Hospital La Timone of Marseille, Cardiology, Marseille, France
| | - L Fauchier
- University Hospital of Tours, Cardiology, Tours, France
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20
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Fauchier L, Bisson A, Deharo P, Bodin A, Herbert J, Lacour T, Quilliet L, Ivanes F, Clerc J, Saint Etienne C, Bourguignon T, Babuty D, Bernard A. Development of a claims-based EuroSCORE II in patients with aortic stenosis needing surgical or transcatheter aortic valve replacement using electronic hospital records: a nationwide study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2612] [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: 11/12/2022] Open
Abstract
Abstract
Background
Prediction of operative risk in patients with aortic stenosis (AS) undergoing surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) remains a challenge, particularly in high-risk patients. The EuroSCORE II is now commonly used to improve risk prediction. Large analyses from administrative database have provided opportunities for conducting health research in the field of structural heart disease interventions but may have a lack of granularity and do not routinely include EuroSCORE II, which may result in a risk of uncontrolled biases. We sought to approximate the EuroSCORE II using only administrative claims data to enable the operative risk to be assessed without clinical or paraclinical performance measures.
Methods
Based on the administrative hospital-discharge database, we collected information for all patients with AS treated with SAVR or TAVI between 2010 and 2019 in France. A total of 78,085 SAVR and 60,821 patients with AS treated with transcatheter aortic valve replacement (TAVR) were found in the database. For each patient, the EuroSCORE II was estimated using the formulas available at the EuroSCORE website. Age, gender, extracardiac arteriopathy, poor mobility, previous cardiac surgery, chronic lung disease, active endocarditis, diabetes on insulin, recent MI, dialysis are items available in the PMSI database using the ICD-10 or CCAM codes. For renal impairment, NYHA class, LVEF, pulmonary hypertension, “critical preoperative state” and urgent intervention, different proxies were built based on ICD-10 codes likely to represent increasing severity of these items.
Results
In the cohort of patients with SAVR, mean estimated EuroSCORE II was 3.3±1.1 while all-cause death at day 30 after SAVR was 3.8%. In the cohort of patients with TAVI, mean estimated EuroSCORE II was 3.8±1.0 while all-cause death at day 30 after TAVI was 5.5%. In the whole cohort, the area under the curve (AUC) of the estimated EuroSCORE II for predicting the risk of all-cause death at day 30 was 0.72 (95% CI 0.71–0.73) and was higher in patients treated with SAVR (AUC 0.76, 95% CI 0.75–0.77) than in those treated with TAVI (AUC 0.67, 95% CI 0.65–0.68, p<0.00001 for DeLong test). The observed versus predicted risks of all-cause death at day 30 post-TAVI OR SAVR within risk deciles are shown in Figure 1. Calibration of the prediction score was satisfying across the 10 deciles and a predicted 30-day mortality rate of approximately 15%.
Conclusions
Claims data alone can be used to identify individuals with AS at operative risk when they are considered for SAVR or TAVI. The Claims-based EuroSCORE II might be used in research with large datasets for confounding adjustment or risk prediction. It provides hospitals and health systems with a low-cost, systematic way to identify a group of patients who are at greater risk of adverse outcomes with these interventions and for whom a more specific approach might be useful.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- L Fauchier
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bisson
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - P Deharo
- APHM La Timone Hospital, Marseille, France
| | - A Bodin
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - J Herbert
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - T Lacour
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - L Quilliet
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - F Ivanes
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - J.M Clerc
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - C Saint Etienne
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - T Bourguignon
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - D Babuty
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bernard
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
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21
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Nguyen PT, Boral LI, O’Brien J, Zhang D, Gao Y, Bernard A. Reducing Inappropriate Overutilization of the Massive Transfusion Protocol. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction/Objective
Massive transfusion protocols (MTPs) make it possible to deliver blood products to exsanguinating patients in an efficient, sustained, and immediate manner. However, overutilization of MTPs continues to remain a significant problem for hospital blood banks. The study aims to address the characteristics of possibly inappropriate MTP activations during the first phase (cooler) at a level 1 trauma academic medical center.
Methods
This was a retrospective review of 328 phase 1 MTPs out of 696 total MTPs performed during a two-year period (Jan 1, 2017 and Dec 31, 2018) and divided into three categories: trauma, non-trauma surgery, and medicine services. We assumed that a possibly inappropriate MTP for trauma cases would show an Assessment of Blood Component (ABC) score of 1 or less and physicians used clinical discretion. For possibly inappropriate MTP non- trauma surgical and medicine cases, we devised a new system where we looked at only whether the blood pressure was equal to or less than 90 mm Hg and/or the pulse was greater than or equal to 120 beats per minute. If there was a score of 0 where there were neither vital sign criteria, then the MTP was considered possibly inappropriate.
Results
For trauma service, there were 43/168 (25.6%) cases that had an ABC score of 0, 49/168 (29.2%) cases that had an ABC score of 1, 53/168 (31.5%) cases that had an ABC score of 2, 21/168 (12.5%) cases that had an ABC score of 3, and only 2/168 (1.2%) case that had an ABC score of 4. Non-trauma surgery service had 31/51 (60.8%) cases with a new score of 0, 20/51 (39.2%) cases with a new score of 1, and 0/51 (0%) cases with a new score of 2. Medicine services had 57/109 (52.3%) patients with a new score of 0, 47/109 (43.1%) patients with a new score of 1, and 5/109 (4.6%) patients with a new score of 2. Non-trauma surgery service had the greatest possibly inappropriate MTP activations [31/51 cases (60.8%)], followed by trauma [92/168 (54.8%) cases] and medicine [57/109 (52.3%) cases].
Conclusion
Our study shows greater overutilization with MTPs using clinical judgment than with using the ABC criteria. Non-trauma surgery service had the greatest number of possibly inappropriate MTP activations at our hospital without having a significantly abnormal pulse or blood pressure. While ABC criteria is already liberal for activating an MTP, physician discretion appears to be more liberal in activating a possibly inappropriate MTP.
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Affiliation(s)
- P T Nguyen
- Pathology and Laboratory Medicine, University of Kentucky Healthcare, Lexington, Kentucky, UNITED STATES
| | - L I Boral
- Pathology and Laboratory Medicine, University of Kentucky Healthcare, Lexington, Kentucky, UNITED STATES
| | - J O’Brien
- Pathology and Laboratory Medicine, University of Kentucky Healthcare, Lexington, Kentucky, UNITED STATES
| | - D Zhang
- Pathology and Laboratory Medicine, University of Kentucky Healthcare, Lexington, Kentucky, UNITED STATES
| | - Y Gao
- Pathology and Laboratory Medicine, University of Kentucky Healthcare, Lexington, Kentucky, UNITED STATES
| | - A Bernard
- Pathology and Laboratory Medicine, University of Kentucky Healthcare, Lexington, Kentucky, UNITED STATES
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22
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Heren-Le Bastard C, Bernard A, Fliss R, Legouvello S, Allain P. [Psychometric validation of an Assessment Questionnaire on the Perception of and Adaptation to Visual Handicap in Adults (QUEPAHVA). French translation of the article]. J Fr Ophtalmol 2020; 44:S0181-5512(20)30447-2. [PMID: 34756385 DOI: 10.1016/j.jfo.2020.01.036] [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: 12/05/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE Handicap evaluation in adults with acquired or progressive congenital visual loss allows for identification of the individual's specific needs and targeted therapy (medical, technical, rehabilitative and psychological). Currently, the subjective dimension of the handicap remains poorly explored in the field of visual loss. Our questionnaire aims to understand the whole of these subjective impacts. It differs from existing quality of life scales in ophthalmology in its approach centered on the process of adaptation, individual resources (technical, cognitive, psychic and environmental), and investigation of the perception of the handicap. The goal of the present study is to validate this questionnaire, which could be used in any adult with a visual handicap, regardless of the extent of the visual loss, its etiology, or the type of treatment or compensatory mechanisms. MATERIALS AND METHODS The Assessment Questionnaire on the Perception of and Adaptation to Visual Handicap in Adults (QUEPAHVA) is composed of 28 items relating to perception of the visual impairment, its impact, and adaptive resources. They are divided into 3 sub-categories: perception of daily life and relationships (10 items), Perception of visual status and compensatory mechanisms (8 items), and Psychological impact of the visual handicap (10 items). The responses are graded on a Likert scale. Factor analysis and verification of psychometric qualities were performed based on the responses of 446 subjects. The discriminatory validity of the NEI-VFQ 25 was proven with 99 subjects. Reliability over time (mean interval between T1 and T2=49.43 days) was measured in 31 subjects. Sensitivity to change between pre- and post-management (mean interval between T1 and T2=410 days) was tested in 123 subjects. RESULTS Internal consistency was very good for the global scale (α=.90) as well as for the 3 sub-dimensions (α=.86; α=.79; α=.80). The discriminatory validity was satisfactory (r=.70). This result had to be interpreted as a function of the qualitative specificity of the questionnaire. The questionnaire enjoyed good reproducibility over time with regard to its total score and relatively satisfactory reproducibility with regard to its sub-dimensions. Sensitivity to change was very high and accounted for adaptations to the disability over time. CONCLUSION The QUEPAHVA displays good psychometric qualities. It constitutes a new means of evaluation. Its potential applications are many. It permits evaluation of the needs of the individual and adaptation of the protocol of care. Its use in institutions may support a step forward in the science of evaluation and continued improvement in quality of care.
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Affiliation(s)
- C Heren-Le Bastard
- Centre régional basse vision et troubles de l'audition, 4, rue de l'Abbé-Frémond, 49100 Angers, France; Laboratoire de psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, Maison de la recherche Germaine Tillion, université Angers, université Nantes, 5, bis boulevard Lavoisier, 49045 Angers cedex 01, France.
| | - A Bernard
- Équipe BePsyLab, université d'Angers, 5, bis boulevard Lavoisier, 49045 Angers cedex 01, France
| | - R Fliss
- Département de neurologie, CHU Angers, 49033 Angers, France; Centre de réadaptation Les Capucins, 49100 Angers, France
| | - S Legouvello
- Centre régional basse vision et troubles de l'audition, 4, rue de l'Abbé-Frémond, 49100 Angers, France
| | - P Allain
- Laboratoire de psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, Maison de la recherche Germaine Tillion, université Angers, université Nantes, 5, bis boulevard Lavoisier, 49045 Angers cedex 01, France; Département de neurologie, CHU Angers, 49033 Angers, France
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23
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Heren-Le Bastard C, Bernard A, Fliss R, Legouvello S, Allain P. Psychometric validation of an Assessment Questionnaire on the Perception of and Adaptation to Visual Handicap in Adults (QUEPAHVA). J Fr Ophtalmol 2020; 43:e341-e350. [PMID: 33020020 DOI: 10.1016/j.jfo.2020.09.001] [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] [Indexed: 10/23/2022]
Abstract
PURPOSE Handicap evaluation in adults with acquired or progressive congenital visual loss allows for identification of the individual's specific needs and targeted therapy (medical, technical, rehabilitative and psychological). Currently, the subjective dimension of the handicap remains poorly explored in the field of visual loss. Our questionnaire aims to understand the whole of these subjective impacts. It differs from existing quality of life scales in ophthalmology in its approach centered on the process of adaptation, individual resources (technical, cognitive, psychic and environmental), and investigation of the perception of the handicap. The goal of the present study is to validate this questionnaire, which could be used in any adult with a visual handicap, regardless of the extent of the visual loss, its etiology, or the type of treatment or compensatory mechanisms. MATERIALS AND METHODS The Assessment Questionnaire on the Perception of and Adaptation to Visual Handicap in Adults (QUEPAHVA) is composed of 28 items relating to perception of the visual impairment, its impact, and adaptive resources. They are divided into 3 sub-categories: Perception of daily life and relationships (10 items), Perception of visual status and compensatory mechanisms (8 items), and Psychological impact of the visual handicap (10 items). The responses are graded on a Likert scale. Factor analysis and verification of psychometric qualities were performed based on the responses of 446 subjects. The discriminatory validity of the NEI-VFQ 25 was proven with 99 subjects. Reliability over time (mean interval between T1 and T2=49.43 days) was measured in 31 subjects. Sensitivity to change between pre- and post-management (mean interval between T1 and T2=410 days) was tested in 123 subjects. RESULTS Internal consistency was very good for the global scale (α=.90) as well as for the 3 sub-dimensions (α=.86; α=.79; α=.80). The discriminatory validity was satisfactory (r=.70). This result had to be interpreted as a function of the qualitative specificity of the questionnaire. The questionnaire enjoyed good reproducibility over time with regard to its total score and relatively satisfactory reproducibility with regard to its sub-dimensions. Sensitivity to change was very high and accounted for adaptations to the disability over time. CONCLUSION The QUEPAHVA displays good psychometric qualities. It constitutes a new means of evaluation. Its potential applications are many. It permits evaluation of the needs of the individual and adaptation of the protocol of care. Its use in institutions may support a step forward in the science of evaluation and continued improvement in quality of care.
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Affiliation(s)
- C Heren-Le Bastard
- Centre Régional Basse Vision et Troubles de l'Audition, 4, rue de l'Abbé-Frémond, 49100 Angers, France; Laboratoire de Psychologie des Pays-de-la-Loire, LPPL EA 4638, SFR Confluences, UNIV Angers, UNIV Nantes, Maison de la recherche Germaine Tillion, 5 bis Boulevard Lavoisier, 49045 Angers cedex 01, France.
| | - A Bernard
- Équipe BePsyLab, Université d'Angers, 5 bis, Boulevard Lavoisier, 49045 Angers cedex 01, France
| | - R Fliss
- Département de Neurologie, CHU Angers, 49033 Angers, France; Centre de réadaptation Les Capucins, 49100 Angers, France
| | - S Legouvello
- Centre Régional Basse Vision et Troubles de l'Audition, 4, rue de l'Abbé-Frémond, 49100 Angers, France
| | - P Allain
- Laboratoire de Psychologie des Pays-de-la-Loire, LPPL EA 4638, SFR Confluences, UNIV Angers, UNIV Nantes, Maison de la recherche Germaine Tillion, 5 bis Boulevard Lavoisier, 49045 Angers cedex 01, France; Département de Neurologie, CHU Angers, 49033 Angers, France
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Abstract
Gout is a chronic disease due to the deposition of monosodium urate microcrystals in joints and tissues. Its incidence and prevalence are increasing worldwide in close relation with the epidemic of obesity and metabolic syndrome. Gout is related to chronic hyperuricemia that should be treated to ensure the reduction or even the disappearance of acute attacks ("gout flares") and to reduce the size and number of tophi. If arthritis of the first metatarsophalangeal joint is the most typical form, other joints may be affected, including the spine. Demonstration of urate microcrystals arthritis allows diagnosis of gout but, in the absence of possibility of performing joint puncture, imaging may be useful for providing complementary diagnostic elements. Appropriate care is essential to reduce the number of flares and the evolution towards gouty arthropathy but also in terms of public health in order to reduce costs related to this pathology.
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Affiliation(s)
- A Scuiller
- Service de médecine interne et polyvalente, centre hospitalier de Polynésie française, 98714 Pirae, Tahiti
| | - T Pascart
- Service de rhumatologie, hôpital Saint-Philibert, université de Lille, 59462 Lomme cedex, France
| | - A Bernard
- Service de médecine interne et polyvalente, centre hospitalier de Polynésie française, 98714 Pirae, Tahiti
| | - E Oehler
- Service de médecine interne et polyvalente, centre hospitalier de Polynésie française, 98714 Pirae, Tahiti.
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25
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Fauchier L, Bisson A, Herbert J, Lacour T, Bourguignon T, Etienne CS, Bernard A, Deharo P, Bernard L, Babuty D. Incidence and outcomes of infective endocarditis after transcatheter aortic valve implantation versus surgical aortic valve replacement. Clin Microbiol Infect 2020; 26:1368-1374. [PMID: 32036047 DOI: 10.1016/j.cmi.2020.01.036] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 10/22/2019] [Revised: 01/26/2020] [Accepted: 01/30/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (AVR) in aortic stenosis (AS). Infective endocarditis (IE) in patients with prosthetic heart valves is associated with significant morbidity and mortality. Data on the incidence, risk factors, and outcomes of IE after TAVI are conflicting. We evaluated these issues in patients with percutaneous TAVI vs. isolated surgical AVR (SAVR) at a nationwide level. METHODS Based on the administrative hospital discharge database, the study collected information for all patients with aortic stenosis treated with AVR in France between 2010 and 2018. RESULTS A total of 47 553 patients undergoing TAVI and 60 253 patients undergoing isolated SAVR were identified. During a mean follow-up of 2.0 years (median (25th to 75th percentile) 1.2 (0.1-3.4) years), the incidence rates of IE were 1.89 (95% confidence interval (CI) 1.78-2.00) and 1.40 (95% CI 1.34-1.46) events per 100 person-years in unmatched TAVI and SAVR patients, respectively. In 32 582 propensity-matched patients (16 291 with TAVI and 16 291 with SAVR), risk of IE was not different in patients treated with TAVI vs. SAVR (incidence rates of IE 1.86 (95% CI 1.70-2.04) %/year vs 1.71 (95% CI 1.58-1.85) %/year respectively, relative risk (RR) 1.09, 95% CI 0.96-1.23). In these matched patients, total mortality was higher in TAVI patients with IE (43.0% 95% CI 37.3-49.3) than in SAVR patients with IE (32.8% 95% CI 28.6-37.3; RR 1.32, 95% CI 1.08-1.60). DISCUSSION In a nationwide cohort of patients with AS, treatment with TAVI was associated with a risk of IE similar to that following SAVR. Mortality was higher for patients with IE following TAVI than for those with IE following SAVR.
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Affiliation(s)
- L Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA7505, Université de Tours, France.
| | - A Bisson
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA7505, Université de Tours, France
| | - J Herbert
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA7505, Université de Tours, France; Service d'information Médicale, d'épidémiologie et d'économie de la santé, Centre Hospitalier Universitaire et Faculté de Médecine, EA7505, Université de Tours, France
| | - T Lacour
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA7505, Université de Tours, France
| | - T Bourguignon
- Service de Chirurgie Cardiaque, Centre Hospitalier Universitaire et Faculté de Médecine, Université de Tours, France
| | - C Saint Etienne
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA7505, Université de Tours, France
| | - A Bernard
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA7505, Université de Tours, France
| | - P Deharo
- Département de Cardiologie, Centre Hospitalier Universitaire Timone, Inserm, Inra, C2VN, France et Faculté de Médecine, Université Aix-Marseille, Marseille, France
| | - L Bernard
- Service de Médecine interne et Maladies Infectieuses, Centre Hospitalier Universitaire et Faculté de Médecine, Université de Tours, France
| | - D Babuty
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA7505, Université de Tours, France
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Ramayo‐Caldas Y, Zingaretti L, Popova M, Estellé J, Bernard A, Pons N, Bellot P, Mach N, Rau A, Roume H, Perez‐Enciso M, Faverdin P, Edouard N, Ehrlich D, Morgavi DP, Renand G. Identification of rumen microbial biomarkers linked to methane emission in Holstein dairy cows. J Anim Breed Genet 2020; 137:49-59. [PMID: 31418488 PMCID: PMC6972549 DOI: 10.1111/jbg.12427] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [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] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/12/2019] [Accepted: 07/13/2019] [Indexed: 12/29/2022]
Abstract
Mitigation of greenhouse gas emissions is relevant for reducing the environmental impact of ruminant production. In this study, the rumen microbiome from Holstein cows was characterized through a combination of 16S rRNA gene and shotgun metagenomic sequencing. Methane production (CH4 ) and dry matter intake (DMI) were individually measured over 4-6 weeks to calculate the CH4 yield (CH4 y = CH4 /DMI) per cow. We implemented a combination of clustering, multivariate and mixed model analyses to identify a set of operational taxonomic unit (OTU) jointly associated with CH4 y and the structure of ruminal microbial communities. Three ruminotype clusters (R1, R2 and R3) were identified, and R2 was associated with higher CH4 y. The taxonomic composition on R2 had lower abundance of Succinivibrionaceae and Methanosphaera, and higher abundance of Ruminococcaceae, Christensenellaceae and Lachnospiraceae. Metagenomic data confirmed the lower abundance of Succinivibrionaceae and Methanosphaera in R2 and identified genera (Fibrobacter and unclassified Bacteroidales) not highlighted by metataxonomic analysis. In addition, the functional metagenomic analysis revealed that samples classified in cluster R2 were overrepresented by genes coding for KEGG modules associated with methanogenesis, including a significant relative abundance of the methyl-coenzyme M reductase enzyme. Based on the cluster assignment, we applied a sparse partial least-squares discriminant analysis at the taxonomic and functional levels. In addition, we implemented a sPLS regression model using the phenotypic variation of CH4 y. By combining these two approaches, we identified 86 discriminant bacterial OTUs, notably including families linked to CH4 emission such as Succinivibrionaceae, Ruminococcaceae, Christensenellaceae, Lachnospiraceae and Rikenellaceae. These selected OTUs explained 24% of the CH4 y phenotypic variance, whereas the host genome contribution was ~14%. In summary, we identified rumen microbial biomarkers associated with the methane production of dairy cows; these biomarkers could be used for targeted methane-reduction selection programmes in the dairy cattle industry provided they are heritable.
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Affiliation(s)
- Yuliaxis Ramayo‐Caldas
- UMR 1313 GABIINRA, AgroParisTech, Université Paris‐SaclayJouy‐en‐JosasFrance
- Animal Breeding and Genetics ProgramIRTA Torre MarimonCaldes de MontbuiSpain
| | | | - Milka Popova
- VetAgro Sup, UMR 1213 HerbivoresINRA, Université Clermont AuvergneSaint‐Genès‐ChampanelleFrance
| | - Jordi Estellé
- UMR 1313 GABIINRA, AgroParisTech, Université Paris‐SaclayJouy‐en‐JosasFrance
| | - Aurelien Bernard
- VetAgro Sup, UMR 1213 HerbivoresINRA, Université Clermont AuvergneSaint‐Genès‐ChampanelleFrance
| | | | - Pau Bellot
- Department of Animal Genetics, CRAGUABBellaterraSpain
| | - Núria Mach
- UMR 1313 GABIINRA, AgroParisTech, Université Paris‐SaclayJouy‐en‐JosasFrance
| | - Andrea Rau
- UMR 1313 GABIINRA, AgroParisTech, Université Paris‐SaclayJouy‐en‐JosasFrance
| | - Hugo Roume
- INRA METAGENOPOLIS UnitJouy‐en‐JosasFrance
| | | | | | | | | | - Diego P. Morgavi
- VetAgro Sup, UMR 1213 HerbivoresINRA, Université Clermont AuvergneSaint‐Genès‐ChampanelleFrance
| | - Gilles Renand
- UMR 1313 GABIINRA, AgroParisTech, Université Paris‐SaclayJouy‐en‐JosasFrance
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Bernard C, Morgant M, Jazayeri A, Bernard A, Bouchot O. Optimal timing of coronary artery bypass grafting in hemodynamically stable patients after myocardial infarction and definition of poor prognostic factors. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.376] [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]
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28
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Fauchier L, Bernard A, Bisson A, Lacour T, Herbert J, Ivanes F, Bourguignon T, Clerc JM, Quilliet L, Guillon Grammatico L, Angoulvant D, Saint Etienne C, Babuty D. 4070Clinical impact of mitral regurgitation before or following transcatheter aortic valve replacement in patients with aortic stenosis: a nationwide multivariable analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0094] [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
Patients undergoing transcatheter aortic valve replacement (TAVR) may have concomitant mitral regurgitation (MR). The impact of MR at baseline or after TAVR on subsequent prognosis remains to be more precisely determined. We analysed the impact of MR before or after TAVR on prognosis in the systematic analysis of patients treated with TAVR at a nationwide level.
Methods
Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients with aortic stenosis treated with transfemoral TAVR in France between 2008 and 2018. Cox regression was used for the analysis of predictors of events during follow-up.
Results
A total of 47,872 patients with transfemoral TAVR were included in the analysis (mean age 83±7 years). Moderate/severe MR was present at baseline (MRb) in 9.5% of the patients. Few patients (1.6%) revealed moderate/severe MR post-TAVR (MRpt). Mean follow-up was 1.31±1.61 years. MRb was associated with an increased cardiovascular mortality (Hazard ratio 1.29, 95% CI 1.20–1.39) and total mortality (Hazard ratio 1.15, 95% CI 1.10–1.21). However, MRb was not an independent predictor in multivariable analysis, neither for cardiovascular mortality (adjusted HR 1.06, 95% CI 0.98–1.14) nor for total mortality (adjusted HR 1.01, 95% CI 0.96–1.07). MRpt was not a predictor of cardiovascular or total mortality. Older age, male sex, history of pulmonary edema/cardiogenic shock, atrial fibrillation, myocardial infarction, diabetes, renal failure, liver disease, pulmonary disease, previous cancer and anemia at baseline independently predicted mortality during follow-up. All of them (but history of cancer) were also independent predictor of cardiovascular death.
Conclusion
Baseline MR was associated with increased cardiovascular and totality mortality following TAVR but was not an independent predictor of any of them. By contrast, several other predictors of cardiovascular and total mortality were identified. This suggests that MR should not be directly considered to establish the strategy for TAVR decision or for avoiding TAVR-related futility.
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Affiliation(s)
- L Fauchier
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bernard
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bisson
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - T Lacour
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - J Herbert
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - F Ivanes
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - T Bourguignon
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - J M Clerc
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - L Quilliet
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | | | - D Angoulvant
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - C Saint Etienne
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - D Babuty
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
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Fauchier L, Bisson A, Herbert J, Lacour T, Ivanes F, Bourguignon T, Clerc JM, Quilliet L, Lantelme P, Angoulvant D, Babuty D, Guillon Grammatico L, Bernard A, Saint Etienne C. P1794Futility risk model development and validation among patients with aortic stenosis treated with transcatheter aortic valve replacement. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0546] [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
Risk-benefit assessment for transcatheter aortic valve replacement (TAVR) is still a matter of debate. A sizeable group of patients do not fully benefit from intervention despite a technically successful procedure. We therefore sought to identify patients with a bad outcome early after the procedure, and to develop a prediction model and calculator for identification of these patients.
Methods
Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients with aortic stenosis treated with transfemoral TAVR in France between 2008 and 2018. Multivariate logistic regression was used to select the risk factors of early all-cause death in first year after TAVR procedure (considered as futility) for the overall population. Score points were assigned to each risk factor using the β coefficient. Internal validation was performed by a bootstrap method. Calibration was assessed with the Hosmer-Lemeshow goodness of fit test and accuracy with the C-statistic.
Results
A total of 47,872 patients with transfemoral TAVR were included in the analysis (mean age 83±7 years). Mean follow-up was 1.31±1.61 years and 9,338 deaths were recorded (yearly rate 14.9%), among which 4,562 (49%) occurred in first year after TAVR procedure. The final logistic regression model included older age, male sex, history of hospital stay with heart failure, history of acute pulmonary oedema, atrial fibrillation, previous stroke, vascular disease, diabetes, renal disease, liver disease, pulmonary disease, anemia, history of cancer, metastasis and denutrition,. The area under the curve (AUC) for the score was 0.696 (95% CI 0.688–0.704). This score outperformed frailty index and Charlson comorbidity index for identifying futility. AUC was 0.677 (95% CI 0.669–0.86) for internal validation. The Hosmer–Lemeshow goodness of fit test had a p-value of 0.10 suggesting that the model was accurate. We further divided the model into 4 groups with 5%, 12%, 19% and 30% futility, respectively. The low-risk group consisted of 60% of the patients and the high-risk group consisted of 4% of these patients.
Conclusion
This futility prediction score established from a large nationwide cohort of patients treated with TAVR may provide a relevant insight for optimizing healthcare decision. It may facilitate identification of patients who, despite an apparently successful procedure, have risk of death that may outweigh the benefit of an anticipated TAVR.
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Affiliation(s)
- L Fauchier
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bisson
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - J Herbert
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - T Lacour
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - F Ivanes
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - T Bourguignon
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - J M Clerc
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - L Quilliet
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - P Lantelme
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - D Angoulvant
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - D Babuty
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | | | - A Bernard
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - C Saint Etienne
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
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Trada Y, Law P, Bernard A, Foote M, Barbour A, Lambie D, Smithers M, Burmeister B, Pinkham M. FDG-PET Response Assessment in Patients with Locally Advanced Nodal Melanoma Undergoing High-Dose Neo-Adjuvant or Definitive Radiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2489] [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: 10/26/2022]
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31
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David C, Lacout M, Caze C, Saint Etienne C, Clerc J, Quilliet L, Ivanes F, Bernard A. Transaortic valvular replacement prognosis according to aortic stenosis category. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.04.016] [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: 11/25/2022]
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32
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Achour S, Iken I, Abidi K, Dumont X, Messouak O, Belhcen F, Bernard A. Dépistage du saturnisme chez une famille travaillant dans la fabrication artisanale du Khôl. Toxicologie Analytique et Clinique 2019. [DOI: 10.1016/j.toxac.2019.03.063] [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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33
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Waucquier L, Rochepeau C, Bernard A, Burillon C, Kocaba V. [Partial optic nerve avulsion secondary to forced rotation of the ocular globe: A case report]. J Fr Ophtalmol 2019; 42:e117-e120. [PMID: 30833007 DOI: 10.1016/j.jfo.2018.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/22/2018] [Accepted: 06/27/2018] [Indexed: 10/27/2022]
Affiliation(s)
- L Waucquier
- Service d'ophtalmologie, Pavillon C, hôpital Edouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - C Rochepeau
- Service d'ophtalmologie, Pavillon C, hôpital Edouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - A Bernard
- Service d'ophtalmologie, Pavillon C, hôpital Edouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - C Burillon
- Service d'ophtalmologie, Pavillon C, hôpital Edouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France; Université Claude-Bernard Lyon 1, 69100 Villeurbanne, France
| | - V Kocaba
- Service d'ophtalmologie, Pavillon C, hôpital Edouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France; Université Claude-Bernard Lyon 1, 69100 Villeurbanne, France; Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute (SERI), Singapore.
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Bisson A, Bodin A, Clementy N, Bernard A, Pierre B, Babuty D, Lip G, Fauchier L. Thromboembolic and bleeding risk stratification according to the EHRA valvular heart disease classification in patients with atrial fibrillation. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.267] [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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35
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Nicholls LW, Pinkham MB, Bernard A, Lusk R, Watkins T, Hall B, Olson S, Foote MC. Radiological Kinetics of Brain Metastases and Clinical Implications for Patients Treated With Stereotactic Radiosurgery. Clin Oncol (R Coll Radiol) 2018; 31:34-40. [PMID: 30279038 DOI: 10.1016/j.clon.2018.09.005] [Citation(s) in RCA: 2] [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: 04/07/2018] [Revised: 07/03/2018] [Accepted: 08/22/2018] [Indexed: 11/30/2022]
Abstract
AIMS Select patients with brain metastases receive stereotactic radiosurgery (SRS) with the objective of improving survival and intracranial disease control. Brain metastases number and volume are prognostic factors used to inform patient selection. The aim of this study was to assess the rate of change of brain metastases size and number (growth kinetics) between the diagnostic and day of SRS magnetic resonance imaging (MRI) scans. MATERIALS AND METHODS All patients treated with Gamma Knife SRS between October 2015 and April 2017 were included in this single-centre retrospective analysis. Brain metastases number and diameter were recorded at diagnosis and treatment. For patients with multiple brain metastases, the largest lesion was the index lesion. Distant intracranial control and overall survival were reported from the date of SRS. RESULTS In total, 146 patients received 156 episodes of SRS. The median interval between diagnostic and SRS MRI was 20 days (range 1-68). Interval growth in the index lesion of at least 3 mm or the development of a new brain metastasis was noted in 60.2% of patients. This was associated with age less than 60 years (P = 0.001), Eastern Cooperative Oncology Group (ECOG) performance status 2 or above (P = 0.04), non-small cell lung carcinoma (NSCLC) (P = 0.03) or melanoma histologies (P = 0.05) and uncontrolled extracranial disease (P = 0.05). These patients were also more likely to develop distant intracranial recurrence (P = 0.046). Clinically significant growth was not associated with scan interval or differences in overall survival. The Kaplan-Meier estimate of probability of survival at 12 months was 59.3% (95% confidence interval 46.7-75.2%) for all patients. CONCLUSION Intracranial progression between diagnosis and day of SRS is common. Risk factors are uncontrolled extracranial disease, poorer performance status, NSCLC or melanoma histologies and age less than 60 years. These patients would benefit from an MRI closer to treatment to inform patient selection and target delineation for SRS planning.
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Affiliation(s)
- L W Nicholls
- Gamma Knife Centre of Queensland, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia.
| | - M B Pinkham
- Gamma Knife Centre of Queensland, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia
| | - A Bernard
- QFAB Bioinformatics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - R Lusk
- Gamma Knife Centre of Queensland, Princess Alexandra Hospital, Brisbane, Australia
| | - T Watkins
- Gamma Knife Centre of Queensland, Princess Alexandra Hospital, Brisbane, Australia
| | - B Hall
- Gamma Knife Centre of Queensland, Princess Alexandra Hospital, Brisbane, Australia
| | - S Olson
- Gamma Knife Centre of Queensland, Princess Alexandra Hospital, Brisbane, Australia
| | - M C Foote
- Gamma Knife Centre of Queensland, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia
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Von Tokarski F, Lemaignen A, Bernard A, Fauchier L, Bernard L, Halimi J. Insuffisance rénale aiguë au cours de la prise en charge des endocardites infectieuses : incidence, facteurs de risque et pronostic. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.080] [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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37
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Bisson A, Bodin A, Bernard A, Clementy N, Gras M, Andre C, Pierre B, Babuty D, Lip G, Fauchier L. P2899Stroke, thromboembolism and bleeding events in patients with atrial fibrillation according to the new EHRA valvular heart disease classification. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Bisson
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bodin
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bernard
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - N Clementy
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - M Gras
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - C Andre
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - B Pierre
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - D Babuty
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - G Lip
- Birmingham City Hospital, Birmingham, United Kingdom
| | - L Fauchier
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
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Orantin M, Yelnik A, Jousse M, Tlili L, Guillemette M, Bernard A, Quintaine V. Give music therapy a chance in post-stroke rehabilitation. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.1119] [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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39
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Bisson A, Bodin A, Clementy N, Bernard A, Pierre B, Babuty D, Lip G, Fauchier L. P869Stroke, thromboembolism and bleeding events in patients with atrial fibrillation according to the new EHRA valvular heart disease classification. Europace 2018. [DOI: 10.1093/europace/euy015.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Bisson
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bodin
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - N Clementy
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bernard
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - B Pierre
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - D Babuty
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - G Lip
- University of Birmingham, Birmingham, United Kingdom
| | - L Fauchier
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
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Bourgoin-Heck M, Amat F, Trouvé C, Bernard A, Magny JP, Lambert N, Just J. Omalizumab could be effective in children with severe eosinophilic non-allergic asthma. Pediatr Allergy Immunol 2018; 29:90-93. [PMID: 28981968 DOI: 10.1111/pai.12813] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- M Bourgoin-Heck
- Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France.,UPMC Univ Paris 06, Sorbonne Universités, Paris, France.,Equipe EPAR, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR_S1136, INSERM, Paris, France
| | - F Amat
- Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France.,UPMC Univ Paris 06, Sorbonne Universités, Paris, France.,Equipe EPAR, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR_S1136, INSERM, Paris, France
| | - C Trouvé
- Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - A Bernard
- Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - J-P Magny
- Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - N Lambert
- Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France.,UPMC Univ Paris 06, Sorbonne Universités, Paris, France.,Equipe EPAR, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR_S1136, INSERM, Paris, France
| | - J Just
- Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France.,UPMC Univ Paris 06, Sorbonne Universités, Paris, France.,Equipe EPAR, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR_S1136, INSERM, Paris, France
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Brockmann K, Schulte C, Schneiderhan-Marra N, Apel A, Pont-Sunyer C, Vilas D, Ruiz-Martinez J, Langkamp M, Corvol JC, Cormier F, Knorpp T, Joos TO, Bernard A, Gasser T, Marras C, Schüle B, Aasly JO, Foroud T, Marti-Masso JF, Brice A, Tolosa E, Berg D, Maetzler W. Inflammatory profile discriminates clinical subtypes in LRRK2-associated Parkinson's disease. Eur J Neurol 2018; 24:427-e6. [PMID: 28102045 DOI: 10.1111/ene.13223] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/07/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE The presentation of Parkinson's disease patients with mutations in the LRRK2 gene (PDLRRK2 ) is highly variable, suggesting a strong influence of modifying factors. In this context, inflammation is a potential candidate inducing clinical subtypes. METHODS An extensive battery of peripheral inflammatory markers was measured in human serum in a multicentre cohort of 142 PDLRRK2 patients from the MJFF LRRK2 Consortium, stratified by three different subtypes as recently proposed for idiopathic Parkinson's disease: diffuse/malignant, intermediate and mainly pure motor. RESULTS Patients classified as diffuse/malignant presented with the highest levels of the pro-inflammatory proteins interleukin 8 (IL-8), monocyte chemotactic protein 1 (MCP-1) and macrophage inflammatory protein 1-β (MIP-1-β) paralleled by high levels of the neurotrophic protein brain-derived neurotrophic factor (BDNF). It was also possible to distinguish the clinical subtypes based on their inflammatory profile by using discriminant and area under the receiver operating characteristic curve analysis. CONCLUSIONS Inflammation seems to be associated with the presence of a specific clinical subtype in PDLRRK2 that is characterized by a broad and more severely affected spectrum of motor and non-motor symptoms. The pro-inflammatory metabolites IL-8, MCP-1 and MIP-1-β as well as BDNF are interesting candidates to be included in biomarker panels that aim to differentiate subtypes in PDLRRK2 and predict progression.
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Affiliation(s)
- K Brockmann
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - C Schulte
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - N Schneiderhan-Marra
- Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - A Apel
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - C Pont-Sunyer
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clinic de Barcelona, Universitat de Barcelona, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - D Vilas
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clinic de Barcelona, Universitat de Barcelona, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - J Ruiz-Martinez
- Hospital Universitario Donostia, Biodonostia Institut, San Sebastián, Guipuzcoa, Spain
| | | | - J-C Corvol
- Département de Génétique et Cytogénétique, Hôpital de la Pitié Salpêtrière, Sorbonne Universités, INSERM, Paris, France
| | - F Cormier
- Département de Génétique et Cytogénétique, Hôpital de la Pitié Salpêtrière, Sorbonne Universités, INSERM, Paris, France
| | - T Knorpp
- Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - T O Joos
- Natural and Medical Sciences Institute at the University of Tübingen (NMI), Reutlingen, Germany
| | - A Bernard
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - T Gasser
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - C Marras
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - B Schüle
- Parkinson Institute and Clinical Center, Sunnyvale, CA, USA
| | - J O Aasly
- Department of Neurology, St Olavs Hospital, Trondheim, Norway
| | - T Foroud
- Department of Medical and Molecular Genetics, Indiana University, Bloomington, IN, USA
| | - J F Marti-Masso
- Hospital Universitario Donostia, Biodonostia Institut, San Sebastián, Guipuzcoa, Spain
| | - A Brice
- Département de Génétique et Cytogénétique, Hôpital de la Pitié Salpêtrière, Sorbonne Universités, INSERM, Paris, France
| | - E Tolosa
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clinic de Barcelona, Universitat de Barcelona, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - D Berg
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - W Maetzler
- Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
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Samson M, Monnet T, Bernard A, Lacouture P, David L. Analysis of a swimmer's hand and forearm in impulsive start from rest using computational fluid dynamics in unsteady flow conditions. J Biomech 2017; 67:157-165. [PMID: 29269003 DOI: 10.1016/j.jbiomech.2017.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/19/2017] [Accepted: 12/04/2017] [Indexed: 11/25/2022]
Abstract
The propulsive forces generated by the hands and arms of swimmers have so far been determined essentially by quasi-steady approaches. This study aims to quantify the temporal dependence of the hydrodynamic forces for a simple translation movement: an impulsive start from rest. The study, carried out in unsteady numerical simulation, couples the calculation of the lift and the drag on an expert swimmer hand-forearm model with visualizations of the flow and flow vortex structure analysis. The results of these simulations show that the hand and forearm hydrodynamic forces should be studied from an unsteady approach because the quasi-steady model is inadequate. It also appears that the delayed stall effect generates higher circulatory forces during a short translation at high angle of attack than forces calculated under steady state conditions. During this phase the hand force coefficients are approximately twice as large as those of the forearm. The total force coefficients are highest for angles of attack between 40° and 60°. For the same angle of attack, the forces produced when the leading edge is the thumb side are slightly greater than those produced when the leading edge is the little finger side.
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Affiliation(s)
- M Samson
- P' Institute, CNRS-University of Poitiers - ENSMA, UPR 3346, 11 Boulevard Marie et Pierre Curie, Téléport 2, BP 30179, 86962 Futuroscope Cedex, France.
| | - T Monnet
- P' Institute, CNRS-University of Poitiers - ENSMA, UPR 3346, 11 Boulevard Marie et Pierre Curie, Téléport 2, BP 30179, 86962 Futuroscope Cedex, France
| | - A Bernard
- P' Institute, CNRS-University of Poitiers - ENSMA, UPR 3346, 11 Boulevard Marie et Pierre Curie, Téléport 2, BP 30179, 86962 Futuroscope Cedex, France
| | - P Lacouture
- P' Institute, CNRS-University of Poitiers - ENSMA, UPR 3346, 11 Boulevard Marie et Pierre Curie, Téléport 2, BP 30179, 86962 Futuroscope Cedex, France
| | - L David
- P' Institute, CNRS-University of Poitiers - ENSMA, UPR 3346, 11 Boulevard Marie et Pierre Curie, Téléport 2, BP 30179, 86962 Futuroscope Cedex, France
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43
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Samson M, Bernard A, Monnet T, Lacouture P, David L. Unsteady forces on a hand in swimming in impulsive start configuration. Comput Methods Biomech Biomed Engin 2017; 20:187-188. [DOI: 10.1080/10255842.2017.1382925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M. Samson
- Institut Pprime, UPR 3346, CNRS – University of Poitiers – ISAE-ENSMA, France
| | - A. Bernard
- Institut Pprime, UPR 3346, CNRS – University of Poitiers – ISAE-ENSMA, France
| | - T. Monnet
- Institut Pprime, UPR 3346, CNRS – University of Poitiers – ISAE-ENSMA, France
| | - P. Lacouture
- Institut Pprime, UPR 3346, CNRS – University of Poitiers – ISAE-ENSMA, France
| | - L. David
- Institut Pprime, UPR 3346, CNRS – University of Poitiers – ISAE-ENSMA, France
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44
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White K, Scott IA, Bernard A, McCulloch K, Vaux A, Joyce C, Sullivan CM. Patient characteristics, interventions and outcomes of 1151 rapid response team activations in a tertiary hospital: a prospective study. Intern Med J 2017; 46:1398-1406. [PMID: 27600063 DOI: 10.1111/imj.13248] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 06/30/2016] [Revised: 08/23/2016] [Accepted: 08/30/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The characteristics of mature contemporary rapid response systems are unclear. AIM To determine the patient characteristics, processes and outcomes, both in-hospital and post-discharge, of a well-established rapid response system in a tertiary adult hospital. METHODS This is a prospective study of consecutive rapid response team (RRT) activations between 1 July and 25 November 2015. Variables included patient characteristics, timing, location and triggers of RRT activations, interventions undertaken, mortality and readmission status at 28 days post-discharge. RESULTS A total of 1151 RRT activations was analysed (69.1 per 1000 admissions), involving 800 patients, of whom 81.5% were emergency admissions. A total of 351 (30.5%) activations comprised repeat activations for the same patient. Most activations (723; 62.8%) occurred out of hours, and 495 (43%) occurred within 48 h of admission. Hypotension, decreased level of consciousness and oxygen desaturation were the most common triggers. Advanced life support was undertaken in less than 7%; 198 (17.2%) responses led to transfer to higher-level care units. Acute resuscitation plans were noted for only 29.1% of RRT activations, with 80.3% stipulating supportive care only. A total of 103 (12.6%) patients died in hospital, equalling 14 deaths per 100 RRT activations. At 28 days, 150 (18.8%) patients had died, significantly more among those with multiple versus single RRT activations (24.9 vs 16.6%; odds ratio 1.66, 95% confidence interval 1.31-2.44; P = 0.013). CONCLUSION Relatively few RRT activations are associated with acute resuscitation plans, and most interventions during RRT responses are low level. The high rate of post-RRT deaths and transfers to higher-level care units calls for the prospective identification of such patients in targeting appropriate care.
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Affiliation(s)
- K White
- Department of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - I A Scott
- Department of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - A Bernard
- Queensland Facility for Advanced Bioinformatics, Brisbane, Queensland, Australia
| | - K McCulloch
- Division of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - A Vaux
- Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - C Joyce
- Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - C M Sullivan
- Division of Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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45
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Weber AAT, Abi-Rached L, Galtier N, Bernard A, Montoya-Burgos JI, Chenuil A. Positive selection on sperm ion channels in a brooding brittle star: consequence of life-history traits evolution. Mol Ecol 2017; 26:3744-3759. [PMID: 28099777 DOI: 10.1111/mec.14024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/04/2017] [Accepted: 01/09/2017] [Indexed: 01/12/2023]
Abstract
Closely related species are key models to investigate mechanisms leading to reproductive isolation and early stages of diversification, also at the genomic level. The brittle star cryptic species complex Ophioderma longicauda encompasses the sympatric broadcast-spawning species C3 and the internal brooding species C5. Here, we used de novo transcriptome sequencing and assembly in two closely related species displaying contrasting reproductive modes to compare their genetic diversity and to investigate the role of natural selection in reproductive isolation. We reconstructed 20 146 and 22 123 genes for C3 and C5, respectively, and characterized a set of 12 229 orthologs. Genetic diversity was 1.5-2 times higher in C3 compared to C5, confirming that species with low parental investment display higher levels of genetic diversity. Forty-eight genes were the targets of positive diversifying selection during the evolution of the two species. Notably, two genes (NHE and TetraKCNG) are sperm-specific ion channels involved in sperm motility. Ancestral sequence reconstructions show that natural selection targeted the two genes in the brooding species. This may result from an adaptation to the novel environmental conditions surrounding sperm in the brooding species, either directly affecting sperm or via an increase in male/female conflict. This phenomenon could have promoted prezygotic reproductive isolation between C3 and C5. Finally, the sperm receptors to egg chemoattractants differed between C3 and C5 in the ligand-binding region. We propose that mechanisms of species-specific gamete recognition in brittle stars occur during sperm chemotaxis (sperm attraction towards the eggs), contrary to other marine invertebrates where prezygotic barriers to interspecific hybridization typically occur before sperm-egg fusion.
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Affiliation(s)
- A A-T Weber
- Institut Méditerranéen de Biodiversité et d'Ecologie marine et continentale (IMBE) - CNRS - IRD - UAPV, Aix-Marseille Université, Station Marine d'Endoume, Chemin de la Batterie des Lions, 13007, Marseille, France.,Zoological Institute, University of Basel, Vesalgasse 1, 4051, Basel, Switzerland
| | - L Abi-Rached
- Equipe ATIP, URMITE UM 63 CNRS 7278 IRD 198 Inserm U1095, IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France
| | - N Galtier
- UMR 5554 Institut des Sciences de l'Evolution, CNRS, IRD, EPHE, Université de Montpellier, Place E. Bataillon, 34095, Montpellier, France
| | - A Bernard
- UMR 5554 Institut des Sciences de l'Evolution, CNRS, IRD, EPHE, Université de Montpellier, Place E. Bataillon, 34095, Montpellier, France
| | - J I Montoya-Burgos
- Department of Genetics and Evolution, University of Geneva, 4, Bvd d'Yvoy, 1205, Geneva, Switzerland
| | - A Chenuil
- Institut Méditerranéen de Biodiversité et d'Ecologie marine et continentale (IMBE) - CNRS - IRD - UAPV, Aix-Marseille Université, Station Marine d'Endoume, Chemin de la Batterie des Lions, 13007, Marseille, France
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Abstract
One hundred and fifty West African Dwarf (WAD) kids were tested at the National Goats Breeding Station to determine the effects of some neonatal factors on their vigour levels within the first 24 h post-partum. The kids were also tested to establish the relationship between maternal weight, rectal temperature, times of first standing and sucking, sucking period and vigour. The distance covered (in meters) by a kid towards its mother during a 5-min test period was considered as vigour trait. Vigour levels increased significantly (p < 0.05) with increasing age within the first 24 h post-partum. Kids born to second parity mothers had higher (p < 0.05) vigour than those born to first parity mothers. Similarly, high birth weight kids had higher (p < 0.05) vigour levels than low birth weight kids. Weak positive and negative correlations (p < 0.05), respectively, were found between vigour and rectal temperature, and vigour and the time of first successfully standing. However, there was moderate positive correlation (p < 0.01) between vigour and sucking period. The time it took for the newborn kid to stand up for the first time also correlated weakly and negatively (p < 0.01) with the duration of sucking by the newborn within the first 5 min of accessing the teat. Vigour within the first 24 h post-partum in WAD kids increased with increasing age, parity and birth weight and might be responsible for the earlier and longer sucking time and periods, respectively, in high birth weight kids and those dropped by multiparous does.
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Affiliation(s)
- I I Abdul-Rahman
- Department of Animal Science, Faculty of Agriculture, University for Development Studies, Nyankpala Campus, P. O. Box TL 1882, Tamale, Ghana.
| | - A Bernard
- Department of Animal Science, Faculty of Agriculture, University for Development Studies, Nyankpala Campus, P. O. Box TL 1882, Tamale, Ghana
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47
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D'Journo XB, Berbis J, Jougon J, Brichon PY, Mouroux J, Tiffet O, Bernard A, de Dominicis F, Massard G, Falcoz PE, Thomas P, Dahan M. External validation of a risk score in the prediction of the mortality after esophagectomy for cancer. Dis Esophagus 2017; 30:1-8. [PMID: 26730436 DOI: 10.1111/dote.12447] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study was designed as an external evaluation of the Steyerberg score in the prediction of different categories of postoperative mortality after esophagectomy on a large nationwide database of thoracic surgeons. Data collection was obtained from the Epithor national database encompassing the majority of thoracic procedures performed in France. We retrospectively compared the predicted to the observed postoperative 30-day (30DM), 90-day (90DM) and in-hospital mortality (IHM) rate in each decile of equal patient. Patients included in the study were operated for an esophageal cancer and Gastroesophageal junction (GEJ). Steyerberg score was determined according to its logarithmic formula obtained from a sum score including age, comorbidities, neoadjuvant treatment and hospital volume. Deviation of observed from theoretically expected number of deaths was investigated using the calibration test of Hosmer-Lemeshow. Discrimination of the score was determined using the measure of the area under the receiver operating characteristic curve (AUC) of each category of mortality. Over a 9-year period, 1039 consecutive patients underwent an esophagectomy over 42 centers. Among them, 18 centers were considered as intermediate or high-volume institutions, and 24 were low-volume institutions. There were 841 males (81%) with a mean age of 62.3 ± 10 years. Preoperative treatment was allocated to 420 patients (40%). Numbers of comorbidity was: 1 in 261 patients (25%), 2 in 264 patients (25%), 3 in 383 patients (36%) and 4 in 5 patients (1%). The 30DM, 90DM and IHM rate were, respectively, 5.6%, 9.2% and 9.6%. The main causes of postoperative deaths were related to pulmonary complications (44%), complications of the gastric interposition (28%), cardiologic and thromboembolism events (10%). For 30DM, there were significant differences between predicted/observed mortalities in four deciles, whereas there was no significant difference for 90DM and for IHM. In term of calibration, there was a fair agreement of the Steyerberg score with observed 30DM. Predictions were above 20% for seven deciles. Calibration seemed more adequate for 90DM and for IHM. Predictions were above 20% for only three deciles but deviations were not significant. In terms of discrimination, for the 30DM the Steyerberg score overpredicted, the observed mortality rate and AUC was 0.64 (CI 95%: 0.57-0.71). For the 90DM, AUC indicated 0.63 (CI 95%: 0.57-0.68). For the IHM, AUC indicated 0.63 (CI 95%: 0.58-0.68). Steyerberg scoring system seems to be a moderate risk score of the prediction of the IHM and 90DM. This score appears to have a fair discrimination for the 30DM. Nevertheless, because of its simplicity, we believe that this simple predictive score is relevant and transportable to others institution performing such surgery for benchmarking purposes. A reappraisal of the score adapted to current surgical cohort is required.
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Affiliation(s)
- X B D'Journo
- Departments of Thoracic Surgery, ,Hôpital Nord, Chemin des Bourrely, 13915 Marseille cedex 20, France
| | - J Berbis
- Biostatistics, Aix-Marseille Université, France
| | - J Jougon
- Department of Thoracic Surgery, CHU de Bordeaux, Bordeaux, France
| | - P-Y Brichon
- Department of Thoracic Surgery, CHU de Grenoble, Grenoble, France
| | - J Mouroux
- Department of Thoracic Surgery, CHU de Nice, Nice, France
| | - O Tiffet
- Department of Thoracic Surgery, CHU de Saint-Etienne, Saint Etienne, France
| | - A Bernard
- Department of Thoracic Surgery, CHU de Dijon, Marseille, France
| | - F de Dominicis
- Department of Thoracic Surgery, CHU de Lille, Lille, France
| | - G Massard
- Department of Thoracic Surgery, CHU d'Amiens, Amiens, France
| | - P E Falcoz
- Department of Thoracic Surgery, CHU de Strasbourg, Strasbourg, , France
| | - P Thomas
- Departments of Thoracic Surgery, ,Hôpital Nord, Chemin des Bourrely, 13915 Marseille cedex 20, France
| | - M Dahan
- Department of Thoracic Surgery, CHU de Toulouse, Toulouse, France
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Bernard A. [Health technology assessments by the Haute Autorité de Santé (HAS)]. Rev Mal Respir 2016; 33:835-837. [PMID: 27939044 DOI: 10.1016/j.rmr.2016.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/06/2016] [Indexed: 11/27/2022]
Affiliation(s)
- A Bernard
- Unité de chirurgie thoracique, hôpital François-Mitterand, CHU de Dijon, 21079 Dijon, France.
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Brand M, Stefanidis A, Morbach C, Fan YT, Elremisy DRA, Kuznetsov VA, Carrero C, Almodares Q, Abdulrahim H, Galli E, Galli E, Moreno J, Lerena Saenz P, Ikonomidis I, Galuszka OM, Bonapace S, Clerc OF, Kuznetsov VA, Tadic S, Kataoka A, Abdul Rahman E, Calin A, Antonini-Canterin F, Schwartzenberg SS, Christ M, Roeing J, Amirie S, Grett M, Beko M, Breker I, Wennemann R, Trappe HJ, Lagoudakou S, Vintzilaios K, Mokadem N, Vlachou J, Komatanou E, Korlou P, Kakkavas A, Komninos K, Kranidis A, Gelbrich G, Simon J, Cramer M, Knobeloch F, Tiffe T, Wagner M, Heuschmann PU, Stoerk S, Yang D, Wang X, Chan AK, Cheung SH, Lee AP, Salim FF, Bakhoum SW, Ashour ZA, Soldatova AM, Krinochkin DV, Enina TN, Altamirano C, Pipkin M, Constantin I, Fava A, Diaz Babio G, Masson Juarez G, San Miguel J, Vera Janavel G, Stutzbach P, Wallentin Guron C, Thurin A, Fu M, Kontogeorgos S, Thunstrom E, Johansson MC, Da Silva C, Venkateshvaran A, Nagy AI, Lund LH, Manouras A, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Martinez Lugo CML, Zuniga Sedano JZD, Alexanderson EAR, Camilletti JC, Ahmed Abdelrahman M, Raslan H, Ruisanchez Villar C, Cuesta Cosgalla JM, Zarauza Navarro J, Veiga Fernandez G, Rifaie O, Omar AMS, Vlastos D, Frogoudaki A, Vrettou AR, Vlachos S, Varoudi M, Triantafyllidi H, Parissis J, Tsivgoulis G, Lekakis J, Steffens D, Friebel J, Rauch-Krohnert U, Landmesser U, Kasner M, Adamo E, Valbusa F, Ciccio' C, Rossi A, Lanzoni L, Chiampan A, Cecchetto A, Canali G, Barbieri E, Fuchs TA, Stehli J, Benz DC, Graeni C, Buechel RR, Kaufmann PA, Gaemperli O, Yaroslavskaya EI, Krinochkin DV, Kolunin GV, Gorbatenko EA, Dyachkov SM, Jung R, Ilic A, Stojsic-Milosavljevic A, Dejanovic J, Stefanovic M, Stojsic S, Sladojevic M, Watanabe Y, Kozuma K, Yamamoto M, Takagi K, Araki M, Tada N, Shirai S, Tamanaka F, Hayashida K, Ewe SH, Fadzil MA, Najme Khir R, Ismail JR, Lim CW, Chua N, Ibrahim ZO, Kasim SS, Ding ZP, Mateescu AD, Beladan CC, Rosca M, Enache R, Calin C, Cosei I, Botezatu S, Simion M, Ginghina C, Popescu BA, Di Nora C, Poli S, Vriz O, Zito C, Carerj S, Pavan D, Vaturi M, Kazum S, Monakier D, Sagie A, Kornowski R, Shapira Y. Poster Session 2The imaging examination and quality assessmentP520Benefit of early basic transthoracic echocardiography (TTE) in emergency patients performed by physicians with low to intermediate TTE experienceP521Appropriateness criteria in echocardiography. A contemporary necessity in clinical practiceP522Interobserver variability in 2d transthoracic echocardiography impact of scanning and reading on total variability results from the STAAB cohort study quality controlP5233D printing for personalised planning of catheter-based left atrial appendage occlusionP524Central obesity: an independent role or synergistic effect to metabolic syndrome on right atrial structure?P525Dynamics of left ventricular volumes and mortality in patients with early and late effect of cardiac resynchronization therapyP526Variability of thoracic aortic diameters according to gender, age and body surface area. Time to forget absolute cut-off values?P527The association of left ventricular outflow tract velocity time integral to all-cause mortality in elderly patients with heart failureP528Left ventricular myocardial performance and atrioventricular coupling in patients with primary arterial hypertensionP529Interest of a combinatory approach based on traditional left ventricular dyssynchrony parameters and cardiac work estimated by pressure-strain loop curves for the prediction of cardiac resynchronizatP530The evaluation of cardiac performance by pressure-strain loops: a useful tool for the identification of cardiac resynchronization therapy respondersP531Left ventricle cardiac function by 2D-speckle tracking echocardiography in diabetes mellitus population: sub-clinical systolic disfunction studyP532Biphasic tissue doppler mitral annular isovolumic contraction velocities are associated with left ventricular function, isovolumic relaxation, and pulmonary wedge pressure in heart failure patientsP533Abnormal left atrial volumes and strains are associated with increased arterial stiffnes in patients with cryptogenic stroke: a novel pathophysiological pathP534Detection of coronary microvascular disease using two-dimensional speckle-tracking echocardiographyP535Predictive value of a bi-dimensional transthoracic echocardiographic sign of " binary image" to identify the anomalous origin of the left circumflex coronary artery from the right coronary sinusP536Systematic review and meta-analysis of screening for coronary artery disease in asymptomatic diabetic patientsP537Noninvasive screening test for diagnosis of nonobstructive coronary artery disease using echocardiographic criteriaP538Early echocardiography after primary angioplasty, important role in predicting left ventricular remodelingP539Prognostic impact of low-flow severe aortic stenosis in Japanese patients undergoing transcatheter aortic valve implantation: the ocean-tavi registryP540Left ventricular outflow tract geometry and its impact on aortic valve area calculations in aortic stenosis using 3D transoesophageal echocardiography and 2D transthoracic echocardiographyP541Impaired left atrial myocardial deformation predicts postoperative atrial fibrillation after aortic valve replacement in patients with aortic stenosisP542Ejection fraction-velocity ratio in predicting symptoms in severe aortic stenosisP543Incremental value of transesophageal echocardiography in conjunction with transthoracic echocardiography in the assessment of aortic stenosis severity. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pages PB, Cottenet J, Bernard A, Quantin C. La mesure de la qualité à partir de la base de données nationale du PMSI. Application aux résections pulmonaires pour cancer. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.10.009] [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] Open
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