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Randriamiarana T, Boutin D, Thierry A, Lecron JC, Hainaut E, Masson Regnault M. Efficacy and safety of dupilumab for atopic dermatitis in a renal transplant patient. Ann Dermatol Venereol 2024; 151:103259. [PMID: 38507958 DOI: 10.1016/j.annder.2024.103259] [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: 05/04/2023] [Revised: 10/26/2023] [Accepted: 02/05/2024] [Indexed: 03/22/2024]
Affiliation(s)
- T Randriamiarana
- Service de Dermatologie, Centre Hospitalier Universitaire de Poitiers, 2 Rue de la Milétrie, 86000 Poitiers, France.
| | - D Boutin
- Service de Dermatologie, Centre Hospitalier Universitaire de Poitiers, 2 Rue de la Milétrie, 86000 Poitiers, France
| | - A Thierry
- Service de Néphrologie, Centre Hospitalier Universitaire de Poitiers, 2 Rue de la Milétrie, 86000 Poitiers, France
| | - J-C Lecron
- Université de Poitiers, 15 Rue de l'Hôtel-Dieu, TSA 71117, 86000 Poitiers, France; Service d'Immunologie et Inflammation, Centre Hospitalier Universitaire de Poitiers, 2 Rue de la Milétrie, 86000 Poitiers, France; Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), UR15560, Université de Poitiers, Pôle Biologie Santé, B36, 1 rue Georges Bonnet, TSA51106 86073 Poitiers Cedex 9, France
| | - E Hainaut
- Service de Dermatologie, Centre Hospitalier Universitaire de Poitiers, 2 Rue de la Milétrie, 86000 Poitiers, France; Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), UR15560, Université de Poitiers, Pôle Biologie Santé, B36, 1 rue Georges Bonnet, TSA51106 86073 Poitiers Cedex 9, France
| | - M Masson Regnault
- Service de Dermatologie, Centre Hospitalier Universitaire de Poitiers, 2 Rue de la Milétrie, 86000 Poitiers, France; Université de Poitiers, 15 Rue de l'Hôtel-Dieu, TSA 71117, 86000 Poitiers, 119 France; Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), UR15560, Université de Poitiers, Pôle Biologie Santé, B36, 1 rue Georges Bonnet, TSA51106 86073 Poitiers Cedex 9, France
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Delbarre B, Rapin A, Boyer FC, Thierry A, Perotin JM, Dury S, Dumazet A, Hagenburg J, Perdu D, Deslée G, Launois C. Dyspnea assessment in myotonic dystrophy type 1. Neuromuscul Disord 2023; 33:187-195. [PMID: 36669462 DOI: 10.1016/j.nmd.2022.12.015] [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: 03/22/2022] [Revised: 07/29/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023]
Abstract
In myotonic mystrophy type 1 (DM1), combining respiratory symptom screening and respiratory function testing, is crucial to identify the appropriate time for ventilatory support initiation. Dyspnea has been little investigated in DM1. To provide a multidimensional description of dyspnea, questionnaires assessing dyspnea were administered to 34 consecutive adult patients with DM1 (median (25th-75th centile) age of 36 (28-49), Vital Capacity (VC) of 74 (64-87)% of predicted value). Dyspnea scores were low whatever the questionnaire used: Multidimensional Dyspnea Profile score of 2(0-4.7)/50 for dyspnea sensory descriptor and of 0 (0-4.7)/60 for the emotional descriptor, Visual Analogue Scale score of 0 (0-0)/10 in sitting and supine position and Borg score after six-minute walk test (6MWT) of 2.2 (1.8-4.2)/10. Eleven patients (32%) reported disabling dyspnea in daily living (modified Medical Research Council (mMRC) score ≥ 2). In comparison with patients with mMRC score < 2, patients with mMRC score ≥ 2 had a more severe motor handicap (Muscular Impairment Rating score of 4.0 (4.0-4.0) vs 3.0 (2.0-3.5), p<0.01), a lower 6MWT distance (373 (260-424) vs 436 (346-499)m, p = 0.03) and a lower VC (64 (48-74)% vs 75 (69-89)%, p = 0.02). These data suggest that the mMRC scale might be an easy-to-use and useful tool to assess dyspnea in daily living in DM1 patients. However, the interest of integrating the mMRC dyspnea scale in clinical practice to guide therapeutic management of DM1 patients remains to be assessed in further studies.
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Affiliation(s)
- B Delbarre
- Service des Maladies Respiratoires, CHU Reims, France
| | - A Rapin
- Service de Médecine Physique et Réadaptation, CHU Reims, France; UR3797, VieFra, Université de Reims Champagne Ardenne, Reims, France
| | - F C Boyer
- Service de Médecine Physique et Réadaptation, CHU Reims, France; UR3797, VieFra, Université de Reims Champagne Ardenne, Reims, France
| | - A Thierry
- Département de Méthodologie, CHU Reims, France; UR3797, VieFra, Université de Reims Champagne Ardenne, Reims, France
| | - J M Perotin
- Service des Maladies Respiratoires, CHU Reims, France; INSERM UMRS-1250, Université Reims Champagne Ardenne, Reims, France
| | - S Dury
- Service des Maladies Respiratoires, CHU Reims, France
| | - A Dumazet
- Service des Maladies Respiratoires, CHU Reims, France
| | - J Hagenburg
- Service des Maladies Respiratoires, CHU Reims, France
| | - D Perdu
- Service des Maladies Respiratoires, CHU Reims, France
| | - G Deslée
- Service des Maladies Respiratoires, CHU Reims, France; INSERM UMRS-1250, Université Reims Champagne Ardenne, Reims, France
| | - C Launois
- Service des Maladies Respiratoires, CHU Reims, France; INSERM UMRS-1250, Université Reims Champagne Ardenne, Reims, France.
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Edange C, El adli A, Thierry A, Gennai S. Signalement des violences conjugales aux urgences d’un centre hospitalier universitaire. Ann Fr Med Urgence 2023. [DOI: 10.3166/afmu-2022-0467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Objectif : En 2019, 213 000 femmes (18–75 ans) étaient victimes de violences conjugales physiques et/ou sexuelles en France, et 18 % portaient plainte. Dans ce contexte, le CHU de Reims, le Procureur de la République de Reims et l’association « LE MARS France Victime 51 » ont mis en place un dispositif de signalement des violences conjugales au sein des urgences. L’objectif principal de notre étude était de décrire la population de patients consultant aux urgences, pour lesquels des violences conjugales étaient avérées ou soupçonnées au cours de l’interrogatoire. Les objectifs secondaires étaient de décrire la sous-population de patients acceptant le signalement au Procureur de la République et les facteurs associés à l’acceptation du signalement.
Matériel et méthodes : Il s’agissait d’une étude observationnelle, prospective, monocentrique sur une période de six mois. Si les patients acceptaient l’étude, un questionnaire était renseigné avec recueil des informations relatives aux faits rapportés, aux antécédents et aux données issues de la consultation aux urgences.
Résultats : Quarante-sept patients ont été inclus, avec un âge moyen de 34 ans, et 46 était des femmes. Trente-trois (70 %) ont accepté le signalement. Dans le groupe « Accepte », l’âge était plus élevé (p < 0,001), et l’abus d’alcool par le conjoint était plus fréquent (p = 0,045). Les fractures n’étaient présentes que dans le groupe « Accepte ». Dans le groupe « Refuse », le premier enfant était plus jeune (p = 0,007), et les antécédents de violence conjugale par un autre agresseur étaient plus fréquents (p = 0,025). En analyse multivariée, seuls l’âge et le souhait de porter plainte restaient significativement associés au signalement (p = 0,006 et p = 0,03 respectivement).
Conclusion : Cette étude a montré que le signalement avait un taux d’acceptation élevé parmi les victimes, facilitant le processus judiciaire, et a permis d’identifier les facteurs associés au refus de signalement.
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Noelle J, Mayet V, Couzi L, Thierry A, Bertrand D, Lambert C, Heng A, Rouzaire P, Garrouste C. Impact du maintien des inhibiteurs de la calcineurine après arrêt fonctionnel du transplant rénal sur le devenir du nouveau greffon, une étude rétrospective multicentrique avec score de propension. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.266] [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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Brugel M, Letrillart L, Evrard C, Thierry A, Tougeron D, El Amrani M, Piessen G, Truant S, Turpin A, d'Engremont C, Roth G, Hautefeuille V, Regimbeau JM, Williet N, Schwarz L, Di Fiore F, Borg C, Doussot A, Lambert A, Moulin V, Trelohan H, Bolliet M, Topolscki A, Ayav A, Lopez A, Botsen D, Piardi T, Carlier C, Bouché O. Impact of the COVID-19 pandemic on disease stage and treatment for patients with pancreatic adenocarcinoma: A French comprehensive multicentre ambispective observational cohort study (CAPANCOVID). Eur J Cancer 2022; 166:8-20. [PMID: 35259629 PMCID: PMC8828421 DOI: 10.1016/j.ejca.2022.01.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic caused major oncology care pathway disruption. The CAPANCOVID study aimed to evaluate the impact on pancreatic adenocarcinoma (PA) - from diagnosis to treatment - of the reorganisation of the health care system during the first lockdown. METHODS This multicentre ambispective observational study included 833 patients diagnosed with PA between September 1, 2019 and October 31, 2020 from 13 French centres. Data were compared over three periods defined as before the outbreak of COVID-19, during the first lockdown (March 1 to May 11, 2020) and after lockdown. RESULTS During the lockdown, mean weekly number of new cases decreased compared with that of pre-pandemic levels (13.2 vs. 10.8, -18.2%; p = 0.63) without rebound in the post-lockdown period (13.2 vs. 12.9, -1.7%; p = 0.97). The number of borderline tumours increased (13.6%-21.7%), whereas the rate of metastatic diseases rate dropped (47.1%-40.3%) (p = 0.046). Time-to-diagnosis and -treatment were not different over periods. Waiting neoadjuvant chemotherapy in resectable tumours was significantly favoured (24.7%-32.6%) compared with upfront surgery (13%-7.8%) (p = 0.013). The use of mFOLFIRINOX preoperative chemotherapy regimen decreased (84.9%-69%; p = 0.044). After lockdown, the number of borderline tumours decreased (21.7%-9.6%) and advanced diseases increased (59.7%-69.8%) (p = 0.046). SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%). CONCLUSION This cohort study suggests the existence of missing diagnoses and of a shift in disease stage at diagnosis from resectable to advanced diseases with related therapeutic modifications whose prognostic consequences will be known after the planned follow-up. TRIAL REGISTRATION Clinicaltrials.gov NCT04406571.
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Affiliation(s)
- Mathias Brugel
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France.
| | - Léa Letrillart
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France
| | - Camille Evrard
- Medical Oncology Department, CHU Poitiers, Poitiers, France
| | - Aurore Thierry
- Department of Research and Public Health, CHU Reims, Reims, France
| | - David Tougeron
- University of Poitiers, Hepatogastroenterology Department, CHU Poitiers, Poitiers, France
| | - Mehdi El Amrani
- Digestive Surgery and Liver Transplantation Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Guillaume Piessen
- Digestive and Oncological Surgery Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Stéphanie Truant
- Digestive Surgery and Liver Transplantation Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Anthony Turpin
- Medical Oncology Department, CHRU Lille, CANTHER Laboratory Inserm UMR-S1277, University of Lille, Lille, France
| | - Christelle d'Engremont
- Digestive Oncology and Hepatogastroenterology Department, CHU Grenoble-Alpes, Grenoble-Alpes University, Grenoble, France
| | - Gaël Roth
- Digestive Oncology and Hepatogastroenterology Department, CHU Grenoble-Alpes, Grenoble-Alpes University, Grenoble, France
| | - Vincent Hautefeuille
- Digestive Oncology and Gastroenterology Department, CHU Amiens-Picardie, Amiens, France
| | - Jean M Regimbeau
- Digestive Surgery Department, CHU Amiens-Picardie, SSPC (Simplification of Complex Patient Care) UR UPJV 7518, University of Picardie-Jules Verne, Amiens, France
| | - Nicolas Williet
- Hepatogastroenterology Department, CHU Saint Etienne, Saint-Priest-en-Jarez, France
| | - Lilian Schwarz
- Digestive Surgery Department, CHU Rouen, UNIROUEN, Inserm 1245, IRON Group, Normandie University, Rouen, France
| | - Frédéric Di Fiore
- Hepatogastroenterology Department, CHU Rouen, UNIROUEN, Inserm 1245, IRON Group, Normandie University, Rouen, France
| | - Christophe Borg
- Medical Oncology Department, CHU Besançon, INSERM, EFS BFC, UMR1098, RIGHT, University Bourgogne Franche-Comté, Besançon, France
| | - Alexandre Doussot
- Digestive Surgical Oncology and Liver Transplantation Department, CHU Besançon, Besançon, France
| | - Aurélien Lambert
- Medical Oncology Department, Lorraine Cancer Institute, Vandoeuvre-lès-Nancy, France
| | - Valérie Moulin
- Oncology Department, GH La Rochelle, La Rochelle, France
| | | | - Marion Bolliet
- Hepatogastroenterology Department, CH Colmar, Colmar, France
| | | | - Ahmet Ayav
- Hepatobiliary and Pancreatic Surgery Departement, CHRU Nancy, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - Anthony Lopez
- Gastroenterology and Digestive Oncology, CHRU Nancy, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - Damien Botsen
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France; Department of Medical Oncology, Godinot Cancer Institute, Reims, France
| | - Tulio Piardi
- General, Digestive and Endocrine Surgery Department, CHU Reims, Research Unit EA 3797 (VieFra) University of Reims Champagne-Ardenne (URCA), Reims, France
| | - Claire Carlier
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France; Department of Medical Oncology, Godinot Cancer Institute, Reims, France
| | - Olivier Bouché
- University of Reims Champagne-Ardenne (URCA), Digestive Oncology and Hepatogastroenterology Department, CHU Reims, Reims, France
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Hagenburg J, Bertin E, Salmon JH, Thierry A, Perotin JM, Dormoy V, Dury S, Gaubil I, Bolko L, Lebargy F, Deslee G, Launois C. Association between obesity-related dyspnea in daily living, lung function and body composition analyzed by DXA: a prospective study of 130 patients. BMC Pulm Med 2022; 22:103. [PMID: 35337302 PMCID: PMC8957162 DOI: 10.1186/s12890-022-01884-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/09/2022] [Indexed: 01/01/2023] Open
Abstract
Background Obesity is a risk factor for dyspnea. However, investigations of daily living obesity-related dyspnea are limited and its mechanisms remain unclear. We conducted a cross-sectional study to analyze the relationships between dyspnea in daily living, lung function, and body composition in patients with obesity. Methods One-hundred and thirty patients (103 women/27 men), candidate for bariatric surgery, with a mean ± SD Body Mass Index (BMI) of 44.8 ± 6.8 kg/m2 were included. Dyspnea was assessed by the modified Medical Research Council (mMRC) scale. Comorbidities, laboratory parameters, pulmonary function tests, arterial blood gases, six-minute walk test (6MWT), handgrip strength, and DXA body composition were analyzed. Results Thirty-one percent of patients exhibited disabling dyspnea in daily living (mMRC ≥ 2). Compared with patients without disabling dyspnea (mMRC < 2), significant dyspnea (mMRC ≥ 2) was associated with a lower 6MWT distance (395 ± 103 m vs 457 ± 73 m, p < 0.001), lower lung volumes including Expiratory Reserve Volume (42 ± 28% vs 54 ± 27%, p = 0.024), Vital Capacity (95 ± 14 vs 106 ± 15%, p < 0.001) and Forced expiratory volume in one second (95 ± 13 vs 105 ± 15%, p = 0.002), a higher BMI (48.2 ± 7.7 vs 43.2 ± 5.7 kg/m2, p = 0.001) and a higher percentage of fat mass in the trunk (46 ± 5 vs 44 ± 5 p = 0.012) and android region (52 ± 4 vs 51 ± 4%, p = 0.024). There was no difference regarding comorbidities (except hypertension), laboratory parameters, and sarcopenia markers between patients with (mMRC ≥ 2) and without (mMRC < 2) disabling dyspnea. Conclusion Dyspnea in patients with obesity is associated with a reduction in lung volumes and a higher percentage of fat mass in central body regions. How dyspnea and body composition may change with interventions like physical activity or bariatric surgery remains to be investigated. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01884-5.
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Affiliation(s)
- Jean Hagenburg
- Service Des Maladies Respiratoires, CHU Reims, Reims, France
| | - Eric Bertin
- Service d'Endocrinologie Diabète Nutrition, Centre Spécialisé Obésité, CHU Reims, Reims, France
| | | | | | - Jeanne-Marie Perotin
- Service Des Maladies Respiratoires, CHU Reims, Reims, France.,INSERM UMR-S 1250 "Pathologies Pulmonaires Et Plasticité Cellulaire", Reims, France
| | - Valérian Dormoy
- INSERM UMR-S 1250 "Pathologies Pulmonaires Et Plasticité Cellulaire", Reims, France
| | - Sandra Dury
- Service Des Maladies Respiratoires, CHU Reims, Reims, France
| | - Isabelle Gaubil
- Service d'Endocrinologie Diabète Nutrition, Centre Spécialisé Obésité, CHU Reims, Reims, France
| | - Lois Bolko
- Service de Rhumatologie, CHU Reims, Reims, France
| | | | - Gaëtan Deslee
- Service Des Maladies Respiratoires, CHU Reims, Reims, France.,INSERM UMR-S 1250 "Pathologies Pulmonaires Et Plasticité Cellulaire", Reims, France
| | - Claire Launois
- Service Des Maladies Respiratoires, CHU Reims, Reims, France.
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Pierot L, Barbe C, Thierry A, Bala F, Eugene F, Cognard C, Herbreteau D, Velasco S, Chabert E, Desal H, Aggour M, Rodriguez-Regent C, Gallas S, Sedat J, Marnat G, Sourour N, Consoli A, Papagiannaki C, Spelle L, White P. Patient and aneurysm factors associated with aneurysm recanalization after coiling. J Neurointerv Surg 2021; 14:1096-1101. [PMID: 34740986 PMCID: PMC9606530 DOI: 10.1136/neurintsurg-2021-017972] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/20/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND One limitation of the endovascular treatment of intracranial aneurysms is aneurysm recanalization. The Analysis of Recanalization after Endovascular Treatment of intracranial Aneurysm (ARETA) study is a prospective multicenter cohort study evaluating the factors associated with recanalization after endovascular treatment. METHODS The current analysis is focused on patients treated by coiling or balloon-assisted coiling (BAC). Postoperative, mid-term vascular imaging, and evolution of aneurysm occlusion were independently evaluated by two neuroradiologists. A 3-grade scale was used for aneurysm occlusion (complete occlusion, neck remnant, and aneurysm remnant) and for occlusion evolution (improved, stable, and worsened). Recanalization was defined as any worsening of aneurysm occlusion. RESULTS Between December 2013 and May 2015, 16 French neurointerventional departments enrolled 1289 patients. A total of 945 aneurysms in 908 patients were treated with coiling or BAC. The overall rate of aneurysm recanalization at mid-term follow-up was 29.5% (95% CI 26.6% to 32.4%): 28.9% and 30.3% in the coiling and BAC groups, respectively. In multivariate analyses factors independently associated with recanalization were current smoking (36.6% in current smokers vs 24.5% in current non-smokers (OR 1.8 (95% CI 1.3 to 2.4); p=0.0001), ruptured status (31.9% in ruptured aneurysms vs 25.1% in unruptured (OR 1.5 (95% CI 1.1 to 2.1); p=0.006), aneurysm size ≥10 mm (48.8% vs 26.5% in aneurysms <10 mm (OR 2.6 (95% CI 1.8 to 3.9); p<0.0001), wide neck (32.1% vs 25.8% in narrow neck (OR 1.5 (95% CI 1.1 to 2.1); p=0.02), and MCA location (34.3% vs 28.3% in other locations (OR 1.5 (95% CI 1.0 to 2.1); p=0.04). CONCLUSIONS Several factors are identified by the ARETA study as playing a role in aneurysm recanalization after coiling: current smoking, aneurysm status (ruptured), aneurysm size (≥10 mm), neck size (wide neck), and aneurysm location (middle cerebral artery). This finding has important consequences in clinical practice. TRIAL REGISTRATION NUMBER URL: http://www.clinicaltrials.gov; Unique Identifier: NCT01942512.
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Affiliation(s)
| | - Coralie Barbe
- Research on Health University department, University of Reims Champagne-Ardenne, Reims, France
| | | | - Fouzi Bala
- Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | | | - Christophe Cognard
- Diagnostic and Therapeutic Neuroradiology, CHU Toulouse, Toulouse, Occitanie, France
| | | | | | - Emmanuel Chabert
- Neuroradiologie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Mohamed Aggour
- Neuroradiology, CHU Saint-Étienne, Saint-Etienne, France
| | | | - Sophie Gallas
- Diagnostic and Interventional Neuroradiology, Hopital Bicetre, Le Kremlin-Bicetre, France
| | | | - Gaultier Marnat
- Interventional and Diagnostic Neuroradiology, CHU Bordeaux GH Pellegrin, Bordeaux, France
| | | | - Arturo Consoli
- Diagnostic and Interventional Neuroradiology, Hospital Foch, Suresnes, France.,Interventional Neurovascular Unit, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | | | - Laurent Spelle
- NEURI Interventional Neuroradiology, APHP, Paris, France.,Neuroradiology, Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, France
| | - Phil White
- Institute for Ageing & Health, Newcastle University, Newcastle Upon Tyne, UK.,Neuroradiology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
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Ducousso H, Vallée M, Thierry A. Trajectoires de la créatinine après transplantation rénale issue de donneur Maastricht 3. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.144] [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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9
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Delong H, Eutrope J, Thierry A, Sutter-Dallay AL, Vulliez L, Gubler V, Saad Saint-Gilles S, Tessier E, Le Foll J, Viaux S, Apter G, Danion A, Auer J, Rolland AC. Pregnancy denial: a complex symptom with life context as a trigger? A prospective case-control study. BJOG 2021; 129:485-492. [PMID: 34324258 PMCID: PMC9291172 DOI: 10.1111/1471-0528.16853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 05/20/2021] [Accepted: 07/10/2021] [Indexed: 11/28/2022]
Abstract
Objective To identify risk factors for a woman to experience pregnancy denial. Design, setting and population A French multicentric prospective case–control study with 71 mother–infant dyads having experienced a pregnancy denial versus a control group of 71 dyads. Methods Data were collected in the week after delivery using an observational leaflet and two psychiatric scales (MINI and QSSP). Main outcome measures Statistically significant differences between the two groups regarding social, demographic, medical and psychiatric data. Results Not being in a stable relationship (odds ratio [OR] 17.18, 95% CI 3.37–87.60]; P < 0.0001), not having a high school diploma (OR 1.11, 95% CI 1.04–1.38]; P < 0.0001) and having a psychiatric history (OR 6.33, 95% CI 1.62–24.76; P = 0.0002) were risk factors to experience pregnancy denial, whereas being older was a protective factor (OR 0.86, 95% CI 0.79–0.93; P = 0.0054) (logistic regression, Wald 95% CI). Other risk factors included late declarations of pregnancy history and past pregnancy denials (case n = 7, 9.7% versus 0% in controls; P = 0.01), past pregnancy denials in the family (case n = 13, 18% versus control n = 4, 5.6%; P = 0.03), and use of a contraceptive method (75% for cases versus 7% in control; P < 0.0001), primarily an oral contraceptive (75%). Conclusion Family or personal history of pregnancy denial should be part of the systematic anamnesis during the first visit of a patient of child‐bearing age. Further, our study points out that life context (young age, single status, socio‐economic precarity, pill‐based contraception) could be a trigger for pregnancy denial in certain women. Tweetable abstract Life context can be a trigger for pregnancy denial. Life context can be a trigger for pregnancy denial.
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Affiliation(s)
- H Delong
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Centre Hospitalier Universitaire, Université Reims Champagne Ardenne (URCA), Reims Cedex, France
| | - J Eutrope
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Centre Hospitalier Universitaire, Université Reims Champagne Ardenne (URCA), Reims Cedex, France
| | - A Thierry
- Unité d'aide méthodologique, Hôpital Robert Debré, Reims, France
| | - A-L Sutter-Dallay
- Pôle universitaire de psychiatrie de l'enfant et de l'adolescent, Centre Hospitalier Charles Perrens, Bordeaux, France
| | - L Vulliez
- Psychiatrie infanto-juvénile - Centre Hospitalier Régional Universitaire, Hôpital Saint-Jacques, Besançon cedex, France
| | - V Gubler
- Pédopsychiatrie - Hôpital privé la Casamance, Aubagne, France
| | - S Saad Saint-Gilles
- Pôle Universitaire de l'enfant et de l'adolescent, Centre psychothérapique de Nancy, Laxou, France
| | - E Tessier
- Service de Psychiatrie de l'Enfant et de l'Adolescent - Pôle Psychiatrie, Hôpital La Grave, Toulouse Cedex 9, France
| | - J Le Foll
- Polyclinique Ney, Hôpital Bichat, Paris, France
| | - S Viaux
- Service de Psychiatrie de l'Enfant et de l'Adolescent, APHP, Sorbonne Université, Paris, France
| | - G Apter
- Service universitaire de Pédopsychiatrie du Groupe Hospitalier du Havre, Université Rouen Normandie, Mont-Saint-Aignan, France
| | - A Danion
- Service de Psychiatrie de l'Enfant et de l'Adolescent, Pôle de Psychiatrie, Santé Mentale et Addictologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J Auer
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Centre Hospitalier Universitaire, Université Reims Champagne Ardenne (URCA), Reims Cedex, France
| | - A-C Rolland
- Service de Psychothérapie de l'enfant et de l'adolescent, Pôle Femme-Parents-Enfant, Centre Hospitalier Universitaire, Université Reims Champagne Ardenne (URCA), Reims Cedex, France
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Lavenne-Collot N, Ailliot P, Badic S, Favé A, François G, Saint-André S, Thierry A, Bronsard G. [Did child-psychiatry patients really experience the dreaded clinical degradation during the COVID-19 pandemic lockdown?]. Neuropsychiatr Enfance Adolesc 2021; 69:121-131. [PMID: 33727757 PMCID: PMC7951950 DOI: 10.1016/j.neurenf.2021.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectifs La période de confinement qui s’est déroulée en France de la mi-mars à la mi-mai 2020, à l’occasion de la pandémie COVID-19, soulève d’importantes questions sur ses effets psychologiques directs et indirects chez les enfants et adolescents. Considérée intuitivement comme nuisible, voire traumatisante dans le discours médiatique, nous avons tenté de mieux qualifier ses effets à partir de deux démarches complémentaires. D’une part, nous avons réalisé une revue de la littérature sur le sujet, d’autre part, nous y avons associé une objectivation de l’évolution de l’état clinique global des enfants au sein de la file active du service de psychiatrie infanto-juvénile du CHRU de Brest pendant la période de confinement. La revue de la littérature portant sur les effets psychologiques de situations de confinement ou de quarantaine à l’occasion d’épidémies passées ou actuelle de COVID-19, notamment en Chine, rapporte de nombreuses données sur leurs conséquences délétères. Les effets relatés sont de nature variable : symptômes anxieux et dépressifs principalement, mais aussi Stress Post Traumatique, dans des proportions importantes. Cependant, la définition des situations vécues et les contextes dans lesquels se sont déroulées ces études sont en fait peu comparables à la situation française. Par ailleurs, les effets de la peur de la contamination n’y sont pas différenciés de ceux liés au confinement lui-même. Patients et méthodes Parmi les enfants et adolescents suivis dans le service, 354 ont bénéficié d’une mesure de l’impact du confinement sur leur état clinique global évalué à la Clinical Global Impression Improvement (CGI-I) par leur praticien habituel au cours de la période du 16 mars au 11 mai 2020. Résultats Nos résultats mettent en évidence que 50 % des enfants ont connu un état clinique global inchangé en comparaison à leur état avant le confinement, 25 à 30 % ont connu une amélioration et 20 à 25 % ont montré une légère dégradation pendant la période de confinement. L’état décrit est globalement stable dans le temps au cours des huit semaines de la durée du confinement. L’âge ou la sévérité préalable de la pathologie n’a pas d’influence significative, même si on note une amélioration globale plus fréquente chez les adolescents. Conclusion Ces résultats sont assez discordants avec le discours général. Plusieurs hypothèses sont discutées pour expliquer les raisons de cette absence de dégradation qui pourrait éventuellement être étendue aux enfants et adolescents en général pendant cette période.
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Affiliation(s)
- N Lavenne-Collot
- Service hospitalo-universitaire de psychiatrie infanto-juvénile, CHRU de Brest, Brest, France.,Inserm UMR 1101 LaTIM
| | - P Ailliot
- Université de Bretagne Occidentale Brest, CNRS, LMBA - UMR, 6205, Brest, France
| | - S Badic
- Service hospitalo-universitaire de psychiatrie infanto-juvénile, CHRU de Brest, Brest, France
| | - A Favé
- Service hospitalo-universitaire de psychiatrie infanto-juvénile, CHRU de Brest, Brest, France
| | - G François
- Service hospitalo-universitaire de psychiatrie infanto-juvénile, CHRU de Brest, Brest, France
| | - S Saint-André
- Service hospitalo-universitaire de psychiatrie infanto-juvénile, CHRU de Brest, Brest, France
| | - A Thierry
- Service hospitalo-universitaire de psychiatrie infanto-juvénile, CHRU de Brest, Brest, France
| | - G Bronsard
- Service hospitalo-universitaire de psychiatrie infanto-juvénile, CHRU de Brest, Brest, France.,SPURBO, EA7479
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Brunson E, Thierry A, Ligier F, Vulliez-Coady L, Novo A, Rolland AC, Eutrope J. Prevalences and predictive factors of maternal trauma through 18 months after premature birth: A longitudinal, observational and descriptive study. PLoS One 2021; 16:e0246758. [PMID: 33626102 PMCID: PMC7904178 DOI: 10.1371/journal.pone.0246758] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 01/25/2021] [Indexed: 12/15/2022] Open
Abstract
Posttraumatic reactions are common among mothers of preterm infants and can have a negative influence on their quality of life and lead to interactional difficulties with their baby. Given the possible trajectories of posttraumatic reactions, we hypothesized that prevalences of postpartum posttraumatic reactions at given times underestimate the real amount of mothers experiencing these symptoms within 18 months following delivery. Additionally, we examined whether sociodemographic and clinical characteristics of dyads influence the expression of posttraumatic symptoms among these mothers. A sample of 100 dyads was included in this longitudinal study led by 3 french university hospitals. Preterm infants born before 32 weeks of gestation and their mothers were followed-up over 18 months and attended 5 visits assessing the infants’ health conditions and the mothers’ psychological state with validated scales. Fifty dyads were retained through the 18 months of the study. The period prevalence of posttraumatic reactions was calculated and a group comparison was conducted to determine their predictive factors. Thirty-six percent of the mothers currently suffered from posttraumatic symptoms 18 months after their preterm delivery. The 18 months period prevalence was 60.4% among all the mothers who participated until the end of the follow-up. There was a statistical link between posttraumatic symptoms and a shorter gestational age at delivery, C-section, and the mother’s psychological state of mind at every assessment time. Only a small proportion of mothers were receiving psychological support at 18 months. Preterm mothers are a population at risk of developing a long-lasting postpartum posttraumatic disorder, therefore immediate and delayed systematic screenings for posttraumatic symptoms are strongly recommended to guide at-risk mothers towards appropriate psychological support.
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Affiliation(s)
- Emilie Brunson
- Université de Formation et de Recherche de médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Aurore Thierry
- Unité d’Aide Méthodologique, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Fabienne Ligier
- Pôle Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, Centre Psychothérapique de Nancy, Laxou, France
- Unité de recherche EA 4360 APEMAC Adaptation, Mesure et Evaluation en Santé, Approches Interdisciplinaires, Université de Lorraine, Nancy, France
| | - Laurianne Vulliez-Coady
- Service de Psychiatrie de l’Enfant et de l’Adolescent, Hôpital Saint Jacques, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Alexandre Novo
- Université de Formation et de Recherche de médecine, Université de Reims Champagne-Ardenne, Reims, France
- Centre de Recherches Psychanalyse, Médecine et Société, Institut des Humanités, Sciences et Sociétés, Université de Paris, Paris, France
- Service de Psychothérapie de l’Enfant et de l’Adolescent, Hôpital Robert Debré, Centre Hospitalier Universitaire Reims, Reims, France
| | - Anne-Catherine Rolland
- Université de Formation et de Recherche de médecine, Université de Reims Champagne-Ardenne, Reims, France
- Service de Psychothérapie de l’Enfant et de l’Adolescent, Hôpital Robert Debré, Centre Hospitalier Universitaire Reims, Reims, France
- Département de Psychologie, Laboratoire Cognition Santé Société (EA 6291), Université de Reims Champagne-Ardenne, Reims, France
| | - Julien Eutrope
- Université de Formation et de Recherche de médecine, Université de Reims Champagne-Ardenne, Reims, France
- Service de Psychothérapie de l’Enfant et de l’Adolescent, Hôpital Robert Debré, Centre Hospitalier Universitaire Reims, Reims, France
- Département de Psychologie, Laboratoire Cognition Santé Société (EA 6291), Université de Reims Champagne-Ardenne, Reims, France
- * E-mail:
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Thierry A, Gand E, Ecotiere L, Duthe F, Paul J, Ragot S, Bridoux F. Trajectoires de créatininémie en post-transplantation rénale : mise en évidence et valeur pronostique sur la survie du greffon. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.053] [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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Gaiffe E, Crepin T, Bamoulid J, Courivaud C, Büchler M, Cassuto E, Albano L, Chemouny JM, Choukroun G, Hazzan M, Kessler L, Legendre C, Le Meur Y, Ouali N, Thierry A, Anota A, Nerich V, Limat S, Bonnetain F, Vernerey D, Ducloux D. PRODIG (Prevention of new onset diabetes after transplantation by a short term treatment of Vildagliptin in the early renal post-transplant period) study: study protocol for a randomized controlled study. Trials 2019; 20:375. [PMID: 31227028 PMCID: PMC6588872 DOI: 10.1186/s13063-019-3392-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 01/16/2019] [Accepted: 05/02/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Post-transplant diabetes is a frequent and serious complication of kidney transplantation. There is currently no treatment to prevent or delay the disease. Nevertheless, identification of risk factors make it possible to target a population at risk of developing de novo diabetes. We hypothesized that a short-term treatment with vildagliptin may prevent new onset diabetes after transplantation (NODAT) in high-risk patients. METHODS/DESIGN This is a multicenter, double-blind, placebo-controlled randomized clinical trial. Patients undergoing first kidney transplantation will be included from ten French transplant centers. Included patients will be randomized (1:1) to receive either vildagliptin 100 or 50 mg/day (depending on glomerular filtration rate) during 2 months (the first dose being administered before entering the operating theatres) or placebo. Additional antidiabetic therapy could be administered according to glycemic control. The primary outcome is the proportion of diabetic patients 1 year after transplantation, defined as patients receiving a diabetic treatment, or having a fasting glucose above 7 mmol/l, and/or with an abnormal oral glucose tolerance test. Secondary outcomes include glycated hemoglobin, the occurrence of acute rejection, infection, graft loss and patient death at 3 months, 6 months, and 12 months after transplantation. Outcomes will be correlated to clinical and general characteristics of the patient, cardiovascular history, nephropathy, dialysis history, transplantation data, biological data, health-related quality of life, and the cost-effectiveness of prevention of diabetes with vildagliptin. DISCUSSION We have scarce data on the pharmacological prevention of post-transplant diabetes. If our hypothesis is verified, our results will have a direct application in clinical practice and could limit diabetes-associated morbidity, reduce cardiovascular complications, increase quality of life of renal transplant patients, and consequently promote graft and patient survival. Our results may possibly serve for non-transplant patients carrying a high-risk of diabetes associated with other co-morbidities. TRIAL REGISTRATION ClinicalTrials.gov, NCT02849899 . Registered on 8 February 2016.
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Affiliation(s)
- E. Gaiffe
- CHU Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, F-25000 Besançon, France
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, CIC Biothérapie, INSERM CIC1431, F-25000 Besançon, France
| | - T. Crepin
- CHU Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, F-25000 Besançon, France
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, CIC Biothérapie, INSERM CIC1431, F-25000 Besançon, France
| | - J. Bamoulid
- CHU Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, F-25000 Besançon, France
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, CIC Biothérapie, INSERM CIC1431, F-25000 Besançon, France
| | - C. Courivaud
- CHU Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, F-25000 Besançon, France
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, CIC Biothérapie, INSERM CIC1431, F-25000 Besançon, France
| | - M. Büchler
- CHU Bretonneau, Department of Nephrology and Clinical Immunology, EA 4245 Transplantation, Immunology, Inflammation, F-37044 Tours, France
| | - E. Cassuto
- Pasteur hospital, L’Archet hospital group, Department of Nephrology, Dialysis, and Renal Transplantation, F-06000 Nice, France
| | - L. Albano
- Pasteur hospital, L’Archet hospital group, Department of Nephrology, Dialysis, and Renal Transplantation, F-06000 Nice, France
| | - J. M. Chemouny
- CHU de Rennes, Department of Nephrology, F-35033 Rennes, France
| | - G. Choukroun
- CHU Amiens, Department of Nephrology, Dialysis, and Renal Transplantation, F-80054 Amiens, France
| | - M. Hazzan
- CHU de Lille, Nephrology department, University of Lille UMR 995, F-59000 Lille, France
| | - L. Kessler
- CHU Strasbourg, Department of Endocrinology, Diabetes and Nutrition, F-67000 Strasbourg, France
| | - C. Legendre
- Necker hospital, Department of Nephrology, Dialysis, and Renal Transplantation, F-75743 Paris, France
| | - Y. Le Meur
- Department of Nephrology, CHU de Brest, UMR1227, Université de Brest, Inserm, F-29609 Brest, France
| | - N. Ouali
- Tenon hospital, Nephrological Emergencies and Kidney Transplantation, F-75571 Paris, France
| | - A. Thierry
- CHU de Poitiers, Department of Nephrology, Dialysis, and Renal Transplantation, F-86021 Poitiers, France
| | - A. Anota
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, Methodology and quality of life unit, F-25000 Besançon, France
| | - V. Nerich
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, department of Pharmacy, F-25030 Besançon, France
| | - S. Limat
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, department of Pharmacy, F-25030 Besançon, France
| | - F. Bonnetain
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, Methodology and quality of life unit, F-25000 Besançon, France
| | - D. Vernerey
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, Methodology and quality of life unit, F-25000 Besançon, France
| | - D. Ducloux
- CHU Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, F-25000 Besançon, France
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, CIC Biothérapie, INSERM CIC1431, F-25000 Besançon, France
- Service de Néphrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon, 3, boulevard Alexandre Fleming, 25030 Besançon, cedex France
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Rossi M, Thierry A, Delbauve S, Preyat N, Soares M, Leo O, Roumeguère T, Flamand V, Le Moine A, Hougardy J. Contrôle de la lésion d’ischémie-reperfusion rénale par l’hème oxygenase-1 d’origine myéloïde. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Thierry A. PATTERNS OF TELOMERE LENGTH AND PERCEIVED NEIGHBORHOOD CHARACTERISTICS BY U.S. REGION AND RACE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1016] [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
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Epaillard N, Troussier I, Bourdais R, Hammoudi N, Huguet F, Bachet JB, Vaillant JC, Thierry A, Gligorov J, Ozsahin M, Spano JP, Simon JM, Maingon P, Blais E. Faut-il adapter la chimioradiothérapie néoadjuvante des cancers de l’œsophage à l’histologie ? Analyse des essais de phase III. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.025] [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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Boulay H, Oger E, Cantarovich D, Gatault P, Thierry A, Le Meur Y, Sayegh J, Vigneau C, Lorcy N. L’absence de prophylaxie anti-CMV n’est pas délétère chez les greffés rénaux immunisés contre le CMV recevant une induction non déplétante : étude rétrospective multicentrique de 372 patients. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Le Meur Y, Morelon E, Essig M, Thierry A, Buchler M, Drouin S, Deruelle C, Badet L, Pesteil F, Barrou B. Utilisation pour la première fois chez l’homme d’un transporteur d’oxygène d’origine marine pour la préservation des greffons : étude Oxyop. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.056] [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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Belmouaz M, Mihoubi W, Bouteau I, Choquet E, Bridoux F, Thierry A, Bauwens M. Dialysat ultrapur au citrate comparé à l’acétate en hémodialyse conventionnelle : étude monocentrique rétrospective. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.165] [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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Thierry A, Shalev I, Wray L. IS TELOMERE LENGTH ASSOCIATED WITH PHYSICAL DISABILITY IN U.S. MIDLIFE AND OLDER ADULTS? Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2342] [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: 11/13/2022] Open
Affiliation(s)
- A. Thierry
- The Pennsylvania State University, University Park, Pennsylvania
| | - I. Shalev
- The Pennsylvania State University, University Park, Pennsylvania
| | - L.A. Wray
- The Pennsylvania State University, University Park, Pennsylvania
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Collins-Farmer H, Thierry A, Wray L. A BIOBEHAVIORAL APPROACH TO HEALTH IN MIDLIFE AND OLDER AGES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2341] [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: 11/15/2022] Open
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Armendariz M, Collins-Farmer H, Thierry A, Wray L. EXAMINING THE HISPANIC PARADOX IN C-REACTIVE PROTEIN (CRP) IN MIDDLE-AGED AND OLDER AMERICANS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2344] [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)
- M. Armendariz
- Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania
| | - H.R. Collins-Farmer
- Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania
| | - A. Thierry
- Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania
| | - L.A. Wray
- Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania
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Zalzali M, Houdelet-Guerinot V, Socquard E, Thierry A, Delemer B, Lukas-Croisier C. Continuous glucose monitoring and hypoglycemia unawareness in type 1 diabetes: a pilot study. Minerva Endocrinol (Torino) 2017; 42:195-202. [DOI: 10.23736/s0391-1977.16.02326-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Damon C, Luck M, Toullec L, Etienne I, Buchler M, Hurault de Ligny B, Choukroun G, Thierry A, Vigneau C, Moulin B, Heng AE, Subra JF, Legendre C, Monnot A, Yartseva A, Bateson M, Laurent-Puig P, Anglicheau D, Beaune P, Loriot MA, Thervet E, Pallet N. Predictive Modeling of Tacrolimus Dose Requirement Based on High-Throughput Genetic Screening. Am J Transplant 2017; 17:1008-1019. [PMID: 27597269 DOI: 10.1111/ajt.14040] [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] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 01/25/2023]
Abstract
Any biochemical reaction underlying drug metabolism depends on individual gene-drug interactions and on groups of genes interacting together. Based on a high-throughput genetic approach, we sought to identify a set of covariant single-nucleotide polymorphisms predictive of interindividual tacrolimus (Tac) dose requirement variability. Tac blood concentrations (Tac C0 ) of 229 kidney transplant recipients were repeatedly monitored after transplantation over 3 mo. Given the high dimension of the genomic data in comparison to the low number of observations and the high multicolinearity among the variables (gene variants), we developed an original predictive approach that integrates an ensemble variable-selection strategy to reinforce the stability of the variable-selection process and multivariate modeling. Our predictive models explained up to 70% of total variability in Tac C0 per dose with a maximum of 44 gene variants (p-value <0.001 with a permutation test). These models included molecular networks of drug metabolism with oxidoreductase activities and the multidrug-resistant ABCC8 transporter, which was found in the most stringent model. Finally, we identified an intronic variant of the gene encoding SLC28A3, a drug transporter, as a key gene involved in Tac metabolism, and we confirmed it in an independent validation cohort.
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Affiliation(s)
- C Damon
- Hypercube Institute, Paris, France
| | - M Luck
- Hypercube Institute, Paris, France.,Paris Descartes University, Paris, France
| | - L Toullec
- Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - I Etienne
- Department of Nephrology, Rouen University Hospital, Rouen, France
| | - M Buchler
- Department of Nephrology, Tours University Hospital, Tours, France
| | | | - G Choukroun
- Department of Nephrology, Amiens University Hospital, Amiens, France
| | - A Thierry
- Department of Nephrology, Poitiers University Hospital, Poitiers, France
| | - C Vigneau
- Department of Nephrology, Rennes University Hospital, Rennes, France
| | - B Moulin
- Department of Nephrology, Strasbourg University Hospital, Strasbourg, France
| | - A-E Heng
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - J-F Subra
- Department of Nephrology, Angers University Hospital, Angers, France
| | - C Legendre
- Department of Nephrology, Necker Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - A Monnot
- Hypercube Institute, Paris, France
| | | | | | - P Laurent-Puig
- Paris Descartes University, Paris, France.,Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut National pour la Santé et la Recherche Médicale (INSERM) U1147, Paris, France
| | - D Anglicheau
- Department of Nephrology, Necker Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - P Beaune
- Paris Descartes University, Paris, France.,Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut National pour la Santé et la Recherche Médicale (INSERM) U1147, Paris, France
| | - M A Loriot
- Paris Descartes University, Paris, France.,Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut National pour la Santé et la Recherche Médicale (INSERM) U1147, Paris, France
| | - E Thervet
- Paris Descartes University, Paris, France.,Department of Nephrology, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - N Pallet
- Paris Descartes University, Paris, France.,Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut National pour la Santé et la Recherche Médicale (INSERM) U1147, Paris, France.,Department of Nephrology, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
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Muggeo A, Guillard T, Barbe C, Thierry A, Bajolet O, Vernet-Garnier V, Limelette A, Brasme L, De Champs C. Factors associated with carriage of carbapenem-non-susceptible Enterobacteriaceae in North-Eastern France and outcomes of infected patients. J Antimicrob Chemother 2017; 72:1496-1501. [DOI: 10.1093/jac/dkw590] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 12/22/2016] [Indexed: 12/28/2022] Open
Affiliation(s)
- Anaëlle Muggeo
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, Hôpital Robert Debré, CHU Reims, Reims, France
- Structure Fédérative de Recherche CAP-Santé EA4687, UFR Médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Thomas Guillard
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, Hôpital Robert Debré, CHU Reims, Reims, France
- Structure Fédérative de Recherche CAP-Santé EA4687, UFR Médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Coralie Barbe
- Unité d’aide méthodologique, Pôle recherche et santé publique, Hôpital Robert Debré, CHU Reims, Reims, France
| | - Aurore Thierry
- Unité d’aide méthodologique, Pôle recherche et santé publique, Hôpital Robert Debré, CHU Reims, Reims, France
| | - Odile Bajolet
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, Hôpital Robert Debré, CHU Reims, Reims, France
- Structure Fédérative de Recherche CAP-Santé EA4687, UFR Médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Véronique Vernet-Garnier
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, Hôpital Robert Debré, CHU Reims, Reims, France
- Structure Fédérative de Recherche CAP-Santé EA4687, UFR Médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Anne Limelette
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, Hôpital Robert Debré, CHU Reims, Reims, France
- Structure Fédérative de Recherche CAP-Santé EA4687, UFR Médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Lucien Brasme
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, Hôpital Robert Debré, CHU Reims, Reims, France
- Structure Fédérative de Recherche CAP-Santé EA4687, UFR Médecine, Université de Reims Champagne-Ardenne, Reims, France
| | - Christophe De Champs
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, Hôpital Robert Debré, CHU Reims, Reims, France
- Structure Fédérative de Recherche CAP-Santé EA4687, UFR Médecine, Université de Reims Champagne-Ardenne, Reims, France
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Pallet N, Etienne I, Buchler M, Bailly E, Hurault de Ligny B, Choukroun G, Colosio C, Thierry A, Vigneau C, Moulin B, Le Meur Y, Heng AE, Legendre C, Beaune P, Loriot MA, Thervet E. Long-Term Clinical Impact of Adaptation of Initial Tacrolimus Dosing to CYP3A5 Genotype. Am J Transplant 2016; 16:2670-5. [PMID: 26990694 DOI: 10.1111/ajt.13788] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [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: 01/14/2016] [Revised: 02/12/2016] [Accepted: 03/03/2016] [Indexed: 01/25/2023]
Abstract
Pretransplantation adaptation of the daily dose of tacrolimus to CYP3A5 genotype is associated with improved achievement of target trough concentration (C0 ), but whether this improvement affects clinical outcomes is unknown. In the present study, we have evaluated the long-term clinical impact of the adaptation of initial tacrolimus dosing according to CYP3A5 genotype: The transplantation outcomes of the 236 kidney transplant recipients included in the Tactique study were retrospectively investigated over a period of more than 5 years. In the Tactique study, patients were randomly assigned to receive tacrolimus at either a fixed dosage or a dosage determined by their genotype, and the primary efficacy end point was the proportion of patients for whom tacrolimus C0 was within target range (10-15 ng/mL) at day 10. Our results indicate that the incidence of biopsy-proven acute rejection and graft survival were similar between the control and the adapted tacrolimus dose groups, as well as between the patients who achieve the tacrolimus C0 target ranges earlier. Patients' death, cancer, cardiovascular events, and infections were also similar, and renal function did not change. We conclude that optimization of initial tacrolimus dose using pharmacogenetic testing does not improve clinical outcomes.
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Affiliation(s)
- N Pallet
- Clinical Chemistry Department, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.,Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Sorbonne Paris Cité, INSERM UMRS 1147, Paris, France
| | - I Etienne
- Department of Nephrology-Clinical Immmunology, CHU Rouen, Rouen, France
| | - M Buchler
- Department of Nephrology, CHU Tours, Tours, France
| | - E Bailly
- Department of Nephrology, CHU Tours, Tours, France
| | | | - G Choukroun
- Department of Nephrology, CHU Amiens, Amiens, France
| | - C Colosio
- Department of Nephrology, CHU Reims, Reims, France
| | - A Thierry
- Department of Nephrology, CHU Poitiers, Poitiers, France
| | - C Vigneau
- Department of Nephrology, CHU Rennes, Rennes, France
| | - B Moulin
- Department of Nephrology, CHU Strasbourg, Strasbourg, France
| | - Y Le Meur
- Department of Nephrology, CHU Brest, Brest, France
| | - A-E Heng
- Department of Nephrology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - C Legendre
- Department of Nephrology, Necker Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - P Beaune
- Clinical Chemistry Department, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Sorbonne Paris Cité, INSERM UMRS 1147, Paris, France
| | - M A Loriot
- Clinical Chemistry Department, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Sorbonne Paris Cité, INSERM UMRS 1147, Paris, France
| | - E Thervet
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Sorbonne Paris Cité, INSERM UMRS 1147, Paris, France
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27
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Danel Buhl N, Touze I, Quarez S, Verhaeghe M, Klauza J, Degardin A, Lamblin O, Baekeland J, Dendoncker C, Thierry A, Loens I, Séguy D. Prise en charge nutritionnelle en cancérologie ORL : la régularité du suivi est la clé. NUTR CLIN METAB 2016. [DOI: 10.1016/j.nupar.2016.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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28
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Porcène L, Ecotière L, Duthe F, Gand E, Bridoux F, Thierry A. Première transplantation rénale avec et sans stéroïdes chez les receveurs âgés : étude rétrospective observationnelle multicentrique. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.377] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Petit AC, Eutrope J, Thierry A, Bednarek N, Aupetit L, Saad S, Vulliez L, Sibertin-Blanc D, Nezelof S, Rolland AC. Mother's Emotional and Posttraumatic Reactions after a Preterm Birth: The Mother-Infant Interaction Is at Stake 12 Months after Birth. PLoS One 2016; 11:e0151091. [PMID: 27022953 PMCID: PMC4811536 DOI: 10.1371/journal.pone.0151091] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/22/2016] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Very preterm infants are known to be at risk of developmental disabilities and behavioural disorders. This condition is supposed to alter mother-infant interactions. Here we hypothesize that the parental coping with the very preterm birth may greatly influence mother-infant interactions. METHODS 100 dyads were included in 3 university hospitals in France. Preterm babies at higher risk of neurodevelopmental sequelae (PRI>10) were excluded to target the maternal determinants of mother-infant interaction. We report the follow-up of this cohort during 1 year after very preterm birth, with regular assessment of infant somatic state, mother psychological state and the assessment of mother-infant interaction at 12 months by validated scales (mPPQ, HADS, EPDS, PRI, DDST and PIPE). RESULTS We show that the intensity of post-traumatic reaction of the mother 6 months after birth is negatively correlated with the quality of mother-infant interaction at 12 months. Moreover, the anxious and depressive symptoms of the mother 6 and 12 months after birth are also correlated with the quality of mother-infant interaction at 12 months. By contrast, this interaction is not influenced by the initial affective state of the mother in the 2 weeks following birth. In this particular population of infants at low risk of sequelae, we also show that the quality of mother-infant interaction is not correlated with the assessment of the infant in the neonatal period but is correlated with the fine motor skills of the baby 12 months after birth. CONCLUSIONS This study suggests that mothers' psychological condition has to be monitored during the first year of very preterm infants' follow-up. It also suggests that parental interventions have to be proposed when a post-traumatic, anxious or depressive reaction is suspected.
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Affiliation(s)
- Anne-Cécile Petit
- CHU Reims, Hôpital Robert Debré, Service de Psychothérapie de l’Enfant et de l’Adolescent, Reims, France
| | - Julien Eutrope
- CHU Reims, Hôpital Robert Debré, Service de Psychothérapie de l’Enfant et de l’Adolescent, Reims, France
| | - Aurore Thierry
- CHU Reims, Hôpital Robert Debré, Unité d’aide méthodologique, Reims, France
| | - Nathalie Bednarek
- CHU Reims, American-Memorial-Hospital, Service de réanimation néonatale et néonatologie, Reims, France
| | | | - Stéphanie Saad
- CHU Nancy, Centre psychothérapique de Nancy, Service de pédopsychiatrie, Laxou, France
| | - Lauriane Vulliez
- CHU de Besançon, Hôpital Saint Jacques, Service de psychiatrie de l’enfant et de l’adolescent, Besançon, France
| | - Daniel Sibertin-Blanc
- CHU Nancy, Centre psychothérapique de Nancy, Service de pédopsychiatrie, Laxou, France
| | - Sylvie Nezelof
- CHU de Besançon, Hôpital Saint Jacques, Service de psychiatrie de l’enfant et de l’adolescent, Besançon, France
| | - Anne-Catherine Rolland
- CHU Reims, Hôpital Robert Debré, Service de Psychothérapie de l’Enfant et de l’Adolescent, Reims, France
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Pallet N, Jannot AS, El Bahri M, Etienne I, Buchler M, de Ligny BH, Choukroun G, Colosio C, Thierry A, Vigneau C, Moulin B, Le Meur Y, Heng AE, Subra JF, Legendre C, Beaune P, Alberti C, Loriot MA, Thervet E. Kidney transplant recipients carrying the CYP3A4*22 allelic variant have reduced tacrolimus clearance and often reach supratherapeutic tacrolimus concentrations. Am J Transplant 2015; 15:800-5. [PMID: 25588704 DOI: 10.1111/ajt.13059] [Citation(s) in RCA: 57] [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: 09/15/2014] [Revised: 10/08/2014] [Accepted: 10/08/2014] [Indexed: 01/25/2023]
Abstract
CYP3A4*22 is an allelic variant of the cytochrome P450 3A4 associated with a decreased activity. Carriers of this polymorphism may require reduced tacrolimus (Tac) doses to reach the target residual concentrations (Co). We tested this hypothesis in a population of kidney transplant recipients extracted from a multicenter, prospective and randomized study. Among the 186 kidney transplant recipients included, 9.3% (18 patients) were heterozygous for the CYP3A4*22 genotype and none were homozygous (allele frequency of 4.8%). Ten days after transplantation (3 days after starting treatment with Tac), 11% of the CYP3A4*22 carriers were within the target range of Tac Co (10-15 ng/mL), whereas among the CYP3A4*1/*1 carriers, 40% were within the target range (p = 0.02, OR = 0.19 [0.03; 0.69]). The mean Tac Co at day 10 in the CYP3A4*1/*22 group was 23.5 ng/mL (16.6-30.9) compared with 15.1 ng/mL (14-16.3) in the CYP3A4*1/*1 group, p < 0.001. The Tac Co/dose significantly depended on the CYP3A4 genotype during the follow-up (random effects model, p < 0.001) with the corresponding equivalent dose for patients heterozygous for CYP3A4*22 being 0.67 [0.54; 0.84] times the dose for CYP3A4*1/*1 carriers. In conclusion, the CYP3A4*22 allelic variant is associated with a significantly altered Tac metabolism and carriers of this polymorphism often reach supratherapeutic concentrations.
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Affiliation(s)
- N Pallet
- Clinical Chemistry, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France; Sorbonne Paris Cité, INSERM UMRS, 1147, Paris, France
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Eutrope J, Thierry A, Lempp F, Aupetit L, Saad S, Dodane C, Bednarek N, De Mare L, Sibertin-Blanc D, Nezelof S, Rolland AC. Emotional reactions of mothers facing premature births: study of 100 mother-infant dyads 32 gestational weeks. PLoS One 2014; 9:e104093. [PMID: 25153825 PMCID: PMC4143228 DOI: 10.1371/journal.pone.0104093] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 07/09/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This current study has been conducted to clarify the relationship between the mother's post-traumatic reaction triggered by premature birth and the mother-infant interactions. In this article, the precocious maternal feelings are described. METHODS A multicenter prospective study was performed in three French hospitals. 100 dyads with 100 very premature infants and their mothers were recruited. Mothers completed, at two different times self-questionnaires of depression/anxiety, trauma and social support. The quality of interactions in the dyads was evaluated. RESULTS Thirty-nine percent of the mothers obtained a score at HADS suggesting a high risk of depression at the first visit and approximately one-third at visit two. Seventy-five percent of the mothers were at risk of suffering from an anxiety disorder at visit one and half remained so at visit two. A "depressed" score at visits one and two correlated with a hospitalization for a threatened premature labor. We noted a high risk of trauma for 35% of the mothers and high interactional synchrony was observed for approximately two-thirds of the dyads. The mothers' psychological reactions such as depression and anxiety or postnatal depression correlate strongly with the presence of an initial trauma. At visit one and visit two, a high score of satisfaction concerning social support correlates negatively with presence of a trauma. A maternal risk of trauma is more frequent with a C-section delivery. CONCLUSIONS Mothers' psychological reactions such as depression and anxiety correlate greatly with the presence of an initial trauma. The maternal traumatic reaction linked to premature birth does not correlate with the term at birth, but rather with the weight of the baby. Social support perceived by the mother is correlated with the absence of maternal trauma before returning home, and also seems to inhibit from depressive symptoms from the time of the infant's premature birth.
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Affiliation(s)
- Julien Eutrope
- CHU Reims, Hôpital Robert Debré, Structure interne de Psychothérapie de l'Enfant et de l'Adolescent, Reims, F-51092, France
| | - Aurore Thierry
- CHU Reims, Hôptal Robert Debré, Unité d'aide méthodologique, REIMS, F-51092, France
| | - Franziska Lempp
- CHU Reims, Hôpital Robert Debré, Structure interne de Psychothérapie de l'Enfant et de l'Adolescent, Reims, F-51092, France
| | | | - Stéphanie Saad
- CHU Nancy, Centre psychothérapique de Nancy, Service de pédopsychiatrie, Laxou, F-54521, France
| | - Catherine Dodane
- CHU de Besançon, Hôpital Saint Jacques, Service de psychiatrie de l'enfant et de l'adolescent, Besancon, F-25030, France
| | - Nathalie Bednarek
- CHU de Reims, Hôpital Maison Blanche, Structure Interne de Pédiatrie B, Reims, F-51092, France
| | | | - Daniel Sibertin-Blanc
- CHU Nancy, Centre psychothérapique de Nancy, Service de pédopsychiatrie, Laxou, F-54521, France
| | - Sylvie Nezelof
- CHU de Besançon, Hôpital Saint Jacques, Service de psychiatrie de l'enfant et de l'adolescent, Besancon, F-25030, France
| | - Anne-Catherine Rolland
- CHU Reims, Hôpital Robert Debré, Structure interne de Psychothérapie de l'Enfant et de l'Adolescent, Reims, F-51092, France
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Bourlon C, Lehenaff L, Batifoulier C, Bordier A, Chatenet A, Desailly E, Fouchard C, Marsal M, Martinez M, Rastelli F, Thierry A, Bartolomeo P, Duret C. Interaction entre performances posturales et cognitives chez des patients cérébrolésés droits : une étude en double tâche. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.038] [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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Bourlon C, Lehenaff L, Batifoulier C, Bordier A, Chatenet A, Desailly E, Fouchard C, Marsal M, Martinez M, Rastelli F, Thierry A, Bartolomeo P, Duret C. Interaction between postural and cognitive performances in right brain damaged patients: A dual task study. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.053] [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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Slimano F, Catoire C, Mestier LD, Thierry A, Volet J, Petit L, Burde F, Bouche O. OHP-006 Adverse Effects of Day-Hospital Cancer Treatment Monitored at Home: Creation of a Physicianñpatient Logbook. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.380] [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: 11/04/2022] Open
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35
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Pourreau F, Thierry A, Jollet I, Delbes S, Desport E, Bridoux F, Touchard G. Minimisation de l’immunosuppression : impact à long terme sur l’allo-immunisation anti-HLA et la survie du greffon. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2012.07.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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36
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Lebranchu Y, Snanoudj R, Toupance O, Weestel PF, Hurault de Ligny B, Buchler M, Rerolle JP, Thierry A, Moulin B, Subra JF, Deteix P, Le Pogamp P, Finzi L, Etienne I. Five-year results of a randomized trial comparing de novo sirolimus and cyclosporine in renal transplantation: the SPIESSER study. Am J Transplant 2012; 12:1801-10. [PMID: 22486815 DOI: 10.1111/j.1600-6143.2012.04036.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Calcineurin inhibitors improve acute rejection rates and short-term graft survival in renal transplantation, but their continuous use may be deleterious. We evaluated the 5-year outcomes of sirolimus (SRL) versus cyclosporine (CsA) immunosuppressive treatment. This observational study was an extension of the SPIESSER study where deceased donor kidney transplant recipients were randomized before transplantation to a SRL- or CsA-based regimen and followed up 1 year. Data from 131 (63 SRL, 68 CsA) out of 133 patients living with a functional graft at 1 year were collected retrospectively at 5 years posttransplant. Seventy percent of CsA patients versus 54% of SRL patients were still on the allocated treatment at 5 years (p = 0.091), most discontinuations in each group being due to safety issues. In intent-to-treat, mean MDRD eGFR was higher with SRL: 54.2 versus 45.3 mL/min with CsA (p = 0.019); SRL advantage was greater in on-treatment analyses. There were no differences for patient survival (p = 0.873), graft survival (p = 0.121) and acute rejection (p = 0.284). Adverse events were more frequent with SRL (80% vs. 60%, p = 0.015). Results confirmed the high SRL discontinuation rate due to adverse events. Nevertheless, a benefit was evidenced on renal function in patients (more than 50%) still on treatment at 5 years.
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Affiliation(s)
- Y Lebranchu
- Department of Nephrology and Clinical Immunology, Bretonneau Hospital, University Hospital, Tours, France.
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Thierry A, Thervet E, Vuiblet V, Goujon JM, Machet MC, Noel LH, Rioux-Leclercq N, Comoz F, Cordonnier C, François A, Marcellin L, Girardot-Seguin S, Touchard G. Long-term impact of subclinical inflammation diagnosed by protocol biopsy one year after renal transplantation. Am J Transplant 2011; 11:2153-61. [PMID: 21883902 DOI: 10.1111/j.1600-6143.2011.03695.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The long-term impact of subclinical acute rejection (SCAR) on renal graft function remains poorly understood. Furthermore, the interpretation of borderline lesions is difficult and their incidence is variable. The aim of this study was to analyze the characteristics of subclinical inflammation (SCI) in protocol biopsies performed 1-year after renal transplantation. SCI was defined as the presence of borderline lesions or SCAR according to the Banff 2005 classification. The patients included were a subpopulation of the CONCEPT study in which patients were randomized 3 months after transplantation to receive either sirolimus (SRL) or cyclosporine A (CsA) in combination with mycophenolate mofetil. At 1 year, we observed SCI in 37 of the 121 patients observed with an evaluable biopsy. The incidence was more frequent in the SRL group (SRL 45.2% vs. CsA 15.3%). At 30 months , SCI was associated with a significantly lower level of estimated glomerular filtration rate (mean MDRD 50.8 [±13.3] vs. 57.7 [±16.3] mL/min/1.73 m(2) , p = 0.035). In conclusion, SCI at 1-year posttransplantation is associated with worsening renal function and is more frequent in SRL-treated patients. Therefore, evaluation of SCI may be a valuable tool to allow the optimization of immunosuppressive regimens.
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Affiliation(s)
- A Thierry
- Department of Nephrology and Transplantation, University Hospital, Poitiers, France.
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38
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Gatault P, Jollet I, Rabot N, Boulanger MD, Taupin JL, Barbet C, Baron C, Thierry A, Halimi JM, Lebranchu Y, Touchard G, Büchler M. Mothers without HLA antibodies before transplantation have a low risk of alloimmunization post-transplantation. ACTA ACUST UNITED AC 2011; 78:241-8. [DOI: 10.1111/j.1399-0039.2011.01757.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Lebranchu Y, Thierry A, Thervet E, Büchler M, Etienne I, Westeel PF, Hurault de Ligny B, Moulin B, Rérolle JP, Frouget T, Girardot-Seguin S, Toupance O. Efficacy and safety of early cyclosporine conversion to sirolimus with continued MMF-four-year results of the Postconcept study. Am J Transplant 2011; 11:1665-75. [PMID: 21797975 DOI: 10.1111/j.1600-6143.2011.03637.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Calcineurin inhibitor (CNI) withdrawal has been used as a strategy to improve renal allograft function. We previously reported that conversion from cyclosporine A (CsA) to sirolimus (SRL) 3 months after transplantation significantly improved renal function at 1 year. In the Postconcept trial, 77 patients in the SRL group and 85 in the CsA group were followed for 48 months. Renal function (Cockcroft and Gault) was significantly better at month 48 (M48) in the SRL group both in the intent-to-treat population (ITT): 62.6 mL/min/1.73 m(2) versus 57.1 mL/min/1.73 m(2) (p = 0.013) and in the on-treatment population (OT): 67.5 mL/min/1.73 m(2) versus 57.4 mL/min/1.73 m(2) (p = 0.002). Two biopsy proven acute rejection episodes occurred after M12 in each group. Graft and patient survival were comparable (graft survival: 97.4 vs. 100%; patient survival: 97.4 vs. 97.6%, respectively). The incidence of new-onset diabetes was numerically increased in the SRL group (7 vs. 2). In OT, three cancers occurred in the SRL group versus nine in the CsA group and mean proteinuria was increased in the SRL group (0.42 ± 0.44 vs. 0.26 ± 0.37; p = 0.018). In summary, the renal benefits associated with conversion of CsA to SRL, at 3 months posttransplantation, in combination with MMF were maintained for 4 years posttransplantation.
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Affiliation(s)
- Y Lebranchu
- Department of Nephrology, Clinical Immunology, University Hospital, François Rabelais University, Tours, France.
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40
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Abstract
ABSTRACTOur approach consists of improving the molecular architecture of π-electron delocalization and orientations of the polymeric backbone of materials for cubic nonlinear optics. First, the syntheses of new polymers such as substituted polyacetylenes or polyphenyleneynylenes were done, in which the stiff conjugated chain and the flexible side-chains are well adapted to the orientation of the backbone. They have been studied for their third order susceptibility and their ability to give processable optical films. We have found liquid crystal properties with the rigid rod derivative of the poly(ethynylarylene). Unlike previous poly(ethynylarylene), we obtained a high molecular weight: , which allows films of good optical and mechanical properties. Second, in order to increase the third order response, we focused our attention on the orientational order of polydiacetylenes, which we obtained by epitaxial growth of the monomer on a single crystal substrate. From the proposed epitaxial model a possible extension of highly oriented thin films can be applied to a large class of materials.
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41
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El Hamel C, Thierry A, Trouillas P, Bridoux F, Carrion C, Quellard N, Goujon JM, Aldigier JC, Gombert JM, Cogne M, Touchard G. Crystal-storing histiocytosis with renal Fanconi syndrome: pathological and molecular characteristics compared with classical myeloma-associated Fanconi syndrome. Nephrol Dial Transplant 2010; 25:2982-90. [DOI: 10.1093/ndt/gfq129] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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42
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Servais A, Meas-Yedid V, Toupance O, Lebranchu Y, Thierry A, Moulin B, Etienne I, Presne C, Hurault DLB, Le Pogamp P, Le Meur Y, Glotz D, Hayem C, Olivo Marin JC, Thervet E. Interstitial fibrosis quantification in renal transplant recipients randomized to continue cyclosporine or convert to sirolimus. Am J Transplant 2009; 9:2552-60. [PMID: 19843033 DOI: 10.1111/j.1600-6143.2009.02803.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Conversion from cyclosporine (CsA) to sirolimus at week 12 after kidney transplantation is associated with a significant improvement in renal function. The aim of this analysis was to investigate the effect of this conversion on interstitial fibrosis (IF), a hallmark of chronic allograft injury, in patients taking part in the CONCEPT trial. This multicenter, prospective, trial included 193 renal recipients randomized at week 12 to switch from CsA to sirolimus or to continue CsA, with mycophenolate mofetil. Routine biopsy with automated, quantified assessment of IF by a program of color segmentation was performed at 1 year in 121 patients. At 1 year, renal function was significantly improved in the conversion group as assessed by estimated GFR (MDRD) and measured GFR. Biopsy results, however, showed no between-group difference in percentage of IF. Calculated GFR at 1 year was significantly associated with the percentage of IF (p = 0.004, R(2)= 0.07). By multivariate analysis diabetic patients had more fibrosis than non-diabetic patients. In conclusion, although kidney transplant patients converted from CsA to sirolimus showed significant improvement in renal function, we found no difference of IF on 1-year biopsies.
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Affiliation(s)
- A Servais
- Departments of Nephrology, Assistance publique-Hôpitaux de Paris, Necker-Enfants Malades Hospital, Paris, France.
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43
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Lebranchu Y, Thierry A, Toupance O, Westeel PF, Etienne I, Thervet E, Moulin B, Frouget T, Le Meur Y, Glotz D, Heng AE, Onno C, Buchler M, Girardot-Seguin S, Hurault de Ligny B. Efficacy on renal function of early conversion from cyclosporine to sirolimus 3 months after renal transplantation: concept study. Am J Transplant 2009; 9:1115-23. [PMID: 19422337 DOI: 10.1111/j.1600-6143.2009.02615.x] [Citation(s) in RCA: 214] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Sirolimus (SRL) allows to minimize the use of cyclosporine (CsA), but de novo administration after transplantation is associated with various complications. We report a prospective, open-label, multicenter randomized study to evaluate conversion from a CsA-based regimen to a SRL-based regimen 3 months after transplantation. One hundred ninety-two of a total of 237 patients were eligible at 3 months to be converted to SRL (n = 95) or to continue CsA (n = 97). All patients were also given mycophenolate mofetil (MMF) and oral steroids, planned to be discontinued at month 8. The primary endpoint, the clearance estimated according to Cockcroft and Gault at week 52, was significantly better in the SRL group (68.9 vs. 64.4 mL/min, p = 0.017). Patient and graft survival were not statistically different. The incidence of acute rejection episodes, mainly occurring after withdrawal of steroids, was numerically but not statistically higher in the SRL group (17% vs. 8%, p = 0.071). Sixteen patients discontinued SRL, mainly for adverse events (n = 11), and seven patients discontinued CsA for renal failure or acute rejection. Significantly, more patients in the SRL group reported aphthous, diarrhea, acne and high triglyceride levels. Conversion CsA to SRL 3 months after transplantation combined with MMF is associated with improvement in renal function.
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Affiliation(s)
- Y Lebranchu
- Service Nephrologie Immunologie Clinique, CHRU Tours, EA 4245, University François Rabelais, Tours, France.
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44
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Alves PDD, McCulloch JA, Even S, Le Maréchal C, Thierry A, Grosset N, Azevedo V, Rosa CA, Vautor E, Le Loir Y. Molecular characterisation of Staphylococcus aureus strains isolated from small and large ruminants reveals a host rather than tissue specificity. Vet Microbiol 2008; 137:190-5. [PMID: 19157725 DOI: 10.1016/j.vetmic.2008.12.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Revised: 12/10/2008] [Accepted: 12/12/2008] [Indexed: 11/30/2022]
Abstract
Staphylococcus aureus is an important pathogen in domestic ruminants. The main objective of this study was to determine the similarity of epidemiologically unrelated S. aureus isolates from bovine, ovine, and caprine hosts regardless the locus of isolation (nares and udder). By pulsed-field gel electrophoresis, seven major pulsotypes were identified among 153 isolates recovered from 12 different regions of France as well as from Brazil, the USA and Belgium. Typing of the accessory gene regulator (agr) and capsular (cap) serotype was carried out on all the isolates and revealed the predominance of agr I and III and of cap8 regardless the ruminant host species. Screening for methicilin-resistant S. aureus (MRSA) was carried out by disk diffusion and revealed a prevalence of only 3.2% of MRSA among the strains tested. These results suggest the existence of a host rather than tissue specificity among S. aureus isolates colonising the ruminant species and suggest a limited transmission of those isolates between large (bovine) and small (ovine-caprine) ruminants. The agr class and cap types correlated with pulsotype clusters rather than with a specific host species. Antimicrobial resistance appears not to have contributed to the predominance of any given genotypes, and MRSA prevalence appears very low in ruminant isolates.
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Affiliation(s)
- P D D Alves
- INRA, UMR1253 STLO, 85 rue de Saint Brieuc, 35042 Rennes, France
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45
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Dherbécourt J, Maillard MB, Catheline D, Thierry A. Production of branched-chain aroma compounds by Propionibacterium freudenreichii: links with the biosynthesis of membrane fatty acids. J Appl Microbiol 2008; 105:977-85. [PMID: 18444997 DOI: 10.1111/j.1365-2672.2008.03830.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Short branched-chain fatty acids (BCFAs) are cheese flavour compounds, which result from the conversion of branched-chain amino acids (BCAAs). In Swiss cheese, the production of short BCFAs is mainly performed by Propionibacterium freudenreichii and is strain dependent. Our aim was to investigate the possible links between the biosynthesis of short BCFAs and membrane BCFAs in P. freudenreichii. METHODS AND RESULTS Short and membrane BCFAs were analysed by gas chromatography-mass spectrometry. Two strains differing in their capacities to release short BCFAs were selected. Tri-deuterated-labelled leucine was used in both strains as a precursor of short extracellular iso-BCFAs and of membrane iso-BCFAs. The proportions of anteiso : iso BCFAs synthesized varied as function of the BCAAs provided in the growth medium, from 72 : 28 to 100 : 0, with leucine and valine, and with isoleucine as sole BC precursors, respectively. The branching pattern of short BCFAs exactly matched that of membrane BCFAs, whatever the exogenous BCAAs provided. CONCLUSIONS The biosynthesis of short BCFAs is closely related to that of membrane BCFAs in P. freudenreichii. SIGNIFICANCE AND IMPACT OF THE STUDY The biosynthesis of short BCFAs in P. freudenreichii depends more on the strain than on the presence of exogenous BC precursors.
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Affiliation(s)
- J Dherbécourt
- UMR1253 Science et Technologie du Lait et de l'OEuf, INRA, Agrocampus Rennes, Rennes, France
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46
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Mignot A, Bridoux F, Thierry A, Varnous S, Pujo M, Delcourt A, Gombert JM, Goujon JM, Favreau F, Touchard G, Herpin D, Jaccard A. Successful heart transplantation following melphalan plus dexamethasone therapy in systemic AL amyloidosis. Haematologica 2008; 93:e32-5. [DOI: 10.3324/haematol.12108] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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47
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De Freitas I, Pinon N, Berdagué JL, Tournayre P, Lortal S, Thierry A. Kluyveromyces lactis but not Pichia fermentans used as adjunct culture modifies the olfactory profiles of Cantalet cheese. J Dairy Sci 2008; 91:531-43. [PMID: 18218739 DOI: 10.3168/jds.2007-0136] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Yeasts are commonly detected in cheese. Two yeast species, Kluyveromyces lactis and Pichia fermentans, were isolated at high populations from raw-milk Cantalet cheese, a French Protected Denomination of Origin hard cheese. To investigate the interest of these 2 species as adjunct cultures to promote flavor development of Cantalet cheese, they were added at 10(5) cfu/mL to microfiltered milk. The global microbiological, biochemical, and flavor changes induced by the presence of the yeasts in cheese were determined. Adjunct yeasts were present at 10(6) cfu/g in curd, declined to 10(4) to 10(5) cfu/g in cheese, and did not influence gross composition, content of free amino acids, or content of free fatty acids. By using 8-way gas chromatography-olfactometry in parallel with gas chromatography-mass spectrometry, 30 odorous compounds of Cantalet cheese were identified. The olfactory profiles of K. lactis cheeses contained significantly greater levels of 8 odorous compounds (ethanol, ethyl hexanoate, 4 aldehydes, and 2 branched-chain acids) compared with the control and P. fermentans cheeses. Sensory analysis of cheeses flavor discriminated K. lactis cheeses on only 2 attributes (acetaldehyde and alcohol odors). This study shows that yeast contribution is species-specific and that K. lactis, at a population of 10(6) viable cells/g, can influence Cantalet cheese flavor.
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Affiliation(s)
- I De Freitas
- Les Fromageries Occitanes (LFO), Borde Blanche - Zone Industrielle, F-31290 Villefranche de Lauragais, France
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48
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Abou Ayache R, Thierry A, Bridoux F, Bauwens M, Belmouaz M, Desport E, Touchard G. Long-term maintenance of calcineurin inhibitor monotherapy reduces the risk for squamous cell carcinomas after kidney transplantation compared with bi- or tritherapy. Transplant Proc 2007; 39:2592-4. [PMID: 17954185 DOI: 10.1016/j.transproceed.2007.08.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The incidence of skin cancer after organ transplantation is mainly related to type, level, and duration of immunosuppression. The immunosuppressive minimization strategy reduces skin malignancies, but no data are available concerning long-term calcineurin inhibitor (CNI) monotherapy compared with bi- or tritherapy. We studied the benefits of long-term CNI monotherapy (>6 years of exposure) with regard to the incidence of squamous cell carcinomas (SCC) and basal cell carcinomas (BCC) compared with bi- or tritherapy, among first renal allograft adult recipients who were more than 6 years posttransplantation. Among 294 renal transplantations performed between 1986 and 1999, 80 patients received CNI monotherapy (MT) and 86 patients bi- or tritherapy (BTT) with a follow-up of more than 6 years. MT patients were older, had longer follow-up, and fewer biopsy-proven acute rejection episodes. The incidence of SCC was 15.9 SCC/1000 patients/year for MT vs 26.2 for BTT (P = .07). The incidence was significantly lower for patients older than 40 years (22.4 vs 56, respectively; P < .01). The incidence of BCC was 28.3 BCC/1000 patients/year for MT and 10.1 for BTT (P = .05), which failed to show a significant difference in patients older than 40 years (39.7 vs 25, respectively; P = .09). The ratio of SCC/BCC in MT was maintained around 1/2 over time, while it exceeded 2/1 in BTT after 12 years posttransplantation. Patient survival was comparable between the 2 groups. A higher graft survival rate was observed in the MT group. CNI monotherapy should be considered to be a beneficial, safe immunosuppressive minimization strategy for SCC in selected recipients.
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Affiliation(s)
- R Abou Ayache
- Department of Nephrology, Centre Hospitalier Universitaire La Milétrie, 2 Rue de la Milétrie, 86021 Poitiers, France.
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49
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Le Meur Y, Büchler M, Thierry A, Caillard S, Villemain F, Lavaud S, Etienne I, Westeel PF, Hurault de Ligny B, Rostaing L, Thervet E, Szelag JC, Rérolle JP, Rousseau A, Touchard G, Marquet P. Individualized mycophenolate mofetil dosing based on drug exposure significantly improves patient outcomes after renal transplantation. Am J Transplant 2007; 7:2496-503. [PMID: 17908276 DOI: 10.1111/j.1600-6143.2007.01983.x] [Citation(s) in RCA: 316] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Efficacy and safety of mycophenolate mofetil (MMF) may be optimized with individualized doses based on therapeutic monitoring of its active metabolite, mycophenolic acid (MPA). In this 12-month study, 137 renal allograft recipients from 11 French centers receiving basiliximab, cyclosporine A, MMF and corticosteroids were randomized to receive either concentration-controlled doses or fixed-dose MMF. A novel Bayesian estimator of MPA AUC based on three-point sampling was used to individualize doses on posttransplant days 7 and 14 and months 1, 3 and 6. The primary endpoint was treatment failure (death, graft loss, acute rejection and MMF discontinuation). Data from 65 patients/group were analyzed. At month 12, the concentration-controlled group had fewer treatment failures (p = 0.03) and acute rejection episodes (p = 0.01) with no differences in adverse event frequency. The MMF dose was higher in the concentration-controlled group at day 14 (p < 0.0001), month 1 (p < 0.0001) and month 3 (p < 0.01), as were median AUCs on day 14 (33.7 vs. 27.1 mg*h/L; p = 0.0001) and at month 1 (45.0 vs. 30.9 mg*h/L; p < 0.0001). Therapeutic MPA monitoring using a limited sampling strategy can reduce the risk of treatment failure and acute rejection in renal allograft recipients 12 months posttransplant with no increase in adverse events.
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Affiliation(s)
- Y Le Meur
- Department of Nephrology, University Hospital, Limoges, France.
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50
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Büchler M, Caillard S, Barbier S, Thervet E, Toupance O, Mazouz H, Hurault de Ligny B, Le Meur Y, Thierry A, Villemain F, Heng AE, Moulin B, Morin MP, Noël C, Lebranchu Y. Sirolimus versus cyclosporine in kidney recipients receiving thymoglobulin, mycophenolate mofetil and a 6-month course of steroids. Am J Transplant 2007; 7:2522-31. [PMID: 17868057 DOI: 10.1111/j.1600-6143.2007.01976.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
To evaluate the efficacy and tolerance of a calcineurin inhibitor (CNI)-free regimen, 145 renal recipients were prospectively randomized to receive either sirolimus (n = 71) or cyclosporine (CsA; n = 74). All patients received polyclonal antilymphocyte antibodies, mycophenolate mofetil (MMF) and steroids (6 months). The primary endpoint, estimated glomerular filtration rate (eGFR) was not significantly different at 12 months comparing sirolimus- and CsA-treated patients (60 +/- 27 vs. 57 +/- 21 mL/min). At 12 months, patient and graft survival, incidence of biopsy-proven rejection and rates of steroid withdrawal were not statistically different (97% vs. 97%; 90% vs. 93%; 14.3% vs. 8.6% and 82.8% vs. 84.1%, respectively). Delayed and slow graft function (SGF) was not significantly different (18.6% vs. 12.3% and 11.4% vs. 13.7%, respectively). In patients who remained on treatment according to protocol at 12 months, eGFR was significantly higher with sirolimus (69 +/- 19 vs. 60 +/- 14 mL/min, p = 0.01). Overall study drug discontinuation rates were 28.2% with sirolimus and 14.9% with CsA. Adverse events (wound complications, mouth ulcers, diarrhea, hypokalemia, bronchopneumonia) and proteinuria >0.5 g/24h (38.8% vs. 5.6%, p < 0.001) were significantly more frequent in sirolimus-treated patients. Cytomegalovirus (CMV) infections were significantly less frequent with sirolimus (6% vs. 23%, p < 0.01). A CNI-free regimen using sirolimus-MMF can achieve excellent renal function, but patients on sirolimus experienced a high rate of adverse events and study drug discontinuation.
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Affiliation(s)
- M Büchler
- Francois Rabelais University, Department of Nephrology and Clinical Immunology, Bretonneau Hospital, CHU Tours, France.
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