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Soilly AL, Robert-Viard C, Besse C, Bruel AL, Gerard B, Boland A, Piton A, Duffourd Y, Muller J, Poë C, Jouan T, El Doueiri S, Faivre L, Bacq-Daian D, Isidor B, Genevieve D, Odent S, Philip N, Doco-Fenzy M, Lacombe D, Asensio ML, Deleuze JF, Binquet C, Thauvin-Robinet C, Lejeune C. Cost of exome analysis in patients with intellectual disability: a micro-costing study in a French setting. BMC Health Serv Res 2023; 23:386. [PMID: 37085862 PMCID: PMC10120135 DOI: 10.1186/s12913-023-09373-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 04/04/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND With the development of next generation sequencing technologies in France, exome sequencing (ES) has recently emerged as an opportunity to improve the diagnosis rate of patients presenting an intellectual disability (ID). To help French policy makers determine an adequate tariff for ES, we aimed to assess the unit cost per ES diagnostic test for ID from the preparation of the pre-analytical step until the report writing step and to identify its main cost drivers. METHODS A micro-costing bottom-up approach was conducted for the year 2018 in a French setting as part of the DISSEQ study, a cost-effectiveness study funded by the Ministry of Health and performed in collaboration with the GAD (Génétique des Anomalies du Développement), a genetic team from the Dijon University Hospital, and a public sequencing platform, the Centre National de Recherche en Génomique Humaine (CNRGH). The analysis was conducted from the point of view of these two ES stakeholders. All of the resources (labor, equipment, disposables and reagents, reusable material) required to analyze blood samples were identified, collected and valued. Several sensitivity analyses were performed. RESULTS The unit nominal cost per ES diagnostic test for ID was estimated to be €2,019.39. Labor represented 50.7% of the total cost. The analytical step (from the preparation of libraries to the analysis of sequences) represented 88% of the total cost. Sensitivity analyses suggested that a simultaneous price decrease of 20% for the capture kit and 50% for the sequencing support kit led to an estimation of €1,769 per ES diagnostic test for ID. CONCLUSION This is the first estimation of ES cost to be done in the French setting of ID diagnosis. The estimation is especially influenced by the price of equipment kits, but more generally by the organization of the centers involved in the different steps of the analysis and the time period in which the study was conducted. This information can now be used to define an adequate tariff and assess the efficiency of ES. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT03287206 on September 19, 2017.
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Affiliation(s)
- A L Soilly
- CHU Dijon Bourgogne, Délégation à la Recherche Clinique et à l'Innovation, USMR, F-21000, Dijon, France
- CHU Dijon Bourgogne, Délégation à la Recherche Clinique et à l'Innovation, Unité Innovation, F-21000, Dijon, France
| | - C Robert-Viard
- CHU Dijon Bourgogne, Délégation à la Recherche Clinique et à l'Innovation, Unité Innovation, F-21000, Dijon, France
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, F21000, Dijon, France
| | - C Besse
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - A L Bruel
- Inserm, Université Bourgogne-Franche-Comté, UMR1231, équipe GAD, Dijon, France
| | - B Gerard
- Laboratoires de Diagnostic Génétique, Hôpitaux Universitaires de Strasbourg, Institut de Génétique Médicale d'Alsace (IGMA), 67000, Strasbourg, France
| | - A Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - A Piton
- Laboratoires de Diagnostic Génétique, Hôpitaux Universitaires de Strasbourg, Institut de Génétique Médicale d'Alsace (IGMA), 67000, Strasbourg, France
| | - Y Duffourd
- Inserm, Université Bourgogne-Franche-Comté, UMR1231, équipe GAD, Dijon, France
| | - J Muller
- Laboratoires de Diagnostic Génétique, Hôpitaux Universitaires de Strasbourg, Institut de Génétique Médicale d'Alsace (IGMA), 67000, Strasbourg, France
- Unité Fonctionnelle de Bioinformatique Médicale appliquée au diagnostic (UF7363), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Inserm UMRS_1112, Institut de Génétique Médicale d'Alsace, Université de Strasbourg, France et CHRU, Strasbourg, France
| | - C Poë
- Inserm, Université Bourgogne-Franche-Comté, UMR1231, équipe GAD, Dijon, France
| | - T Jouan
- Inserm, Université Bourgogne-Franche-Comté, UMR1231, équipe GAD, Dijon, France
| | - S El Doueiri
- CHU Dijon Bourgogne, Service financier, 21000, Dijon, France
| | - L Faivre
- Inserm, Université Bourgogne-Franche-Comté, UMR1231, équipe GAD, Dijon, France
- CHU Dijon-Bourgogne, Centres de Référence Maladies Rares « Anomalies du Développement et syndromes malformatif de l'Est » et « Déficiences intellectuelles de causes rares », Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (TRANSLAD), Dijon, France
| | - D Bacq-Daian
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - B Isidor
- Service de Génétique Médicale, CHU de Nantes, Nantes, France
| | - D Genevieve
- Département de Génétique Médicale, Centre de Référence Maladies Rares, Anomalies du Développement et Syndromes Malformatifs Sud-Languedoc Roussillon, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - S Odent
- Service de Génétique Clinique, Centre Hospitalier Universitaire Rennes, F-35203, Rennes, France
- Centre National de la Recherche Scientifique Unité Mixte de Recherche 6290, Institut Génétique et Développement de Rennes, Université de Rennes 1, F-35203, Rennes, France
| | - N Philip
- Département de Génétique Médicale, Hôpital d'Enfants de La Timone, Marseille, France
| | - M Doco-Fenzy
- Service de Génétique, CHU de Reims, EA3801, Reims, France
- CRMR Anddi-Rares constitutif, CLAD-EST, CHU Reims, Reims, France
| | - D Lacombe
- CHU de Bordeaux, Génétique Médicale, INSERM U1211, Laboratoire MRGM, Université de Bordeaux, Bordeaux, France
| | - M L Asensio
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, F21000, Dijon, France
| | - J F Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), Evry, France
| | - C Binquet
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, F21000, Dijon, France
| | - C Thauvin-Robinet
- Inserm, Université Bourgogne-Franche-Comté, UMR1231, équipe GAD, Dijon, France
- CHU Dijon-Bourgogne, Centres de Référence Maladies Rares « Anomalies du Développement et syndromes malformatif de l'Est » et « Déficiences intellectuelles de causes rares », Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (TRANSLAD), Dijon, France
| | - C Lejeune
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, F21000, Dijon, France.
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Charleux-Muller D, Romain B, Boisson C, Velten M, Brigand C, Lejeune C. Cost-effectiveness analysis of resorbable biosynthetic mesh in contaminated ventral hernia repair. J Visc Surg 2021; 159:279-285. [PMID: 34116953 DOI: 10.1016/j.jviscsurg.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to compare, in terms of cost and serious complications, the use of biosynthetic resorbable parietal mesh with biologic mesh in patients undergoing contaminated ventral hernia repair (modified Ventral Hernia Working Group grade 3). Poly-4-hydroxy-butyrate (P4HB) biosynthetic mesh has rarely been the subject of comparative studies in the context of contamination. Data are required to confirm the effects of a transition from biological mesh to biosynthetic resorbable mesh. PATIENTS AND METHODS A cost-effectiveness analysis was conducted. It was based on a decision analysis model built with clinical and economic data issued from a before-after study that included 94 patients hospitalized for ventral hernia repair at the University Hospital of Strasbourg (France) from June 2011 to February 2018. The effectiveness endpoint was the number of patients presenting with a serious specific complication or a general complication at 6 months. Data for surgical hospitalization stays, home hospitalizations and ambulatory care costs were included. RESULTS We found fewer serious complications with biosynthetic mesh: 21% versus 33% with biologic mesh. A cost savings of US $5146 was determined. Deterministic sensitivity analyses and a probabilistic analysis confirmed our findings and the robustness of the model. CONCLUSION P4HB biosynthetic resorbable mesh appeared to be the most effective and the least costly option. Additional data will be needed to confirm the superiority of biosynthetic mesh in terms of the recurrence risk reduction over a longer period.
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Affiliation(s)
- D Charleux-Muller
- Department of Digestive Surgery, University Hospital of Strasbourg, 1 avenue Molière, 67200 Strasbourg, France.
| | - B Romain
- Department of Digestive Surgery, University Hospital of Strasbourg, 1 avenue Molière, 67200 Strasbourg, France
| | - C Boisson
- Clinical Epidemiology Unit, Clinical Investigation Center, INSERM, CIC1432, Dijon University Hospital
| | - M Velten
- Department of Public Health, INSERM, UMR-S1113, University Hospital of Strasbourg, 1 place de l'hôpital, 67100 Strasbourg, France
| | - C Brigand
- Department of Digestive Surgery, University Hospital of Strasbourg, 1 avenue Molière, 67200 Strasbourg, France
| | - C Lejeune
- Clinical Epidemiology Unit, Clinical Investigation Center, INSERM, CIC1432, Dijon University Hospital; INSERM, LNC UMR1231, University Bourgogne Franche-Comté, Dijon, France
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Salès-Wuillemin E, Lejeune C, Clain A, Carrel T, Dolard A. Douleur et souffrance : représentations croisées des oncologues et des patients, une étude qualitative. PSYCHO-ONCOLOGIE 2021. [DOI: 10.3166/pson-2021-0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nous mesurons la place de la douleur et de la souffrance dans la représentation du cancer de patients et d’oncologues. Dans l’univers sémantique des patients, la souffrance renvoie à la dégradation du corps et à la vulnérabilité ; la douleur concrétise la maladie et son diagnostic. La souffrance n’est pas évoquée par les oncologues. Pour eux, la douleur est un signe d’évolution de la maladie et un indicateur de la tolérance aux traitements. Au cœur de la relation thérapeutique, l’étude apporte des éléments de réflexion sur l’intercompréhension médecin–patient.
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Nambot S, Sawka C, Bertolone G, Cosset E, Goussot V, Derangère V, Boidot R, Baurand A, Robert M, Coutant C, Loustalot C, Thauvin-Robinet C, Ghiringhelli F, Lançon A, Populaire C, Damette A, Collonge-Rame MA, Meunier-Beillard N, Lejeune C, Albuisson J, Faivre L. Incidental findings in a series of 2500 gene panel tests for a genetic predisposition to cancer: Results and impact on patients. Eur J Med Genet 2021; 64:104196. [PMID: 33753322 DOI: 10.1016/j.ejmg.2021.104196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 02/02/2021] [Accepted: 03/14/2021] [Indexed: 10/21/2022]
Abstract
With next generation sequencing, physicians are faced with more complex and uncertain data, particularly incidental findings (IF). Guidelines for the return of IF have been published by learned societies. However, little is known about how patients are affected by these results in a context of oncogenetic testing. Over 4 years, 2500 patients with an indication for genetic testing underwent a gene cancer panel. If an IF was detected, patients were contacted by a physician/genetic counsellor and invited to take part in a semi-structured interview to assess their understanding of the result, the change in medical care, the psychological impact, and the transmission of results to the family. Fourteen patients (0.56%) were delivered an IF in a cancer predisposition gene (RAD51C, PMS2, SDHC, RET, BRCA2, CHEK2, CDKN2A, CDH1, SUFU). Two patients did not collect the results and another two died before the return of results. Within the 10 patients recontacted, most of them reported surprise at the delivery of IF, but not anxiety. The majority felt they had chosen to obtain the result and enough information to understand it. They all initiated the recommended follow-up and did not regret the procedure. Information regarding the IF was transmitted to their offspring but siblings or second-degree relatives were not consistently informed. No major adverse psychological events were found in our experience. IF will be inherent to the development of sequencing, even for restricted gene panels, so it is important to increase our knowledge on the impact of such results in different contexts.
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Affiliation(s)
- S Nambot
- Centre de Génétique, FHU TRANSLAD, Institut GIMI, CHU Dijon, F-21000, Dijon, France; CGFL, Unité D'oncogénétique et Institut GIMI, F-21000, Dijon, France.
| | - C Sawka
- Centre de Génétique, FHU TRANSLAD, Institut GIMI, CHU Dijon, F-21000, Dijon, France; CGFL, Unité D'oncogénétique et Institut GIMI, F-21000, Dijon, France
| | - G Bertolone
- Centre de Génétique, FHU TRANSLAD, Institut GIMI, CHU Dijon, F-21000, Dijon, France; CGFL, Unité D'oncogénétique et Institut GIMI, F-21000, Dijon, France
| | - E Cosset
- CGFL, Unité D'oncogénétique et Institut GIMI, F-21000, Dijon, France
| | - V Goussot
- Platform of Transfer in Cancer Biology, Department of Biology and Pathology of Tumours, Centre Georges-François Leclerc, Unicancer, F-21000, Dijon, France
| | - V Derangère
- Platform of Transfer in Cancer Biology, Department of Biology and Pathology of Tumours, Centre Georges-François Leclerc, Unicancer, F-21000, Dijon, France
| | - R Boidot
- Platform of Transfer in Cancer Biology, Department of Biology and Pathology of Tumours, Centre Georges-François Leclerc, Unicancer, F-21000, Dijon, France; CNRS, 6302 Unit, Dijon, France
| | - A Baurand
- Centre de Génétique, FHU TRANSLAD, Institut GIMI, CHU Dijon, F-21000, Dijon, France; CGFL, Unité D'oncogénétique et Institut GIMI, F-21000, Dijon, France
| | - M Robert
- Centre de Génétique, FHU TRANSLAD, Institut GIMI, CHU Dijon, F-21000, Dijon, France
| | - C Coutant
- Département de Chirurgie, Centre Georges François Leclerc, F-21000, Dijon, France
| | - C Loustalot
- Département de Chirurgie, Centre Georges François Leclerc, F-21000, Dijon, France
| | - C Thauvin-Robinet
- Centre de Génétique, FHU TRANSLAD, Institut GIMI, CHU Dijon, F-21000, Dijon, France
| | - F Ghiringhelli
- Platform of Transfer in Cancer Biology, Department of Biology and Pathology of Tumours, Centre Georges-François Leclerc, Unicancer, F-21000, Dijon, France; Département D'oncologie Médicale, Centre Georges François Leclerc, Dijon, France; Centre de Recherche INSERM LNC-UMR123, Université de Bourgogne Franche-Comté, F-21000, Dijon, France
| | - A Lançon
- CGFL, Unité D'oncogénétique et Institut GIMI, F-21000, Dijon, France
| | - C Populaire
- Service Génétique et Biologie Du Développement-Histologie, CHU Hôpital Saint-Jacques, Besançon, France
| | - A Damette
- Service Génétique et Biologie Du Développement-Histologie, CHU Hôpital Saint-Jacques, Besançon, France
| | - M A Collonge-Rame
- Service Génétique et Biologie Du Développement-Histologie, CHU Hôpital Saint-Jacques, Besançon, France
| | - N Meunier-Beillard
- INSERM, CIC1432, Module épidémiologie Clinique, Dijon, France; Centre Hospitalier Universitaire Dijon-Bourgogne, Centre D'investigation Clinique, Module épidémiologie Clinique/essais Cliniques, Dijon, France
| | - C Lejeune
- Centre de Recherche INSERM LNC-UMR123, Université de Bourgogne Franche-Comté, F-21000, Dijon, France; INSERM, CIC1432, Module épidémiologie Clinique, Dijon, France; Centre Hospitalier Universitaire Dijon-Bourgogne, Centre D'investigation Clinique, Module épidémiologie Clinique/essais Cliniques, Dijon, France
| | - J Albuisson
- Platform of Transfer in Cancer Biology, Department of Biology and Pathology of Tumours, Centre Georges-François Leclerc, Unicancer, F-21000, Dijon, France; Centre de Recherche INSERM LNC-UMR123, Université de Bourgogne Franche-Comté, F-21000, Dijon, France
| | - L Faivre
- Centre de Génétique, FHU TRANSLAD, Institut GIMI, CHU Dijon, F-21000, Dijon, France; CGFL, Unité D'oncogénétique et Institut GIMI, F-21000, Dijon, France.
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Rohmer J, Couteau‐Chardon A, Trichereau J, Panel K, Gesquiere C, Ben Abdelali R, Bidet A, Bladé J, Cayuela J, Cony‐Makhoul P, Cottin V, Delabesse E, Ebbo M, Fain O, Flandrin P, Galicier L, Godon C, Grardel N, Guffroy A, Hamidou M, Hunault M, Lengline E, Lhomme F, Lhermitte L, Machelart I, Mauvieux L, Mohr C, Mozicconacci M, Naguib D, Nicolini FE, Rey J, Rousselot P, Tavitian S, Terriou L, Lefèvre G, Preudhomme C, Kahn J, Groh M, Ackermann F, Adiko D, Ahwij N, Baruchel A, Beal C, Bemba M, Beylot Barry M, Beyne Rauzy O, Bielefeld P, Boisseau M, Bonmati C, Bonnote B, Borel C, Bouredji D, Brignier A, Brouillard M, Campos F, Carre M, Chalayer E, Chomel JC, Coiteux V, Contejean A, Corby A, Darre S, Dubruille V, Durel CA, El Yamani A, Etancelin P, Etienne N, Evon P, Gyan E, Hachulla E, Hermet M, Huguet F, Ianotto JC, Inchiappa L, Jdid I, Jondeau K, Joubert M, Legrand F, Lejeune C, Le Pendu C, Lidove O, Lemal R, Limal N, Lopinet E, Maloisel F, Marfaing A, Marroun I, Maurier F, Muller E, Muron T, Ojeda M, Paule R, Pignon JM, Rossi C, Roumier M, Sene D, Sene T, Simon L, Slama B, Suarez F, Tcherakian C, Torregrosa JM, Toussaint E, Vatan R, Visanica S, Voilat L, Zini JM. Epidemiology, clinical picture and long-term outcomes of FIP1L1-PDGFRA-positive myeloid neoplasm with eosinophilia: Data from 151 patients. Am J Hematol 2020; 95:1314-1323. [PMID: 32720700 DOI: 10.1002/ajh.25945] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 07/23/2020] [Indexed: 12/11/2022]
Abstract
FIP1L1-PDGFRA-positive myeloid neoplasm with eosinophilia (F/P+ MN-eo) is a rare disease: robust epidemiological data are lacking and reported issues are scarce, of low sample-size and limited follow-up. Imatinib mesylate (IM) is highly efficient but no predictive factor of relapse after discontinuation has yet been identified. One hundred and fifty-one patients with F/P+ MN-eo (143 males; mean age at diagnosis 49 years; mean annual incidence: 0.18 case per million population) were included in this retrospective nationwide study involving all French laboratories who perform the search of F/P fusion gene (study period: 2003-2019). The main organs involved included the spleen (44%), skin (32%), lungs (30%), heart (19%) and central nervous system (9%). Serum vitamin B12 and tryptase levels were elevated in 74/79 (94%) and 45/57 (79%) patients, respectively, and none of the 31 patients initially treated with corticosteroids achieved complete hematologic remission. All 148 (98%) IM-treated patients achieved complete hematologic and molecular (when tested, n = 84) responses. Forty-six patients eventually discontinued IM, among whom 20 (57%) relapsed. In multivariate analysis, time to IM initiation (continuous HR: 1,01 [0.99-1,03]; P = .05) and duration of IM treatment (continuous HR: 0,97 [0,95-0,99]; P = .004) were independent factors of relapse after discontinuation of IM. After a mean follow-up of 80 (56) months, the 1, 5- and 10-year overall survival rates in IM-treated patients were 99%, 95% and 84% respectively. In F/P+ MN-eo, prompt initiation of IM and longer treatment durations may prevent relapses after discontinuation of IM.
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Affiliation(s)
- Julien Rohmer
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine Hôpital Foch Suresnes France
| | - Amélie Couteau‐Chardon
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Intensive Care medicine Centre Hospitalier Annecy Genevois Saint‐Julien‐en‐Genevois France
| | - Julie Trichereau
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Clinical Research Department Hôpital Foch Suresnes France
| | - Kewin Panel
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Clinical Research Department Hôpital Foch Suresnes France
| | - Cyrielle Gesquiere
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
| | - Raouf Ben Abdelali
- Pole Hématologie et Oncologie Laboratoire CERBA Saint‐Ouen‐l'Aumône France
| | - Audrey Bidet
- Laboratory of Hematology CHU de Bordeaux Pessac France
| | | | - Jean‐Michel Cayuela
- Laboratory of Hematology Saint‐Louis Hospital, University of Paris Paris France
| | - Pascale Cony‐Makhoul
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Hematology Department CH Annecy Genevois Annecy France
| | - Vincent Cottin
- National Coordinating Reference Center for Rare Pulmonary Diseases Louis Pradel Hospital Lyon France
- Hospices Civils de Lyon, UMR754, University Claude Bernard Lyon 1 Lyon France
| | - Eric Delabesse
- Laboratory of Hematology Institut Universitaire du Cancer de Toulouse Oncopole, CHU de Toulouse Toulouse France
| | - Mikaël Ebbo
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Aix Marseille University, Department of Internal Medicine Hôpital de la Timone, AP‐HM, CNRS, INSERM, CIML Marseille France
| | - Olivier Fain
- Department of Internal Medicine CHU Saint Antoine Paris France
| | - Pascale Flandrin
- Laboratory of Hematology Hôpital Nord, CHU de Saint‐Étienne Saint‐Étienne France
| | - Lionel Galicier
- Department of Clinical Immunology Saint Louis hospital Paris France
| | - Catherine Godon
- Laboratoire de cytogénétique hématologique CHU de Nantes Nantes France
| | | | - Aurélien Guffroy
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (RESO), Tertiary Center for Primary Immunodeficiency Strasbourg University Hospital Strasbourg France
| | - Mohamed Hamidou
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine CHU de Nantes Nantes France
| | | | | | | | - Ludovic Lhermitte
- University of Paris, Institut National de Recherche Médicale U1151 Laboratory of Onco‐Hematology, Hôpital Necker Enfants‐Malades Paris France
| | - Irène Machelart
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine CHU de Bordeaux Bordeaux France
| | - Laurent Mauvieux
- Université de Strasbourg, INSERM U1113 Interface de Recherche Fondamentale et Appliquée en Cancérologie, Laboratoire d'hématologie du CHRU Strasbourg, Faculté de Médecine de Strasbourg Strasbourg France
| | - Catherine Mohr
- Service d'Hématologie Oncologie, CHU Groupe Hospitalier Sud Réunion Saint Pierre, Reunion France
| | - Marie‐Joelle Mozicconacci
- Institut Paoli‐Calmettes, Centre de Recherche en Cancérologie de Marseille, Biopathologie Marseille France
| | - Dina Naguib
- Laboratory of Hematology CHU Caen Caen France
| | - Franck E. Nicolini
- Department of Hematology INSERM U 1052, CRCL, Centre Léon Bérard Lyon France
| | - Jerome Rey
- Department of Hematology Institut Paoli‐Calmettes Marseille France
| | - Philippe Rousselot
- Hematology Department Versailles André Mignot Hospital, University Paris‐Saclay Le Chesnay France
| | - Suzanne Tavitian
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse‐Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Louis Terriou
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Université de Lille, CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto‐immunes Systémiques Rares du Nord et Nord‐Ouest de France (CeRAINO) Lille France
| | - Guillaume Lefèvre
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Université de Lille, CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto‐immunes Systémiques Rares du Nord et Nord‐Ouest de France (CeRAINO) Lille France
| | | | - Jean‐Emmanuel Kahn
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Université Paris‐Saclay, Department of Internal Medicine Ambroise Paré hospital, Boulogne Billancourt Cedex France
| | - Matthieu Groh
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine Hôpital Foch Suresnes France
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Boeke CE, Khan S, Walsh F, Hettema A, Lejeune C, Spiegelman D, Okello V, Harwell J, Mazibuko S, Bärnighausen T. Universal test and treat in relation to HIV disease progression: results from a stepped-wedge trial in Eswatini. HIV Med 2020; 22:54-59. [PMID: 32876360 DOI: 10.1111/hiv.12941] [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] [Accepted: 07/23/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Universal test and treat (UTT) is recommended for people living with HIV (PLHIV) to reduce morbidity/mortality and minimize transmission. However, concerns exist that this strategy may lead to more crowded hospitals, longer wait times and poorer service, adversely impacting health outcomes for clients with severe disease. We assessed how UTT was related to markers of disease progression in PLHIV overall and specifically among clients with low CD4 count/high World Health Organization (WHO) stage. METHODS The analysis was conducted using data from a stepped-wedge trial of UTT in 14 government-managed health facilities in Eswatini from 2014 to 2017. Disease progression was defined as CD4 count falling below 200 cells/µL or baseline value, > 10% weight loss, body mass index (BMI) dropping below 18.5, incident tuberculosis (TB) or HIV-related death; these outcomes also were assessed individually. We assessed multivariate Cox proportional hazard models overall and specifically among clients with CD4 count < 350 cells/μL or WHO stage 3-4 at enrolment. RESULTS Eight hundred and seven of 3176 clients demonstrated at least one marker of disease progression over 2339 person-years of follow-up. Overall, 62.4% of clients were female; 57.2% were < 35 years old. Compared to clients not exposed to UTT, those exposed to UTT had a lower rate of disease progression overall [adjusted hazard ratio (aHR) 0.60; 95% confidence interval (CI) 0.46-0.78] and a lower rate of CD4 decline (aHR 0.40; 95% CI 0.27-0.58). When the analysis was limited to clients with CD4 count < 350 cells/μL or WHO stage 3-4, UTT was not associated with disease progression (aHR 0.92; 95% CI 0.66-1.29). CONCLUSIONS UTT reduced HIV disease progression overall and was not detrimental for clients with more severe disease.
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Affiliation(s)
- C E Boeke
- Clinton Health Access Initiative, Boston, MA, USA
| | - S Khan
- Clinton Health Access Initiative, Mbabane, Eswatini
| | - F Walsh
- Clinton Health Access Initiative, Boston, MA, USA
| | - A Hettema
- Clinton Health Access Initiative, Mbabane, Eswatini
| | - C Lejeune
- Clinton Health Access Initiative, Mbabane, Eswatini
| | - D Spiegelman
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - V Okello
- Ministry of Health, Mbabane, Eswatini
| | - J Harwell
- Clinton Health Access Initiative, Boston, MA, USA
| | | | - T Bärnighausen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.,Africa Health Research Institute (AHRI), Durban, South Africa
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7
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Chao A, Spiegelman D, Khan S, Walsh F, Mazibuko S, Pasipamire M, Chai B, Reis R, Mlambo K, Delva W, Khumalo G, Zwane M, Fleming Y, Mafara E, Hettema A, Lejeune C, Bärnighausen T, Okello V. Mortality under early access to antiretroviral therapy vs. Eswatini's national standard of care: the MaxART clustered randomized stepped-wedge trial. HIV Med 2020; 21:429-440. [PMID: 32458567 DOI: 10.1111/hiv.12876] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/18/2020] [Accepted: 04/13/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Current WHO guidelines recommend the treatment of all HIV-infected individuals with antiretroviral therapy (ART) to improve survival and quality of life, and decrease infection of others. MaxART is the first implementation trial of this strategy embedded within a government-managed health system, and assesses mortality as a secondary outcome. Because primary findings strongly supported scale-up of the 'treat all' strategy (hereafter Treat All), this analysis examines mortality as an additional indicator of its impact. METHODS MaxART was conducted in 14 Eswatinian health clinics through a clinic-based stepped-wedge design, by transitioning clinics from then-national standard of care (SoC) to the Treat All intervention. All-cause, disease-related, and HIV-related mortality were analysed using the Cox proportional hazards model, censoring SoC participants at clinic transition. Median follow-up time among study participants was 292 days. There were 36/2034 deaths in SoC (1.77%) and 49/1371 deaths in Treat All (3.57%). RESULTS Between September 2014 and August 2017, 3405 participants were enrolled. In SoC and Treat All interventions, respectively, the multivariable-adjusted 12-month all-cause mortality rates were 1.42% [95% confidence interval (CI): 0.66-2.17] and 1.60% (95% CI: 0.78-2.40), disease-related mortality rates were 1.02% (95% CI: 0.40-1.64) and 1.10% (95% CI: 0.46-1.73), and HIV-related mortality rates were 1.03% (95% CI: 0.40-1.65) and 0.99% (95% CI: 0.40-1.58). Treat All had no impact on all-cause [hazard ratio (HR) = 1.12, 95% CI: 0.58-2.18, P = 0.73], disease-related (HR = 1.04, 95% CI: 0.52-2.11, P = 0.90), or HIV-related mortality (HR = 0.93, 95% CI: 0.46-1.87, P = 0.83). CONCLUSION There was no immediate benefit of the Treat All strategy on mortality, nor evidence of harm. Longer follow-up of participants is needed to establish long-term consequences.
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Affiliation(s)
- A Chao
- Department of Biostatistics, Yale School of Public Health, Center for Methods in Implementation and Prevention Science (CMIPS), New Haven, CT, USA
| | - D Spiegelman
- Department of Biostatistics, Yale School of Public Health, Center for Methods in Implementation and Prevention Science (CMIPS), New Haven, CT, USA
| | - S Khan
- Clinton Health Access Initiative (CHAI), Mbabane, Eswatini
| | - F Walsh
- Clinton Health Access Initiative (CHAI), Boston, MA, USA
| | - S Mazibuko
- Eswatini National ART program (SNAP), Ministry of Health, Mbabane, Eswatini
| | - M Pasipamire
- Eswatini National ART program (SNAP), Ministry of Health, Mbabane, Eswatini
| | - B Chai
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - R Reis
- Leiden University Medical Center, Leiden University, Leiden, Netherlands.,Amsterdam Institute for Social Science, University of Amsterdam, Amsterdam, Netherlands.,Children's Institute, University of Cape Town, Cape Town, South Africa
| | - K Mlambo
- Clinton Health Access Initiative (CHAI), Mbabane, Eswatini
| | - W Delva
- The South African Department of Science and Technology - National Research Foundation (DST-NRF) Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa.,Center for Statistics, Hasselt University, Diepenbeek, Belgium.,International Centre for Reproductive Health, Ghent University, Gent, Belgium.,Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - G Khumalo
- Eswatini National Network of People Living with HIV (SWANNEPHA), Mbabane, Eswatini
| | | | | | - E Mafara
- Clinton Health Access Initiative (CHAI), Mbabane, Eswatini
| | - A Hettema
- Clinton Health Access Initiative (CHAI), Mbabane, Eswatini
| | - C Lejeune
- Clinton Health Access Initiative (CHAI), Mbabane, Eswatini
| | - T Bärnighausen
- Heidelberg Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - V Okello
- Directorate Office, Ministry of Health, Mbabane, Eswatini
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8
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Fouillet L, Daguenet E, Guyotat D, Campos-Guyotat L, Grange R, Cornillon J, Jalaber E, Lejeune C, Tavernier E, Flandrin-Gresta P. A complex mutational profile and a distinct clonal evolution during NPM1 myeloid sarcoma. Leuk Lymphoma 2019; 60:2328-2330. [PMID: 30707044 DOI: 10.1080/10428194.2019.1571199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Ludovic Fouillet
- Department of Clinical Hematology, Institut de Cancérologie Lucien Neuwirth , Saint-Priest-en-Jarez , France
| | - Elisabeth Daguenet
- Department of Clinical Hematology, Institut de Cancérologie Lucien Neuwirth , Saint-Priest-en-Jarez , France
| | - Denis Guyotat
- Department of Clinical Hematology, Institut de Cancérologie Lucien Neuwirth , Saint-Priest-en-Jarez , France
| | - Lydia Campos-Guyotat
- Laboratory of Hematology - Molecular Biology, University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Rémi Grange
- Department of Radiology, University Hospital of Saint-Etienne , Saint-Etienne , France
| | - Jérôme Cornillon
- Department of Clinical Hematology, Institut de Cancérologie Lucien Neuwirth , Saint-Priest-en-Jarez , France
| | - Elie Jalaber
- Department of Clinical Hematology, Institut de Cancérologie Lucien Neuwirth , Saint-Priest-en-Jarez , France
| | - Caroline Lejeune
- Department of Clinical Hematology, Institut de Cancérologie Lucien Neuwirth , Saint-Priest-en-Jarez , France
| | - Emmanuelle Tavernier
- Department of Clinical Hematology, Institut de Cancérologie Lucien Neuwirth , Saint-Priest-en-Jarez , France
| | - Pascale Flandrin-Gresta
- Laboratory of Hematology - Molecular Biology, University Hospital of Saint-Etienne , Saint-Etienne , France
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9
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Bernichon E, Daguenet E, Molla C, Cornillon J, Lejeune C, Casteillo F, Guyotat D, Tavernier E. Sinusoidal obstruction syndrome/veno-occlusive disease complication in lymphoma patients treated with oxaliplatin-based regimen: A case series report. Curr Res Transl Med 2018. [DOI: 10.1016/j.retram.2018.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Pozet A, Lejeune C, Bonnet M, Dabakuyo S, Dion M, Fagnoni P, Gaimard M, Meurisse A, Quibel C, Anota A, Nerich V, Bonnetain F. Évaluation de l’impact de l’intervention d’un travailleur social auprès d’aidants informels de personnes âgées atteintes d’une pathologie chronique. Protocole de l’étude ICE : cohorte prospective multicentrique d’aidants informels en BFC. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.03.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Jabre P, Penaloza A, Pinero D, Duchateau FX, Borron SW, Javaudin F, Richard O, de Longueville D, Bouilleau G, Devaud ML, Heidet M, Lejeune C, Fauroux S, Greingor JL, Manara A, Hubert JC, Guihard B, Vermylen O, Lievens P, Auffret Y, Maisondieu C, Huet S, Claessens B, Lapostolle F, Javaud N, Reuter PG, Baker E, Vicaut E, Adnet F. Effect of Bag-Mask Ventilation vs Endotracheal Intubation During Cardiopulmonary Resuscitation on Neurological Outcome After Out-of-Hospital Cardiorespiratory Arrest: A Randomized Clinical Trial. JAMA 2018; 319:779-787. [PMID: 29486039 PMCID: PMC5838565 DOI: 10.1001/jama.2018.0156] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Bag-mask ventilation (BMV) is a less complex technique than endotracheal intubation (ETI) for airway management during the advanced cardiac life support phase of cardiopulmonary resuscitation of patients with out-of-hospital cardiorespiratory arrest. It has been reported as superior in terms of survival. OBJECTIVES To assess noninferiority of BMV vs ETI for advanced airway management with regard to survival with favorable neurological function at day 28. DESIGN, SETTINGS, AND PARTICIPANTS Multicenter randomized clinical trial comparing BMV with ETI in 2043 patients with out-of-hospital cardiorespiratory arrest in France and Belgium. Enrollment occurred from March 9, 2015, to January 2, 2017, and follow-up ended January 26, 2017. INTERVENTION Participants were randomized to initial airway management with BMV (n = 1020) or ETI (n = 1023). MAIN OUTCOMES AND MEASURES The primary outcome was favorable neurological outcome at 28 days defined as cerebral performance category 1 or 2. A noninferiority margin of 1% was chosen. Secondary end points included rate of survival to hospital admission, rate of survival at day 28, rate of return of spontaneous circulation, and ETI and BMV difficulty or failure. RESULTS Among 2043 patients who were randomized (mean age, 64.7 years; 665 women [32%]), 2040 (99.8%) completed the trial. In the intention-to-treat population, favorable functional survival at day 28 was 44 of 1018 patients (4.3%) in the BMV group and 43 of 1022 patients (4.2%) in the ETI group (difference, 0.11% [1-sided 97.5% CI, -1.64% to infinity]; P for noninferiority = .11). Survival to hospital admission (294/1018 [28.9%] in the BMV group vs 333/1022 [32.6%] in the ETI group; difference, -3.7% [95% CI, -7.7% to 0.3%]) and global survival at day 28 (55/1018 [5.4%] in the BMV group vs 54/1022 [5.3%] in the ETI group; difference, 0.1% [95% CI, -1.8% to 2.1%]) were not significantly different. Complications included difficult airway management (186/1027 [18.1%] in the BMV group vs 134/996 [13.4%] in the ETI group; difference, 4.7% [95% CI, 1.5% to 7.9%]; P = .004), failure (69/1028 [6.7%] in the BMV group vs 21/996 [2.1%] in the ETI group; difference, 4.6% [95% CI, 2.8% to 6.4%]; P < .001), and regurgitation of gastric content (156/1027 [15.2%] in the BMV group vs 75/999 [7.5%] in the ETI group; difference, 7.7% [95% CI, 4.9% to 10.4%]; P < .001). CONCLUSIONS AND RELEVANCE Among patients with out-of-hospital cardiorespiratory arrest, the use of BMV compared with ETI failed to demonstrate noninferiority or inferiority for survival with favorable 28-day neurological function, an inconclusive result. A determination of equivalence or superiority between these techniques requires further research. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02327026.
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Affiliation(s)
- Patricia Jabre
- AP-HP, Service d’Aide Médicale d’Urgence (SAMU) de Paris and Paris Sudden Death Expertise Center, Université Paris Descartes, Paris, France
| | - Andrea Penaloza
- Emergency Department, Cliniques universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | - David Pinero
- SAMU de Lyon and Department of Emergency Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France
| | | | - Stephen W. Borron
- Department of Emergency Medicine, Texas Tech University Health Sciences Center, El Paso
| | - Francois Javaudin
- SAMU 44, Department of Emergency Medicine, University Hospital of Nantes, Nantes, France
| | - Olivier Richard
- SAMU 78, Centre Hospitalier de Versailles, Le Chenay, France
| | - Diane de Longueville
- Service des Urgences et du Service Mobile d’Urgence et de Réanimation (SMUR), CHU Saint-Pierre, Brussels, Belgium
| | | | | | - Matthieu Heidet
- AP-HP, SAMU 94, Hôpital Henri Mondor, Université Paris-Est Créteil, EA-4330, Créteil, France
| | | | | | - Jean-Luc Greingor
- SAMU, The Mercy Regional Hospital Centre (CHR) of Metz-Thionville, Ars-Laquenexy, France
| | - Alessandro Manara
- Emergency Department, Cliniques universitaires Saint Luc, Université Catholique de Louvain, Belgium
| | | | | | | | | | | | | | - Stephanie Huet
- AP-HP, SMUR Hôtel-Dieu, hôpital Hôtel-Dieu, Paris, France
| | - Benoît Claessens
- Service des Urgences et du Service Mobile d’Urgence et de Réanimation (SMUR), CHU Saint-Pierre, Brussels, Belgium
| | | | - Nicolas Javaud
- AP-HP, Urgences, Hôpital Louis Mourier, Colombes, France
| | | | - Elinor Baker
- AP-HP, SAMU 93, Hôpital Avicenne, Inserm U942, Bobigny, France
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique, hôpital Fernand Widal, Université Paris-Diderot, Paris, France
| | - Frédéric Adnet
- AP-HP, SAMU 93, Hôpital Avicenne, Inserm U942, Bobigny, France
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Bennedjai A, Houiller C, Choquet S, Cassoux N, Guesquières H, Marolleau J, Chabrot C, Jdid I, Lejeune C, Bodaghi B, Le Hoang P, Hoang-Xuan K, Soussain C, Touitou V. High-dose chemotherapy with autologus hematopoeitic stem cell transplantation in relapsing Vitreoretinal Lymphoma, a LOC network study. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0s081] [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: 11/27/2022]
Affiliation(s)
- A. Bennedjai
- Ophtalmology; hôpital La Pitié Salpêtrière; Paris France
| | | | - S. Choquet
- Hematology; Pitié salpêtrière; Paris France
| | | | | | | | - C. Chabrot
- Hematology; CHU Clermont-Ferrand; Clermont-Ferrand France
| | - I. Jdid
- Hematology; CH Orléans; Orleans France
| | | | - B. Bodaghi
- Ophtalmology; Pitié Salpêtrièe; Paris France
| | - P. Le Hoang
- Ophtalmology; Pitié Salpêtrière; Paris France
| | | | | | - V. Touitou
- Ophtalmology; Pitié Salpêtrière; Paris France
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Boissel A, Gueneau P, Mondoloni P, Hervieu-Begue M, Delpont B, Bejot Y, Lejeune C, Fagnoni P. Telemedicine: Economic and clinical evaluation of the management of ischemic stroke. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.eurtel.2017.02.044] [Citation(s) in RCA: 3] [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: 11/16/2022]
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Fayt G, Lejeune C, Arco D, Higuet S. [News Skin lesions : a case report of fixed drug eruption]. Rev Med Brux 2017; 38:439-441. [PMID: 29178693] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Fixed drug eruption is an erythematous eruption of one or more centimetric rounded or oval lesions well demarcated, recurrent at the same place and leaving a residual purple pigmentation. Diagnosis is clinical. Skin biopsy is not essential except in doubtful cases (eg bullous drug eruption can simulate Lyell Syndrome or mucosal reminiscent of erythema multiforme). The etiology is almost always drug-induced; rare cases of toxic or food issue were reported. Histopathology is immuno-allergic; recurrences correspond to re-exposure to allergen. There is no specific treatment except stopping the causing drug.
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Affiliation(s)
- G Fayt
- Service de Gériatrie, Hôpital André Vésale, C.H.U. de Charleroi
| | - C Lejeune
- Service de Dermatologie, Hôpital André Vésale, C.H.U. de Charleroi
| | - D Arco
- Service de Dermatologie, Hôpital André Vésale, C.H.U. de Charleroi
| | - S Higuet
- Service de Gériatrie, Hôpital André Vésale, C.H.U. de Charleroi
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Brunet L, Garnier N, Lejeune C, Mourey E, Cormier L, Fagnoni P, Guenfoudi M. Photovaporisation prostatique au laser Greenlight® : comparaison des couts (microcosting) et des recettes (t2a). Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Geurten M, Majerus S, Lejeune C, Catale C. Questionnaire of Memory (Q-MEM): A new measure of everyday memory functioning in school-age children. Appl Neuropsychol Child 2016; 7:44-51. [PMID: 27726446 DOI: 10.1080/21622965.2016.1239201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We present a new measure of everyday memory, the Questionnaire of Memory (Q-MEM), which is specifically adapted for the ecological assessment of memory disorders in school-age children and constructed with four sections tapping effortful/intentional learning, automatic/procedural learning, prospective memory/organization, and working memory. Confirmatory Factor Analyses supported the Q-MEM's four-factor structure in 700 five-to twelve-year-old children. The analyses also revealed a good internal reliability and a good test-retest fidelity. Finally, comparisons between Q-MEM profiles of children with learning disabilities and typically developing children revealed significant differences. Therefore, the Q-MEM is a promising measure for identifying memory problems in children.
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Affiliation(s)
- Marie Geurten
- a Psychology and Neuroscience of Cognition Unit , University of Liège , Liège , Belgium.,b Department of Psychology , University of Aix-Marseille , Marseille , France
| | - Steve Majerus
- b Department of Psychology , University of Aix-Marseille , Marseille , France
| | - Caroline Lejeune
- c Psychological and Speech Therapy Consultation Center (CPLU) , University of Liège , Liège , Belgium
| | - Corinne Catale
- c Psychological and Speech Therapy Consultation Center (CPLU) , University of Liège , Liège , Belgium
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Gueneau P, Mondoloni P, Hervieu-Begue M, Boissel A, Delpont B, Bejot Y, Lejeune C, Fagnoni P. Télémédecine et accident vasculaire cérébral : étude de coût sur la téléfibrinolyse. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.eurtel.2016.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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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Lejeune C. Procedural learning in development and in Developmental Coordination Disorder. Ann Phys Rehabil Med 2015. [DOI: 10.1016/j.rehab.2015.07.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Geurten M, Lejeune C, Meulemans T. Time’s up! Involvement of metamemory knowledge, executive functions, and time monitoring in children’s prospective memory performance. Child Neuropsychol 2015; 22:443-57. [DOI: 10.1080/09297049.2014.998642] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lejeune C, Wansard M, Geurten M, Meulemans T. Procedural learning, consolidation, and transfer of a new skill in Developmental Coordination Disorder. Child Neuropsychol 2015; 22:143-54. [DOI: 10.1080/09297049.2014.988608] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lejeune C, Desmottes L, Catale C, Meulemans T. Age difference in dual-task interference effects on procedural learning in children. J Exp Child Psychol 2015; 129:165-72. [DOI: 10.1016/j.jecp.2014.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Revised: 07/11/2014] [Accepted: 07/27/2014] [Indexed: 10/24/2022]
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Catale C, Geurten M, Lejeune C, Meulemans T. The Conners Parent Rating Scale: Psychometric properties in typically developing 4- to 12-year-old Belgian French-speaking children. European Review of Applied Psychology 2014. [DOI: 10.1016/j.erap.2014.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Schmitz X, Bier N, Joubert S, Lejeune C, Salmon E, Rouleau I, Meulemans T. The Benefits of Errorless Learning for Serial Reaction Time Performance in Alzheimer's Disease. J Alzheimers Dis 2014; 39:287-300. [DOI: 10.3233/jad-130887] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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]
Affiliation(s)
- Xavier Schmitz
- Neuropsychology Unit, Department of Cognitive Science, University of Liège, Belgium
| | - Nathalie Bier
- Department of Psychology, Université de Montréal and Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Sven Joubert
- Department of Psychology, Université de Montréal and Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Caroline Lejeune
- Neuropsychology Unit, Department of Cognitive Science, University of Liège, Belgium
| | - Eric Salmon
- Memory Clinic, Department of Neurology, CHU Liège, Belgium
| | - Isabelle Rouleau
- Department of Psychology, Université du Québec à Montréal and Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Thierry Meulemans
- Neuropsychology Unit, Department of Cognitive Science, University of Liège, Belgium
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Catale C, Lejeune C, Schmitz X, Meulemans T. Validation d’un test d’inhibition auprès d’enfants présentant un trouble déficitaire de l’attention avec ou sans hyperactivité. ACTA ACUST UNITED AC 2014. [DOI: 10.1037/a0031006] [Citation(s) in RCA: 7] [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: 11/08/2022]
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Lavolé A, Lejeune C, Epaud C, Rosencher L, Ruppert AM, Gounant V, Créquit P, Rousseau-Bussac G, Wislez M, Cadranel J. Délai de prise en charge du cancer du poumon (CP) en hôpital de jour d’un centre expert en oncologie thoracique. Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2013.10.478] [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: 10/25/2022]
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Soilly AL, Lejeune C, Quantin C, Bejean S, Gouyon JB. Economic analysis of the costs associated with prematurity from a literature review. Public Health 2013; 128:43-62. [PMID: 24360723 DOI: 10.1016/j.puhe.2013.09.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 02/12/2013] [Accepted: 09/23/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To analyse published cost-of-illness studies that had assessed the cost of prematurity according to gestational age at birth. METHODS A review of the literature was carried out in March 2011 using the following databases: Medline, ScienceDirect, The Cochrane Library, Econlit and Business Source Premier, and a French Public-Health database. Key-word sequences related to 'prematurity' and 'costs' were considered. Studies that assessed costs according to the gestational age (GA) at the premature birth (<37 weeks of gestation) in industrialized countries and during the last two decades were included. Variations in the reported costs were analysed using a check-list, which allowed the studies to be described according to several methodological and contextual criteria. RESULTS A total of 18 studies published since 1990 were included. According to these studies, costs were assessed for different follow-up periods (short, medium or long-term), and for different degrees of prematurity (extreme, early, moderate and late). Results showed that whatever the follow-up period, costs correlated inversely with GA. They also showed considerable variability in costs within the same GA group. Differences between studies could be explained by the choices made, concerning i/the study populations, ii/contextual information, iii/and various economic criteria. Despite these variations, a global trend of costs was estimated in the short-term period using mean costs from four American studies that presented similar methodologies. Costs stand at over US$ 100,000 for extreme prematurity, between US$ 40,000 and US$ 100,000 for early prematurity, between US$ 10,000 and US$ 30,000 for moderate prematurity and below US$ 4500 for late prematurity. CONCLUSION This review underlined not only the clear inverse relationship between costs and GA at birth, but also the difficulty to transfer the results to the French context. It suggests that studies specific to the French health system need to be carried out.
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Affiliation(s)
- A L Soilly
- Centre d'Epidémiologie et de Santé Publique de Bourgogne, EA 4184, Université de Bourgogne, Dijon, France; Université de Bourgogne, Laboratoire d'Economie et de Gestion, CNRS FRE3496, Dijon, France.
| | - C Lejeune
- Inserm, CIE1, CHU de Dijon, Dijon, France
| | - C Quantin
- CHRU, Service de Biostatistique et d'Informatique Médicale, CHU de Dijon, France
| | - S Bejean
- Université de Bourgogne, Laboratoire d'Economie et de Gestion, CNRS FRE3496, Dijon, France
| | - J B Gouyon
- Centre d'Epidémiologie et de Santé Publique de Bourgogne, EA 4184, Université de Bourgogne, Dijon, France; CHU de la Réunion, Centre d'Etudes Périnatales de l'Océan Indien, France
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Lejeune C, Catale C, Schmitz X, Quertemont E, Meulemans T. Age-related differences in perceptuomotor procedural learning in children. J Exp Child Psychol 2013; 116:157-68. [DOI: 10.1016/j.jecp.2013.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 05/06/2013] [Accepted: 05/06/2013] [Indexed: 11/17/2022]
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Lejeune C, Catale C, Willems S, Meulemans T. Intact procedural motor sequence learning in developmental coordination disorder. Res Dev Disabil 2013; 34:1974-1981. [PMID: 23584177 DOI: 10.1016/j.ridd.2013.03.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 03/14/2013] [Accepted: 03/14/2013] [Indexed: 06/02/2023]
Abstract
The purpose of the present study was to explore the possibility of a procedural learning deficit among children with developmental coordination disorder (DCD). We tested 34 children aged 6-12 years with and without DCD using the serial reaction time task, in which the standard keyboard was replaced by a touch screen in order to minimize the impact of perceptuomotor coordination difficulties that characterize this disorder. The results showed that children with DCD succeed as well as control children at the procedural sequence learning task. These findings challenge the hypothesis that a procedural learning impairment underlies the difficulties of DCD children in acquiring and automatizing daily activities. We suggest that the previously reported impairment of children with DCD on the serial reaction time task is not due to a sequence learning deficit per se, but rather due to methodological factors such as the response mode used in these studies.
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Affiliation(s)
- Caroline Lejeune
- Department of Psychology, Behavior and Cognition, Neuropsychology Unit, University of Liège, Belgium.
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Catale C, Lejeune C, Merbah S, Meulemans T. French Adaptation of the Childhood Executive Functioning Inventory (CHEXI). European Journal of Psychological Assessment 2013. [DOI: 10.1027/1015-5759/a000141] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Thorell and Nyberg (2008 ) recently developed the Childhood Executive Functioning Inventory (CHEXI), a new rating instrument for executive functioning in day-to-day life which can be divided into four subscales: working memory, planning, inhibition, and regulation. Using an exploratory factor analysis on data from young Swedish children attending kindergarten, Thorell and Nyberg (2008 ) found a two-factor solution that taps working memory and inhibition. In the present study, we explored the psychometric characteristics of the French adaptation of the CHEXI. A group of 95 parents of 5- and 6-year-old children completed the CHEXI, 87 of whom were given clinical inhibition and working memory tasks. Confirmatory factor analyses confirmed the two-factor solution based on inhibition and working memory that was identified in the original study of Swedish children. Supplementary results indicated good internal and test-retest reliability for the entire scale, as well as for the two subscales identified. Correlation analyses showed no relationship between cognitive measures and the CHEXI subscales. Possible clinical applications for the CHEXI scales are discussed.
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Affiliation(s)
| | | | - Sarah Merbah
- Neuropsychology Unit, University of Liège, Belgium
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Lejeune C, Genest L, Miossec E, Simonpoli AM, Simmat-Durand L. [Retrospective analysis of neonatal data in a monocentric cohort of 170 newborns of polydrug-using mothers, Île-de-France, 1999-2008]. Arch Pediatr 2012; 20:146-55. [PMID: 23266175 DOI: 10.1016/j.arcped.2012.11.014] [Citation(s) in RCA: 9] [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] [Received: 02/16/2012] [Revised: 11/09/2012] [Accepted: 11/15/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To analyze neonatal morbidity in a single-center retrospective cohort (1999-2008) according to the mothers' polydrug use and to the social and demographic context. MATERIAL AND METHODS One hundred and seventy newborns were identified whose mothers used two or more substances (such as heroin, cocaine, opioid maintenance treatment, tobacco, alcohol, hashish, amphetamines, benzodiazepines, or other psychotropics) at the beginning of their pregnancies. The database included 168 sociodemographic variables describing mothers' living conditions and their drug-abuse characteristics; perinatal variables such as gestational age, weight, neonatal abstinence syndrome, and modalities of discharge; and correlations with the main neonatal morbidities. RESULTS The mothers' mean age at delivery was 31.6yrs. It was the first pregnancy for 35.2% of the mothers but the mean number of previous abortions was 1.14 and 16.3% already had previous children in foster care. At delivery only 8.2% used only one product, 52.9% 2 or 3 products, and 37.6% four or more substances. All sociodemographic variables, the deprivation score, the number of previous abortions and miscarriages, and poor prenatal monitoring were significantly different for the mothers using four products or more. The uses changed along the years of study: fewer mothers used heroin but more used hashish, combined with other substances. The medical care also changed: greater participation on the part of mothers in neonatal care, more frequent breastfeeding, less medication for neonatal abstinence syndrome with the same severity score: i.e., 45.5% of infants with a Lipsitz score between 8 and 12 received a morphine treatment in 1999-2000 versus only 5.5% in 2005-2006 and none in 2007-2008. The mean gestational age was 38.1weeks. Preterm births (22.2%) and intrauterine growth restriction (18% with birth weight <10th percentile) were mainly correlated with the number of substances at delivery (17.3% preterm if three substances or less and 31.3% if four substances or more; p<0.001), social deprivation, poor prenatal care, and mothers having gained less than 5kg in weight during pregnancy (57.1% of intrauterine growth restriction versus 14.5%). Birth weight, height, and head circumference were significantly different for mothers having drunken alcohol. Among the newborns, seven showed complete fetal alcohol syndrome. The neonatal abstinence syndrome severity (23% with a Lipsitz score>9, one-quarter of whom were medicated with morphine) was correlated with an in-utero exposure to opiates, mainly in combination with benzodiazepines, and with the use of four or more substances. The mean age of infants at discharge was 18.1days (SD 3.39): 21.1% stayed 30 days or more in the hospital, mainly because of prematurity or intrauterine growth restriction, a high neonatal abstinence syndrome score, maternal polydrug use, psychosocial deprivation, or foster care placement decisions. Decisions for foster care placement (15%) applied to polydrug users, with social deprivation, undermonitored pregnancies, or bonding difficulties. CONCLUSION The main factors correlated with poor neonatal results were polydrug use, maternal psychiatric pathologies, and social deprivation. Overall, prenatal and postnatal care such as rooming-in improved the results.
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Affiliation(s)
- C Lejeune
- Service de néonatologie, université Paris Diderot, hôpital Louis-Mourier (AP-HP), 178, rue des Renouillers, 92700 Colombes, France.
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Catteau X, Heenen M, Lejeune C, Noël JC. [A rare lesion of the vulva]. Ann Pathol 2012; 32:156-9. [PMID: 22520613 DOI: 10.1016/j.annpat.2011.09.179] [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: 02/21/2011] [Revised: 05/27/2011] [Accepted: 09/14/2011] [Indexed: 11/16/2022]
Affiliation(s)
- Xavier Catteau
- Laboratoire d'anatomie pathologique, hôpital Erasme, université Libre de Bruxelles, Belgique.
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Toutain S, Simmat-Durand L, Crenn-Hébert C, Simonpoli AM, Vellut N, Genest L, Miossec E, Lejeune C. [Consequences for the newborn of alcohol consumption during pregnancy]. Arch Pediatr 2010; 17:1273-80. [PMID: 20719484 DOI: 10.1016/j.arcped.2010.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2009] [Revised: 05/27/2010] [Accepted: 06/28/2010] [Indexed: 11/16/2022]
Abstract
BACKGROUND This paper aims at showing the immediate and long-term consequences affecting newborns whose mothers did not reduce or stop their consumption of alcohol when they were pregnant; these women were chosen among women who also used psychoactive substances. METHODS A retrospective cohort was constituted of babies who were found to have been exposed in utero to one or more legal or illegal psychoactive substance(s) and who were born or hospitalized between 1999 and 2008 in a hospital near Paris. Among the cohort of 170 babies, 56 had mothers who had not modified their alcohol consumption when they were pregnant, 30 had mothers who had reduced their alcohol consumption, and 84 had mothers who declared having been abstinent. RESULTS The babies born to mothers who did not modify their alcohol consumption when pregnant were more likely to be premature (30%) and hospitalized in the neonatology hospital unit (60.7%). They needed specific care for durations significantly longer than the babies exposed in utero to other psychoactive substances (P<0.005). They were more often diagnosed with fetal alcohol spectrum disorders (18%) and placed in a foster family (18%). CONCLUSION Given the negative consequences on the babies born to mothers who do not modify their alcohol consumption when pregnant, these mothers should be identified and provided with better care. The successful strategies for early therapeutic interventions used in other countries should be studied as examples. This would make it possible to reduce the enormous financial, material and human costs that are a direct consequence of alcohol consumption during pregnancy.
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Affiliation(s)
- S Toutain
- CERMES 3, équipe 2, Cesames université Paris Descartes, 45, rue des Saints-Pères 75270 Paris cedex 06, France.
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Bauby C, Dandres AM, Lejeune C. [Gennevilliers parents-babies unit: PMI-pedopsychiatrist partnership]. Arch Pediatr 2010; 17:624-5. [PMID: 20654811 DOI: 10.1016/s0929-693x(10)70029-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Dahmani S, Stany I, Brasher C, Lejeune C, Bruneau B, Wood C, Nivoche Y, Constant I, Murat I. Pharmacological prevention of sevoflurane- and desflurane-related emergence agitation in children: a meta-analysis of published studies. Br J Anaesth 2010; 104:216-23. [PMID: 20047899 DOI: 10.1093/bja/aep376] [Citation(s) in RCA: 223] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Emergence agitation (EA) in children is increased after sevoflurane anaesthesia. The efficacy of prophylactic treatment is controversial. The aim of this study was to provide a meta-analysis of the studies of the pharmacological prevention of EA in children. METHODS A comprehensive literature search was conducted to identify clinical trials that focused on the prevention of EA in children anaesthetized with sevoflurane, desflurane, or both. The data from each trial were combined using the Mantel-Haenszel model to calculate the pooled odds ratio (OR) and 95% confidence interval. I(2) statistics were used to assess statistics heterogeneity and the funnel plot and the Begg-Mazumdar test to assess bias. RESULTS Thirty-seven articles were found which included a total of 1695 patients in the intervention groups and 1477 in the control ones. Midazolam and 5HT(3) inhibitors were not found to have a protective effect against EA [OR=0.88 (0.44, 1.76); OR=0.39 (0.12, 1.31), respectively], whereas propofol [OR=0.21 (0.16, 0.28)], ketamine [OR=0.28 (0.13, 0.60)], alpha(2)-adrenoceptors [OR=0.23 (0.17, 0.33)], fentanyl [OR=0.31 (0.18, 0.56)], and peroperative analgesia [OR=0.15 (0.07, 0.34)] were all found to have a preventive effect. Subgroup analysis according to the peroperative analgesia given does not affect the results. CONCLUSIONS This meta-analysis found that propofol, ketamine, fentanyl, and preoperative analgesia had a prophylactic effect in preventing EA. The analgesic properties of these drugs do not seem to have a role in this effect.
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Affiliation(s)
- S Dahmani
- Department of Anesthesiology, Robert Debre University Hospital, Assistance Publique des Hôpitaux de Paris, 48 Bd Serurier, 75019 Paris, France.
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Lejeune C, Simonpoli AM, Gressens P. [Obstetrical and pediatric impact of in utero cocaine exposure]. Arch Pediatr 2009; 16 Suppl 1:S56-63. [PMID: 19836669 DOI: 10.1016/s0929-693x(09)75302-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Review of recent publications about perinatal consequences of cocaine use during pregnancy points out that: - dramatic obstetrical, neonatal and developmental abnormalities, reported during 1980-90', are less frequent in recent cohort studies; - pregnant women who use cocaine or crack, also consume other psychoactive drugs (alcohol, tobacco, benzodiazepines, cannabis, opiates, ...) and have a very chaotic life-style; so, it is difficult to distinguish abnormalities caused by cocaine per se, even with numerous cohorts, control groups and multivariate analysis.
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Affiliation(s)
- C Lejeune
- Service de Néonatologie, Hôpital Louis Mourier, Colombes, France.
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37
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Lejeune C, Laporte M, Musette S, Petein M, Heenen M. [Interest of immunohistochemic markers (Ki67, HMB45, p53) in risk analysis of congenital naevi of little and middle size]. Rev Med Brux 2009; 30:477-482. [PMID: 19998792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The risk to develop melanoma from small or medium size congenital naevus remain controversial. The main goal of the present study was to determine the interest of three immunohistochemical markers (Ki67, HMB45 and p53) in predicting malignant transformation of these congenital naevi and to see if a specific immunohistochemical profile of such transformed naevi can be identified. The markers (Ki67, HMB45 and p53) have been used retrospectively on sections of small or medium size congenital naevi (group NC, n = 15), of melanoma developed on small or medium size congenital naevi (group MNC, n = 15) and of melanoma developed on acquired naevi (group MNA, n = 15). The labelled cells have been counted in different cutaneous layers: junction, superficial dermal layer and deep dermal layer. No reactivity was observed for the three markers in group NC. The percentage of labelled cells was significantly different for the three markers between the group NC and the groups MNC and MNA. There was no difference between the groups MNC and MNA. In the groups MNC and MNA, a gradient in the percentage of labelled cells was observed between superficial and deep layers. These three markers do not differentiate melanoma developed from congenital naevi of small or medium size and melanoma developed from acquired naevi. Moreover, the results suggest that these three markers are useless in predicting the risk of malignant transformation of small or medium size congenital naevi.
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Affiliation(s)
- C Lejeune
- Service de Dermatologie, Hôpital Erasme, Bruxelles
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Seror E, Chapelon E, Bué M, Garnier-Lengliné H, Lebeaux-Legras C, Loudenot A, Lejeune C. [Alcohol and pregnancy]. Arch Pediatr 2009; 16:1364-73. [PMID: 19683904 DOI: 10.1016/j.arcped.2009.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2009] [Revised: 04/24/2009] [Accepted: 07/04/2009] [Indexed: 11/29/2022]
Abstract
Alcohol consumption during pregnancy is a major cause of mental retardation in Western countries. Fetal alcohol syndrome (FAS) is mainly characterized by pre- and postnatal stunted growth, neurocognitive disorders, and facial dysmorphism. It compromises the intellectual and behavioral prognosis of the child. Prevention tools exist, through better information of health professionals, for optimal care of high-risk women before, during, and after pregnancy, which would decrease the incidence of SAF in the future.
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Affiliation(s)
- E Seror
- Service d'hématologie pédiatrique, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1 avenue Claude-Vellefaux, Paris cedex 10, France.
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Dumas A, Lejeune C, Simmat-Durand L, Crenn-Hébert C, Mandelbrot L. Grossesse et substances psychoactives : étude de prévalence de la consommation déclarée. ACTA ACUST UNITED AC 2008; 37:770-8. [DOI: 10.1016/j.jgyn.2008.05.014] [Citation(s) in RCA: 6] [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] [Received: 12/07/2007] [Revised: 05/26/2008] [Accepted: 05/28/2008] [Indexed: 10/21/2022]
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Lemonnier I, Baumann C, Jay N, Alzahouri K, Arveux P, Jolly D, Lejeune C, Velten M, Vitry F, Woronoff-Lemsi MC, Guillemin F. La tomographie par émission de positon (TEP) modifie t-elle la prise en charge diagnostique du nodule pulmonaire isolé (NPI) ? Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Vendittelli F, Tessier V, Crenn-Hébert C, Lejeune C. [Medical practice assessment: an introduction]. J Gynecol Obstet Biol Reprod (Paris) 2008; 37:127-134. [PMID: 18313235 DOI: 10.1016/j.jgyn.2008.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Revised: 12/14/2007] [Accepted: 01/08/2008] [Indexed: 05/26/2023]
Abstract
Medical practice assessment is mandatory in France. The goal of this article is to explain to perinatal care providers the concept and the process, which do not seem simple, given the multitude of possible ways to evaluate and validate its medical practices. Concrete examples help to illustrate the process. French regulations now link medical practice assessment with continuing medical education (CME) for physicians. While certification is voluntary, a practice assessment conducted during hospital certification processes and during CME is required for all French physicians.
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Affiliation(s)
- F Vendittelli
- Réseau de santé périnatale d'Auvergne, CHU de Clermont-Ferrand, boulevard Léon-Malfreyt, 63058 Clermont-Ferrand cedex 1, France.
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Folprecht G, Tabernero J, Kohne CH, Zacharchuk C, Paz-Ares L, Rojo F, Quinn S, Casado E, Salazar R, Abbas R, Lejeune C, Marimon I, Andreu J, Ubbelohde U, Cortes-Funes H, Baselga J. Phase I Pharmacokinetic/Pharmacodynamic Study of EKB-569, an Irreversible Inhibitor of the Epidermal Growth Factor Receptor Tyrosine Kinase, in Combination with Irinotecan, 5-Fluorouracil, and Leucovorin (FOLFIRI) in First-Line Treatment of Patients with Metastatic Colorectal Cancer. Clin Cancer Res 2008; 14:215-23. [DOI: 10.1158/1078-0432.ccr-07-1053] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [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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Genet D, Lejeune C, Bonnier P, Aubard Y, Venat-Bouvet L, Adjadj DJ, Martin J, Labourey JL, Benyoub A, Clavère P, Lebrun-Ly V, Juin P, Piana L, Tubiana-Mathieu N. Concomitant intensive chemoradiotherapy induction in non-metastatic inflammatory breast cancer: long-term follow-up. Br J Cancer 2007; 97:883-7. [PMID: 17876327 PMCID: PMC2360400 DOI: 10.1038/sj.bjc.6603987] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [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] [Indexed: 11/08/2022] Open
Abstract
The aim of this study was to evaluate with a long follow-up the efficacy of concomitant chemoradiotherapy in non-metastatic inflammatory breast cancer (IBC) and to evaluate the breast conservation rate. Between 1990 and 2000, 66 non-metastatic patients with IBC were treated with chemotherapy and concomitant irradiation. The induction chemotherapy consisted of epirubicine, cyclophosphamide and vindesine, in association with split-course bi-fractionated irradiation to a total dose of 65 Gy with concomitant cisplatin and 5-fluorouracil. Maintenance chemotherapy consisted of high-dose methotrexate and six cycles of epirubicine, cyclophosphamide and fluorouracil. Hormonal treatment was given if indicated. Mastectomy was not systemic. Among 65 evaluable patients, 57 (87.6%) achieved a complete clinical response and had a breast conservation. Only six loco regional relapses were noted in six patients with a delay of 20 months and with concomitant metastatic dissemination in four cases. Median disease-free survival (DFS) was 28 months. Median overall survival (OS) was 63 months and median follow-up was 55.5 months. Induction chemotherapy and concomitant irradiation is feasible in patients with IBC, permitting a breast conservation with a high rate of local control with an OS comparable to that of the best recent series.
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MESH Headings
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/radiotherapy
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/radiotherapy
- Cisplatin/administration & dosage
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- Disease-Free Survival
- Dose Fractionation, Radiation
- Epirubicin/administration & dosage
- Female
- Fluorouracil/administration & dosage
- Follow-Up Studies
- Humans
- Menopause
- Middle Aged
- Remission Induction
- Survival Rate
- Time Factors
- Treatment Outcome
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Affiliation(s)
- D Genet
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - C Lejeune
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - P Bonnier
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - Y Aubard
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - L Venat-Bouvet
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - D J Adjadj
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - J Martin
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - J L Labourey
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - A Benyoub
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - P Clavère
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - V Lebrun-Ly
- Department of medical oncology, CHU Dupuytren, Limoges, France
| | - P Juin
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - L Piana
- Department of medical oncology, CHU de la Conception, Marseille, France
| | - N Tubiana-Mathieu
- Department of medical oncology, CHU Dupuytren, Limoges, France
- E-mail:
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Affiliation(s)
- C Lejeune
- Service de néonatologie, hôpital Louis-Mourier, universite Paris-VII, Assistance publique-Hôpitaux de Paris, 178, rue des Renouillers, 92701 Colombes, France.
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Affiliation(s)
- C Lejeune
- Service de Néonatologie, Hôpital Louis-Mourier (APHP), Université Paris-VII, 178, rue des Renouillers, 92701 Colomberes cedex, 92701 Colombes, France.
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Ducloy-Bouthors A, Lejeune C, Bauters A, Provost N, Nobecourt C, Tournoys A, Wibaut B, Jude B. 25 ROTEM® normal values at the end of pregnancy and immediate post-partum period. Thromb Res 2007. [DOI: 10.1016/s0049-3848(07)70070-1] [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: 10/23/2022]
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Parent F, Lemenu D, Lejeune C, Komba D, Baulana R, Kahombo G, Coppieters Y. Référentiel de compétences infirmières en RD du Congo dans le cadre du renforcement des ressources humaines en santé. Santé Publique 2006; 18:459-73. [PMID: 17094685 DOI: 10.3917/spub.063.0459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This article describes the results of a participatory process aiming to design and develop a referential of competencies for nurses to be used in secondary professional training within the context of the global South, and more specifically in the Democratic Republic of Congo (DRC). Priority focus is given to the presentation of the final validated product. The competencies' referential is accompanied by a training referential as a pre-requisite guide, which outlines the course of study. Only the referential of competencies is described in this article. The result documents, in the first instance, the shape which this referential of competencies takes in reality, from which a school nurse can be brought to mobilise while practicing his/her profession. The referential's basis and presentation is founded on four key skill sets as a starting point. Each of the four key skills were further broken down and divided according to levels of competencies and minimal criteria for perfecting these skills per year of study. The presentation of the referential of competencies ends by regrouping "families of situations" for each year as well as with an adapted glossary. The discussion focuses on the results of the referential of competencies in its context but also on the use which should be made of this tool within the framework of the implementation of the education and training reform for nurses in DRC. Another point is the interest of this approach by skills for various types of professional training in the health sciences.
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Affiliation(s)
- F Parent
- Département d'Epidémiologie et de Promotion de la Santé, Ecole de Santé publique, Université Libre de Bruxelles (ULB), Bruxelles, Belgique
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Saillant D, Chabrolle JP, Lejeune C. [Treatment of opioid neonatal abstinence syndrome]. Arch Pediatr 2005; 12:1162. [PMID: 15913969 DOI: 10.1016/j.arcped.2005.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Accepted: 02/23/2005] [Indexed: 11/25/2022]
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49
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Alzahouri K, Lejeune C, Woronoff-Lemsi MC, Arveux P, Guillemin F. Cost-effectiveness analysis of strategies introducing FDG-PET into the mediastinal staging of non-small-cell lung cancer from the French healthcare system perspective. Clin Radiol 2005; 60:479-92. [PMID: 15767106 DOI: 10.1016/j.crad.2004.10.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2004] [Revised: 10/03/2004] [Accepted: 10/08/2004] [Indexed: 10/25/2022]
Abstract
AIM To determine the most cost-effective strategy using PET for mediastinal staging of potentially operable non-small-cell lung cancer (NSCLC). METHODS Four decision strategies based on French NSCLC work-up practices for the selection of potential surgical candidates were compared, comprising CT only, PET for negative CT, PET for all with anatomical CT, and CT and PET for all cases. The medical literature was surveyed to obtain values for all variables of interest. Costs were assessed with reimbursements from the French healthcare insurance for the year 1999. Expected cost and life expectancy were calculated for all possible outcomes of each strategy. Sensitivity analysis was performed to determine the effects of changing variables on the expected cost and life expectancy. RESULTS Compared with the CT only strategy, CT and PET for all resulted in a relative reduction of 70% of surgery for persons with mediastinal lymph node metastasis. PET for all with anatomical CT was shown to be a cost-effective alternative to the CT only, with life expectancy increased by 0.10 years and expected cost savings of 61 euros. This strategy was more favourable than PET for negative CT. Overall, sensitivity analyses showed the robustness of the results. CONCLUSION The introduction of thoracic PET for NSCLC staging is potentially cost-effective in France. Further clinical investigation might help to validate this result.
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Affiliation(s)
- K Alzahouri
- CEC-Inserm, Service d'Epidémiologie et Evaluation Cliniques, C.H.U. de Nancy, Nancy, France
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Al Zahour K, Lejeune C, Woronoff-Lemsi F, Arveux P, Guillemin F. C1-1 Analyse coût-efficacité de la tomographie par émission de positons pour le bilan d’extension médiastinale de cancer du poumon non à petites cellules. Rev Epidemiol Sante Publique 2004. [DOI: 10.1016/s0398-7620(04)99151-1] [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] Open
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