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Lázaro-Fontanet E, Clerc D, Girardin T, Martin D, Hübner M, Hahnloser D. Prevention and management of anastomotic leakage after colorectal surgery: A Swiss national consensus. Br J Surg 2022. [DOI: 10.1093/bjs/znac181.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Anastomotic leakage (AL) is one of the most feared complications of colorectal surgery. Despite surgical improvements, AL incidence remains significant and guidance on its prevention and management is lacking. The aim of the study was to achieve a Swiss nationwide consensus on clinical prevention and management of AL.
Methods
A three-step Delphi consensus meeting was performed in 2020 involving 78 Swiss surgeons from 40 centers. A steering-group drafted the questions, gathered best available evidence which was discussed in meetings prior answering the questions. Consensus was defined as ≥70% of agreement.
Results
The three consensus meetings were attended by 66, 57 and 37 surgeons, respectively. Surgeons’ median experience was 14 years, with 47% performing >50 colorectal resections yearly. Consensus was reached on routine use of preoperative nutritional screening (100%) using nutritional scores (88%) and >10% weight loss (95%). but not low BMI (63%) or low albumin (64%). Consensus was reached for no bowel preparation (BP) prior to right colectomy (RC) (76%) and for mechanical BP with oral antibiotics prior anterior resections (AR) (70%). No consensus was found on BP prior left colectomy (LC). Respondents favored a side-to-side anastomosis (76%) after RC, with extra-corporeal confection (70%), without consensus on the anastomosis being stapled or hand-sewn; an end-to-end (73%), stapled (80%) anastomosis after LC and a stapled anastomosis (86%) after AR, irrespective of the anastomosis configuration type. Anastomotic control with transanal leak-test was supported by 92%, while ICG control did not reached consensus (67%). After TME, routine diversion was favored (73%), irrespective of neoadjuvant therapy (94%) or not (70%). Consensus was reached on routine postoperative CRP monitoring (94%). CT-scan with rectal contrast enema was the preferred investigation for suspected AL after RC or LC (82%) and AR (76%). Conservative management of AL, provided appropriate clinical state, was an acceptable option after LC (72%), AR with stoma (95%), but not after RC (59%) or AR without stoma (53%).
Conclusion
Consensus was reached on several clinical aspects for prevention and management of AL among Swiss colorectal surgeons, providing national guidance. Further data is required on intraoperative aspects of anastomosis confection and control to ensure broader consensus.
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Affiliation(s)
- E Lázaro-Fontanet
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - D Clerc
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - T Girardin
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - D Martin
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - M Hübner
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - D Hahnloser
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
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Girardin T, Martin D, Clerc D, Lázaro-Fontanet E, Hübner M, Hahnloser D. Swiss consensus on the management of acute diverticulitis. Br J Surg 2022. [DOI: 10.1093/bjs/znac181.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Acute diverticulitis is a frequent clinical conditions encountered in emergency settings. Despite recent international guidelines, management of acute diverticulitis (AD) varies and is not standardized. The aim of the study was to achieve a Swiss nationwide consensus on clinical management of acute diverticulitis.
Methods
A three-staged consensus meeting according to the Delphi method was performed in 2020 involving 78 Swiss surgeons from 40 hospitals. A steering-group drafted the questionnaires, gathered best available evidence which was presented and discussed in meetings prior answering the questions. Consensus was defined as ≥70% of agreement.
Results
57 surgeons answered all the 3 rounds and 28 (53%) performed > 50 colorectal resections per year. On initial workup in the emergency setting, performing leucocytes count (87%), CRP (98%) and CT imaging (98%) reached consensus for the diagnosis, but no uniform classification system of AD was retained. Signs of generalized peritonitis (100%), requiring intravenous pain medication (98%), inability to tolerate oral intake (95%), lack of adequate social support (86%), immunosuppression (96%), and complicated AD on CT (84%) were criteria for hospitalization. Persisting symptoms (95%) and immunosuppression (89%) were criteria for elective colonic resection, while the number of AD episodes were not (27%). In case of abscess, a size ≥ 4 cm reached consensus for percutaneous drainage (88%). No consensus were reached for surgical approach and techniques in the emergency settings, apart from damage control surgery for instable patients (70%). In the follow-up, recommendation for dietary restrictions or lifestyle habits did not reach reach consensus.
Conclusion
Swiss colorectal surgeons reached consensus for several diagnostics, hospitalization, and elective surgery criterias. However, emergency surgical management and follow-up are less standardized. These variations should be further assessed, and particularly in the context the latest published recommendations.
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Affiliation(s)
- T Girardin
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - D Martin
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - D Clerc
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - E Lázaro-Fontanet
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - M Hübner
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - D Hahnloser
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
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Hanzalova I, Schäfer M, Demartines N, Clerc D. Spigelian hernia: current approaches to surgical treatment-a review. Hernia 2021; 26:1427-1433. [PMID: 34665343 DOI: 10.1007/s10029-021-02511-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/05/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Spigelian hernias (SpH) belong to the group of eponymous abdominal wall hernias. Major reasons for diagnostic difficulties are its low incidence reaching maximum 2% of abdominal wall hernias, a specific anatomical localization with intact external oblique aponeurosis covering the hernia sac and non-constant clinical presentation. METHODS A literature review was completed to summarize current knowledge on surgical treatment options and results. RESULTS SpH presents a high incarceration risk and therefore should be operated upon even if the patient is asymptomatic. Both laparoscopic and open repair approaches are validated by current guidelines with lesser postoperative complications and shorter hospital stay in favour of minimally invasive surgery, regardless of the technique used. Overall recurrence rate is very low. CONCLUSION All diagnosed SpH should be planned for elective operation to prevent strangulated hernia and, therefore emergency surgery. Both open and laparoscopic SpH treatment can be safely performed, depending on surgeon's experience. In most cases, a mesh repair is generally advised.
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Affiliation(s)
- I Hanzalova
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Bugnon 46, 1011, Lausanne, Switzerland
| | - M Schäfer
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Bugnon 46, 1011, Lausanne, Switzerland.
| | - N Demartines
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Bugnon 46, 1011, Lausanne, Switzerland
| | - D Clerc
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Bugnon 46, 1011, Lausanne, Switzerland
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4
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Jurt J, Clerc D, Curchod P, Hübner M, Hahnloser D, Senn L, Demartines N, Grass F. Prospective surveillance after implementation of a colorectal surgical site infection prevention bundle. Br J Surg 2021. [DOI: 10.1093/bjs/znab202.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Objective
Surgical site infections (SSI) are the most frequent complications after colorectal surgery. The aim of the present study was to evaluate the impact of a standardized SSI prevention bundle.
Methods
The multimodal, evidence-based care bundle included 9 intraoperative items (antibiotic type, timing and re-dosing, desinfection, induction temperature control >36.5°, glove change, intracavity lavage, wound protection and closure strategy). The bundle was implemented in November 2018 and applied to all consecutive patients undergoing colonic resections. Demographics, surgical specifics and overall compliance to the care bundle were prospectively assessed until October 2020. The primary outcome SSI was defined according to the definition of the Center for Disease Control (CDC) and independently assessed by the National Infection Surveillance Committee (Swissnoso) up to 30 postoperative days. A historical, institutional pre-implementation control group (2012-2017, DOI: 10.1016/j.jhin.2018.09.011) with identical methodology was used for comparison.
Results
In total, 243 patients were included. The control group included 1’263 patients. Both groups were comparable regarding main demographics (age, sex, body mass index, American Society of Anaesthesiologists class) and surgical characteristics (type and duration of surgery). Overall compliance to the care bundle was 77% (IQR 77-88). Lowest compliance was observed for temperature control (48%), intracavity lavage (59%) and predefined wound closure strategy (74%). Surgical site infections were reported in 54 patients (22.2%) vs. 21.4% in the control group, p = 0.79. Infection rates were comparable throughout the CDC categories: superficial: 11 patients (4.5%) vs. 4.2%, p = 0.82, deep incisional: 9 patients (3.7%) vs. 5.1%, p = 0.34, organ space: 34 (14%) vs. 12.4%, p = 0.48.
Conclusion
Implementation of a standardized surgical care bundle had no impact on SSI rates according to these preliminary results. Improved compliance to individual measures may help to achieve a clinical benefit.
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Affiliation(s)
- J Jurt
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - D Clerc
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - P Curchod
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - M Hübner
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - D Hahnloser
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - L Senn
- Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - N Demartines
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - F Grass
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
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Chapman SJ, Blanco-Colino R, Clerc D, Otto A, Nepogodiev D, Pagano G, Schaeff V, Soares A, Zaffaroni G, Žebrák R. Author response to: Comment on: Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery. Br J Surg 2020; 107:317. [PMID: 31971620 DOI: 10.1002/bjs.11482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 11/28/2019] [Indexed: 01/01/2023]
Affiliation(s)
- S J Chapman
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds
| | - R Blanco-Colino
- Department of General Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - D Clerc
- Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - A Otto
- Riga Stradins University and
| | | | - G Pagano
- Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - V Schaeff
- Riga Eastern University Hospital, Riga, Latvia
| | - A Soares
- Hospital Professor Doutor Fernando da Fonseca, Amadora, Portugal
| | - G Zaffaroni
- Azienda Ospedaliera Universitaria L.Sacco, Milan, Italy
| | - R Žebrák
- Fakultní nemocnice Hradec Králové, Czech Republic
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6
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Kefleyesus A, Clerc D, Hahnloser D. Recurrent perineal hernia repair: perineal approach - a video vignette. Colorectal Dis 2020; 22:1467-1468. [PMID: 32348608 DOI: 10.1111/codi.15100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/13/2020] [Indexed: 02/08/2023]
Affiliation(s)
- A Kefleyesus
- Department of Visceral Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - D Clerc
- Department of Visceral Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - D Hahnloser
- Department of Visceral Surgery, University Hospital of Lausanne, Lausanne, Switzerland
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7
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Affiliation(s)
- D Clerc
- Department of Visceral Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - A Kefleyesus
- Department of Visceral Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - D Hahnloser
- Department of Visceral Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
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Abstract
Liposarcoma is the most common soft tissue sarcoma in adults. Predominant locations are the limbs and retroperitoneum. Intra-abdominal liposarcoma represents only 2% of all cases and visceral location is exceptional. Gastric liposarcoma is extremely rare, with fewer than 20 cases reported. The treatment of choice is wide en-bloc surgical resection. If the tumour arises in the area of the cardia, resection involves resection of the proximal stomach as well as the distal oesophagus. Traditional reconstruction with oesophagogastrostomy often leads to troublesome reflux. We report a case of gastric liposarcoma arising in the gastro-oesophageal junction in a severely obese patient.
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Affiliation(s)
| | - D Clerc
- Department of Surgery, Riviera-Chablais Hospital, Monthey, Switzerland
| | - M Suter
- Department of Surgery, Riviera-Chablais Hospital, Monthey, Switzerland
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9
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Bianchi C, Clerc D, Yersin B. Revue de littérature et dérivation d’un algorithme clinique diagnostique pour une suspicion d’hémorragie sous-arachnoïdienne. Ann Fr Med Urgence 2017. [DOI: 10.1007/s13341-017-0727-3] [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: 02/06/2023]
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10
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Clerc D, Yersin B. Intoxication alcoolique aux urgences : dilemmes de prise en charge. Deux situations cliniques fréquentes. Ann Fr Med Urgence 2014. [DOI: 10.1007/s13341-013-0378-y] [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: 11/27/2022]
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11
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Abstract
AIM Avoiding 'mini-laparotomy' to extract a colectomy specimen may decrease wound complications and further improve recovery after laparoscopic surgery. The aim of this study was to develop a new technique for transrectal specimen extraction (TRSE) and to compare it with conventional laparoscopy (CL) for left sided colectomy. METHOD Eleven patients with benign disease requiring either sigmoid or left colon resection underwent TRSE. The unfired circular stapler was inserted transanally and used as a guide to suture-close the recto-sigmoid junction laparoscopically and as a handle to pull the sutured sigmoid through the opened rectum inside a laparoscopic camera bag. The anvil was inserted into the lumen of the intussuscepted sigmoid and pushed to the level of the anastomosis. The anastomosis was fashioned end-to-end in the first patients and side-to-end in the following patients to improve safety. Intra-operative and postoperative outcomes of patients undergoing TRSE were compared with those of a group of 20 patients undergoing CL, who were matched for type of resection, body mass index and age. RESULTS The procedure was successful in all but the first patient who was converted to conventional laparoscopic colectomy without any additional morbidity. Two patients in the end-to-end anastomosis group, but none in the side-to-end group, developed peri-anastomotic sepsis. Compared with CL, patients undergoing TRSE did not show any significant differences in operative time, recovery or morbidity. CONCLUSION Transrectal specimen extraction after left colectomy using the circular stapler technique is feasible. A side-to-end anastomosis appears safer than an end-to-end anastomosis. Further studies are needed to explore the potential advantages of this procedure over CL.
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Affiliation(s)
- D Christoforidis
- Department of Visceral Surgery, CHUV, University of Lausanne, Lausanne, Switzerland.
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12
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Sautebin A, Clerc D, Büla C, Garcia W, Monod S. [Older people admitted to the emergency department after a fall: what to do?]. Rev Med Suisse 2012; 8:1539-1543. [PMID: 22937670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Falls in older people are frequent. Falls may lead to serious injuries and are associated with greater morbidity, mortality, and reduced overall functioning in the older population. Evidences exist regarding the beneficial effects of fall prevention programs. However, these interventions are rarely implemented in our health system. Older people admitted to the emergency department after a fall should get careful attention in order to initiate specific interventions to prevent new falls. This article provides a clinical assessment strategy to evaluate older persons after a fall and proposes an algorithm for discharge planning decision.
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Affiliation(s)
- A Sautebin
- Service de gériatrie et réadaptation gériatrique, CHUV, Lausanne.
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13
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Clerc D, Rutz P, Hugli O. [Usefulness of a predictive score in subarachnoid hemorrhage diagnosis]. Rev Med Suisse 2011; 7:1579-1583. [PMID: 21922723] [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: 05/31/2023]
Abstract
Usefulness of a predictive score in subarachnoid hemorrhage diagnosis Nearly half of the patients with non-traumatic subarachnoid hemorrhage (SAH) present with no neurological signs, inducing clinical underestimation of the gravity of their affection. As the outcome of aneurismal SAH is highly dependant on the initial neurological status and the recurrence of untreated hemorrhagic events, these neurologically intact patients stand to suffer the most from delayed diagnosis. Although there is currently no validated predictive score that reliably identifies SAH-induced headache, a combination of clinical criteria derived from a cohort of sudden-onset headache patients should allow risk stratification and identification of those patients requiring further investigation.
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Affiliation(s)
- D Clerc
- Service des urgences, CHUV, 1011 Lausanne.
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14
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Pasquier M, Clerc D, Grosgurin O, Marti C, Rutschmann O, Carron PN. [Emergency medicine: update 2010]. Rev Med Suisse 2011; 7:41-45. [PMID: 21309173] [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: 05/30/2023]
Abstract
Several scores with predictive value for morbidity or mortality have been published this year. Their current purpose is to improve the direction of admissions and lengths of stay in hospital. Their use permits more directed care, especially for the elderly, and therefore could improve the proper orientation and admission of patients. Also this year, certain procedures are undergoing evaluation, namely: new assays for troponin, and non-contrast CT in the diagnosis of acute appendicitis. Furthermore in the therapeutic realm: the importance of cardiac massage and the advantages of therapeutic hypothermia in cardiac arrest, and the efficacy of oxygen therapy in cluster headache.
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Gottenberg JE, Roux S, Desmoulins F, Clerc D, Mariette X. Granulocyte colony-stimulating factor therapy resulting in a flare of systemic lupus erythematosus: comment on the article by Yang and Hamilton. Arthritis Rheum 2001; 44:2458-60. [PMID: 11665994 DOI: 10.1002/1529-0131(200110)44:10<2458::aid-art420>3.0.co;2-b] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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Mariette X, Agbalika F, Zucker-Franklin D, Clerc D, Janin A, Cherot P, Brouet JC. Detection of the tax gene of HTLV-I in labial salivary glands from patients with Sjögren's syndrome and other diseases of the oral cavity. Clin Exp Rheumatol 2000; 18:341-7. [PMID: 10895371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To confirm a possible association between Sjögren's syndrome (SS) and the tax gene of human T lymphotropic virus type I (HTLV-I). METHODS We studied by PCR labial salivary glands (LSG) from 50 patients with definite SS and from 58 controls including 32 patients with LSG involved by other inflammatory processes and 26 normal LSG. Antibodies to HTLV-I and antibodies to the Tax protein were searched for in serum. RESULTS We detected the tax gene of HTLV-I in LSG from 15/50 (30%) of patients with SS but also in specimens from 9/32 (28%) patients with LSG involved by other inflammatory processes (3/9 graft-versus-host disease, 5/19 extra-vasated cysts, 1/4 sarcoidosis) and from only 1/26 (4%) normal LSG. A 652 bp region, sequenced in 2 SS patients, was 98-98.5% homologous to the canonic sequence of tax HTLV-I. The HTLV-I gag, pol and env genes were never detected. The serum of the SS patients did not contain antibodies to HTLV-I. However, anti-Tax antibodies were detected in the serum of 18/25 (72%) SS patients, 10/10 (100%) patients positive for tax DNA in their LSG and 8/15 (53%) patients negative for tax DNA in their LSG. CONCLUSION Our observations raise the possibility that a very low number of copies of the tax gene may be harbored innocuously in cells within the oral cavity in some healthy individuals, but that this gene may play a role as a co-factor in the development of SS or other diseases of oral cavity.
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Affiliation(s)
- X Mariette
- Service d'Immunologie Clinique, Hôpital Saint-Louis, Paris, France.
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18
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Paule B, Clerc D, Brion N. [Biosphonates in oncology]. Presse Med 2000; 29:723-9. [PMID: 10797827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
MECHANISM OF ACTION Tumor-induced osteolysis or lytic bone disease is mediated by osteoclast activation. Bisphosphonates inhibit bone resorption by reducing osteoclastic activity. INDICATIONS Bisphosphonates were shown to be effective in treating cancer-related hypercalcemia. Recent large randomized clinical trials have shown the efficacy of bisphosphonates in reducing bone pain, pathological fractures and spinal cord compression for patients with multiple myeloma and breast cancer metastatic to bone. The potential survival benefit from pamidronate in patients with advanced myeloma warrants further study. FUTURE Future clinical trials will use more potent bisphosphonates (zoledronate, ibandronate) with the ultimate goal of trying to prevent bone metastases.
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Affiliation(s)
- B Paule
- Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin Bicêtre
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19
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Paule B, Clerc D. [Renal cancer: bone metastases, immunotherapy and interleukin-6]. Ann Med Interne (Paris) 1999; 150:388-93. [PMID: 10544748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
In renal cell carcinoma, bone metastases remain a major medical challenge because they are refractory to the antiproliferative effects of immunotherapy. We critically review the biological and clinical data which implicate interleukin-6 in the tumor growth, the pathogenesis of the bone metastases and the response to immunotherapy.
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Affiliation(s)
- B Paule
- Service de Rhumatologie, Hôpital de Bicêtre, Le Kemlin-Bicêtre
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20
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Clerc D, Berge E, Benichou O, Paule B, Quillard J, Bisson M. An unusual case of pigmented villonodular synovitis of the spine: benign aggressive and/or malignant? Rheumatology (Oxford) 1999; 38:476-7. [PMID: 10371292 DOI: 10.1093/rheumatology/38.5.476] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Clerc D, Paule B. Pathogenesis of bone metastases. Rev Rhum Engl Ed 1999; 66:158-66. [PMID: 10327495] [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] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- D Clerc
- Rheumatology Department, Bicêtre Teaching Hospital, Le Kremlin Bicêtre, France.
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22
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Luyet A, Giroux E, Clerc D. [The outpatient clinic's role : port of entrance and dispatching centre ?]. Sante Ment Que 1999; 24:143-158. [PMID: 18253566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This article presents an overview of the plan of transformation of services adopted in 1998 at Louis-H. Lafontaine Hospital. The authors present the history, principles and models, the role played by outpatients clinics as well as the challenges related to the implementation of this new plan.
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Abstract
INTRODUCTION Though rare, observations of multiple liposarcomas show that the development of secondary tumors occur in sites usually considered as primary locations. This would be more frequent for myxoid liposarcomas than for other subtypes of the disease. Their origin, either multicentric (i.e., coexistence of several primary tumors) or due to metastatic spreading, is still debated. EXEGESIS We report a case of myxoid-type multicentric (i.e., right popliteal fossa, retroperitoneum and soft tissue of the left arm) liposarcomas of different sizes, without pulmonary, hepatic or osseous involvement. These liposarcomas were simultaneously diagnosed in a patient who presented with pain in the right knee. CONCLUSION This support the hypothesis that multiple liposarcomas have a multicentric origin. Initial and follow-up staging of such tumors must investigate not only usual metastatic sites but also classical primary locations.
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Affiliation(s)
- M Kemula
- Service de rhumatologie, hôpital de Bicêtre, Le Kremlin-Bicêtre, France
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24
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Paule B, Clerc D, Brion N. [Glucocorticoids and multiple myeloma. Mechanism of action, resistance and clinical use]. Ann Med Interne (Paris) 1998; 149:502-7. [PMID: 10021903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
The fundamental and clinical backgrounds for the use of glucocorticoids in multiple myeloma are reviewed. Glucocorticoids induce apoptosis and alter the cellular cycle of malignant cells, interacting with the effects of IL-6. The number of normal or variant glucocorticoid receptors expressed by the tumoral cells and the corticoresistant secretion by stromal cells of IL-6 and its soluble receptor are implicated in resistance to glucocorticoids. Given alone or in association with vincristin and adriamycin, glucocorticoids induce major cytoreduction in tumors and is best used in refractory and relapsing diseases.
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Affiliation(s)
- B Paule
- Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre
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25
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Claudepierre P, Sibilia J, Roudot-Thoraval F, Flipo RM, Wendling D, Goupille P, Eulry F, Clerc D, Berthelot JM, Vergne P, Allanore Y, Larget-Piet B, Chevalier X. Factors linked to disease activity in a French cohort of patients with spondyloarthropathy. J Rheumatol Suppl 1998; 25:1927-31. [PMID: 9779845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To identify risk factors associated with disease activity, in a group of patients with spondyloarthropathy (SpA) living in France. METHODS Patients fulfilling the ESSG or Amor criteria for SpA were enrolled in a cross sectional multicenter study. Disease activity was assessed using a French version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Univariate and multivariate analyses were used to identify a link between BASDAI and disease characteristics, genetic factors, and environmental factors such as infectious events, mental stress, working conditions, and dietary factors. RESULTS We studied 293 patients. On multivariate analysis, BASDAI appeared to be mainly linked to disease duration (negative correlation), the absence of sacroiliitis, and the "frequency of meals taken out of home" (negative correlation). CONCLUSION Disease activity in a French population of patients with SpA appeared to be linked mainly to a shorter disease duration and a peripheral pattern of arthritis, as well as to dietary habits. The underlying links between this last environmental factor and disease activity remained hypothetical and could only reflect a nontested social factor.
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Affiliation(s)
- P Claudepierre
- Service de Rhumatologie, Hôpital Henri Mondor, Créteil, France
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26
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Clerc D, Marfeuille M, Labous E, Desmoulins F, Quillard J, Bisson M. Spinal tophaceous gout. Clin Exp Rheumatol 1998; 16:621. [PMID: 9779316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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27
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Paule B, Clerc D, Rudant C, Coulombel C, Bonhomme-Faivre L, Quillard J, Bisson M. Enhanced expression of interleukin-6 in bone and serum of metastatic renal cell carcinoma. Hum Pathol 1998; 29:421-4. [PMID: 9563797 DOI: 10.1016/s0046-8177(98)90128-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Interleukin-6 (IL-6) is produced by renal cell carcinoma (RCC) cell lines and primary tumors. Using immunohistochemical staining in two RCC patients with hypercalcemia and high serum levels of free and total IL-6, we showed expression of IL-6 in metastatic bone tissue. The role of IL-6 in hypercalcemia and bone resorption would suggest that bisphosphonates or dexamethasone could be useful as adjuvant therapy for IL-6 dependent bone metastases which fail to respond to interferon alpha (IFN) alpha 2a and all trans retinoic acid (ATRA).
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Affiliation(s)
- B Paule
- Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
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28
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Desmoulins F, Clerc D, Marfeuille M, Miquel A, Bisson M. Septic arthritis of the lumbar facet joints. Rev Rhum Engl Ed 1997; 64:859-60. [PMID: 9476282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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29
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Claudepierre P, Sibilia J, Goupille P, Flipo RM, Wendling D, Eulry F, Clerc D, Berthelot JM, Vergne P, Roudot-Thoraval F, Larget-Piet B, Chevalier X. Evaluation of a French version of the Bath Ankylosing Spondylitis Disease Activity Index in patients with spondyloarthropathy. J Rheumatol Suppl 1997; 24:1954-8. [PMID: 9330938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To develop a French version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and to determine its metric properties in patients with all forms of spondyloarthropathies (SpA). METHODS A French version of BASDAI was obtained after a translation and back-translation process. Patients fulfilling the European Spondylarthropathy Study Group or Amor criteria for SpA were included. BASDAI of Day 0, Day 1, and, when treatment was changed, Day 8, and other clinical and biological disease activity variables were recorded, along with assessment of disease activity by the physician or the patient. Scalability, reproducibility, sensitivity to change, internal consistency and redundancy, and construct validity of the index were assessed. RESULTS We studied 293 patients. Good scalability, reproducibility, construct, and internal validity were observed for BASDAI. Sensitivity to change could not be assessed. CONCLUSION The French version of BASDAI exhibited good metric properties in patients with all forms of SpA, confirming its utility in further clinical research in SpA. However, sensitivity to changes due to drug therapy remains to be assessed.
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Affiliation(s)
- P Claudepierre
- Service de Rhumatologie, Hôpital Henri Mondor, Créteil, France
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30
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Stravynski A, Gaudette G, Lesage A, Arbel N, Petit P, Clerc D, Fabian J, Lamontagne Y, Langlois R, Lipp O, Sidoun P. The treatment of sexually dysfunctional men without partners: a controlled study of three behavioural group approaches. Br J Psychiatry 1997; 170:338-44. [PMID: 9246252 DOI: 10.1192/bjp.170.4.338] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [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: 02/04/2023]
Abstract
BACKGROUND Models of sex therapy for sexual dysfunction in single men are available, but their value is not well established. This controlled study compared three approaches to the treatment of sexually dysfunctional single men. METHOD Sixty-nine single men diagnosed as sexually dysfunctional were randomly assigned to treatments focusing on either their sexual dysfunction, their interpersonal problems, a combination of both or a waiting list; 51 completed treatment and 50 the one-year follow-up. Treatment was administered in small groups in 15 weekly sessions and four six-weekly sessions during the first six months of a year-long follow-up. RESULTS No clinically meaningful change was observed during the waiting period. In contrast, a significant and equivalent improvement was observed in all treatment groups by the end of treatment. However, differences between them were in evidence at 6 and 12 months' follow-up. CONCLUSIONS Both treatments paying attention to the patients' interpersonal difficulties resulted in significantly better outcomes overall than the approach that concentrated on problems in sexual functioning alone.
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Affiliation(s)
- A Stravynski
- Fernand Seguin Research Center, Montreal, Quebec, Canada
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31
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Coste J, Spira A, Clerc D, Paolaggi JB. Prediction of articular destruction in rheumatoid arthritis: disease activity markers revisited. J Rheumatol 1997; 24:28-34. [PMID: 9002007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess the predictive value for joint damage progression of commonly used disease activity or process measures in rheumatoid arthritis (RA). METHODS Seventy-two patients fulfilling the American Rheumatism Association criteria for RA were assessed twice yearly for 2 years. Primary outcome variables were progression of articular destruction, evaluated by Sharp's method, for 6, 12, 18, and 24 month periods. RESULTS Regression analysis, using random effects linear models, showed that only C-reactive protein, alpha 1-acid glycoprotein, iron, and erythrocyte sedimentation rate were significantly, but not independently, associated with 6 month radiographic progression. Traditional clinical measures were not predictive. No assessed marker was able to predict longer term outcome (12 or 18 month joint damage progression). Recent onset disease and older age were also associated with more severe radiographic progression. CONCLUSION The lack of association between clinical measures and laboratory markers as predictors of the progression of articular destruction is further evidence of the need to reconsider processes and outcomes in RA. This study also suggests that clinical measures and laboratory markers probably do not reflect the same underlying process, arguing against gathering these measures under the same heading of "disease activity measures".
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Affiliation(s)
- J Coste
- Département de Biostatistique et d'Informatique Médicale, Hôpital Cochin, Paris, France
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32
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Le Gars L, Clerc D, Cariou D, Lavabre C, Metral S, Bisson M. Systemic juvenile rheumatoid arthritis and associated Isaacs' syndrome. J Rheumatol Suppl 1997; 24:178-80. [PMID: 9002031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We describe a patient with systemic onset juvenile chronic arthritis who developed clinical and electromyographic features of acquired Isaacs' syndrome. This association has not been reported before and possible links between the 2 diseases are discussed.
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Affiliation(s)
- L Le Gars
- Department of Rheumatology, Hôpital de Bicêtre, Kremlin-Bicêtre, France
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33
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Abstract
BACKGROUND Different approaches to estimating local catchment-area needs for psychiatric services are illustrated and compared. METHOD Data from an epidemiological morbidity survey of a random sample of 496 adults were available, as were actual service utilisation rates. Four types of utilisation were modelled (i.e. overall, out-patient, in-patient, emergency clinic) using social indicators available from Statistics Canada census-tract data. Finally, a case-control study compared out-patients from a deprived and an affluent catchment area, matched case by case for primary diagnosis, age, sex and residential status (n = 52). RESULTS Modelling proved highly predictive of utilisation, the overall-use model accounting for 73% of the variance. The case-control study indicated a higher rate of Axis II traits, substance abuse and needs for social care in the deprived catchment area. CONCLUSIONS Resource allocation based on the social indicators modelling method was more consistent with sensible distribution of human resources. None of the methods, however, appear to reflect adequately the severity of caseloads evidenced in the case-control study.
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Affiliation(s)
- A D Lesage
- Centre de recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine, Montréal, Canada
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34
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Claudepierre P, Clerc D, Cariou D, Lavabre C, Venencie PY, Bisson M. SAPHO syndrome and pyoderma gangrenosum: is it fortuitous? J Rheumatol Suppl 1996; 23:400-2. [PMID: 8882057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Pyoderma gangrenosum is well known as an associated feature of inflammatory bowel disease (IBD). Recently, higher than normal prevalence of IBD in patients with the SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome has been reported. However, the association of pyoderma gangrenosum with SAPHO syndrome without definitely excluded IBD has not been reported. We describe a case that suggests a possible connection between these 2 entities.
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Affiliation(s)
- P Claudepierre
- Service of Rheumatology, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
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35
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Marfeuille M, Clerc D, Mariette X. Successful treatment of agranulocytosis and sepsis with granulocyte colony stimulating factor in a case of Felty's syndrome. J Rheumatol Suppl 1995; 22:1803-4. [PMID: 8523369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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36
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Paillaud E, Clerc D, Berge E, Durandin M, Bisson M. Pseudotumor of the craniocervical hinge in a patient receiving hemodialysis for 4 years. J Rheumatol 1993; 20:1634-5. [PMID: 8164237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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37
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Cariou D, Clerc D, Durandin M, Berge E, Quillard J, Bisson M. [Pseudo-sarcoidosis form of Whipple's disease. Diagnostic value of treatment]. Rev Med Interne 1993; 14:351. [PMID: 7694348 DOI: 10.1016/s0248-8663(05)81314-1] [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] [Indexed: 01/26/2023]
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38
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Lavabre C, Clerc D, Durandin M, Bergé E, Bisson M. [Rheumatoid arthritis and collagenous colitis. Apropos of a new case]. Rev Rhum Ed Fr 1993; 60:259-60. [PMID: 8293016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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39
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Berge E, Laurent-Puig P, Clerc D, Durandin M, Bisson M. [Psoriatic arthritis in a patient treated with interferon alpha]. Rev Rhum Ed Fr 1993; 60:77. [PMID: 8242032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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40
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Xerri B, Clerc D, Durandin M, Berge E, Bisson M. [Association of sclerodermatomyositis and humero-scapular retractile capsulitis. A new case]. Rev Rhum Mal Osteoartic 1991; 58:901. [PMID: 1780677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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41
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Mariette X, Gozlan J, Clerc D, Bisson M, Morinet F. Detection of Epstein-Barr virus DNA by in situ hybridization and polymerase chain reaction in salivary gland biopsy specimens from patients with Sjögren's syndrome. Am J Med 1991; 90:286-94. [PMID: 1848394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To determine whether Epstein-Barr virus (EBV) could be involved in the pathogenesis of Sjögren's syndrome (SS). PATIENTS AND METHODS In situ hybridization using the BamH1-W fragment of EBV DNA was performed using labial salivary gland biopsy specimens from 14 patients with SS (eight with primary SS and six with secondary SS) and 39 control subjects. Furthermore, labial salivary gland biopsy specimens from 12 patients with SS (seven with primary SS and five with secondary SS) and 24 control subjects were submitted to the polymerase chain reaction to detect EBV DNA. RESULTS In situ hybridization detected EBV DNA in epithelial cells of labial salivary gland biopsy specimens from four of eight (50%) patients with primary SS, zero of six patients with secondary SS, and three of 39 (8%) control subjects. The difference between patients with primary SS and control subjects was statistically significant (p less than 0.02). The polymerase chain reaction detected EBV DNA in six of seven (86%) patients with primary SS, three of five (60%) patients with secondary SS, and seven of 24 (29%) control subjects. The difference between patients with primary SS and control subjects was statistically significant (p less than 0.01). CONCLUSION Both newly developed techniques showed that the presence of EBV DNA was significantly increased in patients with primary SS in comparison with control subjects. In all the positive SS patients who underwent in situ hybridization, epithelial cells of the labial salivary gland were the target of EBV infection. Our results suggest that this virus may play a role in the pathogenesis of SS. We cannot yet determine whether EBV is directly responsible for the destruction of the gland, or if its presence is a secondary event following gland injury.
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Affiliation(s)
- X Mariette
- Service de Rhumatologie, Hôpital de Bicêtre Le Kremlin, France
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42
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Abstract
We demonstrated the feasibility of using integrated optical output grating couplers in direct immunosensing. We monitored as functions of time, first the adsorption of an antigen (Ag) on the waveguide's surface, and subsequently, the binding of the corresponding antibody (Ab), i.e. the formation of the immuno-complex Ag-Ab. The Ag was human immunoglobulin G (h-IgG), and the Ab was rabbit anti-h-IgG. We also studied the adsorption of avidin. The refractive indices nF', thicknesses dF', and surface coverages gamma of the adsorbed adlayers and of the immuno-complex Ag-Ab, respectively, were determined.
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Affiliation(s)
- W Lukosz
- Optics Laboratory, Swiss Federal Institute of Technology, Zürich
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43
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Clerc D, Brousse C, Mariette X, Bennet P, Bisson M. Cytomegalovirus pneumonia in a patient with rheumatoid arthritis treated with low dose methotrexate and prednisone. Ann Rheum Dis 1991; 50:67. [PMID: 1847283 PMCID: PMC1004336 DOI: 10.1136/ard.50.1.67-b] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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44
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Abella A, Clerc D, Francoual J, Chalas J, Baret A, Bauer D, Bisson M, Menkès CJ, Leluc R, Lindenbaum A. [Anti-radical enzymes, oxygenated free radicals and lipoperoxydation in rheumatoid polyarthritis. Effects of treatment with D-penicillamine]. Rev Rhum Mal Osteoartic 1990; 57:855-61. [PMID: 2080397] [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: 12/30/2022]
Abstract
Three aspects of the action of oxygenated free radicals were studied in 10 controls and 20 patients with rheumatoid arthritis, 11 not treated and 9 treated with D-penicillamine. Free radical production was evaluated in whole blood, malondialdehyde was measured in plasma, the concentration of antiradicular enzymes (copper and manganese superoxide dismutase, catalase and glutathion peroxydase) in hemolysate, platelets and plasma and copper superoxide dismutase activity in a chloroform erythrocyte extract. Only patients treated with D-penicillamine showed a significant decrease in the concentration of platelet anti-radicular enzymes and plasma manganese superoxide dismutase. The involvement of oxygenated free radicals in the pathophysiology of rheumatoid arthritis and in the mechanism of action of D-penicillamine in this pathology is discussed.
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Affiliation(s)
- A Abella
- Service de Biochimie, Hôpital Antoine Beclère, Clamart
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Abella A, Clerc D, Chalas J, Bauer D, Lindenbaum A. Effects of D-penicillamine treatment on antioxidant enzymes in rheumatoid arthritis. Br J Rheumatol 1990; 29:397-8. [PMID: 2224414 DOI: 10.1093/rheumatology/29.5.397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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46
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Mariette X, Glon Y, Clerc D, Bennet P, Bisson M, Massias P. [Medical treatment of radicuralgia caused by posterior interapophyseal synovial cysts. 7 cases]. Rev Rhum Mal Osteoartic 1990; 57:73-7. [PMID: 2157274] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- X Mariette
- Service de Rhumatologie, Hôpital de Bicétre
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47
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Fritz P, Mariette X, Clerc D, Glon Y, Bennet P, Bisson M. Rectus femoris sheath: a new localization of hip synovial cyst. J Rheumatol Suppl 1989; 16:1575-8. [PMID: 2625690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Iliopsoas bursitis is the classical manifestation of synovial cysts of the hip. We report the first observation of a new localization of these cysts: the sheath of rectus femoris muscle. The patient presented with a hip osteoarthritis and an important mass of the front of the thigh. Computed tomography was useful in establishing the diagnosis and hip arthrography confirmed the communication between the joint and the rectus femoris sheath.
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Affiliation(s)
- P Fritz
- Service de Rhumatologie, Hôpital de Bicêtre, France
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Mariette X, Bennet P, Clerc D, Bloch-Michel E, Bisson M, Massias P. [Acute anterior uveitis and psoriatic rheumatism. 2 cases and a review of the literature]. Rev Rhum Mal Osteoartic 1989; 56:633-4. [PMID: 2683011] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- X Mariette
- Service de Rhumatologie, Hôpital de Bicetre, Le Kremlin-Bicêtre
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49
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Fritz P, Bennet P, Mariette X, Clerc D, Bisson M, Massias P. [Retrosomatic fissure, bilateral isthmic lysis and spina bifida occulta]. Rev Rhum Mal Osteoartic 1989; 56:635. [PMID: 2683012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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50
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Mariette X, Glon Y, Clerc D, Bennet P, Bisson M. Medical treatment of synovial cysts of the zygapophyseal joints: four cases with long-term followup. Arthritis Rheum 1989; 32:660-1. [PMID: 2719735 DOI: 10.1002/anr.1780320523] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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