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Couvercelle C, Bilger G, Simon E. [Case report: Great toe dorsal defect reconstruction by cross-toe flap]. ANN CHIR PLAST ESTH 2024; 69:228-232. [PMID: 37932174 DOI: 10.1016/j.anplas.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 11/08/2023]
Abstract
Reconstruction of hallux soft-tissue defects is essential for the locomotor function. Some regional flaps are available and have to be preferred in case of small defect. Here, we present the case of a patient treated by a cross-toe flap in order to cover an exposed hallux proximal interphalangeal joint, after an open fracture. The functional outcome of this reliable and easy flap was very satisfying, with quick wound healing and resumption walk.
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Affiliation(s)
- C Couvercelle
- Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France; Service de chirurgie orthopédique traumatologique et arthroscopique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
| | - G Bilger
- Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France; Service de chirurgie orthopédique traumatologique et arthroscopique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - E Simon
- Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France; Service de chirurgie orthopédique traumatologique et arthroscopique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
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2
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Alvernia JE, Simon E, Khandelwal K, Ramos CD, Perkins E, Kim P, Mertens P, Messina R, Luzardo G, Diaz O. Anatomical study of the thoracolumbar radiculomedullary arteries, including the Adamkiewicz artery and supporting radiculomedullary arteries. J Neurosurg Spine 2023; 38:233-241. [PMID: 36152330 DOI: 10.3171/2022.5.spine2214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this paper was to identify and characterize all the segmental radiculomedullary arteries (RMAs) that supply the thoracic and lumbar spinal cord. METHODS All RMAs from T4 to L5 were studied systematically in 25 cadaveric specimens. The RMA with the greatest diameter in each specimen was termed the artery of Adamkiewicz (AKA). Other supporting RMAs were also identified and characterized. RESULTS A total of 27 AKAs were found in 25 specimens. Twenty-two AKAs (81%) originated from a left thoracic or a left lumbar radicular branch, and 5 (19%) arose from the right. Two specimens (8%) had two AKAs each: one specimen with two AKAs on the left side and the other specimen with one AKA on each side. Eight cadaveric specimens (32%) had 10 additional RMAs; among those, a single additional RMA was found in 6 specimens (75%), and 2 additional RMAs were found in each of the remaining 2 specimens (25%). Of those specimens with a single additional RMA, the supporting RMA was ipsilateral to the AKA in 5 specimens (83%) and contralateral in only 1 specimen (17%). The specimens containing 2 additional RMAs were all (100%) ipsilateral to their respective AKAs. CONCLUSIONS The segmental RMAs supplying the thoracic and lumbar spinal cord can be unilateral, bilateral, or multiple. Multiple AKAs or additional RMAs supplying a single anterior spinal artery are common and should be considered when dealing with the spinal cord at the thoracolumbar level.
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Affiliation(s)
- Jorge E Alvernia
- 1Department of Neurosurgery, University of Mississippi, Jackson, Mississippi
- 2Brain and Spine Associates, Monroe, Louisiana
| | - Emile Simon
- 3Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
- 4Laboratory of Anatomy, Faculty of Medicine Lyon Est, Claude Bernard University Lyon 1, Lyon, France
| | | | - Cara D Ramos
- 1Department of Neurosurgery, University of Mississippi, Jackson, Mississippi
| | - Eddie Perkins
- 1Department of Neurosurgery, University of Mississippi, Jackson, Mississippi
| | - Patrick Kim
- 1Department of Neurosurgery, University of Mississippi, Jackson, Mississippi
| | - Patrick Mertens
- 3Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
- 4Laboratory of Anatomy, Faculty of Medicine Lyon Est, Claude Bernard University Lyon 1, Lyon, France
| | - Raffaella Messina
- 5Division of Neurosurgery University "Aldo Moro" of Bari, Italy; and
| | - Gustavo Luzardo
- 1Department of Neurosurgery, University of Mississippi, Jackson, Mississippi
| | - Orlando Diaz
- 6Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas
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3
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André-Obadia N, Hodaj H, Hodaj E, Simon E, Delon-Martin C, Garcia-Larrea L. Better Fields or Currents? A Head-to-Head Comparison of Transcranial Magnetic (rTMS) Versus Direct Current Stimulation (tDCS) for Neuropathic Pain. Neurotherapeutics 2023; 20:207-219. [PMID: 36266501 PMCID: PMC10119368 DOI: 10.1007/s13311-022-01303-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 10/24/2022] Open
Abstract
While high-frequency transcranial magnetic stimulation (HF-rTMS) is now included in the armamentarium to treat chronic neuropathic pain (NP), direct-current anodal stimulation (a-tDCS) to the same cortical targets may represent a valuable alternative in terms of feasibility and cost. Here we performed a head-to-head, randomized, single-blinded, cross-over comparison of HF-rTMS versus a-tDCS over the motor cortex in 56 patients with drug-resistant NP, who received 5 daily sessions of each procedure, with a washout of at least 4 weeks. Daily scores of pain, sleep, and fatigue were obtained during 5 consecutive weeks, and functional magnetic resonance imaging (fMRI) to a motor task was performed in a subgroup of 31 patients. The percentage of responders, defined by a reduction in pain scores of > 2 SDs from pre-stimulus levels, was similar to both techniques (42.0% vs. 42.3%), while the magnitude of "best pain relief" was significantly skewed towards rTMS. Mean pain ratings in responders decreased by 32.6% (rTMS) and 29.6% (tDCS), with half of them being sensitive to only one technique. Movement-related fMRI showed significant activations in motor and premotor areas, which did not change after 5 days of stimulation, and did not discriminate responders from non-responders. Both HF-rTMS and a-tDCS showed efficacy at 1 month in drug-resistant NP, with magnitude of relief slightly favoring rTMS. Since a significant proportion of patients responded to one procedure only, both modalities should be tested before declaring a patient as unresponsive.
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Affiliation(s)
- Nathalie André-Obadia
- Neurophysiology & Epilepsy Unit, Neurological Hospital P. Wertheimer, Hospices Civils de Lyon, 59 Boulevard Pinel, 69677, Bron Cedex, France.
- University Hospital Pain Center (CETD), Neurological Hospital P. Wertheimer, Hospices Civils de Lyon, Lyon, France.
- NeuroPain Lab, INSERM U1028, UMR5292, Lyon Neuroscience Research Center, CNRS, University Claude Bernard Lyon 1, Lyon, France.
| | - Hasan Hodaj
- Pain Center, Department of Anaesthesia and Intensive Care, Grenoble Alpes University Hospital, Grenoble, France
- University Grenoble Alpes, Inserm U1216, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Enkelejda Hodaj
- Clinical Pharmacology Department, Inserm CIC1406, Grenoble Alpes University Hospital, Grenoble, France
| | - Emile Simon
- University Hospital Pain Center (CETD), Neurological Hospital P. Wertheimer, Hospices Civils de Lyon, Lyon, France
- NeuroPain Lab, INSERM U1028, UMR5292, Lyon Neuroscience Research Center, CNRS, University Claude Bernard Lyon 1, Lyon, France
- Functional and Stereotactic Neurosurgical Unit, Neurological Hospital P. Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Chantal Delon-Martin
- University Grenoble Alpes, Inserm U1216, Grenoble Institut Neurosciences, 38000, Grenoble, France
| | - Luis Garcia-Larrea
- University Hospital Pain Center (CETD), Neurological Hospital P. Wertheimer, Hospices Civils de Lyon, Lyon, France
- NeuroPain Lab, INSERM U1028, UMR5292, Lyon Neuroscience Research Center, CNRS, University Claude Bernard Lyon 1, Lyon, France
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4
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Simon E, Welsh J, Marcus C, Krizo J. 181 Hospital System Acute Care at Home to Prevent Emergency Department Visits. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.205] [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: 11/01/2022]
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5
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Rodriguez N, Laurencin C, Klinger H, Simon E, Danaila T, Thobois S. Beware of atypical apathy after STN stimulation. Rev Neurol (Paris) 2022; 178:857-858. [PMID: 36153259 DOI: 10.1016/j.neurol.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- N Rodriguez
- Hospices civils de Lyon, hôpital neurologique Pierre Wertheimer, service de neurologie C, centre expert Parkinson, Bron, France
| | - C Laurencin
- Hospices civils de Lyon, hôpital neurologique Pierre Wertheimer, service de neurologie C, centre expert Parkinson, Bron, France
| | - H Klinger
- Hospices civils de Lyon, hôpital neurologique Pierre Wertheimer, service de neurologie C, centre expert Parkinson, Bron, France
| | - E Simon
- Hospices Civils de Lyon, hôpital Neurologique Pierre Wertheimer, service de neurochirurgie A, Bron, France
| | - T Danaila
- Hospices civils de Lyon, hôpital neurologique Pierre Wertheimer, service de neurologie C, centre expert Parkinson, Bron, France
| | - S Thobois
- Hospices civils de Lyon, hôpital neurologique Pierre Wertheimer, service de neurologie C, centre expert Parkinson, Bron, France; Université Claude Bernard Lyon 1, institut des sciences cognitives Marc Jeannerod, CNRS, UMR 5229, Bron, France; Université Claude Bernard Lyon 1, faculté de médecine et de Maïeutique Lyon Sud Charles Mérieux, Oullins, France.
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6
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Prange S, Lin Z, Nourredine M, Danaila T, Laurencin C, Lagha-Boukbiza O, Anheim M, Klinger H, Longato N, Phillipps C, Voirin J, Polo G, Simon E, Mertens P, Rolland AS, Devos D, Metereau E, Tranchant C, Thobois S. Limbic stimulation drives mania in STN-DBS in Parkinson disease: a prospective study. Ann Neurol 2022; 92:411-417. [PMID: 35703252 DOI: 10.1002/ana.26434] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/30/2022] [Accepted: 06/05/2022] [Indexed: 11/10/2022]
Abstract
In this one-year prospective study, Parkinson's disease (PD) patients with or without mania following STN-DBS were compared to investigate risk and etiological factors, clinical management and consequences. Eighteen (16.2%) out of 111 consecutive PD patients developed mania, of whom 17 were males. No preoperative risk factor was identified. Postoperative mania was related to ventral limbic subthalamic stimulation in 15 (83%) patients, and resolved as stimulation was relocated to the sensorimotor STN, besides discontinuation or reduction of dopamine agonists and use of low-dose clozapine in 12 patients, while motor and nonmotor outcomes were similar. These findings underpin the prominent role of limbic subthalamic stimulation in postoperative mania. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Stéphane Prange
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Bron, France.,Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN network, Bron, France.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany
| | - Zhengyu Lin
- Service de Neurochirurgie fonctionnelle, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon 59 Bd Pinel, 69500, Bron, France.,Department of Neurosurgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Center for Functional Neurosurgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Teodor Danaila
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Bron, France.,Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN network, Bron, France
| | - Chloé Laurencin
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Bron, France.,Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN network, Bron, France
| | - Ouhaid Lagha-Boukbiza
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch-Graffenstaden, France
| | - Hélène Klinger
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN network, Bron, France
| | - Nadine Longato
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Clelie Phillipps
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jimmy Voirin
- Department of Neurosurgery, NS-PARK/F-CRIN, Strasbourg University Hospital, Strasbourg, France
| | - Gustavo Polo
- Service de Neurochirurgie fonctionnelle, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon 59 Bd Pinel, 69500, Bron, France
| | - Emile Simon
- Service de Neurochirurgie fonctionnelle, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon 59 Bd Pinel, 69500, Bron, France
| | - Patrick Mertens
- Service de Neurochirurgie fonctionnelle, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon 59 Bd Pinel, 69500, Bron, France
| | - Anne-Sophie Rolland
- Univ Lille, CHU-Lille, Medical Pharmacology & Neurology, Expert center for Parkinson, Lille Neuroscience & Cognition, Inserm, UMR-S1172, LICEND, NS-Park network, F-59000, Lille, France
| | - David Devos
- Univ Lille, CHU-Lille, Medical Pharmacology & Neurology, Expert center for Parkinson, Lille Neuroscience & Cognition, Inserm, UMR-S1172, LICEND, NS-Park network, F-59000, Lille, France
| | - Elise Metereau
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Bron, France.,Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN network, Bron, France
| | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch-Graffenstaden, France
| | - Stéphane Thobois
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Bron, France.,Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson NS-PARK/FCRIN network, Bron, France.,Univ Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Oullins, France
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Pitts W, Cais S, Simon E, Hunt D. 'Assisted self-proning' in a case of severe COVID-19 pneumonitis. BMJ Mil Health 2022; 168:229-230. [PMID: 34103382 PMCID: PMC8189831 DOI: 10.1136/bmjmilitary-2021-001826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 12/03/2022]
Affiliation(s)
- William Pitts
- Intensive Care, Frimley Health NHS Foundation Trust, Surrey, UK
| | - S Cais
- Intensive Care, Frimley Health NHS Foundation Trust, Surrey, UK
| | - E Simon
- Intensive Care, Frimley Health NHS Foundation Trust, Surrey, UK
| | - D Hunt
- Intensive Care, Frimley Health NHS Foundation Trust, Surrey, UK
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8
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Michel C, Simon E. [Angiotensin-converting enzyme inhibitor and fetal nephromegaly]. Gynecol Obstet Fertil Senol 2022; 50:497-498. [PMID: 35081451 DOI: 10.1016/j.gofs.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Affiliation(s)
- C Michel
- Service de gynécologie obstétrique, médecine fœtale et stérilité conjugale, CHU Dijon Bourgogne, 14, rue Paul-Gaffarel, 21000 Dijon, France.
| | - E Simon
- Service de gynécologie obstétrique, médecine fœtale et stérilité conjugale, CHU Dijon Bourgogne, 14, rue Paul-Gaffarel, 21000 Dijon, France; Université Bourgogne Franche-Comté, Dijon, France
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9
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Seynhaeve S, Deygers B, Simon E. Newly arrived migrant students' perceptions of emergency remote teaching: A Q methodology study. Int J Educ Res Open 2022; 3:100169. [PMID: 35541762 PMCID: PMC9069997 DOI: 10.1016/j.ijedro.2022.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 06/14/2023]
Abstract
In an attempt to curb the spread of COVID-19, Emergency Remote Teaching was implemented worldwide. The global educational disruption led to a rise in quantitative studies investigating the effect of this shift on student outcomes. These studies suggest a greater negative impact of the pandemic on students from disadvantaged backgrounds, but often fall short of exploring learners' perspectives on online teaching practices. A Q study with 23 Newly Arrived Migrant Students in Flemish upper secondary education was conducted to investigate these pupils' perceptions of blended Emergency Remote Teaching. The results show that these students hold at least four different viewpoints regarding Emergency Remote Teaching. The importance pupils assign to interaction and the role of the teacher is an important grouping variable in these analyses.
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Affiliation(s)
- Shauny Seynhaeve
- Translation, Interpreting and Communication, Ghent University, Groot-Brittanniëlaan 45, Ghent 9000, Belgium
| | - B Deygers
- Translation, Interpreting and Communication, Ghent University, Groot-Brittanniëlaan 45, Ghent 9000, Belgium
| | - E Simon
- Linguistics, Ghent University, Ghent, Belgium
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Simon E, Cottenet J, Mariet A, Bechraoui-Quantin S, Rozenberg P, Gouyon J, Quantin C. Impact of the COVID-19 pandemic on preterm birth and stillbirth: A nationwide, population-based retrospective cohort study. Gynécologie Obstétrique Fertilité & Sénologie 2022. [PMCID: PMC9153301 DOI: 10.1016/j.gofs.2022.02.046] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective This study aimed to establish whether there was a decrease in the rate of prematurity in France after the beginning of lockdown (March 17, 2020) and whether there was an increase in the rate of stillbirths compared with 2017 to 2019. Study design We included all births from January to September of each year from 2017 to 2020 from the national Programme de Médicalisation des Systèmes d’Information database: 496,171 newborns from women with singleton pregnancies and 15,441 newborns from women with multiple pregnancies were included for 2020. Concerning the 2017 to 2019 period, we included a mean of 518,798 newborns from women with singleton pregnancies and 16,441 newborns from women with multiple pregnancies per year. Results Between April to May 2017 to 2019 and April to May 2020, there was a decrease of - 7.53% in the rate of prematurity (from 5.31% to 4.91%; P < 0.01) for singleton pregnancies. Between these 2 periods, the rate of change was −12.90% between 22 and 27 WG (P = 0.03), +1.96% between 28 and 31 WG (P = 0.69), and −8.24% between 32 and 36 WG (P < 0.01). The decrease in the rate of prematurity was still observed after the end of lockdown (from June to September 2020). For multiple births, there was no decrease in prematurity between January to September 2017 to 2019 and January to September 2020: 50.14% vs. 50.36% (P = 0.63), respectively, for twins and 95.51% vs. 94.9% (P = 0.62), respectively, for high-order multiple pregnancies. In January to September, there were 363 stillbirths among singleton pregnancies in 2017 to 2019 and 114 in 2020 (0.00% change rate). Among the 1752 women with a diagnosis of SARS-CoV-2 infection with singleton pregnancies, the rate of prematurity was higher in 2020 than in 2017 to 2019 (9.93% vs. 5.32%; P < 0.01), regardless of the severity of prematurity (P < 0.05 for all). Conclusion Large-scale socioenvironmental modifications like the lockdown in spring 2020 may be associated with beneficial effects on perinatal morbidity. We did not find an increase in the rate of stillbirth since the beginning of the pandemic. At this stage, the practical consequences are not obvious, but our results encourage further reflection regarding behaviors that could modify the risk of prematurity outside of the context of an epidemic.
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Aho Glele LS, Simon E, Bouit C, Serrand M, Filipuzzi L, Astruc K, Kadhel P, Sagot P. Association between SARS-Cov-2 infection during pregnancy and adverse pregnancy outcomes: a re-analysis of the data reported by Wei et al. (2021). Infect Dis Now 2022; 52:123-128. [PMID: 35182802 PMCID: PMC8847095 DOI: 10.1016/j.idnow.2022.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 02/08/2022] [Indexed: 11/19/2022]
Abstract
Objectives and background Wei et al. have published a meta-analysis (MA), which aimed to evaluate the association between SARS-CoV-2 infection during pregnancy and adverse pregnancy outcomes. Using classical random-effects model, they found that SARS-CoV-2 infection was associated with preeclampsia, preterm birth and stillbirth. Performing MA with low event rates or with few studies may be challenging insofar as MA relies on several within and between-study distributional assumptions. The objective was to assess the robustness of the results provided by Wei et al. Methods We performed a sensitivity analysis using frequentist and Bayesian meta-analysis methods. We also estimated fragility indexes. Results For eclampsia, the confidence intervals of most frequentist models contain 1. All beta-binomial models (Bayesian) lead to credible intervals containing 1. The prediction interval, based on DL method, ranges from 0.75 to 2.38. The fragility index is 2 for the DL method. For preterm, the confidence (credible) intervals exclude 1. The prediction interval is broad, ranging from 0.84 to 20.61. The fragility index ranges from 27 to 10. For stillbirth, the confidence intervals of most frequentist models contain 1. Six Bayesian MA models lead to credible intervals containing 1. The prediction interval ranges from 0.52 to 8.49. The fragility index is 3. Conclusion Given the available data and the results of our broad sensitivity analysis, we can suggest that SARS-CoV-2 infection during pregnancy is associated with preterm, and that it may be associated with preeclampsia. For stillbirth, more data are needed as none of the Bayesian analyses are conclusive.
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Affiliation(s)
- L S Aho Glele
- Department of epidemiology and infection control. Dijon university hospital, Dijon, France.
| | - E Simon
- Department of obstetrics and gynecology. Dijon university hospital, Dijon, France
| | - C Bouit
- Department of obstetrics and gynecology. Dijon university hospital, Dijon, France
| | - M Serrand
- Department of obstetrics and gynecology. Dijon university hospital, Dijon, France
| | - L Filipuzzi
- Department of obstetrics and gynecology. Dijon university hospital, Dijon, France
| | - K Astruc
- Department of epidemiology and infection control. Dijon university hospital, Dijon, France
| | - P Kadhel
- Department of obstetrics and gynecology. Dijon university hospital, Dijon, France
| | - P Sagot
- Department of obstetrics and gynecology. Dijon university hospital, Dijon, France
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Hills J, Simon E, Mignacca S, Beck K, Vickery C, Lockey R, Thorne J, Griffiths P, Spiropoulos J. Have the Biological Properties of Classical BSE Changed After the Implementation of the Reinforced Feed Ban in 1996 in the UK? J Comp Pathol 2022. [DOI: 10.1016/j.jcpa.2021.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Simon E, Beuriat PA, Delabar V, Jouanneau E, Fernandez-Miranda J, Jacquesson T. Cranial and Cerebral Anatomic Key Points for Neurosurgery: A New Educational Insight. Oper Neurosurg (Hagerstown) 2022; 22:e18-e27. [PMID: 34982906 DOI: 10.1227/ons.0000000000000016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/13/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The anatomy of both the skull and the brain offers many landmarks that could lead surgery. Cranial "craniometric" key points were described many years ago, and then, cerebral key points-along sulci and gyri-were detailed more recently for microneurosurgical approaches that can reach deep structures while sparing the brain. Nonetheless, this anatomic knowledge is progressively competed by new digital devices, such as imaging guidance systems, although they can be misleading. OBJECTIVE To summarize cranial and sulcal key points and their related anatomic structures to renew their interest in modern neurosurgery and help surgical anatomy teaching. METHODS After a literature review collecting anatomic key points of skull and brain, specimens were prepared and images were taken to expose skull and brain from lateral, superior, posterior, and oblique views. A high-definition camera was used, and images obtained were modified, superimposing both key points and underlying anatomic structures. RESULTS From 4 views, 16 cranial key points were depicted: anterior and superior squamous point, precoronal and retrocoronal point, superior sagittal point, intraparietal point, temporoparietal point, preauricular point, nasion, bregma, stephanion, euryon, lambda, asterion, opisthocranion, and inion. These corresponded to underlying cerebral key points and relative brain parts: anterior and posterior sylvian point, superior and inferior rolandic point, supramarginal and angular gyri, parieto-occipital sulcus, and various meeting points between identifiable sulci. Stereoscopic views were also provided to help learning these key points. CONCLUSION This comprehensive overview of the cranial and sulcal key points could be a useful tool for any neurosurgeon who wants to check her/his surgical route and make the surgery more "gentle, safe, and accurate."
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Affiliation(s)
- Emile Simon
- Department of Anatomy, University of Lyon 1, Lyon, France
| | | | - Violaine Delabar
- Skull Base Multi-Disciplinary Unit, Department of Neurosurgery B, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Emmanuel Jouanneau
- Skull Base Multi-Disciplinary Unit, Department of Neurosurgery B, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Juan Fernandez-Miranda
- Department of Neurosurgery, Stanford University Medical Center, Palo Alto, California, USA
| | - Timothée Jacquesson
- Department of Anatomy, University of Lyon 1, Lyon, France.,Skull Base Multi-Disciplinary Unit, Department of Neurosurgery B, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,CREATIS Laboratory, CNRS UMR5220, Inserm U1044, INSA-Lyon, University of Lyon 1, Lyon, France
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Bonnet MP, Garnier M, Keita H, Compere V, Arthuis C, Raia-Barjat T, Berveiller P, Burey J, Bouvet L, Bruyère M, Castel A, Clouqueur E, Estevez MG, Faitot V, Fischer C, Fuchs F, Lecarpentier E, Le Gouez A, Rigouzzo A, Rossignol M, Simon E, Vial F, Vivanti AJ, Zieleskewicz L, Sénat MV, Schmitz T, Sentilhes L. [Reprint of: Severe pre-eclampsia: guidelines for clinical practice from the French Society of anesthesiology and intensive care (SFAR) and the French College of gynaecologists and obstetricians (CNGOF)]. ACTA ACUST UNITED AC 2021; 50:2-25. [PMID: 34781016 DOI: 10.1016/j.gofs.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To provide national guidelines for the management of women with severe preeclampsia. DESIGN A consensus committee of 26 experts was formed. A formal conflict of interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently of any industrial funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasized. METHODS The last SFAR and CNGOF guidelines on the management of women with severe preeclampsia was published in 2009. The literature is now sufficient for an update. The aim of this expert panel guidelines is to evaluate the impact of different aspects of the management of women with severe preeclampsia on maternal and neonatal morbidities separately. The experts studied questions within 7 domains. Each question was formulated according to the PICO (Patients Intervention Comparison Outcome) model and the evidence profiles were produced. An extensive literature review and recommendations were carried out and analyzed according to the GRADE® methodology. RESULTS The SFAR/CNGOF experts panel provided 25 recommendations: 8 have a high level of evidence (GRADE 1±), 9 have a moderate level of evidence (GRADE 2±), and for 7 recommendations, the GRADE method could not be applied, resulting in expert opinions. No recommendation was provided for 3 questions. After one scoring round, strong agreement was reached between the experts for all the recommendations. CONCLUSIONS There was strong agreement among experts who made 25 recommendations to improve practices for the management of women with severe preeclampsia.
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Affiliation(s)
- M-P Bonnet
- Sorbonne Université, GRC 29, DMU DREAM, Department of Anaesthesiology and Intensive Care, Armand Trousseau University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Centre de Recherche épidémiologie et Statistiques Sorbonne Paris Cité (CRESS) U1153, INSERM, Obstetrical, Perinatal and Paediatric Epidemiology (EPOPé) Research Team, Université de Paris, Paris, France.
| | - M Garnier
- Sorbonne Université, APHP, GRC 29, DMU DREAM, Département d'Anesthesie-réanimation, CHU Tenon, Paris, France
| | - H Keita
- Département d'anesthésie-réanimation pédiatrique et obstétricale, hôpital Necker-Enfants malades, université de Paris, AP-HP, Paris, France
| | - V Compere
- Département d'anesthésie-réanimation, CHU de Rouen, Rouen, France
| | - C Arthuis
- Service de gynécologie-obstétrique, centre hospitalier universitaire de Nantes, hôpital Mère-Enfant, Nantes, France
| | - T Raia-Barjat
- Inserm, U 1059 SainBioSE, département de gynécologie, obstétrique, et médecine de la reproduction, CHU de Saint-Étienne, université de Saint-Étienne Jean-Monnet, 42023 Saint-Étienne, France
| | - P Berveiller
- Service de gynécologie-obstétrique, école nationale vétérinaire d'Alfort, CHI Poissy Saint-Germain, UVSQ, INRAE, BREED, Jouy-en-Josas, BREED, Poissy université Paris-Saclay, Maisons-Alfort, France
| | - J Burey
- Service d'anesthésie-réanimation chirurgicale, hôpital Tenon, AP-HP, Paris, France
| | - L Bouvet
- Service d'anesthésie-réanimation, groupement hospitalier Est, hospices civils de Lyon, Bron, Claude-Bernard Lyon 1, hôpital Femme Mère-Enfant, université de Lyon, Villeurbanne, France
| | - M Bruyère
- Service d'anesthésie-réanimation médecine périopératoire, hôpital Bicêtre, AP-HP, université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - A Castel
- Département d'anesthésie-réanimation, hôpital Paule-de-Viguier, Toulouse, France
| | - E Clouqueur
- Service de gynécologie-obstétrique, centre hospitalier de Tourcoing, Tourcoing, France
| | - M Gonzalez Estevez
- Service d'anesthésie-réanimation et de médecine périopératoire, hôpital Jeanne-de-Flandre, CHU de Lille, Lille, France
| | - V Faitot
- Département d'anesthésie-réanimation, hôpital de Hautepierre, CHU de Strasbourg, Strasbourg, France
| | - C Fischer
- Département d'anesthésie-réanimation chirurgicale, hôpital Cochin, Paris, France
| | - F Fuchs
- UMR Inserm, service de gynécologie-obstétrique, institut Desbrest d'épidémiologie et de santé publique (IDESP), IURC, CHU de Montpellier, hôpital Arnaud-de-Villeneuve, université de Montpellier, Campus Santé, Montpellier, France
| | - E Lecarpentier
- Inserm U955, département de gynécologie-obstétrique et médecine de la reproduction, CHIC de Créteil, institut biomédical Henri-Mondor, université Paris Est Créteil, Créteil, France
| | - A Le Gouez
- Département d'anesthésie-réanimation, hôpital Antoine-Béclère, AP-HP, Clamart, France
| | - A Rigouzzo
- Service d'anesthésie-réanimation chirurgicale, hôpital Armand Trousseau, AP-HP, Paris, France
| | - M Rossignol
- Département d'anesthésie-réanimation et SMUR, hôpital Lariboisière, AP-HP, université de Paris, Paris, France
| | - E Simon
- Pôle de gynécologie-obstétrique et biologie de la reproduction, CHU de Dijon-Bourgogne, UFR Sciences de santé Dijon, université de Bourgogne, Bourgogne, France
| | - F Vial
- Service d'anesthésie-réanimation, maternité régionale universitaire-CHRU de Nancy, Nancy, France
| | - A J Vivanti
- Université Paris Saclay, service de gynécologie-obstétrique, hôpital Antoine Béclère, AP-HP, Paris, France
| | - L Zieleskewicz
- Inserm, INRA, département d'anesthésie-réanimation, centre de recherche cardiovasculaire et de nutrition (C2VN), hôpital Nord, université d'Aix-Marseille, université Aix-Marseille, Marseille, France
| | - M-V Sénat
- Inserm, service de gynécologie-obstétrique, UVSQ, CESP, hôpital Bicêtre, université Paris-Saclay, AP-HP, Villejuif, France
| | - T Schmitz
- Inserm, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), service de gynécologie-obstétrique, centre de recherche épidémiologie et statistique Sorbonne Paris Cité (CRESS), hôpital Robert-Debré, université de Paris, AP-HP, 75004 Paris, France
| | - L Sentilhes
- Service de gynécologie-obstétrique, maternité Aliénor d'Aquitaine, CHU de Bordeaux, Bordeaux, France
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Simon E, Crouse B, Sayles S, Muir M, Ramos C, Phelan M. 331 Evaluation of Triage Screening for Influenza Vaccination Status in the Emergency Department. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Simon E, Crouse B, Karamchandani J, Ramos C, Muir M, Sayles S, Phelan M. 174 Modeling the Value of an Emergency Department Influenza Vaccination Program. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Halbgebauer D, Roos J, Funcke JB, Neubauer H, Hamilton BS, Simon E, Amri EZ, Debatin KM, Wabitsch M, Fischer-Posovszky P, Tews D. Latent TGFβ-binding proteins regulate UCP1 expression and function via TGFβ2. Mol Metab 2021; 53:101336. [PMID: 34481123 PMCID: PMC8456047 DOI: 10.1016/j.molmet.2021.101336] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 12/26/2022] Open
Abstract
Objective Activation of brown adipose tissue (BAT) in humans has been proposed as a new treatment approach for combating obesity and its associated diseases, as BAT participates in the regulation of energy homeostasis as well as glucose and lipid metabolism. Genetic contributors driving brown adipogenesis in humans have not been fully understood. Methods Profiling the gene expression of progenitor cells from subcutaneous and deep neck adipose tissue, we discovered new secreted factors with potential regulatory roles in white and brown adipogenesis. Among these, members of the latent transforming growth factor beta-binding protein (LTBP) family were highly expressed in brown compared to white adipocyte progenitor cells, suggesting that these proteins are capable of promoting brown adipogenesis. To investigate this potential, we used CRISPR/Cas9 to generate LTBP-deficient human preadipocytes. Results We demonstrate that LTBP2 and LTBP3 deficiency does not affect adipogenic differentiation, but diminishes UCP1 expression and function in the obtained mature adipocytes. We further show that these effects are dependent on TGFβ2 but not TGFβ1 signaling: TGFβ2 deficiency decreases adipocyte UCP1 expression, whereas TGFβ2 treatment increases it. The activity of the LTBP3–TGFβ2 axis that we delineate herein also significantly correlates with UCP1 expression in human white adipose tissue (WAT), suggesting an important role in regulating WAT browning as well. Conclusions These results provide evidence that LTBP3, via TGFβ2, plays an important role in promoting brown adipogenesis by modulating UCP1 expression and mitochondrial oxygen consumption. Inhibition of LTBP2 and LTBP3 reduces secretion of TGFβ2. Both knockout of LTBP2/3 or TGFβ2 inhibit UCP1 expression and mitochondrial respiration in human adipocytes. Expression of TGFβ2 correlates with UCP1 expression in human adipose tissue. Treatment with TGFβ2 rescues inhibition of UCP1 by LTBP knockout during adipogenesis.
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Affiliation(s)
- D Halbgebauer
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany; Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - J Roos
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - J B Funcke
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - H Neubauer
- Cardiometabolic Diseases Research, Boehringer-Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - B S Hamilton
- Cardiometabolic Diseases Research, Boehringer-Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - E Simon
- Global Computational Biology and Digital Sciences, Boehringer-Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - E Z Amri
- Université Côte d'Azur, CNRS, Inserm, iBV, Nice, France
| | - K M Debatin
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - M Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - P Fischer-Posovszky
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - D Tews
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany; Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany.
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Coussement A, Nevado S, Simon E, Berthier S, Nicolas B, Samson M, Bonnotte B, Audia S. Grossesse compliquée d’une hémophagocytose lymphohistiocytaire secondaire à une infection à Parvovirus B19. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.124] [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: 10/21/2022]
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Ribault S, Simon E, Berthiller J, Polo G, Nunes A, Brinzeu A, Mertens P, Danaila T, Thobois S, Laurencin C. Comparison of clinical outcomes and accuracy of electrode placement between robot-assisted and conventional deep brain stimulation of the subthalamic nucleus: a single-center study. Acta Neurochir (Wien) 2021; 163:1327-1333. [PMID: 33649878 DOI: 10.1007/s00701-021-04790-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 02/23/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Several surgical methods are used for deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson's disease (PD). This study aimed to compare clinical outcomes and electrode placement accuracy after robot-assisted (RAS) versus frame-based stereotactic (FSS) STN DBS in Parkinson's disease. METHODS In this single-center open-label study, we prospectively collected data from 48 consecutive PD patients who underwent RAS (Neuromate®; n = 20) or FSS (n = 28) STN DBS with the same MRI-based STN targeting between October 2016 and December 2018 in the university neurological hospital of Lyon, France. Clinical variables were assessed before and 1 year after surgery. The number of electrode contacts within the STN was determined by merging post-operative CT and pre-operative MRI using Brainlab® GUIDE™XT software. RESULTS One year after surgery, the improvement of motor manifestations (p = 0.18), motor complications (p = 0.80), and quality of life (p= 0.30) and the reduction of dopaminergic treatment (p = 0.94) and the rate of complications (p = 0.99) were similar in the two groups. Surgery duration was longer in the RAS group (p = 0.0001). There was no difference in the number of electrode contacts within the STN. CONCLUSION This study demonstrates that RAS and FSS STN DBS for PD provide similar clinical outcomes and accuracy of electrode placement.
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Affiliation(s)
- Shams Ribault
- Service de Neurologie C, Centre Expert Parkinson, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France
- Service de Médecine Physique et de Réadaptation, Hôpital Henry Gabrielle, Hospices Civils de Lyon, 69230, Saint-Genis-Laval, France
| | - Emile Simon
- Service de Neurochirurgie Fonctionnelle, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France
- Laboratoire d'Anatomie, Faculté de Médecine Lyon Est, Université de Lyon, Université Claude Bernard Lyon 1, 69003, Lyon, France
| | - Julien Berthiller
- Service de Recherche et d'Épidémiologie Clinique, Pôle de Santé Publique, Hospices Civils de Lyon, 69003, Lyon, France
| | - Gustavo Polo
- Service de Neurochirurgie Fonctionnelle, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France
| | - Adélaïde Nunes
- Service de Neurologie C, Centre Expert Parkinson, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France
| | - Andrei Brinzeu
- Service de Recherche et d'Épidémiologie Clinique, Pôle de Santé Publique, Hospices Civils de Lyon, 69003, Lyon, France
| | - Patrick Mertens
- Service de Neurochirurgie Fonctionnelle, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France
- Laboratoire d'Anatomie, Faculté de Médecine Lyon Est, Université de Lyon, Université Claude Bernard Lyon 1, 69003, Lyon, France
| | - Teodor Danaila
- Service de Neurologie C, Centre Expert Parkinson, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France
| | - Stéphane Thobois
- Service de Neurologie C, Centre Expert Parkinson, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, 69675, Lyon, France
- Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Université de Lyon, Université Claude Bernard Lyon 1, 69373, Lyon, France
| | - Chloé Laurencin
- Service de Neurologie C, Centre Expert Parkinson, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, 69003, Lyon, France.
- Centre de Recherche en Neuroscience de Lyon, INSERM U1028, UMR 5292, 69000, Lyon, France.
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Bilger G, Nicolaï M, Perez M, Simon E. [Case report: Epigastric dermatofibroma reconstruction by reverse abdominoplasty with umbilic transposition]. ANN CHIR PLAST ESTH 2021; 66:261-267. [PMID: 33715869 DOI: 10.1016/j.anplas.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 01/24/2021] [Accepted: 02/01/2021] [Indexed: 11/18/2022]
Abstract
Dermatofibrosarcoma is the most common cutaneous sarcoma. Its surgical management is a technical challenge due to the high amount of substance loss. We explain a new technique of abdominal wall reconstruction by a reverse abdominoplasty with umbilical transposition. This new surgical technique allowed, in one time, the excision and the abdominal wall reconstruction. Functional and esthetic results are really satisfactory.
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Affiliation(s)
- G Bilger
- Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
| | - M Nicolaï
- Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - M Perez
- Service de chirurgie générale d'urgence, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - E Simon
- Service de chirurgie plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
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21
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Siepmann T, Sedghi A, Simon E, Winzer S, Barlinn J, de With K, Mirow L, Wolz M, Gruenewald T, Schroettner P, von Bonin S, Pallesen LP, Rosengarten B, Schubert J, Lohmann T, Machetanz J, Spieth P, Koch T, Bornstein S, Reichmann H, Puetz V, Barlinn K. Increased risk of acute stroke among patients with severe COVID-19: a multicenter study and meta-analysis. Eur J Neurol 2021; 28:238-247. [PMID: 32920964 DOI: 10.1111/ene.14535] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [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: 06/01/2020] [Accepted: 08/31/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE Recent observations linked coronavirus disease 2019 (COVID-19) to thromboembolic complications possibly mediated by increased blood coagulability and inflammatory endothelial impairment. We aimed to define the risk of acute stroke in patients with severe and non-severe COVID-19. METHODS We performed an observational, multicenter cohort study in four participating hospitals in Saxony, Germany to characterize consecutive patients with laboratory-confirmed COVID-19 who experienced acute stroke during hospitalization. Furthermore, we conducted a systematic review using PubMed/MEDLINE, Embase, Cochrane Library and bibliographies of identified papers following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines including data from observational studies of acute stroke in COVID-19 patients. Data were extracted by two independent reviewers and pooled with multicenter data to calculate risk ratios (RRs) and 95% confidence intervals (95% CIs) for acute stroke related to COVID-19 severity using a random-effects model. Between-study heterogeneity was assessed using Cochran's Q and I2 statistics. International Prospective Register of Systematic Reviews registration number: CRD42020187194. RESULTS Of 165 patients hospitalized for COVID-19 (49.1% males, median age = 67 years [57-79 years], 72.1% severe or critical) included in the multicenter study, overall stroke rate was 4.2% (95% CI: 1.9-8.7). Systematic literature search identified two observational studies involving 576 patients that were eligible for meta-analysis. Amongst 741 pooled COVID-19 patients, overall stroke rate was 2.9% (95% CI: 1.9-4.5). Risk of acute stroke was increased for patients with severe compared to non-severe COVID-19 (RR = 4.18, 95% CI: 1.7-10.25; P = 0.002) with no evidence of heterogeneity (I2 = 0%, P = 0.82). CONCLUSIONS Synthesized analysis of data from our multicenter study and previously published cohorts indicates that severity of COVID-19 is associated with an increased risk of acute stroke.
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Affiliation(s)
- T Siepmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - A Sedghi
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - E Simon
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - S Winzer
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - J Barlinn
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - K de With
- Division of Infectious Diseases, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - L Mirow
- Department of General and Visceral Surgery, Klinikum Chemnitz gGmbH, Chemnitz
| | - M Wolz
- Department of Neurology, Elblandklinikum Meissen, Meissen
| | - T Gruenewald
- Department of Infectious Diseases/Tropical Medicine, Klinikum Chemnitz gGmbH, Chemnitz
| | - P Schroettner
- Department of Virology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - S von Bonin
- Department of Internal Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - L-P Pallesen
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - B Rosengarten
- Department of Neurology, Klinikum Chemnitz gGmbH, Chemnitz
| | - J Schubert
- Department of Hematology and Oncology, Elblandklinikum Riesa, Riesa
| | - T Lohmann
- Department of Internal Medicine, Städtisches Klinikum Dresden, Dresden
| | - J Machetanz
- Department of Neurology, Städtisches Klinikum Dresden, Dresden
| | - P Spieth
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T Koch
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - S Bornstein
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - H Reichmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - V Puetz
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - K Barlinn
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
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Zambell K, Kealey B, Simon E, Thomopoulos D, Wallace E, Turner S, Yang S, Wang G, Volkow N, Wiers C. Predictors of Increase in Calorie Provision in Alcohol Use Disorder Patients While on a Ketogenic Diet During Withdrawal. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.08.032] [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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Rigoard P, Billot M, Ingrand P, Durand-Zaleski I, Roulaud M, Peruzzi P, Dam Hieu P, Voirin J, Raoul S, Page P, Djian MC, Fontaine D, Lantéri-Minet M, Blond S, Buisset N, Cuny E, Cadenne M, Caire F, Ranoux D, Mertens P, Naous H, Simon E, Emery E, Béraud G, Debiais F, Durand G, Serrie A, Diallo B, Bulsei J, Ounajim A, Nivole K, Duranton S, Naiditch N, Monlezun O, Bataille B. How Should we Use Multicolumn Spinal Cord Stimulation to Optimize Back Pain Spatial Neural Targeting? A Prospective, Multicenter, Randomized, Double-Blind, Controlled Trial (ESTIMET Study). Neuromodulation 2020; 24:86-101. [PMID: 32865344 DOI: 10.1111/ner.13251] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 02/21/2020] [Revised: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent studies have highlighted multicolumn spinal cord stimulation (SCS) efficacy, hypothesizing that optimized spatial neural targeting provided by new-generation SCS lead design or its multicolumn programming abilities could represent an opportunity to better address chronic back pain (BP). OBJECTIVE To compare multicolumn vs. monocolumn programming on clinical outcomes of refractory postoperative chronic BP patients implanted with SCS using multicolumn surgical lead. MATERIALS AND METHODS Twelve centers included 115 patients in a multicenter, randomized, double-blind, controlled trial. After randomization, leads were programmed using only one or several columns. The primary outcome was change in BP visual analogic scale (VAS) at six months. All patients were then programmed using the full potential of the lead up until 12-months follow-up. RESULTS At six months, there was no significant difference in clinical outcomes whether the SCS was programmed using a mono or a multicolumn program. At 12 months, in all patients having been receiving multicolumn SCS for at least six months (n = 97), VAS decreases were significant for global pain (45.1%), leg pain (55.8%), and BP (41.5%) compared with baseline (p < 0.0001). CONCLUSION The ESTIMET study confirms the significant benefit experienced on chronic BP by patients implanted with multicolumn SCS, independently from multicolumn lead programming. These good clinical outcomes might result from the specific architecture of the multicolumn lead, giving the opportunity to select initially the best column on a multicolumn grid and to optimize neural targeting with low-energy requirements. However, involving more columns than one does not appear necessary, once initial spatial targeting of the "sweet spot" has been achieved. Our findings suggest that this spatial concept could also be transposed to cylindrical leads, which have drastically improved their capability to shape the electrical field, and might be combined with temporal resolution using SCS new modalities.
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Affiliation(s)
- Philippe Rigoard
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France.,Department of Neurosurgery, Spine & Neurostimulation Unit, Poitiers University Hospital, Poitiers, France.,UPR 3346, CNRS, P' Institute, Futuroscope, Faculty of Sciences, Poitiers, France
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Pierre Ingrand
- Faculty of Medicine and Pharmacy, Poitiers University Hospital, Poitiers, France
| | | | - Manuel Roulaud
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Philippe Peruzzi
- Department of Neurosurgery, Reims University Hospital, Reims, France
| | - Phong Dam Hieu
- Department of Neurosurgery, Brest University Hospital, Brest, France
| | - Jimmy Voirin
- Department of Neurosurgery, Colmar Hospital, Colmar, France
| | - Sylvie Raoul
- Department of Neurosurgery, Nantes University Hospital, Nantes, France
| | - Philippe Page
- Department of Neurosurgery, Spine & Neurostimulation Unit, Poitiers University Hospital, Poitiers, France
| | | | - Denys Fontaine
- Centre Hospitalier Universitaire de Nice, Department of Neurosurgery, Université Côte d'Azur, Nice, France.,FHU InovPain, Côte Azur University, Nice, France
| | - Michel Lantéri-Minet
- FHU InovPain, Côte Azur University, Nice, France.,Pain Evaluation and Treatment Centre, Nice University Hospital, Nice, France.,INSERM U1107, Neuro-Dol, Trigeminal Pain and Migraine, Auvergne University, Clermont-Ferrand, France
| | - Serge Blond
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | - Nadia Buisset
- Department of Neurosurgery, Lille University Hospital, Lille, France
| | - Emmanuel Cuny
- Department of Neurosurgery, Bordeaux University Hospital, Bordeaux, France
| | - Myriam Cadenne
- Pain Evaluation and Treatment Centre, Bordeaux University Hospital, Bordeaux, France
| | - François Caire
- Department of Neurosurgery, Limoges University Hospital, Limoges, France
| | - Danièle Ranoux
- Pain Evaluation and Treatment Centre, Limoges University Hospital, Limoges, France
| | - Patrick Mertens
- Department of Neurosurgery, Lyon University Hospital, Lyon, France
| | - Hussein Naous
- Department of Neurosurgery, Lyon University Hospital, Lyon, France
| | - Emile Simon
- Department of Neurosurgery, Lyon University Hospital, Lyon, France
| | - Evelyne Emery
- Department of Neurosurgery, Caen University Hospital, Caen, France
| | - Guillaume Béraud
- Internal Medicine/Infectious and Tropical Diseases Department, Poitiers University Hospital, Poitiers, France
| | - Françoise Debiais
- Department of Rheumatology, Poitiers University Hospital, Poitiers, France
| | - Géraldine Durand
- Department of Rheumatology, Poitiers University Hospital, Poitiers, France
| | - Alain Serrie
- Pain Evaluation and Treatment Centre, Lariboisière Hospital, Paris, France
| | - Bakari Diallo
- Pain Evaluation and Treatment Centre, Poitiers University Hospital, Poitiers, France
| | - Julie Bulsei
- Clinical Research Unit in Economics, Hôtel Dieu, Paris, France
| | - Amine Ounajim
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Kevin Nivole
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Sophie Duranton
- Vigilance Department, Clinical Research Direction, Poitiers University Hospital, Poitiers, France
| | - Nicolas Naiditch
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Olivier Monlezun
- PRISMATICS Lab (Predictive Research In Spine/neurostimulation Management and Thoracic Innovation in Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Benoit Bataille
- Department of Neurosurgery, Spine & Neurostimulation Unit, Poitiers University Hospital, Poitiers, France
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Cohet M, De Runz A, Remen T, Brix M, Simon E. [Factors influencing drainage productivity in breast reduction: A retrospective study of 222 breasts]. ANN CHIR PLAST ESTH 2020; 66:144-150. [PMID: 32690427 DOI: 10.1016/j.anplas.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 05/29/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The objective of this study is to highlight the factors that influence drain productivity in reduction mastoplasty. MATERIALS AND METHODS We have retrospectively referenced from November 2015 to November 2017 all breast reduction performed in the plastic surgery, reconstructive and esthetic surgery department of the University Hospital of Nancy. A total of 222 breasts were analyzed by listing age, weight, height, Body Mass Index (BMI), smoking status, surgeon, technical used, hospitalization stay, breast volume removed, type and size of drain and their productivity. Multivariate analysis were realised. RESULTS 118 patients were included with an average age of 42.2 years. The average productivity of drains was 50 millilitres (ml). There was a significant difference in productivity of drainage according to the operator with a median ranging from 10ml to 60ml (P<0.0001). The median was 20ml for 10 Redon-Jost drains versus 50ml for the 16 Redon-Jost drains (P<0.0001). Multivariate analysis of the various factors influencing the total productivity of postoperative drainage showed a relative risk of 1.16 for smokers, 0.24 for one surgeon, 1.68 for the Skoog technique, and 1.000 for breast volume removed. CONCLUSION The drain productivity is not predictable before a breast reduction. Indeed, none of the characteristics studied have sufficient influence on the productivity of the drains.
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Affiliation(s)
- M Cohet
- Service de chirurgie maxillo-facial, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
| | - A De Runz
- Service de chirurgie esthétique, plastique et reconstructrice, 97, rue Claude-Bernard, 57070 Metz, France.
| | - T Remen
- Service de la PARC, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
| | - M Brix
- Service de chirurgie maxillo-facial, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
| | - E Simon
- Service de chirurgie maxillo-facial, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France.
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Malet S, Choux C, Akrich M, Simon E, Sagot P. [Mistreatment during childbirth: A prospective multicentric survey among women in maternities in Burgundy]. ACTA ACUST UNITED AC 2020; 48:790-799. [PMID: 32376481 DOI: 10.1016/j.gofs.2020.04.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Indexed: 01/30/2023]
Abstract
OBJECTIVES The purpose of this study was to estimate the prevalence of mistreatment during childbirth (MDCB), to assess the subjective experience of women and to identify the factors associated with MDCB. METHODS This prospective multicentered study included every single public maternity of the Burgundy Perinatal Network from the 15th of February to the 15th of March 2019. An anonymous questionnaire was distributed on postpartum's second day. It encompassed the following categories of MDCB: verbal, physical abuse, information, consent, failure to meet professional standards of care (PSC), poor rapport between women and providers (PRBWP), and discrimination, as well as the subjective experience, physical and psychological. RESULTS Out of 1793 eligible women, 1149 answered (64.1%). Women reported a positive experience of childbirth, physical (89.8%) and psychological (93.4%). On the other hand, 506 women (44%) reported MDCB. The incidence of verbal (2.3%) or physical (0.4%) abuse or discrimination (3.5%) was marginal. MDCB reported was mainly a lack of research and/or respect of consent (21.5%), lack of satisfying information for at least one procedure (14.4%), declaration of lack of respect of PSC (24.2%), PRBWP (11.1%). When the subjective experience of childbirth was negative on the physical aspect, one MDCB was declared in 80% of cases (P<0.01). CONCLUSIONS This study highlights the importance of involving women in care's decisions. We should systematize the information and seeking of consent in a dynamic way and promote free choice for women.
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Affiliation(s)
- S Malet
- Service de gynécologie-obstétrique, CHU de Dijon Bourgogne, 14, rue Gaffarel, 21000 Dijon, France
| | - C Choux
- Service de gynécologie-obstétrique, CHU de Dijon Bourgogne, 14, rue Gaffarel, 21000 Dijon, France.
| | - M Akrich
- Collectif interassociatif autour de la naissance - CIANE, 40, rue Chanzy, 75011 Paris, France
| | - E Simon
- Service de gynécologie-obstétrique, CHU de Dijon Bourgogne, 14, rue Gaffarel, 21000 Dijon, France
| | - P Sagot
- Service de gynécologie-obstétrique, CHU de Dijon Bourgogne, 14, rue Gaffarel, 21000 Dijon, France
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Jacquesson T, Simon E, Dauleac C, Margueron L, Robinson P, Mertens P. Stereoscopic three-dimensional visualization: interest for neuroanatomy teaching in medical school. Surg Radiol Anat 2020; 42:719-727. [PMID: 32114650 DOI: 10.1007/s00276-020-02442-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/10/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The anatomy of both the brain and the skull is particularly difficult to learn and to teach. Since their anatomical structures are numerous and gathered in a complex tridimensional (3D) architecture, classic schematical drawing or photography in two dimensions (2D) has difficulties in providing a clear, simple, and accurate message. Advances in photography and computer sciences have led to develop stereoscopic 3D visualization, firstly for entertainment then for education. In the present study, we report our experience of stereoscopic 3D lecture for neuroanatomy teaching to early medical school students. METHODS High-resolution specific pictures were taken on various specimen dissections in the Anatomy Laboratory of the University of Lyon, France. Selected stereoscopic 3D views were displayed on a large dedicated screen using a doubled video projector. A 2-h stereoscopic neuroanatomy lecture was given by two neuroanatomists to third-year medicine students who wore passive 3D glasses. Setting up lasted 30 min and involved four people. The feedback from students was collected and analyzed. RESULTS Among the 483 students who have attended the stereoscopic 3D lecture, 195 gave feedback, and all (100%) were satisfied. Among these, 190 (97.5%) reported a better knowledge transfer of brain anatomy and its 3D architecture. Furthermore, 167 (86.1%) students felt it could change their further clinical practice, 179 (91.8%) thought it could enhance their results in forthcoming anatomy examinations, and 150 (76.9%) believed such a 3D lecture might allow them to become better physicians. This 3D anatomy lecture was graded 8.9/10 a mean against 5.9/10 for previous classical 2D lectures. DISCUSSION-CONCLUSION The stereoscopic 3D teaching of neuroanatomy made medical students enthusiastic involving digital technologies. It could improve their anatomical knowledge and test scores, as well as their clinical competences. Depending on university means and the commitment of teachers, this new tool should be extended to other anatomical fields. However, its setting up requires resources from faculties and its impact on clinical competencies needs to be objectively assessed.
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Affiliation(s)
- Timothée Jacquesson
- Department of Anatomy, Faculté de médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon I, 8 Avenue Rockefeller, 69003, Lyon, France. .,Skull Base Multi-Disciplinary Unit, Department of Neurosurgery, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, 59 Bd Pinel, 69677, Lyon, France.
| | - Emile Simon
- Department of Anatomy, Faculté de médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon I, 8 Avenue Rockefeller, 69003, Lyon, France.,Department of Functional Neurosurgery, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, 59 Bd Pinel, 69677, Lyon, France
| | - Corentin Dauleac
- Department of Anatomy, Faculté de médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon I, 8 Avenue Rockefeller, 69003, Lyon, France
| | - Loïc Margueron
- Department of Anatomy, Faculté de médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon I, 8 Avenue Rockefeller, 69003, Lyon, France
| | - Philip Robinson
- Department of Clinical Research and Innovation, Hospices Civils de Lyon, Lyon, France
| | - Patrick Mertens
- Department of Anatomy, Faculté de médecine Lyon-Est, Université de Lyon, Université Claude Bernard Lyon I, 8 Avenue Rockefeller, 69003, Lyon, France.,Department of Functional Neurosurgery, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon, 59 Bd Pinel, 69677, Lyon, France
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Julien L, Genet J, Leymarie N, Honart JF, Rimareix F, Mazouni C, Kolb F, De Frémicourt K, Conversano A, Marchal F, Simon E, Brix M, Sarfati B. [Comparing outcomes of Immediate Breast reconstruction with and without use of radiotherapy]. ANN CHIR PLAST ESTH 2020; 65:181-197. [PMID: 32007227 DOI: 10.1016/j.anplas.2019.12.002] [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: 11/01/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Breast cancer and its treatment remains a public health problem. There is still a lack of epidemiological data concerning complications and aesthetic results bound to radiotherapy after an immediate breast reconstruction. The objective of this study was to compare outcomes of immediate breast reconstruction regardless to the use of radiotherapy (history of radiotherapy or adjuvant radiation therapy), in order to determine risk factor of complications and bad aesthetic results. METHODS We conducted a retrospective study between January 2014 and December 2016 at the hospital "Gustave Roussy" in Paris, concerning breast cancer patients who needed immediate breast reconstruction after total mastectomy. The primary endpoint was to assess the failure rate of reconstruction and the aesthetic result, the secondary endpoint assessed the early and late rate of complications. We realized a multivariate analysis in order to identify risks factors that may predict complications. RESULTS Three hundred and thirty three patients have been included: 157 in the "radiotherapy group" compared to 176 in the "no radiotherapy group". Preoperative characteristics were comparable. Average follow-up was between 1 and 3years without missing. Patients who benefited from radiotherapy had an equal risk failure of reconstruction. The subgroup analysis revealed non-significant differences: 12.7% failure rate reconstruction in the "radiotherapy group" vs. 12.5%. We could notify a better rate of "excellent results" in the "no radiotherapy group": 35% vs. 8.2%. Secondary outcomes were comparable. CONCLUSIONS Radiotherapy related to immediate breast reconstruction didn't increase the failure rate of reconstruction or aesthetic results, comparatively to non-irradiated patients. It is therefore permissible to suggest an immediate breast reconstruction to any patients which would benefit from a total mastectomy followed by radiotherapy; in order to prevent them from a secondary breast reconstruction, who could be physically and psychologically more impactful.
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Affiliation(s)
- L Julien
- Department of plastic and maxillofacial surgery, hôpital Cenral, CHRU Nancy, 54000 Nancy, France.
| | - J Genet
- Department of plastic and maxillofacial surgery, hôpital Cenral, CHRU Nancy, 54000 Nancy, France
| | - N Leymarie
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - J-F Honart
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - F Rimareix
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - C Mazouni
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - F Kolb
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - K De Frémicourt
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - A Conversano
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - F Marchal
- Department of cancer surgery, institut de cancérologie de Lorraine, 54000 Vandoeuvre-les-Nancy, France
| | - E Simon
- Department of plastic and maxillofacial surgery, hôpital Cenral, CHRU Nancy, 54000 Nancy, France
| | - M Brix
- Department of plastic and maxillofacial surgery, hôpital Cenral, CHRU Nancy, 54000 Nancy, France
| | - B Sarfati
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
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Abstract
As part of its R&xD activities in the fields of radioactivewaste drum storage and homeland security, the NuclearMeasurement Laboratory of CEA Cadarache has started studiesrelated to the detection of induced delayed fission gamma rays asa signature of U/Pu presence either in radioactive wastes or incargo containers and luggage. The study described in the presentpaper explores the feasibility of detecting fission delayed gammarays of nuclear materials interrogated by a pulsed neutrongenerator. For this purpose, Monte Carlo simulations have beenperformed with ACT, the MNCP6 Activation Control Card.Simulated results have been compared with experimental data tovalidate the numerical model. Samples of uranium andplutonium have been irradiated for 2 hours with a pulsed D-Tneutron generator delivering 14 MeV neutrons with an averageemission of 8.107n/s, which are thermalised in a graphite cellcalled REGAIN. At the end of irradiation, activated nuclearmaterials were placed in a low-background, high-resolutiongamma spectroscopy station in order to detect delayed gammarays emitted by fission products. Anomalies have been observedin the calculated time decay curve of fission delayed gamma rayswith MCNP6 ACT card, but the time behavior is correct for non-fission activated materials like aluminum or copper. On the otherhand, the number of counts recorded in the main simulatedgamma ray lines from activated nuclear material fission productsis consistent with the experimental results, thus validating thesimulation scheme in view of further studies on thecharacterization of radioactive waste drums or special nuclearmaterial detection in cargo containers.
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Picart T, Barritault M, Simon E, Robinson P, Barrey C, Meyronet D, Mertens P. Anatomical and Histological Analysis of a Complex Structure Too Long Considered a Simple Ligament: The Filum Terminale. World Neurosurg 2019; 129:e464-e471. [PMID: 31150849 DOI: 10.1016/j.wneu.2019.05.184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The intradural filum terminale (iFT) connects the conus medullaris (CM) with the dural sac (DS), and the extradural filum terminale (eFT) connects the DS to the coccyx. The aim of the present study was to update the description of the FT and integrate these data in a physiological and pathological context. METHODS Anatomical measurements and histological investigations were performed on 10 human cadavers. RESULTS The mean length of the iFT and eFT was 167.13 and 87.59 mm, respectively. The mean cranial diameter of the iFT was 1.84 mm. It was >2 mm in 2 specimens. The mean half and caudal diameter of the iFT was 0.71 and 0.74 mm, respectively. The cranial diameter of the eFT correlated with the caudal diameter of the eFT (ρ = 0.94; P = 0.02). The level of the CM-iFT junction correlated significantly with the iFT length (ρ = -0.67; P = 0.03). The mobilization of the iFT was not transmitted to the extradural elements and vice versa. The iFT contained axons and ependymal cells, which were dense in the first third and then randomly arranged caudally in islets. This could explain why ependymomas can occur all along the iFT. Ganglion cells were abundant around the junction with the DS. The eFT contained smooth muscle cells, adipocytes, and axons. A mechanoreceptor was identified in 1 specimen. CONCLUSIONS Consistently with their common embryological origin, a real anatomical and histological continuum is present between the CM and FT. The FT should, therefore, no longer be considered a simple ligament but, rather, a complex fibrocellular structure.
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Affiliation(s)
- Thiébaud Picart
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France.
| | - Marc Barritault
- Department of Molecular Biology, Hospices Civils de Lyon, Groupe Hospitalier Est, Bron, France; Faculty of Medicine Lyon Est, Claude Bernard University Lyon 1, Lyon, France
| | - Emile Simon
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France; Laboratory of Anatomy, Faculty of Medicine Lyon Est, Claude Bernard University Lyon 1, Lyon, France
| | - Philip Robinson
- Hospices Civils de Lyon, Direction de la Recherche Clinique et de l'Innovation, Lyon, France
| | - Cédric Barrey
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - David Meyronet
- Department of Neuropathology, Hospices Civils de Lyon, Groupe Hospitalier Est, Bron, France; Faculty of Medicine Lyon Est, Claude Bernard University Lyon 1, Lyon, France
| | - Patrick Mertens
- Department of Neurosurgery, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Bron, France; Faculty of Medicine Lyon Est, Claude Bernard University Lyon 1, Lyon, France; Laboratory of Anatomy, Faculty of Medicine Lyon Est, Claude Bernard University Lyon 1, Lyon, France
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Kopp Q, Montoya D, Brix M, Dautel G, Simon E. [Analysis of microsurgical reconstruction activity in a university hospital: A 14-year historical cohort]. ANN CHIR PLAST ESTH 2019; 64:311-319. [PMID: 31047765 DOI: 10.1016/j.anplas.2019.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 03/14/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Each university hospital has its own specificities in microsurgical reconstructions. Activities may focus on breast reconstruction, ENT reconstruction or traumatic substance loss. This study analyzes the specificities at the University Hospital of Nancy, studies the indications, the operating data and the failure rates. METHOD We realized a historical cohort of microsurgical reconstructions at Nancy University Hospital from January 1, 2004 to December 31, 2017. All free flaps were included and analyzed. RESULTS A total of 359 free flaps were made. The failure rate was 9.47%. Forty eight different operators have been identified. Substance losses were essentially traumatic (56.8%). A total of 20 different flaps were use with 49% bone reconstruction. The fibula flap was the first flap used (26.5%). Arterial anastomoses were performed in termino-lateral in 44% and venous anastomoses were single in 70.5%. High BMI, diabetes, high blood pressure, atherosclerosis, and arterial or venous graft were identified as risk factors for failure (P<0.05). The smoking and the realisation of the intervention by a young operator have no impact on the success rate. CONCLUSION Our specificity is the bone reconstruction which represents a significant part of our activity. In the university center, the number of etiology of substance losses, operator and flap used is important but it still allows to obtain results in adequacy with the literature.
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Affiliation(s)
- Q Kopp
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Université de Lorraine, 54000 Nancy, France; Service de chirurgie reconstructrice de l'appareil locomoteur et chirurgie de la main, CHRU de Nancy, centre chirurgical Émile-Gale, 54000 Nancy, France.
| | - D Montoya
- Université de Lorraine, 54000 Nancy, France; Service de chirurgie reconstructrice de l'appareil locomoteur et chirurgie de la main, CHRU de Nancy, centre chirurgical Émile-Gale, 54000 Nancy, France
| | - M Brix
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Université de Lorraine, 54000 Nancy, France
| | - G Dautel
- Université de Lorraine, 54000 Nancy, France; Service de chirurgie reconstructrice de l'appareil locomoteur et chirurgie de la main, CHRU de Nancy, centre chirurgical Émile-Gale, 54000 Nancy, France
| | - E Simon
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHRU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Université de Lorraine, 54000 Nancy, France
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Brinzeu A, Cuny E, Fontaine D, Mertens P, Luyet P, Van den Abeele C, Djian M, Le Borgne J, Palfi S, Sol J, Fowo S, Desenclos C, Gadan R, Nizar S, Simon E, Barat J, Blond S, Buisset N, Bougeard R, Borius P, Leveque M, Cistac C, Bouche B, Hoffmann H, Derrey S, Louazon‐Busnel C, Roy D, Pellat J, Schoch J, Diaz P, Hieu PD, Laporte A, Dupont A, Rakover J, Gradischnig M, Sinardet D, Hullen C, Polo G. Spinal cord stimulation for chronic refractory pain: Long‐term effectiveness and safety data from a multicentre registry. Eur J Pain 2019; 23:1031-1044. [DOI: 10.1002/ejp.1355] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 12/10/2018] [Accepted: 12/21/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Andrei Brinzeu
- Service de Neurochirurgie Hôpital Neurologique Pierre Wertheimer Hospices civils de LYON Université LYON Lyon France
| | - Emmanuel Cuny
- CHU de Bordeaux Services de Neurochirurgie Bordeaux France
| | - Denys Fontaine
- Department of Neurosurgery CHU de Nice Université Cote d'Azur Nice France
- Université Cote d'Azur FHU INOVPAIN CHU de Nice Nice France
| | - Patrick Mertens
- Service de Neurochirurgie Hôpital Neurologique Pierre Wertheimer Hospices civils de LYON Université LYON Lyon France
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Fasching PA, Eggemann H, Krocker J, Häberle L, Volz B, Kleine-Tebbe A, Blohmer JU, Kittel K, Hufnagel M, Janni W, Emons G, Simon E, Köhler U, Thomssen C, Kohls A, Beckmann MW, Hielscher C, Krabisch P, Zeiser T, Brodkorb T, Baier F, Nabieva N, Kellner S, Untch M, Stadie S, Budner M, Breitbach GP, Keller M, Stickeler E, Kühn T, Tolkmitt M, Belau AK, Schmidt M, Ulm K, Kümmel S. Abstract P1-13-01: Final results of the ASG1-3 study, a randomized phase III study comparing a standard dose chemotherapy with epirubicin/cyclophosphamide and paclitaxel with a dose dense regimen with epirubicin and paclitaxel. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-13-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Dose dense chemotherapy (DDT) has shown improvements of disease-free survival (DFS) and overall survival for primary breast cancer patients with a high risk of relapse. There are much less data about the effect of DDT in patients with intermediate risk of recurrence (1-3 positive axillary lymph nodes). Aim of this prospectively randomized trial was to investigate the superiority of a DDT schedule over a standard chemotherapy (ST) in primary breast cancer patients with 1-3 positive axillary lymph nodes.
Methods
The ASG1-3 study is a prospectively randomized, open label phase III study of the Adjuvant Study Group of the NOGGO association. Patients were eligible for the trial, if they had a primary invasive breast cancer (pT1-3) with 1-3 positive axillary lymph nodes and no evidence of distant metastases. Patients were randomized to an adjuvant therapy with either 4 cycles epirubicin (90mg/m2 body surface area, BSA) and cyclophosphamide (600mg/m2 BSA) q3w, followed by 4 cycles of paclitaxel (175mg/m2 BSA) referred to as ST or to a therapy with 4 cycles of epicubicin (120 mg/m2 BSA) q2w and primary G-CSF support followed by 4 cycles of paclitaxel (175mg/m2 BSA) q2w and primary G-CSF support referred to as DDT. Trastuzumab was not given in this study. The study was designed to show an increase of 70% DFS (ST) to 80% DFS (DDT) 5 years after randomization. Comparisons were conducted using Kaplan Meier estimates, log rank tests and Cox regression analyses. In an exploratory way, subgroup analyses were performed for HER2, hormone receptor status and grading using Cox regression models with interaction terms.
Results
A total of 936 patients were eligible for survival analysis, of which 465 were randomized to ST and 471 to DDT from 2001 to 2004. Patient characteristics were mainly well balanced, with patients being 52.5/52.1 years old, 71.9/78.1% being hormone receptor positive, 24.4/24.6% being HER2 positive and 38.6/38.8% having a tumor grade of 3 in the ST arm and DDT arm respectively. 53 events occurred after ST and 46 after DDT. Adjusted hazard ratio (HR) was 0.87 (95%CI: 0.57-1.35; p=0.54). 5 year DFS rates were 85% (ST) vs. 87% (DDT). Hematological toxicities were the most common grade 3 or 4 adverse events. Grade 3/4 neutropenia occurred in 57.2 vs. 28.0%, grade 3/4 anemia in 15.3% vs. 17.1% and grade 3 /4 pain symptoms were seen in 13.2 vs. 12.4% of the patients in the ST arm vs. DDT arm respectively. Other grade 3/4 toxicities were less frequent than 10%. Subgroup analysis showed a significant interaction (p<0.001) between HER2 status and randomization arm with regard to DFS. In HER2 negative patients the HR was 1.53 (95%CI: 0.91-2.59), whereas in HER2 positive patients the HR was 0.22 (95%CI: 0.09-0.55). Patients with HER2 positive disease and DDT had a similar prognosis like HER2 negative patients.
Conclusion
In the overall population a statistically significant improvement of DFS could not be shown for the DDT arm. In patients with HER2 positive breast cancer DDT chemotherapy improved the disease-free survival to a prognosis which was similar to patients with HER2 negative disease.
Citation Format: Fasching PA, Eggemann H, Krocker J, Häberle L, Volz B, Kleine-Tebbe A, Blohmer J-U, Kittel K, Hufnagel M, Janni W, Emons G, Simon E, Köhler U, Thomssen C, Kohls A, Beckmann MW, Hielscher C, Krabisch P, Zeiser T, Brodkorb T, Baier F, Nabieva N, Kellner S, Untch M, Stadie S, Budner M, Breitbach G-P, Keller M, Stickeler E, Kühn T, Tolkmitt M, Belau AK, Schmidt M, Ulm K, Kümmel S. Final results of the ASG1-3 study, a randomized phase III study comparing a standard dose chemotherapy with epirubicin/cyclophosphamide and paclitaxel with a dose dense regimen with epirubicin and paclitaxel [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-13-01.
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Affiliation(s)
- PA Fasching
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - H Eggemann
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - J Krocker
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - L Häberle
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - B Volz
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - A Kleine-Tebbe
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - J-U Blohmer
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - K Kittel
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - M Hufnagel
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - W Janni
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - G Emons
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - E Simon
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - U Köhler
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - C Thomssen
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - A Kohls
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - MW Beckmann
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - C Hielscher
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - P Krabisch
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - T Zeiser
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - T Brodkorb
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - F Baier
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - N Nabieva
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - S Kellner
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - M Untch
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - S Stadie
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - M Budner
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - G-P Breitbach
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - M Keller
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - E Stickeler
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - T Kühn
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - M Tolkmitt
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - AK Belau
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - M Schmidt
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - K Ulm
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
| | - S Kümmel
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; University Hospital Magedeburg, Magdeburg, Germany; Breast Cancer Center, Sana Klinkum Lichtenberg, Berlin, Germany; Biostatistics and Data Management Unit; University Hospital Erlangen, Erlangen, Germany; DRK-Kliniken Berlin Köpenick, Berlin, Germany; Charité University Hospital Campus Charité-Mitte, Berlin, Germany; Praxisklinik Krebsheilkunde für Frauen – Brustzentrum, Berlin, Germany; Ulm University Hospital, Ulm, Germany; University Hospital Göttingen, Göttingen, Germany; Torgau Hospital "Johann Kentmann" gGmbH, Torgau, Germany; Hospital St. Georg, Leipzig, Germany; Martin-Luther-University Halle-Wittenberg, Halle, Germany; Evang. Hospital Ludwigsfelde -Teltow gGmbH, Ludwigsfelde-Teltow, Germany; gSUND Gynäkologie Kompetenzzentrum Stralsund, Stralsund, Germany; Klinikum Chemnitz gGmbH, Chemnitz, Germany; Paracelsus Hospital, Henstedt-Ulzburg, Germany; Helios Clinics Berlin Buch, Berlin, Germany; Medical Centre, Pa
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Obst J, Mancuso R, Simon E, Gomez-Nicola D. PD-1 deficiency is not sufficient to induce myeloid mobilization to the brain or alter the inflammatory profile during chronic neurodegeneration. Brain Behav Immun 2018; 73:708-716. [PMID: 30086399 PMCID: PMC6191933 DOI: 10.1016/j.bbi.2018.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/18/2018] [Accepted: 08/03/2018] [Indexed: 12/31/2022] Open
Abstract
Innate immune activation is a major driver of neurodegenerative disease and immune regulatory pathways could be potential targets for therapeutic intervention. Recently, Programmed cell death-1 (PD-1) immune checkpoint inhibition has been proposed to mount an IFN-γ-dependent systemic immune response, leading to the recruitment of peripheral myeloid cells to the brain and neuropathological and functional improvements in mice with Alzheimer's disease-like β-amyloid pathology. Here we investigate the impact of PD-1 deficiency on murine prion disease (ME7 strain), a model of chronic neurodegeneration. Although PD-1 was found to be increased in the brain of prion mice, the absence of PD-1 did not cause myeloid cell infiltration into the brain or major changes in the inflammatory profile. However, we observed a slight exacerbation of the behavioural phenotype of ME7 mice upon PD-1 deficiency. These results do not support the possibility of using immune checkpoint blockade as a therapeutic strategy in neurodegenerative disease.
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Affiliation(s)
- J Obst
- Biological Sciences, University of Southampton, United Kingdom
| | - R Mancuso
- Biological Sciences, University of Southampton, United Kingdom
| | - E Simon
- Biological Sciences, University of Southampton, United Kingdom
| | - D Gomez-Nicola
- Biological Sciences, University of Southampton, United Kingdom.
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Larretxi I, Simon E, Benjumea L, Miranda J, Bustamante MA, Lasa A, Eizaguirre FJ, Churruca I. Gluten-free-rendered products contribute to imbalanced diets in children and adolescents with celiac disease. Eur J Nutr 2018; 58:775-783. [DOI: 10.1007/s00394-018-1685-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 04/04/2018] [Indexed: 12/20/2022]
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Rozenberg P, Deruelle P, Sénat MV, Desbrière R, Winer N, Simon E, Ville Y, Kayem G, Boutron I. [Lower Uterine Segment Trial: A pragmatic open multicenter randomized trial]. ACTA ACUST UNITED AC 2018; 46:427-432. [PMID: 29625873 DOI: 10.1016/j.gofs.2018.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/22/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The data from literature show that trial of labor and elective repeat cesarean delivery after a prior cesarean delivery both present significant risks and benefits, and these risks and benefits differ for the woman and her fetus. The benefits to the woman can be at the expense of her fetus and vice-versa. This uncertainty is compounded by the scarcity of high-level evidence that preclude accurate quantification of the risks and benefits that could help provide a fair counseling about a trial of labor and elective repeat cesarean delivery. An interesting way of research is to evaluate the potential benefits of a decision rule associated to the ultrasound measurement of the lower uterine segment (LUS). Indeed, ultrasonography may be helpful in determining a specific risk for a given patient by measuring the thickness of the LUS, i,e, the thickness of the cesarean delivery scar area. Although only small and often methodologically biased data have been published, they look promising as their results are concordant: ultrasonographic measurements of the LUS thickness is highly correlated with the intraoperative findings at cesarean delivery. Furthermore, the thinner the LUS becomes on ultrasound, the higher the likelihood of a defect in the LUS. Finally, ultrasound assessment of LUS has an excellent negative predictive value for the risk of uterine defect. Therefore, this exam associated with a rule of decision could help to reduce the rate of elective repeat cesarean delivery and especially to reduce the fetal and maternal mortality and morbidity related to trial of labor after a prior cesarean delivery. METHODS/DESIGN This is a pragmatic open multicenter randomized trial with two parallel arms. Randomization will be centralized and computerized. Since blindness is impossible, an adjudication committee will evaluate the components of the primary composite outcome in order to avoid evaluation bias. An interim analysis will be planned mid-strength of the trial. Ultrasound will be performed by expert sonographers after certification by the main investigator. Women aged 18 years or older are eligible for this trial if they have a singleton pregnancy in cephalic presentation at a gestational age from 36 to 38 weeks, a previous low transverse cesarean delivery and sign the informed consent sheet. Women will be asked to participate in this study when they reach a term of 36 to 38 weeks of gestation. After agreement, women will be randomized into two groups: in the study group, they will have the LUS measured by ultrasound and the patient will be informed that, based on a threshold value of 3.5mm for the ultrasound measurement of the LUS thickness, the patient with a higher measurement will be considered at low risk and will be encouraged to choose a trial of labor whereas the patient with a measurement is equal to or less than this threshold will be considered at risk and encouraged to choose an elective repeat cesarean; in the control group, ultrasound LUS measurement will not be performed. The mode of delivery will be decided according to standard practice at the center. The primary composite outcome will include: uterine rupture, uterine dehiscence, hysterectomy, thromboembolic complications, transfusion, endometritis, maternal mortality, fetal prenatal and intrapartum mortality, hypoxic-ischemic encephalopathy and neonatal mortality. DISCUSSION This trial assesses the efficacy of ultrasound measurement of the lower uterine segment in women with a prior cesarean delivery in reducing fetal and maternal morbidity and mortality and it will provide evidence in order to establish clinical recommendations. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01916044 (date of registration: 5 August 2013).
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Affiliation(s)
- P Rozenberg
- Département d'obstétrique et gynécologie, centre hospitalier Poissy-Saint-Germain, rue du Champ-Gaillard, 78303 Poissy cedex, France; Unité de recherche EA7285, université Versailles-St-Quentin, Montigny-le-Bretonneux, France.
| | - P Deruelle
- Département d'obstétrique et gynécologie, Maternité Jeanne-de-Flandre, Lille, France
| | - M-V Sénat
- Département d'obstétrique et gynécologie, CHU de Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | - R Desbrière
- Département d'obstétrique et gynécologie, hôpital Saint-Joseph, Marseille, France
| | - N Winer
- Département d'obstétrique et gynécologie, CHU Mère-Enfant, Nantes, France
| | - E Simon
- Département d'obstétrique et gynécologie, CHRU Bretonneau, Tours, France
| | - Y Ville
- Département d'obstétrique et gynécologie, CHU Necker, AP-HP, Paris, France
| | - G Kayem
- Département d'obstétrique et gynécologie, CHU Trousseau, AP-HP, Paris, France
| | - I Boutron
- Centre d'épidémiologie clinique, CHU Hôtel-Dieu, université Paris Descartes, AP-HP, France
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de Runz A, Boccara D, Bertheuil N, Claudot F, Brix M, Simon E. Three-dimensional imaging, an important factor of decision in breast augmentation. ANN CHIR PLAST ESTH 2018; 63:134-139. [DOI: 10.1016/j.anplas.2017.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 07/26/2017] [Indexed: 10/18/2022]
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Brengard-Bresler T, De Runz A, Bourhis F, Mezzine H, Khairallah G, Younes M, Brix M, Simon E. [Postoperative quality of life of patients with a bacterial necrotizing dermis-hypodermitis or necrotizing fasciitis, a ten-year study]. ANN CHIR PLAST ESTH 2018; 62:31-44. [PMID: 26946930 DOI: 10.1016/j.anplas.2016.02.001] [Citation(s) in RCA: 6] [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: 09/19/2015] [Accepted: 02/02/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Bacterial necrotizing dermis-hypodermitis and necrotizing fasciitis (BNDH-NF) are serious life-threatening soft-tissue infections. The object is to evaluate the quality of life (QOL) of patients who have been operated in our plastic surgery departement. PATIENTS AND METHODS This is a retrospective study of cases who have been treated at Nancy University Hospital between 2005 and 2014. We analyzed the perioperative data (demographic, clinical, bacteriological), the surgical data (excision, reconstruction) and the follow up data (consequences, mortality). The quality of life was assessed by the Short-Form 36 score, and the patients' satisfaction was assessed by a four-level scale. RESULTS We analyzed 23 patients with an average age of 60 years (28-84 years). The main comorbidities were diabetes (43 %) and obesity (39 %). The average number of surgical excision was about 1.9 (1-5) and the average excised body surface area was about 5 % (1-16 %). The short-term mortality was about 17 %. The mortality rate has been statistically correlated with the surgically excised body surface area (short-term 95 days: P=0.02; and long-term: P=0.003). The statistical analysis has shown a strong relative linear relationship between number of surgical excision and the physical score of QOL (P<0.001), between number of surgical excision and mental score of QOL (P=0.032), and between age and physical score of QOL (P≤0.021). The statistical analysis has also shown a strong relative linear relationship between E. coli infections and physical score of QOL (P=0.01). The percentage of patients' satisfaction in our study was evaluated at 86 %. CONCLUSION We have found that multiple surgical excisions, an advanced age of patients and E. coli infections have been associated with poor QOL. The mortality rate increased in relation with the importance of excised body surface. In spite of the gravity of these infections, our patients were satisfied of their treatment.
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Affiliation(s)
- T Brengard-Bresler
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France.
| | - A De Runz
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France
| | - F Bourhis
- Mapi Group, Health Economics and Outcomes Research, 41, rue des Trois-Fontanot, 92000 Nanterre, France
| | - H Mezzine
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France
| | - G Khairallah
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHR de Metz-Thionville, 1, allée du Château, 57085 Metz, France
| | - M Younes
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France
| | - M Brix
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France
| | - E Simon
- Service de chirurgie maxillofaciale, plastique, reconstructrice et esthétique, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Faculté de médecine, université de Lorraine, 54000 Nancy, France
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Simon E, Guimbal P. Performance assessment of imaging plates for the JHR transfer Neutron Imaging System. EPJ Web Conf 2018. [DOI: 10.1051/epjconf/201817004021] [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: 11/14/2022] Open
Abstract
The underwater Neutron Imaging System to be installed in the Jules Horowitz Reactor (JHR-NIS) is based on a transfer method using a neutron activated beta-emitter like Dysprosium. The information stored in the converter is to be offline transferred on a specific imaging system, still to be defined. Solutions are currently under investigation for the JHR-NIS in order to anticipate the disappearance of radiographic films commonly used in these applications. We report here the performance assessment of Computed Radiography imagers (Imaging Plates) performed at LLB/Orphée (CEA Saclay).
Several imaging plate types are studied, in one hand in the configuration involving an intimate contact with an activated dysprosium foil converter: Fuji BAS-TR, Fuji UR-1 and Carestream Flex XL Blue imaging plates, and in the other hand by using a prototypal imaging plate doped with dysprosium and thus not needing any contact with a separate converter foil. The results for these imaging plates are compared with those obtained with gadolinium doped imaging plate used in direct neutron imaging (Fuji BAS-ND).
The detection performances of the different imagers are compared regarding resolution and noise.
The many advantages of using imaging plates over radiographic films (high sensitivity, linear response, high dynamic range) could palliate its lower intrinsic resolution.
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Abstract
ZusammenfassungEs wird die Wirkung der verschiedenen synthetischen und natürlichen Estrogene und Gestagene auf Arterien und Venen dargestellt. Dabei werden die Unterschiede zwischen den einzelnen Derivaten ebenso aufgezeigt, wie die Bedeutung der Applikationsform und -dosis. Von der physiologischen Wirkung ausgehend werden Indikationen, Nutzen und Risiken bei der praktischen Anwendung besprochen sowie Problemsituationen bei der hormonalen Kontrazeption und der Hormonersatztherapie wie Varikosis, Thrombose, Indikationen zum Absetzen, Antikoagulanzien und Pille erläutert.
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Kundrát JT, Balogh Z, Harangi S, Tóthmérész B, Simon E. Assessment of anthropogenic, seasonal and aquatic vegetation effects on the contamination level of oxbows. COMMUNITY ECOL 2017. [DOI: 10.1556/168.2017.18.3.2] [Citation(s) in RCA: 2] [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] [Indexed: 11/19/2022]
Affiliation(s)
- J. T. Kundrát
- Department of Ecology, University of Debrecen, Debrecen, Egyetem sq. 1, H-4032, Hungary
| | - Zs. Balogh
- Department of Ecology, University of Debrecen, Debrecen, Egyetem sq. 1, H-4032, Hungary
| | - S. Harangi
- Department of Ecology, University of Debrecen, Debrecen, Egyetem sq. 1, H-4032, Hungary
| | - B. Tóthmérész
- Department of Ecology, University of Debrecen, Debrecen, Egyetem sq. 1, H-4032, Hungary
| | - E. Simon
- MTA-DE Biodiversity and Ecosystem Services Research Group, Debrecen, Egyetem sq. 1, H-4032, Hungary
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Andre-Obadia N, Magnin M, Simon E, Garcia-Larrea L. Somatotopic effects of rTMS in neuropathic pain? A comparison between stimulation over hand and face motor areas. Eur J Pain 2017; 22:707-715. [DOI: 10.1002/ejp.1156] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2017] [Indexed: 11/09/2022]
Affiliation(s)
- N. Andre-Obadia
- Neurophysiology & Epilepsy Unit; Neurological Hospital P. Wertheimer; Hospices Civils de Lyon; France
- University Hospital Pain Center (CETD); Neurological Hospital P. Wertheimer; Hospices Civils de Lyon; France
- NeuroPain lab; INSERM U1028, CNRS UMR5292; Lyon Neuroscience Research Center; University Claude Bernard Lyon 1; France
| | - M. Magnin
- NeuroPain lab; INSERM U1028, CNRS UMR5292; Lyon Neuroscience Research Center; University Claude Bernard Lyon 1; France
| | - E. Simon
- NeuroPain lab; INSERM U1028, CNRS UMR5292; Lyon Neuroscience Research Center; University Claude Bernard Lyon 1; France
- Neurosurgery Unit; Neurological Hospital P. Wertheimer; Hospices Civils de Lyon; France
| | - L. Garcia-Larrea
- University Hospital Pain Center (CETD); Neurological Hospital P. Wertheimer; Hospices Civils de Lyon; France
- NeuroPain lab; INSERM U1028, CNRS UMR5292; Lyon Neuroscience Research Center; University Claude Bernard Lyon 1; France
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Matusiak C, De Runz A, Maschino H, Brix M, Simon E, Claudot F. Tabac et interventions de chirurgie plastique : vers une contre-indication formelle ? ANN CHIR PLAST ESTH 2017; 62:308-313. [DOI: 10.1016/j.anplas.2017.03.009] [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] [Received: 01/19/2017] [Accepted: 03/27/2017] [Indexed: 11/29/2022]
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Ducloy-Bouthors A, Jeanpierre E, Hennart B, Baptiste A, Giovannoni S, Saidi I, Simon E, Lannoy D, Allorge D, Duhamel A, Susen S. P-013: Thrombin and plasmin generation in a well innovative method development: effect of tranexamic acid concentration in vitro. Thromb Res 2017. [DOI: 10.1016/s0049-3848(17)30111-1] [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: 11/26/2022]
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Ducloy-Bouthors A, Jeanpierre E, Hennart B, Baptiste A, Giovannoni S, Saidi I, Simon E, Lannoy D, Allorge D, Duhamel A, Susen S. P-012: Thrombin and plasmin generation as measured by a single well technique during haemorrhagic and non-hemorrhagic caesarean section: pilot study. Thromb Res 2017. [DOI: 10.1016/s0049-3848(17)30110-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mor P, Levy-Lahad E, Beler U, Carmon M, Strano S, Hadar T, Olsha O, Rabinowitz R, Srebnik N, Simon E, Duchin R, Jackson M, Rabinovitch R. Abstract P3-08-06: Screening, management, cancer diagnoses, and outcomes of women with germline BRCA mutations in Israel: The Noga Clinic experience. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-08-06] [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: 11/16/2022]
Abstract
Abstract
Background: Women with germline BRCA (gBRCA) mutations in the United States are typically diagnosed at the time of cancer diagnosis and most often undergo bilateral mastectomy. Israel's population of 8 million includes over 3 million Jews of Ashkenazi ancestry, of whom 2.5% would be expected to have gBRCA based on population studies. Cross-ancestral and -racial marriages in Israel continue to expand the population at risk for gBRCA mutations. Gene typing for any woman in Israel can be obtained without cost through either the national health care system or genetic screening studies. The Noga Clinic (NC) in Jerusalem was started in September 2007 for women with documented gBRCA mutations at risk for breast and/or ovarian cancer to counsel them on risk-reducing (rr) surgical interventions and provide rigorous screening to diagnose cancer at its earliest stages. Screening is performed in compliance with NCCN and international recommendations. This report presents information from that unique population and clinical experience.
Methods: Clinical records of women with at least one screening visit at NC through December 2015 were retrospectively reviewed. Women with a documented gBRCA mutation with or without a clinical history of breast/ovarian cancer were eligible for assessment every (q) 6 months (m): bilateral breast exam by an experienced breast surgeon (q6m), serum CA-125 (q6m), trans-vaginal ultrasound (q6m), bilateral mammography (q12m) and bilateral breast ultrasound (q12m) alternating with bilateral contrast enhanced MRI (q12m) beginning at age 25. Women are offered rr bilateral mastectomy (BMast); rr salpingo-oophorectomy is recommended by the age of 40. Cancer diagnoses and rr surgeries were recorded.
Results: 611 women have undergone at least one screening assessment at the NC, of whom 44 had a prior cancer diagnosis. Age at the time of initial gene testing ranged from 20-87y (median 38). Of those with recorded mutation data, 272 women (57%) had mutations in gBRCA1, 205 (43%) in BRCA2, and 1 in both. Mutation specifics will be presented in detail. For the 567 women without a prior cancer diagnosis, median age at first screening visit was 37y (range 21-87) and total follow up was 2,141 person-years (per person range 1-9y, median 3.3). Only 21 women (4%) elected rrBMast at a median age of 42y (range 26-60); none developed breast cancer. In the remaining individuals, 31 breast cancers were diagnosed (58% gBRCA1, 42% gBRCA2) from the initiation of screening at a median age of 51y (range 28-88); the majority were DCIS and diagnosed at a median screening follow up of 2.8y. No participant was treated with anti-endocrine chemoprevention. There have been no breast cancer deaths. 5 women were diagnosed with ovarian cancer (all gBRCA1) of whom 1 died of the disease. Methods of cancer detection will be presented.
Conclusion: This is the largest reported data set of women with gBRCA mutations without a prior breast or ovarian cancer diagnosis screened and followed over time. In this highly selected predominantly Jewish population in Israel, the great majority of women chose not to undergo rrBMast and have excellent outcomes when participating in regular and rigorous screening. Further follow-up is ongoing.
Citation Format: Mor P, Levy-Lahad E, Beler U, Carmon M, Strano S, Hadar T, Olsha O, Rabinowitz R, Srebnik N, Simon E, Duchin R, Jackson M, Rabinovitch R. Screening, management, cancer diagnoses, and outcomes of women with germline BRCA mutations in Israel: The Noga Clinic experience [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-08-06.
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Affiliation(s)
- P Mor
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - E Levy-Lahad
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - U Beler
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - M Carmon
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - S Strano
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - T Hadar
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - O Olsha
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - R Rabinowitz
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - N Srebnik
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - E Simon
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - R Duchin
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - M Jackson
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
| | - R Rabinovitch
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel; Breast Surgery, Shaare Zedek Medical Center, Jerusalem, Israel; Imaging Institute, Shaare Zedek Medical Center, Jerusalem, Israel; Obstetric and Gynecologic Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Israel; University of Colorado Comprehensive Cancer Center, Aurora, CO
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Simon E, Kis O, Jakab T, Kolozsvári I, Málnás K, Harangi S, Baranyai E, Miskolczi M, Tóthmérész B, Dévai G. Assessment of contamination based on trace element concentrations in Gomphus flavipes (Odonata: Insect) larvae of the Upper Tisza Region. Ecotoxicol Environ Saf 2017; 136:55-61. [PMID: 27816714 DOI: 10.1016/j.ecoenv.2016.10.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 10/19/2016] [Accepted: 10/25/2016] [Indexed: 06/06/2023]
Abstract
Odonata larvae are frequently used to assess the contamination of aquatic systems, because they tolerate a wide range of chemical and biological conditions in freshwater systems. In early 2000, the sediments of the Hungarian section of the River Tisza and the River Szamos were strongly enriched with heavy metals by an accidental mining spill. Earlier studies demonstrated higher contamination levels in the Szamos than in the Tisza, based on sediment analysis. The aim of our study was to assess the contamination in the Upper Tisza Region, along the upper reach of the Tisza, and the lower reach of the Szamos, based on the trace element concentrations of the Gomphus flavipes larvae. We collected 269 dragonfly specimens for the analyses. The Al, Ba, Cr, Cu, Fe, Mn, Pb, Sr and Zn element contents were analysed in the dragonfly larvae by microwave plasma atomic emission spectrometry (MP-AES). Significantly higher Ba and Cu concentrations were found in the dragonfly larvae of the Tisza than the Szamos. In spite of this, the Cr, Mn, Pb, Sr and Zn concentration was significantly lower in the dragonfly larvae of the Tisza than the Szamos. For all trace elements significant differences were found along the Tisza. Significant differences were also found in all trace element concentrations of dragonfly larvae among studied localities in the Szamos, except in the cases of Al and Ba. Our results demonstrated that the Szamos was more contaminated with Cr, Mn, Pb, Sr and Zn than the Tisza, but that the Tisza was more contaminated with Ba and Cu than the Szamos, based on the trace element concentrations in Gomphus flavipes larvae, which was likely to have been caused by the tributaries of the Tisza. In summary, our results indicated a continuous pollution of the Tisza and the Szamos and their tributaries.
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Affiliation(s)
- E Simon
- Department of Ecology, University of Debrecen, Debrecen, Egyetem sq. 1, H-4010, Hungary.
| | - O Kis
- Department of Hydrobiology, University of Debrecen, Debrecen, Egyetem sq. 1, H-4010, Hungary
| | - T Jakab
- Kossuth Lajos Secondary Grammar-School, Baross Gábor Street 36, Tiszafüred H-5350, Hungary
| | - I Kolozsvári
- Ferenc Rákóczi II. Transcarpathian Hungarian Institute, István Fodor Research Institute, Kossuth Square 6, UA-90202 Beregovo, Ukraine
| | - K Málnás
- BioAqua Pro LTD, Soó Rezső Street 21, Debrecen H-4032, Hungary
| | - S Harangi
- Department of Ecology, University of Debrecen, Debrecen, Egyetem sq. 1, H-4010, Hungary
| | - E Baranyai
- Department of Inorganic and Analytical Chemistry, University of Debrecen, Debrecen, Egyetem sq. 1, H-4010, Hungary
| | - M Miskolczi
- Department of Hydrobiology, University of Debrecen, Debrecen, Egyetem sq. 1, H-4010, Hungary
| | - B Tóthmérész
- MTA-DE Biodiversity and Ecosystem Services Research Group, Debrecen, Egyetem sq. 1, H-4032, Hungary
| | - Gy Dévai
- Department of Hydrobiology, University of Debrecen, Debrecen, Egyetem sq. 1, H-4010, Hungary
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Rio J, Rovira A, Blanco Y, Sainz A, Perkal H, Robles R, Ramio-Torrenta L, Diaz RM, Arroyo R, Urbaneja P, Fernandez O, Garcia-Merino JA, Reyes MP, Oreja-Guevara C, Prieto JM, Izquierdo G, Olascoaga J, Alvarez-Cermeno JC, Simon E, Pujal B, Comabella M, Montalban X. [Response to treatment with interferon beta in patients with multiple sclerosis. Validation of the Rio Score]. Rev Neurol 2016; 63:145-150. [PMID: 27439483] [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: 06/06/2023]
Abstract
INTRODUCTION Different criteria have been proposed for the response to treatment with interferon beta, and the Rio Score is one of the most widely used. The aim of this study was to validate the usefulness of the Rio Score in an independent cohort. PATIENTS AND METHODS A multi-centre, prospective, longitudinal study was conducted on patients with relapsing-remitting multiple sclerosis treated with interferon beta. The patients were classified according to the presence of attacks, active lesions (new in T2 or gadolinium enhancing lesions) in magnetic resonance imaging, a confirmed increase in disability or combinations of these variables (attacks, increase on the Expanded Disability Status Scale and active lesions) after one year's treatment. Regression analysis was used in order to identify the response-predicting variables after a three-year follow-up. RESULTS The sample consisted of 249 patients with relapsing-remitting multiple sclerosis. The logistic model confirmed that the presence of two (odds ratio = 6.6; CI 95% = 2.7-16.1; p < 0.0001) or three (odds ratio = 8.5; CI 95% = 1.6-46; p < 0.01) positive variables during the first year of treatment were indicative of a significant risk of activity (attacks or progression) in the next two years. CONCLUSIONS The usefulness of the Rio Score is confirmed, in an independent cohort, as a means of identifying patients with a higher risk of developing clinical activity or progression of disability during treatment with interferon beta.
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Affiliation(s)
- J Rio
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - A Rovira
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - Y Blanco
- Hospital Clinic de Barcelona, 08036 Barcelona, Espana
| | - A Sainz
- Hospital Clinic de Barcelona, 08036 Barcelona, Espana
| | - H Perkal
- Hospital Universitari Dr. Josep Trueta, 17007 Girona, Espana
| | - R Robles
- Hospital Universitari Dr. Josep Trueta, 17007 Girona, Espana
| | | | - R M Diaz
- Hospital Universitari Son Espases, Palma de Mallorca, Espana
| | - R Arroyo
- Hospital Clinico San Carlos, 28040 Madrid, Espana
| | - P Urbaneja
- Hospital Regional Universitario Carlos Haya, Malaga, Espana
| | - O Fernandez
- Hospital Regional Universitario Carlos Haya, Malaga, Espana
| | | | - M P Reyes
- Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Espana
| | - C Oreja-Guevara
- UAM. Universidad Autonoma de Madrid. Hospital Universitario La Paz, 28046 Madrid, Espana
| | - J M Prieto
- Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Espana
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana
| | - J Olascoaga
- Hospital Donostia, 20014 San Sebastian, Espana
| | | | - E Simon
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - B Pujal
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - M Comabella
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
| | - X Montalban
- Hospitals Vall d'Hebron, 08035 Barcelona, Espana
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Dufort G, Castillo L, Pisano S, Castiglioni M, Carolina P, Andrea I, Simon E, Zuccolo S, Schelotto M, Morosini F, Pereira I, Amarillo P, Silveira A, Guerrero L, Ferreira V, Tiscornia A, Mezzano R, Lemos F, Boggia B, Quarnetti A, Decaro J, Dabezies A. Haploidentical hematopoietic stem cell transplantation in children with high-risk hematologic malignancies: outcomes with two different strategies for GvHD prevention. Ex vivo T-cell depletion and post-transplant cyclophosphamide: 10 years of experience at a single center. Bone Marrow Transplant 2016; 51:1354-1360. [DOI: 10.1038/bmt.2016.161] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 03/26/2016] [Accepted: 05/01/2016] [Indexed: 11/09/2022]
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Belhassen T, Simon E, Potel A, Auclair E, Bergaoui R. Effect of diet supplementation with live yeast (Saccharomyces cerevisiae) on performance of rabbit does and their progenies. World Rabbit Sci 2016. [DOI: 10.4995/wrs.2016.3917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
<p>A study was conducted to determine the effect of live yeast supplementation in the diet of rabbit does on their mortality and reproductive performance and the performance of their progeny. A total of 52 cross-bred rabbit does (New Zealand×Californian) were divided into 2 groups differing in diet offered during 2 reproductive cycles and containing (group S; n=26) or not (group C; n=26) 1 g of yeast (Actisaf Sc 47, S.I. LESAFFRE, France)/kg of feed. Natural mating was performed 11 d after kindling and kits were weaned at 28 d of age. Body weight of litters was measured at birth, 21 d and at 28 d of age (weaning). Mortality of kits and rabbit does was monitored daily, and fertility of rabbit does and viability rate of kits at birth were also determined. Weight and litter size at birth and at weaning, litter weight gain during lactation and length of gestation were similar between the 2 groups during the 2 cycles. The mortality of does during the experiment was higher in group C than in group S (27 vs. 4%; P<0.05). Fertility rate of rabbits does and viability rate of kits at birth were higher (P<0.05) in rabbits fed with the supplemented diet than those with the control diet during the second lactation. In the first cycle, kit mortality was lower in S group (15.5%) than the C group (24.7%) during the first 21 d (P<0.05). However, no difference was observed during the second lactation. In conclusion, our results suggest that the inclusion of yeast in the diet of rabbit does could trigger positive effects on the fertility and mortality of rabbit does, as well as on the viability rate of kits at birth.</p>
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Lelekov-Boissard T, Simon E, Bradley C, Garcia-Larrea L, André-Obadia N. ID 416 – Motor cortex stimulation for chronic pain relief using repetitive magnetic stimulation (rTMS): 20 Hz versus Theta-Burst, which is better? Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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