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Baron M, Sassolas B, Pinard L, Ealet A. Numerical modelling for retrieval of the coating thickness variations from wavefront errors measurements. Opt Express 2023; 31:32968-32986. [PMID: 37859087 DOI: 10.1364/oe.494683] [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] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/08/2023] [Indexed: 10/21/2023]
Abstract
Multilayers coating are needed for large optical components performances, but the thickness non-uniformities over the useful aperture can generate spatial and chromatic variations of the reflectance, the transmittance and the wavefront errors. Although these dependences can be measured, they are difficult to anticipate if the underlying thickness variations are unknown. We present a model to retrieve these variations from wavefront error measurements that enables the computation of any optical properties over the useful aperture at any wavelength, angle of incidence or polarization.
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Chapelle C, Broudeur L, Bessard A, Durand T, Le Berre - Scoul C, Rigaud J, Baron M, Neunlist M, Perrouin-Verbe MA. Urothelial remodeling after spinal cord injury. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Lafont C, Paillaud E, Bertolus C, Baron M, Caillet P, Bouvard E, Laurent M, Salvan D, Chaumette L, De Decker Lemarcis L, Piot B, Barry B, Raynaud-Simon A, Sauvaget E, Minard A, Anota A, Panjo H, Brugel L, Canouï-Poitrine F. 657MO Effectiveness of geriatric assessment-driven interventions on quality of life for 2 years in older patients with head and neck cancer: Results from the EGeSOR trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.781] [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] Open
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Cornu JN, Auble A, Degremont S, Baron M, Roman H, Pfister C, Grise P. Sacral neuromodulation for management of severe bladder dysfunction due to endometriosis: experience from a tertiary reference center. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00779-0] [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: 10/16/2022] Open
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Nevskaya T, Martin Calderon L, Baron M, Pope J. POS0913 INCREASED HEALTH CARE UTILIZATION IN SYSTEMIC SCLEROSIS PATIENTS WHO HAVE DIGITAL ULCERS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4221] [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: 11/03/2022]
Abstract
BackgroundSystemic sclerosis is a multi-system autoimmune disease characterized by fibrosis of the skin and internal organs, and vasculopathy which manifests as pulmonary arterial hypertension and digital ulcers. Digital ulcers are debilitating and painful lesions most commonly present in the digit tips or extensor surfaces of the hands leading to significant morbidity and decreased quality of life. SSc patients with digital ulcers may require increased support and therefore may have greater healthcare resource utilization compared to those patients without digital ulcers.ObjectivesWe assessed the impact of DUs on resource utilization including hospitalizations, outpatient visits and procedures within a large SSc Canadian registry.MethodsA cohort of patients with SSc and digitals ulcers was derived from the Canadian Scleroderma Research Group registry and matched to controls individually based on sex, age (±3 years), SSc subtype, and disease duration (±2 years). Eligible patients met the 2013 ACR/EULAR criteria (confirmed by an experienced rheumatologist), were 18 years of age, had completed the Resource Utilization Questionnaire (RUQ), and had active digital ulcers at two consecutive annual visits (baseline study visit and at 1st year). The Medgser Disease Severity Scale was used to assess ulcer disease severity. Unadjusted and adjusted regression analyses compared the association between DUs and resource utilization.ResultsRUQs in 104 SSc patients with active DUs at two consecutive annual visits were compared with 104 patients without DUs matched 1:1 for age, sex, disease subtype and duration. Over one year, DUs were associated with a higher number of tests (p˂0.05) and visits to health professionals, especially to a rheumatologist (p˂0.0001) and internist (p=0.003), a greater need for an accompanying person (p˂0.05) and aids purchased/received (p˂0.05). Having DUs was associated with more severe disease, even after excluding the peripheral vascular domain from a total DSS (9.7±4.5 vs 5.6±2.7, p˂0.0001). After adjustment for disease severity in other organs, the presence of DUs remained a significant predictor of more frequent physician visits and more tests (all˂0.05) by linear regression analysis.ConclusionSSc patients with DUs utilized significantly more healthcare resources per annum even after adjustment for disease severity in other organ systems.References[1]Khimdas S, Harding S, Bonner A, Zummer B, Baron M, Pope J, Canadian Scleroderma Research Group. Associations with digital ulcers in a large cohort of systemic sclerosis: results from the Canadian Scleroderma Research Group registry. Arthritis care & research. 2011 Jan;63(1):142-9.[2]Nihtyanova SI, Brough GM, Black CM, Denton CP. Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis. Annals of the rheumatic diseases. 2008 Jan 1;67(1):120-3.Disclosure of InterestsNone declared
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Campochiaro C, Suliman YA, Hughes M, Schoones J, Giuggioli D, Moinzadeh P, Maltez N, Ross L, Baron M, Chung L, Allanore Y, Denton CP, Distler O, Frech T, Furst D, Khanna D, Krieg T, Kuwana M, Matucci-Cerinic M, Pope J, Alunno A. POS0888 NON-SURGICAL LOCAL TREATMENTS FOR DIGITAL ULCERS IN SYSTEMIC SCLEROSIS: A SYSTEMATIC LITERATURE REVIEW. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3098] [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: 11/04/2022]
Abstract
BackgroundDigital ulcers(DUs) in systemic sclerosis(SSc) represent a major clinical challenge. There are no recommendations for the local management of SSc-DUs. Systemic therapy is considered the standard of care. However, there is a strong rationale for local approaches to DU by avoiding side effects from systemic therapies. The World Scleroderma Foundation DU Working Group intends to develop evidence-based recommendations for DU management including local, non-surgical treatment(ln-sT).ObjectivesTo summarise the literature on the safety and efficacy of ln-sT for SSc-DUs.MethodsA systematic literature review(SLR) of papers describing the use of ln-sT for DU in SSc was performed up to May 2021 according to the PICO framework. References were independently screened by two reviewers who independently assessed the full text of eligible articles and extracted data.ResultsAmong 790 retrieved references, 12 were included. Median(range) number of patients per study was 9(7–84), mean age ranging from 37 to 62.5 years. In 5(41%) studies a control group was included. Background systemic therapies are summarized in Table 1. The most studied treatment was botulin toxin A(BTA). It was used as hand injection in 3 studies (median dose ranging from 90 to 150 U) and as 50 U single finger injection in 1 study. Healing rate after a median time of 8-49 weeks ranged from 71% to 100%. In 2 studies a reduction in VAS pain was observed from 20% to 100%. Transient muscle weakness was the most common side effect in 10% of patients. Amniotic(Am) and hydrocolloid membranes(HyM) were used in 1 study each. They were associated with a good healing rate, statistically significant for the HyM. Tadalafil 2% cream was studied in 1 study and was associated with a reduction in the median DU number from 1.6 to 1 per patient after a median time of 4 weeks and a reduction by 1.4 point in the 10-mm VAS scale. Vitamin E gel was shown to be associated with a statistically significant reduction in the healing time compared to SoC alone in 1 RCT(13.2 ± 2.7 versus 20.9 ± 3.6 weeks, P=<0.001). Low-level light therapy, hydrodissection and corticosteroid injection and extracorporeal shock wave(ESW) were evaluated in 1 study each. They were all associated with positive outcomes which was statistically significant only for the ESW. The only negative trial examined dimethyl sulfoxide and was associated with local toxicity.Table 1.Characteristics of the studies.TreatmentType of studyPatientsBaseline DUBackground therapy (%) ETA CCB APA PG ARB ACE-I PDE-5i ISFollow-up (weeks)Healing rate(%)*Pain Reduction (VAS/10)ComparatorHydrodissection and corticosteroid injectionP1202334.4Rheumatoid ArthritisTadalafil 2% Vitamin E gelRRCT15131.6(1)3.5±2.30462700130704 241(1)Reduced time to heal**1.4SoCAmHyMRP67310001002800002817033143810090**SoCBTAMedian 90 U per handHigh-concentration hand100 U non-dominant handSingle finger 50 URRPP772010314571140718558551008514201001414718 4981277717510020%100%Untreated CHLow-level light therapyP8102537025378100ESWP9493355661144441**1.31Dimethyl sulfoxideDBRCT84No change, skin toxicity with 70% formulation*Unless otherwise stated. **Statistically significant. ARB= angiotensin receptor antagonist. ACEi= ACE inhibitors. APA= anti-platelet agents. CCB= calcium channel blockers. CH= contralateral hand. DBRCT= double blind randomized-controlled trial. ETA = endothelin antagonist. IS= immunosuppression. PG= prostaglandins. PDE-5i= Phosphodiesterase type-5 inhibitors. P = prospective. R = retrospective. SoC= standard of care (as per local protocol).ConclusionOur SLR supports interest to develop ln-sTs for SSc-DUs. The number of studies is limited and mainly case reports and small single studies are present. Treatments were well tolerated and there was evidence of efficacy for BTA, vitamin E, ESW and HyM in refractory DUs. The evidence is not robust and confounding factors (vasodilators background therapies) could impact on the findings. Future research is indicated to conduct larger, well-designed studies.Disclosure of InterestsCorrado Campochiaro: None declared, Yossra A. Suliman: None declared, Michael Hughes Speakers bureau: Actelion pharmaceuticals, Eli Lilly, and Pfizer, outside of the submitted work., Jan Schoones: None declared, Dilia Giuggioli: None declared, Pia Moinzadeh Speakers bureau: speaking fees from Actelion pharmaceuticals and Boehringer Ingelheim, Nancy Maltez: None declared, Laura Ross: None declared, Murray Baron: None declared, Lorinda Chung: None declared, Yannick Allanore: None declared, Christopher P Denton: None declared, Oliver Distler Speakers bureau: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur, Tracy Frech: None declared, Daniel Furst: None declared, Dinesh Khanna Speakers bureau: Janssen and Eicos Sciences, Inc., Thomas Krieg: None declared, Masataka Kuwana Speakers bureau: Speakers fees from AbbVie, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai, Eisai, GlaxoSmithKline, Janssen, Nippon Shinyaku, Ono Pharmaceuticals, Tanabe-Mitsubishi, and Consultant fees from AstraZeneca, Boehringer Ingelheim, Corbus, Kissei, Mochida, outside of the submitted work., Marco Matucci-Cerinic: None declared, Janet Pope: None declared, Alessia Alunno: None declared
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Suliman YA, Campochiaro C, Hughes M, Schoones J, Giuggioli D, Maltez N, Moinzadeh P, Ross L, Chung L, Allanore Y, Baron M, Denton CP, Distler O, Frech T, Furst D, Khanna D, Krieg T, Kuwana M, Matucci-Cerinic M, Pope J, Alunno A. POS0898 SURGICAL MANAGEMENT OF DIGITAL ULCERS IN SYSTEMIC SCLEROSIS: A SYSTEMATIC LITERATURE REVIEW. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3442] [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: 11/04/2022]
Abstract
BackgroundManagement of digital ulcers (DUs) in systemic sclerosis (SSc) is a major clinical challenge. To date, systemic therapy is generally considered as the ‘standard of care’ for significant SSc-DUs. However, there is a strong rationale to develop local approaches to DUs, to avoid side effects from systemic therapies. World Scleroderma Foundation DU Working Group intends to develop practical, evidence-based recommendations for DU management including local, Surgical Treatment (L-ST).ObjectivesTo summarize the literature on the safety and efficacy of L-ST for SSc-DUs.MethodsA systematic literature review (SLR) was conducted up to May 2021. According to the PICO framework, eligibility criteria were defined and original research articles about surgical treatment of SSc DUs in adult patients were included. References were independently screened by 2 reviewers who assessed the full text of eligible articles and extracted data.ResultsThirteen eligible articles out of 790 total publications were identified (Table 1). Due to the paucity of randomized controlled trials of surgical treatments for SSc-DU, we included retrospective studies and case series with at least 4 patients. Autologous fat (adipose tissue AT) grafting was the surgical modality mostly identified (7 studies of which 1 RCT and 6 prospective open label single arm). The healing rate (HR) with autologous fat grafting (4 studies) ranged from 66-100 %. In the RCT, two age and sex matched groups were included, adipose tissue (AT)group (n=25 pts) and sham procedure (SP) group (n=13), DU healing was reported in 23/25 in AT group versus 1/13 in the SP group in 8 wks, (p<0.0001), 12 pts in the SP group, received rescue AT injection, all of them healed after 8 wks. Three studies reported autologous adipose-derived stromal vascular fraction(SVF) grafting and the HR ranged from 32-60%, followed up to 12 months. Transient edema and paresthesia were reported in 2 studies, and amputation in 2 ulcers in 1 study, and no complications were reported in other studies. Surgical sympathectomy was reported in 3 studies, with a median healing rate of 81%. Bone marrow derived cell transplantation in a single study showed 87% healing rate over (4-24 wks). Two surgical studies (of direct microsurgical revascularization N=4, and microsurgical arteriolysis, N=6), showed 100% healing of ulcers, no complications reported.Table 1.Characteristics of the extracted studies.StudydesignPatients (n)Baseline DU (n)Background therapy (%)Follow-upOutcomeHealed ulcers(%) Adipose tissue graftAutologous fat graftp9.15PG, CCB—100ETA 26PDE-5i 138-12 wks66Adipose tissue graftingRCT25 case13- Ctr25-case13- CtrPG- 100CCB 1008 wks92-case7-CtrAdipose tissue implantp1515no therapy7 wks100Adipose tissue graftp129PG,CCB-100ETA6 month88adipose derived SVFp1215PDE-5i, ccb, PG allowed22m6Adipose derived SVFp1215CCB 50ETA166 m63 Adipose derived SVFp1819CCB 50PG 27ETA 5IS 7124 wks32SympathectomySympathectomyR611CCB-10020 m81SympathectomyR1335PGCCBAPA35Sympathectomy, vascular bypass (+vein graftR1726Ccb 35APA 47PDE-i5 589 m100Bone marrow derived cells transplantation)p88PG-6236 m87Direct microsurgical revascularizationR44m100Limited microsurgical arteriolysisR61712 m100SVF =stromal vascular fraction P = prospective. R = retrospective. RCT= double blind randomized-controlled trial. ETA = endothelin antagonist. CCB= calcium channel blockers. APA= anti-platelet agents. PG= prostaglandins. ARB= angiotensin receptor antagonist. ACEi= ACE inhibitors. PDE-5i= PDE-5 inhibitors. IS= immunosuppression. M=median. SoC= standard of care. HR= healing rateConclusionOur SLR has identified several surgical modalities for SSc-DUs. L-STseemed generally effective and safe for DU healing, thus Significant methodological issues emerged including small numbers of pts, lack of comparator, failure to report confounders such as background therapies and variable follow up. Future research is warranted to rigorously investigate surgical interventions for Dus.Disclosure of InterestsYossra A. Suliman: None declared, Corrado Campochiaro: None declared, Michael Hughes Speakers bureau: speaking fees from Actelion pharmaceuticals, Eli Lilly, and Pfizer, outside of the submitted work, Jan Schoones: None declared, Dilia Giuggioli: None declared, Nancy Maltez: None declared, Pia Moinzadeh Speakers bureau:: speaking fees from Actelion pharmaceuticals and Boehringer Ingelheim, Laura Ross: None declared, Lorinda Chung: None declared, Yannick Allanore: None declared, Murray Baron: None declared, Christopher P Denton: None declared, Oliver Distler Shareholder of: Consultancy relationship with and/or has received research funding from and/or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three calendar years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Speakers bureau: Consultancy relationship with and/or has received research funding from and/or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three calendar years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Consultant of: Consultancy relationship with and/or has received research funding from and/or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three calendar years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Grant/research support from: Consultancy relationship with and/or has received research funding from and/or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three calendar years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Tracy Frech: None declared, Daniel Furst: None declared, Dinesh Khanna Speakers bureau: Janssen and Eicos Sciences, Inc., Paid instructor for: Janssen and Eicos Sciences, Inc., Consultant of: Janssen and Eicos Sciences, Inc., Thomas Krieg: None declared, Masataka KUWANA Speakers bureau: Speakers fees from AbbVie, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai, Eisai, GlaxoSmithKline, Janssen, Nippon Shinyaku, Ono Pharmaceuticals, Tanabe-Mitsubishi, and Consultant fees from AstraZeneca, Boehringer Ingelheim, Corbus, Kissei, Mochida, outside of the submitted work., Paid instructor for: Speakers fees from AbbVie, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai, Eisai, GlaxoSmithKline, Janssen, Nippon Shinyaku, Ono Pharmaceuticals, Tanabe-Mitsubishi, and Consultant fees from AstraZeneca, Boehringer Ingelheim, Corbus, Kissei, Mochida, outside of the submitted work., Consultant of: Speakers fees from AbbVie, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai, Eisai, GlaxoSmithKline, Janssen, Nippon Shinyaku, Ono Pharmaceuticals, Tanabe-Mitsubishi, and Consultant fees from AstraZeneca, Boehringer Ingelheim, Corbus, Kissei, Mochida, outside of the submitted work., Marco Matucci-Cerinic: None declared, Janet Pope: None declared, Alessia Alunno: None declared
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Maltez N, Ross L, Hughes M, Schoones J, Baron M, Chung L, Campochiaro C, Suliman YA, Giuggioli D, Moinzadeh P, Allanore Y, Denton CP, Distler O, Frech T, Furst D, Khanna D, Krieg T, Kuwana M, Matucci-Cerinic M, Pope J, Alunno A. POS0900 SYSTEMIC PHARMACOLOGICAL TREATMENT OF DIGITAL ULCERS IN SYSTEMIC SCLEROSIS: A SYSTEMATIC LITERATURE REVIEW. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3592] [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: 11/04/2022]
Abstract
BackgroundDigital ulcers (DU) are common in systemic sclerosis (SSc) and associated with reduced survival, high morbidity and poor quality of life. Recommendations have previously been proposed for DU management yet there remains significant unmet patient need. Therefore the World Scleroderma Foundation DU Working Group intends to develop practical evidence based recommendations for DU management.ObjectivesTo summarise data on efficacy and safety of systemic treatments for SSc DU.MethodsA systematic literature review to May 2021 was performed. PubMed, MEDLINE, Embase, Web of Science, Cochrane Library, Emcare (OVID) and Academic Search Premier databases were searched for original studies on adult patients with SSc DU treated with systemic pharmacological treatment. Based on the PICO framework, eligibility criteria were defined and references were independently screened by two reviewers. Reviewers independently assessed the full text of eligible articles. Owing to interstudy heterogeneity narrative summaries were used to present data.ResultsThe search strategy identified 1271 references of which 45 eligible articles were included. Seventeen studies were randomised placebo controlled trials (RCT) pertaining to PDE5 antagonists (PDE5i) (n=3), endothelin receptor antagonists (ERA) (n=3), prostanoids (n=7), antiplatelet agents (n=1) and other (n=3) (Table 1). No head to head RCT was retrieved. All other studies were observational studies (OBS). Studies were highly heterogeneous with application of differing definition of DU, variable study eligibility criteria, clinical endpoints and follow up periods. This limited the calculation of effect size and comparison across studies.Table 1.Characteristics of placebo controlled randomised controlled trialsAuthor YearInterventionnFollow upOutcomeFavours interventionHachulla 2016Sildenafil8312 weeksTime to DU healing-Andrigueti 2017Sildenafil4112 weeksDU healing+Shenoy 2010Tadalafil246 weeksNew DU+Khanna 2016Macitentan55416 weeksNew DU-Matucci-Cerinic 2011Bosentan18832 weeksNew DU Time to healing of DU+-Korn 2004Bosentan12212 weeksNew DU+Kawald 2008IV iloprost5012 monthsDU healing-Wigley 1992IV iloprost3510 weeksDU healing+Wigley 1994IV iloprost739 weeks50% reduction in DU score-Seibold 2017Treprostinil14820 weeksNet DU burden-Vayssairat 1999Beraprost10725 weeks% patients with new DU-Denton 2017Selexipag7412 weeksNumber of new DU DU healing-Lau 1993Cicaprost334 weeksNumber of DU-Abou-Raya 2008Atorvastatin844 monthsNumber of DU+Au 2010Cyclophosphamide15812 monthsNumber of patients with DU-Beckett 1984Dipyridamole / aspirin412 yearsChange in general SSc-Nagaraja 2019Riociguat1732 weeksNet DU burden-+ significantly superior to comparator- non significantly different from comparatorDU: digital ulcers IV: intravenous SSc: systemic sclerosisSeveral RCT found improved DU healing with treatment: two with PDE5i, one with iloprost and one showed improved DU healing and prevention with atorvastatin. Two RCT demonstrated effective prevention of new DU with bosentan. OBS studies with a total of 621 patients showed variable improvements in the healing of DU with CCB, PDE5i, ERA, statins, N-acetylcysteine, prostanoids and ketanserin and prevention of new DU with ERA.Regarding safety, all treatments were generally tolerated with few serious adverse events. Treatment was ceased in 6.25-17.5% of patients in RCT due to treatment related side effects.ConclusionDespite several studies assessing the efficacy and safety of systemic pharmacological treatment of SSc DU, it is not possible to draw solid conclusions due to study heterogeneity. Small RCT have shown treatment benefit with PDE5i, iloprost and atorvastatin. Large studies demonstrated effective prevention of new DU with bosentan. Our results highlight the urgent need for improved clinical trial design to generate more robust evidence and novel therapies to guide the management SSc DU.AcknowledgementsThis work was supported by the World Scleroderma Foundation.Disclosure of InterestsNancy Maltez: None declared, Laura Ross: None declared, Michael Hughes Speakers bureau: Actelion Pharmaceuticals, Eli Lilly and Pfizer outside of the submitted work., Jan Schoones: None declared, Murray Baron: None declared, Lorinda Chung Consultant of: Eicos, Corrado Campochiaro: None declared, Yossra A. Suliman: None declared, Dilia Giuggioli: None declared, Pia Moinzadeh Speakers bureau: Actelion Pharmaceuticals, Boehringer Ingelheim, Yannick Allanore: None declared, Christopher P Denton: None declared, Oliver Distler Speakers bureau: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur., Consultant of: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur., Grant/research support from: Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143), Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galapagos, Glenmark, Horizon, Inventiva, Kymera, Lupin, Medscape, Miltenyi Biotec, Mitsubishi Tanabe, MSD, Novartis, Prometheus, Roivant, Sanofi and Topadur., Tracy Frech: None declared, Daniel Furst: None declared, Dinesh Khanna Consultant of: Eicos Sciences Inc, Janssen, Thomas Krieg: None declared, Masataka Kuwana Speakers bureau: Speaker fees from AbbVie, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai, Eisai, GlaxoSmithKline, Janssen, Nippon Shinyaku, Ono Pharmaceuticals, Tanabe-Mitsubishi, and consultancy fees from AstraZeneca, Boehringer Ingelheim, Corbus, Kissei, Mochida outside of the submitted work., Marco Matucci-Cerinic: None declared, Janet Pope: None declared, Alessia Alunno: None declared
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Wortman B, Post C, Powell M, Khaw P, Fyles A, D’Amico R, Haie-Meder C, Jurgenliemk-Schulz I, McCormack M, Do V, Katsaros D, Bessette P, Baron M, Nout R, Whitmarsh K, Mileshkin L, Lutgens L, Kitchener H, Brooks S, Nijman H, Astreinidou E, Putter H, Creutzberg C, de Boer S. OC-0298 Toxicity and patient-reported symptoms after 3D-conformal or intensity-modulated pelvic radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06845-6] [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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Martin Calderon L, Baron M, Pope J. AB0419 ACCESS TO TREATMENT FOR RAYNAUD’S PHENOMENON AND DIGITAL ULCERS FOR PATIENTS WITH SYSTEMIC SCLEROSIS DOESN’T FOLLOW EULAR/EUSTAR GUIDELINES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1265] [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: 11/04/2022]
Abstract
Background:Patients with Raynaud’s Phenomenon (RP) from systemic sclerosis (SSc) may experience severe complications. Digital ulcers (DUs), occur in approximately half the patients with SSc, and cause hand dysfunction, severe pain, and decreased quality of life. DUs lead to increased healthcare utilization and systemic economic burden through hospitalizations, ED visits, and ambulatory services (1). However, access to medications such as PDE5 inhibitors and prostacyclins that are within the EULAR/EUSTAR SSc guidelines (2) in a country with global health care but patchy pharmacare such as Canada has not been studied.Objectives:The purpose of this study was to elucidate the access to treatment of medications for RP and DU in patients with SSc in Canadian provinces through identifying the provincial and private insurance coverage of PDE5 inhibitors (PDE5i) and prostanoids, the timelines and procedures of requesting these medications, and the process of administering IV prostanoids if required for patient care.Methods:We designed an online survey and collected data through the Survey Monkey platform. The survey was administered to rheumatologists affiliated with the Canadian Scleroderma Research Group (CSRG) from December 2020 to January 2021. Responders were asked to report if the province or private insurance automatically provided PDE5i for patients with RP and DU or if a dedicated process was required to attain these medications. Additionally, responders were asked to describe the process of administering Iloprost, Epoprostenol and Alprostadil and the barriers inherent to their administration. Of note, there is no DIN number for Iloprost in Canada so every time it is used there must be an application to Health Canada.Results:The survey was completed by 100% of CSRG researchers (17/17), representing 8 provinces in Canada. None of the provincial governments provided coverage for PDE5i without special requests that were adjudicated on a case by case basis with approximately half the provinces paying for PDE5i upon special request if a patient was eligible for provincial drug insurance (ex elderly, youths, low income families). Two provinces, Quebec and Saskatchewan, provided PDE5i “all the time”. Whereas NS, MB, ON, BC, and AB provided them “sometimes”; NFLD provided them “never”. Provincial governments and private insurance fulfilled requests “within 1 month” 62% of the time and the other requests took longer to be answered. Private insurance approved coverage with special request in AB, MB, QC, ON, and NS. Respondents described administration of IV prostanoids as “inconsistent”, requiring “a lot of work”, and that patients in most jurisdictions be admitted as in-patients for provinces to cover these medications.Conclusion:Most jurisdiction within Canada do not provide coverage for PDE5i and the process to obtain access for patients is delayed, non-uniform, and often not approved. Intravenous prostanoid infusions are difficult to obtain and have system barriers. Advocacy and cost effectiveness data should be used to advocate for access to medications that are recommended within SSc recommendations.References:[1]Morrisroe K, et al. Digital ulcers in systemic sclerosis: their epidemiology, clinical characteristics, and associated clinical and economic burden. Arthritis research & therapy. 2019 Dec;21(1):1-2.[2]Kowal-Bielecka O, et al. Update of EULAR recommendations for the treatment of systemic sclerosis. Annals of the rheumatic diseases. 2017 Aug 1;76(8):1327-39.Disclosure of Interests:None declared
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Bérubé A, Clément MÈ, Lafantaisie V, LeBlanc A, Baron M, Picher G, Turgeon J, Ruiz-Casares M, Lacharité C. How societal responses to COVID-19 could contribute to child neglect. Child Abuse Negl 2021; 116:104761. [PMID: 33077248 PMCID: PMC7561330 DOI: 10.1016/j.chiabu.2020.104761] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 07/28/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 05/07/2023]
Abstract
BACKGROUND The ecosystemic approach to children's needs demands a cohesive response from societies, communities, and families. During the COVID-19 pandemic, the choices societies made to protect their community members from the virus could have created contexts of child neglect. With the closure of services and institutions, societies were no longer available to help meet the needs of children. OBJECTIVE The purpose of this study is to examine parents' reports on the response their children received to their needs during the COVID-19 crisis. METHODS During the period of the spring 2020 lockdown, 414 parents in the province of Quebec, Canada, completed an online questionnaire about the impact of the crisis on the response their children received to their needs. RESULTS Compared to parents of younger children, parents of older children reported less fulfillment of their child's needs in three measured domains, namely cognitive and affective, security, and basic care needs. CONCLUSION These results are discussed in light of the policies and the resources societies have put in place during the crisis to help families meet the needs of their children. Societies must learn from this crisis to put children at the top of their priorities in the face of a societal crisis. Thoughtful discussions and energy must be given to ensure that, while facing a crisis, the developmental trajectories of children are not sacrificed.
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Affiliation(s)
- A Bérubé
- Université du Québec en Outaouais, 283 Boul Alexandre-Taché, Gatineau, J8X 3X7, Canada.
| | - M-È Clément
- Université du Québec en Outaouais, 283 Boul Alexandre-Taché, Gatineau, J8X 3X7, Canada
| | - V Lafantaisie
- Université du Québec en Outaouais, 283 Boul Alexandre-Taché, Gatineau, J8X 3X7, Canada
| | - A LeBlanc
- Université Laval, 2325 Rue de l'Université, Québec, QC G1V 0A6, Canada; VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center (CIUSSS de la Capitale Nationale), Canada
| | - M Baron
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center (CIUSSS de la Capitale Nationale), Canada
| | - G Picher
- Université Laval, 2325 Rue de l'Université, Québec, QC G1V 0A6, Canada; CERVO Research Center, Quebec Integrated University Health and Social Services Center (CIUSSS de la Capitale Nationale), Canada
| | - J Turgeon
- Université du Québec en Outaouais, 283 Boul Alexandre-Taché, Gatineau, J8X 3X7, Canada
| | - M Ruiz-Casares
- McGill University, 845 Sherbrooke Ouest, Montreal, H3A 0G4, Canada
| | - C Lacharité
- Université du Québec à Trois-Rivières, 3351 Boulevard des Forges, Trois-Rivières, G8Z 4M3, Canada
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Muntyanu A, Ouchene L, Hudson M, Baron M, Netchiporouk E. 317 Geographical distribution of systemic sclerosis in Canada: A large Canadian database study. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.339] [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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Fosse A, Karam G, Kerleau C, Perrouin-Verbe, Rigaud J, Baron M, Mesnard B, Hedhli O, Ville S, De Vergie S, Chelghaf I, Loubersac T, Boutin JM, Faivre d'Arcier B, Bruyère F, Cantarovich D, Branchereau J. [Acute renal failure of the donor in encephalic death: A real contraindication to kidney transplantation?]. Prog Urol 2021; 31:519-530. [PMID: 33478867 DOI: 10.1016/j.purol.2020.11.002] [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: 09/04/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The shortage of kidney transplants encourages the expansion of the limits of eligibility criteria for donation. Many donors who are brain dead display acute renal failure at the time of death; is this a real contraindication to harvesting? The aim of this study was to assess kidney graft survival from donors after brain death with confirmed acute renal failure, with or without anuria previous donation. MATERIALS AND METHODS All of the transplants performed in two university hospitals between 2010 and 2017 were analyzed retrospectively. All patients who underwent single kidney transplant from a brain-dead donor with acute renal failure (ARF) were included in this study. ARI was defined here by a decrease over 50 % of glomerular filtration rate (GFR) to a threshold below 45mL/min/1.73 m2 at the time of kidney procurement. Kidney graft survival, incidence of delayed graft function (DGF) and the GFR at 12 months were analyzed. Analysis of kidney transplant survival based on pre-implantation biopsies was additionally done. RESULTS One hundred and sixty four patients were transplanted with a kidney from donor with ARF during the selected period. At the admission in ICU the average GFR was 67,7±19mL/min/1,73m2. At the time of donation, the average age of donors was 56.4±17.7 years, the GFR was 33.7±8.0mL/min/1.73 m2 16 % of donors were anuric. Cold ischemia time (CIT) was 16.8±5.0hours. The average age of recipients was 55.6±14.1 years. 81 % of the cases were primary transplants. Graft function took place within 7.8±9.4 days after transplantation. There were two non-primary functions (PNF). One hundred and fifty two patients (93 %) had a functional graft at 12 months. The mean GFR at 12 months was 46.8±20.1mL/min/1.73 m2 and 122 patients (73 %) had a GFR greater than 30mL/min/1.73 m2. Seventy-one percent of preimplantation biopsies revealed acute tubular necrosis (ATU); no cortical necrosis was observed. Survival of theses grafts was 85 %, comparable to the total population of study (P=0,21) CONCLUSION: The acute renal failure of the brain-dead donor should not alone be systematically a contraindication to harvesting and kidney transplantation.
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Affiliation(s)
- A Fosse
- Service d'urologie et de transplantations rénales, CHRU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
| | - G Karam
- Service d'urologie et de transplantations rénales, CHRU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France; Institut de transplantation urologie-néphrologie, 30, boulevard Jean-Monnet, 44093 Nantes, France
| | - C Kerleau
- Institut de transplantation urologie-néphrologie, 30, boulevard Jean-Monnet, 44093 Nantes, France; Centre de recherche en transplantation et immunologie, UMR 1064, Inserm, 30, boulevard Jean-Monnet, 44093 Nantes, France
| | - Perrouin-Verbe
- Institut de transplantation urologie-néphrologie, 30, boulevard Jean-Monnet, 44093 Nantes, France
| | - J Rigaud
- Service d'urologie et de transplantations rénales, CHRU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France; Institut de transplantation urologie-néphrologie, 30, boulevard Jean-Monnet, 44093 Nantes, France
| | - M Baron
- Service d'urologie, CHU de Rouen, 76031 Rouen cedex 1, France
| | - B Mesnard
- Service d'urologie et de transplantations rénales, CHRU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - O Hedhli
- Service d'urologie et de transplantations rénales, CHRU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - S Ville
- Institut de transplantation urologie-néphrologie, 30, boulevard Jean-Monnet, 44093 Nantes, France; Centre de recherche en transplantation et immunologie, UMR 1064, Inserm, 30, boulevard Jean-Monnet, 44093 Nantes, France
| | - S De Vergie
- Service d'urologie et de transplantations rénales, CHRU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - I Chelghaf
- Service d'urologie et de transplantations rénales, CHRU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - T Loubersac
- Service d'urologie et de transplantations rénales, CHRU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - J M Boutin
- Service d'urologie, CHRU de Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | - B Faivre d'Arcier
- Service d'urologie, CHRU de Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | - F Bruyère
- Service d'urologie, CHRU de Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex, France
| | - D Cantarovich
- Institut de transplantation urologie-néphrologie, 30, boulevard Jean-Monnet, 44093 Nantes, France; Centre de recherche en transplantation et immunologie, UMR 1064, Inserm, 30, boulevard Jean-Monnet, 44093 Nantes, France
| | - J Branchereau
- Service d'urologie et de transplantations rénales, CHRU de Nantes-Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France; Institut de transplantation urologie-néphrologie, 30, boulevard Jean-Monnet, 44093 Nantes, France; Centre de recherche en transplantation et immunologie, UMR 1064, Inserm, 30, boulevard Jean-Monnet, 44093 Nantes, France; Nuffield department of surgical sciences, Oxford university, Oxford, UK
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Post C, De Boer S, Powell M, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, Ottevanger P, Ledermann J, Khaw P, D'Amico R, Fyles A, Baron M, Kitchener H, Nijman H, Lutgens L, Brooks S, Jürgenliemk-Schulz I, Feeney A, Nout R, Verhoeven-Adema K, Smit V, Putter H, Creutzberg C. OC-0369: Long-Term Quality of Life after (chemo)radiotherapy for high-risk Endometrial Cancer in PORTEC-3. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00393-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Baron M, Aublé A, Paret F, Pfister C, Cornu JN. Long-term follow-up reveals a low persistence rate of abobotulinumtoxinA injections for idiopathic overactive bladder. Prog Urol 2020; 30:684-691. [PMID: 32891504 DOI: 10.1016/j.purol.2020.07.242] [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: 03/29/2020] [Revised: 06/28/2020] [Accepted: 07/28/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Little is known about long-term efficacy and tolerance of intra-detrusor injections of abobotulinumtoxinA for management of idiopathic overactive bladder (OAB). We report long-term efficacy and compliance of abobotulinumtoxinA in patients treated for OAB. METHODS All patients treated with abotulinumtoxinA for OAB in a tertiary reference centre between 2005 and 2012 were included in a retrospective analysis. Patients received 150, 250 or 500 U of abotulinumtoxinA as first injection. The primary endpoint was the discontinuation rate at 5 years. Other outcomes of interest were: rate of failure, reasons for discontinuation and subsequent treatment elected in those who did not persist with abobotulinumtoxinA. RESULTS Fifty-nine patients (50 women and 9 men) were included. Forty-one patients (69.4%) received 250 U of abobotulinumtoxinA as first injection. Thirteen patients (22%) received 500 U and 5 (8.4%) received 150 U of BoNT-A. Median follow-up was 83.6 months [0.3-183.6]. Median number of injections per patient was 2 [1-15] and median reinjection interval was 10.7 [3-86.4] months. The estimated 5-year discontinuation-free survival rate was 23.4%. Fourteen patients (23.7%) experienced persistent improvement of symptoms and 12 patients (20.3%) stopped the injections because of tolerability issues. Main cause of discontinuation was primary failure, which occurred in 21 patients (35.5%). CONCLUSION Overall, 59.3% of patients were successfully treated with first abobotulinumtoxinA injection. Although the estimated 5-year discontinuation-free survival rate is low, abobotulinumtoxinA could be considered as an alternative off-labelled in patients not responders to onabotulinumtoxinA after failure of other conservative measures. LEVEL OF PROOF 3.
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Affiliation(s)
- M Baron
- Urology Department, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex 1, France.
| | - A Aublé
- Urology Department, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex 1, France
| | - F Paret
- Urology Department, Nantes University Hospital, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - C Pfister
- Urology Department, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex 1, France
| | - J-N Cornu
- Urology Department, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex 1, France
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Auble A, Desprez C, Baron M, Leroi A, Pfister C, Cornu J. Sacral neuromodulation and material infections: Retrospective data from an expert center. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33988-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Auble A, Baron M, Chebbi A, Surlemont L, Leroi A, Cornu J. Sacral neuromodulation and non-obstructive retention: Monocentric retrospective study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33570-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nevskaya T, Jiang Y, Wang M, Baron M, Pope J, Pope JE, Baron M, Hudson M, Gyger G, Larché MJ, Khalidi NA, Masetto A, Sutton E, Robinson D, Rodriguez-Reyna TS, Smith D, Thorne C, Fortin PR, Fritzler MJ. FRI0258 CUMULATIVE INCIDENCE, SURVIVAL AND PREDICTORS OF PULMONARY HYPERTENSION IN SYSTEMIC SCLEROSIS SUBSETS: PAH IS NOT INCREASED IN LIMITED VS DIFFUSE PATIENTS BY ADJUSTED COMPETING RISK ANALYSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Pulmonary hypertension (PH) is a life-threatening complication of systemic sclerosis (SSc), thought to be more commonly found in limited cutaneous (lcSSc) compared to diffuse (dcSSc) subset. Since lcSSc has a better prognosis, it is unclear whether a higher occurrence of PH in lcSSc reflects survival bias.Objectives:To compare the cumulative PH incidence in disease subsets, after accounting for death as a competing event, in a large multi-center SSc cohort.Methods:Cumulative incidence of PH was studied in 1431 Canadian Scleroderma Research Group (CSRG) database patients (57% lcSSc; follow-up 3.5±2.9 years, range 1-14) by Fine-Gray analysis, unadjusted and adjusted for sex, age and SSc-related autoantibodies (SAS 9.4). Survival curves, predictors of PH development and survival were analyzed by Kaplan-Meier and Cox proportional hazards analyses (SPSS 25.0). Subgroup analysis was performed for PAH.Results:157 SSc patients had PH (including 117 PAH), either confirmed by RHC or postmortem. Compared to those without PH, lcSSc-PH patients had longer disease and older age at SSc diagnosis, while dcSSc-PH patients - more severe peripheral vascular and gastrointestinal involvement. The cumulative incidences of PH/PAH were similar in dcSSc and lcSSc after accounting for death in the adjusted competitive risk model (Table 1; Fig.1). 47% of PH- and 42% of PAH-patients died over a FU period. Male gender (p<0.0001) and anti-Scl-70 (p<0.001) were associated with earlier PH development, while older age (p=0.006) - with PAH (Table 2). ACA-negativity and older age predicted worse PH prognosis.Figure 1.Cumulative incidence curves for PH (A) and PAH (B).Conclusion:Cumulative incidence of PH, after accounting for death as competing event, was comparable in SSc subsets. Vigilance should be considered in males, Scl-70 positive and late age-onset SSc.Table 1.Sub-distribution Hazard ratio of incident PH and PAH.PHPAHHazard ratio (95% CIs)P valuesHazard ratio (95% CIs)P valuesCrude ModelDcSSc vs lcSSc2.03 (1.13, 3.66)0.01861.60 (0.82, 3.16)0.1710Adjusted modelDcSSc vs lcSSc1.82 (0.93, 3.57)0.08181.57 (0.69, 3.59)0.2812Female vs male0.98 (0.42, 2.32)0.96602.10 (0.51, 8.65)0.3040Age1.00 (0.99, 1.02)0.70411.01 (0.98, 1.03)0.5498AntibodiesACA vs negative0.95 (0.46, 1.96)0.89911.08 (0.50, 2.35)0.8391ATA vs negative1.93 (0.84, 4.42)0.11980.59 (0.13, 2.73)0.4970Anti-RNAP vs negative1.24 (0.45, 3.43)0.68411.77 (0.58, 5.44)0.3181Disclosure of Interests:Tatiana Nevskaya: None declared, Yuxuan Jiang: None declared, Mianbo Wang: None declared, Murray Baron: None declared, Janet Pope Grant/research support from: AbbVie, Bristol-Myers Squibb, Eli Lilly & Company, Merck, Roche, Seattle Genetics, UCB, Consultant of: AbbVie, Actelion, Amgen, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Eicos Sciences, Eli Lilly & Company, Emerald, Gilead Sciences, Inc., Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, UCB, Speakers bureau: UCB
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Hu A, Nevskaya T, Baron M, Pope J. FRI0245 PULMONARY ARTERIAL HYPERTENSION IN SYSTEMIC SCLEROSIS IS NEARLY ALWAYS ACCOMPANIED BY A LOW DIFFUSING CAPACITY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3394] [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: 11/04/2022]
Abstract
Background:Scleroderma (systemic sclerosis; SSc) has high morbidity and mortality. Pulmonary hypertension (PH) and pulmonary arterial hypertension (PAH) is common with a high mortality (1). SSc patients are screened with pulmonary function tests (diffusing capacity of the lung for carbon monoxide; DLCO) (2).Objectives:The DLCO%predicted was analyzed comparing patients with and without PAH to determine if it is always low at time of PAH diagnosis.Methods:The Canadian Scleroderma Research Group (CSRG) database was used containing more than 1300 SSc patients with a mean disease duration of 8 years. All patients with at least one follow up visit and DLCO recorded at least twice were eligible for enrolment into this nested case control study. Diagnosis of PH was verified using several algorithms within the database including R heart catheterization, use of PH medications and physician response of ‘yes’ to question has this patient been diagnosed with pulmonary hypertension. Sensitivity, specificity and positive (PPV) and negative predictive values (NPV) were calculated for DLC0%predicted <50% and presence of PH/PAH.Results:At time of PH diagnosis, the mean DLCO% predicted was 47% (N=30) vs no PH 73% (N=960) P<0.0001, and proven documented PAH also showed the differences (PAH, N=22 DLCO% predicted 51% vs. PAH negative (N=968) DLCO% pred 72%, P<0.0001) (Table 1). The OR of a DLCO%predicted less than 60 was 4.7 for PAH and 7.6 for PH (both P<0.001) and even higher if DLCO<50% (OR 11.5 for PH and 7.6 for PAH). Table 2 shows the PPV of DLCO at varying levels.Table 1.DLCO comparison between PH+ and PH- SSc patients and between PAH+ and PAH- SSc patients, at the time of diagnosis.PH+(n=30)PH-(n=960)P-valuePAH+(n=22)PAH- (n=968)P-valuemean±SD47.17±17.5372.74±20.79<0.000151.23±17.5572.44±20.99<0.0001Range18-8113-14725-8113-147Table 2.Sensitivity, specificity and predictive values in SSc-PH and -PAH for DLCO at various cut points.ORPPVSpecificityNPVSensitivityDLCO<50%11.5 (CI 95% 5.4-24.8),p<0.000113.2%87.0%98.7%63.3%PHDLCO<60%7.6 (CI 95% 3.3-17.2), p<0.00017.9%73.3%98.9%73.3%DLCO>80%0.06 (CI 95% 0.008-0.46), p=0.0070.3%64.5%95.5%3.3%DLCO<50%7.6 (CI 95% 3.2-17.9), p<0.00018.3%86.4%98.8%54.5%PAHDLCO<60%4.7 (1.9-11.3), p<0.0015.0%72.7%98.9%63.6%DLCO>80%0.1 (0.01-0.7), p=0.0180.3%64.8%96.8%4.5%Conclusion:A low DLCO is associated with a high odds of PH/PAH in SSc and the NPV is very high at both DLCO<50% predicted and <60% predicted. This may aid in determining who should recieve a right heart catheterization in SSc patients.References:[1]Mukerjee D et al (2003) Prevalence and outcome in systemic sclerosis associated pulmonary arterial hypertension: application of a registry approach. Ann Rheum Dis 62(11):1088-93[2]Khanna D et al (2013) Recommendations for screening and detection of connective tissue disease-associated pulmonary arterial hypertension. Arthritis Rheum 65(12):3194-201Disclosure of Interests:None declared
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Park R, Nevskaya T, Baron M, Pope J. AB0598 THE INCREASING USE OF IMMUNOSUPPRESSANTS IN EARLY SYSTEMIC SCLEROSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4600] [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: 11/04/2022]
Abstract
Background:Immunosuppression (IS) remains the main treatment for progressing skin involvement, active interstitial lung disease (ILD) and underlying inflammatory joint (IJ) or muscle disease in systemic sclerosis (SSc).Objectives:This study investigated the pattern and trends in immunosuppressive agent use in patients with early SSc diagnosed before and after 2007 to determine whether the changes in the preferred type and combination of IS, timing and predictors of administration took place over the past decade.Methods:397 SSc patients from Canadian Scleroderma Research Group (CSRG) database (183dcSSc, 214 lcSSc) who had baseline and follow-up visits within 3 years (1.8±0.8) after disease onset were included: 82% females, age at diagnosis 53±13 years, disease duration 1.6±0.8 years. Organ involvement was assessed by modified Rodnan skin score, Medsger Disease Severity Score (DSS) and CSRG definitions using bivariate, chi-squared, ANOVA, and adjusted regression analyses.Results:115 dcSSc patients (63%) and 62 lcSSc (29%) received IS, most commonly methotrexate (MTX) (72% dcSSc and 52% lcSSc), followed by mycophenylate mofetil (MMF) and cyclophosphamide (CYC). Within the patients receiving IS, monotherapy prevailed (77% dcSSc and 68% lcSSc); CYC and azathioprine were the preferred choice of IS more frequently in lcSSc compared to dcSSc (p<0.006 and p<0.02, respectively). In dcSSc, IS were predominantly prescribed at years 2 and 3 after the onset of first non-Raynaud’s phenomenon (RP) manifestation, when about half of the patients received IS. The proportion of lcSSc patients receiving IS was significantly lower and distributed more equally through the first three years. After 2007, dcSSc patients received IS more often (74% vs 50%, p=0.001), especially MTX (p=0.02) and MMF (p<0.05), and earlier (peaked at 2 years after disease onset)(Table 1).Table 1.Proportion of patients receiving immunosuppressive treatment at each year after disease onset in SSc diagnosed before and after 2007.Years after the first non-RP symptomlcSScBefore 2007After 2007Total N of pts seen at each year% receiving immune suppressivesTotal N of pts seen at each year% receiving immune suppressivesP-value113154717>0.92242182180.7723491410714>0.9dcSSc1242940430.2862512665650.00013624563540.325IS administration was associated with male gender, ILD, a-Scl-70 positivity, ACA-negativity and IJ disease in lcSSc, and with ACA-negativity and a higher mRSS in dcSSc. Multivariate logistic regression analysis showed that IS treatment could be predicted by ACA-negativity in lcSSc patients (Exp(B) 0.317, p=0.012) and younger age in dcSSc patients (Exp(B) 0.974, p=0.002).Conclusion:Over the past decade, there has been a trend to prescribe IS more often, especially MTX, and earlier in dcSSc patients. MMF has gained favour over CYC. Autoantibody status was the most consistent predictor whether a patient is likely to take IS over the course of the disease.Disclosure of Interests:Ryan Park: None declared, Tatiana Nevskaya: None declared, Murray Baron: None declared, Janet Pope Grant/research support from: AbbVie, Bristol-Myers Squibb, Eli Lilly & Company, Merck, Roche, Seattle Genetics, UCB, Consultant of: AbbVie, Actelion, Amgen, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Eicos Sciences, Eli Lilly & Company, Emerald, Gilead Sciences, Inc., Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, UCB, Speakers bureau: UCB
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Semalulu T, Rudski L, Huynh T, Langleben D, Wang M, Fritzler MJ, Pope J, Baron M, Hudson M. An evidence-based strategy to screen for pulmonary arterial hypertension in systemic sclerosis. Semin Arthritis Rheum 2020; 50:1421-1427. [PMID: 32245697 DOI: 10.1016/j.semarthrit.2020.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/20/2020] [Accepted: 02/25/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Clinical practice guidelines recommend screening all systemic sclerosis (SSc) patients for pulmonary arterial hypertension (PAH) with yearly echocardiograms. There is a paucity of evidence to support these guidelines. RESEARCH QUESTION Can a prediction model identify SSc patients with a very low probability of PAH and therefore not requiring annual screening echocardiogram? STUDY DESIGN AND METHODS We performed a case-control study of 925 unselected SSc subjects nested in a multi-centered, longitudinal cohort. The probability of PAH for each subject was calculated using the results of multivariate logistic regression models. A cut-off was identified for the estimated probability of PAH below which no subject developed PAH (100% sensitivity). RESULTS Study subjects were predominantly female (87.5%), with mean (SD) age 58.6 (11.7) years and disease duration of 18.2 (12.2) years. Thirty-seven subjects developed PAH during 5407.97 person-years of observation (incidence rate 0.68 per 100 person-years). Shortness of breath (SOB), diffusing capacity for carbon monoxide (DLCO) and NT-proBNP were independent predictors of PAH. All SSc-PAH cases had a probability of PAH of >1.1%. Subjects below this cut-off, none of whom had PAH, accounted for 46.2% of the study population. INTERPRETATION A simple prediction model identified subjects at very low probability of PAH who could potentially forego annual screening echocardiogram. This represents almost half of SSc subjects in a general SSc population. This study, which is the first evidence-based study for the rational use of follow-up echocardiograms in an unselected SSc cohort, requires validation. The scoring system is freely available online at http://pahtool.ladydavis.ca.
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Affiliation(s)
- T Semalulu
- Department of Medicine, McMaster University, Canada
| | - L Rudski
- Department of Medicine, McGill University, Montreal, Canada; Division of Cardiology, Jewish General Hospital, Montreal, Canada
| | - T Huynh
- Department of Medicine, McGill University, Montreal, Canada; Division of Cardiology, McGill University Health Centre, Montreal, Canada
| | - D Langleben
- Department of Medicine, McGill University, Montreal, Canada; Division of Cardiology, Jewish General Hospital, Montreal, Canada; Lady Davis Institute for Medical Research, Montreal, Canada
| | - M Wang
- Lady Davis Institute for Medical Research, Montreal, Canada
| | | | - M J Fritzler
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - J Pope
- St. Joseph's Healthcare, London, Canada
| | - M Baron
- Department of Medicine, McGill University, Montreal, Canada; Division of Rheumatology, Jewish General Hospital, Room A-725, 3755 Côte Sainte-Catherine Road, Montreal, Quebec H3T 1E2, Canada
| | - M Hudson
- Department of Medicine, McGill University, Montreal, Canada; Lady Davis Institute for Medical Research, Montreal, Canada; Division of Rheumatology, Jewish General Hospital, Room A-725, 3755 Côte Sainte-Catherine Road, Montreal, Quebec H3T 1E2, Canada.
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Worcel J, Tarelho M, Baron M, Ponvert C, Bidat E, Benoist G, Lezmi G. Drug-induced enterocolitis syndrome (DIES) in a 10-year-old girl. Arch Pediatr 2019; 27:51-52. [PMID: 31784292 DOI: 10.1016/j.arcped.2019.11.005] [Citation(s) in RCA: 5] [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: 01/31/2019] [Revised: 08/30/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
Abstract
We report the case of a child presenting with an adverse drug reaction highly suggestive of drug-induced enterocolitis syndrome (DIES) to amoxicillin (AMX). A 10-year-old girl developed repetitive vomiting and pallor without cutaneous or respiratory symptoms 2h after AMX intake. DIES is not a well-described entity, and very few data are available in the literature. In the absence of an existing definition, the diagnosis of DIES can only be suspected and is based on its homology with food protein-induced enterocolitis (FPIES). The major criterion is the recurrence of repetitive and often incoercible vomiting occurring within 1-4h of ingestion of the culprit food in the absence of IgE-mediated allergic classic skin and respiratory symptoms. Once the diagnosis of DIES to AMX is suspected, an open challenge with AMX should be undertaken with caution, under medical supervision in a day hospital unit because of the risk of severe recurrence. Once the diagnosis is confirmed, AMX should be contraindicated to avoid severe reactions.
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Affiliation(s)
- J Worcel
- Service de pneumologie et allergologie pédiatriques, hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - M Tarelho
- Service de pneumologie et allergologie pédiatriques, hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - M Baron
- Service de pédiatrie générale, hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France
| | - C Ponvert
- Service de pneumologie et allergologie pédiatriques, hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - E Bidat
- Service de pédiatrie générale, hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France
| | - G Benoist
- Service de pédiatrie générale, hôpital Ambroise Paré, AP-HP, Boulogne-Billancourt, France
| | - G Lezmi
- Service de pneumologie et allergologie pédiatriques, hôpital Necker-Enfants Malades, AP-HP, Paris, France; Université Paris Descartes, Paris, France.
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Salituri J, Patey N, Takano T, Fiset P, Del Rincon S, Berkson L, Baron M, Hudson M, Baron M, Hudson M, Gyger G, Pope J, Larché M, Khalidi N, Masetto A, Sutton E, Robinson D, Rodriguez-Reyna T, Smith D, Thorne C, Fortin P, Fritzler M. Mammalian target of rapamycin is activated in the kidneys of patients with scleroderma renal crisis. Journal of Scleroderma and Related Disorders 2019; 5:152-158. [DOI: 10.1177/2397198319885488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022]
Abstract
Objectives: Scleroderma renal crisis is a rare but serious complication affecting 2%–15% of patients with systemic sclerosis. Despite treatment with angiotensin-converting enzyme inhibitors, outcomes for scleroderma renal crisis patients are still poor. The cellular signaling mechanisms in scleroderma renal crisis are not yet known. Mammalian target of rapamycin, comprised of the subunits mTORC1 and mTORC2, has been shown to be activated in vascular lesions of renal transplant patients with anti-phospholipid antibody syndrome. Given the similarities between the pathophysiology of scleroderma renal crisis and anti-phospholipid antibody syndrome, we hypothesized that the mammalian target of rapamycin pathway would also be activated in the renal vasculature of patients with scleroderma renal crisis. Methods: We retrospectively analyzed renal biopsies of five patients with scleroderma renal crisis in the Canadian Scleroderma Research Group cohort. Immunostaining was performed using anti-P-S6RP antibodies to evaluate the phosphorylation of mTORC1, and anti-Rictor and anti-S473 to determine activation of mTORC2. Results: Four of the five patients showed mTORC1 activation in arteriolar endothelial cells, and three of the five patients showed mTORC1 activation in the arterial endothelial cells. Two of four samples showed Rictor expression in the arteriolar and arterial endothelial cells, showing mTORC2 activation. There was no expression of mTORC1 or mTORC2 in samples from two healthy controls. Conclusion: We demonstrate that both mTORC1 and mTORC2 are activated in renal biopsies with typical histologic features of scleroderma renal crisis. Dual mammalian target of rapamycin inhibitors are currently available and in development. These findings could inform further research into novel treatment targets for scleroderma renal crisis.
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Affiliation(s)
| | - Natalie Patey
- Department of Pathology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada
| | - Tomoko Takano
- Department of Medicine, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University Health Center, Montreal, QC, Canada
| | - Pierre Fiset
- Department of Medicine, McGill University Health Center, Montreal, QC, Canada
| | | | - Laeora Berkson
- Department of Medicine, McGill University, Montreal, QC, Canada
- Division of Rheumatology, Jewish General Hospital, Montreal, QC, Canada
| | - Murray Baron
- Department of Medicine, McGill University, Montreal, QC, Canada
- Division of Rheumatology, Jewish General Hospital, Montreal, QC, Canada
| | - Marie Hudson
- Department of Medicine, McGill University, Montreal, QC, Canada
- Lady Davis Institute, Montreal, QC, Canada
- Division of Rheumatology, Jewish General Hospital, Montreal, QC, Canada
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Aublé A, Baron M, Grise P, Pfister C, Cornu J. Neuromodulation sacrée et troubles de vidange: étude rétrospective monocentrique. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.205] [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: 11/15/2022]
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Choquet S, Baron M, Soussain C, Houillier C, Gyan E, Soubeyran P, Cassoux N, Touitou V, Bodaghi B, Hoang-Xuan K, Leblond V. TEMOZOLOMIDE IN RELAPSE/REFRACTORY PRIMARY VITREO-RETINAL LYMPHOMA (R/R PVRL): A SIMPLE, CHEAP, EFFECTIVE AND WELL TOLERATED TREATMENT. RESULT OF THE LARGEST STUDY ON R/R PVRL, FROM THE LOC NETWORK. Hematol Oncol 2019. [DOI: 10.1002/hon.79_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- S. Choquet
- Clinical Haematology; APHP, Pitie-Salpetriere; Paris France
| | - M. Baron
- Clinical Haematology; APHP, Pitie-Salpetriere; Paris France
| | - C. Soussain
- Clinical Haematology; Institut Curie, Rene Huguenin; Saint-Cloud France
| | - C. Houillier
- Neuro-Oncology; Pitie Salpetriere Hospital; Paris France
| | - E. Gyan
- Clinical Haematology; CHRU Trousseau; Chambray-lès-Tours France
| | - P. Soubeyran
- Clinical Haematology; Institut Bergonié; Bordeaux France
| | - N. Cassoux
- Ophtalmology; Institut Curie; Paris Paris France
| | - V. Touitou
- Ophtalmology; Pitie Salpetriere Hospital; Paris France
| | - B. Bodaghi
- Ophtalmology; Pitie Salpetriere Hospital; Paris France
| | - K. Hoang-Xuan
- Neuro-Oncology; Pitie Salpetriere Hospital; Paris France
| | - V. Leblond
- Clinical Haematology; APHP, Pitie-Salpetriere; Paris France
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Tannyhill R, Baron M, Troulis M. Do american oral and maxillofacial surgery chief residents feel competent to practice the full scope of the specialty? Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McKinnell JA, Bhaurla S, Marquez-Sung P, Pucci A, Baron M, Kamali T, Bugante J, Schwartz B, Balter S, Terashita D, Butler-Wu S, Gunzenhauser J, Hindler J, Humphries RM. Public Health Efforts Can Impact Adoption of Current Susceptibility Breakpoints, but Closer Attention from Regulatory Bodies Is Needed. J Clin Microbiol 2019; 57:e01488-18. [PMID: 30567751 PMCID: PMC6425187 DOI: 10.1128/jcm.01488-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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] [Received: 09/13/2018] [Accepted: 12/11/2018] [Indexed: 11/20/2022] Open
Abstract
Microbiological testing, including interpretation of antimicrobial susceptibility testing results using current breakpoints, is crucial for clinical care and infection control. Continued use of obsolete Enterobacteriaceae carbapenem breakpoints is common in clinical laboratories. The purposes of this study were (i) to determine why laboratories failed to update breakpoints and (ii) to provide support for breakpoint updates. The Los Angeles County Department of Public Health conducted a 1-year outreach program for 41 hospitals in Los Angeles County that had reported, in a prior survey of California laboratories, using obsolete Enterobacteriaceae carbapenem breakpoints. In-person interviews with hospital stakeholders and customized expert guidance and resources were provided to aid laboratories in updating breakpoints, including support from technical representatives from antimicrobial susceptibility testing device manufacturers. Forty-one hospitals were targeted, 7 of which had updated breakpoints since the prior survey. Of the 34 remaining hospitals, 27 (79%) assumed that their instruments applied current breakpoints, 17 (50%) were uncertain how to change breakpoints, and 10 (29%) lacked resources to perform a validation study for off-label use of the breakpoints on their systems. Only 7 hospitals (21%) were familiar with the FDA/CDC Antibiotic Resistance Isolate Bank. All hospitals launched a breakpoint update process; 16 (47%) successfully updated breakpoints, 12 (35%) received isolates from the CDC in order to validate breakpoints on their systems, and 6 (18%) were planning to update within 1 year. The public health intervention was moderately successful in identifying and overcoming barriers to updating Enterobacteriaceae carbapenem breakpoints in Los Angeles hospitals. However, the majority of targeted hospitals continued to use obsolete breakpoints despite 1 year of effort. These findings have important implications for the quality of patient care and patient safety. Other public health jurisdictions may want to utilize similar resources to bridge the patient safety gap, while manufacturers, the FDA, and others determine how best to address this growing public health issue.
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Affiliation(s)
- James A McKinnell
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
- Infectious Disease Clinical Outcomes Research Unit, Division of Infectious Disease, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, California, USA
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - S Bhaurla
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - P Marquez-Sung
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - A Pucci
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - M Baron
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - T Kamali
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - J Bugante
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - B Schwartz
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - S Balter
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - D Terashita
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - S Butler-Wu
- University of Southern California, Los Angeles, California, USA
| | - J Gunzenhauser
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - J Hindler
- Acute Communicable Disease Control Unit, Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - R M Humphries
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Ferdowsi N, Stevens W, Baron M, Nikpour M. Damage indices in rheumatic diseases: A systematic review of the literature. Semin Arthritis Rheum 2019; 49:27-34. [PMID: 30745021 DOI: 10.1016/j.semarthrit.2019.01.007] [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: 09/27/2018] [Revised: 12/22/2018] [Accepted: 01/14/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To review the current literature, and evaluate the psychometric properties of disease damage indices in rheumatic diseases. METHODS A search of Medline, EMBASE, and Cochrane Library databases was performed to June 2018 to identify damage indices in all systemic rheumatic diseases. Articles were included in a systematic review if indices were composite (multi-organ) in nature and if adequate detail on methodology was described. Articles pertaining to the validation of these indices were also reviewed in order to assess the psychometric properties of the indices using the Outcome Measures in Rheumatology Arthritis Clinical Trials (OMERACT) filter as a guide. RESULTS Of the 2659 articles retrieved through the search, we identified 7 damage indices in five diseases: idiopathic inflammatory myopathy, systemic lupus erythematosus, systemic vasculitis, Sjӧgren's syndrome and antiphospholipid syndrome. A further 48 articles were identified pertaining to the validation of these damage indices. The methodological process for the development of these indices included expert consensus, item reduction and item weighting methods. The level of validation that these indices have achieved is variable, with only 2 damage indices fulfilling all criteria of the OMERACT filter. CONCLUSIONS To date, there have been 7 composite disease damage indices created in a variety of rheumatic diseases, with the exception of systemic sclerosis (SSc). This review has informed methodology for the development of a disease damage index in SSc.
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Affiliation(s)
- N Ferdowsi
- The University of Melbourne, St Vincent's Hospital, Melbourne, Australia; St Vincent's Hospital, Melbourne, Australia
| | - W Stevens
- St Vincent's Hospital, Melbourne, Australia
| | - M Baron
- Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, Canada
| | - M Nikpour
- The University of Melbourne, St Vincent's Hospital, Melbourne, Australia; St Vincent's Hospital, Melbourne, Australia.
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Baron M, Marie-Aimée P, Hedli O, Le Normand L, Levesque A, Rigaud J. Gestion de la récidive d’incontinence urinaire après ablation de bandelette sous-urétrale pour douleur pelvienne ou périnéale. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gas J, Matillon X, Bart S, Dominique I, Akakpo W, Olivier J, Gambachizde D, Lebacle C, Nedelec M, Baron M, Gondran-Tellier B, Manuguerra A, Perrot E, Bergerat S, Pradére B. Évaluation du burn-out chez les urologues en formation en France. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Baron M, Hausfater P, Yordanov Y. Caractéristiques de la première promotion nationale d’internes du nouveau diplôme d’études spécialisées de médecine d’urgence. Ann Fr Med Urgence 2018. [DOI: 10.3166/afmu-2018-0092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction : Depuis novembre 2017, la médecine d’urgence est filiarisée en France. Le profil des internes ayant choisi cette spécialité à l’issue de l’examen classant national, inconnu actuellement, différerait de celui de leurs aînés du diplôme d’études spécialisées complémentaire. Nous avons voulu connaître les caractéristiques des étudiants inscrits en phase socle du nouveau diplôme d’études spécialisées de médecine d’urgence, les motivations de leur choix et leur vision de leur futur exercice.
Méthode : Nous avons mené une étude épidémiologique transversale déclarative à partir d’un questionnaire anonyme envoyé par courriel à tous les internes de phase socle du diplôme de médecine d’urgence affectés en 2017 dans les 28 subdivisions françaises.
Résultats : Trois cent soixante-dix-sept internes ont répondu, dont 51 % de femmes, et l’âge moyen était de 26 ans. Quatrevingt- six pour cent avaient réalisé un stage aux urgences et 44 % un stage ou des gardes en service d’aide médicale urgente. La médecine d’urgence était un premier choix chez 81 % des étudiants et un choix par défaut chez 18 %. Leurs principales motivations étaient la transversalité de la spécialité, les gestes techniques, le contexte aigu, le travail en équipe et les lieux d’exercice variés. La majorité souhaitait exercer à l’hôpital public. Quatre-vingt-douze pour cent envisageaient un exercice partagé entre urgences et service d’aide médicale urgente. Leurs principales craintes concernaient l’absence de réorientation possible et l’épuisement.
Discussion : La très grande majorité des internes du diplôme d’études spécialisées de médecine d’urgence sont venus vers la spécialité par choix. Malgré leur jeune expérience, ils ont des idées bien précises du type de pratique qu’ils souhaiteraient. L’exercice exclusif, qu’il soit aux urgences ou en service mobile d’urgence et de réanimation, ne semble plus être le modèle idéal pour ces jeunes professionnels qui plébiscitent l’exercice partagé.
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Hascoet J, Peyronnet B, Forin V, Baron M, Capon G, Prudhomme T, Allenet C, Tournier S, Maurin C, Cornu J, Bouali O, Peycelon M, Arnaud A, Renaux-Petel M, Liard A, Olivari-Philiponnet C, Karsenty G, Manunta A, Gamé X. Intra-detrusor injections of botulinum toxin type a in children with spina bifida: A multicenter study. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.121] [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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Liu YP, Rajamanikham V, Baron M, Patel S, Mathur SK, Schwantes EA, Ober C, Jackson DJ, Gern JE, Lemanske RF, Smith JA. Association of ORMDL3 with rhinovirus-induced endoplasmic reticulum stress and type I Interferon responses in human leucocytes. Clin Exp Allergy 2017; 47:371-382. [PMID: 28192616 DOI: 10.1111/cea.12903] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 01/11/2017] [Accepted: 02/06/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Children with risk alleles at the 17q21 genetic locus who wheeze during rhinovirus illnesses have a greatly increased likelihood of developing childhood asthma. In mice, overexpression of the 17q21 gene ORMDL3 leads to airway remodelling and hyperresponsiveness. However, the mechanisms by which ORMDL3 predisposes to asthma are unclear. Previous studies have suggested that ORMDL3 induces endoplasmic reticulum (ER) stress and production of the type I interferon (IFN)-regulated chemokine CXCL10. OBJECTIVE The purpose of this study was to determine the relationship between ORMDL3 and rhinovirus-induced ER stress and type I IFN in human leucocytes. METHODS ER stress was monitored by measuring HSPA5, CHOP and spliced XBP1 gene expression, and type I IFN by measuring IFNB1 (IFN-β) and CXCL10 expression in human cell lines and primary leucocytes following treatment with rhinovirus. Requirements for cell contact and specific cell type in ORMDL3 induction were examined by transwell assay and depletion experiments, respectively. Finally, the effects of 17q21 genotype on the expression of ORMDL3, IFNB1 and ER stress genes were assessed. RESULTS THP-1 monocytes overexpressing ORMDL3 responded to rhinovirus with increased IFNB1 and HSPA5. Rhinovirus-induced ORMDL3 expression in primary leucocytes required cell-cell contact, and induction was suppressed by plasmacytoid dendritic cell depletion. The degree of rhinovirus-induced ORMDL3, HSPA5 and IFNB1 expression varied by leucocyte type and 17q21 genotype, with the highest expression of these genes in the asthma-associated genotype. CONCLUSIONS AND CLINICAL RELEVANCE Multiple lines of evidence support an association between higher ORMDL3 and increased rhinovirus-induced HSPA5 and type I IFN gene expression. These associations with ORMDL3 are cell type specific, with the most significant 17q21 genotype effects on ORMDL3 expression and HSPA5 induction evident in B cells. Together, these findings have implications for how the interaction of increased ORMDL3 and rhinovirus may predispose to asthma.
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Affiliation(s)
- Y-P Liu
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - V Rajamanikham
- Department of Biostatistics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - M Baron
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - S Patel
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - S K Mathur
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - E A Schwantes
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - C Ober
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - D J Jackson
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - J E Gern
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - R F Lemanske
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - J A Smith
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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De Vergie S, Gaschignard N, Baron M, Branchereau J, Luyckx F, Butel T, Perrouin-Verbe MA, Bouchot O, Rigaud J. [Long-term outcomes of prostate cancer patients with lymph nodes metastasis after radical prostatectomy and pelvic lymph node dissection]. Prog Urol 2017; 28:25-31. [PMID: 29221663 DOI: 10.1016/j.purol.2017.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 07/09/2017] [Revised: 09/29/2017] [Accepted: 10/19/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate biochemical recurrence-free survival (RFS) and to identify useful predictors of such survival in localized prostate cancer patients (cN0) and pelvic lymph node metastasis (pN+) treated with radical prostatectomy and pelvic lymph node dissection. PATIENTS AND METHODS This multicenter and retrospective study, assessed overall survival (OS), cancer specific survival (CSS) and biochemical recurrence-free survival (RFS), between January 2005 until December 2010 with 5 years of distance. We evaluated factors predicting long-term RFS in node positive prostate cancer patients. RESULTS Thus, 30 patients were included. Median follow-up was 89.9±27.4 months. After surgery, patients were treated with surveillance (n=4, 13.5%), adjuvant hormone therapy (n=22, 73%) or combination of radio and hormone therapy, (n=4, 13.5%). During the follow-up, 50% of patients had biochemical recurrence, with a mean time period of 38±30 months. Five and 10-year RFS were 57% and 41% respectively. Extra lymph nodes extension (P=0.00021) and pathological margin status (P=0.0065) were independent predictors of 5-year RFS. CONCLUSION Biochemical RFS of patients treated with radical prostatectomy and subclinical lymph node metastatic disease is adequate and multifactorial. However, this study identifies pathological margin status and extra lymph node extension as independent factors of b RFS. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- S De Vergie
- Service d'urologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - N Gaschignard
- Service d'urologie, centre hospitalier de la Roche/Yon, 85000 La Roche/Yon, France
| | - M Baron
- Service d'urologie, centre hospitalier de Saint-Nazaire, 44600 Saint-Nazaire, France
| | - J Branchereau
- Service d'urologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - F Luyckx
- Service d'urologie, centre hospitalier de la Roche/Yon, 85000 La Roche/Yon, France
| | - T Butel
- Service d'oncologie pédiatrique, institut Gustave-Roussy, 94805 Villejuif, France
| | - M-A Perrouin-Verbe
- Service d'urologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - O Bouchot
- Service d'urologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - J Rigaud
- Service d'urologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
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Malval B, Rebibo JD, Baron M, Nouhaud FX, Pfister C, Cornu JN, Grise P. Long-term outcomes of I-Stop TOMS™ male sling implantation for post-prostatectomy incontinence management. Prog Urol 2017; 27:1084-1090. [DOI: 10.1016/j.purol.2017.09.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/12/2017] [Accepted: 09/14/2017] [Indexed: 10/18/2022]
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Baron M, Atmani K, Gourcerol G. Effet de la sensibilisation vésicale et de la stimulation nociceptive colique sur l’activation chronique des centres neuronaux médullaires chez la souris. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Baron M, Delcourt C, Pfister C, Cornu J. Efficacité et tolérance à long terme de la toxine botulique Dysport dans l’hyperactivité vésicale idiopathique. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.155] [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: 10/18/2022]
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Johnson SR, Soowamber ML, Fransen J, Khanna D, Van Den Hoogen F, Baron M, Matucci-Cerinic M, Denton CP, Medsger TA, Carreira PE, Riemekasten G, Distler J, Gabrielli A, Steen V, Chung L, Silver R, Varga J, Müller-Ladner U, Vonk MC, Walker UA, Wollheim FA, Herrick A, Furst DE, Czirjak L, Kowal-Bielecka O, Del Galdo F, Cutolo M, Hunzelmann N, Murray CD, Foeldvari I, Mouthon L, Damjanov N, Kahaleh B, Frech T, Assassi S, Saketkoo LA, Pope JE. There is a need for new systemic sclerosis subset criteria. A content analytic approach. Scand J Rheumatol 2017; 47:62-70. [DOI: 10.1080/03009742.2017.1299793] [Citation(s) in RCA: 14] [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] [Indexed: 01/06/2023]
Affiliation(s)
- SR Johnson
- Toronto Scleroderma Program, Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - ML Soowamber
- Toronto Scleroderma Program, Division of Rheumatology, Department of Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - J Fransen
- The Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - D Khanna
- Division of Rheumatology, University of Michigan Scleroderma Program, Ann Arbor, MI, USA
| | - F Van Den Hoogen
- The Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - M Baron
- Division of Rheumatology, Department of Medicine, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - M Matucci-Cerinic
- Department of Rheumatology AVC, Department of BioMedicine, Division of Rheumatology AOUC, Department of Medicine and Denothe Centre, University of Florence, Florence, Italy
| | - CP Denton
- Centre for Rheumatology and Connective Tissue Diseases, Royal Free Hospital, London, UK
| | - TA Medsger
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - PE Carreira
- Department of Rheumatology, University Hospital 12 de Octubre, Madrid, Spain
| | - G Riemekasten
- Department of Rheumatology, University of Lübeck, Lung Research Center Borstel, a Leibniz institute, Lübeck, Germany
| | - J Distler
- Department of Internal Medicine 3 and Institute for Clinical Immunology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - A Gabrielli
- Department of Molecular and Clinical Sciences, Clinical Medicine, University of Marche, Ancona, Italy
| | - V Steen
- Department of Medicine, Division of Rheumatology, Clinical Immunology and Allergy, Georgetown University School of Medicine, Washington, DC, USA
| | - L Chung
- Department of Medicine and Dermatology, Division of Immunology and Rheumatology, Stanford University, Stanford, CA, USA
| | - R Silver
- Department of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - J Varga
- Department of Medicine, Division of Rheumatology, Clinical Immunology and Allergy, Northwestern University, Chicago, IL, USA
| | - U Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Kerckhoff Clinic, Bad Nauheim, Germany
| | - MC Vonk
- Department of Rheumatic Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - UA Walker
- Department of Rheumatology, University of Basel, Basel, Switzerland
| | - FA Wollheim
- Department of Rheumatology, Lund University Hospital, Lund, Sweden
| | - A Herrick
- Centre for Musculoskeletal Research, Institute of Inflammation and Repair, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - DE Furst
- Division of Rheumatology, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - L Czirjak
- Department of Rheumatology and Immunology, University of Pécs, Clinical Center, Pécs, Hungary
| | - O Kowal-Bielecka
- Department of Rheumatology and Internal Medicine, Medical University of Bialystok, Białystok, Poland
| | - F Del Galdo
- Scleroderma Programme, Leeds Institute of Rheumatic and Musculoskeletal Medicine, LMBRU, University of Leeds, Leeds, UK
| | - M Cutolo
- Research Laboratory and Academic Division of Clinical Rheumatology, University of Genova, IRCCS AOU S Martino, Genova, Italy
| | - N Hunzelmann
- Department of Dermatology, University of Cologne, Cologne, Germany
| | - CD Murray
- Inflammatory Bowel Disease Unit, Royal Free London NHS Foundation Trust, London, UK
| | - I Foeldvari
- Hamburg Center for Paediatric Rheumatology, Eilbek Clinic, Hamburg, Germany
| | - L Mouthon
- Department of Internal Medicine, Paris Descartes University, the Public Hospitals of Paris, Paris, France
| | - N Damjanov
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia
| | - B Kahaleh
- Division of Rheumatology, Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA
| | - T Frech
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - S Assassi
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - LA Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, Tulane University Lung Center, New Orleans, LA, USA
| | - JE Pope
- Division of Rheumatology, Department of Medicine, St Joseph Health Care, University of Western Ontario, London, ON, Canada
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Mercadal S, Vidal N, López-Parra M, Ibañez M, Caldú R, Bobillo S, Barceló I, García E, Martinez P, Cacabelos P, Dlouhy I, Sancho J, Muntañola A, Gómez L, Erro E, Gállego J, Salar A, Caballero A, Solé M, Huertas N, Estela J, Baron M, Barbero N, González-Barca E, Graus F, Velasco R. Initial management of primary central nervous system lymphoma in Spain in the last decade. The experience of the GELTAMO and Spanish neuro-oncology groups. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S. Mercadal
- Hematology; Catalan Institute of Oncology. Hospital Duran i Reynals., L'Hospitalet de Llobregat; Barcelona Spain
| | - N. Vidal
- Pathology; Hospital de Bellvitge, L'Hospitalet de Llobregat; Barcelona Spain
| | - M. López-Parra
- Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - M. Ibañez
- Neurology; Hospital Universitario i Politècnic La Fe; Valencia Spain
| | - R. Caldú
- Neurology; Hospital Universitario Miguel Servet; Zaragoza Spain
| | - S. Bobillo
- Hematology; Hospital Vall d'Hebrón; Barcelona Spain
| | - I. Barceló
- Neurology; Hospital Universitario Son Espases; Palma de Mallorca Spain
| | - E. García
- Neurology; Hospital Universitario Virgen de la Arrixaca; Murcia Spain
| | - P. Martinez
- Hematology; Hospital Universitario Doce de Octubre; Madrid Spain
| | - P. Cacabelos
- Neurology; Complejo hospitalario Santiago Compostela; Santiago Compostela Spain
| | - I. Dlouhy
- Hematology; Hospital Clínic; Barcelona Spain
| | - J. Sancho
- Hematology; ICO. Hospital Germans Trias i Pujol; Badalona Spain
| | - A. Muntañola
- Hematology; Hospital Mutua de Terrassa; Terrassa Spain
| | - L. Gómez
- Neurology; Hospital Quirón; Madrid Spain
| | - E. Erro
- Neurology; Hospital de Navarra; Pamplona Spain
| | - J. Gállego
- Neurology; Clínica Universitaria de Navarra; Pamplona Spain
| | - A. Salar
- Hematology; Hospital del Mar; Barcelona Spain
| | - A. Caballero
- Hematology; Hospital de Sant Pau; Barcelona Spain
| | - M. Solé
- Hematology; Hospital Virgen del Rocío; Sevilla Spain
| | - N. Huertas
- Neurology; Hospiatl Severo Ochoa; Leganés Spain
| | - J. Estela
- Neurology; Hospital Parc Taulí; Sabadell Spain
| | - M. Baron
- Neurology; Hospital Fundación Alcorcón; Alcorcón Spain
| | - N. Barbero
- Neurology; Hospital Rey Juan Carlos; Móstoles Spain
| | - E. González-Barca
- Hematology; Catalan Institute of Oncology. Hospital Duran i Reynals., L'Hospitalet de Llobregat; Barcelona Spain
| | - F. Graus
- Hematology; Hospital Clínic; Barcelona Spain
| | - R. Velasco
- Neurology; Hospital de Bellvitge, L'Hospitalet de Llobregat; Barcelona Spain
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Baron M, Lozeron P, Harel S, Bengoufa D, Vignon M, Asli B, Malphettes M, Parquet N, Brignier A, Fermand JP, Kubis N, Arnulf B. Plasma exchanges for severe acute neurological deterioration in patients with IgM anti-myelin-associated glycoprotein (anti-MAG) neuropathy. J Neurol 2017; 264:1132-1135. [DOI: 10.1007/s00415-017-8502-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 03/20/2017] [Accepted: 04/18/2017] [Indexed: 12/14/2022]
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Vignon M, Placais L, Malphettes M, Bouaziz JD, Asli B, Bedossa P, Rivet J, Szalat R, Zagdanski AM, Rybojad M, Fermand JP, Baron M, Rautou PE, Arnulf B. Non-cirrhotic portal hypertension in necrobiotic xanthogranuloma associated with monoclonal gammopathy. J Eur Acad Dermatol Venereol 2017; 31:e403-e405. [PMID: 28295661 DOI: 10.1111/jdv.14213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- M Vignon
- Department of Clinical Immunology, Saint-Louis Hospital, 75010, Paris, France.,Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, 75010, Paris, France
| | - L Placais
- Department of Clinical Immunology, Saint-Louis Hospital, 75010, Paris, France
| | - M Malphettes
- Department of Clinical Immunology, Saint-Louis Hospital, 75010, Paris, France.,Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, 75010, Paris, France
| | - J D Bouaziz
- Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, 75010, Paris, France.,Department of Dermatology, Saint-Louis Hospital, 75010, Paris, France
| | - B Asli
- Department of Clinical Immunology, Saint-Louis Hospital, 75010, Paris, France.,Department of Dermatology, Saint-Louis Hospital, 75010, Paris, France
| | - P Bedossa
- Department of Pathology, Beaujon Hospital, 75010, Paris, France
| | - J Rivet
- Department of Pathology, Saint-Louis Hospital, 75010, Paris, France
| | - R Szalat
- Department of Clinical Immunology, Saint-Louis Hospital, 75010, Paris, France.,Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, 75010, Paris, France
| | - A M Zagdanski
- Department of Radiology, Saint Louis Hospital, 75010, Paris, France
| | - M Rybojad
- Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, 75010, Paris, France.,Department of Dermatology, Saint-Louis Hospital, 75010, Paris, France
| | - J P Fermand
- Department of Clinical Immunology, Saint-Louis Hospital, 75010, Paris, France
| | - M Baron
- Department of Clinical Immunology, Saint-Louis Hospital, 75010, Paris, France
| | - P E Rautou
- Department of Hepatology, Beaujon Hospital, 92110, Clichy, France
| | - B Arnulf
- Department of Clinical Immunology, Saint-Louis Hospital, 75010, Paris, France.,Groupe d'Etude des Dermatoses associées à une Immunoglobuline Monoclonale, 75010, Paris, France
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Baron M, Hourie A, Nouhaud F, Pfister C, Grise P, Cornu J. Traitement séquentiel par pose de ballonnets latéro-uréthraux après échec de bandelettes sous-urétrales dans l’incontinence masculine. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Huet R, Baron M, Nouhaud F, Cornu J, Bensalah K, Peyronnet B, Verhoest G, Sibert L, Vincendeau S, Mathieu R. Comparaison multicentrique de l’énucléation prostatique au laser Greenlight® (GreenLEP) comparée au laser Holmium (HoLEP) dans le traitement chirurgical de l’HBP en début d’expérience. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Peyronnet B, Even A, Verrando A, Capon G, De Seze M, Hascoet J, Lenormand C, Maurin C, Biardeau X, Monleon L, Castel-lacanal E, Marcelli F, Perrouin-Verbe M, Allenet C, Mouracade P, Baron M, Boutin J, Saussine C, Grise P, Lenormand L, Chartier-Kastler E, Cornu J, Karsenty G, Schurch B, Denys P, Manunta A, Amarenco G, Gamé X. Injections intra-détrusoriennes de toxine botulique chez l’adulte spina bifida : résultats d’une étude multicentrique. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.111] [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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Peyronnet B, Amarenco G, De seze M, Schurch B, Even A, Capon G, Baron M, Hascoet J, Castel-lacanal E, Lenormand C, Biardeau X, Maurin C, Monleon L, Marcelli F, Perrouin-verbe M, Allenet C, Cornu J, Mouracade P, Boutin J, Saussine C, Grise P, Lenormand L, Kerdraon J, Chartier-kastler E, Karsenty G, Denys P, Manunta A, Gamé X. Peut-on éviter l’entérocystoplastie d’agrandissement en cas d’échec d’une première injection intra-détrusorienne de toxine botulique chez un patient spina bifida ? Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.112] [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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Auble A, Baron M, Ala C, Hourie A, Grise P, Nicolas CJ. Repressurisation de sphincter AMS800 pour perte secondaire d’efficacité : une expérience monocentrique. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.269] [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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Berton-Rigaud D, Selle F, Floquet A, Mollon D, Lescaut W, Kaminsky MC, Ray-Coquard I, Largillier R, Savoye AM, Barletta H, Pautier P, Orfeuvre H, Baron M, Marti A, Mouysset JL, Paoli JB, Cailleux PE, Cornea C, Pujade-Lauraine E. Use of bevacizumab (Bev) in real life for first-line (fl) treatment of ovarian cancer (OC). Part1: the ENCOURAGE cohort of 1158 patients (pts) by GINECO. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.42] [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: 11/14/2022] Open
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Baron M, Nouhaud FX, Delcourt C, Grise P, Pfister C, Cornu JN, Sibert L. [HoLEP learning curve: Toward a standardised formation and a team strategy]. Prog Urol 2016; 26:492-9. [PMID: 27614386 DOI: 10.1016/j.purol.2016.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 07/02/2016] [Accepted: 08/01/2016] [Indexed: 11/30/2022]
Abstract
AIM Holmium laser enucleation of prostate (HoLEP) is renowned for the difficulty of its learning curve. Our aim was to evaluate the interest of a three-step tutorial in the HoLEP learning curve, in a university center. METHODS It is a retrospective, monocentric study of the 82 first procedures done consecutively by the same operator with a proctoring in early experience and after 40 procedures. For all patients were noted: enucleation efficiency (g/min), morcellation efficiency (g/min), percentage of enucleated tissue (enucleated tissue/adenome weigth evaluated by ultrasonography. g/g), perioperative morbidity (Clavien), length of hospital stay, length of urinary drainage, functional outcomes at short and middle term (Qmax, post-void residual volume [PVR], QOL scores and IPSS at 3 and 6months). RESULTS Enucleation and morcellation efficiency were significantly higher after the second proctoring (0.87 vs 0.44g/min; P<0.0001 and 4.2 vs 3.37g/min, P=0.038, respectively) so as the prostatic volume (43.5 vs 68.1mL, P=0.0001). Percentage of enucleated tissue was higher in the second group, however, the difference was not significant (69.5% vs 80.4%, P=0.03). Per- and postoperative complications, hospital length of stay, urinary drainage length and functional results at 3 and 6months were not significantly different. CONCLUSION The learning curve did not interfere with functional results. The second proctoring was essential to us in order to grasp the technique. These data underlined the necessity of a pedagogic reflexion in order to built a standardized formation technique to the HoLEP. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- M Baron
- Service d'urologie, université de Rouen, CHU Charles-Nicolle, 1 rue de Germont, 76031 Rouen cedex, France
| | - F-X Nouhaud
- Service d'urologie, université de Rouen, CHU Charles-Nicolle, 1 rue de Germont, 76031 Rouen cedex, France
| | - C Delcourt
- Service d'urologie, université de Rouen, CHU Charles-Nicolle, 1 rue de Germont, 76031 Rouen cedex, France
| | - P Grise
- Service d'urologie, université de Rouen, CHU Charles-Nicolle, 1 rue de Germont, 76031 Rouen cedex, France
| | - C Pfister
- Service d'urologie, université de Rouen, CHU Charles-Nicolle, 1 rue de Germont, 76031 Rouen cedex, France
| | - J-N Cornu
- Service d'urologie, université de Rouen, CHU Charles-Nicolle, 1 rue de Germont, 76031 Rouen cedex, France.
| | - L Sibert
- Service d'urologie, université de Rouen, CHU Charles-Nicolle, 1 rue de Germont, 76031 Rouen cedex, France
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Hoa S, Hudson M, Troyanov Y, Proudman S, Walker J, Stevens W, Nikpour M, Assassi S, Mayes M, Wang M, Baron M, Fritzler M. Single-specificity anti-Ku antibodies in an international cohort of 2140 systemic sclerosis subjects: clinical associations. Medicine (Baltimore) 2016; 95:e4713. [PMID: 27583908 PMCID: PMC5008592 DOI: 10.1097/md.0000000000004713] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Autoantibodies directed against the Ku autoantigen are present in systemic sclerosis (SSc) and have been associated with myositis overlap and interstitial lung disease (ILD). However, there is a paucity of data on the clinical correlates of anti-Ku antibodies in the absence of other SSc-specific antibodies. The aim of this study was to assess the clinical correlates of single-specificity anti-Ku in SSc.An international (Canada, Australia, USA, Mexico) cohort of 2140 SSc subjects was formed, demographic and clinical variables were harmonized, and sera were tested for anti-Ku using a line immunoassay. Associations between single-specificity anti-Ku antibodies (i.e., in isolation of other SSc-specific antibodies) and outcomes of interest, including myositis, ILD, and survival, were investigated.Twenty-four (1.1%) subjects had antibodies against Ku, and 13 (0.6%) had single-specificity anti-Ku antibodies. Subjects with single-specificity anti-Ku antibodies were more likely to have ILD (58% vs 34%), and to have increased creatine kinase levels (>3× normal) at baseline (11% vs 1%) and during follow-up (10% vs 2%). No difference in survival was noted in subjects with and without single-specificity anti-Ku antibodies.This is the largest cohort to date focusing on the prevalence and disease characteristics of single-specificity anti-Ku antibodies in subjects with SSc. These results need to be interpreted with caution in light of the small sample. International collaboration is key to understanding the clinical correlates of uncommon serological profiles in SSc.
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Affiliation(s)
- S. Hoa
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - M. Hudson
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Division of Rheumatology, Jewish General Hospital, Montreal, Quebec, Canada
- Correspondence: Dr Marie Hudson, Jewish General Hospital, Room A-725, 3755 Côte Sainte-Catherine Road, Montreal, Quebec H3T 1E2, Canada (e-mail: )
| | - Y. Troyanov
- Division of Rheumatology, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
- Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - S. Proudman
- Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia
- Discipline of Medicine, University of Adelaide, Bedford Park, Australia
| | - J. Walker
- Department of Allergy and Immunology, Flinders Medical Centre, Bedford Park, Australia
| | - W. Stevens
- Department of Rheumatology, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - M. Nikpour
- Department of Rheumatology, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Department of Medicine, The University of Melbourne at St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - S. Assassi
- Division of Rheumatology and Immunogenetics, University of Texas Health Science Centre at Houston, Houston, TX
| | - M.D. Mayes
- Division of Rheumatology and Immunogenetics, University of Texas Health Science Centre at Houston, Houston, TX
| | - M. Wang
- Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - M. Baron
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Division of Rheumatology, Jewish General Hospital, Montreal, Quebec, Canada
| | - M.J. Fritzler
- Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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Monticone G, Shimizu H, Baron M. ‘Notch’ wings to target cancer. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61604-0] [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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