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Binet L, Debillon T, Beck J, Vilotitch A, Guellec I, Ego A, Chevallier M. Effect of gestational age on cerebral lesions in neonatal encephalopathy. Arch Dis Child Fetal Neonatal Ed 2024:fetalneonatal-2023-326131. [PMID: 38418209 DOI: 10.1136/archdischild-2023-326131] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/08/2024] [Indexed: 03/01/2024]
Abstract
OBJECTIVE To determine the risk on brain lesions according to gestational age (GA) in neonates with neonatal encephalopathy. DESIGN Secondary analysis of the prospective national French population-based cohort, Long-Term Outcome of NeonataL EncePhALopathy. SETTING French neonatal intensive care units. PATIENTS Neonates with moderate or severe neonatal encephalopathy (NE) born at ≥34 weeks' GA (wGA) between September 2015 and March 2017. MAIN OUTCOME MEASURES The results of MRI performed within the first 12 days were classified in seven injured brain regions: basal ganglia and thalami, white matter (WM), cortex, posterior limb internal capsule, corpus callosum, brainstem and cerebellum. A given infant could have several brain structures affected. Risk of brain lesion according to GA was estimated by crude and adjusted ORs (aOR). RESULTS MRI was available for 626 (78.8%) of the 794 included infants with NE. WM lesions predominated in preterm compared with term infants. Compared with 39-40 wGA neonates, those born at 34-35 wGA and 37-38 wGA had greater risk of WM lesions after adjusting for perinatal factors (aOR 4.0, 95% CI (1.5 to 10.7) and ORa 2.0, 95% CI (1.1 to 3.5), respectively). CONCLUSION WM is the main brain structure affected in late-preterm and early-term infants with NE, with fewer WM lesions as GA increases. This finding could help clinicians to estimate prognosis and improve the understanding of the pathophysiology of NE. TRIAL REGISTRATION NUMBER NCT02676063, ClinicalTrials.gov.
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Affiliation(s)
- Lauren Binet
- Neonatal Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France
| | - Thierry Debillon
- Neonatal Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France
- Université Grenoble Alpes, CNRS, Public Health Department, Grenoble Alpes, Grenoble Institute of Engineering, TIMC-IMAG, Grenoble, France
| | - Jonathan Beck
- Department of Neonatology, Reims University Hospital Alix de Champagne, Reims, France
| | - Antoine Vilotitch
- Univversité Grenoble Alpes, Data Engineering Unit, Public Health Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Isabelle Guellec
- 7 Neonatal Intensive Care Medicine Department, University Hospital Nice Cote d'Azur, Nice, France
| | - Anne Ego
- Université Grenoble Alpes, CNRS, Public Health Department, Grenoble Alpes, Grenoble Institute of Engineering, TIMC-IMAG, Grenoble, France
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, F-75004, Paris, France
| | - Marie Chevallier
- Neonatal Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France
- Université Grenoble Alpes, CNRS, Public Health Department, Grenoble Alpes, Grenoble Institute of Engineering, TIMC-IMAG, Grenoble, France
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Barbier M, Boisseau I, Lemale J, Chevallier M, Mortamet G. Medical management of vegetarian and vegan children in France: Medical practices and parents' perceptions. Arch Pediatr 2024; 31:136-140. [PMID: 38135618 DOI: 10.1016/j.arcped.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 10/10/2023] [Accepted: 10/29/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES Despite a significant increase in the prevalence of vegetarianism and veganism in children in France, data on the care pathway of these children are scarce. This study aimed to describe the characteristics of the medical follow-up of vegan/vegetarian children, to evaluate the medical practices, and to analyze the perceptions of parents. MATERIALS AND METHODS This was a double cross-sectional survey. One questionnaire was sent to parents of vegetarian/vegan children, and the other to French doctors (pediatricians or general practitioners). RESULTS A total of 241 vegetarian families responded to the study and nearly one quarter (n = 67, 28 %) were unsatisfied with the medical follow-up of their child. Parents considered that their child's diet was responsible for refusing a medical consultation in 11 % (n = 27) of cases. In almost one third of cases (n = 70, 29 %), participants declared that the doctor was unaware of their child's diet. Vitamin B12 supplementation was commonly used (n = 195, 81 %), mainly by self-medication, and laboratory testing was performed for 30 % (n = 72) of children. Regarding the questionnaire for doctors, most of the participants (n = 318/501, 63 %) reported having vegetarian/vegan children in their cohort. A few of them (n = 70, 14 %) declared they did not systematically screen for meat and fish consumption during consultations. Doctors caring for vegetarian/vegan children had 27 % correct answers to questions regarding the nutrition guidelines. Overall, 36 % of them (n = 117) systematically referred the child to a specialist. CONCLUSION The medical follow-up of vegetarian/vegan children in France is very heterogeneous. Parents and doctors alike stressed the need to develop reliable sources of knowledge. A systematic screening of the diet and a referral to a specialist could help to improve the management of vegetarian/vegan children.
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Affiliation(s)
- Marion Barbier
- Pediatric Department, Grenoble-Alps University Hospital, La Tronche, France.
| | - Irène Boisseau
- Pediatric Department, Grenoble-Alps University Hospital, La Tronche, France
| | - Julie Lemale
- Department of Nutrition and Gastroenterology Pediatric Unit, Trousseau Hospital (AP-HP), Sorbonne University, Paris, France
| | - Marie Chevallier
- Neonatal Intensive Care Unit, Grenoble-Alps University Hospital, La Tronche, France
| | - Guillaume Mortamet
- Pediatric Intensive Care Unit, Grenoble-Alps University Hospital, La Tronche, France
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3
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Loth C, Treluyer L, Pierrat V, Ego A, Aubert AM, Debillon T, Zeitlin J, Torchin H, Chevallier M. Variations in neonatal mortality of preterm infants with intraparenchymal haemorrhage in Europe: the EPICE cohort. Arch Dis Child Fetal Neonatal Ed 2024:fetalneonatal-2023-326038. [PMID: 38272659 DOI: 10.1136/archdischild-2023-326038] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 01/14/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE The aim of this study was to investigate variations in mortality before neonatal intensive care unit (NICU) discharge of infants born preterm with intraparenchymal haemorrhage (IPH) in Europe with a special interest for withdrawing life-sustaining therapy (WLST). DESIGN Secondary analysis of the Effective Perinatal Intensive Care in Europe (EPICE) cohort, 2011-2012. SETTING Nineteen regions in 11 European countries. PATIENTS All infants born between 24+0 and 31+6 weeks' gestational age (GA) with a diagnosis of IPH. MAIN OUTCOME MEASURES Mortality rate with multivariable analysis after adjustment for GA, antenatal steroids and gender. WLST policies were described among NICUs and within countries. RESULTS Among 6828 infants born alive between 24+0 and 31+6 weeks' GA and without congenital anomalies admitted to NICUs, IPH was diagnosed in 234 infants (3.4%, 95% CI 3.3% to 3.9%) and 138 of them (59%) died. The median age at death was 6 days (3-13). Mortality rates varied significantly between countries (extremes: 30%-81%; p<0.004) and most infants (69%) died after WLST. After adjustment and with reference to the UK, mortality rates were significantly higher for France, Denmark and the Netherlands, with ORs of 8.8 (95% CI 3.3 to 23.6), 5.9 (95% CI 1.6 to 21.4) and 4.8 (95% CI 1.1 to 8.9). There were variations in WLST between European regions and countries. CONCLUSION In infants with IPH, rates of death before discharge and death after WLST varied between European countries. These variations in mortality impede studying reliable outcomes in infants with IPH across European countries and encourage reflection of clinical practices of WLST across European units.
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Affiliation(s)
- Charline Loth
- University Grenoble Alpes, Neonatology Department, CHU Grenoble-Alpes, Grenoble, France
| | - Ludovic Treluyer
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004 Paris, France
| | - Véronique Pierrat
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004 Paris, France
| | - Anne Ego
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004 Paris, France
- Grenoble Alpes, Inserm CIC1406, CHU Grenoble, Grenoble, France
| | - Adrien M Aubert
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004 Paris, France
| | - Thierry Debillon
- University Grenoble Alpes, Neonatology Department, CHU Grenoble-Alpes, Grenoble, France
- University Grenoble Alpes, CNRS, Public Health Department CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG, Institute of Engineering, University Grenoble Alpes, Grenoble, France
| | - Jennifer Zeitlin
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004 Paris, France
| | - Heloise Torchin
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004 Paris, France
- Neonatal Intensive Care Unit, Port-Royal Maternity, Paris, Île-de-France, France
| | - Marie Chevallier
- University Grenoble Alpes, Neonatology Department, CHU Grenoble-Alpes, Grenoble, France
- University Grenoble Alpes, CNRS, Public Health Department CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG, Institute of Engineering, University Grenoble Alpes, Grenoble, France
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Chevallier M, Barrington KJ, Terrien Church P, Luu TM, Janvier A. Decision-making for extremely preterm infants with severe hemorrhages on head ultrasound: Science, values, and communication skills. Semin Fetal Neonatal Med 2023; 28:101444. [PMID: 37150640 DOI: 10.1016/j.siny.2023.101444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Severe intracranial hemorrhages are not rare in extremely preterm infants. They occur early, generally when babies require life-sustaining interventions. This may lead to ethical discussions and decision-making about levels of care. Prognosis is variable and depends on the extent, location, and laterality of the lesions, and, importantly also on the subsequent occurrence of other clinical complications or progressive ventricular dilatation. Decision-making should depend on prognosis and parental values. This article will review prognosis and the uncertainty of outcomes for different lesions and provide an outline of ways to conduct an ethically appropriate discussion on the decision of whether to continue life sustaining therapy. It is possible to communicate in a compassionate and honest way with parents and engage in decision-making, focussing on personalized information and decisions, and on function, as opposed to diagnosis.
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Affiliation(s)
- M Chevallier
- Department of Neonatal Intensive Care Unit, CHU Grenoble, Grenoble, France; TIMC-IMAG Research Department; Grenoble Alps University; Grenoble, France
| | - K J Barrington
- Department of Pediatrics, Université de Montréal, Montréal, Canada; Division of Neonatology, CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Canada; Centre de Recherche Du CHU Sainte-Justine, Montréal, Québec, Canada
| | - P Terrien Church
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - T M Luu
- Department of Pediatrics, Université de Montréal, Montréal, Canada; Centre de Recherche Du CHU Sainte-Justine, Montréal, Québec, Canada
| | - A Janvier
- Department of Pediatrics, Université de Montréal, Montréal, Canada; Division of Neonatology, CHU Sainte-Justine Research Center, CHU Sainte-Justine, Montréal, Canada; Centre de Recherche Du CHU Sainte-Justine, Montréal, Québec, Canada; Bureau de L'éthique Clinique, Université de Montréal, Canada; Unité D'éthique Clinique, Unité de Soins Palliatifs, Bureau Du Partenariat Patients-Familles-Soignants; CHU Sainte-Justine, Montréal, Canada.
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Jaloustre M, Cohen R, Biran V, Decobert F, Layese R, Audureau E, Le Saché N, Chevallier M, Boukhris MR, Bolot P, Caeymaex L, Tauzin M. Determinants of morbidity and mortality related to health care-associated primary bloodstream infections in neonatal intensive care units: a prospective cohort study from the SEPREVEN trial. Front Pediatr 2023; 11:1170863. [PMID: 37325351 PMCID: PMC10264575 DOI: 10.3389/fped.2023.1170863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/10/2023] [Indexed: 06/17/2023] Open
Abstract
Background Health care-associated primary bloodstream infections (BSIs), defined as not secondary to an infection at another body site, including central line-associated BSI, are a leading cause of morbidity and mortality in patients in neonatal intensive care units (NICUs). Our objective was to identify factors associated with severe morbidity and mortality after these infections in neonates in NICUs. Methods This ancillary study of the SEPREVEN trial included neonates hospitalized ≥2 days in one of 12 French NICUs and with ≥ 1 BSI during the 20-month study period. BSIs (all primary and health care-associated) were diagnosed in infants with symptoms suggestive of infection and classified prospectively as possible (one coagulase-negative staphylococci (CoNS)-growing blood culture) or proven (two same CoNS, or ≥1 recognized pathogen-growing blood culture). BSI consequences were collected prospectively as moderate morbidity (antibiotic treatment alone) or severe morbidity/mortality (life-saving procedure, permanent damage, prolonged hospitalization, and/or death). Results Of 557 BSIs identified in 494 patients, CoNS accounted for 378/557 (67.8%) and recognized bacterial or fungal pathogens for 179/557 (32.1%). Severe morbidity/mortality was reported in 148/557 (26.6%) BSIs. Independent factors associated with severe morbidity/mortality were corrected gestational age <28 weeks (CGA) at infection (P < .01), fetal growth restriction (FGR) (P = .04), and proven pathogen-related BSI vs. CoNS-related BSI (P < .01). There were no differences in severe morbidity and mortality between proven and possible CoNS BSIs. In possible BSI, S. epidermidis was associated with a lower risk of severe morbidity than other CoNS (P < .01), notably S. capitis and S. haemolyticus. Conclusions In BSIs in the NICU, severe morbidity/mortality was associated with low CGA at infection, FGR, and proven pathogen-related BSIs. When only one blood culture was positive, severe morbidity/mortality were less frequent if it grew with S. epidermidis compared to other CoNS. Further studies to help distinguish real CoNS BSIs from contaminations are needed. Study registration ClinicalTrials.gov (NCT02598609).
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Affiliation(s)
- Morgane Jaloustre
- Neonatal Intensive Care Unit, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Robert Cohen
- Neonatal Intensive Care Unit, Centre Hospitalier Intercommunal de Creteil, Creteil, France
- Faculty of Medicine, University Paris Est Creteil, Creteil, France
- Groupe de Pathologie Infectieuse Pédiatrique, Paris, France
| | - Valérie Biran
- Neonatal Intensive Care Unit, APHP, CHU Robert Debré, Paris, France
| | - Fabrice Decobert
- Neonatal Intensive Care Unit, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Richard Layese
- Assistance Publique-Hôpitaux de Paris AP-HP, Hôpital Henri Mondor, Unité de Recherche Clinique (URC Mondor), Creteil, France
- University Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France
| | - Etienne Audureau
- Assistance Publique-Hôpitaux de Paris AP-HP, Hôpital Henri Mondor, Unité de Recherche Clinique (URC Mondor), Creteil, France
- University Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France
| | - Nolwenn Le Saché
- Pediatric Intensive Care and Neonatal Medicine, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Marie Chevallier
- Neonatal Intensive Care Unit, CHU Grenoble Alpes, Grenoble, France
| | | | - Pascal Bolot
- Neonatal Intensive Care Unit, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Laurence Caeymaex
- Neonatal Intensive Care Unit, Centre Hospitalier Intercommunal de Creteil, Creteil, France
- Faculty of Medicine, University Paris Est Creteil, Creteil, France
| | - Manon Tauzin
- Neonatal Intensive Care Unit, Centre Hospitalier Intercommunal de Creteil, Creteil, France
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Tréluyer L, Chevallier M, Jarreau PH, Baud O, Benhammou V, Gire C, Marchand-Martin L, Marret S, Pierrat V, Ancel PY, Torchin H. Intraventricular Hemorrhage in Very Preterm Children: Mortality and Neurodevelopment at Age 5. Pediatrics 2023; 151:e2022059138. [PMID: 36919442 PMCID: PMC10071431 DOI: 10.1542/peds.2022-059138] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVES The objectives were to describe mortality and causes of death in children with intraventricular hemorrhage (IVH) and to study neurodevelopmental outcomes. METHODS The study was a secondary analysis of the French national prospective and population-based cohort EPIPAGE-2. Children were recruited in 2011. A standardized assessment was conducted at age 5. Children born before 32 weeks' gestation and admitted to a NICU were eligible. Exposure was IVH defined by the Papile classification. Main outcomes were mortality, causes of death, and neurodevelopmental outcomes at age 5. RESULTS Among the 3468 children included, 578 (16.7%) had grade 1 IVH, 424 (12.2%) grade 2 IVH, and 114 (3.3%) grade 3 IVH; 144 (4.1%) had intraparenchymal hemorrhage (IPH). Mortality was 29.7% (36 of 114) for children with grade 3 IVH and 74.4% (109 of 144) for those with IPH; 67.6% (21 of 31) and 88.7% (86 of 97) of deaths, respectively, were because of withholding and withdrawing of life-sustaining treatment. As compared with no IVH, low-grade IVH was not associated with measured neurodevelopmental disabilities at age 5. High-grade IVH was associated with moderate and severe neurodevelopmental disabilities, reduced full-scale IQ, and cerebral palsy. CONCLUSIONS Rates of neurodevelopmental disabilities at age 5 did not differ between children without IVH and those with low-grade IVH. For high-grade IVH, mortality rate was high, mostly because of withholding and withdrawal of life-sustaining treatment, and we found a strong association with overall neurodevelopmental disabilities in survivors.
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Affiliation(s)
- Ludovic Tréluyer
- CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, Université Paris Cité, Paris, France
- Department of Neonatal Medicine of Port Royal, Cochin Hospital, FHU PREMA, AP-HP Centre – Université Paris Cité, Paris, France
| | - Marie Chevallier
- NICU, Grenoble Alps University Hospital Centre Couples and Children Section, Grenoble, France
- TIMC-IMAG Research Department, Grenoble Alps University, Grenoble, France
| | - Pierre-Henri Jarreau
- CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, Université Paris Cité, Paris, France
- Department of Neonatal Medicine of Port Royal, Cochin Hospital, FHU PREMA, AP-HP Centre – Université Paris Cité, Paris, France
| | - Olivier Baud
- Division of Neonatology and Pediatric Intensive Care, Children’s University Hospital of Geneva, Geneva, Switzerland
- Université Paris Cité, Inserm U1141, Paris, France
| | - Valérie Benhammou
- CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, Université Paris Cité, Paris, France
| | - Catherine Gire
- Department of Neonatology, North Hospital, University Hospital of Marseille,Chemin des Bourrelys, CEDEX 20, Marseille, France
| | - Laetitia Marchand-Martin
- CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, Université Paris Cité, Paris, France
| | - Stéphane Marret
- Department of Neonatal Pediatrics, Intensive Care, and Neuropediatrics, Rouen University Hospital, Rouen, France and INSERM Unit 1245, Team Perinatal Handicap, School of Medicine of Rouen, Normandy University, Normandy, France
| | - Véronique Pierrat
- CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, Université Paris Cité, Paris, France
- Department of Neonatal Medicine, CHU Lille, Jeanne de Flandre Hospital, Lille, France
| | - Pierre-Yves Ancel
- CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, Université Paris Cité, Paris, France
- Clinical Research Unit, Center for Clinical Investigation P1419, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Héloïse Torchin
- CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, Université Paris Cité, Paris, France
- Department of Neonatal Medicine of Port Royal, Cochin Hospital, FHU PREMA, AP-HP Centre – Université Paris Cité, Paris, France
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Galusca CI, Clerc O, Chevallier M, Bertrand C, Audeou F, Pascalis O, Fort M. The effect of masks on the visual preference for faces in the first year of life. Infancy 2023; 28:92-105. [PMID: 36523138 DOI: 10.1111/infa.12518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 12/23/2022]
Abstract
To prevent the spread of COVID-19, face masks were mandatory in many public spaces around the world. Since faces are the gateway to early social cognition, this raised major concerns about the effect face masks may have on infants' attention to faces as well as on their language and social development. The goal of the present study was to assess how face masks modulate infants' attention to faces over the course of the first year of life. We measured 3, 6, 9, and 12-month-olds' looking behavior using a paired visual preference paradigm under two experimental conditions. First, we tested infants' preference for upright masked or unmasked faces of the same female individual. We found that regardless of age, infants looked equally long at the masked and unmasked faces. Second, we compared infants' attention to an upright masked versus an inverted masked face. Three- and 6-month-olds looked equally long to the masked faces when they were upright or inverted. However, 9- and 12-month-old infants showed a novelty preference for the inverted masked face. Our findings suggest that more experience with faces, including masked faces, leads to efficient adaptations of infants' visual system for processing impoverished social stimuli, such as partially occluded faces.
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Affiliation(s)
- Cristina Ioana Galusca
- Laboratoire de Psychologie et Neurocognition, LPNC, Université Grenoble Alpes, Grenoble, France.,Centre National de La Recherche Scientifique, CNRS, Grenoble, France
| | - Olivier Clerc
- Laboratoire de Psychologie et Neurocognition, LPNC, Université Grenoble Alpes, Grenoble, France.,Centre National de La Recherche Scientifique, CNRS, Grenoble, France
| | - Marie Chevallier
- Department of Neonatal Intensive Care Unit, Centre Hospitalier Universitaire Grenoble Alpes, CHU-GA, Grenoble, France.,TIMC-IMAG Research Department, Université Grenoble Alpes, Grenoble, France
| | - Caroline Bertrand
- Department of Neonatal Intensive Care Unit, Centre Hospitalier Universitaire Grenoble Alpes, CHU-GA, Grenoble, France
| | - Frederique Audeou
- Department of Neonatal Intensive Care Unit, Centre Hospitalier Universitaire Grenoble Alpes, CHU-GA, Grenoble, France
| | - Olivier Pascalis
- Laboratoire de Psychologie et Neurocognition, LPNC, Université Grenoble Alpes, Grenoble, France.,Centre National de La Recherche Scientifique, CNRS, Grenoble, France
| | - Mathilde Fort
- Laboratoire de Psychologie et Neurocognition, LPNC, Université Grenoble Alpes, Grenoble, France.,Centre de Recherche en NeuroSciences de Lyon, CRNL, Université Lyon 1, Lyon, France
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8
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Gebus M, Chevallier M, Hatton L, Jacquez L, Vilotitch A, Ego A, Pin I, Debillon T. Neurodevelopment at two years and appropriate schooling at five years in children born very preterm. Acta Paediatr 2022; 111:1729-1735. [PMID: 35608527 DOI: 10.1111/apa.16421] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022]
Abstract
AIM This single-centre French cohort study evaluated the relationship between standardised assessment at 2 years of corrected age and schooling level at 5 years of age in children born at ≤32 weeks' gestational age. METHODS This was a single-centre retrospective study of children born preterm between 2010 and 2014 included in a follow-up network. At 5 years of age, the population was divided into 2 groups: (1) 'appropriate schooling', defined as age-appropriate schooling without support, and (2) 'schooling with support'. At 2 years of corrected age, the developmental quotient (DQ) was calculated using the revised Brunet-Lezine test. Neonatal variables and DQ categories were compared between the 2 groups on univariate and multivariate analyses. RESULTS DQ was available for 251 of the 270 children included (93%), with a median score of 93.0 (IQR [87.0-100.0]), and 171 children (68%) were in the schooling without support group. On multivariate analysis, DQ ≥100 (n = 67) was the only variable that significantly associated with schooling without support (OR = 13.9; 95% CI: 5.5-35.4) at 5 years of age. CONCLUSION This result may be useful for clinicians in their routine practice and for information given to parents in neonatal follow-up.
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Affiliation(s)
- Maya Gebus
- Neonatal Intensive Care Unit Grenoble Alpes University Hospital Grenoble France
| | - Marie Chevallier
- Neonatal Intensive Care Unit Grenoble Alpes University Hospital Grenoble France
- TIMC‐MESP Grenoble Alpes University Hospital, CNRS Grenoble France
| | - Laure‐Anne Hatton
- Neonatal Intensive Care Unit Grenoble Alpes University Hospital Grenoble France
| | - Laure Jacquez
- Neonatal Intensive Care Unit Grenoble Alpes University Hospital Grenoble France
| | - Antoine Vilotitch
- TIMC‐MESP Grenoble Alpes University Hospital, CNRS Grenoble France
- Data Engineering Unit Public Health Department Grenoble Alpes University Hospital Grenoble France
| | - Anne Ego
- Univ. Grenoble Alpes, CNRS Public Health Department Grenoble Alpes University Hospital, TIMC‐IMAG Grenoble France
| | - Isabelle Pin
- Paediatric Unit Grenoble Alpes University Hospital Grenoble France
| | - Thierry Debillon
- Neonatal Intensive Care Unit Grenoble Alpes University Hospital Grenoble France
- TIMC‐MESP Grenoble Alpes University Hospital, CNRS Grenoble France
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9
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Chevallier M, Debillon T, Darlow BA, Synnes AR, Pierrat V, Hurrion E, Yang J, Ego A, Ancel PY, Lui K, Shah PS, Luu TM. Mortality and significant neurosensory impairment in preterm infants: an international comparison. Arch Dis Child Fetal Neonatal Ed 2022; 107:317-323. [PMID: 34509987 DOI: 10.1136/archdischild-2021-322288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/25/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To compare mortality and rates of significant neurosensory impairment (sNSI) at 18-36 months' corrected age in infants born extremely preterm across three international cohorts. DESIGN Retrospective analysis of prospectively collected neonatal and follow-up data. SETTING Three population-based observational cohort studies: the Australian and New Zealand Neonatal Network (ANZNN), the Canadian Neonatal and Follow-up Networks (CNN/CNFUN) and the French cohort Etude (Epidémiologique sur les Petits Ages Gestationnels: EPIPAGE-2). PATIENTS Extremely preterm neonates of <28 weeks' gestation in year 2011. MAIN OUTCOME MEASURES Primary outcome was composite of mortality or sNSI defined by cerebral palsy with no independent walking, disabling hearing loss and bilateral blindness. RESULTS Overall, 3055 infants (ANZNN n=960, CNN/CNFUN n=1019, EPIPAGE-2 n=1076) were included in the study. Primary composite outcome rates were 21.3%, 20.6% and 28.4%; mortality rates were 18.7%, 17.4% and 26.3%; and rates of sNSI among survivors were 4.3%, 5.3% and 3.3% for ANZNN, CNN/CNFUN and EPIPAGE-2, respectively. Adjusted for gestational age and multiple births, EPIPAGE-2 had higher odds of composite outcome compared with ANZNN (OR 1.71, 95% CI 1.38 to 2.13) and CNN/CNFUN (OR 1.72, 95% CI 1.39 to 2.12). EPIPAGE-2 did have a trend of lower odds of sNDI but far short of compensating for the significant increase in mortality odds. These differences may be related to variations in perinatal approach and practices (and not to differences in infants' baseline characteristics). CONCLUSIONS Composite outcome of mortality or sNSI for extremely preterm infants differed across high-income countries with similar baseline characteristics and access to healthcare.
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Affiliation(s)
- Marie Chevallier
- Neonatal Intensive Care Unit, Grenoble Alps University Hospital Centre Couples and Children Section, Grenoble, France .,TIMC-IMAG Research Department, Grenoble Alps University, Grenoble, France
| | - Thierry Debillon
- Neonatal Intensive Care Unit, Grenoble Alps University Hospital Centre Couples and Children Section, Grenoble, France.,TIMC-IMAG Research Department, Grenoble Alps University, Grenoble, France
| | - Brian A Darlow
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Anne R Synnes
- Department of Neonatology, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Véronique Pierrat
- Obstetrical Perinanal And Pediatric Epidemiology Research team (EPOPé), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris, Île-de-France, France.,Departement of Neonatal medicine, Lille University Hospital, Lille, France
| | - Elizabeth Hurrion
- Department of Newborn Services, Mater Mothers Hospital and Mater Medical Research Institute, South Brisbane, Queensland, Australia
| | - Junmin Yang
- Maternal Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Anne Ego
- TIMC-IMAG Research Department, Grenoble Alps University, Grenoble, France.,CIC U1406, INSERM, Grenoble, France.,Department of Public Health, Grenoble Alps University Hospital, Grenoble, France
| | - Pierre Yves Ancel
- Obstetrical Perinanal And Pediatric Epidemiology Research team (EPOPé), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris, Île-de-France, France.,Clinical Investigation center P1419, Paris Public Assistance Hospital, Paris, France
| | - Kei Lui
- Department of Newborn Care, Australian and New Zealand Neonatal Network, Royal Hospital for Women, National Perinatal Epidemiology and Statistic Unit, University of New South Wales, Sydney, New South Wales, Australia
| | - Prakeshkumar S Shah
- Maternal Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Thuy Mai Luu
- Pediatrics and Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
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10
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Nigolian H, Nieke JP, Chevallier M, Stathaki E, Sloan-Béna F, Carminho-Rodrigues MT, Jandus P. Immunodeficiency and lymphoma in Jacobsen syndrome. J Investig Allergol Clin Immunol 2022; 32:408-409. [PMID: 35029149 DOI: 10.18176/jiaci.0777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H Nigolian
- Division of Immunology and Allergology, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland
| | - J P Nieke
- Division of Immunology and Allergology, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland
| | - M Chevallier
- Division of Oncology, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland
| | - E Stathaki
- Division of Genetic Medicine, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland
| | - F Sloan-Béna
- Division of Genetic Medicine, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland
| | - M T Carminho-Rodrigues
- Division of Genetic Medicine, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland
| | - P Jandus
- Division of Immunology and Allergology, University Hospitals and Medical Faculty of Geneva, Geneva, Switzerland
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11
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Hascoët JM, Chevallier M, Gire C, Brat R, Rozé JC, Norbert K, Chen Y, Hartweg M, Billeaud C. Use of a Liquid Supplement Containing 2 Human Milk Oligosaccharides: The First Double-Blind, Randomized, Controlled Trial in Pre-term Infants. Front Pediatr 2022; 10:858380. [PMID: 35601412 PMCID: PMC9119431 DOI: 10.3389/fped.2022.858380] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022] Open
Abstract
There is growing evidence supporting the benefit of human milk oligosaccharides (HMOs) on reducing risk of illnesses and improving immune function in newborn infants, but evidence in pre-term infants is lacking. This randomized, double-blind, placebo-controlled trial (NCT03607942) of pre-term infants evaluated the effects of HMO supplementation on feeding tolerance, growth, and safety in 7 neonatal units in France. Pre-term infants (27-33 weeks' gestation, birth weight <1,700 g) were randomized early after birth to receive HMO supplement (n = 43) [2'-fucosyllactose (2'FL) and lacto-N-neotetraose (LNnT) in a 10:1 ratio (0.374 g/kg body weight/day)] or an isocaloric placebo (n = 43) consisting of only glucose (0.140 g/kg/day) until discharge from the neonatal unit. Anthropometric z-scores were calculated using Fenton growth standards. Primary outcome was feeding tolerance, measured by non-inferiority (NI) in days to reach full enteral feeding (FEF) from birth in HMO vs. placebo group (NI margin = 4+ days). Mean number of days on intervention prior to FEF was 8.9 and 10.3 days in HMO and placebo, respectively. Non-inferiority in time to reach FEF in HMO (vs. placebo) was achieved [LS mean difference (95% CI) = -2.16 (-5.33, 1.00); upper bound of 95% CI < NI margin] in full analysis set and similar for per protocol. Adjusted mean time to reach FEF from birth was 2 days shorter in HMO (12.2) vs. placebo (14.3), although not statistically significant (p = 0.177). There was no difference in weight-for-age z-scores between groups throughout the FEF period until discharge. Length-for-age z-scores were higher in HMO at FEF day 14 [0.29 (0.02, 0.56), p = 0.037] and 21 [0.31 (0.02, 0.61), p = 0.037]. Head circumference-for-age z-score was higher in HMO vs. placebo at discharge [0.42 (0.12, 0.71), p = 0.007]. Occurrence of adverse events (AEs) was similar in both groups and relatively common in this population, whereas 2.3 and 14.3%, respectively, experienced investigator-confirmed, related AEs. HMO supplementation is safe and well-tolerated in pre-term infants. After 9 days of supplementation, the HMO group reached FEF 2 days earlier vs. placebo, although the difference was not statistically significant. In addition, HMO supplementation supports early postnatal growth, which may have a positive impact on long-term growth and developmental outcomes.
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Affiliation(s)
| | | | | | | | - Jean-Christophe Rozé
- Hôpital Femme Enfant Adolescent Néonatologie et Réanimation Pédiatrique, Nantes, France
| | | | - Yipu Chen
- Nestlé Product Technology Center-Nutrition, Vevey, Switzerland
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12
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Durrmeyer X, Walter-Nicolet E, Chollat C, Chabernaud JL, Barois J, Chary Tardy AC, Berenguer D, Bedu A, Zayat N, Roué JM, Beissel A, Bellanger C, Desenfants A, Boukhris R, Loose A, Massudom Tagny C, Chevallier M, Milesi C, Tauzin M. Premedication before laryngoscopy in neonates: Evidence-based statement from the French society of neonatology (SFN). Front Pediatr 2022; 10:1075184. [PMID: 36683794 PMCID: PMC9846576 DOI: 10.3389/fped.2022.1075184] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/01/2022] [Indexed: 01/06/2023] Open
Abstract
CONTEXT Laryngoscopy is frequently required in neonatal intensive care. Awake laryngoscopy has deleterious effects but practice remains heterogeneous regarding premedication use. The goal of this statement was to provide evidence-based good practice guidance for clinicians regarding premedication before tracheal intubation, less invasive surfactant administration (LISA) and laryngeal mask insertion in neonates. METHODS A group of experts brought together by the French Society of Neonatology (SFN) addressed 4 fields related to premedication before upper airway access in neonates: (1) tracheal intubation; (2) less invasive surfactant administration; (3) laryngeal mask insertion; (4) use of atropine for the 3 previous procedures. Evidence was gathered and assessed on predefined questions related to these fields. Consensual statements were issued using the GRADE methodology. RESULTS Among the 15 formalized good practice statements, 2 were strong recommendations to do (Grade 1+) or not to do (Grade 1-), and 4 were discretionary recommendations to do (Grade 2+). For 9 good practice statements, the GRADE method could not be applied, resulting in an expert opinion. For tracheal intubation premedication was considered mandatory except for life-threatening situations (Grade 1+). Recommended premedications were a combination of opioid + muscle blocker (Grade 2+) or propofol in the absence of hemodynamic compromise or hypotension (Grade 2+) while the use of a sole opioid was discouraged (Grade 1-). Statements regarding other molecules before tracheal intubation were expert opinions. For LISA premedication was recommended (Grade 2+) with the use of propofol (Grade 2+). Statements regarding other molecules before LISA were expert opinions. For laryngeal mask insertion and atropine use, no specific data was found and expert opinions were provided. CONCLUSION This statement should help clinical decision regarding premedication before neonatal upper airway access and favor standardization of practices.
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Affiliation(s)
- Xavier Durrmeyer
- Neonatal Intensive Care Unit, Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Université Paris Est Créteil, Faculté de Santé de Créteil, IMRB, GRC CARMAS, Créteil, France
| | - Elizabeth Walter-Nicolet
- Neonatal Medicine and Intensive Care Unit, Saint Joseph Hospital, Paris, France.,University of Paris-Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, Paris, France
| | - Clément Chollat
- Department of Neonatology, Hôpital Armand Trousseau, APHP, Sorbonne Université, Paris, France
| | - Jean-Louis Chabernaud
- Division of Neonatal and Pediatric Critical Care Transportation, Hôpital Antoine Beclere, AP-HP, Paris - Saclay University Hospital, Clamart, France
| | - Juliette Barois
- Department of Neonatology and Neonatal Intensive Care, CH de Valenciennes, Valenciennes, France
| | - Anne-Cécile Chary Tardy
- Department of Neonatology and Neonatal Intensive Care, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Daniel Berenguer
- Department of Pediatric Anesthesia and Pediatric Transport (SMUR Pédiatrique), Hôpital des Enfants, CHU de Bordeaux, Bordeaux, France
| | - Antoine Bedu
- Department of Neonatal Pediatrics and Intensive Care, Limoges University Hospital, Limoges, France
| | - Noura Zayat
- Department of Neonatal Intensive Care and Pediatric Transport, CHU de Nantes, Nantes, France
| | - Jean-Michel Roué
- Department of Pediatric and Neonatal Critical Care, Brest University Hospital, Brest, France
| | - Anne Beissel
- Neonatal Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Claire Bellanger
- Department of Neonatology and Neonatal Intensive Care, AP-HP, Hôpital Necker-Enfants Malades, Paris, France
| | - Aurélie Desenfants
- Department of Neonatology, CHU Nimes, Université Montpellier, Nimes, France
| | - Riadh Boukhris
- Department of Neonatology, Pôle Femme-Mère-Nouveau-Né, Hôpital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Anne Loose
- Department of Neonatology, CHRU de Tours, Hôpital Bretonneau, Tours, France
| | - Clarisse Massudom Tagny
- Department of Neonatology and Neonatal Intensive Care, Grand Hôpital de L'Est Francilien, Meaux, France
| | - Marie Chevallier
- Department of Neonatal Intensive Care Unit, CHU Grenoble, Grenoble, France.,TIMC-IMAG Research Department, Grenoble Alps University, Grenoble, France
| | - Christophe Milesi
- Department of Neonatal Medicine and Pediatric Intensive Care, Montpellier University Hospital, Université de Montpellier, Montpellier, France
| | - Manon Tauzin
- Neonatal Intensive Care Unit, Centre Hospitalier Intercommunal de Créteil, Créteil, France
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13
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Smiljkovic M, Chevallier M, Freycon C, Mortamet G. Lack of dedicated research time was the main barrier to French paediatric residents publishing academic papers. Acta Paediatr 2021; 110:1963-1964. [PMID: 33484010 DOI: 10.1111/apa.15770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/14/2021] [Accepted: 01/20/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Mina Smiljkovic
- Infectious Disease Department Sick Kids Hospital Toronto Ontario Canada
| | - Marie Chevallier
- Neonatology Department Grenoble‐Alpes University Hospital La Tronche France
| | - Claire Freycon
- Pediatric Oncology Department Grenoble‐Alpes University Hospital La Tronche France
| | - Guillaume Mortamet
- Pediatric Intensive Care Unit Grenoble‐Alpes University Hospital La Tronche France
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14
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Chevallier M, Smiljkovic M, Cesar T, Mortamet G. Publishing during residency: Not just a question of time. Acta Paediatr 2021; 110:1966. [PMID: 33660334 DOI: 10.1111/apa.15830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Marie Chevallier
- Neonatology Department Grenoble‐Alpes University Hospital La Tronche France
| | - Mina Smiljkovic
- Pediatric Department Grenoble‐Alpes University Hospital La Tronche France
| | - Thibaut Cesar
- Pediatric Department Grenoble‐Alpes University Hospital La Tronche France
| | - Guillaume Mortamet
- Pediatric Intensive Care Unit Grenoble‐Alpes University Hospital La Tronche France
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15
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Chevallier M, Durrmeyer X, Ego A, Debillon T. Propofol versus placebo (with rescue with ketamine) before less invasive surfactant administration: study protocol for a multicenter, double-blind, placebo controlled trial (PROLISA). BMC Pediatr 2020; 20:199. [PMID: 32384914 PMCID: PMC7206779 DOI: 10.1186/s12887-020-02112-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/29/2020] [Indexed: 01/05/2023] Open
Abstract
Background One major limitation for less invasive surfactant administration (LISA) is the difficulty in providing sedation before this procedure and the competitive risk of respiratory depression versus avoidance of intubation for most sedative or analgesic drugs used in this context. The objective of this study is to compare the need for mechanical ventilation within 72 h of life following premedication with propofol, versus placebo (rescue with ketamine), for the LISA procedure in preterm neonates born before 32 weeks gestational age (wGA). Methods ProLISA is a phase III, non-inferiority, multicenter, double blind, randomized, placebo controlled trial designed according to the SPIRIT Statement. Neonates born before 32 wGA in 12 geographically dispersed Neonatal Intensive Care Units in France needing surfactant will be included from September 2019 to September 2022. A sample of 542 patients is needed. The neonate is randomized to the intervention (propofol) or control placebo group. Open label rescue treatment with ketamine is possible in both groups if FANS (Faceless Acute Neonatal pain Scale) is ≥6. To guide drug administration, FANS is scored before attempting laryngoscopy. Once an adequate score has been obtained, LISA is performed according to a standardized protocol. The primary outcome is the need for mechanical ventilation within 72 h of life. Secondary outcomes are tolerance of the procedure, pain evaluation, hemodynamic and neurologic parameters after the intervention, morbidities before discharge and neurodevelopmental assessment at 2 years of age. Discussion This paper describes the first multicenter, double-blind, randomized, placebo-controlled trial on this topic and will provide crucial information to support implementation of the LISA procedure. Trial registration ClinicalTrials.gov: NCT04016246. Registered 06 June 2019, N°EUDRACT: 2018–002876-41.
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Affiliation(s)
- Marie Chevallier
- UMR 5525 ThEMAS, CNRS, TIMC-IMAG, Grenoble Alps University, Grenoble, France. .,Neonatal Intensive Care Unit, Grenoble Alps University Hospital, Grenoble, France.
| | - Xavier Durrmeyer
- Neonatal Intensive Care Unit, Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Université Paris Est, IMRB- GRC GEMINI, Créteil, France.,Inserm, U1153, Obstetrical, Perinatal and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne, Paris Descartes University, Paris, France
| | - Anne Ego
- Neonatal Intensive Care Unit, Grenoble Alps University Hospital, Grenoble, France
| | - Thierry Debillon
- UMR 5525 ThEMAS, CNRS, TIMC-IMAG, Grenoble Alps University, Grenoble, France.,Neonatal Intensive Care Unit, Grenoble Alps University Hospital, Grenoble, France
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16
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Bonnet Ducrot S, Plantaz D, Mathieu N, Debillon T, Bost Bru C, Brenier-Pinchart MP, Fricker-Hidalgo H, Chevallier M. Neonatal fever: A puzzling case. Arch Pediatr 2018; 25:435-438. [PMID: 30249489 DOI: 10.1016/j.arcped.2018.08.004] [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: 03/27/2018] [Revised: 06/17/2018] [Accepted: 08/15/2018] [Indexed: 02/07/2023]
Abstract
Toxoplasmosis is a potentially serious fetal infection associated with maternal seroconversion of toxoplasmosis during pregnancy. Follow-up and treatment vary between different countries. We present a case of congenital toxoplasmosis with unusual physiopathology and symptomatology. The mother was immunized before the beginning of pregnancy but immunosuppressive treatments for Crohn disease maintained during the pregnancy could explain toxoplasmosis reactivation in the mother and congenital toxoplasmosis. The baby presented reversible B lymphopenia and hypogammaglobulinemia.
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Affiliation(s)
- S Bonnet Ducrot
- Neonatal Intensive Care Unit, Grenoble Alpes University, CS10217, Grenoble University Hospital, 38043 Grenoble, France.
| | - D Plantaz
- Department of Pediatrics, Unit of Pediatric Immuno-Hemato-Oncology, Grenoble Alpes University, CS10217, Grenoble University Hospital, 38043 Grenoble, France
| | - N Mathieu
- Hepato-gastroenterology Unit, Grenoble Alpes University, CS10217, Grenoble University Hospital, 38043 Grenoble, France
| | - T Debillon
- Neonatal Intensive Care Unit, Grenoble Alpes University, CS10217, Grenoble University Hospital, 38043 Grenoble, France; ThEMAS, TIMC-IMAG, CNRS UMR5525, Université Grenoble Alpes, 38041 Grenoble, France
| | - C Bost Bru
- Department of Pediatrics, General Pediatrics and Infectious Diseases, Grenoble Alpes University, CS10217, Grenoble University Hospital, 38043 Grenoble, France
| | - M-P Brenier-Pinchart
- Laboratory of Parasitology and Mycology, Grenoble Alpes University, CS10217, Grenoble University Hospital, 38043 Grenoble, France
| | - H Fricker-Hidalgo
- Laboratory of Parasitology and Mycology, Grenoble Alpes University, CS10217, Grenoble University Hospital, 38043 Grenoble, France
| | - M Chevallier
- Neonatal Intensive Care Unit, Grenoble Alpes University, CS10217, Grenoble University Hospital, 38043 Grenoble, France; ThEMAS, TIMC-IMAG, CNRS UMR5525, Université Grenoble Alpes, 38041 Grenoble, France
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17
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Aite M, Chevallier M, Frioux C, Trottier C, Got J, Cortés MP, Mendoza SN, Carrier G, Dameron O, Guillaudeux N, Latorre M, Loira N, Markov GV, Maass A, Siegel A. Traceability, reproducibility and wiki-exploration for "à-la-carte" reconstructions of genome-scale metabolic models. PLoS Comput Biol 2018; 14:e1006146. [PMID: 29791443 PMCID: PMC5988327 DOI: 10.1371/journal.pcbi.1006146] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 06/05/2018] [Accepted: 04/17/2018] [Indexed: 11/27/2022] Open
Abstract
Genome-scale metabolic models have become the tool of choice for the global analysis of microorganism metabolism, and their reconstruction has attained high standards of quality and reliability. Improvements in this area have been accompanied by the development of some major platforms and databases, and an explosion of individual bioinformatics methods. Consequently, many recent models result from "à la carte" pipelines, combining the use of platforms, individual tools and biological expertise to enhance the quality of the reconstruction. Although very useful, introducing heterogeneous tools, that hardly interact with each other, causes loss of traceability and reproducibility in the reconstruction process. This represents a real obstacle, especially when considering less studied species whose metabolic reconstruction can greatly benefit from the comparison to good quality models of related organisms. This work proposes an adaptable workspace, AuReMe, for sustainable reconstructions or improvements of genome-scale metabolic models involving personalized pipelines. At each step, relevant information related to the modifications brought to the model by a method is stored. This ensures that the process is reproducible and documented regardless of the combination of tools used. Additionally, the workspace establishes a way to browse metabolic models and their metadata through the automatic generation of ad-hoc local wikis dedicated to monitoring and facilitating the process of reconstruction. AuReMe supports exploration and semantic query based on RDF databases. We illustrate how this workspace allowed handling, in an integrated way, the metabolic reconstructions of non-model organisms such as an extremophile bacterium or eukaryote algae. Among relevant applications, the latter reconstruction led to putative evolutionary insights of a metabolic pathway.
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Affiliation(s)
| | - Marie Chevallier
- IRISA, Univ Rennes, Inria, CNRS, Rennes, France
- ECOBIO, Univ Rennes, CNRS, Rennes, France
| | | | - Camille Trottier
- IRISA, Univ Rennes, Inria, CNRS, Rennes, France
- UMR 6004 ComBi, Université de Nantes, CNRS, Nantes, France
| | - Jeanne Got
- IRISA, Univ Rennes, Inria, CNRS, Rennes, France
| | - María Paz Cortés
- Centro de Modelamiento Matemático, Universidad de Chile, Santiago, Chile
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibáñez, Santiago, Chile
- Centro para la Regulación del Genoma (Fondap 15090007), Universidad de Chile, Santiago, Chile
| | - Sebastián N. Mendoza
- Centro de Modelamiento Matemático, Universidad de Chile, Santiago, Chile
- Centro para la Regulación del Genoma (Fondap 15090007), Universidad de Chile, Santiago, Chile
| | - Grégory Carrier
- Laboratoire de Physiologie et de Biotechnologie des Algues, IFREMER, Nantes, France
| | | | | | - Mauricio Latorre
- Centro de Modelamiento Matemático, Universidad de Chile, Santiago, Chile
- Centro para la Regulación del Genoma (Fondap 15090007), Universidad de Chile, Santiago, Chile
- Instituto de ciencias de la ingeniería, Universidad de O'Higgins, Rancagua, Chile
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Nicolás Loira
- Centro de Modelamiento Matemático, Universidad de Chile, Santiago, Chile
- Centro para la Regulación del Genoma (Fondap 15090007), Universidad de Chile, Santiago, Chile
| | - Gabriel V. Markov
- UMR 8227, Integrative Biology of Marine Models, Station biologique de Roscoff, Sorbonne Université, CNRS, Roscoff, France
| | - Alejandro Maass
- Centro de Modelamiento Matemático, Universidad de Chile, Santiago, Chile
- Centro para la Regulación del Genoma (Fondap 15090007), Universidad de Chile, Santiago, Chile
| | - Anne Siegel
- IRISA, Univ Rennes, Inria, CNRS, Rennes, France
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18
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Descamps CS, Chevallier M, Ego A, Pin I, Epiard C, Debillon T. Propofol for sedation during less invasive surfactant administration in preterm infants. Arch Dis Child Fetal Neonatal Ed 2017; 102:F465. [PMID: 28483817 DOI: 10.1136/archdischild-2017-312791] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Claire Sophie Descamps
- Neonatal Intensive Care Unit, CHU de Grenoble, Grenoble, 38 043 Grenoble Cedex 9, France
| | - Marie Chevallier
- Neonatal Intensive Care Unit, CHU de Grenoble, Grenoble, 38 043 Grenoble Cedex 9, France.,Grenoble Alps University, CNRS, TIMC-IMAG, UMR 5525 ThEMAS, Grenoble, France
| | - Anne Ego
- Grenoble Alps University, CNRS, TIMC-IMAG, UMR 5525 ThEMAS, Grenoble, France
| | - Isabelle Pin
- Département de pédiatrie - Centre mucoviscidose, CHU de Grenoble, Hôpital Albert Michallon, Grenoble, France
| | - Chloé Epiard
- Neonatal Intensive Care Unit, CHU de Grenoble, Grenoble, 38 043 Grenoble Cedex 9, France
| | - Thierry Debillon
- Neonatal Intensive Care Unit, CHU de Grenoble, Grenoble, 38 043 Grenoble Cedex 9, France.,Grenoble Alps University, CNRS, TIMC-IMAG, UMR 5525 ThEMAS, Grenoble, France.,Univ Grenoble Alpes, Grenoble, France
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Schoorl M, Schoorl M, Chevallier M, van der Ploeg T, van Pelt J. Multicenter verification of the Sysmex XN-Series. Int J Lab Hematol 2017; 39:489-496. [DOI: 10.1111/ijlh.12674] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/27/2017] [Indexed: 12/13/2022]
Affiliation(s)
- M. Schoorl
- Department of Clinical Chemistry, Haematology & Immunology; Northwest Clinics; Alkmaar the Netherlands
| | - M. Schoorl
- Department of Clinical Chemistry, Haematology & Immunology; Northwest Clinics; Alkmaar the Netherlands
| | - M. Chevallier
- Department of Clinical Chemistry, Haematology & Immunology; Northwest Clinics; Alkmaar the Netherlands
| | - T. van der Ploeg
- Foreest Medical School; Northwest Clinics; Alkmaar the Netherlands
| | - J. van Pelt
- Department of Clinical Chemistry, Haematology & Immunology; Northwest Clinics; Alkmaar the Netherlands
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Chevallier M, Riaublanc A, Lopez C, Hamon P, Rousseau F, Croguennec T. Aggregated whey proteins and trace of caseins synergistically improve the heat stability of whey protein-rich emulsions. Food Hydrocoll 2016. [DOI: 10.1016/j.foodhyd.2016.06.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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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Gerard-Boncompain M, Claudel JP, Gaussorgues P, Salord F, Sirodot M, Chevallier M, Robert D. Hepatic Cytolytic and Cholestatic Changes Related to a Change of Lipid Emulsions in Four Long-Term Parenteral Nutrition Patients With Short Bowel. JPEN J Parenter Enteral Nutr 2016; 16:78-83. [PMID: 1346655 DOI: 10.1177/014860719201600178] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Long-term parenteral nutrition hepatic-related impairment is commonly reported and diversely explained. However, with a low cyclic caloric intake (100% to 130% of basal metabolism calculated with the Harris-Benedict formula) consisting of two-thirds glucose, one-third lipid, and 0.20 to 0.25 g of nitrogen per kilogram per day, these complications were infrequent in a clinical practice of home long-term parenteral nutrition. Retrospectively, it was noticed that the switch from Intralipid 20% to Ivelip 20% at the same amount was followed within 2 months by four cases of jaundice in a population of four home long-term parenteral nutrition patients with short bowel disease. Hepatic disturbances were characterized by cytolysis and cholestasis and were reversible after switching from Ivelip 20% back to Intralipid 20%. Neither viral, nor biliary, nor septic etiologies were detected. The exact pathological mechanism remains unknown. The basal composition of both lipid emulsions seems to be identical: soy oil emulsion emulsified by egg phospholipids. However, some differences exist such as the size of particles, the presence of sodium oleate in Ivelip 20%, and the purification process of lecithin. These may explain the difference in hepatic tolerance during long-term parenteral nutrition.
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Affiliation(s)
- M Gerard-Boncompain
- Service de Réanimation Médicale et Assistance Respiratoire, Hôpital de la Croix Rousse, Lyon, France
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Lecoindre A, Lecoindre P, Cadoré JL, Chevallier M, Guerret S, Derré G, Mcdonough SP, Simpson KW. Focal intestinal lipogranulomatous lymphangitis in 10 dogs. J Small Anim Pract 2016; 57:465-71. [PMID: 27359251 DOI: 10.1111/jsap.12522] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 04/06/2016] [Accepted: 04/21/2016] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To describe the clinical and pathological features of canine focal lipogranulomatous lymphangitis, to evaluate its underlying infectious cause and to compare it with human Crohn's disease. METHODS Retrospective review of case records with a histopathological diagnosis of focal lipogranulomatous lymphangitis. Bacterial and fungal colonisation was evaluated using fluorescence in situ hybridisation and histochemical staining, respectively. A comparison with Crohn's disease was performed by a human pathologist. RESULTS Ten dogs were evaluated. The historical complaints were predominantly chronic diarrhoea (10/10) and vomiting (5/10). The biochemical abnormalities included hypoalbuminaemia (6/10) and hypocobalaminaemia (4/6). Abdominal sonography revealed a thickened distal ileum±ileocolic junction. Colonoscopy showed a swollen caecal ostium and oedematous caecum in 7/10 dogs. A stenotic ileo-colic opening prevented endoscopic intubation in all dogs. Histology from the resected lesions revealed granulomatous inflammation involving the muscularis and serosa. Fluorescence in situ hybridization demonstrated invasive bacteria in 2/10 dogs. Post-resection, all dogs received metronidazole and tapering immunosuppressive doses of prednisolone. Remission (median 17 months) was achieved in 8/10 dogs. CLINICAL SIGNIFICANCE Focal lipogranulomatous lymphangitis is a rare and severe form of canine inflammatory bowel disease with preferential localisation to the ileum and the ileocolic junction. An underlying infectious aetiology was not identified.
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Affiliation(s)
- A Lecoindre
- Service de Médecine Interne, VetAgro Sup Campus Vétérinaire, Université de Lyon, 69280 Marcy l'Etoile, 69007 Lyon, France
| | - P Lecoindre
- CVC Clinique des Cerisioz, Route de Saint-Symphorien-d'Ozon, 69800 Lyon, France
| | - J L Cadoré
- Service de Médecine interne, VetAgro Sup Campus Vétérinaire, Université de Lyon, 69280 Marcy l'Etoile, 69007 Lyon, France
| | - M Chevallier
- Laboratoire Biomnis, 17/19 avenue Tony Garnier, 69007, Lyon, France
| | - S Guerret
- Laboratoire Biomnis, 17/19 avenue Tony Garnier, 69007, Lyon, France
| | - G Derré
- Clinique Vétérinaire de la Plage, 1 Promenade George Pompidou, 13008, Marseille, France
| | - S P Mcdonough
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, 14853, USA
| | - K W Simpson
- College of Veterinary Medicine, Cornell University, Ithaca, New York, 14853, USA
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Norwood EA, Chevallier M, Le Floch-Fouéré C, Schuck P, Jeantet R, Croguennec T. Heat-Induced Aggregation Properties of Whey Proteins as Affected by Storage Conditions of Whey Protein Isolate Powders. FOOD BIOPROCESS TECH 2016. [DOI: 10.1007/s11947-016-1686-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Schoorl M, Schoorl M, Chevallier M, Elout J, van Pelt J. Flagging performance of the Sysmex XN2000 haematology analyser. Int J Lab Hematol 2016; 38:160-6. [DOI: 10.1111/ijlh.12461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/04/2015] [Indexed: 11/28/2022]
Affiliation(s)
- M. Schoorl
- Department of Clinical Chemistry, Haematology & Immunology; Medical Centre Alkmaar in Noordwest Ziekenhuisgroep; Alkmaar The Netherlands
| | - M. Schoorl
- Department of Clinical Chemistry, Haematology & Immunology; Medical Centre Alkmaar in Noordwest Ziekenhuisgroep; Alkmaar The Netherlands
| | - M. Chevallier
- Department of Clinical Chemistry, Haematology & Immunology; Medical Centre Alkmaar in Noordwest Ziekenhuisgroep; Alkmaar The Netherlands
| | - J. Elout
- Department of Clinical Chemistry, Haematology & Immunology; Medical Centre Alkmaar in Noordwest Ziekenhuisgroep; Alkmaar The Netherlands
| | - J. van Pelt
- Department of Clinical Chemistry, Haematology & Immunology; Medical Centre Alkmaar in Noordwest Ziekenhuisgroep; Alkmaar The Netherlands
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Sesma C, Guedj M, Ribou G, Chevallier M, Conte A, Bouix O, Aznar R. Un cas exceptionnel de détection d’un anti-PP1Pk sur incohérence de groupage. Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.274] [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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Guedj M, Chevallier M, Bouix O, Aznar R. Un anti-MNS1 (anti-M) chez une patiente MNS:1 (M+). Auto-anticorps ou non ? Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.135] [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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Guedj M, Chevallier M, Aznar R. D faible de type 2 immunisé ou anti-RH12 ? Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.166] [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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Pinto M, Bajard M, Brons S, Chevallier M, Dauvergne D, Dedes G, De Rydt M, Freud N, Krimmer J, La Tessa C, Létang JM, Parodi K, Pleskač R, Prieels D, Ray C, Rinaldi I, Roellinghoff F, Schardt D, Testa E, Testa M. Absolute prompt-gamma yield measurements for ion beam therapy monitoring. Phys Med Biol 2014; 60:565-94. [DOI: 10.1088/0031-9155/60/2/565] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Krimmer J, Caponetto L, Chen X, Chevallier M, Dauvergne D, De Rydt M, Deng S, Ley JL, Mathez H, Ray C, Reithinger V, Testa E, Zoccarato Y. 111: Real-time monitoring of the ion range during hadrontherapy: An update on the beam tagging hodoscope. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34132-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bachelet JT, Buiret G, Chevallier M, Bergerot JF, Ory L, Gleizal A. [Conidiobolus coronatus infections revealed by a facial tumor]. ACTA ACUST UNITED AC 2014; 115:114-7. [PMID: 24462378 DOI: 10.1016/j.revsto.2013.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 10/20/2012] [Accepted: 12/12/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Conidiobolomycoses (Conidiobolus coronatus fungal infections) are rare and potentially severe infections prevalent in the tropics. The disease starts in the facial sinus and evolves as a subcutaneous tumor on the mid face OBSERVATION A 19-year-old female patient from Burkina Faso presented with an acquired nasal deformation having evolved for a few months, associated to bilateral nasal obstruction. The patient had no medical or surgical history. The pathological analysis of the surgical exeresis allowed diagnosing a C. coronatus infection. DISCUSSION The C. coronatus lives in decaying vegetation in hot and humid climates. It is a potential human pathogen that infects immunocompetent patients presenting with micro-wounds of the sinus and nasal mucosa. Hundred cases have been reported. The management is specific. The diagnosis should be discussed in case of distorting tumors of the midface.
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Affiliation(s)
- J-T Bachelet
- Service de chirurgie maxillo-faciale, groupement hospitalier Nord, centre hospitalo-universitaire de Lyon, université Claude-Bernard Lyon-1, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France.
| | - G Buiret
- Service de chirurgie maxillo-faciale, groupement hospitalier Nord, centre hospitalo-universitaire de Lyon, université Claude-Bernard Lyon-1, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France
| | - M Chevallier
- Service de chirurgie maxillo-faciale, groupement hospitalier Nord, centre hospitalo-universitaire de Lyon, université Claude-Bernard Lyon-1, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France
| | - J-F Bergerot
- Service de chirurgie maxillo-faciale, groupement hospitalier Nord, centre hospitalo-universitaire de Lyon, université Claude-Bernard Lyon-1, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France
| | - L Ory
- Service de chirurgie maxillo-faciale, groupement hospitalier Nord, centre hospitalo-universitaire de Lyon, université Claude-Bernard Lyon-1, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France
| | - A Gleizal
- Service de chirurgie maxillo-faciale, groupement hospitalier Nord, centre hospitalo-universitaire de Lyon, université Claude-Bernard Lyon-1, 103, Grande-Rue-de-la-Croix-Rousse, 69004 Lyon, France
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Chevallier M, Ego A, Cans C, Debillon T. Adherence to hypothermia guidelines: a French multicenter study of fullterm neonates. PLoS One 2013; 8:e83742. [PMID: 24391817 PMCID: PMC3877096 DOI: 10.1371/journal.pone.0083742] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 11/07/2013] [Indexed: 11/18/2022] Open
Abstract
AIM The objective of this study was to describe the French practice of hypothermia treatment (HT) in full-term newborns with hypoxic-ischemic encephalopathy (HIE) and to analyze the deviations from the guidelines of the French Society of Neonatology. MATERIALS AND METHODS From May 2010 to March 2012 we recorded all cases of HIE treated by HT in a French national database. The population was divided into three groups, "optimal HT" (OHT), "late HT" (LHT) and "non-indicated" HT (NIHT), according to the guidelines. RESULTS Of the 311 newborns registered in the database and having HT, 65% were classified in the OHT group, 22% and 13% in the LHT and NIHT groups respectively. The severity of asphyxia and HIE were comparable between newborns with OHT and LHT, apart from EEG. HT was initiated at a mean time of 12 hours of life in the LHT group. An acute obstetrical event was more likely to be identified among newborns with LHT (46%), compared to OHT (34%) and NIHT (22%). There was a gradation in the rate of complications from the NIHT group (29%) to the LHT (38%) group and the OHT group (52%). Despite an insignificant difference in the rates of death or abnormal neurological examination at discharge, nearly 60% of newborns in the OHT group had an MRI showing abnormalities, compared to 44% and 49% in the LHT and NIHT groups respectively. CONCLUSION The conduct of the HT for HIE newborns is not consistent with French guidelines for 35% of newborns, 22% being explained by an excessive delay in the start of HT, 13% by the lack of adherence to the clinical indications. This first report illustrates the difficulties in implementing guidelines for HT and should argue for an optimization of perinatal care for HIE.
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Affiliation(s)
- Marie Chevallier
- Neonatology and Pediatric Intensive Care Unit, Grenoble University Hospital, Grenoble, France
| | - Anne Ego
- Clinical Research Center (CICO3), Grenoble University Hospital, Grenoble, France
| | - Christine Cans
- THEMAS (Techniques pour l'évaluation et la modélisation des actions de santé), Joseph Fourier University-Grenoble1, Grenoble, France
| | - Thierry Debillon
- Neonatology and Pediatric Intensive Care Unit, Grenoble University Hospital, Grenoble, France
- * E-mail:
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Chevallier M, Chabbert A, Juchet A, Didier A. Expérience de la biopuce ISAC® dans l’exploration de l’allergie alimentaire en pédiatrie. Revue Française d'Allergologie 2013. [DOI: 10.1016/j.reval.2013.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Saade F, Buronfosse T, Guerret S, Pradat P, Chevallier M, Zoulim F, Jamard C, Cova L. In vivo infectivity of liver extracts after resolution of hepadnaviral infection following therapy associating DNA vaccine and cytokine genes. J Viral Hepat 2013; 20:e56-65. [PMID: 23490390 DOI: 10.1111/jvh.12023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 08/24/2012] [Indexed: 12/19/2022]
Abstract
DNA-based vaccination appears of promise for chronic hepatitis B immunotherapy, although there is an urgent need to increase its efficacy. In this preclinical study, we evaluated the therapeutic benefit of cytokine (IL-2, IFN-γ) genes co-delivery with DNA vaccine targeting hepadnaviral proteins in the chronic duck hepatitis B virus (DHBV) infection model. Then, we investigated the persistence of replication-competent virus in the livers of apparently resolved animals. DHBV carriers received four injections of plasmids encoding DHBV envelope and core alone or co-delivered with duck IL-2 (DuIL-2) or duck IFN-γ (DuIFN-γ) plasmids. After long-term (8 months) follow-up, viral covalently closed circular (ccc) DNA was analysed in duck necropsy liver samples. Liver homogenates were also tested for in vivo infectivity in neonatal ducklings. Co-delivery of DuIFN-γ resulted in significantly lower mean viremia starting from week 21. Viral cccDNA was undetectable by conventional methods in the livers of 25% and 57% of animals co-immunized with DuIL-2 and DuIFN-γ, respectively. Interestingly, inoculation of liver homogenates from 7 such apparently resolved animals, exhibiting cccDNA undetectable in Southern blotting and DHBV expression undetectable or restricted to few hepatocytes, revealed that three liver homogenates transmitted high-titre viremia (3-5×10(10) vge/mL) to naïve animals. In conclusion, our results indicate that IFN-γ gene co-delivery considerably enhances immunotherapeutic efficacy of DNA vaccine targeting hepadnaviral proteins. Importantly, we also showed that livers exhibiting only minute amounts of hepadnaviral cccDNA could induce extremely high-titre infection, highlighting the caution that should be taken in occult hepatitis B patients to prevent HBV transmission in liver transplantation context.
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Affiliation(s)
- F Saade
- Université de Lyon, Lyon, Lyon, France
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Chevallier M, Chabbert A, Labouret G, Juchet A. Allergie à l’éthylvanilline. À propos d’une observation chez une adolescente de 14ans. Revue Française d'Allergologie 2013. [DOI: 10.1016/j.reval.2012.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lecoindre P, Chevallier M, Guerret S. Les entéropathies exsudatives d'origine non néoplastique du chien: étude rétrospective de 34 cas. SCHWEIZ ARCH TIERH 2013; 152:141-6. [DOI: 10.1024/0036-7281/a000033] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Lecoindre P, Bystricka M, Chevallier M, Peyron C. Gastric carcinoma associated with Menetrier's-like disease in a West Highland white terrier. J Small Anim Pract 2012; 53:714-8. [DOI: 10.1111/j.1748-5827.2012.01291.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- P. Lecoindre
- Clinique Vétérinaire des Cerisioz; 5 Route de Saint Symphorien d'Ozon; 69 800; Saint Priest; France
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Henriquet P, Testa E, Chevallier M, Dauvergne D, Dedes G, Freud N, Krimmer J, Létang JM, Ray C, Richard MH, Sauli F. Interaction vertex imaging (IVI) for carbon ion therapy monitoring: a feasibility study. Phys Med Biol 2012; 57:4655-69. [DOI: 10.1088/0031-9155/57/14/4655] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Testa E, Chevallier M, Dauvergne D, Dedes G, De Rydt M, Freud N, Krimmer J, Henriquet P, Letang J, Ray C, Reithinger V, Richard M. 240 SPATIAL CORRELATIONS BETWEEN IMAGES DERIVED FROM DYNAMIC FDG-PET. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70207-4] [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: 10/28/2022]
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De Rydt M, Chevallier M, Dauvergne D, Deng S, Dedes G, Freud N, Krimmer J, Létang JM, Mattez H, Pinto M, Ray C, Richard MH, Roellinghoff F, Reithinger V, Testa E, Zoccaratto Y. 136 REAL-TIME MONITORING OF THE BRAGG PEAK DURING ION THERAPY: RECENT DEVELOPMENTS OF THE BEAM DETECTION SYSTEM. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70108-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Miailhes P, Pradat P, Chevallier M, Lacombe K, Bailly F, Cotte L, Trabaud MA, Boibieux A, Bottero J, Trepo C, Zoulim F. Proficiency of transient elastography compared to liver biopsy for the assessment of fibrosis in HIV/HBV-coinfected patients. J Viral Hepat 2011; 18:61-9. [PMID: 20196798 DOI: 10.1111/j.1365-2893.2010.01275.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Transient elastography (TE) is a noninvasive technique to evaluate liver fibrosis. We compared the performance of TE with liver biopsy (LB) in patients with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection. Patients prospectively underwent TE and LB. The diagnosis accuracy of TE was calculated using receiver operating characteristic (ROC) curves for different stages of fibrosis, and optimal cut-off values were defined. A sequential algorithm combining TE with biochemical score (Fibrotest) is proposed. Fifty-seven patients had both TE and LB (median time: 3 days) and two with proven cirrhosis, only TE. Forty-six (78%) were under antiretroviral therapy with anti-HBV drugs in 98%, and 19 (32%) had elevated alanine aminotransferase (ALT). A significant correlation was observed between liver stiffness measurement (LSM) and METAVIR fibrosis stages (P < 0.0001). Patients with elevated ALT tended to have higher LSM than those with normal ALT. The areas under the ROC curves were 0.85 for significant fibrosis (≥ F2), 0.92 for advanced fibrosis (≥ F3) and 0.96 for cirrhosis. Using a cut-off of 5.9 kPa for F ≥ 2 and 7.6 kPa for F ≥ 3, the diagnosis accuracy was 83% and 86%, respectively. With an algorithm combining TE and Fibrotest, 97% of patients were well classified for significant fibrosis. Using this algorithm, the need for LB can be reduced by 67%. In HIV/HBV-coinfected patients, most of them with normal ALT under antiretroviral treatment including HBV active drugs, TE was proficient in discriminating moderate to severe fibrosis from minimal liver disease.
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Affiliation(s)
- P Miailhes
- Hospices Civils de Lyon, Hôpital Hôtel-Dieu, Service d'Hépatogastroentérologie, Lyon, France.
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Testa M, Bajard M, Chevallier M, Dauvergne D, Freud N, Henriquet P, Karkar S, Le Foulher F, Létang JM, Plescak R, Ray C, Richard MH, Schardt D, Testa E. Real-time monitoring of the Bragg-peak position in ion therapy by means of single photon detection. Radiat Environ Biophys 2010; 49:337-343. [PMID: 20352439 DOI: 10.1007/s00411-010-0276-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Accepted: 03/06/2010] [Indexed: 05/29/2023]
Abstract
For real-time monitoring of the longitudinal position of the Bragg-peak during an ion therapy treatment, a novel non-invasive technique has been recently proposed that exploits the detection of prompt gamma-rays issued from nuclear fragmentation. Two series of experiments have been performed at the GANIL and GSI facilities with 95 and 305 MeV/u (12)C(6+) ion beams stopped in PMMA and water phantoms. In both experiments, a clear correlation was obtained between the carbon ion range and the prompt photon profile. Additionally, an extensive study has been performed to investigate whether a prompt neutron component may be correlated with the carbon ion range. No such correlation was found. The present paper demonstrates that a collimated set-up can be used to detect single photons by means of time-of-flight measurements, at those high energies typical for ion therapy. Moreover, the applicability of the technique both at cyclotron and at synchrotron facilities is shown. It is concluded that the detected photon count rates provide sufficiently high statistics to allow real-time control of the longitudinal position of the Bragg-peak under clinical conditions.
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Affiliation(s)
- M Testa
- IPNL, Université de Lyon, 69003 Lyon, France.
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42
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Ascione A, De Luca M, Tartaglione MT, Lampasi F, Di Costanzo GG, Lanza AG, Picciotto FP, Marino-Marsilia G, Fontanella L, Leandro G, Lafeuille H, Ughetto S, Darcha C, Chevallier M, Martineau N, Dubost S, Randl K, Dhumeaux D, Bommelaer G, Bonny C. Peginterferon alfa-2a plus ribavirin is more effective than peginterferon alfa-2b plus ribavirin for treating chronic hepatitis C virus infection. Gastroenterology 2010; 138:116-22. [PMID: 19852964 DOI: 10.1053/j.gastro.2009.10.005] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 10/11/2009] [Accepted: 10/15/2009] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Patients with chronic hepatitis C virus (HCV) infection are frequently treated with a combination of pegylated interferon (peginterferon) and ribavirin. This study compared the efficacy and safety of peginterferon alfa-2a and peginterferon alfa-2b, each in combination with ribavirin. METHODS A total of 320 consecutive, treatment-naive, HCV RNA-positive patients with chronic hepatitis were randomly assigned to once-weekly peginterferon alfa-2a (180 microg, group A) or peginterferon alfa-2b (1.5 microg/kg, group B) plus ribavirin 1000 mg/day (body weight <75 kg) or 1200 mg/day (body weight >or=75 kg) for 48 weeks (genotype 1 or 4) or 24 weeks (genotype 2 or 3). The primary end point was sustained virological response (SVR) by intention-to-treat. RESULTS More patients in group A than group B achieved an SVR (110/160 [68.8%] vs 87/160 [54.4%]; P = .008). Higher SVR rates were obtained in group A than group B among patients with genotype 1/4 (51/93 [54.8%] vs 37/93 [39.8%]; P = .04), with genotype 2/3 (59/67 [88.1%] vs 50/67 [74.6%]; P = .046), without cirrhosis (96/127 [75.6%] vs 75/134 [55.9%]; P = .005), and with baseline levels HCV RNA >500,000 IU/mL (58/84 [69%] vs 43/93 [46.2%]; P = .002). SVR rates in groups A and B were not statistically different among patients with baseline HCV RNA <or=500,000 IU/mL (52/76 [68.4%] vs 44/67 [65.7%]; P = .727) or in patients with cirrhosis (14/33 [42.4%] vs 12/26 [46.1%]; P = .774). CONCLUSIONS In patients with chronic HCV infection, peginterferon alfa-2a plus ribavirin produced a significantly higher SVR rate than peginterferon alfa-2b plus ribavirin.
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Affiliation(s)
- Antonio Ascione
- Department of Gastroenterology, Liver Unit, Cardarelli Hospital, Napoli, Italy.
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43
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Svendsen H, Overgaard J, Chevallier M, Collet E, Iversen B. Photomagnetic Switching of the Complex [Nd(dmf)4(H2O)3(μ-CN)Fe(CN)5]⋅H2O Analyzed by Single-Crystal X-Ray Diffraction. Angew Chem Int Ed Engl 2009. [DOI: 10.1002/ange.200805997] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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44
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Svendsen H, Overgaard J, Chevallier M, Collet E, Iversen B. Photomagnetic Switching of the Complex [Nd(dmf)4(H2O)3(μ-CN)Fe(CN)5]⋅H2O Analyzed by Single-Crystal X-Ray Diffraction. Angew Chem Int Ed Engl 2009; 48:2780-3. [DOI: 10.1002/anie.200805997] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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45
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Wendum D, Lacombe K, Chevallier M, Callard P, Valet F, Miailhes P, Bonnard P, Molina JM, Lascoux-Combe C, Flejou JF, Girard PM. Histological scoring of fibrosis and activity in HIV-chronic hepatitis B related liver disease: performance of the METAVIR score assessed on virtual slides. J Clin Pathol 2009; 62:361-3. [DOI: 10.1136/jcp.2008.062349] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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46
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Morjean M, Jacquet D, Charvet JL, L'Hoir A, Laget M, Parlog M, Chbihi A, Chevallier M, Cohen C, Dauvergne D, Dayras R, Drouart A, Escano-Rodriguez C, Frankland JD, Kirsch R, Lautesse P, Nalpas L, Ray C, Schmitt C, Stodel C, Tassan-Got L, Testa E, Volant C. Fission time measurements: a new probe into superheavy element stability. Phys Rev Lett 2008; 101:072701. [PMID: 18764526 DOI: 10.1103/physrevlett.101.072701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2008] [Indexed: 05/26/2023]
Abstract
Reaction mechanism analyses performed with a 4pi detector for the systems 208Pb + Ge, 238U + Ni and 238U + Ge, combined with analyses of the associated reaction time distributions, provide us with evidence for nuclei with Z=120 and 124 living longer than 10(-18) s and arising from highly excited compound nuclei. By contrast, the neutron deficient nuclei with Z=114 possibly formed in 208Pb + Ge reactions have shorter lifetimes, close to or below the sensitivity limit of the experiment.
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Affiliation(s)
- M Morjean
- GANIL, CEA-DSM, and IN2P3-CNRS, B.P. 55027, F-14076 Caen Cedex, France.
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47
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Mrani S, Chemin I, Menouar K, Guillaud O, Pradat P, Borghi G, Trabaud MA, Chevallier P, Chevallier M, Zoulim F, Trépo C. Occult HBV infection may represent a major risk factor of non-response to antiviral therapy of chronic hepatitis C. J Med Virol 2007; 79:1075-81. [PMID: 17596829 DOI: 10.1002/jmv.20943] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Occult hepatitis B virus (HBV) infection is common in chronic hepatitis C patient. However, its significance and consequences are still unclear. The aim of this study was to evaluate the prevalence of occult HBV among HCV chronic carriers in France and to assess its impact on liver histology and response to antiviral therapy. To this end a cohort of 203 patients with chronic hepatitis C without hepatitis B surface antigen (HBsAg) has been examined. Serum HBV-DNA was detected using a highly sensitive PCR with primers located in the S and X genes. HBV viraemia levels were further determined by real-time PCR. Results showed that 47 of 203 (23%) patients had occult HBV infection with a low HBV load (10(2)-10(4) copies/ml) but significantly higher HCV-RNA titers (P < 0.05). No significant difference in age, gender, serum ALT level, HCV genotypes, and the presence of anti-HBc was observed between patients with or without HBV-DNA. When compared histologically, patients with occult HBV infection had higher activity (A2-A3 in 53% vs. 38%, P < 0.01) and more advanced fibrosis (60% vs. 33%, P < 0.001) than HBV-DNA negative cases. Sustained response to combination therapy against Chronic hepatitis C was achieved in 11 (28%) of 40 HBV-DNA positive cases, compared with 65 (45%) of the 144 HBV-DNA negative cases (P < 0.05). Among the 144 HBV-DNA negative HCV patients those with genotype 1 responded less frequently to therapy as compared to other genotypes infected patients (38% vs. 55%, P < 0.05). Surprisingly, when considering all patients studied, irrespective to the HBV-DNA status no significant difference was observed in response to combination therapy regarding HCV genotypes (39% vs. 44%, P > 0.05). In conclusion, HBV-DNA is found in 1/4 of French chronic hepatitis C patients regardless of the presence of anti-HBc. Such an occult HBV co-infection is associated with more severe liver disease, higher HCV viral load and decreased response to antiviral therapy irrespective of HCV genotypes.
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Affiliation(s)
- S Mrani
- INSERM U271, 151 Cours A Thomas, 69003 Lyon, France
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48
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Perrot G, Miailhes P, Bailly F, Chevallier M, Cotte L, Pradat P, Boibieux A, Trepo C. Étude prospective comparant l'élastométrie impulsionnelle à la ponction biopsie hépatique pour l'évaluation de la fibrose hépatique chez les co-infectés VIH–VHB. Rev Med Interne 2007. [DOI: 10.1016/j.revmed.2007.03.197] [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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49
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Abergel A, Hezode C, Leroy V, Barange K, Bronowicki JP, Tran A, Alric L, Castera L, Bernard PH, Henquell C, Lafeuille H, Ughetto S, Darcha C, Chevallier M, Martineau N, Dubost S, Randl K, Dhumeaux D, Bommelaer G, Bonny C. Peginterferon alpha-2b plus ribavirin for treatment of chronic hepatitis C with severe fibrosis: a multicentre randomized controlled trial comparing two doses of peginterferon alpha-2b. J Viral Hepat 2006; 13:811-20. [PMID: 17109680 DOI: 10.1111/j.1365-2893.2006.00768.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We compared sustained virological response (SVR) in chronic hepatitis C patients with severe fibrosis treated with pegylated interferon (Peg-IFN) alpha-2b 1.5 microg/kg/week or 0.75 microg/kg/week in combination with ribavirin 800 mg/day for 48 weeks. This was a multicentre randomized controlled study. SVR was observed in 44.5% (45/101) of patients treated with the standard dose of Peg-IFN and 37.2% (38/102) of patients treated with the low dose (NS). In patients with genotypes 1, 4 and 5, SVR was observed in 25.0% of patients who received the standard dose and 16.9% of patients who received the low dose of Peg-IFN (P = NS). In patients with genotypes 1, 4 and 5 and low viraemia, SVR was obtained in 27.3% of patients treated with the standard dose and 25.8% of patients treated with the low dose (P = NS). In the high-viraemia subgroup, SVR was obtained in 24.0% and 9.1% of patients, respectively. In patients with genotypes 2 and 3, SVR was similar in both groups (73.2%vs 73.0%). Thus, (1) patients with genotypes 2 and 3 and severe fibrosis can be treated with low dose of Peg-IFN and ribavirin, (2) this study suggests that patients with genotypes 1, 4 and 5 and high viraemia could receive a standard dose of Peg-IFN associated with ribavirin for 48 weeks, (3) side effects limit the efficacy of the treatment with standard dose of Peg-IFN in patients with genotypes 1, 4 and 5 and low viraemia, (4) more studies are needed for patients with genotype 2 or 3 to define the optimal duration (24 or 48 weeks) in patients with severe fibrosis.
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Affiliation(s)
- A Abergel
- Service d'Hépato-Gastroentérologie, Hôtel-Dieu, Clermont-Ferrand, France.
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50
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Chevallier M, Ducerf C, Dumortier J, Bizollon T, Boillot O, Scoazec J. Statut histologique du greffon hépatique après plus de 10 ans d’évolution : étude de 110 patients. Ann Pathol 2006. [DOI: 10.1016/s0242-6498(06)78416-4] [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: 10/22/2022]
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