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Titeca-Beauport D, Diouf M, Daubin D, Vong LV, Belliard G, Bruel C, Zerbib Y, Vinsonneau C, Klouche K, Maizel J. The combination of kidney function variables with cell cycle arrest biomarkers identifies distinct subphenotypes of sepsis-associated acute kidney injury: a post-hoc analysis (the PHENAKI study). Ren Fail 2024; 46:2325640. [PMID: 38445412 PMCID: PMC10919311 DOI: 10.1080/0886022x.2024.2325640] [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: 09/25/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The severity and course of sepsis-associated acute kidney injury (SA-AKI) are correlated with the mortality rate. Early detection of SA-AKI subphenotypes might facilitate the rapid provision of individualized care. PATIENTS AND METHODS In this post-hoc analysis of a multicenter prospective study, we combined conventional kidney function variables with serial measurements of urine (tissue inhibitor of metalloproteinase-2 [TIMP-2])* (insulin-like growth factor-binding protein [IGFBP7]) at 0, 6, 12, and 24 h) and then using an unsupervised hierarchical clustering of principal components (HCPC) approach to identify different phenotypes of SA-AKI. We then compared the subphenotypes with regard to a composite outcome of in-hospital death or the initiation of renal replacement therapy (RRT). RESULTS We included 184 patients presenting SA-AKI within 6 h of the initiation of catecholamines. Three distinct subphenotypes were identified: subphenotype A (99 patients) was characterized by a normal urine output (UO), a low SCr and a low [TIMP-2]*[IGFBP7] level; subphenotype B (74 patients) was characterized by existing chronic kidney disease (CKD), a higher SCr, a low UO, and an intermediate [TIMP-2]*[IGFBP7] level; and subphenotype C was characterized by very low UO, a very high [TIMP-2]*[IGFBP7] level, and an intermediate SCr level. With subphenotype A as the reference, the adjusted hazard ratio (aHR) [95%CI] for the composite outcome was 3.77 [1.92-7.42] (p < 0.001) for subphenotype B and 4.80 [1.67-13.82] (p = 0.004) for subphenotype C. CONCLUSIONS Combining conventional kidney function variables with urine measurements of [TIMP-2]*[IGFBP7] might help to identify distinct SA-AKI subphenotypes with different short-term courses and survival rates.
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Affiliation(s)
- Dimitri Titeca-Beauport
- Medical Intensive Care Unit and EA7517, Boreal Study Group, Amiens University Hospital, Amiens, France
| | - Momar Diouf
- Department of Statistics, Amiens University Hospital, Amiens, France
| | - Delphine Daubin
- Department of Intensive Care Medicine, Lapeyronie University Hospital, PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Ly Van Vong
- Intensive Care Unit, Groupe Hospitalier Sud Ile de France, Melun, France
| | - Guillaume Belliard
- Medical-Surgical Intensive Care Unit, Centre Hospitalier de Bretagne Sud, Lorient, France
| | - Cédric Bruel
- Medical and Surgical Intensive Care Unit, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Yoann Zerbib
- Medical Intensive Care Unit and EA7517, Boreal Study Group, Amiens University Hospital, Amiens, France
| | | | - Kada Klouche
- Department of Intensive Care Medicine, Lapeyronie University Hospital, PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Julien Maizel
- Medical Intensive Care Unit and EA7517, Boreal Study Group, Amiens University Hospital, Amiens, France
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Bar S, Moussa MD, Descamps R, El Amine Y, Bouhemad B, Fischer MO, Lorne E, Dupont H, Diouf M, Guinot PG. Determinants of postoperative complications in high-risk noncardiac surgery patients optimized with hemodynamic treatment strategies: A post-hoc analysis of a randomized multicenter clinical trial. J Clin Anesth 2024; 93:111325. [PMID: 37992534 DOI: 10.1016/j.jclinane.2023.111325] [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: 04/06/2023] [Revised: 10/23/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023]
Abstract
STUDY OBJECTIVE This post-hoc analysis of a randomized controlled trial was undertaken to establish the determinants of postoperative complications and acute kidney injury in high-risk noncardiac surgery patients supported with hemodynamic treatment strategies. DESIGN We conducted a post-hoc analysis of patients enrolled in the OPtimization Hemodynamic Individualized by the respiratory QUotiEnt (OPHIQUE) trial. SETTING Operating rooms in four university medical centers and one non-university hospital from December 26, 2018, to September 9, 2021. PATIENTS We enrolled 350 patients with a high risk of postoperative complications undergoing high-risk noncardiac surgery lasting 2 h or longer under general anesthesia. INTERVENTIONS All patients were treated according to hemodynamic treatment strategies which included cardiac output optimization by titration of fluid challenge and targeted systolic blood pressure to remain within ±10% of the reference value. MEASUREMENTS We assessed the association between pre-operative and intra-operative exposure of interest with a composite primary outcome of major complications or death within seven days following surgery using a multivariable logistic regression model. We also assessed the association between these exposures of interest and acute kidney injury. MAIN RESULTS The data of 341 patients were analyzed. In multivariate analysis, the factors independently associated with the primary outcome were age (OR = 1.04 (1.01-1.06), P = 0.002), preoperative hemoglobin concentration (OR = 0.85 (0.75-0.96), P = 0.012), non-vascular surgery (OR = 0.30 (0.17-0.53), P < 0.0001), and intraoperative surgical complications (OR = 2.08 (1.02-4.24), P = 0.046). The factors independently associated with postoperative acute kidney injury were age (OR = 1.04 (1.01-1.08), P = 0.008), preoperative creatinine concentration (OR = 1.01 (1.00-1.01), P = 0.049), non-vascular surgery (OR = 0.36 (0.20-0.66), P = 0.001), and intraoperative surgical complications (OR = 3.36 (1.50-7.55), P = 0.031). CONCLUSIONS Surgical complications, a lower preoperative hemoglobin concentration, age, and vascular surgery were associated with postoperative complications in a high-risk noncardiac surgery population supported with hemodynamic treatment strategies.
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Affiliation(s)
- Stéphane Bar
- Department of Anesthesiology and Critical Care Medicine, Amiens University Medical Centre, Amiens, France; SSPC UPJV 7518 (Simplifications des Soins Patients Chirurgicaux Complexes - Simplification of Care of Complex Surgical Patients) Clinical Research Unit, Jules Verne University of Picardie, Amiens, France.
| | - Mouhamed Djahoum Moussa
- Department of Anesthesiology and Critical Care Medicine, Lille University Medical Centre, Lille, France
| | - Richard Descamps
- Department of Anesthesiology and Critical Care Medicine, Caen University Medical Center, Caen, France
| | - Younes El Amine
- Department of Anesthesiology and Critical Care Medicine, Valenciennes Medical Center, Valenciennes, France
| | - Belaid Bouhemad
- Department of Anesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France
| | | | - Emmanuel Lorne
- Department of Anesthesia and Critical Care Medicine, Millénaire Clinic, Montpellier, France
| | - Hervé Dupont
- Department of Anesthesiology and Critical Care Medicine, Amiens University Medical Centre, Amiens, France; SSPC UPJV 7518 (Simplifications des Soins Patients Chirurgicaux Complexes - Simplification of Care of Complex Surgical Patients) Clinical Research Unit, Jules Verne University of Picardie, Amiens, France
| | - Momar Diouf
- Biostatistical Unit, Direction de la Recherche Clinique, University Hospital of Amiens Picardy, Amiens, France
| | - Pierre Grégoire Guinot
- Department of Anesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France
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Singlas M, Tran THC, Boucenna W, Diouf M, Godefroy O. Is internal retinal thickness an early marker of Alzheimer's and Lewy body diseases? Rev Neurol (Paris) 2024; 180:220-223. [PMID: 37925357 DOI: 10.1016/j.neurol.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 08/30/2023] [Accepted: 10/04/2023] [Indexed: 11/06/2023]
Affiliation(s)
- M Singlas
- Department of Ophthalmology, Amiens University Hospital, Amiens, France
| | - T H C Tran
- Department of Ophthalmology, Amiens University Hospital, Amiens, France; Laboratory of Lille Neurosiences &Cognition, INSERM U1172, Lille, France
| | - W Boucenna
- Department of Ophthalmology, Amiens University Hospital, Amiens, France
| | - M Diouf
- Department of Biostatistic, Amiens University Hospital, Amiens, France
| | - O Godefroy
- Department of Neurology, Amiens University Hospital, 80054 Amiens, France; Laboratory of and Neurosciences Functional Pathology, (UR 4559), Picardie Jules Verne University, Picardie, France.
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Maaziz N, Georges M, Basille D, Gallet M, Gardie B, Diouf M, Garçon L, Girodon F. Carbon monoxide rebreathing method is a reliable test to evaluate the red cell mass in polycythaemia. Br J Haematol 2024; 204:706-709. [PMID: 38044575 DOI: 10.1111/bjh.19169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Nada Maaziz
- Service de Génétique Chromosomique et Moléculaire, Pôle Biologie, Centre Hospitalier Universitaire (CHU) de Dijon, Dijon, France
- Inserm U1231, Université de Bourgogne, Dijon, France
| | - Marjolaine Georges
- Service de Pneumologie, Centre Hospitalier Universitaire (CHU) de Dijon, Dijon, France
| | - Damien Basille
- Service de Pneumologie, Centre Hospitalier Universitaire (CHU) d'Amiens-Picardie, Amiens, France
- UR 4294 AGIR, Université Picardie Jules Verne, Amiens, France
| | - Matthieu Gallet
- Unité de Radiopharmacie et/ou Service Pharmacie, Centre Georges François Leclerc (CGFL), Dijon, France
| | - Betty Gardie
- Université de Nantes, CNRS, INSERM, l'institut du Thorax, Nantes, France
- Ecole Pratique des Hautes Etudes (EPHE), Université PSL, Paris, France
- Laboratoire d'Excellence GR-Ex, Paris, France
| | - Momar Diouf
- Direction de la Recherche et de l'innovation, Centre Hospitalier Universitaire (CHU) d'Amiens-Picardie, Amiens, France
| | - Loïc Garçon
- Service d'Hématologie, Centre Hospitalier Universitaire (CHU) d'Amiens-Picardie, Amiens, France
- UR4666 HEMATIM, Université Picardie Jules Verne, Amiens, France
| | - François Girodon
- Inserm U1231, Université de Bourgogne, Dijon, France
- Laboratoire d'Excellence GR-Ex, Paris, France
- Service d'Hématologie Biologique, Pôle Biologie, Centre Hospitalier Universitaire (CHU) de Dijon, Dijon, France
- Membre du France Intergroupe des Myéloprolifératifs (FIM), Paris, France
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Bohbot Y, Hucleux E, Rusinaru D, Diouf M, Levy F, Altes A, Maréchaux S, Tribouilloy C. Right Ventricle to Pulmonary Artery Coupling in Severe Aortic Stenosis With Preserved Ejection Fraction. JACC Cardiovasc Imaging 2024; 17:220-222. [PMID: 37855799 DOI: 10.1016/j.jcmg.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 10/20/2023]
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Yzet C, Riault C, Brazier F, Grados L, Nguyen-Khac E, Chatelain D, Sabbagh C, Buisson A, Diouf M, Fumery M. Positive margins and plexitis increase the risk of recurrence after ileocecal resection: A systematic review and meta-analysis. Dig Liver Dis 2023; 55:1611-1620. [PMID: 36658042 DOI: 10.1016/j.dld.2022.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/23/2022] [Accepted: 12/23/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION There is debate over the impact of residual microscopic disease after ileocecal resection in Crohn's disease (CD) to predict recurrence. We conducted a meta-analysis to evaluate the impact of positive histological margins and plexitis after ileocecal resection on the risk of postoperative recurrence. METHODS Using a systematic search, we identified. 30 studies evaluating the impact of inflammatory margins on CD recurrence. The primary outcome was the postoperative clinical recurrence and secondary outcomes were surgical, and endoscopic recurrence. We performed random-effects meta-analysis and estimated odds ratio (OR) and 95% CIs. RESULTS Thirty studies were analyzed, seven focused on myenteric plexitis, six on submucosal plexitis and twenty-three on positive margins. Inflammatory margins were associated with a higher rate of clinical and surgical recurrences: respectively 14 studies - OR 2.38; 95% CI, 1.54 - 3.68- I2 = 68.2%, Q test-p = 0.0003 and 8 studies - OR, 1.52; 95% CI, 1.07-2.16 - I2 =0%; Q test-p = 0.43. The presence of myenteric plexitis was associated with a higher rate of clinical recurrence (4 studies- OR, 1.60; 95%CI, 1.12-2.29; I2= 0%, Q-test-p = 0.61), and of endoscopic recurrence (4 studies - OR, 4.25; 95%CI; 2.06-8.76; I2= 0%, Q test-p = 0.97). Submucosal plexitis was not associated with an increased risk of endoscopic recurrence (4 studies - OR, 0.94; 95%CI; 0.58-1.52; I2= 0%, Q test-p = 0.79). CONCLUSION Inflammatory margins and/or plexitis were associated with postoperative recurrence after ileocecal resection for CD. These elements should be taken into account in future algorithm for prevention of postoperative recurrence.
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Affiliation(s)
- Clara Yzet
- Department of gastroenterology, Amiens University hospital, Picardie University, Amiens, France
| | - Clémentine Riault
- Department of gastroenterology, Amiens University hospital, Picardie University, Amiens, France
| | - Franck Brazier
- Department of gastroenterology, Amiens University hospital, Picardie University, Amiens, France
| | - Lucien Grados
- Department of gastroenterology, Amiens University hospital, Picardie University, Amiens, France
| | - Eric Nguyen-Khac
- Department of gastroenterology, Amiens University hospital, Picardie University, Amiens, France
| | | | | | - Anthony Buisson
- Department of gastroenterology, Clermont-Ferrand University hospital, Clermont-Ferrand, France
| | - Momar Diouf
- Department of statistics, Amiens University hospital, Picardie University, Amiens, France
| | - Mathurin Fumery
- Department of gastroenterology, Amiens University hospital, Picardie University, Amiens, France; PériTox Laboratory, Périnatalité & Risques Toxiques, UMR-I 01 INERIS, Picardie Jules Verne University, Amiens, France.
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Candellier A, Bohbot Y, Pasquet A, Diouf M, Vermes E, Goffin E, Gun M, Peugnet F, Hénaut L, Rusinaru D, Mentaverri R, Kamel S, Choukroun G, Vanoverschelde JL, Tribouilloy C. Chronic kidney disease is a key risk factor for aortic stenosis progression. Nephrol Dial Transplant 2023; 38:2776-2785. [PMID: 37248048 PMCID: PMC10689189 DOI: 10.1093/ndt/gfad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Rapid progression of aortic stenosis (AS) has been observed in patients undergoing dialysis, but existing cross-sectional evidence is contradictory in non-dialysis-dependent chronic kidney disease (CKD). The present study sought to evaluate whether CKD is associated with the progression of AS over time in a large cohort of patients with AS. METHODS We retrospectively studied all consecutive patients diagnosed with AS [peak aortic jet velocity (Vmax) ≥2.5 m/s] and left ventricular ejection fraction ≥50% in the echocardiography laboratories of two tertiary centers between 2000 and 2018. The estimated glomerular filtration rate (eGFR) (mL/min/1.73 m2) was calculated from serum creatinine values. Patients were divided into five CKD stages according to the baseline eGFR. Annual rates of change in the aortic valve area (AVA) were determined by a linear mixed-effects model. RESULTS Among the 647 patients included, 261 (40%) had CKD. After a median follow-up of 2.9 (interquartile range 1.8-4.8) years, the mean overall rate of change in AVA was -0.077 (95% confidence interval -0.082; -0.073) cm2/year. There was an inverse relationship between the progression rate and kidney function. The more severe the CKD stage, the greater the AVA narrowing (P < .001). By multivariable linear regression analysis, the eGFR was also negatively associated (P < .001) with AS progression. An eGFR strata below 45 mL/min/1.73 m2 was associated with higher odds of rapid progression of AS than normal kidney function. During the clinical follow-up, event-free survival (patients free of aortic valve replacement or death) decreased as CKD progressed. Rapid progression of AS in patients with kidney dysfunction was associated with worse outcomes. CONCLUSIONS Patients with CKD exhibit more rapid progression of AS over time and require close monitoring. The link between kidney dysfunction and rapid progression of AS is still unknown and requires further research.
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Affiliation(s)
- Alexandre Candellier
- Department of Nephrology Dialysis and Transplantation, Amiens University Hospital, Amiens, France
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
| | - Yohann Bohbot
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
- Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Agnes Pasquet
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
- Department of Cardiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Momar Diouf
- Department of Clinical Research, Amiens University Hospital, Amiens, France
| | - Emmanuelle Vermes
- Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Eric Goffin
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
- Department of Nephrology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Mesut Gun
- Department of Cardiology, Amiens University Hospital, Amiens, France
- Department of Clinical Research, Amiens University Hospital, Amiens, France
| | - Fanny Peugnet
- Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Lucie Hénaut
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
| | - Dan Rusinaru
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
- Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Romuald Mentaverri
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
- Department of Biochemistry, Amiens-Picardie University Hospital, Amiens, France
| | - Saïd Kamel
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
- Department of Biochemistry, Amiens-Picardie University Hospital, Amiens, France
| | - Gabriel Choukroun
- Department of Nephrology Dialysis and Transplantation, Amiens University Hospital, Amiens, France
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
| | - Jean-Louis Vanoverschelde
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
- Department of Cardiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Christophe Tribouilloy
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
- Department of Cardiology, Amiens University Hospital, Amiens, France
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Brault C, Zerbib Y, Mercado P, Diouf M, Michaud A, Tribouilloy C, Maizel J, Slama M. Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock. BJA Open 2023; 7:100220. [PMID: 37638090 PMCID: PMC10457489 DOI: 10.1016/j.bjao.2023.100220] [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] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/19/2023] [Accepted: 07/20/2023] [Indexed: 08/29/2023]
Abstract
Background Using easy-to-determine bedside measurements, we developed an echocardiographic algorithm for predicting left ventricular ejection fraction (LVEF) and longitudinal strain (LVLS) in patients with septic shock. Methods We measured septal and lateral mitral annular plane systolic excursion (MAPSE), septal and lateral mitral S-wave velocity, and the left ventricular longitudinal wall fractional shortening in patients with septic shock. We used a conditional inference tree method to build a stratification algorithm. The left ventricular systolic dysfunction was defined as an LVEF <50%, an LVLS greater than -17%, or both. Results We included 71 patients (males: 61%; mean [standard deviation] age: 61 [15] yr). Septal MAPSE (cut-off: 1.2 cm) was the best predictor of left ventricular systolic dysfunction. The level of agreement between the septal MAPSE and the left ventricular systolic dysfunction was 0.525 [0.299-0.751]. A septal MAPSE ≥1.2 cm predicted normal LVEF in 17/18 patients, or 94%. In contrast, a septal MAPSE <1.2 cm predicted left ventricular systolic dysfunction with impaired LVLS in 46/53 patients (87%), although 32/53 (60%) patients had a preserved LVEF. Conclusions Septal MAPSE is easily measured at the bedside and might help clinicians to detect left ventricular systolic dysfunction early-especially when myocardial strain measurements are not feasible.
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Affiliation(s)
- Clément Brault
- Intensive Care Department, Amiens-Picardie University Hospital, Amiens, France
| | - Yoann Zerbib
- Intensive Care Department, Amiens-Picardie University Hospital, Amiens, France
| | - Pablo Mercado
- Intensive Care Department, Amiens-Picardie University Hospital, Amiens, France
- Universidad del Desarrollo, Departamento de Paciente Crítico, Facultad de Medicina Clínica Alemana, Santiago, Chile
| | - Momar Diouf
- Clinical Research Department Amiens-Picardie University Hospital, Amiens, France
| | - Audrey Michaud
- Clinical Research Department Amiens-Picardie University Hospital, Amiens, France
| | | | - Julien Maizel
- Intensive Care Department, Amiens-Picardie University Hospital, Amiens, France
| | - Michel Slama
- Intensive Care Department, Amiens-Picardie University Hospital, Amiens, France
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Kubala M, Bohbot Y, Rusinaru D, Maréchaux S, Diouf M, Tribouilloy C. Atrial fibrillation in severe aortic stenosis: Prognostic value and results of aortic valve replacement. J Thorac Cardiovasc Surg 2023; 166:771-779. [PMID: 34937660 DOI: 10.1016/j.jtcvs.2021.11.055] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 11/05/2021] [Accepted: 11/15/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Although atrial fibrillation (AF) is common, its impact on long-term mortality has not been reliably determined in patients with aortic stenosis (AS). We aimed to assess whether AF is associated with survival in patients with severe AS and to determine the impact of AF on the results of aortic valve replacement (AVR). METHODS The study included 1838 consecutive patients with severe AS (77 ± 11 years, male 47%). Upon AS diagnosis, patients were screened for AF using a 12-lead electrocardiogram. The treatment strategy (conservative management or AVR) was selected by the heart team in accordance with current guidelines. The effect of AVR on survival was analyzed as a time-dependent covariate using the entire follow-up period. RESULTS AF, diagnosed in 593 (32%) patients was associated with poor survival at 5 years (55 ± 2% vs 74 ± 1% for patients in sinus rhythm, P < .001), even after adjustment for established outcome predictors (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.33-1.84; P < .001). In patients with AF, AVR was associated with lower mortality (HR, 0.16; 95% CI, 0.12-0.22; P < .001) even in those with no or minimal symptoms (HR, 0.12; 95% CI, 0.08-0.20; P < .001). However, among patients who underwent AVR, those in AF had an excess mortality (HR, 1.59; 95% CI, 1.22-2.08; P < .001). CONCLUSIONS In severe AS, AF is a strong predictor of mortality even in asymptomatic or minimally symptomatic patients. After AVR, AF remains associated with poorer survival than sinus rhythm. In patients in AF, AVR is associated with lower mortality compared with conservative treatment. Further studies are needed to confirm the benefits of AVR in asymptomatic patients in AF with severe AS.
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Affiliation(s)
- Maciej Kubala
- Department of Cardiology, Amiens University Hospital, Amiens, France; UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
| | - Yohann Bohbot
- Department of Cardiology, Amiens University Hospital, Amiens, France; UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
| | - Dan Rusinaru
- Department of Cardiology, Amiens University Hospital, Amiens, France; UR UPJV 7517, Jules Verne University of Picardie, Amiens, France
| | - Sylvestre Maréchaux
- UR UPJV 7517, Jules Verne University of Picardie, Amiens, France; Groupement des Hôpitaux de l'Institut Catholique de Lille/Faculté Libre de Médecine, Université Lille Nord de France, Lille, France
| | - Momar Diouf
- Department of Clinical Research, Amiens University Hospital, Amiens, France
| | - Christophe Tribouilloy
- Department of Cardiology, Amiens University Hospital, Amiens, France; UR UPJV 7517, Jules Verne University of Picardie, Amiens, France.
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Bar S, Moussa MD, Descamps R, El Amine Y, Bouhemad B, Fischer MO, Lorne E, Dupont H, Diouf M, Guinot PG. Respiratory Exchange Ratio guided management in high-risk noncardiac surgery: The OPHIQUE multicentre randomised controlled trial. Anaesth Crit Care Pain Med 2023; 42:101221. [PMID: 36958473 DOI: 10.1016/j.accpm.2023.101221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND There is a need to develop non-invasive markers to identify the occurrence of anaerobic metabolism in high-risk surgery. Our objective was to demonstrate that a goal-directed therapy algorithm incorporating the respiratory exchange ratio (ratio between CO2 production and O2 consumption) can reduce postoperative complications. METHODS We conducted a randomized, multicenter, controlled clinical trial in four university medical centers and one non-university hospital from December 26, 2018, to September 9, 2021. 350 patients with a high risk of postoperative complications undergoing high-risk noncardiac surgery lasting 2 h or longer under general anesthesia were enrolled. The control group was treated according to current hemodynamic guidelines. The interventional group was treated according to an algorithm based on the measurement of the respiratory exchange ratio. The primary outcome was a composite of major complications or death within seven days of surgery. The secondary outcomes were the length of hospital stay, 30-day mortality, and the total intraoperative volume of fluids administered. RESULTS The primary outcome occurred for 78 patients (45.6%) in the interventional group and 83 patients (48.8%) in the control group (relative risk: 0.93, 95% confidence interval [CI]: 0.75-1.17; p = 0.55). There were no clinically relevant differences between the two groups for secondary outcomes. CONCLUSIONS In high-risk surgery, a goal-directed therapy algorithm integrating the measurement of the respiratory-exchange ratio did not reduce a composite outcome of major postoperative complications or death within seven days after surgery compared to routine care. TRIAL REGISTRATION ClinicalTrials.gov, NCT03852147.
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Affiliation(s)
- Stéphane Bar
- Department of Anaesthesiology and Critical Care Medicine, Amiens University Medical Centre, Amiens, France; SSPC UPJV 7518 (Simplifications des Soins Patients Chirurgicaux Complexes - Simplification of Care of Complex Surgical Patients) Clinical Research Unit, Jules Verne University of Picardie, Amiens, France.
| | - Mouhamed Djahoum Moussa
- Department of Anaesthesiology and Critical Care Medicine, Lille University Medical Centre, Lille, France
| | - Richard Descamps
- Department of Anaesthesiology and Critical Care Medicine, Caen University Medical Center, Caen, France
| | - Younes El Amine
- Department of Anaesthesiology and Critical Care Medicine, Valenciennes Medical Center, Valenciennes, France
| | - Belaid Bouhemad
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France
| | - Marc-Olivier Fischer
- Department of Anaesthesiology and Critical Care Medicine, Caen University Medical Center, Caen, France; Saint Augustin Clinic, Bordeaux, France
| | - Emmanuel Lorne
- Department of Anaesthesia and Critical Care Medicine, Millénaire Clinic, Montpellier, France
| | - Hervé Dupont
- Department of Anaesthesiology and Critical Care Medicine, Amiens University Medical Centre, Amiens, France; SSPC UPJV 7518 (Simplifications des Soins Patients Chirurgicaux Complexes - Simplification of Care of Complex Surgical Patients) Clinical Research Unit, Jules Verne University of Picardie, Amiens, France
| | - Momar Diouf
- Biostatistical Unit, Direction de la Recherche Clinique, University Hospital of Amiens Picardy, Amiens, France
| | - Pierre Grégoire Guinot
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France
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11
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André J, Diouf M, Martinetti MP, Ortelli O, Gierski F, Fürst F, Pierrefiche O, Naassila M. A new statistical model for binge drinking pattern classification in college-student populations. Front Psychol 2023; 14:1134118. [PMID: 37529316 PMCID: PMC10390312 DOI: 10.3389/fpsyg.2023.1134118] [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] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/16/2023] [Indexed: 08/03/2023] Open
Abstract
Background Binge drinking (BD) among students is a frequent alcohol consumption pattern that produces adverse consequences. A widely discussed difficulty in the scientific community is defining and characterizing BD patterns. This study aimed to find homogenous drinking groups and then provide a new tool, based on a model that includes several key factors of BD, to assess the severity of BD regardless of the individual's gender. Methods Using the learning sample (N1 = 1,271), a K-means clustering algorithm and a partial proportional odds model (PPOM) were used to isolate drinking and behavioral key factors, create homogenous groups of drinkers, and estimate the probability of belonging to these groups. Robustness of our findings were evaluated with Two validations samples (N2 = 2,310, N3 = 120) of French university students (aged 18-25 years) were anonymously investigated via demographic and alcohol consumption questionnaires (AUDIT, AUQ, Alcohol Purchase Task for behavioral economic indices). Results The K-means revealed four homogeneous groups, based on drinking profiles: low-risk, hazardous, binge, and high-intensity BD. The PPOM generated the probability of each participant, self-identified as either male or female, to belong to one of these groups. Our results were confirmed in two validation samples, and we observed differences between the 4 drinking groups in terms of consumption consequences and behavioral economic demand indices. Conclusion Our model reveals a progressive severity in the drinking pattern and its consequences and may better characterize binge drinking among university student samples. This model provides a new tool for assessing the severity of binge drinking and illustrates that frequency of drinking behavior and particularly drunkenness are central features of a binge drinking model.
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Affiliation(s)
- Judith André
- INSERM UMR 1247, Groupe de Recherche sur l’alcool et les Pharmacodépendances, GRAP, Université Picardie Jules Verne, Amiens, France
| | - Momar Diouf
- Biostatistics Unit, Clinical Research Department, Amiens-Picardie University Hospital, Amiens, France
| | - Margaret P. Martinetti
- INSERM UMR 1247, Groupe de Recherche sur l’alcool et les Pharmacodépendances, GRAP, Université Picardie Jules Verne, Amiens, France
- Department of Psychology, The College of New Jersey, Ewing, NJ, United States
| | - Olivia Ortelli
- Department of Psychology, The College of New Jersey, Ewing, NJ, United States
| | - Fabien Gierski
- INSERM UMR 1247, Groupe de Recherche sur l’alcool et les Pharmacodépendances, GRAP, Université Picardie Jules Verne, Amiens, France
- Cognition, Health, Society Laboratory (C2S – EA 6291), University of Reims Champagne Ardenne (URCA), Reims, France
- Fédération Hospitalo-Universitaire A2M2P, Améliore le Pronostic des Troubles Addictifs et Mentaux par une Médecine Personnalisée, Paris, France
- GDR CNRS 3557 Psychiatrie-Addictions, Institut de Psychiatrie, Paris, France
| | - Frederic Fürst
- Laboratoire MIS (Modélisation, Information et Système) UR 4290, Université Picardie Jules Verne, Amiens, France
| | - Olivier Pierrefiche
- INSERM UMR 1247, Groupe de Recherche sur l’alcool et les Pharmacodépendances, GRAP, Université Picardie Jules Verne, Amiens, France
| | - Mickael Naassila
- INSERM UMR 1247, Groupe de Recherche sur l’alcool et les Pharmacodépendances, GRAP, Université Picardie Jules Verne, Amiens, France
- Fédération Hospitalo-Universitaire A2M2P, Améliore le Pronostic des Troubles Addictifs et Mentaux par une Médecine Personnalisée, Paris, France
- GDR CNRS 3557 Psychiatrie-Addictions, Institut de Psychiatrie, Paris, France
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12
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Jacob V, Lambour A, Swinyard B, Zerbib Y, Diouf M, Soudet S, Brochot E, Six I, Maizel J, Slama M, Guillaume N. Annexin-V positive extracellular vesicles level is increased in severe COVID-19 disease. Front Med (Lausanne) 2023; 10:1186122. [PMID: 37332749 PMCID: PMC10272544 DOI: 10.3389/fmed.2023.1186122] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives To evaluate extracellular vesicles levels in a cohort of SARS-CoV-2's patients hospitalized in an intensive care unit with and without COVID-19 associated thromboembolic events. Methods In this study, we aim to assess endothelial and platelet membrane-derived extracellular vesicles levels in a cohort of SARS-CoV-2 patients with and without COVID-19-associated thromboembolic events who were hospitalized in an intensive care unit. Annexin-V positive extracellular vesicles levels were prospectively assessed by flow cytometry in one hundred twenty-three critically ill adults diagnosed with acute respiratory distress syndrome associated with a SARS-CoV-2 infection, ten adults diagnosed for moderate SARS-CoV-2 infection and 25 healthy volunteers. Results On our critically ill patients, thirty-four patients (27.6%) had a thromboembolic event, Fifty-three (43%) died. Endothelial and platelet membrane-derived extracellular vesicles were drastically increased in SARS-CoV-2 patients hospitalized in the ICU compared to healthy volunteers. Moreover a slighty higher small/large ratio for platelets membrane-derived extracellular vesicles in patients was linked to thrombo-embolic events. Conclusion A comparison between total annexin-V positive extracellular vesicles levels in severe and moderate SARS-CoV-2 infection and healthy controls showed a significant increase in patients with severe infection and their sizes could be considered as biomarkers of SARS-CoV-2 associated thrombo-embolic events.
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Affiliation(s)
- Valentine Jacob
- Department of Human Biology Center, Amiens University Medical Center, Amiens, France
- EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
| | - Alexis Lambour
- Department of Medical Intensive Care Unit, Amiens University Medical Center, Amiens, France
| | - Benjamin Swinyard
- Department of Medical Intensive Care Unit, Amiens University Medical Center, Amiens, France
| | - Yoann Zerbib
- Department of Medical Intensive Care Unit, Amiens University Medical Center, Amiens, France
| | - Momar Diouf
- Department of Statistics, Amiens University Medical Center, Amiens, France
| | - Simon Soudet
- Department of Vascular Medicine, Amiens University Medical Center, Amiens, France
| | - Etienne Brochot
- Department of Human Biology Center, Amiens University Medical Center, Amiens, France
- AGIR Research Unit, Jules Verne University of Picardie, Amiens, France
| | - Isabelle Six
- UR 7517 UPJV, Pathophysiological Mechanisms and Consequences of Cardiovascular Calcifications (MP3CV), Jules Verne University of Picardie, Amiens, France
| | - Julien Maizel
- Department of Medical Intensive Care Unit, Amiens University Medical Center, Amiens, France
- UR 7517 UPJV, Pathophysiological Mechanisms and Consequences of Cardiovascular Calcifications (MP3CV), Jules Verne University of Picardie, Amiens, France
| | - Michel Slama
- Department of Medical Intensive Care Unit, Amiens University Medical Center, Amiens, France
- UR 7517 UPJV, Pathophysiological Mechanisms and Consequences of Cardiovascular Calcifications (MP3CV), Jules Verne University of Picardie, Amiens, France
| | - Nicolas Guillaume
- Department of Human Biology Center, Amiens University Medical Center, Amiens, France
- EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
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Hakem R, Soudet S, Diouf M, Sevestre MA. Venous Thrombosis Recurrence After Catheter-Related Upper Extremity Deep Venous Thrombosis in Cancer Patients: A Retrospective Analysis. Angiology 2023:33197231176985. [PMID: 37195809 DOI: 10.1177/00033197231176985] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Long-term indwelling central venous catheters (CVC) are frequently used to secure vascular access to deliver injectable treatment. Catheter-related thrombosis (CRT) occurs in approximately 2-6% of cancer patients. We conducted a single-center retrospective study to assess the rate of venous thromboembolism (VTE) recurrence in cancer patients; 200 patients were included. Mean age was 56 ± 15.15 years, median follow-up duration was 16.5 [range: 10-36] months. The incidence of recurrence was estimated using Gray's method for competing risk with death as the competing event of VTE. Recurrent VTE occurred in 25.5% of patients with a median occurrence time of 6.5 [range: 5-11.25] months. In case of recurrence, 94.6% of patients were treated for cancer and 80.4% of them received anticoagulants; 4 major bleeds and 17 non-major bleeds occurred during follow-up. In multivariate analysis, previous VTE (Hazard Ratio (HR) 2.48 (95% CI 1.42-4.32) and presence of CVC (HR 5.56 (95% CI 1.96-15.75) were significant recurrence risk factors. After a first episode of CRT, 25.5% of patients experienced VTE recurrence as UEDVT in 30 cases (55.5%), PE in 17 cases (31.5%), and DVT in 7 cases (13%), mostly during anticoagulation therapy. Anticoagulation therapy does not avoid CRT in case of cancer and must be balanced with hemorrhagic risk.
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Affiliation(s)
- Rabiaa Hakem
- Department of Vascular Medicine, Amiens-Picardie University Hospital, Amiens, France
| | - Simon Soudet
- Department of Vascular Medicine, Amiens-Picardie University Hospital, Amiens, France
- EA CHIMERE, Picardie Jules Verne University, Amiens, France
| | - Momar Diouf
- DRCI, Amiens-Picardie University Hospital, Amiens, France
| | - Marie Antoinette Sevestre
- Department of Vascular Medicine, Amiens-Picardie University Hospital, Amiens, France
- EA CHIMERE, Picardie Jules Verne University, Amiens, France
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14
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Godefroy O, Aarabi A, Dorchies F, Barbay M, Andriuta D, Diouf M, Thiebaut de Schotten M, Kassir R, Tasseel-Ponche S, Roussel M. Functional architecture of executive processes: Evidence from verbal fluency and lesion mapping in stroke patients. Cortex 2023; 164:129-143. [PMID: 37207410 DOI: 10.1016/j.cortex.2023.03.013] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 03/03/2023] [Accepted: 03/19/2023] [Indexed: 05/21/2023]
Abstract
The functional organization and related anatomy of executive functions are still largely unknown and were examined in the present study using a verbal fluency task. The objective of this study was to determine the cognitive architecture of a fluency task and related voxelwise anatomy in the GRECogVASC cohort and fMRI based meta-analytical data. First, we proposed a model of verbal fluency in which two control processes, lexico-semantic strategic search process and attention process, interact with semantic and lexico-phonological output processes. This model was assessed by testing 404 patients and 775 controls for semantic and letter fluency, naming, and processing speed (Trail Making test part A). Regression (R2 = .276 and .3, P = .0001, both) and structural equation modeling (CFI: .88, RMSEA: .2, SRMR: .1) analyses supported this model. Second, voxelwise lesion-symptom mapping and disconnectome analyses demonstrated fluency to be associated with left lesions of the pars opercularis, lenticular nucleus, insula, temporopolar region, and a large number of tracts. In addition, a single dissociation showed specific association of letter fluency with the pars triangularis of F3. Disconnectome mapping showed the additional role of disconnection of left frontal gyri and thalamus. By contrast, these analyses did not identify voxels specifically associated with lexico-phonological search processes. Third, meta-analytic fMRI data (based on 72 studies) strikingly matched all structures identified by the lesion approach. These results support our modeling of the functional architecture of verbal fluency based on two control processes (strategic search and attention) operating on semantic and lexico-phonologic output processes. Multivariate analysis supports the prominent role of the temporopolar area (BA 38) in semantic fluency and the F3 triangularis area (BA 45) in letter fluency. Finally, the lack of voxels specifically dedicated to strategic search processes could be due to a distributed organization of executive functions warranting further studies.
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Affiliation(s)
- Olivier Godefroy
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France; Departments of Neurology, Amiens University Hospital, France.
| | - Ardalan Aarabi
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
| | - Flore Dorchies
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
| | - Mélanie Barbay
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France; Departments of Neurology, Amiens University Hospital, France
| | - Daniela Andriuta
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France; Departments of Neurology, Amiens University Hospital, France
| | - Momar Diouf
- Departments of Biostatistics, Amiens University Hospital, France
| | - Michel Thiebaut de Schotten
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA, University of Bordeaux, Bordeaux, France; Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France
| | - Rania Kassir
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France; Laboratoire de Recherche en Neurosciences (LAREN), Université Saint-Joseph, Beyrouth, Lebanon
| | - Sophie Tasseel-Ponche
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France; Departments of Physical Medicine and Rehabilitation, Amiens University Hospital, France
| | - Martine Roussel
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France; Departments of Neurology, Amiens University Hospital, France
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15
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Gabrion P, Beyls C, Martin N, Jarry G, Facq A, Fournier A, Malaquin D, Mahjoub Y, Dupont H, Diouf M, Duquenne H, Maizel J, Bohbot Y, Leborgne L, Hermida A. Two-year prognosis of acute coronary syndrome during the first wave of the coronavirus disease 2019 pandemic. Arch Cardiovasc Dis 2023; 116:240-248. [PMID: 37032221 PMCID: PMC10038673 DOI: 10.1016/j.acvd.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND The first wave of the coronavirus disease 2019 pandemic significantly changed behaviour in terms of access to healthcare. AIM To assess the effects of the pandemic and initial lockdown on the incidence of acute coronary syndrome and its long-term prognosis. METHODS Patients admitted for acute coronary syndrome from 17 March to 6 July 2020 and from 17 March to 6 July 2019 were included. The number of admissions for acute coronary syndrome, acute complication rates and 2-year rates of survival free from major adverse cardiovascular events or death from any cause were compared according to the period of hospitalization. RESULTS In total, 289 patients were included. We observed a 30±3% drop in acute coronary syndrome admissions during the first lockdown, which did not recover in the 2months after it was lifted. At 2years, there were no significant differences in the combined endpoint of major adverse cardiovascular events or death from any cause between the different periods (P=0.34). Being hospitalized during lockdown was not predictive of adverse events during follow-up (hazard ratio 0.87, 95% confidence interval 0.45-1.66; P=0.67). CONCLUSIONS We did not observe an increased risk of major cardiovascular events or death at 2years from initial hospitalization for patients hospitalized during the first lockdown, adopted in March 2020 in response to the coronavirus disease 2019 pandemic, potentially as a result of the lack of power of the study.
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Affiliation(s)
- Paul Gabrion
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Christophe Beyls
- Surgical Intensive Care Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Nicolas Martin
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Genevieve Jarry
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Arthur Facq
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Alexandre Fournier
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Dorothée Malaquin
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Yazine Mahjoub
- Surgical Intensive Care Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Hervé Dupont
- Surgical Intensive Care Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Momar Diouf
- Biostatistics Unit, Clinical Research and Innovation Directorate, Amiens-Picardie University Hospital Centre, 80054 Amiens, France
| | - Helene Duquenne
- Cardiology and Arrhythmia Service, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Julien Maizel
- Medical Intensive Care Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Yohann Bohbot
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Laurent Leborgne
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Alexis Hermida
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France; Cardiology and Arrhythmia Service, Amiens-Picardie University Hospital, 80054 Amiens, France.
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Rivière P, Pekow J, Hammoudi N, Wils P, De Cruz P, Wang CP, Mañosa M, Ollech J, Allez M, Nachury M, Kamm MA, Ahanori M, Ferrante M, Buisson A, Singh S, Laharie D, Diouf M, Fumery M. Comparison of the Risk of Crohn's Disease Postoperative Recurrence Between Modified Rutgeerts Score i2a and i2b Categories: An Individual Patient Data Meta-analysis. J Crohns Colitis 2023; 17:269-276. [PMID: 36124813 DOI: 10.1093/ecco-jcc/jjac137] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND The modified Rutgeerts' score [RS] differentiates i2a-lesions confined to the anastomosis-and i2b-more than five aphthous ulcers in the neoterminal ileum with normal intervening mucosa, with or without anastomotic lesions-categories. Its relevance for the therapeutic management of Crohn's disease [CD] patients after ileocolic resection is still debated. Our objective was to compare the postoperative recurrence risk in patients with an i2a or i2b score, using an individual patient data meta-analysis. METHODS We conducted a systematic literature search until July 2020, to identify all relevant studies reporting the i2a/i2b status in the year following ileocolic resection and clinical and/or surgical postoperative CD recurrence in their follow-up. Individual patient-level data were obtained from the corresponding authors. The association between the modified RS and time-to-event was evaluated using a mixed Cox model with the centre as the random effect. RESULTS Seven studies published between 2008 and 2019 were included, corresponding to 400 patients: 189 [47%] i2a and 211 [53%] i2b. Median [interquartile range, IQR] time from ileocolic resection to ileocolonoscopy was 6.2 [5.5, 7.9] months and median [IQR] follow-up time after ileocolonoscopy was 4.5 [2.9, 7.3] years. The risk of clinical postoperative recurrence at 1 and 3 years was 11% [6-15%], and 25% [18-32%] in the i2a group versus 9% [5-13%] and 33% [26-41%] in the i2b group [p = 0.63 and p = 0.12, respectively]. No significant difference was observed in terms of time to clinical postoperative recurrence [p = 0.16] or surgical postoperative recurrence [p = 0.87]. Results did not change after excluding patients having initiated an immunosuppressant or a biologic in the 3 months after endoscopy [remaining cohort, n = 361]. CONCLUSIONS In this individual patient data meta-analysis, no difference was observed between i2a and i2b subcategories with regards to clinical or surgical postoperative recurrence. As we wait for prospective trials, the same treatment strategy could be applied to all patients classified as i2 on the Rutgeerts score.
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Affiliation(s)
- Pauline Rivière
- Hôpital Haut-Lévêque, Service d'Hépato-gastroentérologie et oncologie digestive - Université de Bordeaux, Bordeaux, France
| | - Joel Pekow
- Gastroenterology Department, University of Chicago, Chicago, IL, USA
| | - Nassim Hammoudi
- Service d'Hépato-gastroentérologie, Hôpital Saint-Louis, Université de Paris, Paris, France
| | - Pauline Wils
- Univ. Lille, Institute for Translational Research in Inflammation, Lille, France
| | - Peter De Cruz
- Gastroenterology Department, Austin Health, Heidelberg, VIC, Australia
| | - Christina Pu Wang
- Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Míriam Mañosa
- Hospital Universitari Germans Trias i Pujol, Badalona, Catalunya, Spain
| | - Jacob Ollech
- Gastroenterology Department, University of Chicago, Chicago, IL, USA
| | - Matthieu Allez
- Service d'Hépato-gastroentérologie, Hôpital Saint-Louis, Université de Paris, Paris, France
| | - Maria Nachury
- Univ. Lille, Institute for Translational Research in Inflammation, Lille, France
| | - Michael A Kamm
- Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Maya Ahanori
- Gastroenterology Department, University of Chicago, Chicago, IL, USA
| | - Marc Ferrante
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Anthony Buisson
- Service d'Hépato-gastroentérologie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Siddarth Singh
- Division of Gastroenterology and Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - David Laharie
- Hôpital Haut-Lévêque, Service d'Hépato-gastroentérologie et oncologie digestive - Université de Bordeaux, Bordeaux, France
| | - Momar Diouf
- Direction de la recherche clinique, Centre Hospitalier Universitaire Amiens-Picardie Site Sud, Amiens, France
| | - Mathurin Fumery
- Service d'Hépato-gastroentérologie, Centre Hospitalier Universitaire Amiens-Picardie Site Sud, Amiens, France
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CANDELLIER A, Bohbot Y, Pasquet A, Diouf M, Vermes E, Goffin E, Gun M, Peugnet F, Hénaut L, Rusinaru D, Mentaverri R, Kamel S, Choukroun G, Vanoverschelde J, Tribouilloy C. WCN23-0900 CHRONIC KIDNEY DISEASE IS A KEY RISK FACTOR FOR AORTIC STENOSIS PROGRESSION. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.351] [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: 03/22/2023] Open
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Aubignat M, Roussel M, Aarabi A, Lamy C, Andriuta D, Tasseel-Ponche S, Makki M, Godefroy O, Roussel M, Barbay M, Canaple S, Lamy C, Leclercq C, Arnoux A, Despretz-Wannepain S, Despretz P, Berrissoul H, Picard C, Diouf M, Loas G, Deramond H, Taillia H, Ardisson AE, Nédélec-Ciceri C, Bonnin C, Thomas-Anterion C, Vincent-Grangette F, Varvat J, Quaglino V, Beaunieux H, Moroni C, Martens-Chazelles A, Batier-Monperrus S, Monteleone C, Costantino V, Theunssens E. Poststroke apathy: Major role of cognitive, depressive and neurological disorders over imaging determinants. Cortex 2023; 160:55-66. [PMID: 36745966 DOI: 10.1016/j.cortex.2022.12.012] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/11/2022] [Accepted: 12/01/2022] [Indexed: 01/19/2023]
Abstract
Apathy occurs in approximately one third of people after stroke. Despite its frequency and functional consequences, the determinants of apathy have only been partially defined. The major difficulty lies in disentangling the reduction in activity due to apathy itself from those secondary to comorbidities, such as depression, sensorimotor deficits, and cognitive impairment. Here, we aimed to examine the prevalence of apathy, identify confounding sources of hypoactivity, and define its neuroimaging determinants using multivariate voxel lesion symptom-mapping (mVLSM) analyses. We assessed apathy in a subgroup (n = 325, mean age: 63.8 ± 10.5 years, 91.1% ischemic stroke) of the GRECogVASC cohort using the validated Behavioral Dysexecutive Syndrome Inventory, interpreted using GREFEX criteria, as well as confounding factors (depression, anxiety, severity of the neurological deficit, and gait disorders). mVLSM analysis was used to define neuroimaging determinants and was repeated after controlling for confounding factors. Apathy was present for 120 patients (36.9%, 95% CI: 31.7-42.2). Stepwise linear regression identified three factors associated with apathy: depressive symptoms (R2 = .3, p = .0001), cognitive impairment (R2 = .015, p = .02), and neurological deficit (R2 = .110, p = .0001). Accordingly, only 9 (7.5%) patients had apathy without a confounding factor, i.e., isolated apathy. In conventional VLSM analysis, apathy was associated with a large number of subcortical lesions that were no longer considered after controlling for confounding factors. Strategic site analysis identified five regions associated with isolated apathy: the F3 orbitalis pars, left amygdala, left thalamus, left pallidum, and mesencephalon. mVLSM analysis identified four strategic sites associated with apathy: the right corticospinal tract (R2 = .11; p = .0001), left frontostriatal tract (R2 = .11; p = .0001), left thalamus (R2 = .04; p = .0001), and left amygdala (R2 = .01; p = .013). These regions remained significant after controlling for confounding factors but explained a lower amount of variance. These findings indicate that poststroke apathy is more strongly associated with depression, neurological deficit, and cognitive impairment than with stroke lesions locations, at least using VLSM analysis.
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Affiliation(s)
- Mickael Aubignat
- Department of Neurology, Amiens University Hospital, Amiens, France
| | - Martine Roussel
- Department of Neurology, Amiens University Hospital, Amiens, France; Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
| | - Ardalan Aarabi
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
| | - Chantal Lamy
- Department of Neurology, Amiens University Hospital, Amiens, France; Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
| | - Daniela Andriuta
- Department of Neurology, Amiens University Hospital, Amiens, France; Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
| | - Sophie Tasseel-Ponche
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France; Departments of Rehabilitation, Amiens University Hospital, Amiens, France
| | - Malek Makki
- Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France
| | - Olivier Godefroy
- Department of Neurology, Amiens University Hospital, Amiens, France; Laboratory of Functional Neurosciences (UR UPJV 4559), Jules Verne University of Picardie, Amiens, France.
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Krief D, Foulon A, Tondreau A, Diouf M, Sergent F, Gondry J, Chevreau J. Transperineal ultrasound in routine uterine cervix measurement. Arch Gynecol Obstet 2023; 307:387-393. [PMID: 35318500 DOI: 10.1007/s00404-022-06521-4] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 03/09/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Transvaginal ultrasound (TVUS) is used in routine practice to evaluate cervical length (CL). This technique is nevertheless invasive and often viewed as uncomfortable, which is less the case with transperineal ultrasound (TPUS). This study was conducted in light of recent technological improvements in the ultrasound field to evaluate whether TPUS could be used as an alternative to TVUS in CL assessment. METHODS This was a prospective single-blind study. Pregnant women requiring CL measurement during their emergency consultation were offered a second assessment by TPUS after an initial TVUS. TPUS was performed by a third-year OBGYN resident, unaware of the CL measurement obtained via TVUS. RESULTS Seventy-three women were included. The mean ∂ was 0.59 mm. The interclass Pearson correlation coefficient between the two techniques was 0.8987 (95% CI [0.8429; 0.9353]). None of the tested factors were found to be associated with a difference between TPUS and TVUS CL measurements. ROC curve analysis indicated that a transperineal CL cut-off measurement of 24.9 mm was predictive of a transvaginal CL measurement below 25 mm. This threshold enabled a 95% sensitivity [75.1-99.9%] and a 100% specificity [93.3-100%] for the TPUS CL measurement technique. CONCLUSION TPUS should be acknowledged as a reliable alternative to TVUS for CL assessment in routine every day practice.
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Affiliation(s)
- David Krief
- Obstetrics and Gynecology Department, CHU Amiens Picardie, Amiens-Picardie University Hospital, 1 rond-point du Pr Christian Cabrol, 80054, Amiens cedex 1, France
| | - Arthur Foulon
- Obstetrics and Gynecology Department, CHU Amiens Picardie, Amiens-Picardie University Hospital, 1 rond-point du Pr Christian Cabrol, 80054, Amiens cedex 1, France.
| | - Ambre Tondreau
- Obstetrics and Gynecology Department, CHU Amiens Picardie, Amiens-Picardie University Hospital, 1 rond-point du Pr Christian Cabrol, 80054, Amiens cedex 1, France
| | - Momar Diouf
- Clinical Research Department, Amiens-Picardie University Hospital, 80000, Amiens, France
| | - Fabrice Sergent
- Obstetrics and Gynecology Department, CHU Amiens Picardie, Amiens-Picardie University Hospital, 1 rond-point du Pr Christian Cabrol, 80054, Amiens cedex 1, France
| | - Jean Gondry
- Obstetrics and Gynecology Department, CHU Amiens Picardie, Amiens-Picardie University Hospital, 1 rond-point du Pr Christian Cabrol, 80054, Amiens cedex 1, France
| | - Julien Chevreau
- Obstetrics and Gynecology Department, CHU Amiens Picardie, Amiens-Picardie University Hospital, 1 rond-point du Pr Christian Cabrol, 80054, Amiens cedex 1, France
- Obstetrics and Gynecology Department, Jura Bernois Hospital, 2345, Saint Imier, Switzerland
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Tasseel-Ponche S, Delafontaine A, Godefroy O, Yelnik AP, Doutrellot PL, Duchossoy C, Hyra M, Sader T, Diouf M. Walking speed at the acute and subacute stroke stage: A descriptive meta-analysis. Front Neurol 2022; 13:989622. [PMID: 36226075 PMCID: PMC9549366 DOI: 10.3389/fneur.2022.989622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
Gait disorders are one of the leading patient complaints at the sub-acute stroke stage (SSS) and a main determinant of disability. Walking speed (WS) is a major vital and functional index, and the Ten-Meter Walk Test is considered the gold standard after stroke. Based on a systematic review of the literature, studies published between January 2000 and November 2021 were selected when WS was reported (ten-meter walk test for short distance and/or 6-min walking distance for long distance) within 6 months following a first ischemic and/or hemorrhagic stroke (SSS) in adults prior to receiving specific walking rehabilitation. Following PRISMA guidelines, a meta-analysis was conducted on two kinds of WS: the principal criterion focused on short-distance WS (ten-meter walking test) and the secondary criteria focused on long-distance WS (6-min test) and meta-regressions to study the association of WS with balance, cognitive disorders and autonomy. Nine studies comprising a total of 939 data on post-stroke patients were selected. The weighted average age was 61 years [95% IC [55-67] and males represented 62% ± 2.7 of patients [57-67]. Average short-distance WS was 0.36 ± 0.06 m.s−1 [95% CI (0.23–0.49)]. Average long-distance WS was 0.46 ± 0.1 m.s−1 [95% CI (0.26–0.66)]. The funnel plot revealed asymmetry of publication bias and high heterogeneity of the nine studies (I2 index 98.7% and Q-test p < 0.0001). Meta-regressions of secondary endpoints could not be performed due to a lack of study data. At the SSS, WS would be lower than data in general population published in literature, but above all, lower than the WS required for safe daily autonomy and community ambulation after stroke. WS must be a priority objective of stroke rehabilitation to increase walking function but also for survival, autonomy, social participation and health-related quality of life.
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Affiliation(s)
- Sophie Tasseel-Ponche
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
- Laboratory of Functional Neurosciences (EA 4559), Amiens University Hospital, Amiens, France
- *Correspondence: Sophie Tasseel-Ponche
| | - Arnaud Delafontaine
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
- CIAMS, Paris-Saclay University, Orsay, France
- CIAMS, Orléans University, Orléans, France
| | - Olivier Godefroy
- Laboratory of Functional Neurosciences (EA 4559), Amiens University Hospital, Amiens, France
- Department of Neurology, Amiens University Hospital, Amiens, France
| | - Alain P. Yelnik
- Physical Medicine and Rehabilitation Department, Hôpital Lariboisière-F. Widal AP-HP, Paris, France
- INSERM U1153 - CRESS EpiAgeing, Paris University, Hôtel-Dieu, Paris, France
| | - Pierre-Louis Doutrellot
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
| | - Charline Duchossoy
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
| | - Marie Hyra
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
| | - Thibaud Sader
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
| | - Momar Diouf
- Department of Biostatistics, Amiens University Hospital, Amiens, France
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Demagny J, Roussel C, Le Guyader M, Guiheneuf E, Harrivel V, Boyer T, Diouf M, Dussiot M, Demont Y, Garçon L. Combining imaging flow cytometry and machine learning for high-throughput schistocyte quantification: A SVM classifier development and external validation cohort. EBioMedicine 2022; 83:104209. [PMID: 35986949 PMCID: PMC9404284 DOI: 10.1016/j.ebiom.2022.104209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022] Open
Abstract
Background Schistocyte counts are a cornerstone of the diagnosis of thrombotic microangiopathy syndrome (TMA). Their manual quantification is complex and alternative automated methods suffer from pitfalls that limit their use. We report a method combining imaging flow cytometry (IFC) and artificial intelligence for the direct label-free and operator-independent quantification of schistocytes in whole blood. Methods We used 135,045 IFC images from blood acquisition among 14 patients to extract 188 features with IDEAS® software and 128 features from a convolutional neural network (CNN) with Keras framework in order to train a support vector machine (SVM) blood elements’ classifier used for schistocytes quantification. Finding Keras features showed better accuracy (94.03%, CI: 93.75-94.31%) than ideas features (91.54%, CI: 91.21-91.87%) in recognising whole-blood elements, and together they showed the best accuracy (95.64%, CI: 95.39-95.88%). We obtained an excellent correlation (0.93, CI: 0.90-0.96) between three haematologists and our method on a cohort of 102 patient samples. All patients with schistocytosis (>1% schistocytes) were detected with excellent specificity (91.3%, CI: 82.0-96.7%) and sensitivity (100%, CI: 89.4-100.0%). We confirmed these results with a similar specificity (91.1%, CI: 78.8-97.5%) and sensitivity (100%, CI: 88.1-100.0%) on a validation cohort (n=74) analysed in an independent healthcare centre. Simultaneous analysis of 16 samples in both study centres showed a very good correlation between the 2 imaging flow cytometers (Y=1.001x). Interpretation We demonstrate that IFC can represent a reliable tool for operator-independent schistocyte quantification with no pre-analytical processing which is of most importance in emergency situations such as TMA. Funding None.
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Pierson-Marchandise M, Castelain S, Chevalier C, Brochot E, Schmit JL, Diouf M, Ganry O, Gignon M. Hospital-wide SARS-CoV-2 antibody screening of 4840 staff members in a University Medical Center in France: a cross-sectional study. BMJ Open 2022; 12:e047010. [PMID: 35545377 PMCID: PMC9096052 DOI: 10.1136/bmjopen-2020-047010] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Healthcare workers are more likely to be infected by SARS-CoV-2. In order to assess the infectious risk associated with working in a hospital, we sought to estimate the proportion of healthcare professionals infected with SARS-CoV-2 by screening staff in a University Medical Center in France. SETTING A hospital-wide screening campaign (comprising a serological test and a questionnaire) ran from 18 May to 26 July 2020. PRIMARY AND SECONDARY OUTCOME MEASURES The seroprevalence rate was analysed in a multivariate analysis according to sociodemographic variables (age, sex and profession), exposure to SARS-CoV-2 and symptoms. RESULTS A total of 4840 professionals were included, corresponding to 74.5% of the centre's staff. The seroprevalence rate (95% CI) was 9.7% (7.0% to 12.4%). Contact with a confirmed case of COVID-19 was significantly associated with seropositivity (OR (95% CI: 1.43, (1.15 to 1.78)). The seroprevalence rate was significantly higher among nursing assistants (17.6%) than among other healthcare professionals. The following symptoms were predictive of COVID-19: anosmia (OR (95% CI): 1.55, (1.49 to 1.62)), ageusia (1.21, (1.16 to 1.27)), fever (1.15, (1.12 to 1.18)), myalgia (1.03, (1.01 to 1.06)) and headache (1.03, (1.01 to 1.04)).
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Affiliation(s)
- Marion Pierson-Marchandise
- Department of Preventions, Risks, Medical Information and Epidemiology, CHU Amiens-Picardie, Amiens, France
| | - Sandrine Castelain
- Department of Virology, CHU Amiens-Picardie, Amiens, France
- AGIR Research Unit, EA 4294, Amiens University, Amiens, France
| | - Cassandra Chevalier
- Department of Preventions, Risks, Medical Information and Epidemiology, CHU Amiens-Picardie, Amiens, France
| | - Etienne Brochot
- Department of Virology, CHU Amiens-Picardie, Amiens, France
- AGIR Research Unit, EA 4294, Amiens University, Amiens, France
| | - Jean-Luc Schmit
- AGIR Research Unit, EA 4294, Amiens University, Amiens, France
- Infectious Disease, CHU Amiens-Picardie, Amiens, France
| | - Momar Diouf
- Department of Statistics, University Hospital Centre Amiens-Picardie, Amiens, France
| | - Olivier Ganry
- Department of Preventions, Risks, Medical Information and Epidemiology, CHU Amiens-Picardie, Amiens, France
| | - Maxime Gignon
- Department of Preventions, Risks, Medical Information and Epidemiology, CHU Amiens-Picardie, Amiens, France
- CRP CPO, Amiens University, Amiens, France
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23
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Manceau G, Alves A, Meillat H, Benhaïm L, Ouaïssi M, Panis YH, Tuech JJ, Dousset B, Brigand C, Cotte E, Lakkis Z, Badic B, Marchal F, Sabbagh C, Diouf M, Karoui M. What Is the Optimal Elective Colectomy for Splenic Flexure Cancer: End of the Debate? A Multicenter Study From the GRECCAR Group With a Propensity Score Analysis. Dis Colon Rectum 2022; 65:55-65. [PMID: 34882628 DOI: 10.1097/dcr.0000000000001937] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Indexed: 12/24/2022]
Abstract
BACKGROUND The optimal elective colectomy in patients with splenic flexure tumor is debated. OBJECTIVE This study aimed to compare splenic flexure colectomy, left hemicolectomy, and subtotal colectomy for perioperative, histological, and survival outcomes in this setting. DESIGN This is a multicenter retrospective cohort study. SETTING Patients diagnosed with nonmetastatic splenic flexure tumor who underwent elective colectomy were included. PATIENTS Between 2006 and 2014, 313 consecutive patients were operated on in 15 French Research Group of Rectal Cancer Surgery centers. INTERVENTIONS Propensity score weighting was performed to compare short- and long-term outcomes. MAIN OUTCOME MEASURES The primary end point was disease-free survival. Secondary end points included overall survival, quality of surgical resection, overall postoperative morbidity, surgical postoperative morbidity, and rate of anastomotic leakage. RESULTS The most performed surgery was splenic flexure colectomy (59%), followed by subtotal colectomy (23%) and left hemicolectomy (18%). Subtotal colectomy was more often performed by laparotomy compared with splenic flexure colectomy and left hemicolectomy (93% vs 61% vs 56%, p < 0.0001), and was associated with a longer operative time (260 minutes (120-460) vs 180 minutes (68-440) vs 217 minutes (149-480), p < 0.0001). Postoperative morbidity was similar between the 3 groups, but the median length of hospital stay was significantly longer after subtotal colectomy (13 days (5-56) vs 10 (4-175) vs 9 (4-55), p = 0.0007). The median number of harvested lymph nodes was significantly higher after subtotal colectomy compared with splenic flexure colectomy and left hemicolectomy (24 (8-90) vs 15 (1-81) vs 16 (3-52), p < 0.0001). The rate of stage III disease and the number of patients treated by adjuvant chemotherapy were similar between the 3 groups. There was no difference in terms of disease-free survival and overall survival between the 3 procedures. LIMITATIONS The study was limited by its retrospective design. CONCLUSIONS In the elective setting, splenic flexure colectomy is safe and oncologically adequate for patients with nonmetastatic splenic flexure tumor. However, given the oncological clearance after splenic flexure colectomy, it seems that the debate is not completely closed. See Video Abstract at http://links.lww.com/DCR/B703. CUL ES LA COLECTOMA ELECTIVA PTIMA PARA EL CNCER DE NGULO ESPLNICO FIN DEL DEBATE UN ESTUDIO MULTICNTRICO DEL GRUPO GRECCAR CON UN ANLISIS DE PUNTAJE DE PROPENSIN ANTECEDENTES:La colectomía electiva óptima en pacientes con tumores del ángulo esplénico continua en debate.OBJETIVO:Comparar la colectomía de ángulo esplénico, hemicolectomía izquierda y colectomía subtotal para los resultados perioperatorios, histológicos y de supervivencia en este escenario.DISEÑO:Estudio de cohorte retrospectivo multicéntrico.ESCENARIO:Se incluyeron pacientes diagnosticados de tumores del ángulo esplénico no metastásicos que se sometieron a colectomía electiva.PACIENTES:Entre 2006 y 2014, 313 pacientes consecutivos fueron intervenidos en 15 centros GRECCAR.INTERVENCIONES:Se realizó una ponderación del puntaje de propensión para comparar los resultados a corto y largo plazo.PRINCIPALES MEDIDAS DE RESULTADO:El criterio de valoración principal fue la supervivencia libre de enfermedad. Los criterios de valoración secundarios incluyeron la supervivencia general, la calidad de la resección quirúrgica, la morbilidad posoperatoria general, la morbilidad posoperatoria quirúrgica y la tasa de fuga anastomótica.RESULTADOS:La cirugía más realizada fue la colectomía del ángulo esplénico (59%), seguida de la colectomía subtotal (23%) y la hemicolectomía izquierda (18%). La colectomía subtotal se realizó con mayor frecuencia mediante laparotomía en comparación con la colectomía de ángulo esplénico y la hemicolectomía izquierda (93% frente a 61% frente a 56%, p <0.0001), y se asoció con un tiempo quirúrgico más prolongado (260 min [120-460] frente a 180 min [68-440] frente a 217 min [149-480], p <0.0001). La morbilidad posoperatoria fue similar entre los tres grupos, pero la duración media de la estancia hospitalaria fue significativamente más prolongada después de la colectomía subtotal (13 días [5-56] frente a 10 [4-175] frente a 9 [4-55], p = 0.0007). La mediana del número de ganglios linfáticos extraídos fue significativamente mayor después de la colectomía subtotal en comparación con la colectomía del ángulo esplénico y la hemicolectomía izquierda (24 [8-90] frente a 15 [1-81] frente a 16 [3-52], p <0.0001). La tasa de enfermedad en estadio III y el número de pacientes tratados con quimioterapia adyuvante fueron similares entre los 3 grupos. No hubo diferencias en términos de supervivencia libre de enfermedad y supervivencia general entre los 3 procedimientos.LIMITACIONES:El estudio estuvo limitado por su diseño retrospectivo.CONCLUSIONES:En un escenario electivo, la colectomía del ángulo esplénico es segura y oncológicamente adecuada para pacientes con tumores del ángulo esplénico no metastásicos. Sin embargo, dado el aclaramiento oncológico tras la colectomía del ángulo esplénico, parece que el debate no está completamente cerrado. Consulte Video Resumen en http://links.lww.com/DCR/B703.
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Affiliation(s)
- Gilles Manceau
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Digestive and Oncologic Surgery, Paris, France
| | - Arnaud Alves
- University Hospital of Caen, Department of Digestive Surgery, Caen, France
| | - Hélène Meillat
- Institut Paoli Calmettes, Department of Digestive Surgical Oncology, Marseille, France
| | - Léonor Benhaïm
- Gustave Roussy Cancer Campus, Department of Surgical Oncology, Villejuif, France
| | - Mehdi Ouaïssi
- Trousseau Hospital, Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Chambray Les Tours, France
| | - Yves H Panis
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Beaujon Hospital, Department of Colorectal Surgery, Clichy, France
| | - Jean-Jacques Tuech
- Charles Nicolle Hospital, Rouen University, Department of Digestive and General Surgery, Rouen, France
| | - Bertrand Dousset
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Cochin Hospital, Department of Digestive, Hepato-Biliary and Endocrine Surgery, Paris, France
| | - Cécile Brigand
- Strasbourg University Hospital, Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg, France
| | - Eddy Cotte
- Lyon University Hospital, Center for Digestive and Endocrine Surgery, Lyon Sud Hospital, Lyon, France
| | - Zaher Lakkis
- University Hospital of Besançon, Department of Digestive Surgery, Besançon, France
| | - Bogdan Badic
- La Cavale Blanche University Hospital, Department of General and Digestive Surgery, Brest, France
| | - Frédéric Marchal
- University of Lorraine, Cancer Institute of Lorraine, Department of Surgery, Vandœuvre-lès-Nancy Cedex, France
| | - Charles Sabbagh
- Amiens University Hospital, Department of Digestive Surgery, Amiens, France
| | - Momar Diouf
- Department of Clinical Research and Innovation, Amiens University Hospital, France
| | - Mehdi Karoui
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Digestive and Oncologic Surgery, Paris, France
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Sabbagh C, Manceau G, Mege D, Abdalla S, Voron T, Bridoux V, Lakkis Z, Venara A, Beyer-Berjot L, Diouf M, Karoui M. Is Adjuvant Chemotherapy Necessary for Obstructing Stage II Colon Cancer? Results From a Propensity Score Analysis of the French Surgical Association Database. Ann Surg 2022; 275:149-156. [PMID: 32068553 DOI: 10.1097/sla.0000000000003832] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to compare the survival of patients with stage II obstructing colon cancer (OCC) who had adjuvant chemotherapy with those who did not. SUMMARY BACKGROUND DATA The need for adjuvant chemotherapy in stage II colon cancer is still debated. METHODS All consecutive patients treated for a stage II OCC in a curative intent (with primary tumor resection) between January 2000 and December 2015 were included in this retrospective, multicenter cohort study which included a propensity score analysis using an odds of treatment weighting (Average Treatment effect on the Treated, ATT). The endpoint was the comparison between the 2 groups for overall survival (OS) and disease-free survival (DFS) according to whether or not patients received adjuvant chemotherapy. RESULTS During the study period, 504 patients underwent a curative colectomy for a stage II OCC. Among these patients, 179 (35.5%) had adjuvant chemotherapy and 325 (64.5%) had no adjuvant treatment. Among the 179 patients who received adjuvant chemotherapy, 108 patients (60%) received oxaliplatin based regimen and 99 patients (55%) completed all scheduled cycles. At multivariate analysis, after weighting by the odds (ATT analysis) and adjustment, adjuvant chemotherapy after resection of a stage II OCC was associated with improvements in OS [hazard ratio (HR) = 0.42 (0.17-0.99), P = 0.0498] and DFS [HR = 0.57 (0.37-0.88), P = 0.0116]. CONCLUSION This study suggests that adjuvant chemotherapy after curative resection of stage II OCC may improve oncological outcomes.
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Affiliation(s)
- Charles Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, Amiens, France
| | - Gilles Manceau
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Department of Digestive Surgery, Paris, France
| | - Diane Mege
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - Solafah Abdalla
- Université Paris-Sud, Assistance Publique Hôpitaux de Paris, Bicêtre University Hospital, Department of Digestive Surgery, Le Kremlin Bicêtre, France
| | - Thibault Voron
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Saint Antoine University Hospital, Department of Digestive Surgery, Paris, France
| | - Valérie Bridoux
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Zaher Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - Aurélien Venara
- Department of Digestive Surgery, Angers University Hospital, Angers, France
| | - Laura Beyer-Berjot
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - Momar Diouf
- Department of Clinical Research and Innovation, Amiens University Hospital, France
| | - Mehdi Karoui
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Department of Digestive Surgery, Paris, France
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Boissel L, Pinchaux E, Guilé M, Corde P, Crovetto C, Diouf M, Mariana C, Meynier J, Picard C, Scoury D, Cohen D, Benarous X, Viaux-Savelon S, Guilé JM. Development and reliability of the coding system evaluating maternal sensitivity to social interactions with 34- to 36-week postmenstrual age preterm infants. Front Psychiatry 2022; 13:938482. [PMID: 36276306 PMCID: PMC9579434 DOI: 10.3389/fpsyt.2022.938482] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Maternal sensitivity (MS), the ability to perceive and synchronously respond to the social signals (SSs), is affected by prematurity. The development of early supportive psychotherapy to foster MS, before discharge of the infant from the neonatal intensive care unit (NICU) is a major challenge in the prevention of subsequent developmental and mental disorders in the child. There are currently no reliable methods for evaluating MS to social interactions with very to moderate preterm infants. We investigated the reliability of a newly developed procedure for assessing MS in interactions between the mother and her 34- to 36-week postmenstrual age (PMA) preterm infant: the Preterm Infant Coding System for Maternal Sensitivity (PRICOSMAS). METHOD This study encompassed three steps: testing of the capacity to videorecord SSs in very to moderate preterm infants, selection, by an expert committee, of the recordable and relevant SSs, and investigation of the internal consistency and interrater reliability. The synchronicity between infant and mother's SSs was determined on a 1 s period basis, using ELAN software. Preterm infants born after 25-weeks gestational age (GA) were included while being between 34- and 36-weeks PMA. A perinatal risk inventory score > 10 for the infant precluded from inclusion. Interrater reliabilities were assessed independently by two raters blind to the clinical situation of the mother and infant. RESULTS The resulting PRICOSMAS encompassed two four-item SS sections, one covering the preterm infant's SSs and the other, the mother's SSs. Reliability was assessed on a sample of 26 videorecorded observations for 13 mother-preterm infant dyads. Infants' mean age at birth was 30.4 ± 3.1-weeks GA (range: 26.4-35) and PMA at the time of the test was 34.7-weeks (±0.8). Internal consistency ranged from 0.81 to 0.89. Interrater reliability ranged from substantial to almost perfect (0.73-0.88). CONCLUSION This study shows that the infants' SSs and MS can be reliably scored in preterm infants as young as 34- to 36-weeks PMA. Our findings suggest that the PRICOSMAS is sufficiently reliable for use, including in NICU, by healthcare professionals or researchers for coding early parent-infant interactions with 34- to 36-week PMA preterm infants.
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Affiliation(s)
- Laure Boissel
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France
| | - Emeric Pinchaux
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France.,Department of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Marine Guilé
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France.,Department of Medicine, Université Paris Descartes, Paris, France
| | - Pascal Corde
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Cécile Crovetto
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Momar Diouf
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Charlotte Mariana
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Jonathan Meynier
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Carl Picard
- Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Daphné Scoury
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France
| | - David Cohen
- Child and Adolescent Psychiatry Services, APHP-GHPS, Sorbonne Université, Paris, France
| | - Xavier Benarous
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France.,Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France
| | - Sylvie Viaux-Savelon
- Child and Adolescent Psychiatry Services, Hospices civils de Lyon, Hôpital de la Croix Rousse, Université Lyon 1, Lyon, France
| | - Jean-Marc Guilé
- Department of Psychiatry, Université Picardie Jules Verne, Amiens, France.,Child and Adolescent Psychiatry Services, University Hospital Centre (CHU), Amiens, France.,Department of Psychiatry, McGill University, Montreal, QC, Canada
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26
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Fourdinier O, Glorieux G, Brigant B, Diouf M, Pletinck A, Vanholder R, Choukroun G, Verbeke F, Massy ZA, Metzinger-Le Meuth V, Metzinger L, Group-EUTox OBOTEUTW. Syndecan-1 and Free Indoxyl Sulfate Levels Are Associated with miR-126 in Chronic Kidney Disease. Int J Mol Sci 2021; 22:ijms221910549. [PMID: 34638892 PMCID: PMC8508835 DOI: 10.3390/ijms221910549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 01/02/2023] Open
Abstract
Chronic kidney disease (CKD) is a major cause of death worldwide and is associated with a high risk for cardiovascular and all-cause mortality. In CKD, endothelial dysfunction occurs and uremic toxins accumulate in the blood. miR-126 is a regulator of endothelial dysfunction and its blood level is decreased in CKD patients. In order to obtain a better understanding of the physiopathology of the disease, we correlated the levels of miR-126 with several markers of endothelial dysfunction, as well as the representative uremic toxins, in a large cohort of CKD patients at all stages of the disease. Using a univariate analysis, we found a correlation between eGFR and most markers of endothelial dysfunction markers evaluated in this study. An association of miR-126 with all the evaluated uremic toxins was also found, while uremic toxins were not associated with the internal control, specifically cel-miR-39. The correlation between the expression of endothelial dysfunction biomarker Syndecan-1, free indoxyl sulfate, and total p-cresyl glucuronide on one side, and miR-126 on the other side was confirmed using multivariate analysis. As CKD is associated with reduced endothelial glycocalyx (eGC), our results justify further evaluation of the role of correlated parameters in the pathophysiology of CKD.
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Affiliation(s)
- Ophélie Fourdinier
- Nephrology Dialysis and Transplantation Department, Amiens University Hospital, 80054 Amiens, France; (O.F.); (G.C.)
| | - Griet Glorieux
- Nephrology Section, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; (G.G.); (A.P.); (R.V.); (F.V.)
| | - Benjamin Brigant
- UPJV HEMATIM UR 4666, C.U.R.S, Université de Picardie Jules Verne, CEDEX 1, 80025 Amiens, France; (B.B.); (V.M.-L.M.)
| | - Momar Diouf
- Biostatistics Unit, Clinical Research and Innovation Department, Amiens-Picardie University Hospital, 80054 Amiens, France;
| | - Anneleen Pletinck
- Nephrology Section, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; (G.G.); (A.P.); (R.V.); (F.V.)
| | - Raymond Vanholder
- Nephrology Section, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; (G.G.); (A.P.); (R.V.); (F.V.)
| | - Gabriel Choukroun
- Nephrology Dialysis and Transplantation Department, Amiens University Hospital, 80054 Amiens, France; (O.F.); (G.C.)
| | - Francis Verbeke
- Nephrology Section, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; (G.G.); (A.P.); (R.V.); (F.V.)
| | - Ziad A. Massy
- Ambroise Paré Hospital, Division of Nephrology, APHP, Paris Ile de France Ouest (UVSQ) University, et INSERM 1018 Eq. 5, CESP, Boulogne Billancourt et Villejuif, 92100 Paris, France;
| | - Valérie Metzinger-Le Meuth
- UPJV HEMATIM UR 4666, C.U.R.S, Université de Picardie Jules Verne, CEDEX 1, 80025 Amiens, France; (B.B.); (V.M.-L.M.)
- INSERM UMRS 1148, Laboratory for Vascular Translational Science (LVTS), UFR SMBH, Université Sorbonne Paris Nord, CEDEX, 93017 Bobigny, France
| | - Laurent Metzinger
- UPJV HEMATIM UR 4666, C.U.R.S, Université de Picardie Jules Verne, CEDEX 1, 80025 Amiens, France; (B.B.); (V.M.-L.M.)
- Correspondence: ; Tel.: +33-322-82-5356
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Riault C, Diouf M, Chatelain D, Yzet C, Turpin J, Brazier F, Dupas JL, Sabbagh C, Nguyen-Khac E, Fumery M. Positive histologic margins is a risk factor of recurrence after ileocaecal resection in Crohn's disease. Clin Res Hepatol Gastroenterol 2021; 45:101569. [PMID: 33199239 DOI: 10.1016/j.clinre.2020.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/04/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Surgical resection is not curative in Crohn's disease (CD) and, recurrence after surgery is a common situation. The identification of patients at high risk of recurrence remains disappointing in clinical practice. OBJECTIVE To evaluate the impact of residual microscopic disease on margins on the risk of recurrence after ileocaecal resection in CD. PATIENTS AND METHODS All patients who underwent ileocaecal resection between January 1992 and December 2016 were prospectively identified. Demographic data, clinical, surgical and histological variables were retrospectively collected. Positive histologic margin was assessed prospectively and defined by the presence of acute inflammatory lesions on margins: erosion, ulceration, chorion infiltration by neutrophils, cryptic abscesses or cryptitis. RESULTS One hundred twenty five patients were included, with a median follow-up of 8 years (Interquartile Range (IQR), 4.3-15.2). Half (49.6%, n = 62) were women, and the median age at surgery was 33 years (IQR, 24-42). Fifty-six (44.8%) had positive inflammatory margins. Five years after surgery, respectively 29 (51%) and 23 (34%) patients with positive and negative margins had clinical recurrence (p = 0.034). At the end of the follow-up, respectively 60% (n = 34) and 47% (n = 33) patients had clinical recurrence (p = 0.07). CD-related hospitalizations were observed in respectively 37.5% (n = 21) and 18.8% (n = 13) with positive and negative margins (p = 0.02). Fourteen patients (25%) with positive intestinal margins had surgical recurrence at the end of the follow-up compared to 5 patients (7%) with negative margins (p = 0.04). Multivariate analysis confirmed that positive intestinal margin was independently associated with surgical recurrence (OR, 4.7 (CI95%, 1.4-15.3), p = 0.01). CONCLUSION Positive histologic margin was associated with an increased risk of clinical and surgical recurrence after ileocaecal resection for Crohn's disease.
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Affiliation(s)
- Clementine Riault
- Gastroenterology, Amiens University and Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Momar Diouf
- Pathology Unit, Amiens University and Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Denis Chatelain
- Department of Biostatistics, University Hospital of Amiens, Amiens, France
| | - Clara Yzet
- Gastroenterology, Amiens University and Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Justine Turpin
- Gastroenterology, Amiens University and Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Franck Brazier
- Gastroenterology, Amiens University and Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Jean-Louis Dupas
- Gastroenterology, Amiens University and Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Charles Sabbagh
- Digestive Surgery, Amiens University and Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Eric Nguyen-Khac
- Gastroenterology, Amiens University and Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Mathurin Fumery
- Gastroenterology, Amiens University and Hospital, Université de Picardie Jules Verne, Amiens, France.
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Rusinaru D, Bohbot Y, Kubala M, Diouf M, Altes A, Pasquet A, Maréchaux S, Vanoverschelde JL, Tribouilloy C. Myocardial Contraction Fraction for Risk Stratification in Low-Gradient Aortic Stenosis With Preserved Ejection Fraction. Circ Cardiovasc Imaging 2021; 14:e012257. [PMID: 34403263 DOI: 10.1161/circimaging.120.012257] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Myocardial contraction fraction (MCF) is a volumetric measure of myocardial shortening independent of left ventricular size and geometry. This multicenter study investigates the usefulness of MCF for risk stratification in low-gradient severe aortic stenosis with preserved ejection fraction. METHODS We included 643 consecutive patients with low-gradient severe aortic stenosis with preserved ejection fraction in whom MCF was computed at baseline and analyzed mortality during follow-up. RESULTS Throughout follow-up with medical and surgical management (34.9 [16.1-65.3] months), lower MCF tertiles had higher mortality than the highest tertile. Eighty-month survival was 56±4% for MCF>41%, 41±4% for MCF 30% to 41%, and 40±4% for MCF<30% (P<0.001). After comprehensive adjustment, mortality risk remained high for MCF 30% to 41% (adjusted hazard ratio, 1.53 [1.08-2.18]) and for MCF<30% (adjusted hazard ratio, 1.82 [1.24-2.66]) versus MCF>41%. The optimal MCF cutoff point for mortality prediction was 41%. Age, body mass index, Charlson index, peak aortic velocity, and ejection fraction were independently associated with mortality. MCF (χ2 to improve 10.39; P=0.001), provided greater additional prognostic value over the baseline parameters than stroke volume (SV) index (χ2 to improve 5.41; P=0.042), left ventricular mass index (χ2 to improve 2.15; P=0.137), or global longitudinal strain (χ2 to improve 3.67; P=0.061). MCF outperformed ejection fraction for mortality prediction. When patients were classified by SV index and MCF, mortality risk was low when SV index was ≥30 mL/m2 and MCF>41%, higher for patients with SV index ≥30 mL/m2 and MCF≤41% (adjusted hazard ratio, 1.47 [1.05-2.07]) and extremely high for patients with SV index <30 mL/m2 (adjusted hazard ratio, 2.29 [1.45-3.62]). CONCLUSIONS MCF is a valuable marker of risk in low-gradient severe aortic stenosis with preserved ejection fraction and could improve decision-making, especially in normal-flow low-gradient severe aortic stenosis with preserved ejection fraction.
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Affiliation(s)
- Dan Rusinaru
- Pôle Coeur-Thorax-Vaisseaux, Department of Cardiology (D.R., Y.B., M.K., C.T.), University Hospital Amiens, France
- Centre Universitaire de Recherche en Santé, Laboratoire MP3CV - EA 7517, Université de Picardie, Amiens, France (D.R., Y.B., S.M., C.T.)
| | - Yohann Bohbot
- Pôle Coeur-Thorax-Vaisseaux, Department of Cardiology (D.R., Y.B., M.K., C.T.), University Hospital Amiens, France
- Centre Universitaire de Recherche en Santé, Laboratoire MP3CV - EA 7517, Université de Picardie, Amiens, France (D.R., Y.B., S.M., C.T.)
| | - Maciej Kubala
- Pôle Coeur-Thorax-Vaisseaux, Department of Cardiology (D.R., Y.B., M.K., C.T.), University Hospital Amiens, France
| | - Momar Diouf
- Division of Clinical Research and Innovation (M.D.), University Hospital Amiens, France
| | - Alexandre Altes
- Groupement des Hôpitaux de l'Institut Catholique de Lille/Faculté libre de médecine, Université Lille Nord de France (A.A., S.M.)
| | - Agnès Pasquet
- Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P., J.-L.V.)
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium (A.P., J.-L.V.)
| | - Sylvestre Maréchaux
- Centre Universitaire de Recherche en Santé, Laboratoire MP3CV - EA 7517, Université de Picardie, Amiens, France (D.R., Y.B., S.M., C.T.)
- Groupement des Hôpitaux de l'Institut Catholique de Lille/Faculté libre de médecine, Université Lille Nord de France (A.A., S.M.)
| | - Jean-Louis Vanoverschelde
- Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P., J.-L.V.)
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium (A.P., J.-L.V.)
| | - Christophe Tribouilloy
- Pôle Coeur-Thorax-Vaisseaux, Department of Cardiology (D.R., Y.B., M.K., C.T.), University Hospital Amiens, France
- Centre Universitaire de Recherche en Santé, Laboratoire MP3CV - EA 7517, Université de Picardie, Amiens, France (D.R., Y.B., S.M., C.T.)
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Abou-Arab O, Huette P, Haye G, Guilbart M, Touati G, Diouf M, Beyls C, Dupont H, Mahjoub Y. Effect of the oXiris membrane on microcirculation after cardiac surgery under cardiopulmonary bypass: study protocol for a randomised controlled trial (OXICARD Study). BMJ Open 2021; 11:e044424. [PMID: 34244250 PMCID: PMC8273472 DOI: 10.1136/bmjopen-2020-044424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 06/17/2021] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Cytokine storm and endotoxin release during cardiac surgery with cardiopulmonary bypass (CPB) have been related to vasoplegic shock and organ dysfunction. We hypothesised that early (during CPB) cytokine adsorption with oXiris membrane for patients at high risk of inflammatory syndrome following cardiac surgery may improve microcirculation, endothelial function and outcomes. METHODS AND ANALYSIS The Oxicard trial is a prospective, monocentric trial, randomising 70 patients scheduled for cardiac surgery. The inclusion criterion is patients aged more than 18 years old undergoing elective cardiac surgery under CPB with an expected CPB time >90 min (double valve replacement or valve replacement plus coronary arterial bypass graft). Patients will be allocated to the intervention group (n=35) or the control group (n=35). In the intervention group, oXiris membrane will be used on the Prismaflex device (Baxter) at blood pump flow of 450 mL/min during cardiac surgery under CPB. In the control group, cardiac surgery under CPB will be conducted as usual without oXiris membrane. An intention-to-treat analysis will be performed. The primary endpoint will be the microcirculatory flow index measured by sublingual microcirculation device at day 1 following cardiac surgery. The secondary endpoints will be other microcirculation variables at CPB end, 6 hours after CPB, at day 1 and at day 2. We also aim to evaluate the occurrence of major cardiovascular and cerebral events (eg, myocardial infarction, stroke, ischaemic mesenteric, resuscitated cardiac arrest, acute kidney injury) within the first 30 days. Cumulative catecholamine use, intensive care unit length of stay, endothelium glycocalyx shedding parameters (syndecan-1, heparan-sulfate and hyaluronic acid), inflammatory cytokines (tumour necrosis factor (TNF) alpha, interleukin 1 (IL1) beta, IL 10, IL 6, lipopolysaccharide, endothelin) and endothelial permeability biomarkers (angiopoietin 1, angiopoietin 2, Tie2 soluble receptor and Vascular Endothelial Growth Factor (VEGF) will also be evaluated. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Institutional Review Board of the University Hospital of Amiens (registration number ID RDB: 2019-A02437-50 in February 2020). Results of the study will be disseminated via peer-reviewed publications and presentations at national and international conferences. TRIAL REGISTRATION NUMBER NCT04201119.
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Affiliation(s)
- Osama Abou-Arab
- Anesthesiology and Critical Care, CHU Amiens-Picardie, Amiens, France
| | - Pierre Huette
- Anesthesiology and Critical Care, CHU Amiens-Picardie, Amiens, France
| | - Guillaume Haye
- Anesthesiology and Critical Care, CHU Amiens-Picardie, Amiens, France
| | - Mathieu Guilbart
- Anesthesiology and Critical Care, CHU Amiens-Picardie, Amiens, France
| | - Gilles Touati
- Cardiac Surgery Department, CHU Amiens-Picardie, Amiens, France
| | - Momar Diouf
- Statistic Department, CHU Amiens-Picardie, Amiens, France
| | - Christophe Beyls
- Anesthesiology and Critical Care, CHU Amiens-Picardie, Amiens, France
| | - Herve Dupont
- Anesthesiology and Critical Care, CHU Amiens-Picardie, Amiens, France
| | - Yazine Mahjoub
- Anesthesiology and Critical Care, CHU Amiens-Picardie, Amiens, France
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30
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Bohbot Y, Rusinaru D, Kubala M, Diouf M, Altes A, Pasquet A, Marechaux S, Vanoverschelde J, Tribouilloy C. Myocardial Contraction fraction for risk stratification in low-gradient aortic stenosis with preserved ejection fraction. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.021] [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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31
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Diouf M, Gueye L, Ndiaye L, Ngom K, Mbacké A, Sarré A. Key factors in the contingency plan for COVID-19 during the Magal celebration in 2020. Public Health 2021; 198:e1-e2. [PMID: 33975716 PMCID: PMC8030707 DOI: 10.1016/j.puhe.2021.03.009] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- M Diouf
- Epidemiologist, Public Health, Cheikh Anta Diop University, Senegal; UMI 3189 Unit Mixte International UCAD-CNRST- CNRS-USTTB- UGB Environment, Health, Society, 45391, Dakar, Fann, Senegal; Epidemiological Alert and Prevention Unit, Senegal.
| | - L Gueye
- Epidemiological Alert and Prevention Unit, Senegal; Quality Assurance Authority at the Ministry of Higher Education and Innovation of Senegal, Senegal; UMI 3189 Unit Mixte International UCAD-CNRST- CNRS-USTTB- UGB Environment, Health, Society, 45391, Dakar, Fann, Senegal
| | - L Ndiaye
- Epidemiological Alert and Prevention Unit, Senegal; Sociology, Cheikh Anta Diop University, Senegal
| | - K Ngom
- Epidemiological Alert and Prevention Unit, Senegal
| | - A Mbacké
- Epidemiological Alert and Prevention Unit, Senegal
| | - A Sarré
- Epidemiological Alert and Prevention Unit, Senegal
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32
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Yzet C, Diouf M, Singh S, Brazier F, Turpin J, Nguyen-Khac E, Meynier J, Fumery M. No Benefit of Concomitant Immunomodulator Therapy on Efficacy of Biologics That Are Not Tumor Necrosis Factor Antagonists in Patients With Inflammatory Bowel Diseases: A Meta-analysis. Clin Gastroenterol Hepatol 2021; 19:668-679.e8. [PMID: 32629124 DOI: 10.1016/j.cgh.2020.06.071] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/03/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS There is debate over whether patients with inflammatory bowel diseases (IBD) treated with biologics that are not tumor necrosis factor antagonists (such as vedolizumab or ustekinumab) should receive concomitant treatment with immunomodulators. We conducted a meta-analysis to compare the efficacy and safety of concomitant immunomodulator therapy vs vedolizumab or ustekinumab monotherapy. METHODS In a systematic search of publications, through July 31, 2019, we identified 33 studies (6 randomized controlled trials and 27 cohort studies) of patients with IBD treated with vedolizumab or ustekinumab. The primary outcome was clinical benefit, including clinical remission, clinical response, or physician global assessment in patients who did vs did not receive combination therapy with an immunomodulator. Secondary outcomes were endoscopic improvement and safety. We performed random-effects meta-analysis and estimated odds ratio (OR) and 95% CIs. RESULTS Overall, combination therapy was not associated with better clinical outcomes in patients receiving vedolizumab (16 studies: OR, 0.84; 95% CI, 0.68-1.05; I2=13.9%; Q test P = .17) or ustekinumab (15 studies: OR, 1.1; 95% CI, 0.87-1.38; I2 = 11%; Q test P = .28). Results were consistent in subgroup analyses, with no difference in clinical remission or response in induction vs maintenance studies or in patients with Crohn's disease vs ulcerative colitis in studies of vedolizumab. Combination therapy was not associated with better endoscopic outcomes in patients receiving vedolizumab (3 studies: OR, 1.13; 95% CI, 0.48-2.68; I2 = 0; Q test P=.96) or ustekinumab (2 studies: OR, 0.58; 95% CI, 0.21-1.16; I2 = 47%; Q test P = .17). Combination therapy was not associated with an increase in adverse events during vedolizumab therapy (4 studies: OR, 1.17; 95% CI, 0.75-1.84; I2 = 0; Q test P = .110). CONCLUSIONS In a meta-analysis of data from studies of patients with IBD, we found that combining vedolizumab or ustekinumab with an immunomodulator is no more effective than monotherapy in induction or maintenance of remission.
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Affiliation(s)
- Clara Yzet
- Department of Gastroenterology, Amiens University Hospital, Picardie University, Amiens, France
| | - Momar Diouf
- Department of Statistics, Amiens University Hospital, Picardie University, Amiens, France; Division of Gastroenterology, University of California San Diego, La Jolla, California
| | - Siddarth Singh
- Division of Biomedical Informatics, University of California, San Diego, La Jolla, California
| | - Franck Brazier
- Department of Gastroenterology, Amiens University Hospital, Picardie University, Amiens, France
| | - Justine Turpin
- Department of Gastroenterology, Amiens University Hospital, Picardie University, Amiens, France
| | - Eric Nguyen-Khac
- Department of Gastroenterology, Amiens University Hospital, Picardie University, Amiens, France
| | - Jonathan Meynier
- Department of Statistics, Amiens University Hospital, Picardie University, Amiens, France; Division of Gastroenterology, University of California San Diego, La Jolla, California
| | - Mathurin Fumery
- Department of Gastroenterology, Amiens University Hospital, Picardie University, Amiens, France; PériTox Laboratory, Périnatalité and Risques Toxiques, UMR-I 01 INERIS, Picardie Jules Verne University, Amiens, France.
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Tribouilloy C, Bohbot Y, Rusinaru D, Belkhir K, Diouf M, Altes A, Delpierre Q, Serbout S, Kubala M, Levy F, Maréchaux S, Enriquez Sarano M. Excess Mortality and Undertreatment of Women With Severe Aortic Stenosis. J Am Heart Assoc 2020; 10:e018816. [PMID: 33372529 PMCID: PMC7955469 DOI: 10.1161/jaha.120.018816] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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] [Indexed: 01/05/2023]
Abstract
Background Although women represent half of the population burden of aortic stenosis (AS), little is known whether sex affects the presentation, management, and outcome of patients with AS. Methods and Results In a cohort of 2429 patients with severe AS (49.5% women) we aimed to evaluate 5‐year excess mortality and performance of aortic valve replacement (AVR) stratified by sex. At presentation, women were older (P<0.001), with less comorbidities (P=0.030) and more often symptomatic (P=0.007) than men. Women had smaller aortic valve area (P<0.001) than men but similar mean transaortic pressure gradient (P=0.18). The 5‐year survival was lower compared with expected survival, especially for women (62±2% versus 71% for women and 69±1% versus 71% for men). Despite longer life expectancy in women than men, women had lower 5‐year survival than men (66±2% [expected‐75%] versus 68±2% [expected‐70%], P<0.001) after matching for age. Overall, 5‐year AVR incidence was 79±2% for men versus 70±2% for women (P<0.001) with male sex being independently associated with more frequent early AVR performance (odds ratio, 1.49; 1.18–1.97). After age matching, women remained more often symptomatic (P=0.004) but also displayed lower AVR use (64.4% versus 69.1%; P=0.018). Conclusions Women with severe AS are diagnosed at later ages and have more symptoms than men. Despite prevalent symptoms, AVR is less often performed in women and 5‐year excess mortality is noted in women versus men, even after age matching. These imbalances should be addressed to ensure that both sexes receive equivalent care for severe AS.
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Affiliation(s)
- Christophe Tribouilloy
- Department of Cardiology Amiens University Hospital Amiens France.,UR UPJV 7517 Jules Verne University of Picardie Amiens France
| | - Yohann Bohbot
- Department of Cardiology Amiens University Hospital Amiens France.,UR UPJV 7517 Jules Verne University of Picardie Amiens France
| | - Dan Rusinaru
- Department of Cardiology Amiens University Hospital Amiens France.,UR UPJV 7517 Jules Verne University of Picardie Amiens France
| | - Khadija Belkhir
- Department of Cardiology Amiens University Hospital Amiens France
| | - Momar Diouf
- Department of Clinical Research Amiens Picardy University Hospital Amiens France
| | - Alexandre Altes
- Groupement des Hôpitaux de l'Institut Catholique de Lille/Faculté Libre de Médecine Université Lille Nord de France Lille France
| | | | - Saousan Serbout
- Department of Cardiology Amiens University Hospital Amiens France
| | - Maciej Kubala
- Department of Cardiology Amiens University Hospital Amiens France.,UR UPJV 7517 Jules Verne University of Picardie Amiens France
| | - Franck Levy
- Department of Cardiology Centre Cardio-Thoracique de Monaco Monaco
| | - Sylvestre Maréchaux
- UR UPJV 7517 Jules Verne University of Picardie Amiens France.,Groupement des Hôpitaux de l'Institut Catholique de Lille/Faculté Libre de Médecine Université Lille Nord de France Lille France
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Darmon I, Rebibo L, Diouf M, Chivot C, Riault C, Yzet T, Le Mouel JP, Regimbeau JM. Management of bleeding peptic duodenal ulcer refractory to endoscopic treatment: surgery or transcatheter arterial embolization as first-line therapy? A retrospective single-center study and systematic review. Eur J Trauma Emerg Surg 2020; 46:1025-1035. [PMID: 32246169 DOI: 10.1007/s00068-020-01356-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 09/08/2019] [Accepted: 03/25/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND The objective of this study was to compare the results of transcatheter arterial embolization (TAE) with surgery in terms of efficacy in the context of bleeding duodenal ulcer (BDU) refractory to endoscopic treatment. MATERIALS AND METHODS From January 2006 to December 2016, all patients treated for a BDU refractory to endoscopic treatment were included in this observational, comparative, retrospective, single-center study. Primary endpoint was the overall success of treatment of BDU requiring surgical and/or TAE. The secondary endpoints were pre-interventional data, recurrence rates, feasibility of secondary treatment, morbidity and mortality of surgical and radiological treatment, intensive care unit and length of stay. A systematic review of the literature was performed to compare results of surgery and TAE. RESULTS 59 out of 396 patients (14.9%) treated for BDU required embolization and/or surgery: 15 patients underwent surgery (group S) including 7 patients after embolization failure and 44 patients underwent TAE (group TAE). The overall treatment success in intention to treat (85.7% vs 67.3%), per protocol (80% vs 79.5%) and bleeding recurrence rates (20% vs 15.9%) were also identical. Mortality (14.2% vs 15.3%) was similar between the two groups. Our study data were pooled with data from eight published studies and suggest that surgery have significant increased overall success (68.3% vs. 55.4%, p < 0.005). CONCLUSION The overall success rate was in favour of surgery according our meta-analysis. Our single-center study highlights the fact that predictive factors for recurrent bleeding after TAE must be identified to select good candidates for TAE and/or surgery.
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Affiliation(s)
- Ilan Darmon
- Department of Digestive Surgery, Amiens University Medical Center, Avenue René Laennec, 80054, Amiens cedex 01, France
| | - Lionel Rebibo
- Department of Digestive, Esogastric and Bariatric Surgery, Bichat Claude Bernard University Hospital, 46 rue Henri Huchard, 75018, Paris, France
- Université de Paris, Inserm UMR 1149, 75018, Paris, France
| | - Momar Diouf
- Biostatistics Unit, Clinical Research and Innovation Department, Amiens-Picardie University Hospital, 80054, Amiens, France
| | - Cyril Chivot
- Department of Radiology, Amiens University Medical Center, Avenue René Laennec, 80054, Amiens cedex 01, France
| | - Clémentine Riault
- Department of Gastroenterology, Amiens University Medical Center, Avenue René Laennec, 80054, Amiens cedex 01, France
| | - Thierry Yzet
- Department of Radiology, Amiens University Medical Center, Avenue René Laennec, 80054, Amiens cedex 01, France
| | - Jean Philippe Le Mouel
- Department of Gastroenterology, Amiens University Medical Center, Avenue René Laennec, 80054, Amiens cedex 01, France
| | - Jean-Marc Regimbeau
- Department of Digestive Surgery, Amiens University Medical Center, Avenue René Laennec, 80054, Amiens cedex 01, France.
- SSPC (Simplification of Surgical Patients Care), Clinical Research Unit, University of Picardie Jules Verne, 80054, Amiens Cedex 01, France.
- Service de Chirurgie Digestive, CHU Amiens-Picardie, Site Sud, 1 Rond-Point du Professeur Christian Cabrol, 80054, Amiens Cedex 1, France.
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Bohbot Y, Candellier A, Diouf M, Rusinaru D, Altes A, Pasquet A, Maréchaux S, Vanoverschelde JL, Tribouilloy C. Severe Aortic Stenosis and Chronic Kidney Disease: Outcomes and Impact of Aortic Valve Replacement. J Am Heart Assoc 2020; 9:e017190. [PMID: 32964785 PMCID: PMC7792421 DOI: 10.1161/jaha.120.017190] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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] [Indexed: 11/23/2022]
Abstract
Background The prognostic significance of chronic kidney disease (CKD) in severe aortic stenosis is poorly understood and no studies have yet evaluated the effect of aortic‐valve replacement (AVR) versus conservative management on long‐term mortality by stage of CKD. Methods and Results We included 4119 patients with severe aortic stenosis. The population was divided into 4 groups according to the baseline estimated glomerular filtration rate: no CKD, mild CKD, moderate CKD, and severe CKD. The 5‐year survival rate was 71±1% for patients without CKD, 62±2% for those with mild CKD, 54±3% for those with moderate CKD, and 34±4% for those with severe CKD (P<0.001). By multivariable analysis, patients with moderate or severe CKD had a significantly higher risk of all‐cause (hazard ratio [HR] [95% CI]=1.36 [1.08–1.71]; P=0.009 and HR [95% CI]=2.16 [1.67–2.79]; P<0.001, respectively) and cardiovascular mortality (HR [95% CI]=1.39 [1.03–1.88]; P=0.031 and HR [95% CI]=1.69 [1.18–2.41]; P=0.004, respectively) than patients without CKD. Despite more symptoms, AVR was less frequent in moderate (P=0.002) and severe CKD (P<0.001). AVR was associated with a marked reduction in all‐cause and cardiovascular mortality versus conservative management for each CKD group (all P<0.001). The joint‐test showed no interaction between AVR and CKD stages (P=0.676) indicating a nondifferentialeffect of AVR across stages of CKD. After propensity matching, AVR was still associated with substantially better survival for each CKD stage relative to conservative management (all P<0.0017). Conclusions In severe aortic stenosis, moderate and severe CKD are associated with increased mortality and decreased referral to AVR. AVR markedly reduces all‐cause and cardiovascular mortality, regardless of the CKD stage. Therefore, CKD should not discourage physicians from considering AVR.
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Affiliation(s)
- Yohann Bohbot
- Department of Cardiology Amiens University Hospital Amiens France.,UR UPJV 7517 Jules Verne University of Picardie Amiens France
| | - Alexandre Candellier
- UR UPJV 7517 Jules Verne University of Picardie Amiens France.,Department of Nephrology Amiens University Hospital Amiens France
| | - Momar Diouf
- Department of Clinical Research Amiens University Hospital Amiens France
| | - Dan Rusinaru
- Department of Cardiology Amiens University Hospital Amiens France.,UR UPJV 7517 Jules Verne University of Picardie Amiens France
| | - Alexandre Altes
- Groupement des Hôpitaux de l'Institut Catholique de Lille/Faculté Libre de Médecine Université Lille Nord de France Lille France
| | - Agnes Pasquet
- Pôle de Recherche Cardiovasculaire Institut de Recherche Expérimentale et Clinique Université Catholique de Louvain Brussels Belgium.,Division of Cardiology Cliniques Universitaires Saint-Luc Brussels Belgium
| | - Sylvestre Maréchaux
- UR UPJV 7517 Jules Verne University of Picardie Amiens France.,Groupement des Hôpitaux de l'Institut Catholique de Lille/Faculté Libre de Médecine Université Lille Nord de France Lille France
| | - Jean-Louis Vanoverschelde
- Pôle de Recherche Cardiovasculaire Institut de Recherche Expérimentale et Clinique Université Catholique de Louvain Brussels Belgium.,Division of Cardiology Cliniques Universitaires Saint-Luc Brussels Belgium
| | - Christophe Tribouilloy
- Department of Cardiology Amiens University Hospital Amiens France.,UR UPJV 7517 Jules Verne University of Picardie Amiens France
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Fumery M, Peyrin-Biroulet L, Nancey S, Altwegg R, Gilletta C, Veyrard P, Bouguen G, Viennot S, Poullenot F, Filippi J, Buisson A, Bozon A, Brazier F, Pouillon L, Flourie B, Boivineau L, Siproudhis L, Laharie D, Roblin X, Diouf M, Treton X. Effectiveness And Safety Of Ustekinumab Intensification At 90 Mg Every Four Weeks In Crohn's Disease: A Multicenter Study. J Crohns Colitis 2020; 15:jjaa177. [PMID: 32898232 DOI: 10.1093/ecco-jcc/jjaa177] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 05/05/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The approved maintenance regimens for ustekinumab in Crohn's disease (CD) are 90 mg every 8 or 12 weeks. Some patients will partially respond to ustekinumab or will experience a secondary loss of response. It remains poorly known if these patients may benefit from shortening the interval between injections. METHODS All patients with active CD, as defined by Harvey-Bradshaw score ≥ 4 and one objective sign of inflammation (CRP > 5 mg/L and/or fecal calprotectin > 250 µg/g and/or radiologic and/or endoscopic evidence of disease activity) who required ustekinumab dose escalation to 90mg every 4 weeks for loss of response or incomplete response to ustekinumab 90mg every 8 weeks were included in this retrospective multicenter cohort study. RESULTS One hundred patients, with a median age of 35 years (Interquartile Range (IQR), 28 - 49) and median disease duration of 12 (7 - 20) years were included. Dose intensification was performed after a median of 5.0 (2.8 - 9.0) months of ustekinumab treatment and was associated with corticosteroids and immunosuppressants in respectively 29% and 27% of cases. Short-term clinical response and clinical remission were observed in respectively 61% and 31% after a median of 2.4 (1.3 - 3.0) months. After a median follow-up of 8.2 (5.6-12.4) months, 61% of patients were still treated with ustekinumab, and 26% in steroid-free clinical remission. Among the 39 patients with colonoscopy during follow-up, 14 achieved endoscopic remission (no ulcers). At the end of follow-up, 27% of patients were hospitalized, and 19% underwent intestinal resection surgery. Adverse events were reported in 12% of patients, including five serious adverse events. CONCLUSION In this multicenter study, two-thirds of patients recaptured response following treatment intensification with ustekinumab 90 mg every 4 weeks.
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Affiliation(s)
- Mathurin Fumery
- Department of Gastroenterology, and PeriTox, UMR I0-I, Amiens University Hospital, Amiens, France
| | - Laurent Peyrin-Biroulet
- INSERM U1256 NGERE, Department of Gastroenterology, Nancy University Hospital, Lorraine University, Nancy, France
| | - Stephane Nancey
- Department of Gastroenterology, Hospices Civils de Lyon and University Claude Bernard Lyon 1, and INSERM U1111, CIRI, Lyon, France
| | - Romain Altwegg
- Department of Gastroenterology, Hôpital Saint-Eloi, University Hospital of Montpellier, Montpellier, France
| | - Cyrielle Gilletta
- Department of Gastroenterology, Toulouse University Hospital, Toulouse, France
| | - Pauline Veyrard
- Department of Gastroenterology, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Guillaume Bouguen
- CHU Rennes, Univ Rennes, INSERM, CIC1414, Institut NUMECAN (Nutrition Metabolism and Cancer), Rennes, France
| | - Stephanie Viennot
- Department of Gastroenterology, Caen University Hospital, Caen, France
| | - Florian Poullenot
- CHU de Bordeaux, Hôpital Haut-Lévêque, Service d'Hépato-gastroentérologie et oncologie digestive - Université de Bordeaux, Bordeaux, France
| | - Jerome Filippi
- Department of Gastroenterology, Archet 2 University Hospital, Nice, France
| | - Anthony Buisson
- Université Clermont Auvergne, Inserm, U1071, M2iSH, USC-INRA 2018 3iHP, CHU Clermont-Ferrand, Service d'Hépato-Gastroentérologie, Clermont-Ferrand, France
| | - Anne Bozon
- Department of Gastroenterology, IBD and Nutrition Support, Beaujon Hospital, Université de Paris site Denis Diderot, Clichy, France
| | - Franck Brazier
- Department of Gastroenterology, and PeriTox, UMR I0-I, Amiens University Hospital, Amiens, France
| | - Lieven Pouillon
- INSERM U1256 NGERE, Department of Gastroenterology, Nancy University Hospital, Lorraine University, Nancy, France
| | - Bernard Flourie
- Department of Gastroenterology, Hospices Civils de Lyon and University Claude Bernard Lyon 1, and INSERM U1111, CIRI, Lyon, France
| | - Lucile Boivineau
- Department of Gastroenterology, Hôpital Saint-Eloi, University Hospital of Montpellier, Montpellier, France
| | - Laurent Siproudhis
- CHU Rennes, Univ Rennes, INSERM, CIC1414, Institut NUMECAN (Nutrition Metabolism and Cancer), Rennes, France
| | - David Laharie
- CHU de Bordeaux, Hôpital Haut-Lévêque, Service d'Hépato-gastroentérologie et oncologie digestive - Université de Bordeaux, Bordeaux, France
| | - Xavier Roblin
- Department of Gastroenterology, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Momar Diouf
- Department of Biostatistics, Amiens University Hospital, Amiens, France
| | - Xavier Treton
- Department of Gastroenterology, IBD and Nutrition Support, Beaujon Hospital, Université de Paris site Denis Diderot, Clichy, France
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Yzet C, Diouf M, Le Mouel JP, Brazier F, Turpin J, Loreau J, Dupas JL, Peyrin-Biroulet L, Fumery M. Complete Endoscopic Healing Associated With Better Outcomes Than Partial Endoscopic Healing in Patients With Crohn's Disease. Clin Gastroenterol Hepatol 2020; 18:2256-2261. [PMID: 31743755 DOI: 10.1016/j.cgh.2019.11.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 06/26/2019] [Revised: 09/26/2019] [Accepted: 11/06/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Mucosal healing (MH) has been associated with good outcomes of patients with Crohn's disease (CD). It is not clear what levels of endoscopic healing, based on CD endoscopic index score (CDEIS), associate with different courses of disease progression. We assessed long-term outcomes of patients with CD according to different levels of MH. METHODS We performed a retrospective study of 84 patients with CD and MH who received biologic therapy (80% with infliximab) from 2008 through 2015 at 2 university hospitals in France and compared outcomes of patients with CD endoscopic index scores (CDEISs) of 0 vs CDEISs greater than 0 but less than 4. Patients were followed until treatment failure or through June 2016. The primary outcome measure was treatment failure, defined by the need for biologic optimization, initiation of corticosteroids, or a Harvey-Bradshaw score above 4 associated with change in treatment, CD-related hospitalization, and/or intestinal resection. RESULTS After a median follow-up time of 4.8 years (interquartile range, 2.1-7.2), 27 patients (32%) had treatment failure and 3 patients (3.6%) underwent an intestinal resection. Rates of treatment failure were 25% in patients with a CDEIS of 0 and 48% in patients with CDEISs greater than 0 but less than 4 (P = .045). Median times to treatment failure were 21 months (interquartile range, 5-43 months) in patients with a CDEIS of 0 and 13 months (interquartile range, 3.6-35 months) in patients with CDEISs greater than 0 but less than 4 (P = .047). None of the patients with a CEDIS of 0 underwent intestinal resection whereas 11% patients with CDEISs greater than 0 but less than 4 required intestinal resection (P = .031). Patients with a CDEIS of 0 also had a significant lower rate of CD-related hospitalizations than patients with CDEISs greater than 0 but less than 4 (3.5% vs 18%; P = .013). In multivariate analysis, CDEISs greater than 0 but less than 4 (vs CDEIS = 0) was the only factor associated with treatment failure (hazard ratio, 2.6; 95% CI, 1.2-5.8; P = .02). CONCLUSIONS Complete endoscopic healing (CDEIS = 0) is associated with better long-term outcomes than partial endoscopic healing (CDEIS = 1-4) in patients with CD, as well as fewer surgeries and hospitalizations and an overall decreased risk of treatment failure.
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Affiliation(s)
- Clara Yzet
- Gastroenterology Unit, Amiens University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Momar Diouf
- Department of Biostatistics, Amiens University Hospital, Amiens, France
| | - Jean-Philippe Le Mouel
- Gastroenterology Unit, Amiens University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Franck Brazier
- Gastroenterology Unit, Amiens University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Justine Turpin
- Gastroenterology Unit, Amiens University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Julien Loreau
- Gastroenterology Unit, Amiens University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Jean Louis Dupas
- Gastroenterology Unit, Amiens University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology, Nancy University Hospital, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Mathurin Fumery
- Gastroenterology Unit, Amiens University Hospital, Université de Picardie Jules Verne, Amiens, France.
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Dernoncourt A, El Samad Y, Schmidt J, Emond JP, Gouraud C, Brocard A, El Hamri M, Plassart C, Rousseau F, Salle V, Diouf M, Varon E, Hamdad F. Case Studies and Literature Review of Pneumococcal Septic Arthritis in Adults. Emerg Infect Dis 2020; 25. [PMID: 31538930 PMCID: PMC6759247 DOI: 10.3201/eid2510.181695] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
We saw an increase in this condition related to emergence of Streptococcus pneumoniae serotype 23B. We conducted a retrospective study on all cases of pneumococcal septic arthritis (SA) in patients >18 years of age reported to the Picardie Regional Pneumococcal Network in France during 2005–2016. Among 1,062 cases of invasive pneumococcal disease, we observed 16 (1.5%) SA cases. Although SA is uncommon in adult patients, the prevalence of pneumococcal SA in the Picardie region increased from 0.69% during 2005–2010 to 2.47% during 2011–2016 after introduction of the pneumococcal 13-valent conjugate vaccine. We highlight the emergence of SA cases caused by the 23B serotype, which is not covered in the vaccine.
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Bar S, Lecourtois A, Diouf M, Goldberg E, Bourbon C, Arnaud E, Domisse L, Dupont H, Gosset P. The association of lung ultrasound images with COVID-19 infection in an emergency room cohort. Anaesthesia 2020; 75:1620-1625. [PMID: 32520406 PMCID: PMC7300460 DOI: 10.1111/anae.15175] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2020] [Indexed: 12/16/2022]
Abstract
Lung ultrasound could facilitate the triage of patients with suspected COVID‐19 infection admitted to the emergency room. We developed a predictive model for COVID‐19 diagnosis based on lung ultrasound and clinical features. We used ultrasound to image the lung bilaterally at two anterior sites, one and two hands below each clavicle, and a posterolateral site that was the posterior transverse continuation from the lower anterior site. We studied 100 patients, 31 of whom had a COVID‐19 positive reverse transcriptase polymerase chain reaction. A positive test was independently associated with: quick sequential organ failure assessment score ≥1; ≥3 B‐lines at the upper site; consolidation and thickened pleura at the lower site; and thickened pleura line at the posterolateral site. The model discrimination was an area (95%CI) under the receiver operating characteristic curve of 0.82 (0.75–0.90). The characteristics (95%CI) of the model’s diagnostic threshold, applied to the population from which it was derived, were: sensitivity, 97% (83–100%); specificity, 62% (50–74%); positive predictive value, 54% (41–98%); and negative predictive value, 98% (88–99%). This model may facilitate triage of patients with suspected COVID‐19 infection admitted to the emergency room.
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Affiliation(s)
- S Bar
- Anaesthesiology and Critical Care Department, Amiens University Hospital, Amiens, France
| | - A Lecourtois
- Emergency Medicine Department, Amiens University Hospital, Amiens, France
| | - M Diouf
- Amiens University Hospital, Amiens, France
| | - E Goldberg
- Anaesthesiology and Critical Care Department, Amiens University Hospital, Amiens, France
| | - C Bourbon
- Emergency Medicine Department, Amiens University Hospital, Amiens, France
| | - E Arnaud
- Emergency Medicine Department, Amiens University Hospital, Amiens, France
| | - L Domisse
- Emergency Medicine Department, Amiens University Hospital, Amiens, France
| | - H Dupont
- Anaesthesiology and Critical Care Department, Amiens University Hospital, Amiens, France
| | - P Gosset
- Emergency Medicine Department, Amiens University Hospital, Amiens, France
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Sabbagh C, Siembida N, Dupont H, Diouf M, Schmit JL, Boddaert S, Regimbeau JM. The value of post-operative antibiotic therapy after laparoscopic appendectomy for complicated acute appendicitis: a prospective, randomized, double-blinded, placebo-controlled phase III study (ABAP study). Trials 2020; 21:451. [PMID: 32487213 PMCID: PMC7268648 DOI: 10.1186/s13063-020-04411-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/14/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Approximately 30% of appendectomies are for complicated acute appendicitis (CAA). With laparoscopy, the main post-operative complication is deep abscesses (12% of cases of CAA, versus 4% for open surgery). A recent cohort study compared short and long courses of postoperative antibiotic therapy in patients with CAA. There was no significant intergroup difference in the post-operative complication rate (12% of organ/space surgical site infection (SSI)). Moreover, antibiotic therapy is increasingly less indicated for other situations (non-complicated appendicitis, post-operative course of cholecystitis, perianal abscess), calling into question whether post-operative antibiotic therapy is required after laparoscopic appendectomy for CAA. METHODS/DESIGN This study is a prospective, multicenter, parallel-group, randomized (1:1), double-blinded, placebo-controlled, phase III non-inferiority study with blind evaluation of the primary efficacy criterion. The primary objective is to evaluate the impact of the absence of post-operative antibiotic therapy on the organ/space surgical site infection (SSI) rate in patients presenting with CAA (other than in cases of generalized peritonitis). Patients in the experimental group will receive at least one dose of preoperative and perioperative antibiotic therapy (2 g ceftriaxone by intravenous injection every 24 h up to the operation) and metronidazole (500 mg by intravenous injection every 8 h up to the operation) and, in the post-operative period, a placebo for ceftriaxone (2 g/24 h in one intravenous injection) and a placebo for metronidazole (1500 mg/24 h in three intravenous injections, for 3 days). In the control group, patients will receive at least one dose of preoperative and perioperative antibiotic therapy (2 g ceftriaxone by intravenous injection every 24 h up to the operation) and metronidazole (500 mg by intravenous injection every 8 h up to the operation) and, in the post-operative period, antibiotic therapy (ceftriaxone 2 g/24 h and metronidazole 1500 mg/24 h for 3 days). In the event of allergy to ceftriaxone, it will be replaced by levofloxacin (500 mg/24 h in one intravenous injection, for 3 days). The expected organ space SSI rate is 12% in the population of patients with CAA operated on by laparoscopy. With a non-inferiority margin of 5%, a two-sided alpha risk of 5%, a beta risk of 20%, and a loss-to-follow-up rate of 10%, the calculated sample size is 1476 included patients, i.e., 738 per group. Due to three interim analyses at 10%, 25%, and 50% of the planned sample size, the total sample size increases to 1494 patients (747 per arm). TRIAL REGISTRATION Ethical authorization by the Comité de Protection des Personnes and the Agence Nationale de Sécurité du Médicament: ID-RCB 2017-00334-59. Registered on ClinicalTrials.gov (NCT03688295) on 28 September 2018.
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Affiliation(s)
- C Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, Amiens University Medical Center, Avenue Laennec, F-80054, Amiens cedex 01, France.,Jules Verne University of Picardie, Amiens, France.,SSPC (Simplifications des Soins Patients Chirurgicaux Complexes) Research Unit, University of Picardie Jules Verne, Amiens, France
| | - N Siembida
- Department of Digestive Surgery, Amiens University Hospital, Amiens University Medical Center, Avenue Laennec, F-80054, Amiens cedex 01, France.,SSPC (Simplifications des Soins Patients Chirurgicaux Complexes) Research Unit, University of Picardie Jules Verne, Amiens, France
| | - H Dupont
- Jules Verne University of Picardie, Amiens, France.,SSPC (Simplifications des Soins Patients Chirurgicaux Complexes) Research Unit, University of Picardie Jules Verne, Amiens, France.,Intensive Care Unit, Amiens University Medical Center, Amiens, France
| | - M Diouf
- Department of Methodology, Biostatistics, Direction of Clinical Research, Amiens University Medical Center, Amiens, France
| | - J L Schmit
- Jules Verne University of Picardie, Amiens, France.,Department of Infectious Diseases, Amiens University Medical Center, Amiens, France
| | - S Boddaert
- Department of Pharmacology, Amiens University Medical Center, Amiens, France
| | - J M Regimbeau
- Department of Digestive Surgery, Amiens University Hospital, Amiens University Medical Center, Avenue Laennec, F-80054, Amiens cedex 01, France. .,Jules Verne University of Picardie, Amiens, France. .,SSPC (Simplifications des Soins Patients Chirurgicaux Complexes) Research Unit, University of Picardie Jules Verne, Amiens, France.
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41
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Titeca-Beauport D, Daubin D, Van Vong L, Belliard G, Bruel C, Alaya S, Chaoui K, Andrieu M, Rouquette-Vincenti I, Godde F, Pascal M, Diouf M, Vinsonneau C, Klouche K, Maizel J. Urine cell cycle arrest biomarkers distinguish poorly between transient and persistent AKI in early septic shock: a prospective, multicenter study. Crit Care 2020; 24:280. [PMID: 32487237 PMCID: PMC7268340 DOI: 10.1186/s13054-020-02984-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/12/2020] [Indexed: 12/31/2022]
Abstract
Background The urine biomarkers tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been validated for predicting and stratifying AKI. In this study, we analyzed the utility of these biomarkers for distinguishing between transient and persistent AKI in the early phase of septic shock. Methods We performed a prospective, multicenter study in 11 French ICUs. Patients presenting septic shock, with the development of AKI within the first 6 h, were included. Urine [TIMP-2]*[IGFBP7] was determined at inclusion (0 h), 6 h, 12 h, and 24 h. AKI was considered transient if it resolved within 3 days. Discriminative power was evaluated by receiver operating characteristic (ROC) curve analysis. Results We included 184 patients, within a median [IQR] time of 1.0 [0.0–3.0] h after norepinephrine (NE) initiation; 100 (54%) patients presented transient and 84 (46%) presented persistent AKI. Median [IQR] baseline urine [TIMP-2]*[IGFBP7] was higher in the persistent AKI group (2.21 [0.81–4.90] (ng/ml)2/1000) than in the transient AKI group (0.75 [0.20–2.12] (ng/ml)2/1000; p < 0.001). Baseline urine [TIMP-2]*[IGFBP7] was poorly discriminant, with an AUROC [95% CI] of 0.67 [0.59–0.73]. The clinical prediction model combining baseline serum creatinine concentration, baseline urine output, baseline NE dose, and baseline extrarenal SOFA performed well for the prediction of persistent AKI, with an AUROC [95% CI] of 0.81 [0.74–0.86]. The addition of urine [TIMP-2]*[IGFBP7] to this model did not improve the predictive performance. Conclusions Urine [TIMP-2]*[IGFBP7] measurements in the early phase of septic shock discriminate poorly between transient and persistent AKI and do not improve clinical prediction over that achieved with the usual variables. Trial registration NCT02812784
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Affiliation(s)
- Dimitri Titeca-Beauport
- BoReal Study Group, Medical Intensive Care Unit and EA7517, Amiens University Hospital, F-80054, Amiens, France.
| | - Delphine Daubin
- Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Ly Van Vong
- Intensive Care Unit, Groupe Hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77000, Melun, France
| | - Guillaume Belliard
- Medical-Surgical Intensive Care Unit, Centre Hospitalier de Bretagne Sud, Lorient, France
| | - Cédric Bruel
- Medical and Surgical Intensive Care Unit, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Sami Alaya
- Intensive Care Unit, Centre Hospitalier Général, 13300, Salon-de-Provence, France
| | - Karim Chaoui
- Intensive Care Unit, Jean Rougier Hospital, 335, rue du Président Wilson, 46000, Cahors, France
| | - Maud Andrieu
- Medical and Surgical Intensive Care Unit, Centre Hospitalier de Dax-Côte d'Argent, Dax, France
| | - Isabelle Rouquette-Vincenti
- Department of Anesthesia and Intensive Care, Princess Grace Hospital, Avenue Pasteur, Monaco (Principality), Monaco
| | - Frederic Godde
- Département de Réanimation Polyvalente, Centre Hospitalier Avranches-Granville, Granville, France
| | - Michel Pascal
- Intensive Care Unit, Centre Hospitalier de Mont De Marsan, 40000, Mont-de-Marsan, France
| | - Momar Diouf
- Clinical Research and Innovation Directorate, Amiens University Hospital, Amiens, France
| | | | - Kada Klouche
- Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Julien Maizel
- BoReal Study Group, Medical Intensive Care Unit and EA7517, Amiens University Hospital, F-80054, Amiens, France
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42
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Sall I, Faye M, Ndiaye B, Faye ST, Diouf M, Diémé E, Fall O, Sow A, Ogougbémy M. Comment on: Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society. Br J Surg 2020; 107:e217. [PMID: 32342488 DOI: 10.1002/bjs.11579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 11/09/2022]
Affiliation(s)
- I Sall
- Department of General Surgery, Principal Hospital of Dakar, Dakar, Senegal
| | - M Faye
- Department of General Surgery, Principal Hospital of Dakar, Dakar, Senegal
| | - B Ndiaye
- Department of General Surgery, Principal Hospital of Dakar, Dakar, Senegal
| | - S T Faye
- Department of General Surgery, Principal Hospital of Dakar, Dakar, Senegal
| | - M Diouf
- Department of General Surgery, Principal Hospital of Dakar, Dakar, Senegal
| | - E Diémé
- Department of General Surgery, Principal Hospital of Dakar, Dakar, Senegal
| | - O Fall
- Department of General Surgery, Principal Hospital of Dakar, Dakar, Senegal
| | - A Sow
- Department of General Surgery, Principal Hospital of Dakar, Dakar, Senegal
| | - M Ogougbémy
- Department of General Surgery, Principal Hospital of Dakar, Dakar, Senegal
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Lai KF, Hermann V, Trivikram TM, Diouf M, Schlösser M, Ubachs W, Salumbides EJ. Precision measurement of the fundamental vibrational frequencies of tritium-bearing hydrogen molecules: T 2, DT, HT. Phys Chem Chem Phys 2020; 22:8973-8987. [PMID: 32292981 DOI: 10.1039/d0cp00596g] [Citation(s) in RCA: 6] [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] [Indexed: 11/21/2022]
Abstract
High-resolution coherent Raman spectroscopic measurements of all three tritium-containing molecular hydrogen isotopologues T2, DT and HT were performed to determine the ground electronic state fundamental Q-branch (v = 0 → 1, ΔJ = 0) transition frequencies at accuracies of 0.0005 cm-1. An over hundred-fold improvement in accuracy over previous experiments allows the comparison with the latest ab initio calculations in the framework of non-adiabatic perturbation theory including nonrelativisitic, relativisitic and QED contributions. Excellent agreement is found between experiment and theory, thus providing a verification of the validity of the NAPT-framework for these tritiated species. While the transition frequencies were corrected for ac-Stark shifts, the contributions of non-resonant background as well as quantum interference effects between resonant features in the nonlinear spectroscopy were quantitatively investigated, also leading to corrections to the transition frequencies. Methods of saturated CARS with the observation of Lamb dips, as well as the use of continuous-wave radiation for the Stokes frequency were explored, that might pave the way for future higher-accuracy CARS measurements.
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Affiliation(s)
- K-F Lai
- Department of Physics and Astronomy, LaserLaB, Vrije Universiteit Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands.
| | - V Hermann
- Tritium Laboratory Karlsruhe, Institute of Nuclear Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - T M Trivikram
- Department of Physics and Astronomy, LaserLaB, Vrije Universiteit Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands.
| | - M Diouf
- Department of Physics and Astronomy, LaserLaB, Vrije Universiteit Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands.
| | - M Schlösser
- Tritium Laboratory Karlsruhe, Institute of Nuclear Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - W Ubachs
- Department of Physics and Astronomy, LaserLaB, Vrije Universiteit Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands.
| | - E J Salumbides
- Department of Physics and Astronomy, LaserLaB, Vrije Universiteit Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands.
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Fischer MO, Joosten A, Desebbe O, Boutros M, Debroczi S, Broch O, Malbrain ML, Ameloot K, Hofer CK, Bubenek-Turconi ŞI, Monnet X, Diouf M, Lorne E. Interchangeability of cardiac output measurements between non-invasive photoplethysmography and bolus thermodilution: A systematic review and individual patient data meta-analysis. Anaesth Crit Care Pain Med 2020; 39:75-85. [DOI: 10.1016/j.accpm.2019.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/29/2019] [Accepted: 05/27/2019] [Indexed: 01/30/2023]
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Andriuta D, Diouf M, Roussel M, Godefroy O. Is Reaction Time Slowing an Early Sign of Alzheimer's Disease? A Meta-Analysis. Dement Geriatr Cogn Disord 2020; 47:281-288. [PMID: 31408867 DOI: 10.1159/000500348] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 11/28/2018] [Accepted: 04/13/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although simple reaction time (SRT) slowing is associated with dementia in Alzheimer's disease (AD), its presence in individuals with mild cognitive impairment (MCI) is subject to debate. OBJECTIVE The aim of this study was to perform a systematic review and meta-analysis of the literature data on SRT slowing in MCI. METHODS Publications with data on SRT, age, and educational level in participants with MCI were included. After calculating the log SRT and its variance for each study, we took interstudy heterogeneity into account by conducting a random effects (restricted maximum likelihood estimation) meta-analysis. RESULTS The 7 selected studies featured a total of 327 participants with MCI and 468 healthy controls (HCs). The mean age was 68.2 years for participants with MCI and 72.3 years for HCs. The weighted mean Mini-Mental State Examination score was 26.4 in the MCI group, and 28.4 in the HC group. The mean SRT was significantly (p = 0.0217) longer in the MCI group (by 11%) than in the HC group. CONCLUSION This meta-analysis showed that SRTs are longer in individuals with MCI. Further studies are needed to determine the mechanism of SRT slowing, its anatomical correlates, and a threshold value for diagnosing prodromal AD.
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Affiliation(s)
- Daniela Andriuta
- Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France,
| | - Momar Diouf
- Department of Biostatistics, Amiens University Hospital, Amiens, France
| | - Martine Roussel
- Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France
| | - Olivier Godefroy
- Department of Neurology and Laboratory of Functional Neurosciences, Amiens University Medical Center, Amiens, France
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Wankap R, Amzallag Y, Diouf M, Moalic G, Cracco C, Riche A. A rare case of non-traumatic rupture of spleen secondary to Plasmodium ovale malaria. IDCases 2020; 21:e00757. [PMID: 32637318 PMCID: PMC7327264 DOI: 10.1016/j.idcr.2020.e00757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/12/2020] [Accepted: 03/21/2020] [Indexed: 11/25/2022] Open
Abstract
Objective Plasmodium ovale malaria occurs mainly from mild form of malaria. We present a rare case of a splenic rupture secondary to complication of Plasmodium ovale malaria. Clinical presentation A 41-year-old female from Mali admitted to intensive care unit with hemorrhagic shock secondary to splenic rupture. A laparoscopic exploration was performed and patient received a massive blood transfusion for a hemodynamic stabilization. The diagnosis of malaria was confirmed by a blood smear test indicating the presence of P. ovale. A treatment of injectable Quinine was initiated with a positive outcome. Conclusion Although usually considered as a cause of a mild form of malaria, P. ovale may be responsible for a ruptured spleen which can lead to a state of life- threatening hemorrhagic shock.
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Affiliation(s)
- R. Wankap
- Angoulême Hospital Center, France
- Corresponding author at: University of RENNES 1, Faculty of Medicine, Angoulême Hospital, Department of Internal Medicine and Infectious Diseases, Rond-point de Girac, 16959, Angoulême, France.
| | | | - M. Diouf
- Nice University Hospital Center, France
| | | | | | - A. Riche
- Angoulême Hospital Center, France
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Deme H, Akpo LG, Badji N, Benmansour W, Niang FG, Diop AD, Diallo A, Kasse Y, Diouf M, Mbaye A, Faye I, Diop PA, Fall MC, Ba S, Niang EH. [Diagnostic performance of imaging examinations in acute non-traumatic abdominal pain in the radiology department of the Kaolack Regional Hospital]. Mali Med 2020; 35:15-22. [PMID: 37978730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
AIM The aim of this work was to evaluate the diagnostic performance of imaging examinations in the presence of acute non-traumatic abdominal pain. MATERIALS AND METHODS This was a prospective, cross-sectional and descriptive study over 6 months in the radiology and medical imaging department of the Kaolack Regional Hospital, including any patient received for acute non-traumatic abdominal pain with informed consent in whom the etiological diagnosis is supported by an imaging examination. We investigated the etiologies of acute abdominal pain and compared the imaging findings with surgical exploration. Our data were analyzed using SPSS 24.0 and Excel 2013 with a coefficient of significance of less than 5%. RESULTS 106 patients were enrolled. The mean age was 32 years and the gender-ratio was 1.52 in favour of women. Acute abdominal pain was diffuse in 25.5% of patients and localized in 74.5%, of which 18.9% were at right iliac fossa.Abdominal X-ray was performed alone in 4 patients (3.8%), ultrasound alone in 46 patients (43.3%) and abdominal CT scan in 34 patients (32%). CT was combined with ultrasound in 6 patients (5.7%) and with abdominal X-ray in 16 patients (15%). The initial clinical diagnosis was corrected in 49.1% of patients. The sensitivity of the imaging compared to the final diagnosis retained was 96.2%. CONCLUSION Imaging represents a turning point in the management of patients with acute non-traumatic abdominal pain by providing better diagnostic guidance and avoiding serious complications and unnecessary interventions.
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Affiliation(s)
- H Deme
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
| | - L G Akpo
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
| | - N Badji
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
| | - W Benmansour
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
- Service d'imagerie médicale du Centre hospitalier El Hadj Ibrahima Niass de Kaolack
| | - F G Niang
- Service d'imagerie médicale du Centre Hospitalier Universitaire National de FANN
| | - A D Diop
- Service d'imagerie médicale du Centre Hospitalier Universitaire National de FANN
| | - A Diallo
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
- Service d'imagerie médicale du Centre hospitalier El Hadj Ibrahima Niass de Kaolack
| | - Y Kasse
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
| | - M Diouf
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
| | - A Mbaye
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
| | - I Faye
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
| | - P A Diop
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
| | - M C Fall
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
| | - S Ba
- Service d'imagerie médicale du Centre Hospitalier Universitaire National de FANN
| | - E H Niang
- Service d'imagerie médicale de l'Hôpital Aristide Le DANTEC (HALD)
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Salle V, Gomila C, Diouf M, Schmidt J, Galmiche A, Conte M, Smail A, Boulu X, Morel P, Marolleau J, Dersigny A, Herpe Y, Duhaut P. Dosage de l’annexine A2 au cours du myélome multiple. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.027] [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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Dhaille F, Dillies A, Dessirier F, Reygagne P, Diouf M, Balthazard T, Lombart F, Hébert V, Chopinnaud M, Verneuil L, Becquart C, Delaporte E, Lok C, Chaby G. Single typical trichoscopic feature predictive of tinea capitis. Br J Dermatol 2019. [DOI: 10.1111/bjd.18495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dhaille F, Dillies A, Dessirier F, Reygagne P, Diouf M, Balthazard T, Lombart F, Hébert V, Chopinnaud M, Verneuil L, Becquart C, Delaporte E, Lok C, Chaby G. 单一典型的毛发镜检特征可预测头癣. Br J Dermatol 2019. [DOI: 10.1111/bjd.18507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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