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Bar Ilan M, Dovrat S, Cohen R, Georgaki M, Papadopoulou E, Nikitakis NG, Yarom N. Virucidal effect of mouthwash on acyclovir-resistant herpes simplex virus. Oral Dis 2023. [PMID: 38151043 DOI: 10.1111/odi.14843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/13/2023] [Accepted: 12/03/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES The symptoms of herpes simplex viruses type 1 (HSV-1) infections might be severe and persistent in immunocompromised patients in whom they reactivate at a high frequency. The development of Acyclovir (ACV) resistant strains due to long-term treatment with antiviral agents in those patients is not uncommon. The aim of the present study was to assess the virucidal effect of commercially available mouthwashes against ACV-resistant HSV-1 strains. MATERIALS AND METHODS Two acyclovir-resistant HSV-1 strains were exposed for 30 s to essential oil-based (Listerine Fresh Burst® and Listerine Zero®), chlorhexidine gluconate 0.2% (Hexidyl®) and povidone-iodine 7.5% (Betadine Gargle®) mouthwashes. Loss of virus infectivity was determined by means of plaque reduction assays in a cell culture system. RESULTS All 4 of the tested solutions significantly reduced virus infectivity, with the essential oil-based and povidone-iodine mouthwashes being slightly more efficacious, compared to chlorhexidine. CONCLUSION The findings of this analysis revealed that the tested oral rinses demonstrated in-vitro antiviral activity against ACV-resistant HSV. Comparative clinical trials are required to establish the clinical effectiveness of daily use of oral rinses in reducing the appearance of oral HSV lesions in immunocompromised patients.
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Affiliation(s)
- M Bar Ilan
- Oral Medicine Unit, Sheba Medical Center, Tel-Hashomer, Israel
- Oral Medicine Unit, Department of Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - S Dovrat
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Tel-Hashomer, Israel
| | - R Cohen
- Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Tel-Hashomer, Israel
| | - M Georgaki
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - E Papadopoulou
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - N G Nikitakis
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - N Yarom
- Oral Medicine Unit, Sheba Medical Center, Tel-Hashomer, Israel
- School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Cohen R, Madhi F, Thollot F, Hau I, Vie le Sage F, Lemaître C, Magendie C, Werner A, Gelbert N, Cohen JF, Couloigner V. Antimicrobial treatment of ENT infections. Infect Dis Now 2023; 53:104785. [PMID: 37730165 DOI: 10.1016/j.idnow.2023.104785] [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: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023]
Abstract
Ear, nose and throat (ENT) or upper respiratory tract infections (URTI) are the most common infections in children and the leading causes of antibiotic prescriptions. In most cases, these infections are due to (or are triggered by) viruses and even when bacterial species are implicated, recovery is usually spontaneous. The first imperative is to refrain from prescribing antibiotics in a large number of URTIs: common cold, most cases of sore throat, laryngitis, congestive otitis, and otitis media with effusion. On the contrary, a decision to treat sore throats with antibiotics is based primarily on the positivity of the Group A Streptococcus (GAS) rapid antigen diagnostic tests. For ear infections, only (a) purulent acute otitis media in children under 2 years of age and (b) complicated or symptomatic forms of purulent acute otitis media (PAOM) in older children should be treated with antibiotics. Amoxicillin is the first-line treatment in the most cases of ambulatory ENT justifying antibiotics. Severe ENT infections (mastoiditis, epiglottitis, retro- and parapharyngeal abscesses, ethmoiditis) are therapeutic emergencies necessitating hospitalization and initial intravenous antibiotic therapy.
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Affiliation(s)
- R Cohen
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, France; ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Créteil, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France.
| | - F Madhi
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Service de Pédiatrie Centre Hospitalier Intercommunal de Créteil, France
| | - F Thollot
- Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Primary Care Paediatrician, Association Française de Pédiatrie Ambulatoire, France
| | - I Hau
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Service de Pédiatrie Centre Hospitalier Intercommunal de Créteil, France
| | - F Vie le Sage
- Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Primary Care Paediatrician, Association Française de Pédiatrie Ambulatoire, France
| | - C Lemaître
- Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Primary Care Paediatrician, Association Française de Pédiatrie Ambulatoire, France
| | - C Magendie
- Primary Care Paediatrician, Association Française de Pédiatrie Ambulatoire, France
| | - A Werner
- Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Primary Care Paediatrician, Association Française de Pédiatrie Ambulatoire, France
| | - N Gelbert
- Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France; Primary Care Paediatrician, Association Française de Pédiatrie Ambulatoire, France
| | - Jeremie F Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Créteil, France
| | - V Couloigner
- Service d'ORL Pédiatrique - Hôpital Necker - Enfants Malades, AP-HP, Université Paris Descartes, France; Secrétaire Général de la Société Française d'ORL - General Secretary of the French ENT Society, France; Head of the Education Commission of the European Society of Pediatric Otorhinolaryngology, France
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Yegya-Raman N, Lee SH, Friedes C, Iocolano M, Kim KN, Duan L, Li B, Sun L, Cohen R, Cengel KA, Levin WP, Langer C, Aggarwal C, Ky B, O'Quinn RP, Zou W, Teo K, Deasy JO, Xiao Y, Feigenberg SJ. Association of Cardiac Dose with Cardiac Events and Survival for Locally Advanced Non-Small Cell Lung Cancer (LA-NSCLC) Treated with Concurrent Chemoradiotherapy (cCRT) in the Era of Immune Checkpoint Inhibitor (ICI) Consolidation. Int J Radiat Oncol Biol Phys 2023; 117:S169-S170. [PMID: 37784421 DOI: 10.1016/j.ijrobp.2023.06.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To assess the association of cardiac dose with post-cCRT cardiac events and survival among patients (pts) with LA-NSCLC after adoption of ICI consolidation, modern radiotherapy (RT) techniques, and data-driven cardiac constraints. MATERIALS/METHODS This single-institution, multi-site retrospective study included 335 pts with LA-NSCLC treated with definitive cCRT (60-70 Gy) from October 2017 to December 2021. Pts were evaluated for ICI consolidation. Cardiac dose constraints included heart volume receiving ≥50 Gy (V50) <25% and mean heart dose (MHD) <20 Gy. Heart, left anterior descending artery (LAD), and left ventricle were autocontoured, manually reviewed, and edited. 21 dosimetric parameters (mean dose, max dose, and min dose to the hottest x% volume [Dx%(Gy); x from 5-95 in 5% intervals]) for each were extracted, as well as LAD V15. Baseline cardiovascular disease (bCVD) was defined as heart failure (HF), coronary artery disease, peripheral vascular disease, or cerebrovascular disease. Primary endpoint was post-cCRT major adverse cardiac events (MACE), defined as acute coronary syndrome, HF hospitalization/urgent visit, coronary revascularization, or cardiac death. Secondary endpoints were grade ≥3 cardiac events (CTCAE v5.0), overall survival (OS), cancer specific mortality (CSM), and other cause mortality (OCM). Competing risk regression was used for MACE and grade ≥3 cardiac events, and Cox regression for OS, CSM, and OCM. RESULTS Median age was 68 years, 139 (41%) had bCVD, and 225 (67%) received consolidation ICI. Proton therapy was used in 117 (35%), intensity-modulated RT in 199 (59%), and 3D conformal RT in 19 (6%). Median MHD was 8.7 Gy (IQR 4.6-14.4) and median LAD V15 1.4% (IQR 0-22). Median follow-up was 39.5 months. 35 MACE events occurred; 1- and 2-year cumulative incidence (CI) were 4.2% and 9.5%. No cardiac dosimetric parameter associated with MACE after adjusting for bCVD and age (e.g., MHD sHR 0.98/Gy, 95% CI 0.93-1.03, p = 0.43) or within the following 3 subgroups: no bCVD, photon therapy, and ICI consolidation. 87 grade ≥3 cardiac events occurred; 1- and 2- year CI were 12.6% and 20.4%. Heart dose was not associated with grade ≥3 cardiac events after adjusting for bCVD, ECOG, and BMI (e.g., MHD sHR 1.00/Gy, 95% CI 0.97-1.03, p = 0.85) or within the 3 aforesaid subgroups. 183 OS events occurred, including 125 CSM and 58 OCM events. Multiple cardiac dosimetric parameters associated with worse OS on multivariable analysis (e.g., LAD V15 HR 1.01/%, 95% CI 1.00-1.02, p = 0.003), driven by associations with CSM (LAD V15 HR 1.02/%, p<0.001) but not OCM (LAD V15 HR 1.00/%, p = 0.73). Median OS was worse for LAD V15 ≥10% (22.2 vs 35.1 months, p = 0.004). CONCLUSION Among pts with LA-NSCLC treated with cCRT after adoption of ICI consolidation, modern RT techniques, and cardiac constraints, post-cCRT cardiac events were common but showed no association with cardiac dose. Cardiac dose associated with OS, driven by an association with CSM and not OCM, which may not reflect cardiac toxicity.
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Affiliation(s)
- N Yegya-Raman
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - S H Lee
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - C Friedes
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - M Iocolano
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - K N Kim
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - L Duan
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - B Li
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - L Sun
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - R Cohen
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - K A Cengel
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - W P Levin
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - C Langer
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - C Aggarwal
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - B Ky
- Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA
| | - R P O'Quinn
- Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA
| | - W Zou
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - K Teo
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - J O Deasy
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Y Xiao
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - S J Feigenberg
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
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4
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Iocolano M, Yegya-Raman N, Wang X, Friedes C, Lee SH, Duan L, Li B, Levin WP, Cengel KA, Langer C, Cohen R, Sun L, Aggarwal C, Doucette A, Xiao Y, Teo K, O'Reilly SE, Zou W, Simone CB, Feigenberg SJ. Proton Beam Therapy (PBT) Versus Intensity-Modulated Radiotherapy (IMRT) for Locally Advanced Non-Small Cell Lung Cancer (LA-NSCLC) in the Era of Immune Checkpoint Inhibitor (ICI) Consolidation: A Retrospective Cohort Study. Int J Radiat Oncol Biol Phys 2023; 117:e26. [PMID: 37784996 DOI: 10.1016/j.ijrobp.2023.06.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients (pts) with LA-NSCLC treated with concurrent chemoradiation (cCRT) and ICI consolidation are at high risk for treatment-related toxicities and subsequent hospitalization. We hypothesized that PBT is associated with a reduction in acute unplanned hospitalizations as compared to IMRT in the era of ICI consolidation. MATERIALS/METHODS This single institution, multi-site retrospective study included consecutive pts with LA-NSCLC treated with definitive cCRT with either PBT or IMRT from October 2017 to December 2021. Pts were evaluated for consolidative ICI. Primary endpoint was unplanned treatment-related hospitalization within 90 days of first radiation (RT) treatment. Secondary endpoints included grade 3+ pneumonitis, grade 3+ esophagitis, PFS and OS. Logistic regression was used to assess associations with 90-day hospitalization. Competing risk regression was used for grade 3+ pneumonitis and esophagitis, and Cox regression for PFS and OS. RESULTS A total of 316 pts were included: 117 (37%) received PBT and 199 (63%) IMRT. Median age was 68.5 yrs; median RT dose 66.6 Gy (IQR 65.9-70.0). PBT group was older (median 71.1 vs 67.2 yrs, p<0.005) and had a higher Charlson comorbidity index (CCI) (median 4 vs 3, p = 0.02). There was no significant difference in ECOG, smoking pack-years, T stage, N stage, target volume size, or receipt of ICI consolidation (66.7% vs 68.3%, p = 0.76). PBT group had lower mean heart dose (5.9 vs 10.8 Gy, p<0.001), LAD V15 (0 vs 6 %, p = 0.001), mean lung dose (14.7 vs 15.7 Gy, p <0.008) and effective dose to immune circulating cells (median 3.7 vs 4.9 Gy, p<0.001) but not mean esophagus dose. PBT was associated with fewer unplanned 90-day hospitalizations (23.9% vs 34.7%); which persisted on multivariable analysis (OR 0.52, 95% CI 0.30-0.90, p = 0.02) after adjusting for CCI, smoking pack-years, T4 tumors and target volume. Reasons for hospitalization in PBT and IMRT groups included progression (1.7% vs 1.5%), definite/probable toxicity from cCRT (11.1% vs 18.6%), possible toxicity from cCRT (7.7% vs 12.6%) or unrelated to cCRT (3.4% vs 2.0%). There was no significant difference between PBT or IMRT groups in G3+ pneumonitis (1-year 6.0% vs 9.1%, p = 0.49), G3+ esophagitis (1-year 6.0% vs 6.5%, p = 0.71), PFS (median 14.4 vs 15.1 months, p = 0.69), or OS (median 34.2 vs 29.4 months, p = 0.41). CONCLUSION Among pts with LA-NSCLC treated with cCRT in the era of ICI consolidation, PBT was associated with fewer acute unplanned hospitalizations compared to IMRT. There was no difference in G3+ pneumonitis, G3+ esophagitis, PFS or OS.
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Affiliation(s)
- M Iocolano
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - N Yegya-Raman
- Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - X Wang
- University of Pennsylvania, Department of Biostatistics and Epidemiology, Philadelphia, PA
| | - C Friedes
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - S H Lee
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - L Duan
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - B Li
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - W P Levin
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - K A Cengel
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - C Langer
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - R Cohen
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - L Sun
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - C Aggarwal
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - A Doucette
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - Y Xiao
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - K Teo
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - S E O'Reilly
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - W Zou
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | | | - S J Feigenberg
- Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Friedes C, Yegya-Raman N, Iocolano M, Lee SH, Li B, Duan L, Levin WP, Cengel KA, Sun L, Aggarwal C, Marmarelis ME, Doucette A, Cohen R, Xiao Y, Langer C, Feigenberg SJ. Patterns of Failure, Volume of Disease Progression, and Subsequent Ablative Management in Locally Advanced Non-Small Cell Lung Cancer (LA-NSCLC) Treated with Definitive Chemoradiation and Consolidation Immune Checkpoint Inhibitors (ICI). Int J Radiat Oncol Biol Phys 2023; 117:e18-e19. [PMID: 37784800 DOI: 10.1016/j.ijrobp.2023.06.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) For patients (pts) with LA-NSCLC treated with chemoradiation and consolidation ICI (CRT+ICI), the patterns of failure (POF) and volume of disease progression (PD) are not well characterized. The primary objective of this study was to classify POFs, the frequency of low volume relapse (LVR), and identify pts eligible for further ablative therapy. MATERIALS/METHODS We retrospectively identified pts with unresectable stage III NSCLC treated with CRT+ICI between October 2017 and December 2021 at a single institution. Site of first failure was classified as locoregional (LRF), distant (DF), or synchronous LRF + DF. Any LRF was subclassified as in field (IFF; PD within 90% isodose line), marginal (MF; within 50% isodose line) or out of field (OOF; outside of 50% isodose line). LVR was defined as < 3 discrete sites of PD in any number or location of organs. Pts with distant LVR were considered to have oligometastatic relapse. Ablative candidates were defined as pts with < 3 discrete sites of PD amenable to further RT or surgery. Cumulative incidence of PD was calculated with death as a competing risk. Progression free survival (PFS) and overall survival (OS) were calculated from the end of RT and assessed via Kaplan Meier. Multivariable Cox modeling was used to assess correlation of pt characteristics and time-to-event outcomes. Logistic regression was used to predict variables associated with LVR. RESULTS A total of 229 pts received CRT+ICI. Median follow up was 39 months and 119 pts experienced PD. Median PFS and OS were 18.4 and 34.5 months, respectively. Of pts with PD, 71 (60%) had DF, 28 (24%) had LRF+DF, and 20 (17%) had LRF. Of pts with any LRF, 28 (57%) had IFF, 10 (21%) had MF, and 10 (21%) had OOF. Estimated 1-year cumulative incidence of LRF, DF, and LRF+DF were 9.3% (95% CI 4.5-16), 39% (95% CI 31-48), and 19% (95% CI 12-27), respectively. A total of 63 (53%) pts had LVR. In pts with LVR, 19 (30%) had isolated thoracic relapse and 44 (69%) had oligometastatic relapse. Most oligometastatic disease was intracranial (22 metastases, 44%). Pts with LVR had a longer median OS vs pts with high volume relapse (37.4 vs 15.2 months, p<0.001). At time of PD, 56 (47%) pts were candidates for further ablative therapies. Subsequent anticancer therapies were local therapy alone (35%), local and systemic therapy (16%), systemic therapy alone (36%), or no therapy (13%). On multivariable analysis, LVR (HR 0.39; 95% CI 0.21-0.73, p = 0.003) and longer receipt of ICI (HR 0.96; 95% CI 0.95-0.98; p<0.001) were associated with improved survival while squamous histology (HR 2.26; 95% CI 1.18-4.32; p = 0.039) was associated with worse survival. Longer receipt of ICI was the only variable predictive for the development of LVR (OR 1.03; 95% CI 1.01-1.05; p = 0.004). CONCLUSION This is the largest real-world series reporting POF after CRT+ICI for stage III NSCLC. Approximately half of pts experience LVR and are candidates for further ablative therapy. Further data are needed to define optimal treatment strategies for pts with LVR after CRT+ICI.
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Affiliation(s)
- C Friedes
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - N Yegya-Raman
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - M Iocolano
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - S H Lee
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - B Li
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - L Duan
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - W P Levin
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - K A Cengel
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - L Sun
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - C Aggarwal
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - M E Marmarelis
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - A Doucette
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - R Cohen
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - Y Xiao
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - C Langer
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - S J Feigenberg
- Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Miller DG, Yegya-Raman N, Friedes C, Cengel KA, Plastaras JP, Simone Ii CB, Cohen R, Langer C, Feigenberg SJ, Butala AA. Pneumonitis after Palliative Thoracic Radiotherapy +/- Immunotherapy: A Retrospective Propensity-Matched Cohort Study. Int J Radiat Oncol Biol Phys 2023; 117:e138. [PMID: 37784706 DOI: 10.1016/j.ijrobp.2023.06.945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients (pts) with advanced lung cancer often receive combined palliative thoracic radiotherapy (RT) and immune checkpoint inhibitors (ICI). There are limited data assessing the toxicities of combined ICI-RT in this setting. We sought to compare the rates of clinically significant pneumonitis among pts with lung cancer receiving palliative thoracic RT with or without recent or concomitant ICI. We hypothesized there would be a higher rate of grade 2+ pneumonitis among RT pts who received recent or concomitant ICI compared to those who did not. MATERIALS/METHODS We retrospectively identified consecutive pts with advanced/recurrent lung cancer from a tertiary academic center who received palliative thoracic RT with recent (defined as within 95 days of RT start) or concomitant ICI (ICI-RT group) between January 2014 and February 2020. Pts were propensity matched in a 1:1 manner (by age, sex, ECOG, RT modality, and RT dose) to lung cancer pts who received palliative thoracic RT without any history of ICI receipt (RT-only group). The presence and grade (CTCAE v5.0) of pneumonitis were independently assessed by two investigators. The primary endpoint was grade 2+ pneumonitis, estimated using the cumulative incidence function and compared between the ICI-RT and RT-only groups using Gray's test. The secondary endpoint was overall survival, estimated using the Kaplan-Meier method and compared between groups using the log-rank test. RESULTS A total of 146 pts were included in the study (73 in each group). There were no statistically significant differences between the ICI-RT and RT-only groups with respect to age (median 67.7 vs. 67.6, p = 0.97), sex (52% vs. 52% female, p = 1.00), pre-treatment ECOG 0-1 (74% vs 75%, p = 0.85), or biologically effective dose greater than 45 (48% vs. 48%, p = 1.00). The most common RT regimens were 30 Gy in 10 fractions (33 pts, 23%) and 20 Gy in 5 fractions (18 patients, 12%). A plurality of cases utilized 3DCRT (67 pts, 46%). In the ICI-RT group, the median time from last dose of ICI to the start of palliative RT was 16 days; three pts in this group-initiated ICI while receiving RT treatment. The most common ICI was pembrolizumab (36 pts, 49%). A total of eleven grade 2+ pneumonitis events (nine grade 2 and two grade 3 events) were observed. The ICI-RT group had a higher cumulative incidence of grade 2+ pneumonitis compared with the RT-only group (1-year rate, 12.3% vs. 2.7%, p = 0.029); grade 3 pneumonitis occurred in 1/73 (1.4%) in each group. There was no difference in overall survival between groups (median 239 vs. 218 days, p = 0.76). CONCLUSION In pts with advanced lung cancer treated with palliative thoracic RT, recent or concomitant ICI use was associated with a higher cumulative incidence of grade 2+ pneumonitis. However, the incidence of grade 3+ pneumonitis was low (1.4%) regardless of ICI receipt.
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Affiliation(s)
- D G Miller
- Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - N Yegya-Raman
- Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - C Friedes
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | - K A Cengel
- Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - J P Plastaras
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
| | | | - R Cohen
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - C Langer
- Department of Hematology and Oncology, University of Pennsylvania, Philadelphia, PA
| | - S J Feigenberg
- Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - A A Butala
- Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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7
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Levy C, Cohen R, Béchet S, Ravilly S, Werner A, Romain O, Guiso N. Pediatric ambulatory pertussis epidemiology in France, recent updates. Infect Dis Now 2023; 53:104727. [PMID: 37268040 DOI: 10.1016/j.idnow.2023.104727] [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: 04/05/2023] [Revised: 04/11/2023] [Accepted: 05/24/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Following various changes in the vaccine strategy in 2013 and the mandatory vaccination in 2018, we aimed to analyze the vaccination status, age, and source of contamination of pertussis and parapertussis cases in outpatient surveillance. PATIENTS AND METHODS Confirmed pertussis and parapertussis cases were enrolled by 35 pediatricians. RESULTS From 2014 to 2022, 73 confirmed cases of pertussis (n = 65) and parapertussis (n = 8) were reported. For children below 6 years of age, the number of cases with a 2 + 1 schedule (n = 22) was higher than that of those with a 3 + 1 schedule (n = 7). The age of cases with a 3 + 1 or a 2 + 1 schedule was not significantly different (3.8y ± 1.4 vs 4.2y ± 1.5). The main source of contamination was either adults or adolescents. CONCLUSION Vaccination status and source of contamination are crucial to study the impact of vaccination recommendations.
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Affiliation(s)
- C Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France.
| | - R Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - S Béchet
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - S Ravilly
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - A Werner
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - O Romain
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | - N Guiso
- Independent Expert, Paris, France
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8
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Sok F, Cohen R, Mauvais F. Ventral hernia: Treatment using the intraperitoneal "suture-stayed prosthesis" technique. J Visc Surg 2023:S1878-7886(23)00044-9. [PMID: 37419775 DOI: 10.1016/j.jviscsurg.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Affiliation(s)
- F Sok
- Digestive surgery department, Beauvais hospital center, 60000 Beauvais, ,France
| | - R Cohen
- Digestive surgery department, Beauvais hospital center, 60000 Beauvais, ,France
| | - F Mauvais
- Digestive surgery department, Beauvais hospital center, 60000 Beauvais, ,France.
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9
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Ratovomanana T, Nicolle R, Cohen R, Diehl A, Siret A, Letourneur Q, Buhard O, Perrier A, Guillerm E, Coulet F, Cervera P, Benusiglio P, Labrèche K, Colle R, Collura A, Despras E, Le Rouzic P, Renaud F, Cros J, Alentorn A, Touat M, Ayadi M, Bourgoin P, Prunier C, Tournigand C, de la Fouchardière C, Tougeron D, Jonchère V, Bennouna J, de Reynies A, Fléjou JF, Svrcek M, André T, Duval A. Prediction of Response to Immune Checkpoint Blockade in Patients with Metastatic Colorectal Cancer with Microsatellite Instability. Ann Oncol 2023:S0923-7534(23)00695-6. [PMID: 37269904 DOI: 10.1016/j.annonc.2023.05.010] [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: 02/06/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Mismatch repair deficient (dMMR) tumors displaying microsatellite instability (MSI) represent a paradigm for the success of immune checkpoint inhibitor (ICI)-based immunotherapy, particularly in patients with metastatic colorectal cancer (mCRC). However, a proportion of patients with dMMR/MSI mCRC exhibit resistance to ICI. Identification of tools predicting MSI mCRC patient response to ICI are required for the design of future strategies further improving this therapy. PATIENTS AND METHODS We combined high-throughput DNA and RNA sequencing of tumors from 116 patients with MSI mCRC treated with anti-PD-1 +/- anti-CTLA-4 of the NIPICOL phase II trial (C1, NCT03350126, discovery set) and the IMMUNOMSI prospective cohort (C2, validation set). The DNA/RNA predictors whose status was significantly associated with ICI status of response in C1 were subsequently validated in C2. Primary endpoint was iPFS (progression-free survival by iRECIST). RESULTS Analyses showed no impact of previously suggested DNA/RNA indicators of resistance to ICI, e.g., MSISensor score, tumor mutational burden, or specific cellular and molecular tumoral contingents. By contrast, iPFS under ICI was shown in C1 and C2 to depend both on a multiplex MSI signature involving the mutations of 19 microsatellites (HRC2 = 3.63; 95% CI [1.65-7.99] ; p = 1.4x10-3) and the expression of a set of 182 RNA markers with a non-epithelial TGFB-related desmoplastic orientation (HRC2 = 1.75 ; 95% CI [1.03-2.98] ; p = 0.035). Both DNA and RNA signatures were independently predictive of iPFS. CONCLUSIONS iPFS in patients with MSI mCRC can be predicted by simply analyzing the mutational status of DNA microsatellite-containing genes in epithelial tumor cells together with nonepithelial TGFB-related desmoplastic RNA markers.
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Affiliation(s)
- T Ratovomanana
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - R Nicolle
- Université Paris Cité, Centre de Recherche sur l'Inflammation (CRI), INSERM, U1149, CNRS, ERL 8252, F-75018 Paris, France; GERCOR, Groupe Coopérateur Multidisciplinaire en Oncologie, F-75011 Paris, France
| | - R Cohen
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; GERCOR, Groupe Coopérateur Multidisciplinaire en Oncologie, F-75011 Paris, France; Sorbonne Université, Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - A Diehl
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - A Siret
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - Q Letourneur
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - O Buhard
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - A Perrier
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Molecular Biology and Medical Genetics, AP-HP, Hospital Pitié-Salpêtrière, F-75012 Paris, France
| | - E Guillerm
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Molecular Biology and Medical Genetics, AP-HP, Hospital Pitié-Salpêtrière, F-75012 Paris, France
| | - F Coulet
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Molecular Biology and Medical Genetics, AP-HP, Hospital Pitié-Salpêtrière, F-75012 Paris, France
| | - P Cervera
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - P Benusiglio
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Molecular Biology and Medical Genetics, AP-HP, Hospital Pitié-Salpêtrière, F-75012 Paris, France
| | - K Labrèche
- CinBioS, MS 37 PASS Production de données en Sciences de la vie et de la Santé, INSERM, Sorbonne Université et SIRIC CURAMUS, 75013 Paris
| | - R Colle
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; GERCOR, Groupe Coopérateur Multidisciplinaire en Oncologie, F-75011 Paris, France; Sorbonne Université, Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - A Collura
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - E Despras
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - P Le Rouzic
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - F Renaud
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - J Cros
- Department of Pathology, Beaujon Hospital, AP-HP, Clichy, France
| | - A Alentorn
- Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - M Touat
- Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - M Ayadi
- Programme "Cartes d'Identité des Tumeurs", Ligue Nationale Contre le Cancer, Paris, France
| | - P Bourgoin
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Pathology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - C Prunier
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Signalisation TGFB, plasticité cellulaire et Cancer, F-75012 Paris, France
| | - C Tournigand
- Department of medical Oncology, Hôpital Henri-Mondor, APHP, Université Paris Est Creteil, INSERM U955
| | | | - D Tougeron
- ProDicET, UR 24144, University of Poitiers and Hepato-Gastroenterology Department, Poitiers University Hospital, 86000 Poitiers, France
| | - V Jonchère
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - J Bennouna
- Centre De Recherche En Cancérologie Et Immunologie Nantes-Angers (CRCINA), INSERM, Université d'Angers, Université De Nantes, Nantes, France
| | - A de Reynies
- Cartes d'Identité des Tumeurs Program, Ligue Nationale Contre Cancer, Paris, France
| | - J-F Fléjou
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Pathology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - M Svrcek
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Pathology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - T André
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; GERCOR, Groupe Coopérateur Multidisciplinaire en Oncologie, F-75011 Paris, France; Sorbonne Université, Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - A Duval
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Molecular Biology and Medical Genetics, AP-HP, Hospital Pitié-Salpêtrière, F-75012 Paris, France.
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Alouani E, Mercier M, Flecchia C, Auclin E, Hollebecque A, Mazard T, Turpin A, Pernot S, Cohen R, Dutherage M, Kim S, Sclafani F, Ben-Abdelghani M, Herve C, Aparicio T, De La Fouchardière C, Perkins G, Hautefeuille V, Jaffrelot M, Gallois C, Bongard V, Tougeron D, Taïeb J, Guimbaud R. Efficacy of immunotherapy in mismatch repair-deficient advanced colorectal cancer in routine clinical practice. An AGEO study. ESMO Open 2023; 8:101574. [PMID: 37244250 DOI: 10.1016/j.esmoop.2023.101574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/23/2023] [Accepted: 04/25/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Immunotherapy demonstrated remarkable efficacy in metastatic colorectal cancers (mCRCs) with mismatch repair deficiency (MMRd)/microsatellite instability (MSI). However, data regarding efficacy and safety of immunotherapy in the routine clinical practice are scarce. PATIENTS AND METHODS This is a retrospective, multicenter study aiming to evaluate efficacy and safety of immunotherapy in routine clinical practice and to identify predictive markers for long-term benefit. Long-term benefit was defined as progression-free survival (PFS) exceeding 24 months. All patients who received immunotherapy for an MMRd/MSI mCRC were included. Patients who received immunotherapy in combination with another known effective therapeutic class agent (chemotherapy or tailored therapy) were excluded. RESULTS Overall, 284 patients across 19 tertiary cancer centers were included. After a median follow-up of 26.8 months, the median overall survival (mOS) was 65.4 months [95% confidence interval (CI) 53.8 months-not reached (NR)] and the median PFS (mPFS) was 37.9 months (95% CI 30.9 months-NR). There was no difference in terms of efficacy or toxicity between patients treated in the real-world or as part of a clinical trial. Overall, 46.6% of patients had long-term benefit. Independent markers associated with long-term benefit were Eastern Cooperative Oncology Group-performance status (ECOG-PS) 0 (P = 0.025) and absence of peritoneal metastases (P = 0.009). CONCLUSIONS Our study confirms the efficacy and safety of immunotherapy in patients with advanced MMRd/MSI CRC in the routine clinical practice. ECOG-PS score and absence of peritoneal metastases provide simple markers that could help identify patients who benefit the most from this treatment.
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Affiliation(s)
- E Alouani
- Digestive Oncology Department, Rangueil Hospital, University Hospital of Toulouse, Toulouse.
| | - M Mercier
- University of Poitiers and Gastroenterology and Hepatology Department, Poitiers University Hospital, Poitiers
| | - C Flecchia
- Institut du Cancer Paris CARPEM, Université Paris Cité, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris
| | - E Auclin
- Department of Oncology, Hôpital Européen Georges Pompidou, AP-HP Centre, Université Paris Cité, Paris
| | - A Hollebecque
- Drug Development Department (DITEP), Gustave Roussy, Saclay University of Paris, Villejuif
| | - T Mazard
- Institute de Recherche en Cancérologie de Montpellier, INSERM, University of Montpellier, ICM, Montpellier
| | - A Turpin
- Department of Medical Oncology, CNRS UMR9020, Inserm UMR-S 1277-Canther-Cancer Heterogeneity, Plasticity and Resistance to Therapies, University Lille, CHU Lille, Lille
| | - S Pernot
- Department of Digestive Oncology, Institut Bergonié, Bordeaux
| | - R Cohen
- Sorbonne University, Department of Medical Oncology, Saint-Antoine Hospital, AP-HP, SIRIC CURAMUS, INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe Labellisée par la Ligue Nationale Contre le Cancer, Paris
| | - M Dutherage
- Department of Medical Oncology, Henri Becquerel Centre, Rouen
| | - S Kim
- Department of Medical Oncology, University Hospital of Besançon, Besançon, France
| | - F Sclafani
- Department of Digestive Oncology, The Brussels University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | | | - C Herve
- Clinique Mutualiste de Grenoble, Institut de cancérologie Daniel Hollard, Grenoble
| | - T Aparicio
- Gastroenterology Department, Saint Louis Hospital, Paris
| | | | - G Perkins
- Department of Gastroenterology, University Hospital Pontchaillou, Rennes
| | - V Hautefeuille
- Department of Hepato-Gastroenterology and Digestive Oncology, CHU Amiens Picardie, Amiens
| | - M Jaffrelot
- Digestive Oncology Department, Rangueil Hospital, University Hospital of Toulouse, Toulouse
| | - C Gallois
- Institut du Cancer Paris CARPEM, Université Paris Cité, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris
| | - V Bongard
- Epidemiology Department CHU de Toulouse, UMR 1295, Centre d'Epidémiologie et de Recherche en santé des Populations, Université Paul Sabatier Toulouse III-Inserm, Toulouse, France
| | - D Tougeron
- University of Poitiers and Gastroenterology and Hepatology Department, Poitiers University Hospital, Poitiers
| | - J Taïeb
- Institut du Cancer Paris CARPEM, Université Paris Cité, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris
| | - R Guimbaud
- Digestive Oncology Department, Rangueil Hospital, University Hospital of Toulouse, Toulouse
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Cohen R, Olivier F, Bendacha Y, Catheline J. La perte de cheveux après chirurgie bariatrique. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Cohen R, Duval V, Al Rifai R, Vilar J, Silvestre JS, Tedgui A, Mallat Z, Ait-Oufella H. TREKING: TaRgEting NK cells in post-Ischemic cardiac remodeliNG. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.221] [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: 12/31/2022]
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Yegya-Raman N, Kegelman T, Lee S, Kim K, Natarajan J, Kallan M, Levin W, Cengel K, Kao G, Langer C, Cohen R, Aggarwal C, Singh A, Adusumalli S, O'Quinn R, Ky B, Apte A, Deasy J, Xiao Y, Feigenberg S. Association Between Cardiovascular Substructure Dose and Death Without Progression after Chemoradiation for Locally Advanced Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1563] [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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Su W, Maity A, Pryma D, Mankoff D, Cohen R, Lukens J, Lin A. A Phase II Study of Nelfinavir plus Concurrent Chemoradiation for Advanced, HPV-Negative Squamous Cell Carcinoma of the Head and Neck. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lukens J, Poirier K, Reardon B, Weinstein G, Newman J, Chalian A, Brody R, Rajasekaran K, Cannady S, Basu D, Rassekh C, Shanti R, Montone K, Sun L, Singh A, Cohen R, Lin A. A Phase II Study of Volume and Dose De-Intensification Following Transoral Robotic Surgery (TORS) and Neck Dissection for p16+ Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Zwart K, van der Baan F, Koopman M, Vink G, Wensink E, Punt C, Verheijden R, Cohen R, Zaanan A, de la Fouchardiere C, Sefrioui D, Lecomte T, Aparicio T, Tougeron D, Roodhart J. 365P Prognostic value of Lynch syndrome, BRAFV600E and RAS mutation status in dMMR/MSI-H metastatic colorectal cancer in a pooled analysis of the national Dutch and French cohorts. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Cohen R, Rybak A, Ouldali N, Angoulvant F, Béchet S, Gajdos V, Hau I, Sellam A, El Aouane El Ghomari I, Elmerich F, Batard C, Auvrignon A, Grimprel E, Favier M, Jung C, Levy C. From the original SARS-CoV-2 strain to the Omicron variant: predictors of COVID-19 in ambulatory symptomatic children. Infect Dis Now 2022; 52:432-440. [PMID: 36116761 PMCID: PMC9477611 DOI: 10.1016/j.idnow.2022.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the predictors of a positive SARS-CoV-2 test in a pediatric ambulatory setting. PATIENTS AND METHODS We performed a cross-sectional prospective study (November 2020-February 2022) of 93 ambulatory settings in France. We included symptomatic children < 15 years old tested for SARS-CoV-2. For each period corresponding to the spread of the original strain and its variants (period 1: original strain; period 2: Alpha, period 3: Delta; period 4: Omicron), we used a multivariate analysis to estimate adjusted odds ratios (aORs) associated with COVID-19 among age, signs, symptoms or contact, and 95 % confidence intervals (95CIs). RESULTS Of 5,336 children, 13.9 % (95CI 13.0-14.8) had a positive test. During the first three periods, the positivity rate ranged from 5.6 % (95CI 4.6-6.7) to 12.6 % (95CI 10.8-14.6). The main factors associated with a positive test were contact with an infected adult at home or outside the home (aOR 11.5 [95CI 4.9-26.9] to 38.9 [95CI 19.3-78.7]) or an infected household child (aOR 15.0 [95CI 4.8-47.1] to 28.4 [95CI 8.7-92.6]). By contrast, during period 4, aORs for these predictors were substantially lower (2.3 [95CI 1.1-4.5] to 5.5 [95CI 3.2-7.7]), but the positivity rate was 45.7 % (95CI 42.3-49.2). CONCLUSIONS In pediatric ambulatory settings, before the Omicron period, the main predictor of a positive test was contact with an infected person. During the Omicron period, the odds of these predictors were substantially lower while the positivity rate was higher. An accurate diagnostic strategy should only rely on testing and not on age, signs, symptoms or contact.
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Affiliation(s)
- R Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - A Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; Unité d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, ECEVE INSERM UMR 1123, Paris, France.
| | - N Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Unité d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, ECEVE INSERM UMR 1123, Paris, France; Assistance Publique - Hôpitaux de Paris, Pediatric Department, Robert Debré Hospital, France
| | - F Angoulvant
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Assistance Publique - Hôpitaux de Paris, Pediatric Department, Robert Debré Hospital, France; INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - S Béchet
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - V Gajdos
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Centre for Research in Epidemiology and Population Health, INSERM UMR1018, Villejuif, France; Assistance Publique-Hôpitaux de Paris, Pediatric Department, Antoine Béclère University Hospital, Université de Paris Saclay, Clamart, France
| | - I Hau
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Service de pédiatrie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - A Sellam
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | | | - F Elmerich
- CHU Reims, Urgences Pédiatriques, France
| | - C Batard
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - A Auvrignon
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - E Grimprel
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Service de pédiatrie, Hôpital Trousseau, Paris, France
| | - M Favier
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Urgences Pédiatriques CHU de Bordeaux, Bordeaux, France
| | - C Jung
- Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - C Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France.
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Eddama M, Gurung R, Fragkos K, Cohen R, Loizidou M, Clapp L. SPOD2 Microvesicles as biomarkers for the screening of colorectal neoplasm. Br J Surg 2022. [DOI: 10.1093/bjs/znac246.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background
Colorectal cancer (CRC) is the second cause of cancer death worldwide. Screening for CRC by Faecal Immunochemical Test (FIT) aims to detect early cases before symptoms occur. Yet, the FIT has poor predictive value and low compliance rate. To address this, the role of circulating microvesicles as potential screening tool is a novel approach that warrants prioritised research.
Methods
In a two-gate diagnostic accuracy study, 35 patients with benign colorectal polyps (BCRP) (n=16) and colorectal cancer (CRC) (n=19) were compared to 17 age-matched healthy controls. Total annexin-V positive microvesicles and sub-populations positive for selected biomarkers relevant to bowel neoplasm were evaluated in patients’ plasma using flow cytometry.
Results
Total plasma microvesicles, and sub-populations positive for CD31, CD42a, CD31+/CD42a-, EPHB2, ICAM and LGR5 (component factor-1) were able to identify patients with BCRP and CRC with a receiver operator curve (AUC) accuracy of a 100% (95% CI: 100% to 100%) and 95% (95% CI: 88% to 100%) respectively. To identify patients with BCRP, a cut-off point value of component factor-1 ≥761 microvesicles/µL demonstrated a 100% sensitivity, specificity and negative predictive value (NPV) and a 93% positive predictive value (PPV). To identify patients with CRC, a cut-off value of component factor-1 ≥439 microvesicles/µL demonstrated a 100% sensitivity, specificity and NPV and a 65% PPV. CEA+ microvesicles sub-population were significantly (p<0.02) higher in CRC in comparison to BCRP.
Conclusion
Microvesicles as biomarkers for the early detection of CRC is a simple and effective tool that yields a potential breakthrough in clinical management.
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Affiliation(s)
- Mohammad Eddama
- Research Department of Surgical Biotechnology, University College London , London , UK
- Department of General Surgery, University College Hospital , London , UK
| | - Rijan Gurung
- Research Department of Surgical Biotechnology, University College London , London , UK
| | | | - Richard Cohen
- Division of Surgery and Interventional Science, University College London , London , UK
| | - Marilena Loizidou
- Research Department of Surgical Biotechnology, University College London , London , UK
| | - Lucie Clapp
- Institute of Cardiovascular Sciences, University College London , London , UK
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19
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Abu-Hanna J, Patel JA, Anastasakis E, Cohen R, Clapp LH, Loizidou M, Eddama MMR. Therapeutic potential of inhibiting histone 3 lysine 27 demethylases: a review of the literature. Clin Epigenetics 2022; 14:98. [PMID: 35915507 PMCID: PMC9344682 DOI: 10.1186/s13148-022-01305-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 07/03/2022] [Indexed: 11/16/2022] Open
Abstract
Histone 3 lysine 27 (H3K27) demethylation constitutes an important epigenetic mechanism of gene activation. It is mediated by the Jumonji C domain-containing lysine demethylases KDM6A and KDM6B, both of which have been implicated in a wide myriad of diseases, including blood and solid tumours, autoimmune and inflammatory disorders, and infectious diseases. Here, we review and summarise the pre-clinical evidence, both in vitro and in vivo, in support of the therapeutic potential of inhibiting H3K27-targeting demethylases, with a focus on the small-molecule inhibitor GSK-J4. In malignancies, KDM6A/B inhibition possesses the ability to inhibit proliferation, induce apoptosis, promote differentiation, and heighten sensitivity to currently employed chemotherapeutics. KDM6A/B inhibition also comprises a potent anti-inflammatory approach in inflammatory and autoimmune disorders associated with inappropriately exuberant inflammatory and autoimmune responses, restoring immunological homeostasis to inflamed tissues. With respect to infectious diseases, KDM6A/B inhibition can suppress the growth of infectious pathogens and attenuate the immunopathology precipitated by these pathogens. The pre-clinical in vitro and in vivo data, summarised in this review, suggest that inhibiting H3K27 demethylases holds immense therapeutic potential in many diseases.
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Affiliation(s)
- Jeries Abu-Hanna
- Division of Surgery and Interventional Science, Research Department of Surgical Biotechnology, University College London, GI Services, Ground Floor, 250 Euston Road, London, NW1 2PG, UK
| | - Jigisha A Patel
- Division of Surgery and Interventional Science, Research Department of Surgical Biotechnology, University College London, GI Services, Ground Floor, 250 Euston Road, London, NW1 2PG, UK
| | | | - Richard Cohen
- Division of Surgery and Interventional Science, Research Department of Surgical Biotechnology, University College London, GI Services, Ground Floor, 250 Euston Road, London, NW1 2PG, UK.,Department of Gastroenterology, University College London Hospital, London, UK
| | - Lucie H Clapp
- Institute of Cardiovascular Science, University College London, London, UK
| | - Marilena Loizidou
- Division of Surgery and Interventional Science, Research Department of Surgical Biotechnology, University College London, GI Services, Ground Floor, 250 Euston Road, London, NW1 2PG, UK
| | - Mohammad M R Eddama
- Division of Surgery and Interventional Science, Research Department of Surgical Biotechnology, University College London, GI Services, Ground Floor, 250 Euston Road, London, NW1 2PG, UK. .,Department of Gastroenterology, University College London Hospital, London, UK.
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20
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Margalit O, Harmsen W, Shacham-Shmueli E, Voss M, Boursi B, Cohen R, Olswold C, Saltz L, Hurwitz H, Adams R, Chibaudel B, Grothey A, Yoshino T, Zalcberg J, de Gramont A, Shi Q, Lenz H. P-106 Evaluating sex as a predictive marker for response to bevacizuamb in metastatic colorectal carcinoma: Pooled analysis of 3,369 patients in the ARCAD database. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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21
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Rigsby D, Clark T, Chittams J, Cohen R, Mantell M, Kobrin S, Trerotola S. Abstract No. 212 Percutaneous management of dialysis access steal syndrome can reduce need for surgery: outcomes from a single institution 20-year experience. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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22
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Rigsby D, Clark T, Cohen R, Chittams J, Mantell M, Kobrin S, Trerotola S. Abstract No. 205 Percutaneous angioplasty of distal brachial artery stenosis in dialysis access steal syndrome can result in clinically successful outcomes. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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23
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Eddama MMR, Gurung R, Fragkos K, Lorgelly P, Cohen R, Loizidou M, Clapp L. The role of microvesicles as biomarkers in the screening of colorectal neoplasm. Cancer Med 2022; 11:2957-2968. [PMID: 35343093 PMCID: PMC9359869 DOI: 10.1002/cam4.4664] [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] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/26/2021] [Accepted: 01/18/2022] [Indexed: 11/23/2022] Open
Abstract
Background Colorectal cancer (CRC) is the second cause of cancer death worldwide. The role of circulating microvesicles as a screening tool is a novel, yet effective approach that warrants prioritised research. Methods In a two‐gate diagnostic accuracy study, 35 patients with benign colorectal polyps (BCRP) (n = 16) and colorectal cancer (CRC) (n = 19) were compared to 17 age‐matched healthy controls. Total annexin‐V positive microvesicles and sub‐populations positive for selected biomarkers relevant to bowel neoplasm were evaluated in patients' plasma using flow cytometry. Statistical methods including factor analysis utilising two component factors were performed to obtain optimal diagnostic accuracy of microvesicles in identifying patients with colorectal neoplasms. Results Total plasma microvesicles, and sub‐populations positive for CD31, CD42a, CD31+/CD42a‐, EPHB2, ICAM and LGR5 (component factor‐1) were able to identify patients with BCRP and CRC with a receiver operator curve (AUC) accuracy of a 100% (95% CI: 100%–100%) and 95% (95% CI: 88%–100%), respectively. To identify patients with BCRP, a cut‐off point value of component factor‐1761 microvesicles/μl demonstrated a 100% sensitivity, specificity and negative predictive value (NPV) and a 93% positive predictive value (PPV). To identify patients with CRC, a cut‐off value of component factor‐1 3439 microvesicles/μl demonstrated a 100% sensitivity, specificity and NPV and a 65% PPV. CEA+ microvesicles sub‐population were significantly (p < 0.02) higher in CRC in comparison to BCRP. Conclusions Microvesicles as biomarkers for the early and accurate detection of CRC is a simple and effective tool that yields a potential breakthrough in clinical management.
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Affiliation(s)
- Mohammad M R Eddama
- Research Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK.,Department of Surgery, University College London Hospital, London, UK
| | - Rijan Gurung
- Research Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK
| | | | - Paula Lorgelly
- Department of Applied Health Research, Institute of Epidemiology and Health, University College London, London, UK
| | - Richard Cohen
- Research Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK.,Department of Surgery, University College London Hospital, London, UK
| | - Marilena Loizidou
- Research Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK
| | - Lucie Clapp
- Institute of Cardiovascular Sciences, University College London, London, UK
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24
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Stahl JP, Castan B, Bonnet E, Bru JP, Cohen R, Diamantis S, Faye A, Hitoto H, Issa N, Lesprit P, Maulin L, Poitrenaud D, Raymond J, Strady C, Varon E, Verdon R, Vuotto F, Welker Y, Gauzit R. Utilization of macrolides: State of the art 2022 Spilf and GPIP. Infect Dis Now 2022; 52:252-266. [DOI: 10.1016/j.idnow.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Lee D, Wright C, Shimunov D, Carmona R, Barsky A, Sun L, Cohen R, Bauml J, Brody R, Basu D, Rassekh C, O'Malley B, Chalian A, Newman J, Rajasekaran K, Weinstein G, Lukens J, Lin A, Swisher-McClure S. Definitive Tumor Directed Therapy for Metachronous Oligometastatic HPV-Associated Oropharyngeal Cancer Following Trans-Oral Robotic Surgery. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Maxwell R, Poirier K, Montone K, Swisher-McClure S, Kumar S, Kuperwasser C, Bauml J, Cohen R, Newman J, Brody R, Rajasekaran K, Chalian A, Rassekh C, Weinstein G, Lin A, Lukens J. Detection of Plasma Circulating Tumor-Tissue Modified HPV DNA Following Trans-Oral Robotic Surgery (TORS) and Neck Dissection for p16+ Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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27
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Cohen R, Borzutzky C, Wilkinson TA, Thompson M, Collins J. POSTER ABSTRACTS. Contraception 2021. [DOI: 10.1016/j.contraception.2021.07.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Yegya-Raman N, Kegelman T, Kim K, Kallan M, Levin W, Cengel K, Langer C, Cohen R, Aggarwal C, Singh A, Bauml J, Adusumalli S, Denduluri S, O'Quinn R, Ky B, Berman A, Feigenberg S. MA06.01 Death From Intercurrent Disease After Proton- Versus Photon-Based Chemoradiotherapy for Non-Small Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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29
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Clure CE, Sheeder J, Teal SB, Cohen R. POSTER ABSTRACTS. Contraception 2021. [DOI: 10.1016/j.contraception.2021.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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30
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Svrcek M, Colle R, Cayre A, Mas L, Bourgoin P, Cohen R, André T, Penault-Llorca F, Radosevic-Robin N. 444P Prevalence of NTRK1/2/3 fusions in dMMR/MSI metastatic colorectal cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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31
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Cohen R, Bouderlique E, Bureau C, Baron S, Larceneux F, Seervai R, Blanchard A, Houillier P, Vrigneaud L, Bertocchio JP. Waterline : le test de charge hydrique identifie un groupe de patients avec Syndrome d’Anti-Diurèse Inappropriée (SIAD) avec une natrémie > 135 mM. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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32
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Cohen R, Nikolaevsky M, Salem R, Frydman A. Setup for pressurizing thin films through the superconductor-insulator transition. Rev Sci Instrum 2021; 92:083903. [PMID: 34470441 DOI: 10.1063/5.0053906] [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] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/25/2021] [Indexed: 06/13/2023]
Abstract
We describe an experimental setup designed for transport measurement of thin disordered superconducting films as a function of pressure up to several GPa. We use a specially designed single screw diamond anvil cell that allows the gradual increase of high pressure at cryogenic temperatures. By depositing amorphous films of disordered superconducting indium oxide directly on the diamond, we avoid the effect of pressure-induced structural changes in the substrate. Using this technique, we are able to drive thin films through a pressure tuned superconductor-insulator transition.
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Affiliation(s)
- R Cohen
- Department of Physics, Jack and Pearl Resnick Institute and the Institute of Nanotechnology and Advanced Materials, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - M Nikolaevsky
- Department of Physics, Jack and Pearl Resnick Institute and the Institute of Nanotechnology and Advanced Materials, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - R Salem
- Physics Department, Nuclear Research Centre - Negev, P.O. Box 9001, 84190 Beer Sheva, Israel
| | - A Frydman
- Department of Physics, Jack and Pearl Resnick Institute and the Institute of Nanotechnology and Advanced Materials, Bar-Ilan University, Ramat-Gan 52900, Israel
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33
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Cohen R, Shi Q, Meyers J, Jin Z, Svrcek M, Fuchs C, Couture F, Kuebler P, Ciombor KK, Bendell J, De Jesus-Acosta A, Kumar P, Lewis D, Tan B, Bertagnolli MM, Philip P, Blanke C, O'Reilly EM, Shields A, Meyerhardt JA. Combining tumor deposits with the number of lymph node metastases to improve the prognostic accuracy in stage III colon cancer: a post hoc analysis of the CALGB/SWOG 80702 phase III study (Alliance) ☆. Ann Oncol 2021; 32:1267-1275. [PMID: 34293461 DOI: 10.1016/j.annonc.2021.07.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [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: 06/15/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In colon cancer, tumor deposits (TD) are considered in assigning prognosis and staging only in the absence of lymph node metastasis (i.e. stage III pN1c tumors). We aimed to evaluate the prognostic value of the presence and the number of TD in patients with stage III, node-positive colon cancer. PATIENTS AND METHODS All participants from the CALGB/SWOG 80702 phase III trial were included in this post hoc analysis. Pathology reports were reviewed for the presence and the number of TD, lymphovascular and perineural invasion. Associations with disease-free survival (DFS) and overall survival (OS) were evaluated by multivariable Cox models adjusting for sex, treatment arm, T-stage, N-stage, lymphovascular invasion, perineural invasion and lymph node ratio. RESULTS Overall, 2028 patients were included with 524 (26%) TD-positive and 1504 (74%) TD-negative tumors. Of the TD-positive patients, 80 (15.4%) were node negative (i.e. pN1c), 239 (46.1%) were pN1a/b (<4 positive lymph nodes) and 200 (38.5%) were pN2 (≥4 positive lymph nodes). The presence of TD was associated with poorer DFS [adjusted hazard ratio (aHR) = 1.63, 95% CI 1.33-1.98] and OS (aHR = 1.59, 95% CI 1.24-2.04). The negative effect of TD was observed for both pN1a/b and pN2 groups. Among TD-positive patients, the number of TD had a linear negative effect on DFS and OS. Combining TD and the number of lymph node metastases, 104 of 1470 (7.1%) pN1 patients were re-staged as pN2, with worse outcomes than patients confirmed as pN1 (3-year DFS rate: 65.4% versus 80.5%, P = 0.0003; 5-year OS rate: 87.9% versus 69.1%, P = <0.0001). DFS was not different between patients re-staged as pN2 and those initially staged as pN2 (3-year DFS rate: 65.4% versus 62.3%, P = 0.4895). CONCLUSION Combining the number of TD and the number of lymph node metastases improved the prognostication accuracy of tumor-node-metastasis (TNM) staging.
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Affiliation(s)
- R Cohen
- Department of Health Science Research, Mayo Clinic, Rochester, USA; Sorbonne Université, Department of Medical Oncology, Saint-Antoine Hospital, Paris, France; Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France.
| | - Q Shi
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, USA
| | - J Meyers
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, USA
| | - Z Jin
- Division of Oncology, Mayo Clinic and Mayo Comprehensive Cancer Center, Rochester, USA
| | - M Svrcek
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Department of Pathology, Saint-Antoine Hospital, Paris, France
| | - C Fuchs
- Genentech, South San Francisco, USA; Division of Hematology and Medical Oncology, Department of Internal Medicine, Yale School of Medicine, and Yale Cancer Center, New Haven, USA
| | - F Couture
- Hôtel-Dieu de Québec, Quebec, Canada
| | - P Kuebler
- Columbus NCI Community Clinical Oncology Research Program, Columbus, USA
| | - K K Ciombor
- Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, USA
| | - J Bendell
- Sarah Cannon Research Institute/Tennessee Oncology, Nashville, USA
| | - A De Jesus-Acosta
- Department of Medical Oncology, John Hopkins University, Baltimore, USA
| | - P Kumar
- Illinois Cancercare, P.C., Peoria, USA
| | - D Lewis
- Southeast Clinical Oncology Research, Cone Health Medical Group, Asheboro, USA
| | - B Tan
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, USA
| | - M M Bertagnolli
- Office of the Alliance Group Chair, Brigham and Women's Hospital, Boston, USA
| | - P Philip
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, USA
| | - C Blanke
- SWOG Cancer Research Network Group Chair's Office, Oregon Health and Science University Knight Cancer Institute, Portland, USA
| | - E M O'Reilly
- Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical Center, New York, USA
| | - A Shields
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, USA
| | - J A Meyerhardt
- Department of Medical Oncology, Dana-Farber/Partners Cancer Care, Boston, USA
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Cohen R, Vazharova M, Sokofowski A, Burczyk B, Exerova D. Foam stabilizing properties of linear acetals containing oxyethylene units in their molecules. TENSIDE SURFACT DET 2021. [DOI: 10.1515/tsd-1981-180408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Lefebvre M, Vignier N, Pitard B, Botelho-Nevers E, Wyplosz B, Cohen R, Epaulard O. COVID-19 vaccines: Frequently asked questions and updated answers. Infect Dis Now 2021; 51:319-333. [PMID: 33681861 PMCID: PMC7910656 DOI: 10.1016/j.idnow.2021.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 02/23/2021] [Indexed: 12/29/2022]
Abstract
At the end of December 2019, China notified the World Health Organization about a viral pneumonia epidemic soon to be named COVID-19, of which the infectious agent, SARS-CoV-2, was rapidly identified. Less than one year later, published phase 3 clinical trials underlined the effectiveness of vaccines utilizing hitherto unusual technology consisting in injection of the messenger RNA (m-RNA) of a viral protein. In the meantime, numerous clinical trials had failed to identify a maximally effective antiviral treatment, and mass vaccination came to be considered as the strategy most likely to put an end to the pandemic. The objective of this text is to address and hopefully answer the questions being put forward by healthcare professionals on the different anti-SARS-CoV-2 vaccines as regards their development, their modes of action, their effectiveness, their limits, and their utilization in different situations; we are proposing a report on both today's state of knowledge, and the 14 February 2021 recommendations of the French health authorities.
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Affiliation(s)
- M Lefebvre
- Service des maladies infectieuses et tropicales, centre de prévention des maladies infectieuses et transmissibles, centre hospitalo-universitaire Hôtel-Dieu, Inserm CIC1413, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - N Vignier
- Centre d'investigation clinique Antilles Guyane, CIC Inserm 1424, DRISP, centre hospitalier Andrée-Rosemon, Cayenne, French Guyana; Inserm, Sorbonne université, institut Pierre-Louis d'épidémiologie et de santé publique, IPLESP, 75012 Paris, France; Department of infectious disease, Groupe hospitalier Sud Ile-de-France, 77000 Melun, France
| | - B Pitard
- Université de Nantes, CNRS ERL6001, Inserm 1232, CRCINA, Nantes, France
| | - E Botelho-Nevers
- Service d'infectiologie, centre hospitalo-universitaire de Saint-Étienne, CIC 1408 Inserm, 42055 Saint-Étienne, France; Centre international de recherche en infectiologie (CIRI), Team GIMAP, université Lyon, université Jean-Monnet, université Claude-Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, 42023 Saint-Étienne, France
| | - B Wyplosz
- Service des maladies infectieuses et tropicales, Assistance publique-hôpitaux de Paris, Centre hospitalier universitaire Bicêtre, Paris, France
| | - R Cohen
- InfoVac, centre hospitalier intercommunal de Créteil, service de pédiatrie, 40, avenue de Verdun, 94000 Créteil, France
| | - O Epaulard
- Service des maladies infectieuses, centre hospitalo-universitaire Grenoble Alpes, Grenoble, France, CIC 1406 Inserm, Grenoble, France
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Menuey A, Cohen R, Béchet S, Levy C. Infovac-France survey in pediatric vaccinology: How does it compare with the literature? Arch Pediatr 2021; 28:355-359. [PMID: 33994268 DOI: 10.1016/j.arcped.2021.04.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/15/2021] [Accepted: 04/16/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Immunization is experienced as painful and may be responsible for needle fear and noncompliance. There are rare evidence-based methods to reduce pain and improve comfort during immunization. There are no French immunization guidelines summarizing the good practices, based on recent studies. This study focused on the methods used by physicians and how they compared with those validated by clinical trials. METHODS An online questionnaire was sent to the practitioners from the Infovac network, and a PubMed bibliographic search was conducted. RESULTS Almost 2000 doctors responded to this survey. Purging the needle was a habit in 77.9% of them and aspiration before injection in 21.1%. Only one-quarter of the responding doctors injected in the deltoid muscle between 15 and 24 months, and some injected in the buttocks at any age. Half of the physicians vaccinated infants in their parent's arms, children were seated with half of the pediatricians and only one-third of the general practitioners (GPs), and teenagers were seated when vaccinated by three-quarters of the doctors. Anesthetic creams were used by 46.6% of the physicians, mostly by pediatricians (61.9%), and for infants. Breastfeeding was suggested by three-quarters of the physicians for infants under 4 months of age, and sugared solutions were used by 55.5% of the pediatricians and 32.3% of the GPs. Half of the doctors used rocking and cuddling for babies under 24 months of age and toys between 11 and 24 months. CONCLUSION Many methods are available to distract and improve comfort during immunization. Physicians should choose those they prefer, adjusting for the child's age. There should be French guidelines for immunization techniques, based to the latest clinical surveys, to help improve immunization practice.
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Affiliation(s)
- A Menuey
- Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), 94000 Créteil, France.
| | - R Cohen
- Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), 94000 Créteil, France; Université Paris Est, IMRB- GRC GEMINI, 31, rue Le Corbusier, 94000 Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France; Groupe de pathologie infectieuse pédiatrique (GPIP), CHU Lenval, 57, avenue de la Californie, 06200 Nice, France
| | - S Béchet
- Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), 94000 Créteil, France
| | - C Levy
- Association Clinique et Thérapeutique Infantile du Val de Marne (ACTIV), 94000 Créteil, France; Université Paris Est, IMRB- GRC GEMINI, 31, rue Le Corbusier, 94000 Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France; Groupe de pathologie infectieuse pédiatrique (GPIP), CHU Lenval, 57, avenue de la Californie, 06200 Nice, France.
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Eskander E, Levy C, Batard C, Bonnel A, Jung C, Béchet S, Gillet Y, Cahn-Sellem F, Kochert F, Elbez A, Ryback A, Cohen R. Infection SARS CoV-2 en ambulatoire chez l’enfant. Perfectionnement en Pédiatrie 2021. [PMCID: PMC7997596 DOI: 10.1016/j.perped.2021.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Ceratti DR, Cohen AV, Tenne R, Rakita Y, Snarski L, Jasti NP, Cremonesi L, Cohen R, Weitman M, Rosenhek-Goldian I, Kaplan-Ashiri I, Bendikov T, Kalchenko V, Elbaum M, Potenza MAC, Kronik L, Hodes G, Cahen D. The pursuit of stability in halide perovskites: the monovalent cation and the key for surface and bulk self-healing. Mater Horiz 2021; 8:1570-1586. [PMID: 34846465 DOI: 10.1039/d1mh00006c] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
We find significant differences between degradation and healing at the surface or in the bulk for each of the different APbBr3 single crystals (A = CH3NH3+, methylammonium (MA); HC(NH2)2+, formamidinium (FA); and cesium, Cs+). Using 1- and 2-photon microscopy and photobleaching we conclude that kinetics dominate the surface and thermodynamics the bulk stability. Fluorescence-lifetime imaging microscopy, as well as results from several other methods, relate the (damaged) state of the halide perovskite (HaP) after photobleaching to its modified optical and electronic properties. The A cation type strongly influences both the kinetics and the thermodynamics of recovery and degradation: FA heals best the bulk material with faster self-healing; Cs+ protects the surface best, being the least volatile of the A cations and possibly through O-passivation; MA passivates defects via methylamine from photo-dissociation, which binds to Pb2+. DFT simulations provide insight into the passivating role of MA, and also indicate the importance of the Br3- defect as well as predicts its stability. The occurrence and rate of self-healing are suggested to explain the low effective defect density in the HaPs and through this, their excellent performance. These results rationalize the use of mixed A-cation materials for optimizing both solar cell stability and overall performance of HaP-based devices, and provide a basis for designing new HaP variants.
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Affiliation(s)
- D R Ceratti
- Weizmann Institute of Science, Department of Materials and Interfaces, 7610001, Rehovot, Israel.
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Guyot D'Asnières De Salins A, Tachon G, Cohen R, Karayan-Tapon L, Junca A, Frouin E, Godet J, Evrard C, Randrian V, Duval A, Svrcek M, Lascols O, Vignot S, Coulet F, André T, Fléjou JF, Cervera P, Tougeron D. Discordance between immunochemistry of mismatch repair proteins and molecular testing of microsatellite instability in colorectal cancer. ESMO Open 2021; 6:100120. [PMID: 33930657 PMCID: PMC8102173 DOI: 10.1016/j.esmoop.2021.100120] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [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: 02/12/2021] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 12/12/2022] Open
Abstract
Background DNA mismatch repair system deficiency (dMMR) is found in 15% of colorectal cancers (CRCs). Two methods are used to determine dMMR, immunohistochemistry (IHC) of MMR proteins and molecular testing of microsatellite instability (MSI). Only studies with a low number of patients have reported rates of discordance between these two methods, ranging from 1% to 10%. Materials and methods Overall, 3228 consecutive patients with CRCs from two centers were included. Molecular testing was carried out using the Pentaplex panel and IHC evaluated four (MLH1, MSH2, MSH6, and PMS2; cohort 1; n = 1085) or two MMR proteins (MLH1 and MSH2; cohort 2; n = 2143). The primary endpoint was the rate of discordance between MSI and MMR IHC tests. Results Fifty-one discordant cases (1.6%) were initially observed. Twenty-nine out of 51 discordant cases were related to IHC misclassifications. In cohort 1, after re-reading IHC and/or carrying out new IHC, 16 discordant cases were reclassified as nondiscordant. In cohort 2, after the addition of MSH6/PMS2 IHC and re-examination, 13 were reclassified as nondiscordant. In addition, 10 misclassifications of molecular tests were identified. Finally, only 12 discordant cases (0.4%) remained: 5 were proficient MMR/MSI and 7 were dMMR/microsatellite stable. Conclusions Our study confirmed the high degree of concordance between MSI and MMR IHC tests. Discordant cases must be reviewed, and if needed, tests must be repeated and analyzed by an expert team. Concordance between MMR IHC (four proteins) and MSI molecular testing (Pentaplex) is superior to 98% in CRC cases Most discordant cases are related to misinterpretation of the tests, which may lead to clinical management errors. Discordant cases must be reviewed and tests must be repeated because most cases will be reclassified as nondiscordant.
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Affiliation(s)
| | - G Tachon
- Faculty of Medicine, University of Poitiers, Poitiers, France; INSERM 1084, Experimental and Clinical Neurosciences Laboratory, University of Poitiers, Poitiers, France; Cancer Biology Department, Poitiers University Hospital, Poitiers, France
| | - R Cohen
- Sorbonne University, Department of Medical Oncology, Saint-Antoine Hospital, AP-HP, Paris, France
| | - L Karayan-Tapon
- Faculty of Medicine, University of Poitiers, Poitiers, France; INSERM 1084, Experimental and Clinical Neurosciences Laboratory, University of Poitiers, Poitiers, France; Cancer Biology Department, Poitiers University Hospital, Poitiers, France
| | - A Junca
- Pathology Department, Poitiers University Hospital, Poitiers, France
| | - E Frouin
- Pathology Department, Poitiers University Hospital, Poitiers, France
| | - J Godet
- Pathology Department, Poitiers University Hospital, Poitiers, France
| | - C Evrard
- Medical Oncology Department, Poitiers University Hospital, Poitiers, France
| | - V Randrian
- Gastroenterology Department, Poitiers University Hospital, Poitiers, France; Faculty of Medicine, University of Poitiers, Poitiers, France
| | - A Duval
- Sorbonne University, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - M Svrcek
- Sorbonne University, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne University, Department of Pathology, Saint-Antoine Hospital, AP-HP, Paris, France
| | - O Lascols
- Sorbonne University, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - S Vignot
- Sorbonne University, Department of Medical Oncology, Saint-Antoine Hospital, AP-HP, Paris, France
| | - F Coulet
- Department of Genetics, Pitié Salpétrière Hospital, AP-HP and Sorbonne University, Paris, France
| | - T André
- Sorbonne University, Department of Medical Oncology, Saint-Antoine Hospital, AP-HP, Paris, France; Sorbonne University, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - J-F Fléjou
- Sorbonne University, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne University, Department of Pathology, Saint-Antoine Hospital, AP-HP, Paris, France
| | - P Cervera
- Sorbonne University, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne University, Department of Pathology, Saint-Antoine Hospital, AP-HP, Paris, France
| | - D Tougeron
- Gastroenterology Department, Poitiers University Hospital, Poitiers, France; Faculty of Medicine, University of Poitiers, Poitiers, France; Medical Oncology Department, Poitiers University Hospital, Poitiers, France.
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Giannoli JM, Albarede S, Avellan T, Bouilloux JP, Cartier R, Cohen R, Colard N, Essemilaire L, Galinier JL, Kuentz M, Paris M, Portugal H, Scherrer F, Siest JP, Vassault A, Vialle JM. Recommendations for the application and follow-up of quality controls in medical laboratories. Biochem Med (Zagreb) 2021; 31:020501. [PMID: 33927549 PMCID: PMC8047787 DOI: 10.11613/bm.2021.020501] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/28/2021] [Indexed: 11/25/2022] Open
Abstract
This is a translation of the paper “Recommendations for the application and follow-up of quality controls in medical biology laboratories” published in French in the journal Annales de Biologie Clinique (Recommandations pour la mise en place et le suivi des contrôles de qualité dans les laboratoires de biologie médicale. Ann Biol Clin (Paris). 2019;77:577-97.). The recommendations proposed in this document are the result of work conducted jointly by the Network of Accredited Medical Laboratories (LABAC), the French Society of Medical Biology (SFBC) and the Federation of Associations for External Quality Assessment (FAEEQ). The different steps of the implementation of quality controls, based on a risk analysis, are described. The changes of reagent or internal quality control (IQC) materials batches, the action to be taken in case of non-conform IQC results, the choice of external quality assessment (EQA) scheme and interpretation of their results as well as the new issue of analyses performed on several automatic systems available in the same laboratory are discussed. Finally, the concept of measurement uncertainty, the robustness of the methods as well as the specificities of near-patient testing and rapid tests are described. These recommendations cannot apply for all cases we can find in medical laboratories. The implementation of an objective alternative strategy, supported with documented evidence, might be equally considered.
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Affiliation(s)
| | - Stéphanie Albarede
- Toulouse Center for Quality Control in Medical laboratories (CTCB), Toulouse, France
| | - Thierry Avellan
- Accredited Medical Laboratories Network (LABAC), Lyon, France
| | | | - Régine Cartier
- Association for Promotion of Quality Control in Medical Laboratories (Probioqual), Lyon, France
| | - Richard Cohen
- Association for Promotion of Quality Control in Medical Laboratories (Probioqual), Lyon, France
| | - Nathalie Colard
- Accredited Medical Laboratories Network (LABAC), Lyon, France
| | - Luc Essemilaire
- Accredited Medical Laboratories Network (LABAC), Lyon, France
| | - Jean-Louis Galinier
- Toulouse Center for Quality Control in Medical laboratories (CTCB), Toulouse, France
| | - Mathieu Kuentz
- French Society for Medical Biology (SFBC), Paris, France
| | - Mickaël Paris
- Accredited Medical Laboratories Network (LABAC), Lyon, France
| | - Henri Portugal
- Accredited Medical Laboratories Network (LABAC), Lyon, France
| | | | | | - Anne Vassault
- Quality Assurance for Medical Laboratories (Asqualab), Paris, France
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Gauzit R, Castan B, Bonnet E, Bru JP, Cohen R, Diamantis S, Faye A, Hitoto H, Issa N, Lebeaux D, Lesprit P, Maulin L, Poitrenaud D, Raymond J, Strady C, Varon E, Verdon R, Vuotto F, Welker Y, Stahl JP. Anti-infectious treatment duration: The SPILF and GPIP French guidelines and recommendations. Infect Dis Now 2021; 51:114-139. [PMID: 34158156 DOI: 10.1016/j.idnow.2020.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 12/28/2020] [Indexed: 02/07/2023]
Affiliation(s)
- R Gauzit
- Infectiologie transversale, CHU Cochin, AP-HP, 75014 Paris, France.
| | - B Castan
- Maladies infectieuses et tropicales, CHG, 24000 Périgueux, France
| | - E Bonnet
- Équipe Mobile d'Infectiologie, Hôpital Joseph-Ducuing, Clinique Pasteur, 31300 Toulouse, France
| | - J P Bru
- Maladies Infectieuses, CH Annecy-Genevois, 74374 Pringy, France
| | - R Cohen
- Unité petits nourrissons, CHI, 94000 Créteil, France
| | - S Diamantis
- Maladies Infectieuses et Tropicales, groupe hospitalier Sud Île-de-France, 77000 Melun, France
| | - A Faye
- Pédiatrie Générale et maladies infectieuses, Hôpital Robert-Debré, Université de Paris, AP-HP, 75019 Paris, France
| | - H Hitoto
- Maladies Infectieuses et Tropicales, CH, 72037 Le Mans, France
| | - N Issa
- Réanimation médicale et maladies infectieuses, Hôpital Saint-André, CHU, 33000 Bordeaux, France
| | - D Lebeaux
- Université de Paris, 75006 Paris, France; Microbiologie, Unité Mobile d'Infectiologie, HEGP, AP-HP, 75015 Paris, France
| | - P Lesprit
- Unité transversale d'hygiène et d'infectiologie, Service de Biologie Clinique, Hôpital Foch, 92150 Suresnes, France
| | - L Maulin
- Maladies Infectieuses et tropicales, CHIAP, 13616 Aix-en-Provence, France
| | - D Poitrenaud
- Unité fonctionnelle d'Infectiologie Régionale, CH Ajaccio, 20303 Ajaccio, France
| | - J Raymond
- Bactériologie, Centre Hospitalier Bicêtre, 94270 Kremlin-Bicêtre, France
| | - C Strady
- Cabinet d'infectiologie, Groupe Courlancy, 51100 Reims, France
| | - E Varon
- Laboratoire de Biologie Médicale et Centre National de Référence des Pneumocoques, CHIC, 94000 Créteil, France
| | - R Verdon
- Maladies Infectieuses et Tropicales, CHU, 14033 Caen, France; Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Normandie Univ, UNICAEN, UNIROUEN, GRAM 2.0, 14000 Caen, France
| | - F Vuotto
- Maladies Infectieuses, CHU, Hôpital Huriez, 59000 Lille, France
| | - Y Welker
- Maladies Infectieuses, CHI, 78100 Saint-Germain-en-Laye, France
| | - J P Stahl
- Infectiologie, CHU Grenoble Alpes, 38043 Grenoble, France
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Bhatnagar G, Rodriguez-Justo M, Higginson A, Bassett P, Windsor A, Cohen R, Halligan S, Taylor SA. Inflammation and fibrosis in Crohn's disease: location-matched histological correlation of small bowel ultrasound features. Abdom Radiol (NY) 2021; 46:144-155. [PMID: 32564208 PMCID: PMC7864849 DOI: 10.1007/s00261-020-02603-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate the utility of mural and extramural sonographic features of Crohn's Disease as potential imaging biomarkers of inflammation and fibrosis against whole-mount histological sections. METHODS Twelve Crohn's disease patients (Mean age 35(25-69), 7 males) underwent small bowel ultrasound prior to small bowel resection. Two radiologists in consensus graded multiple parameters including mural, mucosal and submucosal thickness, submucosal/mesenteric echogenicity and clarity and mural Doppler signal in 50 selected bowel cross-sections. Matching with histological sampling sites was facilitated via scanning of the resected specimen. A histopathologist scored acute and chronic inflammation, and fibrosis (using histological scoring systems) following analysis of whole mount block sections. The association between sonographic observations and histopathological scores was examined via univariable and multivariable analysis. RESULTS In univariate analyses, bowel wall thickness (regression co-efficient and 95% CI 0.8 (0.3, 1.3) p = 0.001), mesenteric fat echogenicity (8.7(3.0, 14.5) p = 0.005), submucosal layer thickness (7.4(1.2, 13.5) p = 0.02), submucosal layer clarity (4.4(0.6, 8.2) p = 0.02) and mucosal layer thickness (4.6(1.8, 7.4) p = 0.001) were all significantly associated with acute inflammation. Mesenteric fat echogenicity (674(8.67, 52404) p = 0.009), submucosal layer thickness (79.9(2.16, 2951) p = 0.02) and mucosal layer thickness (13.6(1.54, 121) p = 0.02) were significantly associated with chronic inflammation. Submucosal layer echogenicity (p = 0.03), clarity (25.0(1.76, 356) p = 0.02) and mucosal layer thickness (53.8(3.19, 908) p = 0.006) were significantly associated with fibrosis. In multivariate analyses, wall and mucosal thickness remained significantly associated with acute inflammation (p = 0.02), mesenteric fat echogenicity with chronic inflammation (p = 0.009) and mucosal thickness (p = 0.006) with fibrosis. CONCLUSION Multiple sonographic parameters are associated with histological phenotypes in Crohn's disease although there is overlap between ultrasonic stigmata of acute inflammation, chronic inflammation and fibrosis.
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Affiliation(s)
- Gauraang Bhatnagar
- grid.83440.3b0000000121901201Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS UK
| | - Manuel Rodriguez-Justo
- grid.439749.40000 0004 0612 2754Department of Histology, University College Hospitals, London, UK
| | - Antony Higginson
- grid.415470.30000 0004 0392 0072Department of Radiology, Queen Alexandra Hospital, Portsmouth, UK
| | | | - Alastair Windsor
- grid.439749.40000 0004 0612 2754Department of Colorectal Surgery, University College Hospitals, London, UK
| | - Richard Cohen
- grid.439749.40000 0004 0612 2754Department of Colorectal Surgery, University College Hospitals, London, UK
| | - Steve Halligan
- grid.83440.3b0000000121901201Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS UK
| | - Stuart A. Taylor
- grid.83440.3b0000000121901201Centre for Medical Imaging, University College London, 2nd Floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS UK
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Godin O, Leboyer M, Belzeaux R, Bellivier F, Loftus J, Courtet P, Dubertret C, Gard S, Henry C, Llorca PM, Schwan R, Passerieux C, Polosan M, Samalin L, Olié E, Etain B, Henry C, Olié E, Leboyer M, Haffen E, Llorca PM, Barteau V, Bensalem S, Godin O, Laouamri H, Souryis K, Hotier S, Pelletier A, Drancourt N, Sanchez JP, Saliou E, Hebbache C, Petrucci J, Willaume L, Bourdin E, Bellivier F, Carminati M, Etain B, Maruani J, Marlinge E, Meyrel M, Antoniol B, Desage A, Gard S, Jutant A, Mbailara K, Minois I, Zanouy L, Bardin L, Cazals A, Courtet P, Deffinis B, Ducasse D, Gachet M, Henrion A, Molière F, Noisette B, Olié E, Tarquini G, Belzeaux R, Correard N, Groppi F, Lefrere A, Lescalier L, Moreau E, Pastol J, Rebattu M, Roux B, Viglianese N, Cohen R, Schwan R, Kahn J, Milazzo M, Wajsbrot‐Elgrabli O, Bougerol T, Fredembach B, Suisse A, Halili B, Pouchon A, Polosan M, Galliot A, Grévin I, Cannavo A, Kayser N, Passerieux C, Roux P, Aubin V, Cussac I, Dupont M, Loftus J, Medecin I, Dubertret C, Mazer N, Portalier C, Scognamiglio C, Bing A. Non-alcoholic fatty liver disease in a sample of individuals with bipolar disorders: results from the FACE-BD cohort. Acta Psychiatr Scand 2021; 143:82-91. [PMID: 33011976 DOI: 10.1111/acps.13239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/02/2020] [Accepted: 09/21/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Non-Alcoholic fatty liver disease (NAFLD) is becoming the most common liver disease in Western populations. While obesity and metabolic abnormalities are highly frequent in bipolar disorders (BD), no studies have been performed to estimate the prevalence of NALFD in individuals with BD. The aim of our study is to estimate the prevalence of NAFLD and to identify the potential associated risk factors in a large sample of BD individuals. METHODS Between 2009 and 2019, 1969 BD individuals from the FACE-BD cohort were included. Individuals with liver diseases, Hepatitis B or C, and current alcohol use disorders were excluded from the analyses. A blood sample was drawn from participants. Screening of NAFLD was determined using fatty liver index (FLI). Individuals with FLI> 60 were considered as having NAFLD. RESULTS The prevalence of NAFDL in this sample was estimated at 28.4%. NAFLD was observed in 40% of men and 21% of women. NAFLD was independently associated with older age, male gender, sleep disturbances, and current use of atypical antipsychotics or anxiolytics. As expected, the prevalence of NALFD was also higher in individuals with overweight and in those with metabolic syndrome. CONCLUSIONS This study reinforces the view that individuals with BD are highly vulnerable to metabolic and cardiovascular diseases. The prevalence of NAFLD in individuals with BD was two times higher than the prevalence reported in the general population. The regular screening of the MetS in individuals with BD should be therefore complemented by the additional screening of NAFLD among these vulnerable individuals.
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Affiliation(s)
- Ophelia Godin
- Fondation FondaMental, Créteil, France.,Inserm U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Université Paris Est Créteil, Créteil, France.,AP-HP, HU Henri Mondor, Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Fédération Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), Créteil, France.,Fondation FondaMental, Créteil, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France.,Inserm U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Université Paris Est Créteil, Créteil, France.,AP-HP, HU Henri Mondor, Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Fédération Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), Créteil, France.,Fondation FondaMental, Créteil, France
| | - Raoul Belzeaux
- Fondation FondaMental, Créteil, France.,Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France.,INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Frank Bellivier
- Fondation FondaMental, Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), GHU Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, INSERM UMRS 1144, Université de Paris, Paris, France
| | - Joséphine Loftus
- Fondation FondaMental, Créteil, France.,Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco, France
| | - Philippe Courtet
- Fondation FondaMental, Créteil, France.,Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.,PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France.,AP-HP, Groupe Hospitalo-universitaire Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hopital Louis Mourier, Colombes, France.,Inserm U1266, Faculté de Médecine, Université de Paris, Paris, France
| | - Sebastien Gard
- Fondation FondaMental, Créteil, France.,Centre Expert Troubles Bipolaires, Service de Psychiatrie Adulte, Hôpital Charles-Perrens, Bordeaux, France
| | - Chantal Henry
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France.,CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Raymund Schwan
- Fondation FondaMental, Créteil, France.,Inserm U1114, Centre Psychothérapique de Nancy, Université de Lorraine, Nancy, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie d'Adultes, Centre Hospitalier de Versailles, Le Chesnay, Université Paris-Saclay, UVSQ, Inserm, CESP, Team "DevPsy", Villejuif, France
| | - Mircea Polosan
- Fondation FondaMental, Créteil, France.,Grenoble Institut des Neurosciences (GIN) Inserm U 1216, CHU de Grenoble et des Alpes, Université Grenoble Alpes, Grenoble, France
| | - Ludovic Samalin
- Fondation FondaMental, Créteil, France.,CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Emilie Olié
- Fondation FondaMental, Créteil, France.,INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Bruno Etain
- Fondation FondaMental, Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), GHU Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, INSERM UMRS 1144, Université de Paris, Paris, France
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Benvenga R, Roussel J, Cohen R, Bouchoucha M, Bendacha Y, Catheline JM. Long-term endoscopic follow-up after sleeve gastrectomy. J Visc Surg 2020; 159:39-42. [PMID: 33257281 DOI: 10.1016/j.jviscsurg.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Endoscopic follow-up after sleeve gastrectomy (SG) sometime reveals worrisome findings as the presence of major digestive lesions such as esophagitis, Barrett's esophagus (BE), and also esophageal cancer. OBJECTIVES The aim of this study was to investigate the frequency and severity of esophageal and gastric lesions after SG. METHODS Our team collected the results of esogastric endoscopies performed on patients who underwent SG up to five years before in our hospital, from April 2010 to August 2014. Summons were sent by mail to all patients operated on between those dates. The results were collected from January 2018 to June 2019. RESULTS Of the 765 patients who underwent SG up to five years before, only 78 (10.2%) agreed to undergo an upper digestive endoscopy. The average age before surgery was 51 years (range: 25-70 years). The mean preoperative body mass index (BMI) was 44.2±4.6kg/m2. For 12 out of these 78 patients (15.4%) it was revisional surgery: 9 SG after gastric banding, and 3 revisional SG (Re-SG). With an average follow-up of 6.3±0.8 years, the endoscopic results of the 78 patients were found to be normal in 31 cases (39.7%): gastritis was found in 28 patients (35.9%), severe grade C or D esophagitis was found in 15 cases (19.2%), hiatal hernia in 18 cases (23.1%), a benign gastric polyp in 2 cases (2.6%). Of the 28 patients with gastritis, HelicobacterPylori was detected in 8 cases (28.6%). No cancer was diagnosed, and BE after SG was found in only one case (1.3%) (normal before surgery). Six of 15 patients with esophagitis (40%) had reflux symptoms. Fourteen of these patients (93.3%) developed de novo esophagitis. CONCLUSION Only 10.2% of operated patients agreed to a long-term esogastric endoscopy. The frequency and severity of endoscopic anomalies observed with an average follow-up of more than 6 years pleads for a policy of systematic upper endoscopies of long-term control after SG.
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Affiliation(s)
- R Benvenga
- Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur Delafontaine, 93200 Saint-Denis, France.
| | - J Roussel
- Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur Delafontaine, 93200 Saint-Denis, France.
| | - R Cohen
- Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur Delafontaine, 93200 Saint-Denis, France.
| | - M Bouchoucha
- Department of gastroenterology, hôpital Avicenne AP-HP, route de Stalingrad, 93000 Bobigny, France.
| | - Y Bendacha
- Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur Delafontaine, 93200 Saint-Denis, France.
| | - J-M Catheline
- Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur Delafontaine, 93200 Saint-Denis, France.
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Martinot A, Leboucher B, Cohen R, Stahl JP, Subtil D, Pujol P, Lepetit H, Longfier L, Gaudelus J. Evolution between 2008 and 2018 of mothers' perception regarding vaccination and infant vaccine coverage in France. Infect Dis Now 2020; 51:153-158. [PMID: 33059002 DOI: 10.1016/j.medmal.2020.09.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 09/22/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Monitoring of vaccination coverage rates (VCRs) is essential to assess the implementation of a country's vaccine policy and its effectiveness. Through the French Vaccinoscopy study, we measured the evolution of VCRs as well as mothers' opinion towards vaccination between 2008 and 2018, before and after implementation of infant mandatory vaccination extension. METHODS This is a study based on an internet-standardised questionnaire. In 2018, a representative sample of 3000 mothers of infants 0 to 35 months of age answered on their opinion on vaccination and reported all vaccinations recorded in their child's health record. RESULTS On the period considered, infant VCRs were stable and high for diphtheria, tetanus, poliomyelitis, pertussis and pneumococcus components and progressed for measles, mumps rubella, 2 doses at 24 months of age from 45.3% in 2008 to 81.0% in 2018, hepatitis B (HepB) complete primovaccination at 6 months of age from 45.9% in 2008 to 86.3% in 2017 and 95.5% in 2018, and meningococcus C (MenC) 1 dose at 6 months of age from 43.0% in 2017 to 74.2% in 2018. In 2018, 69.0% of mothers were in favour of vaccination while this rate dropped from 80.2% in 2012 to 64.0% in 2017, and 80.8 to 89.6% perceived HepB, MenC measles and pertussis vaccinations as useful/essential, percentages in progress versus 2017. CONCLUSION Following the implementation of infant mandatory vaccination in 2018, proportion of mothers in favour of vaccination increased significantly. HepB and MenC VCRs significantly progressed between 2017 and 2018.
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Affiliation(s)
- A Martinot
- Université de Lille, CHU de Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, 59000 Lille, France
| | - B Leboucher
- Unité de réanimation et médecine neonatales, pole femme-mère-enfant, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - R Cohen
- Unité court séjour petits nourrissons, CHI de Créteil, 40, avenue de Verdun, 94010 Créteil cedex, France
| | - J-P Stahl
- Service de maladies infectieuses et tropicales, université-1 de Grenoble, CHU, BP 217, 38043 Grenoble, France
| | - D Subtil
- Service de gynéco-obstétrique, CHU de Lille, Lille, France
| | - P Pujol
- GSK France, 23, rue François-Jacob, 92500 Rueil-Malmaison, France.
| | - H Lepetit
- IDM Families, 10, boulevard des Frères-Voisin, 92130 Issy-les-Moulineaux, France
| | - L Longfier
- IDM Families, 10, boulevard des Frères-Voisin, 92130 Issy-les-Moulineaux, France
| | - J Gaudelus
- Service de pédiatrie, hôpital Jean-Verdier, 93140 Bondy, France; Université Paris-XIII, 93017 Bobigny, France
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Godin O, Leboyer M, Mazroui Y, Aouizerate B, Azorin JM, Raoul B, Bellivier F, Polosan M, Courtet P, Dubertret C, Henry C, Kahn JP, Loftus J, Olié E, Passerieux C, Costagliola D, Etain B, Llorca P, Barteau V, Bensalem S, Laaidi M, Laouamri H, Souryis K, Hotier S, Pelletier A, Drancourt N, Sanchez J, Saliou E, Hebbache C, Petrucci J, Willaume L, Bourdin E, Carminati M, Etain B, Marlinge E, Meheust J, Antoniol B, Desage A, Gard S, Jutant A, Mbailara K, Minois I, Zanouy L, Abettan C, Bardin L, Cazals A, Deffinis B, Ducasse D, Gachet M, Henrion A, Martinerie E, Molière F, Noisette B, Tarquini G, Belzeaux R, Correard N, Consoloni JL, Groppi F, Lescalier L, Montant J, Rebattu M, Viglianese N, Cohen R, Milazzo M, Wajsbrot-Elgrabli O, Bougerol T, Fredembach B, Garçon S, Grignon P, Perrin A, Galliot A, Grévin I, Cannavo A, Kayser N, Roux P, Aubin V, Cussac I, Dupont M, Medecin I, Mazer N, Portalier C. Trajectories of functioning in bipolar disorders: A longitudinal study in the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort. Aust N Z J Psychiatry 2020; 54:985-996. [PMID: 32779531 DOI: 10.1177/0004867420945796] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE We aimed at identifying distinct trajectories of functioning and at describing their respective clinical characteristics in a cohort of individuals with bipolar disorders. METHODS We included a sample of 2351 individuals with bipolar disorders who have been followed-up to 3 years as part as the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort. Global functioning was measured using the Functioning Assessment Short Test. We used latent class mixed models to identify distinct longitudinal trajectories of functioning over 3 years. Multivariable logistic regression models were used to identify the baseline factors that were associated with the membership to each trajectory of functioning. RESULTS Three distinct trajectories of functioning were identified: (1) a majority of individuals (72%) had a stable trajectory of mild functional impairment, (2) 20% of individuals had a stable trajectory of severe functional impairment and (3) 8% of individuals had a trajectory of moderate functional impairment that improved over time. The membership to a trajectory of stable severe versus stable mild functional impairment was associated with unemployment, a higher number of previous hospitalizations, childhood maltreatment, a higher level of residual depressive symptoms, higher sleep disturbances, a higher body mass index and a higher number of psychotropic medications being prescribed at baseline. The model that included these seven factors led to an area under the curve of 0.85. CONCLUSION This study enabled to stratify individuals with bipolar disorders according to three distinct trajectories of functioning. The results regarding the potential determinants of the trajectory of severe functional impairment needs to be replicated in independent samples. Nevertheless, these potential determinants may represent possible therapeutic targets to improve the prognosis of those patients at risk of persistent poor functioning.
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Affiliation(s)
- Ophelia Godin
- Fondation FondaMental, Créteil, France.,Université Paris Est Créteil, Inserm U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Créteil, France.,AP-HP, HU Henri Mondor, Departement Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Federation Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), Paris, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France.,Université Paris Est Créteil, Inserm U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Créteil, France.,AP-HP, HU Henri Mondor, Departement Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Federation Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), Paris, France
| | - Yassin Mazroui
- Laboratoire de Probabilités, Statistiques et Modélisation (LPSM), Sorbonne Université, Paris, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France.,Centre Expert Troubles Bipolaires, Service de Psychiatrie Adulte, Hôpital Charles-Perrens, Bordeaux, France
| | - Jean-Michel Azorin
- Fondation FondaMental, Créteil, France.,Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France.,CNRS Aix-Marseille Université, Marseille, France
| | - Belzeaux Raoul
- Fondation FondaMental, Créteil, France.,Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France.,CNRS Aix-Marseille Université, Marseille, France
| | - Frank Bellivier
- Fondation FondaMental, Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), GHU Saint-Louis-Lariboisière-Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, INSERM UMRS 1144, Université de Paris, Paris, France
| | - Mircea Polosan
- Fondation FondaMental, Créteil, France.,Université Grenoble Alpes, CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) Inserm U1216, Grenoble, France
| | - Philippe Courtet
- Fondation FondaMental, Créteil, France.,Département Urgence et Post-urgence Psychiatrique, CHU Montpellier, INSERM U1061, Université de Montpellier, Montpellier, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France.,AP-HP, Groupe Hospitalo-Universitaire Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hopital Louis Mourier, Colombes, Inserm U1266, Faculté de Médecine, Université de Paris, Paris, France
| | - Chantal Henry
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Jean-Pierre Kahn
- Fondation FondaMental, Créteil, France.,Université de Lorraine, CHRU de Nancy et Pôle de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy, Nancy, France
| | - Josephine Loftus
- Fondation FondaMental, Créteil, France.,Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco, France
| | - Emilie Olié
- Fondation FondaMental, Créteil, France.,Département Urgence et Post-urgence Psychiatrique, CHU Montpellier, INSERM U1061, Université de Montpellier, Montpellier, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie d'Adultes, Centre Hospitalier de Versailles, Le Chesnay, Université Paris-Saclay, UVSQ, Inserm, CESP, Team 'DevPsy', Villejuif, France
| | - Dominique Costagliola
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Bruno Etain
- Fondation FondaMental, Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), GHU Saint-Louis-Lariboisière-Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, INSERM UMRS 1144, Université de Paris, Paris, France
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Abstract
The educational and social benefits provided by school far outweigh the risks of a possible COVID-19 contamination of children in school environments or in daycare centers. Following summer break, the back-to-school period in France is taking place in the context of an increasing viral spread and requires strict adherence to health measures to limit the risk of outbreaks in communities. Based on a critical update of the role of children in the transmission of the infection, and of children's susceptibility to infection, the French Pediatric Society published practical guidelines for school re-entry and the management of COVID-19 infections in schools.
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Affiliation(s)
- R Cohen
- Centre hospitalier intercommunal de Créteil, 94000 Créteil, France
| | - C Delacourt
- AP-HP, hôpital universitaire Necker-Enfants-Malades, 75015 Paris, France.
| | - C Gras-Le Guen
- Service de pédiatrie générale, hôpital Mère-Enfant, CHU Nantes, 44000 Nantes, France
| | - E Launay
- Service de pédiatrie générale, hôpital Mère-Enfant, CHU Nantes, 44000 Nantes, France
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Laccourreye O, Cohen R, Couloigner V. Keys for analysis of diagnostic and serologic tests for CoV-2. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:323-324. [PMID: 32473864 PMCID: PMC7255273 DOI: 10.1016/j.anorl.2020.05.013] [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] [Indexed: 11/26/2022]
Abstract
Based on a review of the medical literature, the authors document the key points regarding the tests available in France to screen for and diagnose of CoV-2 infestation.
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49
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Launay E, Gras Le Guen C, Pinquier D, Dommergues MA, Cohen R, Grimprel E. Antiviraux chez l’enfant en pratique de ville : infections herpétiques, varicelle, grippe. Perfectionnement en Pédiatrie 2020. [PMCID: PMC7144846 DOI: 10.1016/j.perped.2020.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Les infections liées à l’herpès virus humain (HSV), au virus de la varicelle et du zona (VZV) et au virus de la grippe (Influenza A et B) sont très fréquentes en pédiatrie et sont le plus souvent bénignes avec une guérison spontanée. L’utilisation des antiviraux antigrippaux (inhibiteurs de neuraminidase) a été étudiée dans de larges essais randomisés et fait l’objet de recommandations nationales et internationales. Celle des anti-HSV et anti-VZV n’a pas fait l’objet d’études de la même ampleur et de ce fait, leur prescription est plus discutée avec des bénéfices moins bien définis et variables (à l’exception des infections néonatales et/ou neuro-méningées). L’objectif de cette mise au point est donc de proposer une synthèse des données disponibles dans la littérature concernant les indications des antiviraux en pratique de ville pour les infections liées à l’HSV (gingivostomatite, herpès récurrent, faux panaris herpétique), au VZV (varicelle, zona) et à la grippe.
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Affiliation(s)
- E. Launay
- Pédiatrie générale et infectiologie pédiatrique, hôpital Femme-Enfant-Adolescent, CHU de Nantes, 7, quai Moncousu, 44000 Nantes, France
- Auteur correspondant : pédiatrie générale et infectiologie pédiatrique, hôpital Femme-Enfant-Adolescent, CHU de Nantes, 7, quai Moncousu, 44000 Nantes, France.
| | - C. Gras Le Guen
- Pédiatrie générale et infectiologie pédiatrique, hôpital Femme-Enfant-Adolescent, CHU de Nantes, 7, quai Moncousu, 44000 Nantes, France
| | - D. Pinquier
- Pavillon Mère et Enfant, pédiatrie néonatale et réanimation, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France
| | - M.-A. Dommergues
- Service de pédiatrie, CH de Versailles, 177, rue de Versailles, 78157 Le Chesnay, France
| | - R. Cohen
- Service de néonatalogie, unité court séjour, petits nourrissons, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
| | - E. Grimprel
- Service de pédiatrie, hôpital Armand-Trousseau, Assistance publique–Hôpitaux de Paris, 26, avenue du Dr Arnold-Netter, 75012 Paris, France
| | - Groupe de pathologie infectieuse pédiatrique (GPIP) de la Société française de pédiatrie (SFP)
- Pédiatrie générale et infectiologie pédiatrique, hôpital Femme-Enfant-Adolescent, CHU de Nantes, 7, quai Moncousu, 44000 Nantes, France
- Pavillon Mère et Enfant, pédiatrie néonatale et réanimation, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France
- Service de pédiatrie, CH de Versailles, 177, rue de Versailles, 78157 Le Chesnay, France
- Service de néonatalogie, unité court séjour, petits nourrissons, centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
- Service de pédiatrie, hôpital Armand-Trousseau, Assistance publique–Hôpitaux de Paris, 26, avenue du Dr Arnold-Netter, 75012 Paris, France
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Shaw L, Cohen R, Altman Y, Eyal S, Baharav A. 0206 Sleep Opportunity and Duration are Related to Risk Injury in Elite Athletes. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Sleep is essential to musculoskeletal recovery, acquisition of new skills and emotional regulation in athletes. Insufficient sleep is detrimental to performance. Recent publications indicate that sleep duration is related to risk for injury in young athletes. We aimed at analyzing the relation between sleep opportunity and duration and the likelihood of an injury among adult elite athletes.
Methods
We studied 7,237 nights recorded with the Sleeprate application by 71 adult elite athletes from diverse sports, during the period September 2018-October 2019. Night recordings included perceived and measured sleep parameters. In addition, athletes reported their previous day nap duration, injuries and illness status. Out of the total number of nights, 4,205 included reported injury status with no injury and no illness for the previous night. Nightly total time in bed (TIB), TIB including reported naps (TIB24hr) and measured total sleep time (TST) were examined.
Results
Average TIB was significantly shorter (508±77 minutes, mean±STD) in healthy days preceding injuries than in healthy days preceding days with no injury (525±70 minutes, p<.001). Similar results were found when comparing the TIB24hr (injury: 517±83 minutes, no injury: 543±76 minutes, p<.001) and TST (injury: 443±72 minutes, no injury: 457±69 minutes, p<.001).
Conclusion
Average sleep opportunities of the elite athletes in this study were in accordance with their age and workouts load. The time athletes allow themselves as an opportunity for sleep is inversely correlated to the chances of developing an injury. These findings corroborate published research regarding sleep duration and risk of injury in athletes, yet our findings are based on real life data of elite athletes, and demonstrate the importance of sleep as part of the elite or professional athlete’s routine, suggesting that even as little as around 20 minutes of added sleep may be efficient in preventing injury.
Support
N/A
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Affiliation(s)
- L Shaw
- United States Olympic & Paralympic Committee, Colorado Springs, CO
| | - R Cohen
- Wingate Institute, Netanya, ISRAEL
| | | | - S Eyal
- HypnoCore, Petach Tiqva, ISRAEL
| | - A Baharav
- HypnoCore, Petach Tiqva, ISRAEL
- Wingate Institute, Netanya, ISRAEL
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