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Acidi B, Faron M, Mir O, Levy A, Ghallab M, Haddag-Miliani L, Ngo C, Kasraoui I, Kanaan C, Verret B, Le Péchoux C, Le Cesne A, Honoré C. Intraoperative motive for incomplete resection in primary retroperitoneal sarcoma. Prog Urol 2023; 33:1026-1032. [PMID: 37858378 DOI: 10.1016/j.purol.2023.09.029] [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: 06/18/2023] [Revised: 08/21/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION Surgical resection is the current standard of care for retroperitoneal sarcoma (RPS). Recent data suggests that up to 5% of patient have incomplete (R2) resection. The exact reason why patients scheduled for surgery with a curative intent to treat ended up with an R2 resection is largely unknown. AIM OF THE STUDY To identify intraoperative findings responsible for incomplete (R2) resection in primary RPS. METHODS All records of consecutive patients scheduled for a non-metastatic primary RPS surgery between 1995 and 2020 in a tertiary care sarcoma centre were retrospective analyzed. RESULTS Among the 347 patients scheduled for surgery, 13 (3.7%) had an incomplete (R2) resection. The reasons for incomplete surgery were intraoperative finding of vascular involvement of great vessels in 5 patients, previously undetected peritoneal metastases in 5 patients, invasion of contralateral kidney/ureter in 2 patients and the need to preserve both kidneys in 1 patient because of his past medical history. Among these patients, 3 had a laparotomy without resection and 10 had a partial resection (i.e. debulking surgery). Severe postoperative complications occurred in 5 patients. The median length of stay in hospital was 19days. After a median follow-up of 12months, the median survival of patients after incomplete resection was 18months. The 1-y, 5-y and 8-y overall survival (OS) for these patients were 46%, 14%, and 7%, respectively. CONCLUSION Incomplete (R2) resection for a primary RPS surgery is rare in specialized sarcoma center. The next steps should be to identify the preoperative criteria that lead to this accurate selection and to define the best practice in front of a peroperative discovery of an unresectable RPS. LEVEL OF EVIDENCE III.
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Affiliation(s)
- B Acidi
- Department of Surgical Oncology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
| | - M Faron
- Department of Surgical Oncology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - O Mir
- Department of Medical Oncology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France; Department of Ambulatory Care, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - A Levy
- Department of Radiation Oncology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - M Ghallab
- Department of Surgical Oncology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - L Haddag-Miliani
- Department of Radiology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - C Ngo
- Department of Pathology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - I Kasraoui
- Department of Radiology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - C Kanaan
- Department of Pathology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - B Verret
- Department of Medical Oncology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - C Le Péchoux
- Department of Radiation Oncology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - A Le Cesne
- Department of Medical Oncology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - C Honoré
- Department of Surgical Oncology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
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Lin Y, Cheng A, Pirie J, Davidson J, Levy A, Matava C, Aubin CE, Robert E, Buyck M, Hecker K, Gravel G, Chang TP. Quantifying Simulated Contamination Deposition on Healthcare Providers Using Image Analysis. Simul Healthc 2023; 18:207-213. [PMID: 35561347 DOI: 10.1097/sih.0000000000000664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Simulation-based research has played an important role in improving care for communicable diseases. Unfortunately, few studies have attempted to quantify the level of contamination in these simulation activities. We aim to assess the feasibility and provide validity evidence for using integrated density values and area of contamination (AOC) to differentiate various levels of simulated contamination. METHODS An increasing number of simulated contamination spots using fluorescent marker were applied on a manikin chest to simulate a contaminated healthcare provider. An ultraviolet light was used to illuminate the manikin to highlight the simulated contamination. Images of increasing contamination levels were captured using a camera with different exposure settings. Image processing software was used to measure 2 outcomes: (1) natural logarithm of integrated density; and (2) AOC. Mixed-effects linear regression models were used to assess the effect of contamination levels and exposure settings on both outcome measures. A standardized "proof-of-concept" exercise was set up to calibrate and formalize the process for human subjects. RESULTS A total of 140 images were included in the analyses. Dose-response relationships were observed between contamination levels and both outcome measures. For each increment in the number of contaminated simulation spots (ie, simulated contaminated area increased by 38.5 mm 2 ), on average, log-integrated density increased by 0.009 (95% confidence interval, 0.006-0.012; P < 0.001) and measured AOC increased by 37.8 mm 2 (95% confidence interval, 36.7-38.8 mm 2 ; P < 0.001), which is very close to actual value (38.5 mm 2 ). The "proof-of-concept" demonstration further verified results. CONCLUSIONS Integrated density and AOC measured by image processing can differentiate various levels of simulated, fluorescent contamination. The AOC measured highly agrees with the actual value. This method should be optimized and used in the future research to detect simulated contamination deposited on healthcare providers.
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Affiliation(s)
- Yiqun Lin
- From the KidSIM Simulation Program (Y.L., J.D.), Alberta Children's Hospital; Departments of Pediatrics and Emergency Medicine (A.C.), University of Calgary, Calgary; Pediatric Emergency Medicine Simulation Program (J.P.), The Hospital for Sick Children University of Toronto, Toronto; Departments of Paediatric Emergency Medicine and Paediatrics (A.L., M.B.), University of Montréal Sainte-Justine's Hospital University Centre, Montréal; Department of Anesthesia and Pain Medicine (C.M.), The Hospital for Sick Children, Toronto; Department of Mechanical Engineering (C.-E.A., E.R.), Polytechnique Montréal, Montréal; Department of Veterinary Clinical and Diagnostic Sciences (K.H.), Faculty of Veterinary Medicine University of Calgary, Calgary; Department of Family Medicine and Emergency Medicine (G.G.), Laval University Laval University Hospital Center, Québec City, Canada; and Children's Hospital Los Angeles (T.P.C.), University of Southern California, Los Angeles, CA
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Cheng A, Pirie J, Lin Y, Lo CY, Davidson J, Chang T, Matava C, Buyck M, Harel DS, Collia N, Neveu G, Pellerin S, Madadi M, Manshadi K, Wan B, Levy A. Aerosol Box Use in Reducing Health Care Worker Contamination During Airway Procedures (AIRWAY Study): A Simulation-Based Randomized Clinical Trial. JAMA Netw Open 2023; 6:e237894. [PMID: 37043197 PMCID: PMC10099073 DOI: 10.1001/jamanetworkopen.2023.7894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
Importance The aerosol box has been used during the management of patients with COVID-19 to reduce health care practitioner (HCP) exposure during aerosol-generating medical procedures (AGMPs). Little is known about the effect of aerosol box use on HCP contamination and AGMP procedure time. Objective To investigate whether use of an aerosol box during AGMPs reduces HCP contamination or influences the time to successful completion and first-pass success rate for endotracheal intubation (ETI) and laryngeal mask airway (LMA) insertion. Design, Setting, and Participants This multicenter, simulation-based, randomized clinical trial was conducted from May to December 2021 at tertiary care pediatric hospitals. Participant teams performed 3 simulated patient scenarios: bag-valve-mask ventilation, ETI, and LMA insertion. During the scenarios, aerosols were generated using Glo Germ. Teams of 2 HCPs were randomly assigned to control (no aerosol box) or intervention groups (aerosol box). Statistical analysis was performed from July 2022 to February 2023. Interventions The aerosol box (or SplashGuard CG) is a transparent, plastic barrier covering the patient's head and shoulders with access ports allowing HCPs to manage the airway. Main Outcomes and Measures The primary outcome was surface area of contamination (AOC) on participants. Secondary outcomes were time to successful completion and first-pass success rates for ETI and LMA insertion. Results A total of 64 teams (128 participants) were enrolled, with data from 61 teams (122 participants) analyzed. Among the 122 participants analyzed, 79 (64.8%) were female and 85 (69.7%) were physicians. Use of an aerosol box was associated with a 77.5% overall decreased AOC to the torso (95% CI, -86.3% to -62.9%; P < .001) and a 60.7% overall decreased AOC to the facial area (95% CI, -75.2% to -37.8%; P < .001) in airway HCPs. There was no statistically significant difference in surface contamination after doffing personal protective equipment between groups. Time to completing ETI was longer in the aerosol box group compared with the control group (mean difference: 10.2 seconds; 95% CI, 0.2 to 20.2 seconds; P = .04), but there was no difference between groups for LMA insertion (mean difference: 2.4 seconds; 95% CI, -8.7 to 13.5 seconds; P = .67). Conclusions and Relevance In this randomized clinical trial of aerosol box use in AGMPs, use of an aerosol box reduced contamination deposition on HCPs' torso and face predoffing; the use of an aerosol box delayed time to successful intubation. These results suggest that the incremental benefits of reduced surface contamination from aerosol box use should be weighed against delayed time to complete intubation, which may negatively affect patient outcome. Trial Registration ClinicalTrials.gov Identifier: NCT04880668.
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Affiliation(s)
- Adam Cheng
- Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Pirie
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Yiqun Lin
- KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Carl Y Lo
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles, University of Southern California, Los Angeles
| | - Jennifer Davidson
- KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Todd Chang
- Department of Emergency Medicine, Children's Hospital of Los Angeles, University of Southern California, Los Angeles
| | - Clyde Matava
- Department of Anesthesiology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Michael Buyck
- Department of Mother and Child Medicine, Division of Pediatric Emergency Medicine, Geneva University Hospitals and University of Geneva, Switzerland
| | - Dana Singer Harel
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Natasha Collia
- Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Guylaine Neveu
- Department of Respiratory Therapy, Sainte-Justine Hospital Mother and Child Simulation Center, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Stephanie Pellerin
- Department of Respiratory Therapy, Sainte-Justine Hospital Mother and Child Simulation Center, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Mohsen Madadi
- Department of Emergency Medicine, Children's Hospital of Los Angeles, Los Angeles, California
| | - Keya Manshadi
- Department of Emergency Medicine, Children's Hospital of Los Angeles, Los Angeles, California
| | - Brandi Wan
- KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Arielle Levy
- Department of Respiratory Therapy, Sainte-Justine Hospital Mother and Child Simulation Center, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
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Mavrikios A, Baldini C, Loriot Y, Aix SP, Champiat S, Danlos FX, Quevrin C, Gazzah A, Bahleda R, Deutsch E, Levy A. 140P Stereotactic radiotherapy improves disease control in oligoprogressive patients included in early clinical trials, with focus on NSCLC. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00395-7] [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: 04/03/2023]
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Assi T, Honoré C, Bahleda R, Henon C, Verret B, Faron M, Ngo C, Le Pechoux C, Levy A, Le Cesne A. 48MO Characteristics and outcomes of 76 patients with pleomorphic liposarcoma: The Gustave Roussy experience. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101085] [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: 04/05/2023] Open
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Mavrikios A, Baldini C, Loriot Y, Ponce Aix S, Champiat S, Danlos FX, Quevrin C, Gazzah A, Bahleda R, Deutsch E, Levy A. 85P Stereotactic radiotherapy improves disease control in oligoprogressive patients included in early clinical trials. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100943] [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: 04/05/2023] Open
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Rousset L, Bohelay G, Gille T, Le Roux-Villet C, Kambouchner M, Levy A, Brauner M, Tandjaoui H, Aucouturier F, Mignot S, Caux F, Prost-Squarcioni C, Alexandre M. Bronchial involvement in mucous membrane pemphigoid: 2 cases and a literature review. Ann Dermatol Venereol 2023; 150:64-70. [PMID: 36435654 DOI: 10.1016/j.annder.2022.08.009] [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] [Received: 01/10/2022] [Revised: 05/05/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022]
Affiliation(s)
- L Rousset
- Department of Dermatology, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France; Referral Centre for Autoimmune Blistering Diseases (MALIBUL), France
| | - G Bohelay
- Department of Dermatology, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France; Referral Centre for Autoimmune Blistering Diseases (MALIBUL), France
| | - T Gille
- Department of Physiology and Functional Explorations, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France; Inserm U1272 "Hypoxia and the Lung", UFR SMBH Léonard de Vinci, Paris 13 University, France
| | - C Le Roux-Villet
- Department of Dermatology, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France; Referral Centre for Autoimmune Blistering Diseases (MALIBUL), France
| | - M Kambouchner
- Department of Pathology, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France
| | - A Levy
- Department of Pathology, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France
| | - M Brauner
- Department of Radiology, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France
| | - H Tandjaoui
- Department of Pulmonology, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France
| | - F Aucouturier
- Department of Immunology, Saint-Louis Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 7 University, 75010 Paris, France
| | - S Mignot
- Department of Immunology, Bichat Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 7 University, 75018 Paris, France
| | - F Caux
- Department of Dermatology, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France; Referral Centre for Autoimmune Blistering Diseases (MALIBUL), France
| | - C Prost-Squarcioni
- Department of Dermatology, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France; Referral Centre for Autoimmune Blistering Diseases (MALIBUL), France; Histology Laboratory, UFR SMBH Léonard de Vinci, Paris 13 University, Bobigny, France
| | - M Alexandre
- Department of Dermatology, Avicenne Hospital, Assistance Publique Hôpitaux De Paris (AP-HP), Paris 13 University, Bobigny, France; Referral Centre for Autoimmune Blistering Diseases (MALIBUL), France.
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Levy A, Georgeon C, Knoeri J, Tourabaly M, Leveziel L, Bouheraoua N, Borderie VM. Corneal Epithelial Thickness Mapping in the Diagnosis of Ocular Surface Disorders Involving the Corneal Epithelium: A Comparative Study. Cornea 2022; 41:1353-1361. [PMID: 35349542 PMCID: PMC9555759 DOI: 10.1097/ico.0000000000003012] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/25/2021] [Accepted: 12/05/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to analyze the role of corneal epithelial thickness (ET) mapping provided by spectral domain optical coherence tomography in the diagnosis of ocular surface disorders (OSDs) involving the corneal epithelium. DESIGN This was a retrospective comparative study. METHODS Institutional settings are as follows. Study population includes 303 eyes with an OSD and 55 normal eyes (controls). Observation procedures include spectral domain optical coherence tomography with epithelial mapping in the central 6 mm. Main outcome measures include ET map classification (normal, doughnut, spoke-wheel, localized/diffuse, and thinning/thickening patterns) and ET data and statistics (minimum, maximum, and SD). A quantitative threshold was determined with receiver operating curves to distinguish pathological from normal corneas. Sensitivity and specificity of classification and quantitative data were calculated using all eyes to assess the ability to distinguish corneas with a given corneal disorder from other conditions. RESULTS Classification of full agreement between 3 readers was obtained in 75.4% to 99.4% of cases. Main OSD features were keratoconus (135 eyes), doughnut pattern (sensitivity/specificity = 56/94%), and max-min ET ≥ 13 μm (84/43%); limbal deficiency (56 eyes), spoke-wheel pattern (66/98%), and max-min ET ≥ 14 μm (91/59%); epithelial basement membrane dystrophy (55 eyes), inferior thickening pattern (55/92%), and central ET > 56 μm (53/81%); dry eye (21 eyes), superior thinning pattern (67/88%), and minimal ET ≤ 44 μm (86/48%); pterygium (10 eyes), nasal thickening pattern (100/86%), and nasal ET > 56 μm (80/71%); and in situ carcinoma (11 eyes), max ET > 60 μm (91/60%), and ET SD >5 μm (100/58%). CONCLUSIONS The epithelial map pattern recognition combined with quantitative analysis of ET is relevant for the diagnosis of OSDs and for distinguishing various OSDs from each other. Deep learning analysis of big data could lead to the fully automated diagnosis of these disorders.
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Affiliation(s)
- Arielle Levy
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Cristina Georgeon
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Juliette Knoeri
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Moïse Tourabaly
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Loïc Leveziel
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Nacim Bouheraoua
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | - Vincent M. Borderie
- GRC 32, Transplantation et Thérapies Innovantes de la Cornée, Sorbonne Université, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
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Tabone L, Rivest D, Levy A, Buyck M, Jouvet P, Aubin CE, François T, Robert E, Baudin F. Prevention of submicron aerosolized particle dispersion: evaluation of an aerosol box using a pediatric simulation model. Exp Lung Res 2022; 48:266-274. [PMID: 36269071 DOI: 10.1080/01902148.2022.2135795] [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: 01/25/2023]
Abstract
Background and Aim: The SplashGuard CG (SG) is a barrier enclosure developed to protect healthcare workers from SARS-CoV-2 transmission during aerosol-generating procedures. Our objective was to evaluate the protection provided by the SG against aerosolized particles (AP), using a pediatric simulation model of spontaneous ventilation (SV) and noninvasive ventilation (NIV). Methods: An aerosol generator was connected to the airways of a pediatric high-fidelity manikin with a breathing simulator. AP concentrations were measured both in SV and NIV in the following conditions: with and without SG, inside and outside the SG, with and without suction applied to the device. Results: In the SV simulated setting, AP peaks were lower with SG: 0.1 × 105 particles/L compared to without: 1.6 × 105, only when the ports were closed and suction applied. In the NIV simulated setting, AP peaks outside the SG were lower than without SG (20.5 × 105 particles/L), whatever the situation, without suction (14.4 × 105particles/L), with suction and ports open or closed: 10.3 and 0.7 × 105 particles/L. In SV and NIV simulated settings, the AP peaks measured within the SG were much higher than the AP peaks measured without SG, even when suction was applied to the device. Conclusions: The SG seems to decrease peak AP exposure in the 2 ventilation contexts, but only with closed port and suction in SV. However, high concentrations of AP remain inside even with suction and SG should be used cautiously.
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Affiliation(s)
- Laurence Tabone
- Pediatric Intensive Care, Department of Pediatrics, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada.,Pediatric Intensive Care Unit and Pediatric Emergency Department, CHRU de Tours, Tours, France
| | - Dominic Rivest
- Department of Mechanical Engineering, Ecole Polytechnique de Montreal, Montreal, Québec, Canada
| | - Arielle Levy
- Department of Emergency Care, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Michael Buyck
- Department of Emergency Care, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Philippe Jouvet
- Pediatric Intensive Care, Department of Pediatrics, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Carl-Eric Aubin
- Department of Mechanical Engineering, Ecole Polytechnique de Montreal, Montreal, Québec, Canada
| | - Tine François
- Pediatric Intensive Care, Department of Pediatrics, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Etienne Robert
- Department of Mechanical Engineering, Ecole Polytechnique de Montreal, Montreal, Québec, Canada
| | - Florent Baudin
- Department of Anesthesiology, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada.,Pediatric Intensive Care Unit, Lyon University Hospital, Hôpital Femme Mère Enfant, Bron, France
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Weill O, Labrosse M, Levy A, Desjardins MP, Trottier ED, Gravel J. 69 Triage Administration of Ondansetron for Gastroenteritis in children; a randomized controlled trial. Paediatr Child Health 2022. [PMCID: PMC9620576 DOI: 10.1093/pch/pxac100.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Acute gastroenteritis is an important reason for emergency department (ED) consultation in children. Ondansetron is reported to be effective in reducing vomiting in children with gastroenteritis, leading to less intravenous rehydration and hospital admission. Objectives The aim of this study was to assess the effectiveness of triage nurse-initiated administration of ondansetron for children with suspected gastroenteritis in the paediatric ED to reduce the number of patients requiring observation following the first physician assessment. Design/Methods This was a randomized controlled trial performed in a tertiary care paediatric ED. All children 6 months to 17 years old who presented to the ED with at least four episodes of non-billous, non-bloody vomiting in the previous 24 hours and the last vomiting occurring within the previous 2h were eligible. The intervention consisted of administration of a liquid formulation of an adapted to weight dose of ondansetron at triage compared to a color- and taste-matched placebo. The primary outcome was the number of patients requiring observation after the first physician’s evaluation. Secondary outcomes were the number of episodes of vomiting after receiving the intervention, length of stay in the ED, comfort, and the proportion of children who returned for a medical visit within 48 hours. A sample size of 248 participants was initially identified to have a power of 90% to find a 20% difference in the proportion of children needing observation following physician evaluation. Results Because of multiple external factors, including the COVID-19 pandemic, recruitment was stopped before the expected sample size was reached. A total of 91 patients were included and randomized to receive ondansetron (n= 44) or a placebo (n=47) just after triage. The baseline characteristics of the participants was similar between the two groups. A total of 40 (45%) participants were discharged immediately after the first evaluation by the treating physician. This was similar for both groups 44% vs. 45%; (95% CI for the difference -20 to 19%). There was no difference between the two groups for the total length of stay (median 232 vs. 227 minutes; p= 0.677) and for the length of stay after being seen by the physician (72 vs. 68 minutes; p=0.821). There was no statistical difference between the two groups in the number of vomiting episodes (difference of 15%; 95% CI -2, 31), and proportion of participants needing a rescue medication (difference: 19%; 95%CI:-0.6 to 36%) or an intravenous rehydration (difference: 8; 95%CI:-6, 22). Conclusion This study failed to demonstrate any benefit in using ondansetron at triage for children with presumed gastroenteritis. ![]()
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Zeng H, Zheng D, Witlox W, Levy A, Traverso A, Kong FM, Houben R, De Ruysscher D, Hendriks L. EP14.01-014 Risk Factors for Brain Metastasis in Patients with Small Cell Lung Cancer: A Systematic Review and Meta-analysis. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Morgan RW, Atkins DL, Hsu A, Kamath-Rayne BD, Aziz K, Berg RA, Bhanji F, Chan M, Cheng A, Chiotos K, de Caen A, Duff JP, Fuchs S, Joyner BL, Kleinman M, Lasa JJ, Lee HC, Lehotzky RE, Levy A, McBride ME, Meckler G, Nadkarni V, Raymond T, Roberts K, Schexnayder SM, Sutton RM, Terry M, Walsh B, Zelop CM, Sasson C, Topjian A. Guidance for Cardiopulmonary Resuscitation of Children With Suspected or Confirmed COVID-19. Pediatrics 2022; 150:188494. [PMID: 35818123 DOI: 10.1542/peds.2021-056043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/24/2022] Open
Abstract
This article aims to provide guidance to health care workers for the provision of basic and advanced life support to children and neonates with suspected or confirmed coronavirus disease 2019 (COVID-19). It aligns with the 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular care while providing strategies for reducing risk of transmission of severe acute respiratory syndrome coronavirus 2 to health care providers. Patients with suspected or confirmed COVID-19 and cardiac arrest should receive chest compressions and defibrillation, when indicated, as soon as possible. Because of the importance of ventilation during pediatric and neonatal resuscitation, oxygenation and ventilation should be prioritized. All CPR events should therefore be considered aerosol-generating procedures. Thus, personal protective equipment (PPE) appropriate for aerosol-generating procedures (including N95 respirators or an equivalent) should be donned before resuscitation, and high-efficiency particulate air filters should be used. Any personnel without appropriate PPE should be immediately excused by providers wearing appropriate PPE. Neonatal resuscitation guidance is unchanged from standard algorithms, except for specific attention to infection prevention and control. In summary, health care personnel should continue to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission through vaccination and use of appropriate PPE during pediatric resuscitations. Health care organizations should ensure the availability and appropriate use of PPE. Because delays or withheld CPR increases the risk to patients for poor clinical outcomes, children and neonates with suspected or confirmed COVID-19 should receive prompt, high-quality CPR in accordance with evidence-based guidelines.
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Affiliation(s)
- Ryan W Morgan
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Dianne L Atkins
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Antony Hsu
- Department of Emergency Medicine, St. Joseph Mercy Ann Arbor Hospital, Superior Township, Michigan
| | - Beena D Kamath-Rayne
- Global Newborn and Child Health, American Academy of Pediatrics, Itasca, Illinois
| | - Khalid Aziz
- Department of Pediatrics, Division of Newborn Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Robert A Berg
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Farhan Bhanji
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Melissa Chan
- Departments of Pediatrics and Pediatric Emergency Medicine, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Adam Cheng
- Department of Paediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Kathleen Chiotos
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Allan de Caen
- Department of Pediatrics, Division of Critical Care, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Jonathan P Duff
- Department of Pediatrics, Division of Critical Care, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | | | - Benny L Joyner
- Departments of Pediatrics, Anesthesiology & Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Monica Kleinman
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Javier J Lasa
- Cardiovascular ICU, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Henry C Lee
- Division of Neonatology, Stanford University, Stanford, California
| | | | - Arielle Levy
- Departments of Pediatrics and Pediatric Emergency Medicine, Sainte-Justine Hospital University Center, University of Montreal, Montreal, Quebec, Canada
| | - Mary E McBride
- Cardiology, and Critical Care Medicine, Northwestern University, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Garth Meckler
- Departments of Pediatrics and Pediatric Emergency Medicine, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vinay Nadkarni
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Tia Raymond
- Department of Pediatric Cardiac Critical Care, Medical City Children's Hospital, Dallas, Texas
| | - Kathryn Roberts
- Center for Nursing Excellence, Education & Innovation, Joe DiMaggio Children's Hospital, Hollywood, Florida
| | - Stephen M Schexnayder
- Departments of Critical Care Medicine and Emergency Medicine, Arkansas Children's Hospital, Springdale, Arkansas
| | - Robert M Sutton
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Mark Terry
- National Registry of Emergency Medical Technicians, Columbus, Ohio
| | - Brian Walsh
- Respiratory Care, Children's Hospital Colorado, Aurora, Colorado
| | - Carolyn M Zelop
- Department of Obstetrics and Gynecology, NYU School of Medicine and The Valley Hospital, New York City, New York
| | - Comilla Sasson
- ECC Science & Innovation, American Heart Association, Dallas, Texas
| | - Alexis Topjian
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Levy A, Botticella A, Cohen-Jonathan Moyal E, Massabeau C, Le Péchoux C, Khalifa J. PO-1272 SBRT for oligoprogressive/oligorecurrent SCLC: is it worth it? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03236-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Botticella A, Levy A, Mercier O, Auzac G, Traore-Diallo A, Frelaut M, Pradere P, Caramella C, Kasraoui I, Besse B, Planchard D, Le Pechoux C. PO-1246 Lung SBRT after pneumonectomy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03210-8] [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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Levy A, Le Péchoux C. SP-0030 Value of EBRT. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03881-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tagliamento M, Vasseur D, A. Bayle, Aldea M, Gazzah A, Nicotra C, Hollebecque A, Planchard D, Frelaut M, Botticella A, Levy A, Lacroix L, Marzac C, Micol J, Ponce S, Rouleau E, Italiano A, Besse B. 169P Characteristics of clonal hematopoiesis (CH) in patients with non-small cell lung cancer (NSCLC): A retrospective analysis of plasma cell-free DNA (cfDNA) comprehensive genomic profiling. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.201] [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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Nassif EF, Blay JY, Massard C, Dufresne A, Brahmi M, Cassier P, Ray-Coquard I, Pautier P, Leary A, Sunyach MP, Bahleda R, Levy A, Le Pechoux C, Honoré C, Mir O, Le Cesne A. Early phase trials in soft-tissue sarcomas: clinical benefit of inclusion in early lines of treatment, molecular screening, and histology-driven trials. ESMO Open 2022; 7:100425. [PMID: 35255445 PMCID: PMC9058915 DOI: 10.1016/j.esmoop.2022.100425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- E F Nassif
- Cancer Medicine Department, Centre Léon Bérard, Lyon, France. https://twitter.com/NassifElise
| | - J-Y Blay
- Cancer Medicine Department, Centre Léon Bérard, Lyon, France. https://twitter.com/jeanyvesblay
| | - C Massard
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France. https://twitter.com/drcmassard
| | - A Dufresne
- Cancer Medicine Department, Centre Léon Bérard, Lyon, France
| | - M Brahmi
- Cancer Medicine Department, Centre Léon Bérard, Lyon, France
| | - P Cassier
- Early Phase Trial Unit, Centre Léon Bérard, Lyon, France
| | - I Ray-Coquard
- Cancer Medicine Department, Centre Léon Bérard, Lyon, France. https://twitter.com/CoquardRay
| | - P Pautier
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - A Leary
- Cancer Medicine Department, Gustave Roussy, Villejuif, France
| | - M-P Sunyach
- Radiation Oncology Department, Centre Léon Bérard, Lyon, France
| | - R Bahleda
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France
| | - A Levy
- Radiation Oncology Department, Gustave Roussy, Villejuif, France
| | - C Le Pechoux
- Radiation Oncology Department, Gustave Roussy, Villejuif, France
| | - C Honoré
- Surgical Oncology Department, Gustave Roussy, Villejuif, France
| | - O Mir
- Ambulatory Cancer Care Department, Gustave Roussy, Villejuif, France
| | - A Le Cesne
- International Department, Gustave Roussy, Villejuif, France.
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18
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Moya-Plana A, Tselikas L, Lambotte O, Temam S, De Baere T, Deutsch E, Barlesi F, Blanchard P, Levy A. Postgraduate oncology educational shifts during the COVID-19 pandemic: results of faculty and medical student surveys. ESMO Open 2022; 7:100451. [PMID: 35427841 PMCID: PMC8888032 DOI: 10.1016/j.esmoop.2022.100451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has disrupted clinical practice, research and teaching. During peaks, virtual courses were implemented but these changes are poorly described, especially for oncology postgraduate students and faculty teachers. PATIENTS AND METHODS We administered two surveys from June 2021 to October 2021 to students and faculty teachers (250 and 80 responses, respectively) who registered at Gustave Roussy School of Cancer Sciences (Université Paris-Saclay) during 3 consecutive university years (October 2018 to October 2021), where a major shift to e-learning was associated with COVID-19 pandemic. RESULTS Most students were female (53%), attending physicians (50%), aged 30-39 years (54%) and 2020-2021 (66.4%) was the main year of training. Most faculty teachers were male (58%), aged 40-50 years (44%) and had participated in training for at least 3 years (83%). More than half of the students received 100% virtual training [55% versus 45% face-to-face/mixed teaching modalities; online (84%) versus remote teaching (16%)]. Only 34% of students declared >80% 'active listening' and only 16% of teachers considered e-learning to be more suitable (compared with face-to-face) for postgraduate education. Virtual teaching decreased student-teacher interactions as compared with mixed/face-to-face (lessons were sufficiently interactive for 54% students if virtual only teaching versus for 71% if other teaching modalities; P = 0.009). Teachers stated that virtual learning did not lead to any improvements in terms of attendance (68%), interaction (74%) and quality of teaching (68%). However, most faculty (76%) acknowledged that partial e-learning training should be maintained outside the pandemic, if it represents ≤50% of the whole teaching (teachers: 79% versus student: 66%; P = 0.04). CONCLUSIONS COVID-19 accelerated the transition toward novel practices. Students and faculty teachers agreed on the need for future mixed (≤50% e-learning) teaching modalities. Adequate formation and the use of codified best newer virtual practices are required.
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Affiliation(s)
- A Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM U981, Villejuif, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France.
| | - L Tselikas
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Interventional Radiology, Department of Surgery and Anesthesiology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM 1428 CIC Biotheris, Villejuif, France.
| | - O Lambotte
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Université Paris-Saclay, AP-HP, Hôpital Bicêtre, Clinical Immunology Department, Le Kremlin Bicêtre, France; Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IDMIT/IMVA-HB), UMR1184, Le Kremlin Bicêtre, France
| | - S Temam
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France
| | - T De Baere
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Interventional Radiology, Department of Surgery and Anesthesiology, Gustave Roussy, Villejuif, France
| | - E Deutsch
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM U1030, Molecular Radiotherapy, Villejuif, France
| | - F Barlesi
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Medical Oncology, Gustave Roussy, Villejuif, France; Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France
| | - P Blanchard
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France
| | - A Levy
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM U1030, Molecular Radiotherapy, Villejuif, France.
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19
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Ashur A, Levy A, Liel-Cohen N, Michael T, Sergienko R, Kobal S. Prognostic value of incidental finding of pulmonary hypertension detected by echocardiography in patients without known cardiovascular or pulmonary disease. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.316] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
The estimated overall prevalence of pulmonary hypertension (PHT) is ∼1% in the global population, and up to 10% among patients older than 65 years. PHT is associated with a worst prognosis in patients with cardiovascular or pulmonary disease. However, the significance of PHT as an incidental finding among subjects who do not suffer from cardiac or pulmonary diseases is unknown. The aim of our study is to examine whether incidental diagnosis of PHT in patients without cardiovascular or pulmonary comorbidity is associated with long-term all-cause mortality.
Methods
This retrospective cohort study included 8296 patients (58% females, mean age, 63 ± 14 years), who performed a first echo study (echo 1) in the years 2006-2009 and a follow up study (echo 2) until 01/2020 in a large single center echo-lab. Patients were excluded if they had evidence of moderate or more left ventricular dysfunction (LVD), significant valvular disease or diagnosis of pulmonary disease at echo 1. The association between PHT and LV function degree (Ejection fraction above or below 55%) to all-cause mortality was examined between four groups [group 1 (G1)- normal LV function (NLV)+ no PTH (NPH), G2- LVD and NPH, G3- NLV and PHT, G4- LVD and PHT] using a Kaplan-Meier analysis and Cox proportional-hazards model, accounting for various covariates.
Results
Survival time of patients with or without PHT in echo 1 and LV function status at echo 2 was found significantly different among all groups (Pv < 0.001 for all comparisons) (Figure 1). Patients in G1 had the longest mean survival time (141 ± 23 months) compared to any other group (G2-134 ± 30 months, G3-129 ± 32 months, G4-119 ± 38 months). In the multivariable analysis conducted (Table 1), PHT adjusted for various demographic factors and comorbidities was found to be an independent risk factor for long term all-cause mortality with increased risk of up to 34% (adjusted HR-1.34; 95% CI: 1.21-1.47, PV < 0.001).
Conclusion
Incidental finding of PHT in patients without known cardiovascular or pulmonary disease is an independent risk factor for long term all-cause mortality. Future studies should be conducted to assess the impact of an early diagnosis on all-cause mortality, and the need for further diagnostic and therapeutic steps. Abstract Figure. Abstract Figure.
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Affiliation(s)
- A Ashur
- Ben Gurion University of the Negev, Department of Public Health, Beer Sheva, Israel
| | - A Levy
- Ben Gurion University of the Negev, Department of Public Health, Beer Sheva, Israel
| | - N Liel-Cohen
- Ben-Gurion University of the Negev, Department of Health Science , Beer Sheva, Israel
| | - T Michael
- Ben Gurion University of the Negev, Department of Public Health, Beer Sheva, Israel
| | - R Sergienko
- Ben Gurion University of the Negev, Department of Public Health, Beer Sheva, Israel
| | - S Kobal
- Ben-Gurion University of the Negev, Department of health science, Soroka Medical Center, Cardiology Department, Beer Sheva, Israel
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Butaney M, Patel A, Qi J, Singh K, Johnson A, Levy A, Noyes S, Ghani K, Rogers C, Lane B. Assessing renal mass management of patients with increased comorbidities: Results from a statewide registry. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00306-2] [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: 11/04/2022]
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21
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Atkins DL, Sasson C, Hsu A, Aziz K, Becker LB, Berg RA, Bhanji F, Bradley SM, Brooks SC, Chan M, Chan PS, Cheng A, Clemency BM, de Caen A, Duff JP, Edelson DP, Flores GE, Fuchs S, Girotra S, Hinkson C, Joyner BL, Kamath-Rayne BD, Kleinman M, Kudenchuk PJ, Lasa JJ, Lavonas EJ, Lee HC, Lehotzky RE, Levy A, McBride ME, Meckler G, Merchant RM, Moitra VK, Nadkarni V, Panchal AR, Ann Peberdy M, Raymond T, Roberts K, Sayre MR, Schexnayder SM, Sutton RM, Terry M, Topjian A, Walsh B, Wang DS, Zelop CM, Morgan RW. 2022 Interim Guidance to Health Care Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association in Collaboration With the American Academy of Pediatrics, American Association for Respiratory Care, the Society of Critical Care Anesthesiologists, and American Society of Anesthesiologists. Circ Cardiovasc Qual Outcomes 2022; 15:e008900. [PMID: 35072519 DOI: 10.1161/circoutcomes.122.008900] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Dianne L Atkins
- Carver College of Medicine, University of Iowa (D.L.A., S.G.)
| | | | - Antony Hsu
- St Joseph Mercy Hospital, Ann Arbor, MI (A.H.)
| | - Khalid Aziz
- University of Alberta, Edmonton, Canada (K.A.)
| | - Lance B Becker
- Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY (L.B.B.)
| | - Robert A Berg
- The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.N., A.T., R.W.M., R.M.S.)
| | | | - Steven M Bradley
- Minneapolis Heart Institute, Healthcare Delivery Innovation Center, MN (S.M.B.)
| | | | - Melissa Chan
- University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada (M.C., G.M.)
| | - Paul S Chan
- Mid America Heart Institute and the University of Missouri-Kansas City, MO (P.S.C.)
| | - Adam Cheng
- Alberta Children's Hospital, University of Calgary, AB, Canada (A.C.)
| | | | - Allan de Caen
- Stollery Children's Hospital, University of Alberta, Edmonton, Canada (A.d.C., J.P.D.)
| | - Jonathan P Duff
- Stollery Children's Hospital, University of Alberta, Edmonton, Canada (A.d.C., J.P.D.)
| | | | - Gustavo E Flores
- Emergency & Critical Care Trainings, San Juan, Puerto Rico (G.E.F.)
| | - Susan Fuchs
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL (S.F., M.E.M.)
| | - Saket Girotra
- Carver College of Medicine, University of Iowa (D.L.A., S.G.)
| | - Carl Hinkson
- Providence Regional Medical Center, Everett, WA (C.H.)
| | - Benny L Joyner
- University of North Carolina at Chapel Hill, NC (B.L.J.)
| | - Beena D Kamath-Rayne
- Global Newborn and Child Health, American Academy of Pediatrics, Itasca, IL (B.D.K.-R.)
| | | | | | | | | | | | | | - Arielle Levy
- Sainte-Justine Hospital University Center, University of Montreal, QC, Canada (A.L.)
| | - Mary E McBride
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL (S.F., M.E.M.)
| | - Garth Meckler
- University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada (M.C., G.M.)
| | - Raina M Merchant
- The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.N., A.T., R.W.M., R.M.S.).,University of Pennsylvania, Philadelphia, PA (R.M.M.)
| | - Vivek K Moitra
- College of Physicians & Surgeons of Columbia University, NY (V.K.M.)
| | - Vinay Nadkarni
- The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.N., A.T., R.W.M., R.M.S.)
| | - Ashish R Panchal
- The Ohio State University Wexner Medical Center, Columbus, OH (A.R.P.)
| | | | - Tia Raymond
- Medical City Children's Hospital, Dallas, TX (T.R.)
| | | | | | | | - Robert M Sutton
- The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.N., A.T., R.W.M., R.M.S.)
| | - Mark Terry
- National Registry of Emergency Medical Technicians, Columbus, OH (M.T.)
| | - Alexis Topjian
- Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY (L.B.B.)
| | - Brian Walsh
- Children's Hospital Colorado, Aurora, CO (B.W.)
| | - David S Wang
- Columbia University Irving Medical Center, NY (D.S.W.)
| | | | - Ryan W Morgan
- The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., V.N., A.T., R.W.M., R.M.S.)
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22
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Fardeau C, Bencheqroun M, Levy A, Bonnin S, Ferchaud MA, Fardeau L, Coscas F, Bodaghi B, Lebrun-Vignes B. Uveitis associated with cancer immunotherapy: long-term outcomes. Immunotherapy 2021; 13:1465-1481. [PMID: 34709074 DOI: 10.2217/imt-2021-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: We report the long-term outcome of uveitis associated with cancer immunotherapy (CIT). Methods: This retrospective review included serial patients with CIT-associated uveitis treated using various regimen. Results: Eight patients treated with rituximab (anti-CD20), nivolumab (anti-PD-1), ipilimumab (anti-CTLA-4), vemurafenib and dabrafenib (anti-BRAF), trametinib (anti-MEK) and ibritunib showed uveitis with hypopion (one patient), macular edema (five patients) and choroiditis (two patients). Various regimens of corticosteroid therapy showed a favorable ophthalmological outcome, whether the CIT was continuing or suspended. Conclusion: Local corticosteroid injections in combination with CIT could be suggested as a first-line treatment. This could help to preserve the quality of life without threatening the vital prognosis.
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Affiliation(s)
- Christine Fardeau
- Department of Ophthalmology, Reference Center for Rare Diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, 75013, France
| | - Mehdi Bencheqroun
- Department of Ophthalmology, Reference Center for Rare Diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, 75013, France
| | - Arielle Levy
- Department of Ophthalmology, Reference Center for Rare Diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, 75013, France
| | - Sophie Bonnin
- Department of Ophthalmology, Reference Center for Rare Diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, 75013, France.,Department of Ophthalmology, Fondation Rothschild, Université de Paris, Paris, 75019, France
| | - Marie-Adélaïde Ferchaud
- Department of Ophthalmology, Reference Center for Rare Diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, 75013, France
| | - Leila Fardeau
- Institut de Démographie, Université Paris 1 - Panthéon Sorbonne, Paris, France
| | - Florence Coscas
- Centre Ophtalmologique de l'Odéon, Agora Académie, Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, Reference Center for Rare Diseases, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, 75013, France
| | - Bénédicte Lebrun-Vignes
- Department of Pharmacovigilance, La Pitié-Salpêtrière Hospital, Paris-Sorbonne University, Paris, 75013, France
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Hsu A, Sasson C, Kudenchuk PJ, Atkins DL, Aziz K, Becker LB, Berg RA, Bhanji F, Bradley SM, Brooks SC, Chan M, Chan PS, Cheng A, Clemency BM, de Caen A, Duff JP, Edelson DP, Flores GE, Fuchs S, Girotra S, Hinkson C, Joyner BL, Kamath-Rayne BD, Kleinman M, Lasa JJ, Lavonas EJ, Lee HC, Lehotzky RE, Levy A, Mancini ME, McBride ME, Meckler G, Merchant RM, Moitra VK, Morgan RW, Nadkarni V, Panchal AR, Peberdy MA, Raymond T, Roberts K, Sayre MR, Schexnayder SM, Sutton RM, Terry M, Walsh B, Wang DS, Zelop CM, Topjian A. 2021 Interim Guidance to Health Care Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19. Circ Cardiovasc Qual Outcomes 2021; 14:e008396. [PMID: 34641719 PMCID: PMC8522336 DOI: 10.1161/circoutcomes.121.008396] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Antony Hsu
- Department of Emergency Medicine, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, MI (A.H.)
| | - Comilla Sasson
- ECC Science & Innovation, American Heart Association, Dallas, TX (C.S., R.E.L.)
| | - Peter J Kudenchuk
- Department of Medicine/Division of Cardiology (P.J.K.), University of Washington, Seattle
| | - Dianne L Atkins
- Stead Family Department of Pediatrics (D.L.A), Carver College of Medicine, University of Iowa
| | - Khalid Aziz
- Division of Newborn Medicine, Department of Pediatrics, University of Alberta, Edmonton, Canada (K.A.)
| | - Lance B Becker
- Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY (L.B.B.)
| | - Robert A Berg
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Farhan Bhanji
- Department of Pediatrics, McGill University, Montreal, QC, Canada (F.B.)
| | - Steven M Bradley
- Minneapolis Heart Institute, Healthcare Delivery Innovation Center, MN (S.M.B.)
| | - Steven C Brooks
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada (S.C.B.)
| | - Melissa Chan
- Department of Pediatrics and Department of Pediatric Emergency Medicine, BC Children's Hospital, University of British Columbia, Vancouver, Canada (M.C., G.M.)
| | - Paul S Chan
- Department of Internal Medicine, Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City (P.S.C.)
| | - Adam Cheng
- Department of Paediatrics, Alberta Children's Hospital, University of Calgary, Canada (A.C.)
| | - Brian M Clemency
- Department of Emergency Medicine, University at Buffalo, NY (B.M.C.)
| | - Allan de Caen
- Division of Critical Care, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada (A.d.C., J.P.D.)
| | - Jonathan P Duff
- Division of Critical Care, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada (A.d.C., J.P.D.)
| | - Dana P Edelson
- Section of Hospital Medicine, University of Chicago, IL (D.P.E.)
| | - Gustavo E Flores
- Emergency and Critical Care Trainings, San Juan, Puerto Rico (G.E.F.)
| | - Susan Fuchs
- Division of Emergency Medicine (S.F.), Department of Pediatrics, Northwestern University/Ann & Robert H. Lurie Children's Hospital, Chicago, IL
| | - Saket Girotra
- Department of Internal Medicine and Division of Cardiovascular Diseases (S.G.), Carver College of Medicine, University of Iowa
| | - Carl Hinkson
- Respiratory Care, Providence Regional Medical Center, Everett, WA (C.H.)
| | - Benny L Joyner
- Departments of Pediatrics, Anesthesiology & Social Medicine, University of North Carolina at Chapel Hill (B.L.J.)
| | - Beena D Kamath-Rayne
- Global Newborn and Child Health, American Academy of Pediatrics, Itasca, IL (B.D.K.-R.)
| | - Monica Kleinman
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, MA (M.K.)
| | - Javier J Lasa
- Cardiovascular Intensive Care Unit, Texas Children's Hospital, Baylor College Of Medicine, Houston (J.J.L.)
| | - Eric J Lavonas
- Department of Emergency Medicine, Denver Health and Hospital Authority, CO (E.J.L.)
| | - Henry C Lee
- Division of Neonatology, Stanford University, CA (H.C.L.)
| | - Rebecca E Lehotzky
- ECC Science & Innovation, American Heart Association, Dallas, TX (C.S., R.E.L.)
| | - Arielle Levy
- Department of Pediatrics and Department of Pediatric Emergency Medicine, Sainte-Justine Hospital University Center, University of Montreal, QC, Canada (A.L.)
| | - Mary E Mancini
- College of Nursing, University of Texas at Arlington (M.E. Mancini)
| | - Mary E McBride
- Divisions of Cardiology and Critical Care Medicine (M.E. McBride), Department of Pediatrics, Northwestern University/Ann & Robert H. Lurie Children's Hospital, Chicago, IL
| | - Garth Meckler
- Department of Pediatrics and Department of Pediatric Emergency Medicine, BC Children's Hospital, University of British Columbia, Vancouver, Canada (M.C., G.M.)
| | - Raina M Merchant
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia (R.M.M.)
| | - Vivek K Moitra
- Department of Anesthesiology, Division of Critical Care Medicine, Columbia University Irving Medical Center, New York, NY (V.K.M., D.S.W.)
| | - Ryan W Morgan
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Vinay Nadkarni
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Ashish R Panchal
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus (A.R.P.)
| | - Mary Ann Peberdy
- Division of Cardiology, Virginia Commonwealth University, Richmond (M.A.P.)
| | - Tia Raymond
- Department of Pediatrics and Pediatric Cardiac Critical Care, Medical City Children's Hospital, Dallas, TX (T.R.)
| | - Kathryn Roberts
- Center for Nursing Excellence, Education & Innovation, Joe DiMaggio Children's Hospital, Hollywood, FL (K.R.)
| | - Michael R Sayre
- Department of Emergency Medicine (M.R.S.), University of Washington, Seattle
| | - Stephen M Schexnayder
- Departments of Critical Care Medicine and Emergency Medicine, Arkansas Children's Hospital, Little Rock (S.M.S.)
| | - Robert M Sutton
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
| | - Mark Terry
- National Registry of Emergency Medical Technicians, Columbus, OH (M.T.)
| | - Brian Walsh
- Respiratory Care, Children's Hospital Colorado, Aurora (B.W.)
| | - David S Wang
- Department of Anesthesiology, Division of Critical Care Medicine, Columbia University Irving Medical Center, New York, NY (V.K.M., D.S.W.).,Department of Obstetrics and Gynecology, New York, NY (D.S.W.)
| | - Carolyn M Zelop
- NYU School of Medicine, New York, NY and The Valley Hospital, Ridgewood, NJ (C.M.Z.)
| | - Alexis Topjian
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine (R.A.B., R.W.M., V.N., R.M.S., A.T.)
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Nassif E, Blay JY, Bahleda R, Dufresne A, Mehdi B, Ray-Coquard I, Pautier P, Leary A, Levy A, Le Pechoux C, Honoré C, Mir O, Massard C, Le Cesne A. 1551P Efficacy of early phase trials for soft-tissue sarcoma patients: The Centre Léon Bérard and Gustave Roussy experience. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.881] [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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25
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Levy A. SP-0450 The microbiome: An emerging concept impacting the tumour and normal tissue with implications for treatment personalisation. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08587-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Le Pechoux C, Levy A. SP-0665 Multi-modality treatment of soft tissue sarcoma. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08649-7] [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: 11/27/2022]
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27
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Murray P, McCracken M, Levy A, Lathi R, Monseur B. FAMILY BUILDING THROUGH “EMBRYO ADOPTION”: RECIPIENT QUALIFICATIONS, ORGANIZATION CHARACTERISTICS, AND LGBTQ+/SINGLE WEBSITE CONTENT. Fertil Steril 2021. [DOI: 10.1016/j.fertnstert.2021.05.044] [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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Pettersen G, Gauvin F, Robitaille N, Sansregret A, Lesage S, Levy A. Massive Hemorrhage Protocol Application and Teamwork Skills. AEM Educ Train 2021; 5:e10513. [PMID: 34027278 PMCID: PMC8122128 DOI: 10.1002/aet2.10513] [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: 05/26/2020] [Revised: 07/06/2020] [Accepted: 07/22/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Massive hemorrhages (MHs) are rare but serious complications of pediatric trauma and obstetric cases. This study aimed to evaluate the impact of interprofessional simulation to improve adherence to a MH protocol (MHP), teamwork skills and confidence levels during a hemorrhagic crisis situation.Methods: This was a pre-post experimental study conducted at a tertiary care mother-child simulation center. Pediatric emergency and obstetric teams were submitted to simulated trauma and postpartum MH scenarios. Training consisted of two case scenarios followed by debriefing sessions and a lecture on the MHP. The primary outcome was adherence to MHP processes (checklist) measured prior to and 2 weeks following training sessions. Other outcomes were the measure of teamwork skills (Mayo High Performance Teamwork Scale) and confidence of the participants. RESULTS Sixty-two health care professionals were involved in eight interprofessional teams. Mean scores for adherence to the MHP improved from 19.1 in the pretraining phase to 25.8 in the posttraining phase (difference of 6.7; 95% confidence interval [CI] = 4.4 to 8.9). Mean scores pertaining to teamwork skills also improved significantly between pre- and posttraining phases (difference = 3.9; 95% CI = 1.5 to 6.4). Confidence questionnaires showed significant improvements in the posttraining phase (difference = 6.9; 95% CI = 5.3 to 8.3). CONCLUSIONS Targeted training involving simulation and protocol review improved participant adherence to MHP processes and teamwork skills. Confidence levels improved across all disciplines.
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Affiliation(s)
- Géraldine Pettersen
- Critical Care DivisionDepartment of PediatricsUniversity of MontrealMontrealQCCanada
| | - France Gauvin
- Critical Care DivisionDepartment of PediatricsUniversity of MontrealMontrealQCCanada
| | - Nancy Robitaille
- Hematology‐Oncology DivisionUniversity of MontrealMontrealQCCanada
| | - Andrée Sansregret
- Department of Obstetrics‐GynecologyUniversity of MontrealMontrealQCCanada
| | - Sandra Lesage
- Department of AnesthesiologyUniversity of MontrealMontrealQCCanada
| | - Arielle Levy
- Department of Pediatric Emergency MedicineUniversity of MontrealMontrealQCCanada
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29
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Levy A, Roux C, Mercier O, Issard J, Botticella A, Barlesi F, Le Péchoux C. [Radiotherapy for oligometastatic non-small cell lung cancer patients]. Cancer Radiother 2021; 25:517-522. [PMID: 34175225 DOI: 10.1016/j.canrad.2021.06.011] [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: 05/31/2021] [Accepted: 06/05/2021] [Indexed: 10/21/2022]
Abstract
The oligometastatic disease concept suggests that patients with a limited number of metastases have a favorable prognosis. Radical local treatment of oligometastatic patients has then increased given developments in imaging (mainly positron emission tomography and brain magnetic resonance imaging) and access to effective and better tolerated treatments. Stereotactic radiotherapy has the advantage of being noninvasive, allowing a good rate of local control and a limited number of side effects. A better definition of oligometastatic disease, particularly for non-small cell lung cancer (NSCLC), has recently been published. For patients with NSCLC, two randomized phase II trials also suggested that the addition of a radical local treatment results in encouraging survival data, with a good safety profile. A single-arm phase II finally showed a benefit when combining a radical local treatment with an anti-PD1 immunotherapy. This review describes the definitions of oligometastatic disease, the main prospective findings including radiation therapy, and prospects for oligometastatic NSCLC patients.
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Affiliation(s)
- A Levy
- Gustave-Roussy, département d'oncologie radiothérapie, 94805 Villejuif, France; Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France; Université Paris-Saclay, Inserm U1030, radiothérapie moléculaire, 94805 Villejuif, France; Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France.
| | - C Roux
- Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France; Département de radiologie, Gustave-Roussy, 94805 Villejuif, France
| | - O Mercier
- Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France; Université Paris-Saclay, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Département de chirurgie thoracique et vasculaire et transplantation cardiopulmonaire, groupe hospitalier Paris Saint-Joseph-Marie-Lannelongue, 92350 Le Plessis-Robinson, France
| | - J Issard
- Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France; Département de chirurgie thoracique et vasculaire et transplantation cardiopulmonaire, groupe hospitalier Paris Saint-Joseph-Marie-Lannelongue, 92350 Le Plessis-Robinson, France
| | - A Botticella
- Gustave-Roussy, département d'oncologie radiothérapie, 94805 Villejuif, France; Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France
| | - F Barlesi
- Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France; Gustave-Roussy Cancer Campus, Villejuif, France; Aix-Marseille université, Inserm, CNRS, CRCM, Marseille, France
| | - C Le Péchoux
- Gustave-Roussy, département d'oncologie radiothérapie, 94805 Villejuif, France; Centre international des cancers thoraciques (CICT), Gustave-Roussy, 94805 Villejuif, France
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Levy A, Knoeri J, Borderie M, Leveziel L, Borderie V. Therapeutic management of post-traumatic epithelial ingrowth in a 10-year-old boy. J Fr Ophtalmol 2021; 44:e471-e473. [PMID: 33934904 DOI: 10.1016/j.jfo.2020.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/18/2020] [Indexed: 11/26/2022]
Affiliation(s)
- A Levy
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, 28, rue de Charenton, 75012 Paris, France.
| | - J Knoeri
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, 28, rue de Charenton, 75012 Paris, France
| | - M Borderie
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, 28, rue de Charenton, 75012 Paris, France
| | - L Leveziel
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- Centre hospitalier national d'ophtalmologie des Quinze-Vingts, GRC32 Sorbonne Université, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France
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Topjian AA, Raymond TT, Atkins D, Chan M, Duff JP, Joyner BL, Lasa JJ, Lavonas EJ, Levy A, Mahgoub M, Meckler GD, Roberts KE, Sutton RM, Schexnayder SM. Part 4: Pediatric Basic and Advanced Life Support 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics 2021; 147:peds.2020-038505D. [PMID: 33087552 DOI: 10.1542/peds.2020-038505d] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Buyck M, Shayan Y, Gravel J, Hunt EA, Cheng A, Levy A. CPR coaching during cardiac arrest improves adherence to PALS guidelines: a prospective, simulation-based trial. Resusc Plus 2020; 5:100058. [PMID: 34223330 PMCID: PMC8244489 DOI: 10.1016/j.resplu.2020.100058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/12/2020] [Accepted: 11/20/2020] [Indexed: 10/31/2022] Open
Abstract
Aim Recent studies have shown that the integration of a trained cardiopulmonary resuscitation (CPR) Coach during resuscitation enhances the quality of CPR during simulated paediatric cardiac arrest. The objective of our study was to evaluate the effect of a CPR Coach on adherence to Paediatric Advanced Life Support (PALS) guidelines during simulated paediatric cardiac arrest. Methods This was a secondary analysis of data collected from a multicentre randomized controlled trial assessing the quality of CPR in teams with and without a CPR Coach. Forty paediatric resuscitation teams were equally randomized into 2 groups (with or without a CPR Coach). The primary outcome was adherence to PALS guidelines during a simulated paediatric cardiac arrest case as measured by the Clinical Performance Tool (CPT). Video recordings were assigned to 2 pairs of expert raters. Raters were trained to independently score performances using the tool. Results The reliability of the rating was adequate for the Clinical Performance Tool with an intraclass coefficients of 0.67 (95%CI: 0.22 to 0.84). Performance scores of the different teams varied between 51 and 84 points on the Clinical Performance Tool with a mean score of 70. Teams with a CPR Coach demonstrated better adherence to PALS guidelines (i.e. CPT score 73 points) compared to teams without a CPR Coach (68 points, difference 5 points; 95%CI: 1.0-9.3, p = 0.016). Conclusion In addition to improving CPR quality, the presence of a CPR Coach improves adherence to PALS guidelines during simulated paediatric cardiac arrests when compared with teams without a CPR Coach.
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Affiliation(s)
- Michael Buyck
- Department of Pediatric Emergency Medicine, Sainte-Justine Hospital University Centre, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Québec, H3T 1C5, Canada.,Université de Montreal, Montreal, Québec, Canada
| | - Yasaman Shayan
- Department of Pediatric Emergency Medicine, Sainte-Justine Hospital University Centre, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Québec, H3T 1C5, Canada.,Université de Montreal, Montreal, Québec, Canada
| | - Jocelyn Gravel
- Department of Pediatric Emergency Medicine, Sainte-Justine Hospital University Centre, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Québec, H3T 1C5, Canada.,Université de Montreal, Montreal, Québec, Canada
| | - Elizabeth A Hunt
- Departments of Anesthesiology and Critical Care Medicine, Pediatrics and Health Informatics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Adam Cheng
- Departments of Pediatrics and Emergency Medicine, University of Calgary, Calgary, Canada
| | - Arielle Levy
- Department of Pediatric Emergency Medicine, Sainte-Justine Hospital University Centre, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Québec, H3T 1C5, Canada.,Université de Montreal, Montreal, Québec, Canada
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Buyck M, Levy A, Tabone L, Aubin CE, Jouvet P, Baudin F. Pediatric barrier enclosure for nasopharyngeal suctioning during Covid-19 pandemic: A simulation based-study. Am J Emerg Med 2020; 45:608-610. [PMID: 33380356 PMCID: PMC7832753 DOI: 10.1016/j.ajem.2020.11.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 11/30/2020] [Accepted: 11/30/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Michael Buyck
- Departments of Pediatric Emergency and Pediatrics, Sainte-Justine Hospital University Center, Canada; Department of Pediatrics, Université de Montréal, Canada.
| | - Arielle Levy
- Departments of Pediatric Emergency and Pediatrics, Sainte-Justine Hospital University Center, Canada; Sainte-Justine Hospital University Center Mother-child Simulation Center, Canada; Department of Pediatrics, Université de Montréal, Canada
| | - Laurence Tabone
- Pediatric Intensive Care Unit, Sainte-Justine Hospital University Center, Canada; Department of Pediatrics, Université de Montréal, Canada
| | - Carl-Eric Aubin
- Polytechnique Montreal & Sainte-Justine University Hospital Center, Canada
| | - Philippe Jouvet
- Pediatric Intensive Care Unit, Sainte-Justine Hospital University Center, Canada; Department of Pediatrics, Université de Montréal, Canada
| | - Florent Baudin
- Department of anesthesiology, Sainte-Justine Hospital University Center, Canada; Department of Pediatrics, Université de Montréal, Canada
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Levy A, Knoeri J, Borderie V. [Ciprofloxacin deposits under an amniotic membrane graft]. J Fr Ophtalmol 2020; 44:454-455. [PMID: 33308838 DOI: 10.1016/j.jfo.2020.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 11/15/2022]
Affiliation(s)
- A Levy
- Service d'ophtalmologie V, CHNO des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France.
| | - J Knoeri
- Service d'ophtalmologie V, CHNO des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie V, CHNO des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
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Olejarz N, Fertita L, Levy A, Bodemer C, Molina T, Fraitag S, Leclerc Mercier S. Erythème annulaire du jeune enfant : penser à l’érythème neutrophilique figuré. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Larose G, Levy A, Bailey B, Cummins-McManus B, Lebel D, Gravel J. Estimating the Weight of Children During Simulated Emergency Situations Using the Broselow Tape: Are We Underestimating the Risks of Errors? Pediatr Emerg Care 2020; 36:e704-e708. [PMID: 30247454 DOI: 10.1097/pec.0000000000001581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate whether residents can accurately estimate children's weight using the Broselow tape. METHOD We conducted a preplanned secondary analysis from an experimental trial. Participants were residents in pediatrics, family medicine, and emergency medicine rotating in the ED. Residents were randomly assigned to 2 sets of paired scenarios during 2 sessions. They were asked to estimate the weight of a manikin using the Broselow tape at the beginning of each scenario. The first scenario from the initial session and the last scenario from the second session were used for the current study. The primary analysis was the proportion of participants who accurately estimated manikin weight within a 10% margin of error. RESULTS Forty residents were recruited. Thirty-two (80%) reported knowledge of the Broselow tape and 13 (32.5%) reported previous use. Weight estimation was accurate in 60% (24/40; 95% confidence interval [CI], 45%-74%) during the first scenarios. Error in weight estimation differed by greater than 25% in 28% (11/40). Error in estimation was not associated with previous knowledge (odds ratio, 6.2; 95% CI, 0.68-56) or previous use (odds ratio, 0.9; 95% CI, 0.23-3.5) of the Broselow tape. In the last scenario, 88% accurately estimated manikin weight (35/40; 95% CI, 73%-95%). CONCLUSIONS Although most residents reported knowledge of the Broselow tape, 40% made erroneous weight estimations by at least 10% with the first use in this simulation study. With repeated use, they improved significantly over time. Teaching appropriate use of the Broselow tape should be part of residency-training curricula and pediatric advanced life support course.
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Affiliation(s)
- Guylaine Larose
- From the Division of Emergency Medicine, Department of Pediatrics
| | - Arielle Levy
- From the Division of Emergency Medicine, Department of Pediatrics
| | - Benoit Bailey
- From the Division of Emergency Medicine, Department of Pediatrics
| | | | - Denis Lebel
- Department of Pharmacy, Faculty of Medicine, CHU Sainte-Justine, Université de Montreal, Montreal, Quebec, Canada
| | - Jocelyn Gravel
- From the Division of Emergency Medicine, Department of Pediatrics
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Kaiser D, Bohelay G, Bubien V, Levy A, Ostojic A, Longy M, Caux F. Macrodactylie isolée en lien avec une mutation somatique en mosaïque du gène PIK3CA. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Topjian AA, Raymond TT, Atkins D, Chan M, Duff JP, Joyner BL, Lasa JJ, Lavonas EJ, Levy A, Mahgoub M, Meckler GD, Roberts KE, Sutton RM, Schexnayder SM. Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S469-S523. [PMID: 33081526 DOI: 10.1161/cir.0000000000000901] [Citation(s) in RCA: 192] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Berg KM, Cheng A, Panchal AR, Topjian AA, Aziz K, Bhanji F, Bigham BL, Hirsch KG, Hoover AV, Kurz MC, Levy A, Lin Y, Magid DJ, Mahgoub M, Peberdy MA, Rodriguez AJ, Sasson C, Lavonas EJ. Part 7: Systems of Care: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142:S580-S604. [PMID: 33081524 DOI: 10.1161/cir.0000000000000899] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Survival after cardiac arrest requires an integrated system of people, training, equipment, and organizations working together to achieve a common goal. Part 7 of the 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care focuses on systems of care, with an emphasis on elements that are relevant to a broad range of resuscitation situations. Previous systems of care guidelines have identified a Chain of Survival, beginning with prevention and early identification of cardiac arrest and proceeding through resuscitation to post-cardiac arrest care. This concept is reinforced by the addition of recovery as an important stage in cardiac arrest survival. Debriefing and other quality improvement strategies were previously mentioned and are now emphasized. Specific to out-of-hospital cardiac arrest, this Part contains recommendations about community initiatives to promote cardiac arrest recognition, cardiopulmonary resuscitation, public access defibrillation, mobile phone technologies to summon first responders, and an enhanced role for emergency telecommunicators. Germane to in-hospital cardiac arrest are recommendations about the recognition and stabilization of hospital patients at risk for developing cardiac arrest. This Part also includes recommendations about clinical debriefing, transport to specialized cardiac arrest centers, organ donation, and performance measurement across the continuum of resuscitation situations.
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Topjian A, Aziz K, Kamath-Rayne BD, Atkins DL, Becker L, Berg RA, Bradley SM, Bhanji F, Brooks S, Chan M, Chan P, Cheng A, de Caen A, Duff JP, Escobedo M, Flores GE, Fuchs S, Girotra S, Hsu A, Joyner BL, Kleinman M, Lasa JJ, Lee HC, Lehotzky RE, Levy A, Mancini ME, McBride ME, Meckler G, Merchant RM, Morgan RW, Nadkarni V, Panchal AR, Peberdy MA, Raymond T, Roberts K, Sasson C, Schexnayder SM, Sutton RM, Terry M, Walsh B, Wang DS, Zelop CM, Edelson DP. Interim Guidance for Basic and Advanced Life Support in Children and Neonates With Suspected or Confirmed COVID-19. Pediatrics 2020:e20201405. [PMID: 32366608 DOI: 10.1542/peds.2020-1405] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Levy A, Doyen J, Botticella A, Bourdais R, Achkar S, Giraud P, Du C, Naltet C, Lavaud P, Besse B, Pradère P, Mercier O, Caramella C, Planchard D, Deutsch E, Le Péchoux C. [Role of immunotherapy in locally advanced non-small cell lung cancer]. Cancer Radiother 2020; 24:67-72. [PMID: 32037126 DOI: 10.1016/j.canrad.2019.09.007] [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: 08/26/2019] [Revised: 09/02/2019] [Accepted: 09/11/2019] [Indexed: 01/26/2023]
Abstract
Concomitant radiochemotherapy has been the standard of care for unresectable stage III non-small cell lung cancer (NSCLC), irrespective of histological sub-type or molecular characteristics. Currently, only 15-30 % of patients are alive five years after radiochemotherapy, and this figure remains largely unchanged despite multiple phase III randomised trials. In recent years, immune-checkpoint blockades with anti-PD-(L)1 have revolutionised the care of metastatic NSCLC, becoming the standard front- and second-line strategy. Several preclinical studies reported an increased tumour antigen release, improved antigen presentation, and T-cell infiltration in irradiated tumours. Immunotherapy has therefore recently been evaluated for patients with locally advanced stage III NSCLC. Following the PACIFIC trial, the anti-PD-L1 durvalumab antibody has emerged as a new standard consolidative treatment for patients with unresectable stage III NSCLC whose disease has not progressed following concomitant platinum-based chemoradiotherapy. Immunoradiotherapy therefore appears to be a promising association in patients with localised NSCLC. Many trials are currently evaluating the value of concomitant immunotherapy and chemoradiotherapy and/or consolidative chemotherapy with immunotherapy in patients with locally advanced unresectable NSCLC.
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Affiliation(s)
- A Levy
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France; Université Paris Sud, université Paris-Saclay, 94270, Le Kremlin-Bicêtre, France.
| | - J Doyen
- Département d'oncologie radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189, Nice cedex 2, France; Université Côte d'Azur, fédération Claude-Lalanne, Nice cedex 2, France
| | - A Botticella
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - R Bourdais
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - S Achkar
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - P Giraud
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - C Du
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - C Naltet
- Département de médecine oncologique, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805, Villejuif, France
| | - P Lavaud
- Département de médecine oncologique, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805, Villejuif, France
| | - B Besse
- Département de médecine oncologique, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805, Villejuif, France; Université Paris Sud, université Paris-Saclay, 94270, Le Kremlin-Bicêtre, France
| | - P Pradère
- Département de chirurgie vasculaire et thoracique, hôpital Marie-Lannelongue, université Paris-Saclay, Le Plessis Robinson, France
| | - O Mercier
- Département de chirurgie vasculaire et thoracique, hôpital Marie-Lannelongue, université Paris-Saclay, Le Plessis Robinson, France
| | - C Caramella
- Département d'imagerie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
| | - D Planchard
- Département de médecine oncologique, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805, Villejuif, France
| | - E Deutsch
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France; Université Paris Sud, université Paris-Saclay, 94270, Le Kremlin-Bicêtre, France
| | - C Le Péchoux
- Département d'oncologie radiothérapie, Gustave-Roussy, institut d'oncologie thoracique (IOT), université Paris-Saclay, 94805 Villejuif, France
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Levi-Zada A, Levy A, Rempoulakis P, Fefer D, Steiner S, Gazit Y, Nestel D, Yuval B, Byers JA. Diel rhythm of volatile emissions of males and females of the peach fruit fly Bactrocera zonata. J Insect Physiol 2020; 120:103970. [PMID: 31704255 DOI: 10.1016/j.jinsphys.2019.103970] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/19/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
Fruit flies in the genus Bactrocera are among the most destructive insect pests of fruits and vegetables throughout the world. A number of studies have identified volatiles from fruit flies, but few reports have demonstrated behavioral effects or sensitivities of fly antennae to these compounds. We applied a recently developed method of automated headspace analysis using SPME (Solid Phase Microextraction) fibers and GC-MS (gas chromatography mass spectrometry), termed SSGA, to reveal volatiles specific to each sex of B. zonata that are emitted in a diel periodicity. The volatiles released primarily at dusk were identified by GC-MS and chemical syntheses as several spiroacetals, pyrazines, and ethyl esters. Solvent extraction of male rectal glands or airborne collections from each sex, followed by GC-MS, showed that certain of the volatiles increase or decrease in quantity sex-specifically with age of the flies. Electroantennographic (EAG) analysis of dose-response indicates differences in sensitivities of male and female antenna to the various volatiles. Our study provides a comprehensive analysis of the volatile chemicals produced and released by B. zonata and their antennal responses. The possible pheromone and semiochemical roles of the various volatiles released by each sex and the difficulties of establishing behavioral functions are discussed.
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Affiliation(s)
- A Levi-Zada
- Department of Entomology, Agricultural Research Organization, Volcani Center, P.O.B 15159, Rishon LeZion 7505101, Israel.
| | - A Levy
- Department of Entomology, Agricultural Research Organization, Volcani Center, P.O.B 15159, Rishon LeZion 7505101, Israel; Department of Entomology, Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - P Rempoulakis
- Department of Entomology, Agricultural Research Organization, Volcani Center, P.O.B 15159, Rishon LeZion 7505101, Israel; NSW Department of Primary Industries, Ourimbah, NSW 2258, Australia
| | - D Fefer
- Department of Entomology, Agricultural Research Organization, Volcani Center, P.O.B 15159, Rishon LeZion 7505101, Israel
| | - S Steiner
- Department of Entomology, Agricultural Research Organization, Volcani Center, P.O.B 15159, Rishon LeZion 7505101, Israel
| | - Y Gazit
- The "Israel Cohen" Institute for Biological Control, Plants Production and Marketing Board, Citrus Division, Israel
| | - D Nestel
- Department of Entomology, Agricultural Research Organization, Volcani Center, P.O.B 15159, Rishon LeZion 7505101, Israel
| | - B Yuval
- Department of Entomology, Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - J A Byers
- Department of Entomology, Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Kervarrec T, Aljundi M, Appenzeller S, Samimi M, Maubec E, Cribier B, Berthon P, Deschamps L, Levy A, Bousquet G, Touzé A, Guyétant S, Schrama D, Houben R. Histogenèse du carcinome à cellules de Merkel. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Araujo GS, Vilasboa A, Britto MR, Bernardi G, von der Heyden S, Levy A, Floeter SR. Phylogeny of the comb-tooth blenny genus Scartella (Blenniiformes: Blenniidae) reveals several cryptic lineages and a trans-Atlantic relationship. Zool J Linn Soc 2019. [DOI: 10.1093/zoolinnean/zlz142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AbstractHere we present the first phylogeny of the genus Scartella based on mitochondrial data. The analysis strongly corroborates the validity of all species of the genus and shows that Scartella cristata, a species with a disjunct distribution, is a lineage complex comprising five clades: two in Caribbean waters, another in the East Atlantic/Mediterranean and two in Brazil. Brazilian clades occur in sympatry from Rio de Janeiro to Rio Grande do Sul states (southern Brazil). One clade (BRA 1) is unique to Brazil, while the other (BRA 2) is closely related to the eastern Atlantic lineage. Possible explanations for this pattern include both natural and anthropic mechanisms.
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Affiliation(s)
- G S Araujo
- Setor de Ictiologia, Departamento de Vertebrados, Universidade Federal do Rio de Janeiro/Museu Nacional, Rio de Janeiro, RJ, Brazil
- Universidade Federal do Rio de Janeiro, Instituto de Biodiversidade e Sustentabilidade, NUPEM/UFRJ, Avenida São José Barreto, Macaé, RJ, Brazil
| | - A Vilasboa
- Laboratório de Genética Pesqueira e da Conservação, Departamento de Genética, Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro – UERJ, Maracanã, Rio de Janeiro, RJ, Brazil
| | - M R Britto
- Setor de Ictiologia, Departamento de Vertebrados, Universidade Federal do Rio de Janeiro/Museu Nacional, Rio de Janeiro, RJ, Brazil
| | - G Bernardi
- Department of Ecology and Evolutionary Biology, University of California Santa Cruz, Santa Cruz, CA, USA
| | - S von der Heyden
- Evolutionary Genomics Group, Department of Botany and Zoology, University of Stellenbosch, Matieland, South Africa
| | - A Levy
- MARE – Marine and Environmental Sciences Centre, ISPA – Instituto Universitário, Lisbon, Portugal
| | - S R Floeter
- Departamento de Ecologia e Zoologia – CCB, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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Maidan I, Patashov D, Shustak S, Fahoum F, Gazit E, Shapiro B, Levy A, Sosnik R, Giladi N, Hausdorff JM, Mirelman A. A new approach to quantifying the EEG during walking: Initial evidence of gait related potentials and their changes with aging and dual tasking. Exp Gerontol 2019; 126:110709. [PMID: 31449852 DOI: 10.1016/j.exger.2019.110709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/16/2019] [Accepted: 08/21/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND The electroencephalogram (EEG) can be a useful tool to investigate the neurophysiology of gait during walking. Our aims were to develop an approach that identify and quantify event related potentials (ERPs) during a gait cycle and to examine the effects of aging and dual tasking on these gait related potentials (GRPs). METHODS 10 young and 10 older adults walked on a treadmill while wearing a wireless 20-channels EEG and accelerometers on the ankles. Each heel strike extracted from the accelerometers was used as an event to which the electrical brain activity pattern was locked. The subjects performed usual and dual task walking that included an auditory oddball task. GRPs amplitude and latency were computed, and a new measure referred to as Amplitude Pattern Consistency (APC) was developed to quantify the consistency of these GRP amplitudes within a gait cycle. The results were compared between and within groups using linear mixed model analysis. RESULTS The electrical pattern during a gait cycle consisted of two main positive GRPs. Differences in these GRPs between young and older adults were observed in Pz and Cz. In Pz, older adults had higher GRPs amplitude (p = 0.006, p = 0.010), and in Cz lower APC (p = 0.025). Alterations were also observed between the walking tasks. Both groups showed shorter latency during oddball walking compared to usual walking in Cz (p = 0.040). In addition, the APC in Cz was correlated with gait speed (r = 0.599, p = 0.011) in all subjects and with stride time variability in the older adults (r = -0.703, p = 0.023). CONCLUSIONS This study is the first to define specific gait related potentials within a gait cycle using novel methods for quantifying waveforms. Our findings show the potential of this approach to be applied broadly to study the EEG during gait in a variety of contexts. The observed changes in GRPs with aging and walking task and the relationship between GRPs and gait may suggest the neurophysiologic foundation for studying walking and for developing new approaches for improving gait.
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Affiliation(s)
- I Maidan
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
| | - D Patashov
- Faculty of Engineering, Holon Institute of Technology, Holon, Israel; Faculty of Sciences, Holon Institute of Technology, Holon, Israel
| | - S Shustak
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - F Fahoum
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - E Gazit
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - B Shapiro
- Faculty of Engineering, Holon Institute of Technology, Holon, Israel
| | - A Levy
- Faculty of Engineering, Holon Institute of Technology, Holon, Israel
| | - R Sosnik
- Faculty of Engineering, Holon Institute of Technology, Holon, Israel
| | - N Giladi
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - J M Hausdorff
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - A Mirelman
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Le Pechoux C, Botticella A, Levy A, Henry O, Chabert I, Caramella C. MS07.06 Hot Topics in SBRT - Biopsy, Central Lesions, Radiologic Evaluation. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.334] [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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Levra MG, Benet J, Hasan B, Berghmans T, Bruni A, Dingemans A, Levra NG, Edwards J, Faivre-Finn C, Girard N, Gobbini E, Greillier L, Hendriks L, Lantuejoul S, Levy A, Novello S, O'Brien M, Reck M, Pochesci A, Menis J, Besse B. MA08.02 Durvalumab Impact in the Treatment Strategy of Stage III Non-Small Cell Lung Cancer (NSCLC): An EORTC Young Investigator Lung Cancer Group Survey. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Levy A, Deutsch E, Sansonetti P, Nigro G. The bacterial receptor NOD2 mediates LGR5+ intestinal stem cells protection against irradiation via mitophagy activation. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz238.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Levy A, Rangel-Santos A, Torres LC, Silveira-Abreu G, Agena F, Carneiro-Sampaio M. T cell receptor excision circles as a tool for evaluating thymic function in young children. ACTA ACUST UNITED AC 2019; 52:e8292. [PMID: 31241713 PMCID: PMC6596370 DOI: 10.1590/1414-431x20198292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 04/18/2019] [Indexed: 11/21/2022]
Abstract
The thymus is a primary lymphoid organ responsible for the maturation of T cells as well as the immunological central tolerance. It is in the antenatal period and infancy that it plays its major role. In clinical practice, T cell receptor excision circles (TRECs) are considered a direct and reliable measure of the thymic function. TRECs are a by-product of DNA formation in gene rearrangement of T cell receptors. They are stable and they do not duplicate during mitosis, representing the recent emigrant T cells from the thymus. Despite their importance, TRECs have been neglected by physicians and there is a lack of data regarding thymic function during infancy of healthy children. In order to evaluate thymic function in the first years of life, we propose measuring TRECs as a valuable tool. One hundred and three blood samples from children and adolescents between 3 months and 20 years of age were analyzed. The mean TRECs count was 136.77±96.7 copies of TRECs/μL of DNA. The individuals between 0 and 5 years of age had significantly higher TRECs values than those between 10 and 20 years of age. No significant difference was observed in TRECs values among age groups below 5 years of age. An inverse correlation between TRECs and age was found (r=0.3 P=0.003). These data highlight and validate the evidence of decreased thymus function with age, even during infancy. Awareness should be raised with this important albeit ignored organ.
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Affiliation(s)
- A Levy
- Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - A Rangel-Santos
- Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - L C Torres
- Laboratório de Pesquisa Translacional, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE, Brasil
| | - G Silveira-Abreu
- Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - F Agena
- Instituto Central, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - M Carneiro-Sampaio
- Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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