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Souchet B, Audrain M, Gu Y, Lindberg MF, Orefice NS, Rey E, Cartier N, Janel N, Meijer L, Braudeau J. Cerebral Phospho-Tau Acts Synergistically with Soluble Aβ42 Leading to Mild Cognitive Impairment in AAV-AD Rats. J Prev Alzheimers Dis 2022; 9:480-490. [PMID: 35841249 DOI: 10.14283/jpad.2022.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a continuum of events beginning with an increase in brain soluble Aβ42 followed by the appearance of hyperphosphorylated tau (P-tau, asymptomatic stage). Mild Cognitive Impairment (MCI) then appears (prodromal stage). However, the individual contribution of these two soluble proteins in the onset of the first cognitive symptoms remains unclear. OBJECTIVES We sought to understand the specific impact of p-tau on the development of MCI in the AAV-AD rat model, a model of late-onset Alzheimer's disease (LOAD) predementia. METHODS We specifically reduced the phosphorylation level of tau while leaving Aβ42 levels unchanged using a DYRK1A protein kinase inhibitor, Leucettine L41, in an adeno-associated virus-based Alzheimer's disease (AAV-AD) rat model. Leucettine L41 was administered by intraperitoneal injection at 20 mg/kg per day in AAV-AD rats from 9 (late asymptomatic phase) to 10 (prodromal phase) months of age. RESULTS Decreased soluble forms of P-tau induced by chronic administration of Leucettine L41 did not change soluble Aβ42 levels but prevented MCI onset in 10-month-old AAV-AD rats. CONCLUSIONS The present study argues that P-tau is required to induce the development of MCI. Consistent with our previous findings that soluble Aβ42 is also required for MCI onset, the data obtained in the AAV-AD rat model confirm that the transition from the asymptomatic to the prodromal stage may be caused by the combined presence of both soluble brain forms of Aβ42 and p-tau, suggesting that the development of MCI may be the consequence of their synergistic action.
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Affiliation(s)
- B Souchet
- Jérôme Braudeau, AgenT SAS, Evry 91000, France,
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Souchet B, Audrain M, Gu Y, Lindberg M, Orefice N, Rey E, Cartier N, Janel N, Meijer L, Braudeau J. Erratum to: Cerebral phospho-tau acts synergistically with soluble Aβ42 leading to Mild Cognitive Impairment in AAV-AD rats. J Prev Alzheimers Dis 2022. [DOI: 10.14283/jpad.2022.74] [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: 11/05/2022]
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Simard C, Malhamé I, Skeith L, Carson MP, Rey E, Tagalakis V. Management of anticoagulation in pregnant women with venous thromboembolism: An international survey of clinical practice. Thromb Res 2021; 210:20-25. [PMID: 34968851 DOI: 10.1016/j.thromres.2021.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/25/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Venous thromboembolism (VTE) is an important cause of maternal morbidity and mortality. During pregnancy, VTE is treated with low-molecular-weight-heparin (LMWH). Studies assessing the optimal duration and peripartum management of therapeutic anticoagulation are lacking. This survey aimed to assess clinician practices for the management of anticoagulation in pregnant women with acute VTE. METHODS An electronic survey consisting of clinical scenarios addressing anticoagulation management for VTE in pregnancy was created. The target sample was clinicians likely to be involved in the management of pregnant women with acute VTE. The survey completion rate and proportion of individuals selecting a response were determined. RESULTS 96 respondents completed the survey including general internists (56.3%), hematologists (21.9%), and obstetricians (6.3%). In the management of a VTE in first or second trimester, most respondents preferred therapeutic LMWH until 6 weeks postpartum. In the first and second trimester, 48.0% and 37.5% of respondents, respectively, opted to reduce the dose of anticoagulation after 3 or 6 months. 29.2% of physicians opted for bridging with intravenous heparin around delivery when treating a VTE in the third trimester. 73.0% perceived an increased risk of clinically relevant non-major bleeding associated with the use of therapeutic anticoagulation in the peripartum and postpartum periods. CONCLUSIONS The survey highlights a wide variability of practice in the management of therapeutic anticoagulation in pregnancy. Larger scale studies with relevant clinical outcomes including thrombosis and bleeding risks are needed to inform clinical practice.
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Affiliation(s)
- C Simard
- Department of Medicine, McGill University, Montreal, Canada.
| | - I Malhamé
- Division of General Internal Medicine, Department of Medicine, McGill University Health Centre, McGill University, Montreal, Canada; Research Institute of the McGill University Health Centre, Montreal, Canada
| | - L Skeith
- Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Calgary, Canada; Department of Community Health Sciences, University of Calgary, Canada
| | - M P Carson
- Department of Medicine, Hackensack Meridian School of Medicine at Seton Hall University, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - E Rey
- Departments of Medicine and Obstetrics and Gynecology, CHU Sainte-Justine, University of Montreal, Montreal, Canada
| | - V Tagalakis
- Division of General Internal Medicine, Department of Medicine, Jewish General Hospital, McGill University, Montreal, Canada; Centre for Clinical Epidemiology of the Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.
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Magee LA, Singer J, Lee T, Rey E, Asztalos E, Hutton E, Helewa M, Logan AG, Ganzevoort W, Welch R, Thornton JG, Woo Kinshella ML, Green M, Tsigas E, von Dadelszen P. The impact of pre-eclampsia definitions on the identification of adverse outcome risk in hypertensive pregnancy - analyses from the CHIPS trial (Control of Hypertension in Pregnancy Study). BJOG 2021; 128:1373-1382. [PMID: 33230924 DOI: 10.1111/1471-0528.16602] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine the association between pre-eclampsia definition and pregnancy outcome. DESIGN Secondary analysis of Control of Hypertension in Pregnancy Study (CHIPS) trial data. SETTING International multicentre randomised controlled trial (RCT). POPULATION In all, 987 women with non-severe non-proteinuric pregnancy hypertension. METHODS We evaluated the association between pre-eclampsia definitions and adverse pregnancy outcomes, stratified by hypertension type and blood pressure control. MAIN OUTCOME MEASURES Main CHIPS trial outcomes: primary (perinatal loss or high-level neonatal care for >48 hours), secondary (serious maternal complications), birthweight <10th centile, severe maternal hypertension, delivery at <34 or <37 weeks, and maternal hospitalisation before birth. RESULTS Of 979/987 women with informative data, 280 (28.6%) progressed to pre-eclampsia defined restrictively by new proteinuria, and 471 (48.1%) to pre-eclampsia defined broadly as proteinuria or one/more maternal symptoms, signs or abnormal laboratory tests. The broad (versus restrictive) definition had significantly higher sensitivities (range 62-79% versus 36-50%), lower specificities (range 53-65% versus 72-82%), and similar or higher diagnostic odds ratios and 'true-positive' to 'false-positive' ratios. Stratified analyses showed similar results. Addition of available fetoplacental manifestations (stillbirth or birthweight <10th centile) to the broad pre-eclampsia definition improved sensitivity (74-87%). CONCLUSIONS A broad (versus restrictive) pre-eclampsia definition better identifies women who develop adverse pregnancy outcomes. These findings should be replicated in a prospective study within routine healthcare to ensure that the anticipated increase in surveillance and intervention in a larger number of women with pre-eclampsia is associated with improved outcomes, reasonable costs and congruence with women's values. TWEETABLE ABSTRACT A broad (versus restrictive) pre-eclampsia definition better identifies the risk of adverse pregnancy outcomes.
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Affiliation(s)
- L A Magee
- Department of Women and Children's Health, King's College London, London, UK
| | - J Singer
- School of Population and Public Health, Centre for Health Evaluation and Outcome Science, Providence Health Care Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - T Lee
- Centre for Health Evaluation and Outcome Science, Providence Health Care Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - E Rey
- Department of Medicine, Université de Montreal, Montreal, QC, Canada.,Department of Obstetrics and Gynaecology, Université de Montreal, Montreal, QC, Canada
| | - E Asztalos
- Pediatrics, University of Toronto, Toronto, ON, Canada
| | - E Hutton
- Midwifery, McMaster University, Hamilton, ON, Canada
| | - M Helewa
- Obstetrics and Gynaecology, University of Manitoba, Winnipeg, MB, Canada
| | - A G Logan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - W Ganzevoort
- Department of Obstetrics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - R Welch
- University of Plymouth, Plymouth, UK
| | - J G Thornton
- Division of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - M Green
- Action on Pre-eclampsia Charity (APEC), Evesham, UK
| | - E Tsigas
- Preeclampsia Foundation, Melbourne, FL, USA
| | - P von Dadelszen
- Department of Women and Children's Health, King's College London, London, UK
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Pons G, Rey E, Richard MO, Vauzelle F, Francoual C, Moran C, d’Athis P, Badoual J, Olive G. Nitrofurantoin Excretion in Human Milk. ACTA ACUST UNITED AC 2019. [DOI: 10.1159/000480913] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Rodrigues C, Chhun S, Chiron C, Dulac O, Rey E, Pons G, Jullien V. A population pharmacokinetic model taking into account protein binding for the sustained-release granule formulation of valproic acid in children with epilepsy. Eur J Clin Pharmacol 2018; 74:793-803. [PMID: 29564480 DOI: 10.1007/s00228-018-2444-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 03/12/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE The objective of this work was to develop a population pharmacokinetic model for a prolonged-release granule formulation of valproic acid (VPA) in children with epilepsy and to determine the doses providing a VPA trough concentration (Ctrough) within the target range (50-100 mg/L). METHODS Ninety-eight children (1-17.6 years, 325 plasma samples) were included in the study. The model was built with NONMEM 7.3. The probability to obtain Ctrough between 50 and 100 mg/L was determined by the Monte Carlo simulations for doses of 20, 30, 40, and 60 mg/kg/day and body weights between 10 and 70 kg. RESULTS A one compartment model, with first-order absorption and flip-flop parameterization and linear elimination, but taking protein binding into account, was used to describe the data. Typical values for unbound VPA clearance and distribution volume were 6.24 L/h/70 kg and 130 L/h/70 kg respectively. Both parameters were related to body weight via allometric models. The highest probability to obtain a Ctrough within the target range for 10-kg children was obtained with a 40 mg/kg daily dose, whereas daily doses of 30 and 20 mg/kg were found appropriate for 20 to 30- and ≥ 40-kg children respectively. However, for these same doses, the exposure to unbound VPA could differ by 40%. CONCLUSIONS If the present study supports the current dose recommendations of 20-30 mg/kg/day, except for children under 20 kg, who may need higher doses, it also highlights the need for further research on the pharmacokinetics/pharmacodynamic profile of unbound VPA.
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Affiliation(s)
| | - Stéphanie Chhun
- Hôpital Necker-Enfants Malades - Enfants Malades, Inserm U1151, INEM, Laboratoire d'immunologie biologique, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Catherine Chiron
- INSERM U1129, Paris Descartes University, CEA, Gif-sur-Yvette, Paris, France
| | - Olivier Dulac
- INSERM U1129, Paris Descartes University, CEA, Gif-sur-Yvette, Paris, France
| | - Elisabeth Rey
- INSERM U1129, Paris Descartes University, CEA, Gif-sur-Yvette, Paris, France
| | - Gérard Pons
- INSERM U1129, Paris Descartes University, CEA, Gif-sur-Yvette, Paris, France
| | - Vincent Jullien
- INSERM U1129, Paris Descartes University, CEA, Gif-sur-Yvette, Paris, France. .,Service de Pharmacologie, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015, Paris, France.
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Serrano Falcón B, Megía Sánchez M, Ruiz de León A, Rey E. Beer effects on postprandial digestive symptoms and gastroesophagic physiology. Neurogastroenterol Motil 2018; 30. [PMID: 29542842 DOI: 10.1111/nmo.13325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 02/06/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Beer has been related to gastroesophageal reflux (GER) and dyspepsia, based on its alcohol and gas content. The aim of this study is to evaluate the association between moderate consumption of traditional and alcohol-free beer and upper digestive symptoms, gastric accommodation and GER. METHODS Healthy adults without frequent gastrointestinal symptoms and GER disease were included. The intervention involved administration of traditional beer to 10 subjects (substudy 1) and alcohol-free beer to 20 (substudy 2); control intervention entailed administration of water. Study duration was 2 weeks (control/intervention). Postprandial gastric accommodation was assessed through the maximum tolerated volume during a nutrient drink test after the ingestion of water (day 1) and beer (day 8), in which symptoms of dyspepsia were evaluated every 5 minutes. An impedance-pH monitoring assessed 24 hours and post-NDT GER (days 1 and 8). Symptoms were evaluated daily during the study. The defined variables were compared between visits and weeks using a nonparametric test for paired data. KEY RESULTS Dyspepsia symptoms showed a progressive increase during the NDT for both interventions in the 2 substudies, though no significant differences were detected in the MTV analysis. No differences were detected in the sum of weekly symptoms. The analysis of impedance-pH monitoring did not show any differences between intervention and control visits for both interventions. CONCLUSIONS AND INFERENCES Moderate consumption of traditional and alcohol-free beer does not increase dyspeptic symptoms or GER in healthy subjects, whether in a controlled-intake or real-life situation. Neither gastric accommodation nor reflux episodes are modified in this context.
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Affiliation(s)
- B Serrano Falcón
- Department of Digestive Diseases, Hospital Clínico San Carlos, Madrid, Spain
| | - M Megía Sánchez
- Department of Digestive Diseases, Hospital Clínico San Carlos, Madrid, Spain
| | - A Ruiz de León
- Department of Digestive Diseases, Hospital Clínico San Carlos, Madrid, Spain
- Facultad de Medicina, Universidad Cumplutense, Madrid, Spain
| | - E Rey
- Department of Digestive Diseases, Hospital Clínico San Carlos, Madrid, Spain
- Facultad de Medicina, Universidad Cumplutense, Madrid, Spain
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Rodrigues C, Chiron C, Rey E, Dulac O, Comets E, Pons G, Jullien V. Population pharmacokinetics of oxcarbazepine and its monohydroxy derivative in epileptic children. Br J Clin Pharmacol 2017; 83:2695-2708. [PMID: 28771787 DOI: 10.1111/bcp.13392] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 06/27/2017] [Accepted: 07/30/2017] [Indexed: 12/31/2022] Open
Abstract
AIMS Oxcarbazepine is an antiepileptic drug with an activity mostly due to its monohydroxy derivative metabolite (MHD). A parent-metabolite population pharmacokinetic model in children was developed to evaluate the consistency between the recommended paediatric doses and the reference range for trough concentration (Ctrough ) of MHD (3-35 mg l-1 ). METHODS A total of 279 plasma samples were obtained from 31 epileptic children (age 2-12 years) after a single dose of oxcarbazepine. Concentration-time data were analysed with Monolix 4.3.2. The probability to obtain Ctrough between 3-35 mg l-1 was determined by Monte Carlo simulations for doses ranging from 10 to 90 mg kg-1 day-1 . RESULTS A parent-metabolite model with two compartments for oxcarbazepine and one compartment for MHD best described the data. Typical values for oxcarbazepine clearance, central and peripheral distribution volume and distribution clearance were 140 l h-1 70 kg-1 , 337 l 70 kg-1 , 60.7 l and 62.5 l h-1 , respectively. Typical values for MHD clearance and distribution volume were 4.11 l h-1 70 kg-1 and 54.8 l 70 kg-1 respectively. Clearances and distribution volumes of oxcarbazepine and MHD were related to body weight via empirical allometric models. Enzyme-inducing antiepileptic drugs (EIAEDs) increased MHD clearance by 29.3%. Fifty-kg children without EIAEDs may need 20-30 mg kg-1 day-1 instead of the recommended target maintenance dose (30-45 mg kg-1 day-1 ) to obtain Ctrough within the reference range. By contrast, 10-kg children with EIAEDs would need 90 mg kg-1 day-1 instead of the maximum recommended dose of 60 mg kg-1 day-1 . CONCLUSION This population pharmacokinetic model of oxcarbazepine supports current dose recommendations, except for 10-kg children with concomitant EIAEDs and 50-kg children without EIAEDs.
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Affiliation(s)
- Christelle Rodrigues
- INSERM U1129, Paris, France.,Paris Descartes University, CEA, Gif-sur-Yvette, France
| | - Catherine Chiron
- INSERM U1129, Paris, France.,Paris Descartes University, CEA, Gif-sur-Yvette, France
| | - Elisabeth Rey
- INSERM U1129, Paris, France.,Paris Descartes University, CEA, Gif-sur-Yvette, France
| | - Olivier Dulac
- INSERM U1129, Paris, France.,Paris Descartes University, CEA, Gif-sur-Yvette, France
| | - Emmanuelle Comets
- INSERM, IAME, UMR1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,INSERM, CIC 1414, Université Rennes 1, Rennes, France
| | - Gérard Pons
- INSERM U1129, Paris, France.,Paris Descartes University, CEA, Gif-sur-Yvette, France
| | - Vincent Jullien
- INSERM U1129, Paris, France.,Paris Descartes University, CEA, Gif-sur-Yvette, France.,Service de Pharmacologie, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France
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Affiliation(s)
- C. Lago-Peñas
- Faculty of Sport Sciences, University of Vigo, Pontevedra, Spain
| | - E. Rey
- Faculty of Sport Sciences, University of Vigo, Pontevedra, Spain
| | | | - L. Casais
- Faculty of Sport Sciences, University of Vigo, Pontevedra, Spain
| | - E. Domínguez
- Faculty of Sport Sciences, University of Vigo, Pontevedra, Spain
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Mearin F, Ciriza C, Mínguez M, Rey E, Mascort J, Peña E, Cañones P, Júdez J. Guía de práctica clínica del síndrome del intestino irritable con estreñimiento y estreñimiento funcional en adultos: tratamiento. (Parte 2 de 2). Semergen 2017; 43:123-140. [DOI: 10.1016/j.semerg.2017.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 01/12/2017] [Accepted: 01/12/2017] [Indexed: 12/14/2022]
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Mearin F, Ciriza C, Mínguez M, Rey E, Mascort JJ, Peña E, Cañones P, Júdez J. [Irritable bowel syndrome with constipation and functional constipation in adults: Treatment (Part 2 of 2)]. Aten Primaria 2017; 49:177-194. [PMID: 28238460 PMCID: PMC6875999 DOI: 10.1016/j.aprim.2017.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 05/12/2016] [Accepted: 01/12/2017] [Indexed: 12/14/2022] Open
Abstract
In this Clinical practice guide we examine the diagnostic and therapeutic management of adult patients with constipation and abdominal discomfort, at the confluence of the spectrum of irritable bowel syndrome and functional constipation. Both fall within the framework of functional intestinal disorders and have major personal, health and social impact, altering the quality of life of the patients affected. The former is a subtype of irritable bowel syndrome in which constipation and altered bowel habit predominate, often along with recurring abdominal pain, bloating and abdominal distension. Constipation is characterised by infrequent or hard-to-pass bowel movements, often accompanied by straining during defecation or the sensation of incomplete evacuation. There is no underlying organic cause in the majority of cases; it being considered a functional bowel disorder. There are many clinical and pathophysiological similarities between the two conditions, the constipation responds in a similar way to commonly used drugs, the fundamental difference being the presence or absence of pain, but not in an "all or nothing" way. The severity of these disorders depends not only on the intensity of the intestinal symptoms but also on other biopsychosocial factors: association of gastrointestinal and extraintestinal symptoms, degree of involvement, forms of perception and behaviour. Functional bowel disorders are diagnosed using the Rome criteria. This Clinical practice guide adapts to the Rome IV criteria published at the end of May 2016. The first part (96, 97, 98) examined the conceptual and pathophysiological aspects, alarm criteria, diagnostic test and referral criteria between Primary Care and Gastroenterology. This second part reviews all the available treatment alternatives (exercise, fluid ingestion, diet with soluble fibre-rich foods, fibre supplements, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antdepressants, psychological treatment, acupuncture, enemas, sacral root neurostimulation and surgery), and practical recommendations are made for each.
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Affiliation(s)
- F Mearin
- Coordinación de la GPC, Comité Roma de Trastornos Funcionales Intestinales, Asociación Española de Gastroenterología (AEG), Centro Médico Teknon, Barcelona, España
| | - C Ciriza
- Grupo de Trastornos Funcionales, Sociedad Española de Patología Digestiva (SEPD), Hospital Universitario Doce de Octubre, Madrid, España
| | - M Mínguez
- AEG y SEPD, Hospital Clínico Universitario, Universitat de Valencia, Valencia, España
| | - E Rey
- SEPD, Hospital Clínico Universitario San Carlos, Madrid, España
| | - J J Mascort
- Secretaría Científica, Sociedad Española de Medicina de Familia y Comunitaria (semFYC), España.
| | - E Peña
- Coordinación de Digestivo, Sociedad Española de Médicos de Atención Primaria (SEMERGEN), España
| | - P Cañones
- Coordinación de Digestivo, Sociedad Española de Médicos Generales y de Familia (SEMG), España
| | - J Júdez
- Departamento de Gestión del Conocimiento, SEPD, España
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Tack J, Boardman H, Layer P, Schiefke I, Jayne D, Scarpignato C, Fox M, Frieling T, Ducrotte P, Hamdy S, Gill K, Ciriza de Los Rios C, Felt-Bersma R, De Looze D, Stanghellini V, Drewes AM, Simrén M, Pehl C, Hoheisel T, Leodolter A, Rey E, Dalrymple J, Emmanuel A. An expert consensus definition of failure of a treatment to provide adequate relief (F-PAR) for chronic constipation - an international Delphi survey. Aliment Pharmacol Ther 2017; 45:434-442. [PMID: 27910115 DOI: 10.1111/apt.13874] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 03/25/2016] [Accepted: 11/02/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND As treatments for constipation become increasingly available, it is important to know when to progress along the treatment algorithm if the patient is not better. AIM To establish the definition of failure of a treatment to provide adequate relief (F-PAR) to support this management and referral process in patients with chronic constipation. METHODS We conducted an international Delphi Survey among gastroenterologists and general practitioners with a special interest in chronic constipation. An initial questionnaire based on recognised rating scales was developed following a focus group. Data were collected from two subsequent rounds of questionnaires completed by all authors. Likert scales were used to establish a consensus on a shorter list of more severe symptoms. RESULTS The initial focus group yielded a first round questionnaire with 84 statements. There was good consensus on symptom severity and a clear severity response curve, allowing 67 of the symptom-severity pairings to be eliminated. Subsequently, a clear consensus was established on further reduction to eight symptom statements in the final definition, condensed by the steering committee into five diagnostic statements (after replicate statements had been removed). CONCLUSIONS We present an international consensus on chronic constipation, of five symptoms and their severities, any of which would be sufficient to provide clinical evidence of treatment failure. We also provide data representing an expert calibration of commonly used rating scales, thus allowing results of clinical trials expressed in terms of those scales to be converted into estimates of rates of provision of adequate relief.
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Mearin F, Ciriza C, Mínguez M, Rey E, Mascort JJ, Peña E, Cañones P, Júdez J. [Clinical practice guidelines: Irritable bowel syndrome with constipation and functional constipation in adults: Concept, diagnosis, and healthcare continuity. (Part 1 of 2)]. Aten Primaria 2017; 49:42-55. [PMID: 28027792 PMCID: PMC6875955 DOI: 10.1016/j.aprim.2016.11.003] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 11/01/2016] [Indexed: 12/15/2022] Open
Abstract
In this Clinical practice guide, an analysis is made of the diagnosis and treatment of adult patients with constipation and abdominal discomfort, under the spectrum of irritable bowel syndrome and functional constipation. These have an important personal, health and social impact, affecting the quality of life of these patients. In irritable bowel syndrome with a predominance of constipation, this is the predominant change in bowel movements, with recurrent abdominal pain, bloating and frequent abdominal distension. Constipation is characterised by infrequent or difficulty in bowel movements, associated with excessive straining during bowel movement or sensation of incomplete evacuation. There is often no underling cause, with an intestinal functional disorder being considered. They have many clinical and pathophysiological similarities, with a similar response of the constipation to common drugs. The fundamental difference is the presence or absence of pain, but not in a way evaluable way; "all or nothing". The severity depends on the intensity of bowel symptoms and other factors, a combination of gastrointestinal and extra-intestinal symptoms, level of involvement, forms of perception, and behaviour. The Rome criteria diagnose functional bowel disorders. This guide is adapted to the Rome criteria IV (May 2016) and in this first part an analysis is made of the alarm criteria, diagnostic tests, and the criteria for referral between Primary Care and Digestive Disease specialists. In the second part, a review will be made of the therapeutic alternatives available (exercise, diet, drug therapies, neurostimulation of sacral roots, or surgery), making practical recommendations for each one of them.
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Affiliation(s)
- F Mearin
- Coordinación de la guía de práctica clínica (GPC), Comité Roma de Trastornos Funcionales Intestinales, Asociación Española de Gastroenterología (AEG), Centro Médico Teknon, Barcelona, España
| | - C Ciriza
- Grupo de Trastornos Funcionales, Sociedad Española de Patología Digestiva (SEPD), Hospital Universitario Doce de Octubre, Madrid, España
| | - M Mínguez
- AEG y SEPD, Hospital Clínico Universitario, Universitat de Valencia, Valencia, España
| | - E Rey
- SEPD Hospital Clínico Universitario San Carlos, Madrid, España
| | - J J Mascort
- Secretaría Científica, Sociedad Española de Medicina de Familia y Comunitaria (semFYC), España.
| | - E Peña
- Coordinación de Digestivo, Sociedad Española de Médicos de Atención Primaria (SEMERGEN), España
| | - P Cañones
- Coordinación de Digestivo, Sociedad Española de Médicos Generales y de Familia (SEMG), España
| | - J Júdez
- Departamento de Gestión del Conocimiento, SEPD, España
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Mearin F, Ciriza C, Mínguez M, Rey E, Mascort JJ, Peña E, Cañones P, Júdez J. [Clinical practice guidelines: Irritable bowel syndrome with constipation and functional constipation in adults: Concept, diagnosis, and healthcare continuity. (Part 1 of 2)]. Semergen 2016; 43:43-56. [PMID: 27810257 DOI: 10.1016/j.semerg.2016.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/13/2016] [Accepted: 06/14/2016] [Indexed: 12/19/2022]
Abstract
In this Clinical practice guide, an analysis is made of the diagnosis and treatment of adult patients with constipation and abdominal discomfort, under the spectrum of irritable bowel syndrome and functional constipation. These have an important personal, health and social impact, affecting the quality of life of these patients. In irritable bowel syndrome with a predominance of constipation, this is the predominant change in bowel movements, with recurrent abdominal pain, bloating and frequent abdominal distension. Constipation is characterised by infrequent or difficulty in bowel movements, associated with excessive straining during bowel movement or sensation of incomplete evacuation. There is often no underling cause, with an intestinal functional disorder being considered. They have many clinical and pathophysiological similarities, with a similar response of the constipation to common drugs. The fundamental difference is the presence or absence of pain, but not in a way evaluable way; "all or nothing". The severity depends on the intensity of bowel symptoms and other factors, a combination of gastrointestinal and extra-intestinal symptoms, level of involvement, forms of perception, and behaviour. The Rome criteria diagnose functional bowel disorders. This guide is adapted to the Rome criteria IV (May 2016) and in this first part an analysis is made of the alarm criteria, diagnostic tests, and the criteria for referral between Primary Care and Digestive Disease specialists. In the second part, a review will be made of the therapeutic alternatives available (exercise, diet, drug therapies, neurostimulation of sacral roots, or surgery), making practical recommendations for each one of them.
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Affiliation(s)
- F Mearin
- Coordinación de la guía de práctica clínica (GPC), Comité Roma de Trastornos Funcionales Intestinales, Asociación Española de Gastroenterología (AEG), Centro Médico Teknon, Barcelona, España
| | - C Ciriza
- Grupo de Trastornos Funcionales, Sociedad Española de Patología Digestiva (SEPD), Hospital Universitario Doce de Octubre, Madrid, España
| | - M Mínguez
- AEG y SEPD, Hospital Clínico Universitario, Universitat de Valencia, Valencia, España
| | - E Rey
- SEPD Hospital Clínico Universitario San Carlos, Madrid, España
| | - J J Mascort
- Secretaría Científica, Sociedad Española de Medicina de Familia y Comunitaria (semFYC), España
| | - E Peña
- Coordinación de Digestivo, Sociedad Española de Médicos de Atención Primaria (SEMERGEN), España.
| | - P Cañones
- Coordinación de Digestivo, Sociedad Española de Médicos Generales y de Familia (SEMG), España
| | - J Júdez
- Departamento de Gestión del Conocimiento, SEPD, España
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- Sociedad Española de Patología Digestiva (SEPD), Sociedad Española de Medicina de Familia y Comunitaria (semFYC), Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Sociedad Española de Médicos Generales y de Familia (SEMG)
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15
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Rey E, Padrón-Cabo A, Barcala-Furelos R, Mecías-Calvo M. Effect of High and Low Flexibility Levels on Physical Fitness and Neuromuscular Properties in Professional Soccer Players. Int J Sports Med 2016; 37:878-83. [PMID: 27410769 DOI: 10.1055/s-0042-109268] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to analyse the impact of high and low flexibility levels of hamstring and quadriceps muscles on physical fitness and neuromuscular properties in professional soccer players. 62 male professional soccer players participated in this study and performed 2 instrumented flexibility tests (passive straight leg raise [PSLR] and quadriceps flexibility [QF]). Anaerobic performance was assessed using countermovement jump (CMJ), Abalakov vertical jump, 20-m sprint, and Balsom agility test. A k-means cluster analysis was performed to identify a cut-off value of hamstring and quadriceps flexibility and classify players as high hamstring flexibility (HHF) and low hamstring flexibility (LHF) or high quadriceps flexibility (HQF) and low quadriceps flexibility (LQF), respectively, according to the PSLR and QF performances. The LQF players performed better than HQF on CMJ (p=0.042, ES: 0.64) and Balsom agility test (p=0.029, ES: 0.68). In addition, LQF showed higher muscular stiffness than HQF players (p=0.002, ES: 0.88). There were no significant differences between HHF and LHF groups. When pooling the HQF and LQF players' data, the Pearson's correlation showed significant moderate positive association between muscular stiffness and QF (r=0.516, p<0.001). These results support the rationale that baseline stiffness is likely to influence athletic performance rather than flexibility level in soccer players.
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Affiliation(s)
- E Rey
- Faculty of Education and Sports Sciences, University of Vigo, Pontevedra, Spain
| | - A Padrón-Cabo
- Faculty of Education and Sports Sciences, University of Vigo, Pontevedra, Spain
| | - R Barcala-Furelos
- Faculty of Education and Sports Sciences, University of Vigo, Pontevedra, Spain
| | - M Mecías-Calvo
- Faculty of Education and Sports Sciences, University of Vigo, Pontevedra, Spain
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16
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Magee LA, Dadelszen P, Singer J, Lee T, Rey E, Ross S, Asztalos E, Murphy KE, Menzies J, Sanchez J, Gafni A, Gruslin A, Helewa M, Hutton E, Koren G, Lee SK, Logan AG, Ganzevoort JW, Welch R, Thornton JG, Moutquin J. Control of Hypertension In Pregnancy Study randomised controlled trial—are the results dependent on the choice of labetalol or methyldopa? BJOG 2015; 123:1135-41. [DOI: 10.1111/1471-0528.13568] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 12/01/2022]
Affiliation(s)
- LA Magee
- Medicine University of British Columbia Vancouver BC Canada
- Obstetrics and Gynaecology University of British Columbia Vancouver BC Canada
- School of Population and Public Health University of British Columbia Vancouver BC Canada
| | - P Dadelszen
- Obstetrics and Gynaecology University of British Columbia Vancouver BC Canada
- School of Population and Public Health University of British Columbia Vancouver BC Canada
| | - J Singer
- School of Population and Public Health University of British Columbia Vancouver BC Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS) Providence Health Care Research Institute UBC Vancouver BC Canada
| | - T Lee
- Centre for Health Evaluation and Outcome Sciences (CHÉOS) Providence Health Care Research Institute UBC Vancouver BC Canada
| | - E Rey
- Medicine and Obstetrics and Gynaecology University of Montreal Montreal QC Canada
| | - S Ross
- Obstetrics and Gynaecology University of Alberta Edmonton AB Canada
| | - E Asztalos
- Paediatrics University of Toronto Toronto ON Canada
- Obstetrics and Gynaecology University of Toronto Toronto ON Canada
- The Centre for Mother Infant and Child Research Sunnybrook Research Institute University of Toronto Toronto ON Canada
| | - KE Murphy
- Obstetrics and Gynaecology University of Toronto Toronto ON Canada
- The Centre for Mother Infant and Child Research Sunnybrook Research Institute University of Toronto Toronto ON Canada
| | - J Menzies
- Obstetrics and Gynaecology University of British Columbia Vancouver BC Canada
| | - J Sanchez
- The Centre for Mother Infant and Child Research Sunnybrook Research Institute University of Toronto Toronto ON Canada
| | - A Gafni
- Clinical Epidemiology and Biostatistics McMaster University Hamilton ON Canada
| | - A Gruslin
- Obstetrics and Gynaecology University of Ottawa Ottawa ON Canada
| | - M Helewa
- Obstetrics and Gynaecology University of Manitoba Winnipeg MB Canada
| | - E Hutton
- Obstetrics and Gynaecology McMaster University Hamilton ON Canada
| | - G Koren
- Paediatrics University of Toronto Toronto ON Canada
| | - SK Lee
- Paediatrics University of Toronto Toronto ON Canada
| | - AG Logan
- Medicine University of Toronto Toronto ON Canada
| | - JW Ganzevoort
- Obstetrics and Gynaecology University of Amsterdam Amsterdam the Netherlands
| | - R Welch
- Obstetrics and Gynaecology Derriford Hospital Plymouth UK
| | - JG Thornton
- Obstetrics and Gynaecology University of Nottingham Nottingham UK
| | - J‐M Moutquin
- Obstetrics and Gynaecology Universite de Sherbrooke Sherbrooke QC Canada
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Magee LA, von Dadelszen P, Singer J, Lee T, Rey E, Ross S, Asztalos E, Murphy KE, Menzies J, Sanchez J, Gafni A, Gruslin A, Helewa M, Hutton E, Koren G, Lee SK, Logan AG, Ganzevoort JW, Welch R, Thornton JG, Moutquin JM. Do labetalol and methyldopa have different effects on pregnancy outcome? Analysis of data from the Control of Hypertension In Pregnancy Study (CHIPS) trial. BJOG 2015; 123:1143-51. [PMID: 26265372 DOI: 10.1111/1471-0528.13569] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare pregnancy outcomes, accounting for allocated group, between methyldopa-treated and labetalol-treated women in the CHIPS Trial (ISRCTN 71416914) of 'less tight' versus 'tight' control of pregnancy hypertension. DESIGN Secondary analysis of CHIPS Trial cohort. SETTING International randomised controlled trial (94 sites, 15 countries). POPULATION OR SAMPLE Of 987 CHIPS recruits, 481/566 (85.0%) women treated with antihypertensive therapy at randomisation. Of 981 (99.4%) women followed to delivery, 656/745 (88.1%) treated postrandomisation. METHODS Logistic regression to compare outcomes among women who took methyldopa or labetalol, adjusted for the influence of baseline factors. MAIN OUTCOME MEASURES CHIPS primary (perinatal loss or high level neonatal care for >48 hours) and secondary (serious maternal complications) outcomes, birthweight <10th centile, severe maternal hypertension, pre-eclampsia and delivery at <34 or <37 weeks. RESULTS Methyldopa and labetalol were used commonly at randomisation (243/987, 24.6% and 238/987, 24.6%, respectively) and post-randomisation (224/981, 22.8% and 433/981, 44.1%, respectively). Following adjusted analyses, methyldopa (versus labetalol) at randomisation was associated with fewer babies with birthweight <10th centile [adjusted odds ratio (aOR) 0.48; 95% CI 0.20-0.87]. Methyldopa (versus labetalol) postrandomisation was associated with fewer CHIPS primary outcomes (aOR 0.64; 95% CI 0.40-1.00), birthweight <10th centile (aOR 0.54; 95% CI 0.32-0.92), severe hypertension (aOR 0.51; 95% CI 0.31-0.83), pre-eclampsia (aOR 0.55; 95% CI 0.36-0.85), and delivery at <34 weeks (aOR 0.53; 95% CI 0.29-0.96) or <37 weeks (aOR 0.55; 95% CI 0.35-0.85). CONCLUSION These nonrandomised comparisons are subject to residual confounding, but women treated with methyldopa (versus labetalol), particularly those with pre-existing hypertension, may have had better outcomes. TWEETABLE ABSTRACT There was no evidence that women treated with methyldopa versus labetalol had worse outcomes.
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Affiliation(s)
- L A Magee
- Medicine, University of British Columbia, Vancouver, BC, Canada.,Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | - P von Dadelszen
- Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - J Singer
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Health Care Research Institute, UBC, Vancouver, BC, Canada
| | - T Lee
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Health Care Research Institute, UBC, Vancouver, BC, Canada
| | - E Rey
- Medicine and Obstetrics and Gynaecology, University of Montreal, Montreal, QC, Canada
| | - S Ross
- Obstetrics and Gynaecology, University of Alberta, Edmonton, AB, Canada
| | - E Asztalos
- Paediatrics, University of Toronto, Toronto, ON, Canada.,Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.,The Centre for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - K E Murphy
- Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.,The Centre for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - J Menzies
- Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - J Sanchez
- The Centre for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - A Gafni
- Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - A Gruslin
- Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON, Canada
| | - M Helewa
- Obstetrics and Gynaecology, University of Manitoba, Winnipeg, MB, Canada
| | - E Hutton
- Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada
| | - G Koren
- Paediatrics, University of Toronto, Toronto, ON, Canada
| | - S K Lee
- Paediatrics, University of Toronto, Toronto, ON, Canada
| | - A G Logan
- Medicine, University of Toronto, Toronto, ON, Canada
| | - J W Ganzevoort
- Obstetrics and Gynaecology, University of Amsterdam, Amsterdam, the Netherlands
| | - R Welch
- Obstetrics and Gynaecology, Derriford Hospital, Devon, UK
| | - J G Thornton
- Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK
| | - J-M Moutquin
- Obstetrics and Gynaecology, Universite de Sherbrooke, Sherbrooke, QC, Canada
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Piessevaux H, Corazziari E, Rey E, Simren M, Wiechowska-Kozlowska A, Kerstens R, Cools M, Barrett K, Levine A. A randomized, double-blind, placebo-controlled trial to evaluate the efficacy, safety, and tolerability of long-term treatment with prucalopride. Neurogastroenterol Motil 2015; 27:805-15. [PMID: 25808103 DOI: 10.1111/nmo.12553] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 02/24/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Randomized trials have confirmed the efficacy of prucalopride for the treatment of chronic constipation up to 12 weeks. This study aimed to assess the efficacy of prucalopride over a 24-week period (ClinicalTrials.gov: NCT01424228). METHODS Adults with chronic constipation and ≤2 spontaneous complete bowel movements (SCBMs)/week were randomized to receive prucalopride 2 mg or placebo daily for 24 weeks. The primary endpoint was the proportion of patients achieving a mean of ≥3 SCBMs/week over the treatment period, assessed using daily e-diaries. Secondary outcomes and safety parameters were assessed throughout the study. KEY RESULTS Overall, 361 patients were randomized and received prucalopride or placebo. Baseline characteristics were similar in the prucalopride (N = 181) and placebo (N = 180) groups. Mean age was 48.9 years (standard deviation, 16.0) and most patients were women. The proportion of participants achieving the primary endpoint was not statistically different between the prucalopride and placebo groups (25.1% vs 20.7%; p = 0.367). There was also no statistically significant difference between groups over the first 12-week period (prucalopride, 25.1%; placebo, 20.1%; p = 0.341). There were no statistically significant differences between groups for most secondary endpoints. No new safety concerns were identified. CONCLUSIONS & INFERENCES This trial did not show statistically significant improvements in primary or secondary outcomes with prucalopride compared with placebo over 24 or 12 weeks. This is in contrast to the results of four previous 12-week trials, which demonstrated prucalopride to be significantly more effective than placebo. An extensive evaluation did not provide an explanation for the null efficacy results of this study.
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Affiliation(s)
- H Piessevaux
- Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - E Corazziari
- Unità Operativa Complessa di Gastroenterologia, Università degli Studi di Roma "La Sapienza", Rome, Italy
| | - E Rey
- Department of Digestive Diseases, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - M Simren
- University of Gothenburg, Gothenburg, Sweden
| | | | | | - M Cools
- Shire Movetis NV, Turnhout, Belgium
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Rey E, Bulteau C, Motte J, Tran A, Sturm Y, D'Souza J, Markabi S, Pons G, Dulac O. Oxcarbazepine Pharmacokinetics and Tolerability in Children With Inadequately Controlled Epilepsy. J Clin Pharmacol 2013; 44:1290-300. [PMID: 15496647 DOI: 10.1177/0091270004266617] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This two-part, open-label study evaluated the pharmacokinetics, safety, and tolerability of oxcarbazepine as combination therapy in 112 children 2 to 12 years old with inadequately controlled epilepsy. Part I was a pharmacokinetic study in children stratified by age (2-5 years and 6-12 years) and randomized to receive a single oxcarbazepine dose of 5 mg/kg or 15 mg/kg. Mean specific AUC and t(1/2) values of the active metabolite (MHD) were approximately 30% lower in younger children compared with older children, regardless of dose. Part II was a 4-month safety, tolerability, and pharmacokinetic study in which children received oxcarbazepine doses of 11 to 68 mg/kg/day. The mean specific oxcarbazepine daily dose was 38% higher in younger children compared with older children. Similarly, mean trough plasma MHD concentrations were 34% lower in younger children. Six (5%) children discontinued due to adverse events. Oxcarbazepine was safe and well tolerated. Younger children require higher oxcarbazepine doses because of rapid clearance.
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Affiliation(s)
- Elisabeth Rey
- Hôpital St. Vincent de Paul, 74, Avenue Denfert-Rochereau, 75 674 Paris Cedex 14, France
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Jullien V, Urien S, Chappuy H, Dimet J, Rey E, Pons G, Blanche S, Tréluyer JM. Abacavir Pharmacokinetics in Human Immunodeficiency Virus-Infected Children Ranging in Age From 1 Month to 16 Years: A Population Analysis. J Clin Pharmacol 2013; 45:257-64. [PMID: 15703361 DOI: 10.1177/0091270004272215] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abacavir pharmacokinetics was studied in 105 children by a population approach performed with NONMEM. A 1-compartment open model with linear absorption and elimination adequately described the data. Typical population estimates (percent interindividual variability) of absorption rate constant, apparent distribution volume, and apparent plasma clearance were 1.79 h(-1) (58%), 42.9 L (53%), and 24.3 L/h (30%), respectively. Apparent plasma clearance was positively related to body weight. Individual Bayesian estimates of apparent plasma clearance were used to calculate individual abacavir area under the concentration curve (AUC). For the current weight-based regimen, abacavir exposure was found to be constant throughout the age range of the study, with an overall mean AUC value of 8.5 +/- 2.5 mg x h/L, which is slightly greater than the mean AUC value reported in adults. This study confirms the relevance of the current weight-based abacavir dosage regimen in pediatric patients.
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Affiliation(s)
- Vincent Jullien
- Pharmacologie Clinique, Université René Descartes, Groupe Hospitalier Cochin-Saint-Vincent-de-Paul, Assistance Publique-Hôpitaux de Paris, 82 Avenue Denfert-Rochereau, 75674 Paris Cedex 14, France
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Canellada A, Custidiano A, Abraham F, Rey E, Gentile T. Immunoregulatory cytokines in mouse placental extracts inhibit in vitro osteoclast differentiation of murine macrophages. Placenta 2013; 34:231-9. [DOI: 10.1016/j.placenta.2012.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 12/11/2012] [Accepted: 12/30/2012] [Indexed: 12/23/2022]
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Voces R, Pérez P, Rodrigo D, Vitoria Y, Rey E, Boado V. 243. Movimiento septal paradójico: inevitable o defecto de protección. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70439-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
AIM We tested the hypothesis that diabetes in pregnancy may differentially affect neonatal outcomes in twin vs. singleton pregnancies. METHODS In a retrospective cohort analysis of twins (n = 422 068) and singletons (n = 14 298 367) born in the USA from 1998 to 2001, we evaluated the adjusted odds ratios of adverse neonatal outcomes comparing diabetic vs. non-diabetic pregnancies, controlling for maternal characteristics. Primary outcomes include macrosomia (birthweight for gestational age > 90th percentile), congenital anomalies, low 5-min Apgar score (< 4) and neonatal death. RESULTS Diabetes in pregnancy was associated with a similarly increased risk of congenital anomalies (adjusted odds ratios 1.52 vs. 1.59) and smaller increased risks of preterm birth (adjusted odds ratios 1.27 vs. 1.49) and macrosomia (adjusted odds ratios 1.38 vs. 2.03) in twins vs. singletons, but reduced risks of low 5-min Apgar score (adjusted odds ratio 0.74) and neonatal death (adjusted odds ratio 0.76) in twins but not singletons. CONCLUSIONS Diabetes in pregnancy may differentially affect neonatal outcomes in twins and singletons, indicating a need for further studies to differentiate the effects by clinical subtypes of diabetes in pregnancy, and to consider/evaluate differential clinical management protocols of diabetes in multiple vs. singleton pregnancies.
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Affiliation(s)
- Z C Luo
- Department of Obstetrics and Gynecology, Sainte-Justine Hospital, University of Montreal, Montreal, QC, Canada.
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Hamzeh G, Crespo A, Rey E, Blanco R, Luis M, Rodríguez MA, Aramendi J. Right aortic arch with aberrant left subclavian artery and anomalous origin of right pulmonary artery from ascending aorta. World J Pediatr Congenit Heart Surg 2011; 2:324-6. [PMID: 23804994 DOI: 10.1177/2150135110389830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors report a case of a neonate that was operated on with the diagnosis of right aortic arch and aberrant left subclavian artery and anomalous origin of right pulmonary artery from ascending aorta. Computed tomography (CT) scan suggested double aortic arch and cardiac catheterization suggested anomalous origin of right pulmonary artery from ascending aorta versus aorto-pulmonary window. The final diagnosis was made at the operation. There was a right aortic arch and aberrant left subclavian artery and persistent ductus arteriosus. Surgical repair consisted of section of the ductus arteriosus and reimplantation of the right pulmonary artery in the main pulmonary artery.
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Affiliation(s)
- G Hamzeh
- Division of Cardiac Surgery, Hospital de Cruces, Bilbao, Spain
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Rey E, David M. P.19 Sensitivity to subcutaneous and intravenous unfractionated heparin (UFH) at delivery. Thromb Res 2011. [DOI: 10.1016/s0049-3848(11)70074-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bouillon-Pichault M, Nabbout R, Chhun S, Rey E, Chiron C, Dulac O, Pons G, Jullien V. Topiramate pharmacokinetics in infants and young children: contribution of population analysis. Epilepsy Res 2011; 93:208-11. [PMID: 21256717 DOI: 10.1016/j.eplepsyres.2010.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 11/25/2010] [Accepted: 12/12/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine the range of topiramate (TPM) concentrations obtained in children under 4 with the recommended dosage regimen (3-9 mg/kg/day) and to compare them to adult target ranges. METHODS The population pharmacokinetic model developed for TPM, with/without enzyme inducer antiepileptic drugs (EIAEDs) in children was used to determine dosage regimens providing AUC and trough concentrations (C(trough)s) within the adult ranges. RESULTS TPM pharmacokinetics was described by a one-compartment model. EIAEDs increased the apparent clearance (CL/F) and age and body weight increased the apparent distribution volume (Vd/F). Mean population estimates (% CV interindividual variability) were 0.608/1.15 L/h (13%) for CL/F without/with EIAEDs, 28.6L (0.2%) for Vd/F and 1.4h(-1) (124%) for the absorption rate constant. Mean AUC(0-12h) reached with a 2mg/kg/day dosing regimen was within described range. A 6-16 mg/kg/day dose depending on age allowed reaching target C(trough) range with the highest probability. Combined EIAEDs led to a 2- and 3-fold decrease in AUC and C(trough), respectively. CONCLUSION TPM dosage of 2/4 mg/kg/day (without/with EIEADs, respectively) provides the AUC reported in adults. In children under 4, alternative dosing regimen should be considered mainly when associated to EIAED to reach C(trough) comparable to adult values.
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Rey E, Lago-Peñas C, Lago-Ballesteros J, Casais L, Dellal A. The effect of cumulative fatigue on activity profiles of professional soccer players during a congested fixture period. Biol Sport 2010. [DOI: 10.5604/20831862.919337] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tudo G, Rey E, Borrell S, Alcaide F, Codina G, Coll P, Martin-Casabona N, Montemayor M, Moure R, Orcau A, Salvado M, Vicente E, Gonzalez-Martin J. Characterization of mutations in streptomycin-resistant Mycobacterium tuberculosis clinical isolates in the area of Barcelona. J Antimicrob Chemother 2010; 65:2341-6. [DOI: 10.1093/jac/dkq322] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [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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Nakhai-Pour HR, Rey E, Bérard A. Antihypertensive medication use during pregnancy and the risk of major congenital malformations or small-for-gestational-age newborns. ACTA ACUST UNITED AC 2010; 89:147-54. [PMID: 20437474 DOI: 10.1002/bdrb.20238] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND In spite of the widespread use of antihypertensives during pregnancy, data on their risks and benefits for the newborn are limited. We investigated the risk of major congenital malformations or small-for-gestational-age newborns (SGA) in relation to gestational use of antihypertensives. METHODS Within the Quebec Pregnancy Registry, we conducted two case-control studies. First, cases were defined as major congenital malformations diagnosed during the first year of life and controls were selected from the same cohort; index date was date of delivery. Gestational exposure was defined as filling a prescription for an antihypertensive during the 1st trimester of pregnancy. Next, cases (SGA) were defined as newborns with a birth weight <10th percentile for that gestational age and gender; controls were the newborns with a birth weight > or =10 percentile. Gestational exposure was defined as filling a prescription for an antihypertensive during the 2nd or 3rd trimester. Multivariate logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI). RESULTS We found that overall antihypertensives use during the 2nd or 3rd trimesters of pregnancy was associated with a higher risk of SGA (OR 1.53, 95% CI 1.17-1.99). Moreover, selective beta-blocker (OR 6.00, 95% CI 1.06-33.87), alpha beta blocker (OR 2.26, 95% CI 1.04-4.88), or centrally-acting adrenergic agents use (OR 1.70, 95% CI 1.00-2.89) was associated with a higher risk of SGA compared to non-use. CONCLUSION Gestational use of antihypertensives, especially beta-blocker, alpha beta blocker, or centrally-acting adrenergic agents, may increase the risk of SGA.
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Rey E, Locke GR, Jung HK, Malhotra A, Choung RS, Beebe TJ, Schleck CD, Zinsmeister AR, Talley NJ. Measurement of abdominal symptoms by validated questionnaire: a 3-month recall timeframe as recommended by Rome III is not superior to a 1-year recall timeframe. Aliment Pharmacol Ther 2010; 31:1237-47. [PMID: 20222912 DOI: 10.1111/j.1365-2036.2010.04288.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Rome III incorporates changes in the definition of functional gastrointestinal disorder that involve a 3-month recall time for symptoms, rather than 1-year. AIM To validate a new version of the Talley-Bowel Disease Questionnaire (Talley-BDQ) and assess the impact of recall time period on the prevalence of symptoms. METHODS A sample of community residents were randomly mailed a survey using 1-year (n = 396) or 3-month recall period (n = 374). We evaluated the reliability and the concurrent validity of the two versions of the questionnaire. The proportions of subjects reporting symptoms in the two versions were compared. RESULTS The median (IQR) kappa on symptom-related questions was 0.70 (0.57-0.76) from the 1-year version and 0.66 (0.56-0.77) from the 3-month version. A median kappa of 0.39 (0.19-0.70) and 0.58 (0.39-0.73) was observed for concurrent validation of the 1-year and 3-month versions respectively. Except for gastro-oesophageal reflux symptoms, no differences were observed on the prevalence of clinically relevant symptoms. CONCLUSION The revised Talley-BDQ is reliable, with excellent reproducibility and validity. There were few differences in reported symptom rates between the 3-month and 1-year recall time versions of the questionnaire. A 1-year recall time may more efficiently capture infrequent or subtle symptoms.
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Affiliation(s)
- E Rey
- Mayo Clinic College of Medicine, Rochester, MN, USA
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Borrell S, Tudó G, Rey E, González-Martín J, Español M, March F, Coll P, Orcau A, Caylà J, Jansà J, Alcaide F, Martín-Casabona N, Salvadó M, Martinez J, Vidal R, Sanchez F, Altet N. Tuberculosis transmission patterns among Spanish-born and foreign-born populations in the city of Barcelona. Clin Microbiol Infect 2010; 16:568-74. [DOI: 10.1111/j.1469-0691.2009.02886.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [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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Urien S, Doz F, Giraud C, Rey E, Gentet JC, Chastagner P, Vassal G, Corradini N, Auvrignon A, Leblond P, Rubie H, Treluyer JM. Developmental pharmacokinetics of etoposide in 67 children: lack of dexamethasone effect. Cancer Chemother Pharmacol 2010; 67:597-603. [DOI: 10.1007/s00280-010-1357-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Accepted: 04/30/2010] [Indexed: 08/30/2023]
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Rey E, García-Arredondo M. Gastro-esophageal reflux disease and irritable bowel syndrome - why are they associated? Rev Esp Enferm Dig 2010; 102:225-228. [PMID: 20486743 DOI: 10.4321/s1130-01082010000400001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Voces Sánchez R, Hamzeh G, Crespo A, Lizama L, Cubero A, Rey E, Aramendi J. 207. Revascularización arterial completa con técnica de tector: cuando no emplearla. Cirugía Cardiovascular 2010. [DOI: 10.1016/s1134-0096(10)70654-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Bazzoli C, Jullien V, Le Tiec C, Rey E, Mentré F, Taburet AM. Intracellular Pharmacokinetics of Antiretroviral Drugs in HIV-Infected Patients, and their Correlation with Drug Action. Clin Pharmacokinet 2010; 49:17-45. [DOI: 10.2165/11318110-000000000-00000] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Rey E, Alvarez-Sánchez A, Rodríguez-Artalejo F, Moreno Elola-Olaso C, Almansa C, Díaz-Rubio M. Onset and disappearance rates of gastroesophageal reflux symptoms in the Spanish population, and their impact on quality of life. Rev Esp Enferm Dig 2009; 101:477-82. [PMID: 19642839 DOI: 10.4321/s1130-01082009000700005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND few studies have reported the onset and disappearance rates of gastroesophageal reflux symptoms (GERS) in the population. AIM to assess the occurrence and disappearance rates of GERS in Spain, and their impact on health-related quality of life (HRQL). PARTICIPANTS AND METHODS participants were selected at random from the general population of Madrid in age and sex strata. They were interviewed at home twice, 6 months apart. Heartburn, acid regurgitation and consultation were assessed with the gastroesophageal reflux questionnaire, and HRQL with the SF-36. RESULTS 709 individuals were included, and 451 (63.6%) were re-interviewed 6 months later. Among the 325 individuals without GERS, 9 developed weekly symptoms (2.2% [95% CI: 0.8, 3.4%]); 2 (22%) consulted because of GERS. Among the 34 subjects reporting weekly GERS initially, 26 did not report them at 6-months. Onset of GERS was associated with worsening scores in the physical summary of SF-36 (delta = -6.6 [95% CI: -11.8, -1.42]), while disappearance with an improved score (delta = -3.0 [95% CI: 0.0, 5.9]). CONCLUSION despite the lower prevalence of GERS in Spain, the occurrence rate is 2.2% in 6 months; however symptoms disappeared in more than half of subjects six months later. Developing GERS was associated with reduced HRQL, and their disappearance with improvement.
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Affiliation(s)
- E Rey
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CIBER of Edpidemiology and Public Helath (CIBERESP), Spain.
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Martel MJ, Rey E, Beauchesne MF, Malo JL, Perreault S, Forget A, Blais L. Control and severity of asthma during pregnancy are associated with asthma incidence in offspring: two-stage case-control study. Eur Respir J 2009; 34:579-87. [PMID: 19541714 DOI: 10.1183/09031936.00074608] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The extent to which childhood asthma incidence is influenced by asthma control and severity during pregnancy is unknown. We have studied this association during the child's first 10 yrs of life. A two-stage, case-control study, nested in a cohort of 8,226 children of asthmatic mothers, was conducted using three interlinked databases of Quebec, Canada, and mailed questionnaires. A total of 2,681 asthmatic children and 30,318 age-matched controls were selected (< or =20 controls.case(-1); stage 1), and 3,254 selected mothers were mailed questionnaires to obtain additional information (stage 2). Asthma control and severity was defined using validated indexes and childhood asthma incidence based on at least one asthma-related diagnosis and prescription received within 2 yrs. A total of 44 confounders were considered. Compared with children of mild controlled asthmatic mothers, children whose mothers had moderate-to-severe uncontrolled asthma during pregnancy had an increased risk of asthma (adjusted OR 1.27, 95% CI 1.06-1.52). No increased risk was observed for children of mild uncontrolled and moderate-to-severe controlled mothers. Based on one of the largest studies of children of asthmatic mothers, a significant increase in asthma risk was demonstrated among children whose mothers had poor control and increased severity of asthma during pregnancy, indicating that this element should be added to the expanding list of determinants of childhood asthma. As it constitutes a risk factor where pregnant asthmatic females can intervene, it is of great importance for physicians to optimally treat asthmatic females during pregnancy and to encourage females to be adherent to the prescribed asthma medications.
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Duval X, Mentré F, Rey E, Auleley S, Peytavin G, Biour M, Métro A, Goujard C, Taburet AM, Lascoux C, Panhard X, Tréluyer JM, Salmon-Céron D. Benefit of therapeutic drug monitoring of protease inhibitors in HIV-infected patients depends on PI used in HAART regimen--ANRS 111 trial. Fundam Clin Pharmacol 2009; 23:491-500. [PMID: 19709326 PMCID: PMC2933222 DOI: 10.1111/j.1472-8206.2009.00693.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
As a result of high inter-patient variability, and efficacy-concentration and toxicity-concentration relationships, optimization of HIV-protease inhibitor (PI) doses based on plasma concentrations could be beneficial. During a 48-week open prospective non-randomized interventional study of 115 protease inhibitor-naïve patients initiating an indinavir/ritonavir- or lopinavir/ritonavir-, or nelfinavir-containing therapy, protease inhibitor dose was modified when plasma trough concentrations (C(trough)) at weeks 2, 8, 16 and 24 were outside predefined optimal concentration ranges. Failure of the strategy was defined as the proportions of patients with HIV-RNA above 200 copies/mL from weeks 24 to 48 and/or experiencing grades 2, 3 or 4 PI-related adverse events during the study; proportion of patients with last C(trough) measurement outside the concentration range was determined at each visit. Virological failure and/or occurrence of adverse event were observed in 37/94 assessable patients (39%; 95% CI: 29.4-50.0). In the on-treatment analysis, failure of the strategy was noted in 16% of indinavir/r- or lopinavir/r-treated patients (8/51; 95% CI: 7.0-28.6; virological failure: 2; adverse event: 6) but in 44% of nelfinavir-treated patients (11/25; 95% CI: 24.4-65.1; virological failure: 10; adverse event: 1); C(trough) concentrations outside the range were less frequent at the last measurement than at W2 (41% vs. 66%; P < 0.05), with proportions of 35% for indinavir/r- or lopinavir/r-treated patients, but 57% for nelfinavir-treated patients. The proposed strategy of therapeutic drug monitoring may be beneficial to indinavir/r- and lopinavir/r-treated patients, but failed to move concentrations into the predefined range and to produce the expected virological success for nelfinavir-treated patients.
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Magee LA, von Dadelszen P, Chan S, Gafni A, Gruslin A, Helewa M, Hewson S, Kavuma E, Lee SK, Logan AG, McKay D, Moutquin JM, Ohlsson A, Rey E, Ross S, Singer J, Willan AR, Hannah ME. Women's Views of Their Experiences in the CHIPS (Control of Hypertension in Pregnancy Study) Pilot Trial. Hypertens Pregnancy 2009; 26:371-87. [DOI: 10.1080/10641950701547549] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Koyalta D, Charpentier C, Beassamda J, Rey E, Si‐Mohamed A, Djemadji‐Oudjeil N, Bélec L. High Frequency of Antiretroviral Drug Resistance among HIV‐Infected Adults Receiving First‐Line Highly Active Antiretroviral Therapy in N’Djamena, Chad. Clin Infect Dis 2009; 49:155-9. [DOI: 10.1086/599611] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Bertrand J, Treluyer JM, Panhard X, Tran A, Auleley S, Rey E, Salmon-Céron D, Duval X, Mentré F. Influence of pharmacogenetics on indinavir disposition and short-term response in HIV patients initiating HAART. Eur J Clin Pharmacol 2009; 65:667-78. [PMID: 19440701 DOI: 10.1007/s00228-009-0660-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Accepted: 04/07/2009] [Indexed: 01/08/2023]
Abstract
AIMS To assess the relationship between genetic polymorphisms and indinavir pharmacokinetic variability and to study the link between concentrations and short-term response or metabolic safety. METHODS Forty protease inhibitor-naive patients initiating highly active antiretroviral therapy (HAART) including indinavir/ritonavir and enrolled in the COPHAR 2-ANRS 111 trial were studied. At week 2, four blood samples were taken before and up to 6 h following drug intake. A population pharmacokinetic analysis was performed using the stochastic approximation expectation maximization (SAEM) algorithm implemented in MONOLIX software. The area under the concentration-time curve (AUC) and maximum (C(max)) and trough concentrations (C(trough)) of indinavir were derived from the population model and tested for their correlation with short-term viral response and safety measurements, while for ritonavir, these same three parameters were tested for their correlation with short-term biochemical safety RESULTS A one-compartment model with first-order absorption and elimination best described both indinavir and ritonavir concentrations. For indinavir, the estimated clearance and volume of distribution were 22.2 L/h and 97.3 L, respectively. The eight patients with the *1B/*1B genotype for the CYP3A4 gene showed a 70% decrease in absorption compared to those with the *1A/*1B or *1A/*1A genotypes (0.5 vs. 2.1, P = 0.04, likelihood ratio test by permutation). The indinavir AUC and C(trough) were positively correlated with the decrease in human immunodeficiency virus RNA between week 0 and week 2 (r = 0.4, P = 0.03 and r = -0.4, P = 0.03, respectively). Patients with the *1B/*1B genotype also had a significantly lower indinavir C(max) (median 3.6, range 2.1-5.2 ng/mL) than those with the *1A/*1B or *1A/*1A genotypes (median 4.4, range 2.2-8.3 ng/mL) (P = 0.04) and a lower increase in triglycerides during the first 4 weeks of treatment (median 0.1, range -0.7 to 1.4 vs. median 0.6, range -0.5 to 1.7 mmol/L, respectively; P = 0.02). For ritonavir, the estimated clearance and volume of distribution were 8.3 L/h and 60.7 L, respectively, and concentrations were not found to be correlated to biochemical safety. Indinavir and ritonavir absorption rate constants were found to be correlated, as well as their apparent volumes of distribution and clearances, indicating correlated bioavailability of the two drugs. CONCLUSION The CYP3A4*1B polymorphism was found to influence the pharmacokinetics of indinavir and, to some extent, the biochemical safety of indinavir.
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Affiliation(s)
- Julie Bertrand
- UMR 738, INSERM, Université Paris Diderot, UFR de Médecine, 16, rue Henri Huchard, 75018, Paris, France.
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Rey E. Oral and maxillofacial surgery in patients with haemophilia. Int J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.ijom.2009.03.088] [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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Chhun S, Jullien V, Rey E, Dulac O, Chiron C, Pons G. Population pharmacokinetics of levetiracetam and dosing recommendation in children with epilepsy. Epilepsia 2009; 50:1150-7. [DOI: 10.1111/j.1528-1167.2008.01974.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [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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Rey E, Garneau P, David M, Gauthier R, Leduc L, Michon N, Morin F, Demers C, Kahn SR, Magee LA, Rodger M. Dalteparin for the prevention of recurrence of placental-mediated complications of pregnancy in women without thrombophilia: a pilot randomized controlled trial. J Thromb Haemost 2009; 7:58-64. [PMID: 19036070 DOI: 10.1111/j.1538-7836.2008.03230.x] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.6] [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: 11/29/2022]
Abstract
BACKGROUND The role of anticoagulants for the prevention of placental-mediated pregnancy complications is uncertain. OBJECTIVES Our aim was to investigate the effectiveness of dalteparin, a low-molecular-weight heparin, in preventing the recurrence of these complications in women without thrombophilia. PATIENTS/METHODS Between August 1 2000 and June 20 2007, 116 pregnant women with: (i) RESULTS Among the 110 women included in the final analysis, dalteparin was associated with a lower rate of the primary outcome [5.5% (n = 3/55) vs. 23.6% (n = 13/55), adjusted odds ratio (OR) 0.15, 95% confidence interval (CI) 0.03-0.70]. Secondary outcomes were not statistically different between the groups. Bleeding problems or thrombocytopenia did not occur. CONCLUSION In this pilot study, dalteparin is effective in decreasing the recurrence of placental-mediated complications in women without thrombophilia. Our results require confirmation in further randomized trials.
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Affiliation(s)
- E Rey
- Division of Obstetrics Medicine, Department of Obstetrics and Gynaecology, CHU Sainte-Justine, Montreal, QC, Canada.
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Abstract
BACKGROUND Thirteen studies investigating the association between asthma during pregnancy and perinatal mortality reported generally no increased risk. Most of these studies should be interpreted with caution because they were limited in terms of statistical power. A study was therefore undertaken to evaluate whether maternal asthma during pregnancy increases the risk of perinatal mortality. METHODS Through three administrative databases from Québec (Canada), a cohort of women with and without asthma who had at least one pregnancy between 1990 and 2002 was formed. Perinatal mortality was identified by diagnostic codes. The adjusted odds ratio (OR) of perinatal mortality in women with and without asthma was compared using Generalised Estimation Equation (GEE) models. The first model included all potential confounders (except small for gestational age, SGA), the second model excluded birth weight, gestational age at birth and SGA and the third model excluded birth weight, gestational age at birth but included only SGA. This analysis was also stratified for birth weight and gestational age at birth. RESULTS The cohort was formed of 13 100 and 28 042 single pregnancies in women with and without asthma. The crude OR of perinatal mortality was 1.35 (95% CI 1.08 to 1.67), which decreased to 0.93 (95% CI 0.75 to 1.17) after adjustment for birth weight and gestational age at birth. Women with asthma had a higher rate of low birthweight babies and preterm delivery than those without asthma. CONCLUSION The increased risk of low birthweight babies and premature delivery in women with asthma may partly explain the association between maternal asthma and the increased risk of perinatal mortality.
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Affiliation(s)
- M-C Breton
- Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
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Hirt D, Urien S, Ekouévi DK, Rey E, Arrivé E, Blanche S, Amani-Bosse C, Nerrienet E, Gray G, Kone M, Leang SK, McIntyre J, Dabis F, Tréluyer JM. Population pharmacokinetics of tenofovir in HIV-1-infected pregnant women and their neonates (ANRS 12109). Clin Pharmacol Ther 2008; 85:182-9. [PMID: 18987623 DOI: 10.1038/clpt.2008.201] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Thirty-eight human immunodeficiency virus-1 (HIV-1)-infected pregnant women were administered tenofovir disoproxil fumarate (TDF; 300 mg)-emtricitabine (FTC; 200 mg) tablets: two at labor initiation and one daily for 7 days postpartum. Maternal, umbilical, and neonatal plasma tenofovir concentrations were measured by high-performance liquid chromatography and analyzed using a population approach. Data were described using a two-compartment model for the mother, an effect compartment linked to maternal circulation for cord, and a neonatal compartment disconnected after delivery. Absorption was greater for women delivering by caesarian section than for those delivering vaginally. The maternal 600 mg TDF administration before delivery produces the same concentrations as 300 mg administration in other adults. If the time elapsed between maternal administration and delivery is >or=12 h, two tablets of TDF-FTC should be readministered. Tenofovir showed good placental transfer (60%). Administering 13 mg/kg of TDF as soon as possible after birth should produce neonatal concentrations comparable with those observed in adults.
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Affiliation(s)
- D Hirt
- Université Paris Descartes, EA3620, Paris, France.
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Legrand T, Chhun S, Rey E, Blanchet B, Zahar JR, Lanternier F, Pons G, Jullien V. Simultaneous determination of three carbapenem antibiotics in plasma by HPLC with ultraviolet detection. J Chromatogr B Analyt Technol Biomed Life Sci 2008; 875:551-6. [PMID: 18848512 DOI: 10.1016/j.jchromb.2008.09.020] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 09/15/2008] [Accepted: 09/19/2008] [Indexed: 11/26/2022]
Abstract
A simple, precise and accurate high-performance liquid chromatography (HPLC) method using ultraviolet (UV) detection has been developed for simultaneous determination of carbapenem antibiotics: imipenem, meropenem and ertapenem in human plasma. Samples were spiked with ceftazidime as internal standard and proteins were precipitated by acetonitrile. Separation was achieved on a C8 column with a mobile phase composed of phosphate buffer 0.1M (pH 6.8) and methanol in gradient elution mode. Detection was performed at 298 nm. Calibration curves were linear from 0.5 to 80 mg/L for each compound, with correlation coefficients over 0.997. Intra- and inter-day validation studies showed accuracy between -4.5 and 8.1% and precision below 10.4%. Mean recoveries were 82.2, 90.8 and 87.7% for imipenem, meropenem and ertapenem, respectively. This method provides a useful tool for the therapeutic drug monitoring of carbapenems.
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Affiliation(s)
- Tiphaine Legrand
- Université Paris Descartes, Inserm, U663, Service de Pharmacologie Clinique, Groupe Hospitalier Cochin-Saint-Vincent de Paul, AP-HP, 75014 Paris, France
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Le Saux T, Chhun S, Rey E, Launay O, Weiss L, Viard JP, Pons G, Jullien V. Quantification of seven nucleoside/nucleotide reverse transcriptase inhibitors in human plasma by high-performance liquid chromatography with tandem mass-spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2008; 865:81-90. [PMID: 18325857 DOI: 10.1016/j.jchromb.2008.02.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Revised: 02/01/2008] [Accepted: 02/17/2008] [Indexed: 11/27/2022]
Abstract
A simple analytical method was developed in 100 microL of plasma for the simultaneous assay of the 7 nucleoside/nucleotide reverse transcriptase inhibitors (abacavir, didanosine, emtricitabine, lamivudine, stavudine, tenofovir, and zidovudine) currently used for the treatment of HIV-infected patients. After adding the internal standard, 6-beta-hydroxy-theophyline, plasma samples were precipitated with 500 microL acetonitrile and the supernatants were evaporated to dryness. The residues were reconstituted with 500 microL of water and 10 microL of the extracts were injected in the chromatographic system. The chromatographic separation was performed with a C-18 column and a gradient mobile phase consisting of a mixture of water and acetonitrile, both containing 0.05% formic acid. Analytes quantification was performed by electrospray ionisation triple quadrupole mass-spectrometry in the positive mode using selected reaction monitoring (SRM). Intra- and inter-assay precision and accuracy were lower than 20% for the limit of quantification, and 15% for higher concentrations. The method has been implemented to assess plasma concentrations of patients infected by HIV and was found suitable for therapeutic drug monitoring.
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Affiliation(s)
- Thomas Le Saux
- Université Paris-Descartes, Faculté de Médecine, Service de Pharmacologie Clinique, Groupe Hospitalier Cochin - Saint-Vincent de Paul, Assistance Publique, Hôpitaux de Paris, France
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