1
|
Chiche L, Jeandel C, Lyps C, Joly-Monrigal P, Alkar F, Louahem M'Sabah D, Cottalorda J, Delpont M. Fingertip nail bed injuries in children: Comparison of suture repair versus glue (2-octylcyanoacrylate) with 1-year follow-up. Hand Surgery and Rehabilitation 2020; 39:550-555. [DOI: 10.1016/j.hansur.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/09/2020] [Accepted: 09/03/2020] [Indexed: 11/24/2022]
|
2
|
Filleron A, Laurens ME, Marin G, Marchandin H, Prodhomme O, Alkar F, Godreuil S, Nagot N, Cottalorda J, L'Kaissi M, Rodiere M, Vigue MG, Didelot MN, Michon AL, Delpont M, Louahem D, Jeziorski E. Short-course antibiotic treatment of bone and joint infections in children: a retrospective study at Montpellier University Hospital from 2009 to 2013. J Antimicrob Chemother 2020; 74:3579-3587. [PMID: 31504582 DOI: 10.1093/jac/dkz358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Acute haematogenous bone and joint infections (AHBJI) represent a diagnostic and therapeutic emergency in children, with significant potential sequelae in the case of delayed treatment. Although historically the recommendations for treatment have been based on surgery and prolonged antibiotic therapy, recent studies have demonstrated that short-course antibiotic therapy is also effective. OBJECTIVES We evaluated a short-term antibiotic protocol for both osteomyelitis and septic arthritis in a 6 year retrospective study at the University Hospital of Montpellier. METHODS This protocol was based on an initial intravenous treatment with a re-evaluation after 48 h and an early switch to oral therapy in the case of a favourable clinical course for a minimum total duration of 15 days. Antibiotics were selected based on local microbiological epidemiology and systematically adapted to bacteriological results. RESULTS One hundred and seventy-six cases of AHBJI were included, comprising 56 patients with osteomyelitis, 95 with septic arthritis and 25 who had both of these. The aetiological agent was identified in 42% of the cases, with the main pathogens being Staphylococcus aureus (39%) and Kingella kingae (27%). The mean intravenous treatment duration was 4 days, while the total treatment duration was 15 days. There were no treatment failures, mild sequelae occurred in 1% of the cases and the secondary surgical revision rate was 7%. CONCLUSIONS The results of this study are comparable to those reported for evaluations of prolonged antibiotic therapy protocols, thus indicating that a common short-term antimicrobial therapy for the management of both osteomyelitis and septic arthritis (minimum of 15 days) is a viable option for treating AHBJI in children. Further prospective studies to confirm these findings are hence warranted.
Collapse
Affiliation(s)
- A Filleron
- Service de pédiatrie, CHU de Nîmes, Nîmes, France; INSERM U 1183, Université Montpellier-Nîmes, Nîmes, France
| | - M E Laurens
- Département de pédiatrie néonatale et de réanimation, CHU de Montpellier, Montpellier, France
| | - G Marin
- Department d'Information Medicale, CHU Montpellier, Montpellier, France
| | - H Marchandin
- HydroSciences Montpellier, University of Montpellier, CNRS, IRD, Montpellier, France; Laboratoire de microbiologie, CHU Nîmes, Nîmes, France
| | - O Prodhomme
- Département d'imagerie pédiatrique, CHU de Montpellier, Montpellier, France
| | - F Alkar
- Service de chirurgie orthopédique infantile, CHU Montpellier, Montpellier, France
| | - S Godreuil
- Service de bactériologie, CHU Montpellier, Montpellier, France.,Université de Montpellier UMR MIVEGEC, UMR IRD 224-CNRS Inserm, 1058, Montpellier, France
| | - N Nagot
- Department d'Information Medicale, CHU Montpellier, Montpellier, France.,Pathogenesis and Control of Chronic Infections, INSERM, Université de Montpellier, Montpellier, France
| | - J Cottalorda
- Service de chirurgie orthopédique infantile, CHU Montpellier, Montpellier, France
| | - M L'Kaissi
- Service de chirurgie infantile, CHU de la réunion, Saint-Denis, France
| | - M Rodiere
- Département urgences post-urgences, CHU Montpellier, Montpellier, France
| | - M G Vigue
- Département urgences post-urgences, CHU Montpellier, Montpellier, France
| | - M N Didelot
- Service de bactériologie, CHU Montpellier, Montpellier, France.,Pathogenesis and Control of Chronic Infections, INSERM, Université de Montpellier, Montpellier, France
| | - A L Michon
- Service de bactériologie, CHU Montpellier, Montpellier, France
| | - M Delpont
- Service de chirurgie orthopédique infantile, CHU Montpellier, Montpellier, France
| | - D Louahem
- Service de chirurgie orthopédique infantile, CHU Montpellier, Montpellier, France
| | - E Jeziorski
- Pathogenesis and Control of Chronic Infections, INSERM, Université de Montpellier, Montpellier, France.,Département urgences post-urgences, CHU Montpellier, Montpellier, France
| |
Collapse
|
3
|
Vassallo M, Durant J, Ticchioni M, Demonte A, Fabre R, Pradier C, Cottalorda J. Is active hepatitis C associated with the size of HIV reservoir in successfully treated patients? J Clin Virol 2018; 108:103-104. [PMID: 30290324 DOI: 10.1016/j.jcv.2018.09.018] [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: 05/28/2018] [Revised: 09/17/2018] [Accepted: 09/27/2018] [Indexed: 10/28/2022]
Affiliation(s)
- M Vassallo
- Department of Internal Medicine, Cannes General Hospital, France; Department of Infectious Diseases, L'Archet Hospital, University of Nice, France.
| | - J Durant
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, France
| | - M Ticchioni
- Immunology Laboratory Unit, L'Archet Hospital, University of Nice, France
| | - A Demonte
- Virology Laboratory Unit, L'Archet Hospital, University of Nice, France
| | - R Fabre
- Department of Public Health, L'Archet Hospital, University of Nice, France
| | - C Pradier
- Department of Public Health, L'Archet Hospital, University of Nice, France
| | - J Cottalorda
- Virology Laboratory Unit, L'Archet Hospital, University of Nice, France
| |
Collapse
|
4
|
Abstract
The Monteggia injury is defined as radial head dislocation with a fracture of the ulnar shaft. This combination should be sought routinely in patients with ulnar fractures, even when the displacement is small. The emergent management is simple, as reducing the ulnar fracture is usually sufficient to stabilise the radial head. Internal fixation of the ulna deserves to be widely used to fully stabilise the radial head. Irreducibility of the radial head at the acute stage may indicate an interposition, which requires open surgery on the joint. Radial head dislocation may occur even with minimal displacement of the ulnar fragment. Chronic Monteggia fractures are more challenging to treat and their outcomes are more variable. The radial head becomes irreducible after 2 to 3 weeks. When a simple surgical approach fails to ensure stable reduction, the most widely used method at present is open reduction of the radial head and proximal osteotomy of the ulnar shaft. Stability must be obtained intra-operatively. Without treatment, radial head dislocation may be well tolerated for several months or even years. In the long term, however, osteoarticular remodelling results in loss of joint congruence, pain and, eventually, osteoarthritis. Radiographs must therefore be obtained on an emergency basis and analysed with great care to avoid missing a Monteggia fracture.
Collapse
Affiliation(s)
- M Delpont
- Service de chirurgie pédiatrique, hôpital Lapeyronie, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
| | - D Louahem
- Service de chirurgie pédiatrique, hôpital Lapeyronie, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| | - J Cottalorda
- Service de chirurgie pédiatrique, hôpital Lapeyronie, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| |
Collapse
|
5
|
Soulie C, Morand-Joubert L, Cottalorda J, Charpentier C, Bellecave P, Le Guen L, Yerly S, Montes B, Fafi-Kremer S, Dina J, Avettand-Fenoel V, Amiel C, Roussel C, Pallier C, Zafilaza K, Sayon S, Signori-Schmuck A, Mirand A, Trabaud MA, Berger S, Calvez V, Marcelin AG. Performance of genotypic algorithms for predicting tropism for HIV-1 CRF01_AE recombinant. J Clin Virol 2018; 99-100:57-60. [PMID: 29331843 DOI: 10.1016/j.jcv.2017.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/04/2017] [Accepted: 12/28/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES There is no consensus about the performances of genotypic rules for predicting HIV-1 non-B subtype tropism. Three genotypic methods were compared for CRF01_AE HIV-1 tropism determination. METHODS The V3 env region of 207 HIV-1 CRF01_AE and 178 B subtypes from 17 centers in France and 1 center in Switzerland was sequenced. Tropism was determined by Geno2Pheno algorithm with false positive rate (FPR) 5% or 10%, the 11/25 rule or the combined criteria of the 11/25, net charge rule and NXT/S mutations. RESULTS Overall, 72.5%, 59.4%, 86.0%, 90.8% of the 207 HIV-1 CRF01_AE were R5-tropic viruses determined by Geno2pheno FPR5%, Geno2pheno FPR10%, the combined criteria and the 11/25 rule, respectively. A concordance of 82.6% was observed between Geno2pheno FPR5% and the combined criteria for CRF01_AE. The results were nearly similar for the comparison between Geno2pheno FPR5% and the 11/25 rule. More mismatches were observed when Geno2pheno was used with the FPR10%. Neither HIV viral load, nor current or nadir CD4 was associated with the discordance rate between the different algorithms. CONCLUSION Geno2pheno predicted more X4-tropic viruses for this set of CRF01_AE sequences than the combined criteria or the 11/25 rule alone. For a conservative approach, Geno2pheno FPR5% seems to be a good compromise to predict CRF01_AE tropism.
Collapse
Affiliation(s)
- C Soulie
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France.
| | - L Morand-Joubert
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Saint Antoine, Service de Virologie, Paris, France
| | | | - C Charpentier
- IAME, UMR 1137-Université Paris Diderot, Sorbonne Paris Cité, INSERM, AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, France
| | - P Bellecave
- CHU de Bordeaux, Laboratoire de Virologie, Univ. Bordeaux, CNRS UMR 5234, Bordeaux, France
| | - L Le Guen
- Laboratoire de virologie, CHU, Nantes, France
| | - S Yerly
- Laboratory of Virology, Geneva University Hospitals, Switzerland
| | - B Montes
- Laboratoire de Virologie, CHU, Montpellier, France
| | | | - J Dina
- Laboratoire de virologie, CHU, Caen, France
| | - V Avettand-Fenoel
- AP-HP, Laboratoire de Virologie, Hôpital Necker, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, EA7327, France
| | - C Amiel
- AP-HP, Laboratoire de Virologie, Hôpital Tenon, Paris, France
| | | | | | - K Zafilaza
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - S Sayon
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | | | | | - M A Trabaud
- Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - S Berger
- Laboratoire de Virologie, CHU de Nancy Brabois, EA 7300, Université de Lorraine, Faculté de Médecine, Vandoeuvre les Nancy, France
| | - V Calvez
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| | - A G Marcelin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France
| |
Collapse
|
6
|
Bousquet J, Bourret R, Camuzat T, Augé P, Bringer J, Noguès M, Jonquet O, de la Coussaye JE, Ankri J, Cesari M, Guérin O, Vellas B, Blain H, Arnavielhe S, Avignon A, Combe B, Canovas G, Daien C, Dray G, Dupeyron A, Jeandel C, Laffont I, Laune D, Marion C, Pastor E, Pélissier JY, Galan B, Reynes J, Reuzeau JC, Bedbrook A, Granier S, Adnet PA, Amouyal M, Alomène B, Bernard PL, Berr C, Caimmi D, Claret PG, Costa DJ, Cristol JP, Fesler P, Hève D, Millot-Keurinck J, Morquin D, Ninot G, Picot MC, Raffort N, Roubille F, Sultan A, Touchon J, Attalin V, Azevedo C, Badin M, Bakhti K, Bardy B, Battesti MP, Bobia X, Boegner C, Boichot S, Bonnin HY, Bouly S, Boubakri C, Bourrain JL, Bourrel G, Bouix V, Bruguière V, Cade S, Camu W, Carre V, Cavalli G, Cayla G, Chiron R, Coignard P, Coroian F, Costa P, Cottalorda J, Coulet B, Coupet AL, Courrouy-Michel MC, Courtet P, Cros V, Cuisinier F, Danko M, Dauenhauer P, Dauzat M, David M, Davy JM, Delignières D, Demoly P, Desplan J, Dujols P, Dupeyron G, Engberink O, Enjalbert M, Fattal C, Fernandes J, Fouletier M, Fraisse P, Gabrion P, Gellerat-Rogier M, Gelis A, Genis C, Giraudeau N, Goucham AY, Gouzi F, Gressard F, Gris JC, Guillot B, Guiraud D, Handweiler V, Hayot M, Hérisson C, Heroum C, Hoa D, Jacquemin S, Jaber S, Jakovenko D, Jorgensen C, Kouyoudjian P, Lamoureux R, Landreau L, Lapierre M, Larrey D, Laurent C, Léglise MS, Lemaitre JM, Le Quellec A, Leclercq F, Lehmann S, Lognos B, Lussert CM, Makinson A, Mandrick K, Mares P, Martin-Gousset P, Matheron A, Mathieu G, Meissonnier M, Mercier G, Messner P, Meunier C, Mondain M, Morales R, Morel J, Mottet D, Nérin P, Nicolas P, Nouvel F, Paccard D, Pandraud G, Pasdelou MP, Pasquié JL, Patte K, Perrey S, Pers YM, Portejoie F, Pujol JLE, Quantin X, Quéré I, Ramdani S, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Riso JP, Rivier F, Robine JM, Rolland C, Royère E, Sablot D, Savy JL, Schifano L, Senesse P, Sicard R, Stephan Y, Strubel D, Tallon G, Tanfin M, Tassery H, Tavares I, Torre K, Tribout V, Uziel A, Van de Perre P, Venail F, Vergne-Richard C, Vergotte G, Vian L, Vialla F, Viart F, Villain M, Viollet E, Ychou M, Mercier J. MACVIA-LR (Fighting Chronic Diseases for Active and Healthy Ageing in Languedoc-Roussillon): A Success Story of the European Innovation Partnership on Active and Healthy Ageing. J Frailty Aging 2017; 5:233-241. [PMID: 27883170 DOI: 10.14283/jfa.2016.105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Région Languedoc Roussillon is the umbrella organisation for an interconnected and integrated project on active and healthy ageing (AHA). It covers the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA): (A) Prevention and health promotion, (B) Care and cure, (C) and (D) Active and independent living of elderly people. All sub-activities (poly-pharmacy, falls prevention initiative, prevention of frailty, chronic respiratory diseases, chronic diseases with multimorbidities, chronic infectious diseases, active and independent living and disability) have been included in MACVIA-LR which has a strong political commitment and involves all stakeholders (public, private, patients, policy makers) including CARSAT-LR and the Eurobiomed cluster. It is a Reference Site of the EIP on AHA. The framework of MACVIA-LR has the vision that the prevention and management of chronic diseases is essential for the promotion of AHA and for the reduction of handicap. The main objectives of MACVIA-LR are: (i) to develop innovative solutions for a network of Living labs in order to reduce avoidable hospitalisations and loss of autonomy while improving quality of life, (ii) to disseminate the innovation. The three years of MACVIA-LR activities are reported in this paper.
Collapse
Affiliation(s)
- J Bousquet
- Professor Jean Bousquet, CHRU, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France, Tel +33 611 42 88 47,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Pradat P, Pugliese P, Poizot-Martin I, Valantin MA, Cuzin L, Reynes J, Billaud E, Huleux T, Bani-Sadr F, Rey D, Frésard A, Jacomet C, Duvivier C, Cheret A, Hustache-Mathieu L, Hoen B, Cabié A, Cotte L, Chidiac C, Ferry T, Ader F, Biron F, Boibieux A, Miailhes P, Perpoint T, Schlienger I, Lippmann J, Braun E, Koffi J, Longuet C, Guéripel V, Augustin-Normand C, Brochier C, Degroodt S, Pugliese P, Ceppi C, Cua E, Cottalorda J, Courjon J, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Fuzibet J, Garraffo R, Joulie A, Risso K, Mondain V, Naqvi A, Oran N, Perbost I, Pillet S, Prouvost-Keller B, Wehrlen-Pugliese S, Rosenthal E, Sausse S, Rio V, Roger P, Brégigeon S, Faucher O, Obry-Roguet V, Orticoni M, Soavi M, Geneau de Lamarlière P, Laroche H, Ressiot E, Carta M, Ducassou M, Jacquet I, Gallie S, Galinier A, Ritleng A, Ivanova A, Blanco-Betancourt C, Lions C, Debreux C, Obry-Roguet V, Poizot-Martin I, Agher R, Katlama C, Valantin M, Duvivier C, Lortholary O, Lanternier F, Charlier C, Rouzaud C, Aguilar C, Henry B, Lebeaux D, Cessot G, Gergely A, Consigny P, Touam F, Louisin C, Alvarez M, Biezunski N, Cuzin L, Debard A, Delobel P, Delpierre C, Fourcade C, Marchou B, Martin-Blondel G, Porte M, Mularczyk M, Garipuy D, Saune K, Lepain I, Marcel M, Puntis E, Atoui N, Casanova M, Faucherre V, Jacquet J, Le Moing V, Makinson A, Merle De Boever C, Montoya-Ferrer A, Psomas C, Reynes J, Raffi F, Allavena C, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet C, Jovelin T, Hall N, Bernaud C, Morineau P, Reliquet V, Aubry O, Point P, Besnier M, Larmet L, Hüe H, Pineau S, André-Garnier E, Rodallec A, Choisy P, Vandame S, Huleux T, Ajana F, Alcaraz I, Baclet V, Huleux T, Melliez H, Viget N, Valette M, Aissi E, Allienne C, Meybeck A, Riff B, Bani-Sadr F, Rouger C, Berger J, N'Guyen Y, Lambert D, Kmiec I, Hentzien M, Lebrun D, Migault C, Rey D, Batard M, Bernard-Henry C, Cheneau C, de Mautort E, Fischer P, Partisani M, Priester M, Lucht F, Frésard A, Botelho-Nevers E, Gagneux-Brunon A, Cazorla C, Guglielminotti C, Daoud F, Lutz M, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Corbin V, Aumeran C, Baud O, Casanova S, Coban D, Hustache-Mathieu L, Thiebaut-Drobacheff M, Foltzer A, Gendrin V, Bozon F, Chirouze C, Abel S, Cabié A, Césaire R, Santos GD, Fagour L, Najioullah F, Ouka M, Pierre-François S, Pircher M, Rozé B, Hoen B, Ouissa R, Lamaury I. Direct-acting antiviral treatment against hepatitis C virus infection in HIV-Infected patients - "En route for eradication"? J Infect 2017; 75:234-241. [PMID: 28579302 DOI: 10.1016/j.jinf.2017.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 11/10/2016] [Revised: 03/17/2017] [Accepted: 05/11/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Direct-Acting Antivirals (DAAs) opened a new era in HCV treatment. We report the impact of HCV treatment in French HIV-HCV coinfected patients. METHODS All HIV-HCV patients from the Dat'AIDS cohort followed between 2012 and 2015 were included. HCV status was defined yearly as naive, spontaneous cure, sustained virological response (SVR12), failure or reinfection. RESULTS Among 32,945 HIV-infected patients, 15.2% were positive for anti-HCV antibodies. From 2012 to 2015, HCV incidence rate increased from 0.35%PY to 0.69%PY in MSM, while median incidence was 0.08%PY in other patients. Median reinfection rate was 2.56%PY in MSM and 0.22%PY in other patients. HCV treatment initiation rate rose from 8.2% in 2012 to 29.6% (48.0% in pre-treated patients vs 22.6% in naïve patients). SVR12 rate increased from 68.7% to 95.2%. By the end of 2015, 62.7% of the patients were cured either spontaneously or following SVR. CONCLUSIONS HCV treatment dramatically increased in HIV-HCV patients in France from 2012 to 2015 resulting in HCV cure in nearly two-thirds of the patients in this cohort. Combined with a declining HCV prevalence, the prevalence of active HCV infection among HIV patients will drastically decrease in the forthcoming years.
Collapse
Affiliation(s)
- Pierre Pradat
- Center for Clinical Research, Department of Hepatology, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l'Archet, Nice, France
| | - Isabelle Poizot-Martin
- Immuno-hematology Clinic, Assistance Publique - Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, France; Aix-Marseille University, Inserm U912 (SESSTIM), Marseille, France
| | - Marc-Antoine Valantin
- Department of Infectious Diseases, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Lise Cuzin
- CHU Toulouse, COREVIH, Toulouse, France; Université de Toulouse III, Toulouse, France; INSERM, UMR, 1027, Toulouse, France
| | - Jacques Reynes
- Department of Infectious Diseases, UMI 233 INSERM U1175, CHU de Montpellier, Montpellier, France
| | - Eric Billaud
- Department of Infectious Diseases, Hotel Dieu Hospital, Nantes, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Infectious Diseases and Clinical Immunology, Hôpital Robert Debré, CHU, Reims, France; Université de Reims Champagne-Ardenne, Faculté de médecine, EA-4684/SFR CAP-SANTE, Reims, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg, France
| | - Anne Frésard
- Department of Infectious Diseases, CHU, Saint-Etienne, France
| | - Christine Jacomet
- Department of Infectious Diseases, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Claudine Duvivier
- Department of Infectious Diseases, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Assistance Publique - Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, France
| | - Antoine Cheret
- Department of Internal Medicine, CHU, Bicètre, France; Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, France
| | | | - Bruno Hoen
- Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, and Service de Maladies Infectieuses et Tropicales, Dermatologie et Médecine Interne, and Inserm CIC 1424, Centre Hospitalier Universitaire de Pointe-à-Pitre, Pointe-à-Pitre, France
| | - André Cabié
- Department of Infectious Diseases, CHU de Martinique, Fort-de-France, France; Université des Antilles EA4537 and INSERM CIC1424, Fort-de-France, France
| | - Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1052, Lyon, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Vassallo M, Fabre R, Durant J, Lebrun-Frenay C, Joly H, Ticchioni M, DeSalvador F, Harvey-Langton A, Dunais B, Laffon M, Cottalorda J, Dellamonica P, Pradier C. A decreasing CD4/CD8 ratio over time and lower CSF-penetrating antiretroviral regimens are associated with a higher risk of neurocognitive deterioration, independently of viral replication. J Neurovirol 2016; 23:216-225. [PMID: 27815816 DOI: 10.1007/s13365-016-0490-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 09/13/2016] [Accepted: 10/06/2016] [Indexed: 10/20/2022]
Abstract
Persistent immune activation is one of the suspected causes of HIV-associated neurocognitive disorders (HAND) in cART era. The CD4/CD8 ratio has been recently showed as a marker of immune activation and HAND. Our aim was to analyze if a decrease in the CD4/CD8 ratio over time could have an impact on neurocognitive deterioration. Randomly selected HIV-infected patients were followed for neuropsychological (NP) testing during a period of almost 2 years. Tests were adjusted for age, gender, and education. Patients were divided into 5 groups: normal tests (NT), neuropsychological deficit (ND, one impaired cognitive domain), asymptomatic neurocognitive disorders (ANI), mild neurocognitive disorders (MND), and HIV-associated dementia (HAD). Risk factors for neurocognitive deterioration were analyzed. Two hundred fifty-six patients underwent NP tests and 94 participated in the follow-up. The groups were comparable. Upon neuropsychological re-testing, six patients showed clinical improvement, 30 had worsened, and 58 were stable, resulting in 42 patients presenting with HAND (45 %). The majority of HAND cases consisted of ANI (26 %) and MND (16 %). In patients whose NP performance worsened, CPE 2010 score was lower at inclusion (7.13 vs 8.00, p = 0.003) and CD4/CD8 decrease more frequent (60 vs 31 %, p = 0.008) than in those who were stable or improved. Multivariate analysis confirmed these results. A decreasing CD4/CD8 ratio during a longitudinal follow-up of randomly selected HIV-infected patients and lower CSF-penetrating regimens were independently associated with cognitive decline. Monitoring trends in CD4/CD8 ratio could contribute to identifying patients at higher risk of neurocognitive deterioration.
Collapse
Affiliation(s)
- Matteo Vassallo
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France. .,Department of Internal Medicine, Cannes General Hospital, Cannes, France.
| | - R Fabre
- Department of Public Health, L'Archet Hospital, University of Nice, Nice, France
| | - J Durant
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France
| | - C Lebrun-Frenay
- Department of Neurology, Pasteur Hospital, University of Nice, Nice, France
| | - H Joly
- Department of Neurology, Pasteur Hospital, University of Nice, Nice, France
| | - M Ticchioni
- Immunology Laboratory Unit, L'Archet Hospital, University of Nice, Nice, France
| | - F DeSalvador
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France
| | - A Harvey-Langton
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France
| | - B Dunais
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France.,Department of Public Health, L'Archet Hospital, University of Nice, Nice, France
| | - M Laffon
- Department of Neurology, Pasteur Hospital, University of Nice, Nice, France
| | - J Cottalorda
- Virology Laboratory Unit, L'Archet Hospital, University of Nice, Nice, France
| | - P Dellamonica
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France
| | - C Pradier
- Department of Public Health, L'Archet Hospital, University of Nice, Nice, France
| |
Collapse
|
9
|
Cotte L, Durant J, Brochier C, Izopet J, Raffi F, Trabaud M, Lucht F, Cottalorda J, Molina J. COL 3-05 - Efficacité de la combinaison maraviroc-raltegravir chez des patients VIH-1 naïfs d’antirétroviraux : essai No Nuc-No Boost. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30270-0] [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]
|
10
|
Porte M, Patte K, Dupeyron A, Cottalorda J. [Exercise therapy in the treatment of idiopathic adolescent scoliosis: Is it useful?]. Arch Pediatr 2016; 23:624-8. [PMID: 27117993 DOI: 10.1016/j.arcped.2016.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 11/18/2015] [Accepted: 03/05/2016] [Indexed: 11/30/2022]
Abstract
Many practitioners, pediatricians, and general practitioners prescribe physical therapy when tracking scoliosis. However, has physical therapy alone proved its efficacy in the care of the scoliosis to slow down progression? Our purpose is to report the results of a literature review on the effectiveness of rehabilitation in idiopathic scoliosis. No current study presents sufficient scientific proof to validate the efficacy of isolated exercise therapy in scoliosis. Learned societies recognize, however, the efficacy of combining conservative therapy (brace+physiotherapy) in idiopathic scoliosis. Should we then still prescribe rehabilitation without brace treatment? Although physical therapy alone does not seem effective in treating scoliosis, it can limit potential painful phenomena and be beneficial for respiratory function. The physical therapist can also teach the teenager the classic principles of hygiene of the back. It may therefore be appropriate to prescribe physical therapy, but the principles and objectives must be explained to the patient and family in light of current evidence-based medicine.
Collapse
Affiliation(s)
- M Porte
- Service de médecine physique et réadaptation, CHU de Nîmes, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France; Unité de rééducation, institut Saint-Pierre, 371, avenue de l'Évêché-de-Maguelone, 34250 Palavas-les-Flots, France.
| | - K Patte
- Unité de rééducation, institut Saint-Pierre, 371, avenue de l'Évêché-de-Maguelone, 34250 Palavas-les-Flots, France
| | - A Dupeyron
- Service de médecine physique et réadaptation, CHU de Nîmes, place du Pr-Robert-Debré, 30029 Nîmes cedex 9, France
| | - J Cottalorda
- Service d'orthopédie infantile, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| |
Collapse
|
11
|
Louahem D, Cottalorda J. Acute ischemia and pink pulseless hand in 68 of 404 gartland type III supracondylar humeral fractures in children: Urgent management and therapeutic consensus. Injury 2016; 47:848-52. [PMID: 26861802 DOI: 10.1016/j.injury.2016.01.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 10/28/2015] [Revised: 01/04/2016] [Accepted: 01/10/2016] [Indexed: 02/02/2023]
Abstract
UNLABELLED No consensus exists regarding pulseless otherwise well-perfused hand in pediatric Gartland type III fractures. The purpose of this retrospective study was to describe our strategy and to determine the guidelines of therapeutic consensus. PATIENTS AND METHODS 404 children were treated for a type III supracondylar humeral fracture. Extension fractures-induced acute vascular injuries were noticed in 68 patients and nerve injuries were associated in 32 of them. The radial pulse was absent in all patients with two clinical situations at the initial presentation: well-perfused hand with 'pink and warm' hand in 63 patients and ischemia with 'white and cold' hand in five. Urgent closed reduction of the fracture and stabilization were performed in 63 patients with pink pulseless hand, and immediate surgical exploration in the five patients with ischemia. RESULTS 63 patients with vascular injury had posterolateral displacement and 5 had posteromedial displacement. Sixty-three of 68 patients had posterolateral displacement of whom 28 had concomitant median nerve injury and 4 had a deficit to both median and ulnar nerves. The palpable radial pulse was immediately restored in 42 patients and between few hours to eleven days later in eighteen. Three patients with ischemia after unsuccessful reduction required immediate surgical exploration revealing incarceration of the brachial artery at the fracture site. Release and decompression of the brachial artery restored a normal limb perfusion. The five patients with primary ischemia underwent immediate open exploration and vascular repair. One of them had a compartment syndrome and required anterior fasciotomy. The restoration of blood flow with palpable radial pulse was observed in all patients. Full spontaneous nerve recovery was observed in all patients. At an average follow-up of 8.4 years, all patients had normal circulatory status, including a palpable radial pulse. DISCUSSION This study highlighted the reliability of non invasive strategy with good outcomes. We recommend urgent closed reduction of fracture. Close observation and monitoring is mandatory if pulseless hand remains warm and well-perfused. If the patients develop blood circulation disturbances or compartment syndrome following closed reduction, immediate vascular exploration is recommend.
Collapse
Affiliation(s)
- D Louahem
- Orthopaedic Paediatric Surgery Department, Lapeyronie University Hospital, Montpellier, France.
| | - J Cottalorda
- Orthopaedic Paediatric Surgery Department, Lapeyronie University Hospital, Montpellier, France
| |
Collapse
|
12
|
Louahem D, Lozach F, Delpont M, Weiss A, Prodhomme O, Cottalorda J. Mosaicplasty for femoral osteochondritis dissecans. Orthop Traumatol Surg Res 2016; 102:247-50. [PMID: 26896409 DOI: 10.1016/j.otsr.2015.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 11/26/2015] [Accepted: 12/09/2015] [Indexed: 02/02/2023]
Abstract
The authors describe a surgical mosaicplasty technique, with an anterior surgical dislocation approach without trochanterotomy, for osteochondritis dissecans of the hip. A graft was taken from the lateral condyle of the knee. Two adolescents underwent this procedure with good results. No osteonecrosis was observed at the longest follow-up. Mosaicplasty is a useful treatment method for small osteochondritis dissecans (<2cm(2)).
Collapse
Affiliation(s)
- D Louahem
- Service d'orthopédie pédiatrique, CHU de Montpellier, Montpellier, France.
| | - F Lozach
- Service d'orthopédie pédiatrique, CHU de Montpellier, Montpellier, France
| | - M Delpont
- Service d'orthopédie pédiatrique, CHU de Montpellier, Montpellier, France
| | - A Weiss
- Service d'orthopédie pédiatrique, CHU de Montpellier, Montpellier, France
| | - O Prodhomme
- Service de radiologie pédiatrique, CHU de Montpellier, Montpellier, France
| | - J Cottalorda
- Service d'orthopédie pédiatrique, CHU de Montpellier, Montpellier, France
| |
Collapse
|
13
|
Vassallo M, Durant J, Fabre R, DeSalvador F, Lebrun-Frenay C, Laffon M, Ticchioni M, Cottalorda J, Dellamonica P, Pradier C. Immune activation in successfully treated patients with HIV-associated neurocognitive disorders: difference according to the severity of the impairment. J Virus Erad 2015. [DOI: 10.1016/s2055-6640(20)31388-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
14
|
Laffont I, Jourdan C, Coroian F, Blain H, Carre V, Viollet E, Tavares I, Fattal C, Gelis A, Nouvel F, Bakhti K, Cros V, Patte K, Schifano L, Porte M, Galano E, Dray G, Fouletier M, Rivier F, Morales R, Labauge P, Camu W, Combe B, Morel J, Froger J, Coulet B, Cottalorda J, Kouyoumdjian P, Jonquet O, Landreau L, Bonnin HY, Hantkié O, Nicolas P, Enjalbert M, Leblond C, Soua B, Coignard P, Guiraud D, Azevedo C, Mottet D, Fraisse P, Pastor E, Mercier J, Bourret R, Bousquet J, Pélissier J, Bardy B, Herisson C, Dupeyron A. [Living Lab MACVIA. Disability]. Presse Med 2015; 44 Suppl 1:S60-9. [PMID: 26482491 DOI: 10.1016/j.lpm.2015.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- I Laffont
- CHRU de Montpellier, département de médecine physique et de réadaptation, 34090 Montpellier, France; Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France.
| | - C Jourdan
- CHRU de Montpellier, département de médecine physique et de réadaptation, 34090 Montpellier, France
| | - F Coroian
- CHRU de Montpellier, département de médecine physique et de réadaptation, 34090 Montpellier, France; Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France
| | - H Blain
- Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France; CHRU de Montpellier, département de gériatrie, 34090 Montpellier, France
| | - V Carre
- CHRU de Montpellier, département de médecine physique et de réadaptation, 34090 Montpellier, France
| | - E Viollet
- CHU de Nîmes, hôpital Carémeau et du Grau du Roi, département de médecine physique et de réadaptation, 30029 Nîmes, France; CHU Carémeau, CEDMH, 30029 Nîmes, France
| | - I Tavares
- CHRU de Montpellier, département de médecine physique et de réadaptation, 34090 Montpellier, France
| | - C Fattal
- Association APPROCHE, CMRRF de Kerpape, BP 78, 56275 Ploemeur cedex, France
| | - A Gelis
- Centre Mutualiste Propara, 34000 Montpellier, France
| | - F Nouvel
- CHU Carémeau, CEDMH, 30029 Nîmes, France
| | - K Bakhti
- CHRU de Montpellier, département de médecine physique et de réadaptation, 34090 Montpellier, France; Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France
| | - V Cros
- CHRU de Montpellier, département de médecine physique et de réadaptation, 34090 Montpellier, France
| | - K Patte
- Institut Marin Saint-Pierre, 34250 Palavas les Flots, France
| | - L Schifano
- Institut Marin Saint-Pierre, 34250 Palavas les Flots, France
| | - M Porte
- CHU de Nîmes, hôpital Carémeau et du Grau du Roi, département de médecine physique et de réadaptation, 30029 Nîmes, France
| | - E Galano
- CHU de Nîmes, hôpital Carémeau et du Grau du Roi, département de médecine physique et de réadaptation, 30029 Nîmes, France
| | - G Dray
- École des Mines d'Alès, 30100 Alès, France
| | | | - F Rivier
- CHU de Montpellier, centre de référence Grand Sud des maladies neuromusculaires, département de neuropédiatrie, 34090 Montpellier, France
| | - R Morales
- CHRU de Montpellier, département de neurologie, 34090 Montpellier, France
| | - P Labauge
- CHRU de Montpellier, département de neurologie, 34090 Montpellier, France
| | - W Camu
- CHRU de Montpellier, département de neurologie, 34090 Montpellier, France
| | - B Combe
- CHRU de Montpellier, département de rhumatologie, 34090 Montpellier, France
| | - J Morel
- CHRU de Montpellier, département de rhumatologie, 34090 Montpellier, France
| | - J Froger
- Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France; CHU de Nîmes, hôpital Carémeau et du Grau du Roi, département de médecine physique et de réadaptation, 30029 Nîmes, France
| | - B Coulet
- CHRU de Montpellier, département de chirurgie orthopédique, 34090 Montpellier, France
| | - J Cottalorda
- CHRU de Montpellier, département de chirurgie orthopédique et plastique infantile, 34090 Montpellier, France
| | - P Kouyoumdjian
- CHU Carémeau, département de chirurgie orthopédique, 30029 Nîmes, France
| | - O Jonquet
- CHRU de Montpellier, département de réanimation, 34090 Montpellier, France
| | - L Landreau
- CHRU de Montpellier, département de réanimation, 34090 Montpellier, France
| | - H-Y Bonnin
- Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France; CHU de Nîmes, hôpital Carémeau et du Grau du Roi, département de médecine physique et de réadaptation, 30029 Nîmes, France
| | - O Hantkié
- Centre Bourgès, groupe Oc Santé, 34173 Castelneau-le-lez cedex, France
| | - P Nicolas
- Centre Bourgès, groupe Oc Santé, 34173 Castelneau-le-lez cedex, France
| | - M Enjalbert
- Centre Bouffard-Vercelli, 66290 Cerbère, France; Association APPROCHE, CMRRF de Kerpape, BP 78, 56275 Ploemeur cedex, France
| | - C Leblond
- Centre Bouffard-Vercelli, 66290 Cerbère, France
| | - B Soua
- Association ADAGES, Les Fontaines d'Ô, 34000 Montpellier, France
| | - P Coignard
- Association APPROCHE, CMRRF de Kerpape, BP 78, 56275 Ploemeur cedex, France
| | - D Guiraud
- Université de Montpellier, laboratoire d'informatique, de robotique et de microélectronique de Montpellier, 34090 Montpellier, France; Institut national de recherche en informatique et en automatique, LIRMM, université de Montpellier, 34090 Montpellier, France
| | - C Azevedo
- Université de Montpellier, laboratoire d'informatique, de robotique et de microélectronique de Montpellier, 34090 Montpellier, France; Institut national de recherche en informatique et en automatique, LIRMM, université de Montpellier, 34090 Montpellier, France
| | - D Mottet
- Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France
| | - P Fraisse
- Université de Montpellier, laboratoire d'informatique, de robotique et de microélectronique de Montpellier, 34090 Montpellier, France
| | - E Pastor
- CCAS de Lattes, 34970 Lattes, France
| | - J Mercier
- CHRU de Montpellier, U1046 Inserm, université Montpellier 1, 34090 Montpellier, France
| | - R Bourret
- CHRU de Montpellier, Direction générale, 34090 Montpellier, France
| | | | - J Pélissier
- Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France; CHU de Nîmes, hôpital Carémeau et du Grau du Roi, département de médecine physique et de réadaptation, 30029 Nîmes, France
| | - B Bardy
- Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France
| | - C Herisson
- CHRU de Montpellier, département de médecine physique et de réadaptation, 34090 Montpellier, France; Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France
| | - A Dupeyron
- Movement to Health (M2H), Euromov, université de Montpellier, Montpellier, France; CHU de Nîmes, hôpital Carémeau et du Grau du Roi, département de médecine physique et de réadaptation, 30029 Nîmes, France; CHU Carémeau, CEDMH, 30029 Nîmes, France
| |
Collapse
|
15
|
Vassallo M, Durant J, Lebrun-Frenay C, Fabre R, Ticchioni M, Andersen S, DeSalvador F, Harvey-Langton A, Dunais B, Cohen-Codar I, Montagne N, Cua E, Fredouille-Heripret L, Laffon M, Cottalorda J, Dellamonica P, Pradier C. Virologically suppressed patients with asymptomatic and symptomatic HIV-associated neurocognitive disorders do not display the same pattern of immune activation. HIV Med 2015; 16:431-40. [PMID: 25981452 DOI: 10.1111/hiv.12246] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [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: 12/10/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Inversion of the CD4:CD8 ratio is a marker of immune activation and age-associated disease. We measured the CD4:CD8 ratio as a marker of cognitive impairment in HIV-infected patients and explored differences according to clinical severity. METHODS Post hoc analysis of data from two prospective cohorts of HIV-infected patients randomly selected to undergo neuropsychological tests was performed. Test scores were adjusted for age, gender and education. Inclusion criteria were undetectable viral load and stable treatment for at least 6 months. Subjects with HIV-associated dementia were excluded. Patients were divided into an unimpaired group, a group with asymptomatic neurocognitive disorder (ANI) and a group with symptomatic HIV-associated neurocognitive disorder (sHAND), represented by mild neurocognitive disorder (MND). Demographic and background parameters, immune activation markers and the CD4:CD8 ratio were recorded. RESULTS Two hundred patients were included in the study. The mean age was 52 years, 78% were male, the mean CD4 count was 624 cells/μL, the mean nadir CD4 count was 240 cells/μL, 27% were hepatitis C virus (HCV)-coinfected, the mean duration of HIV infection was 16 years, and the mean time on current combination antiretroviral therapy (cART) was 2.9 years. Twenty-nine per cent of subjects had HAND (21% had ANI and 8% had MND). In multivariate analysis, a CD4:CD8 ratio < 1 was associated with a nadir CD4 count < 200 cells/μL [odds ratio (OR) 3.68] and with the presence of CD4(+) CD38(+) HLA(+) cells (OR 1.23). Multinominal logistic regression showed that, in comparison with the unimpaired group, diagnosis of sHAND was associated with a CD4:CD8 ratio < 1 (OR 10.62), longer HIV infection (OR 1.15) and longer current cART (OR 1.34), while the ANI group differed from the unimpaired group only for education level. CONCLUSIONS Aviraemic patients with sHAND did not display the same pattern of immune activation as subjects with ANI, suggesting that the underlying pathophysiological mechanisms could be different.
Collapse
Affiliation(s)
- M Vassallo
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France.,Department of Internal Medicine, Cannes General Hospital, Cannes, France
| | - J Durant
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France
| | - C Lebrun-Frenay
- Department of Neurology, Pasteur Hospital, University of Nice, Nice, France
| | - R Fabre
- Department of Public Health, L'Archet Hospital, University of Nice, Nice, France
| | - M Ticchioni
- Immunology Laboratory Unit, L'Archet Hospital, University of Nice, Nice, France
| | - S Andersen
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France
| | - F DeSalvador
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France
| | - A Harvey-Langton
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France
| | - B Dunais
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France.,Department of Public Health, L'Archet Hospital, University of Nice, Nice, France
| | | | - N Montagne
- Department of Internal Medicine, Cannes General Hospital, Cannes, France
| | - E Cua
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France.,Department of Internal Medicine, Cannes General Hospital, Cannes, France
| | | | - M Laffon
- Department of Neurology, Pasteur Hospital, University of Nice, Nice, France
| | - J Cottalorda
- Virology Laboratory Unit, L'Archet Hospital, University of Nice, Nice, France
| | - P Dellamonica
- Department of Infectious Diseases, L'Archet Hospital, University of Nice, Nice, France
| | - C Pradier
- Department of Public Health, L'Archet Hospital, University of Nice, Nice, France
| |
Collapse
|
16
|
Bosch C, Assi C, Louahem D, Alkar F, Mazeau P, Delfour C, Canavese F, Prodhomme O, Cottalorda J. Diagnosis and surgical treatment of dysplasia epiphysealis hemimelica. A report of nine cases. Orthop Traumatol Surg Res 2014; 100:941-6. [PMID: 25453924 DOI: 10.1016/j.otsr.2014.07.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 07/04/2014] [Accepted: 07/12/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Dysplasia epiphysealis hemimelica (DEH) is a rare developmental bone disorder with hemimelic involvement of one or more epiphysis. We report on nine new cases and discuss the clinical manifestations, the value of MRI, and the results of complete and early surgical resection of these lesions. MATERIALS AND METHODS In this retrospective study, nine patients with a diagnosis of DEH were evaluated. Age at presentation ranged from 1 year to 12 years. The main complaint at diagnosis was a swelling bony mass. Angular deformities were recorded in two patients. All patients were surgically treated and followed up clinically and by imaging. Eight patients underwent excision only. RESULTS The average follow-up was 5.6 years (range, 2-10.5 years). All patients had a good outcome without related symptoms. No epiphysiodesis, angular deformity or recurrence was observed. One patient with femoral lesion involving the distal medial part of the epiphysis developed, four months after surgical excision, a calcification outside the area of total excision. This calcification did not increase in size at two years follow-up. Another patient with lateral involvement of the proximal tibial epiphysis presented a postoperative nervous complication. Spontaneous nervous recovery occurred three months after surgery. DISCUSSION MRI was useful to find a potential plane of cleavage between the epiphysis and the pathological tissue. We recommend early removing ossifications when a cleavage plane is identified. Waiting a possible complication or increasing of size does not seem logical. Of course, the treatment will be not the same if no cleavage plane is found on MRI. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- C Bosch
- Department of Pediatric Orthopaedics Surgery, University hospital of Montpellier, 34295 Montpellier, France
| | - C Assi
- Department of Pediatric Orthopedics Surgery, University hospital of Beirut, Beirut, Lebanon
| | - D Louahem
- Department of Pediatric Orthopaedics Surgery, University hospital of Montpellier, 34295 Montpellier, France
| | - F Alkar
- Department of Pediatric Orthopaedics Surgery, University hospital of Montpellier, 34295 Montpellier, France
| | - P Mazeau
- Department of Pediatric Orthopaedics Surgery, University hospital of Montpellier, 34295 Montpellier, France
| | - C Delfour
- Department of Histopathology, University hospital of Montpellier, 34295 Montpellier, France
| | - F Canavese
- Department of Pediatric Surgery, University hospital of Clermont-Ferrand, 69003 Clermont-Ferrand, France
| | - O Prodhomme
- Department of Pediatric Radiology, University hospital of Montpellier, 34295 Montpellier, France
| | - J Cottalorda
- Department of Pediatric Orthopaedics Surgery, University hospital of Montpellier, 34295 Montpellier, France.
| |
Collapse
|
17
|
Delpont M, Jouve JL, Sales de Gauzy J, Louahem D, Vialle R, Bollini G, Accadbled F, Cottalorda J. Proximal ulnar osteotomy in the treatment of neglected childhood Monteggia lesion. Orthop Traumatol Surg Res 2014; 100:803-7. [PMID: 25304829 DOI: 10.1016/j.otsr.2014.06.022] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/29/2014] [Accepted: 06/24/2014] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The aim of our study was to analyze medium and long-term results of proximal ulnar osteotomy with and without ligament injury in neglected Monteggia injury in children. MATERIAL AND METHODS This retrospective, multicenter study included 28 patients. Clinical criteria concerned the range of motion, pain and MEPI score, and radiologic criteria comprised of Storen line, head-neck ratio, radial neck angle, and signs of osteoarthritic remodeling. RESULTS Twenty-eight patients were reviewed, at a mean 6 years' follow-up (range, 2-34y). Sixteen had proximal ulnar osteotomy without ligament reconstruction, and 12 had associated ligamentoplasty. Both groups showed significant clinical and radiological improvement, with no significant difference. Patients operated within less than 1 year had better clinical and radiographic results. There was no correlation between age at surgery and quality of results. The 5 patients who underwent condyloradial pinning showed early recurrence of dislocation and osteoarthritic remodeling. The three cases of Bado type-3 lesion had early recurrence of dislocation. DISCUSSION Proximal ulnar osteotomy gives good long-term results in Bado type-1 lesions, regardless of age, if performed before 1 year, in the absence of osteoarthritic remodeling. Associated ligamentoplasty does not seem to be useful. LEVEL OF EVIDENCE IV (retrospective).
Collapse
Affiliation(s)
- M Delpont
- Service d'orthopédie infantile, hôpital Trousseau, 26, avenue Netter, 75012 Paris, France
| | - J-L Jouve
- Service d'orthopédie infantile, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France
| | - J Sales de Gauzy
- Service d'orthopédie infantile, hôpital des Enfants, 30, avenue de Grande-Bretagne - TSA 70034, 31059 Toulouse cedex 9, France
| | - D Louahem
- Service d'orthopédie infantile, hôpital Lapeyronie, 371, avenue du Doyen Gaston-Giraud, 34295 Montpellier, France
| | - R Vialle
- Service d'orthopédie infantile, hôpital Trousseau, 26, avenue Netter, 75012 Paris, France
| | - G Bollini
- Service d'orthopédie infantile, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France
| | - F Accadbled
- Service d'orthopédie infantile, hôpital des Enfants, 30, avenue de Grande-Bretagne - TSA 70034, 31059 Toulouse cedex 9, France
| | - J Cottalorda
- Service d'orthopédie infantile, hôpital Lapeyronie, 371, avenue du Doyen Gaston-Giraud, 34295 Montpellier, France.
| |
Collapse
|
18
|
Freychet C, Gay C, Lavocat M, Teyssier G, Patural H, Bacchetta J, Cottalorda J, Bader Meunier B, Linglart A, Baujat A, Stephan J. SFP P-017 - Le syndrome des calcifications artérielles généralisées de l’enfance (GACI): à propos d’une observation à début néonatal. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71987-6] [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: 11/25/2022]
|
19
|
Descamps D, Assoumou L, Chaix ML, Chaillon A, Pakianather S, de Rougemont A, Storto A, Dos Santos G, Krivine A, Delaugerre C, Montes B, Izopet J, Charpentier C, Wirden M, Maillard A, Morand-Joubert L, Pallier C, Plantier JC, Guinard J, Tamalet C, Cottalorda J, Marcelin AG, Desbois D, Henquell C, Calvez V, Brun-Vezinet F, Masquelier B, Costagliola D, Lagier E, Roussel C, Le Guillou-Guillemette H, Alloui C, Bettinger D, Anies G, Reigadas S, Bellecave P, Pinson-Recordon P, Fleury H, Masquelier B, Vallet S, Leroux M, Dina J, Vabret A, Poveda JD, Mirand A, Henquell C, Bouvier-Alias M, Noel C, De Rougemont A, Dos Santos G, Yerly S, Gaille C, Caveng W, Chapalay S, Calmy A, Signori-Schmuck A, Morand P, Pallier C, Bocket L, Mouna L, Ranger-Rogez S, Andre P, Tardy JC, Trabaud MA, Tamalet C, Delamare C, Montes B, Schvoerer E, Andre-Garnier E, Ferre V, Cottalorda J, Guigon A, Guinard J, Descamps D, Charpentier C, Peytavin G, Brun-Vezinet F, Haim-Boukobza S, Roques AM, Soulie C, Lambert-Niclot S, Malet I, Wirden M, Fourati S, Marcelin AG, Calvez V, Flandre P, Assoumou L, Costagliola D, Morand-Joubert L, Delaugerre C, Schneider V, Amiel C, Giraudeau G, Maillard A, Plantier JC, Fafi-Kremer S, Schmitt MP, Raymond S, Izopet J, Chaillon A, Barin F, Marque Juillet S. National sentinel surveillance of transmitted drug resistance in antiretroviral-naive chronically HIV-infected patients in France over a decade: 2001-2011. J Antimicrob Chemother 2013; 68:2626-31. [DOI: 10.1093/jac/dkt238] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
20
|
Abstract
The aim of proximal femoral osteotomies (PFO) in children is to restore normal anatomy and optimal joint congruency to prevent medium and long-terms degenerative deterioration of the hip. They play an important role in the treatment of neurological subluxations or dislocations of the hip. Advances in modern imaging and surgical techniques have improved understanding of the anatomical factors associated with a number of disorders of the growing hip and their sequelae. The indications for isolated PFO or associated with other intra- or extraarticular procedures have become more rational and better adapted to the various architectural defects and the femoroacetabular impingements. Two types of osteotomies are described: intertrochanteric osteotomies (varus and valgus correction, valgisation, flexion, extension), and osteotomies of the greater trochanter, either simple or double with lengthening of the femoral neck. Primary stability of the osteosynthesis is the major problem, as it is often affected by osteopenia. The development of new implants (LCP plate) avoids this inconvenience, resulting in geometrically precise osteotomies and a more stable fixation. Even when it is correctly performed, articular congruence is not always managed by PFO alone, it is sometimes necessary to associate acetabular procedures.
Collapse
Affiliation(s)
- D Louahem M'sabah
- Service de chirurgie orthopédique pédiatrique, CHU Lapeyronie, 371 avenue du Doyen-Gaston-Giraud, Montpellier cedex 5, France.
| | | | | |
Collapse
|
21
|
Cottalorda J, Violas P, Seringe R. Neuro-orthopaedic evaluation of children and adolescents: a simplified algorithm. Orthop Traumatol Surg Res 2012; 98:S146-53. [PMID: 22939865 DOI: 10.1016/j.otsr.2012.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 01/23/2012] [Revised: 03/26/2012] [Accepted: 04/24/2012] [Indexed: 02/02/2023]
Abstract
Orthopaedic surgeons are often the first physicians to evaluate paediatric patients in the event of delayed walking, gait abnormalities, or parental concern about motor abilities. Therefore, orthopaedic surgeons must be thoroughly familiar with the normal neurodevelopmental stages. Neurological disorders are often first recognised during an orthopaedic evaluation. Minimal neurological abnormalities should be taken as warning signs that require additional investigations. Consequently, the evaluation must follow a strict protocol, even in children referred for apparently trivial functional disorders. We have developed an original physical examination protocol in which the largest possible number of signs is sought in each body position to ensure that the examination is both systematic and rapid. About ten minutes are required when all findings are normal. This protocol is extremely helpful for identifying the cause of the problem that motivated the evaluation or for reassuring the child and family. The main causes of paediatric orthopaedic disorders are cerebral palsy, spinal dysraphism, myopathies, peripheral neuropathies, motor neuron diseases, and intraspinal tumours. In some instances, no definitive diagnosis can be established clinically. In this situation, appropriate orthopaedic treatment can be initiated, although considerable caution is in order when establishing the indications. The cause may be detected only much later, when the clinical manifestations become more prominent.
Collapse
Affiliation(s)
- J Cottalorda
- Department of Pediatric Orthopaedics Surgery, University Hospital of Montpellier, Lapeyronie Hospital, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France.
| | | | | | | |
Collapse
|
22
|
Anquetil C, Galano E, Cif AL, Cottalorda J, Coulet B, Thouvenin Y, Hérisson C, Laffont I. Paralysés cérébraux adultes et injection de corticoïde intra-articulaire dans la prise en charge des luxations de hanche. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.903] [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: 11/17/2022]
|
23
|
Anquetil C, Galano E, Cif AL, Cottalorda J, Coulet B, Thouvenin Y, Hérisson C, Laffont I. Intra-articular corticosteroid injections for care of hip dislocations in cerebral palsy adults. Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Casalonga A, Bourelle S, Chalencon F, De Oliviera L, Gautheron V, Cottalorda J. Tibial intercondylar eminence fractures in children: The long-term perspective. Orthop Traumatol Surg Res 2010; 96:525-30. [PMID: 20541992 DOI: 10.1016/j.otsr.2010.01.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2009] [Revised: 11/07/2009] [Accepted: 01/19/2010] [Indexed: 02/02/2023]
Abstract
PURPOSE OF THE STUDY To analyze objective and subjective results on medium-term follow-up of intercondylar fractures of the tibia in children. MATERIAL AND METHODS A retrospective, single-center study of 32 fractures (17 boys, 14 girls) was performed. Fractures were itemized on the Meyers and McKeever classification as modified by Zaricznyj: there were eight type-I, 17 type-II, five type-III and two type-IV fractures. Treatment was conservative for type-I and II fractures (with mild displacement) and for the others surgical. Seven patients were lost to follow-up and one had insufficient follow-up for inclusion. Thirteen patients were assessed on a KT 1000 arthrometer and a dynamometer, and on the IKDC and ARPEGE scoring systems. Ten patients chose to answer only the subjective IKDC questionnaire, by mail. RESULTS The mean IKDC score of subjects answering by mail was 91 and of those with clinical examination was 80. Mean ARPEGE score was 8.3. Subjective IKDC score classified four patients as A, four as B, four as C and one as D. Mean difference in tibial anterior translation between affected and unaffected knees was 0.88mm for type I fractures, 0.82mm for type II and 0.30mm for types III and IV together. DISCUSSION The mean difference in tibial anterior translation between affected and unaffected knees was greater in patients with conservative treatment (0.96mm for conservative vs. 0.29mm for surgical treatment). Seventy per cent of patients reported pain at follow-up. Only two had pathological knee laxity. Twelve out of thirteen had returned to sport activity, half of them at the same level as before injury. CONCLUSION The cases treated surgically had a better objective result than those treated conservatively. Nevertheless there was no correlation between subjective evaluation and degree of knee laxity. Overall, intercondylar fractures of the tibial eminence in children have good long-term prognosis, at least subjectively. This study shows that, in spite of a very satisfactory subjective result for most patients, results were not so good on objective measures. LEVEL OF EVIDENCE Level IV: retrospective study.
Collapse
Affiliation(s)
- A Casalonga
- Children's Surgery Department, Northern Hospital, 2055 Saint-Étienne cedex 2, France
| | | | | | | | | | | |
Collapse
|
25
|
Gautheron V, Edouard P, Bayle B, d'Anjou MC, Tardieu D, Chabrier S, Cottalorda J, Dohin B. [Importance of relay between hospitalization in surgery department and return to home in severely handicapped children]. Arch Pediatr 2010; 17:640-1. [PMID: 20654819 DOI: 10.1016/s0929-693x(10)70037-3] [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] [Indexed: 10/19/2022]
Affiliation(s)
- V Gautheron
- Laboratoire de Physiologie de l'Exercice, Service de Médecine Physique et deRéadaptation, Hôpital Bellevue, CHU de Saint-Etienne, EA 4338, IFR 25, Université Jean-Monnet, Saint-Etienne.
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Monpoux F, Puglièse P, Berthier F, Cottalorda J, Pradier C. Bridging the gap between adult and paediatric outcomes in HIV-1 vertically infected children: a single-centre comparison with adult data. Acta Paediatr 2009; 98:1787-92. [PMID: 19681795 PMCID: PMC2773535 DOI: 10.1111/j.1651-2227.2009.01440.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 06/11/2009] [Accepted: 06/25/2009] [Indexed: 11/28/2022]
Abstract
UNLABELLED Prognosis of HIV-1 infection dramatically improved during the last decade. Meanwhile, treatment-induced virological success has always been different in adult and children patients. AIM To compare 10 years of follow up in HIV-1 vertically infected children and adult patients. METHODS Monocentric retrospective longitudinal analysis of vertically HIV-1-infected children and adult patients followed in the Nice University Hospital between 1999 and 2008. Immunological, virological and antiretroviral treatment data were recorded. RESULTS Forty children and 1752 adult patients were included. Between 1996 and 2008, the percentage of children receiving HAART increased from 3.2% to 91%. Mean CD4% in the paediatric group remained stable between 29 +/- 8.1% in 1998 and 30 +/- 9.4% in 2008. Mean adult CD4-cell count significantly increased from 410 in 1998 to 556 cells/mL in 2008. Logistic regression analysis showed that the children-to-adult difference for indetectability (HIV PCR-RNA below 400 copies/mL) was significant (p < 0.0001) with an odds ratio of 0.61 (CI(95th): 0.52-0.72). Year-to-patient interaction was also significant with a decreasing divergence over time (p: 0.038). CONCLUSION Nowadays as in adult patients, the control of HIV-1 replication is achieved in nearly eight of 10 children and the percentage of patients with severe immunodeficiency dramatically decreased compared with the mid 1990s.
Collapse
Affiliation(s)
- F Monpoux
- Service de Pédiatrie, Hôpital de l'Archet II, Centre Hospitalier Universitaire de Nice, Nice Cedex, France.
| | | | | | | | | |
Collapse
|
27
|
Descamps D, Assoumou L, Masquelier B, Marcelin AG, Saidi S, Tamalet C, Cottalorda J, Plantier JC, Montes B, Izopet J, Peytavin G, Yerly S, Schneider V, Delaugerre C, Ferre V, Ruffault A, Pallier C, Morand-Joubert L, Chaix ML, Calvez V, Brun-Vezinet F, Costagliola D. HIV-1-infected patients from the French National Observatory experiencing virological failure while receiving enfuvirtide. J Antimicrob Chemother 2008; 62:451-5. [DOI: 10.1093/jac/dkn225] [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] [Indexed: 11/12/2022] Open
|
28
|
Garraffo R, Cottalorda J, Rahelinirina V, Lavrut T, Ferrando S, Durant J, Hadacek B. L-06 Relation entre les concentrations résiduelles plasmatiques et intracellulaires d’APV, le GIQ et la CV à S24 et les mutations de résistance sur l’ADN proviral chez des patients prétraités switchant vers du fosamprénavir : résultats préliminaires de l’étude MUTAPHARM. Med Mal Infect 2008. [DOI: 10.1016/s0399-077x(08)73169-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: 11/15/2022]
|
29
|
Cottalorda J, de Billy B, Bourelle S, Al Bitar B, Diraduryan N, Mory O. Aspects orthopédiques de la traumatologie accidentelle non sportive de l’adolescent. Arch Pediatr 2008; 15:756-7. [DOI: 10.1016/s0929-693x(08)71900-6] [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: 11/28/2022]
|
30
|
Masquelier B, Assoumou KL, Descamps D, Bocket L, Cottalorda J, Ruffault A, Marcelin AG, Morand-Joubert L, Tamalet C, Charpentier C, Peytavin G, Antoun Z, Brun-Vézinet F, Costagliola D. Clinically validated mutation scores for HIV-1 resistance to fosamprenavir/ritonavir. J Antimicrob Chemother 2008; 61:1362-8. [PMID: 18390885 DOI: 10.1093/jac/dkn127] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We developed clinically relevant genotypic scores for resistance to fosamprenavir/ritonavir in HIV-1 protease inhibitor (PI)-experienced patients. METHODS PI-experienced patients with virological failure receiving fosamprenavir/ritonavir as the sole PI for at least 3 months and with detectable fosamprenavir plasma levels were included. The impact of baseline protease mutations on virological response (VR, i.e. decrease in plasma HIV-1 RNA between baseline and month 3) was analysed using the Mann-Whitney test. Mutations with prevalence >10% and P value <0.10 were retained. The Jonckheere-Terpstra test was used to select the combination of mutations most strongly associated with VR. The association between score and VR was assessed by multivariate backward regression. RESULTS In the 73 patients included, the median baseline HIV-1 RNA was 4.6 log(10) copies/mL (range: 2.7-6.9) and the mean decrease at month 3 was -1.07 +/- 1.40 log(10) copies/mL. Ninety per cent of the patients were infected by HIV-1 subtype B variants. Two fosamprenavir/ritonavir mutation scores were constructed: score A (L10F/I/V + L33F + M36I + I54L/M/V/A/T/S + I62V + V82A/F/C/G + I84V + L90M) was based only on mutations associated with a worse VR, whereas score B (L10FIV + L33F + M36I + I54L/M/V/A/T/S + A71V - V77I - N88S + L90M) also took into account favourable mutations. Both scores were independent predictors of VR, however, co-administration of tenofovir was associated with a worse VR and the presence of the N88S protease mutation and co-administration of enfuvirtide with a better VR. CONCLUSIONS These clinically validated mutation scores should be of interest for the clinical management of PI-experienced patients. The fosamprenavir/ritonavir score A was introduced in the 2006 ANRS algorithm along with isolated mutations I50V and V32I + I47V.
Collapse
Affiliation(s)
- B Masquelier
- Laboratoire de Virologie, CHU de Bordeaux and EA 2968, Université Victor Segalen, Bordeaux, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Delaugerre C, Flandre P, Marcelin A, Descamps D, Tamalet C, Cottalorda J, Schneider V, Yerly S, LeGoff J, Morand-Joubert L, Chaix M, Costagliola D, Calvez V. National survey of the prevalence and conditions of selection of HIV-1 reverse transcriptase K70E mutation. J Med Virol 2008; 80:762-5. [DOI: 10.1002/jmv.21158] [Citation(s) in RCA: 6] [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] [Indexed: 11/08/2022]
|
32
|
Abstract
The etiology of aneurysmal bone cyst is probably multifactorial. Recent progress in genetics and immunohistochemistry tends to prove that aneurysmal bone cyst is tumor and not a pseudo-tumor. Involvement of chromosomes 17p11-13 or 16q22 has been described. MRI is indispensable. Signs highly suggestive of aneurysmal bone cyst are: well-limited expansive bone lesion, low intensity T1 signal associated with high intensity T2 signal (liquid component), a low intensity peripheral line with enhancement after contrast injection, septal partitioning and fluid levels. Gadolinium injection is informative since it demonstrates the thick regular septal partitioning and the amorphous contents (lack of contrast uptake), a structure which is not seen in any other tumors, particularly malignant tumors. Plain x-ray and MRI contribute well to diagnosis but histological confirmation is always required. The debate on Ethibloc(R) remains open. For certain authors, this technique is an effective safe treatment which can be proposed as a first-line option. Ethibloc(R) should however be reserved for specialized teams because of the serious complications reported in the literature. A new treatment has also been reported to be promising, but further results will be required for confirmation. With this technique demineralized allogenic bone particles associated with autologous bone marrow are implanted in the cyst to achieve an osteogenic effect. This induces the cyst to pass from the destructive resorption phase to the repairing osteogenic phase. Curettage is not necessary. This method, which avoids extensive surgery and blood loss, is well adapted to difficult localizations such as the pelvis.
Collapse
Affiliation(s)
- J Cottalorda
- Service de Chirurgie Pédiatrique, Hôpital Nord, 42055 Saint-Etienne Cedex 2.
| | | |
Collapse
|
33
|
Ferigo N, Cottalorda J, Allard D, Gentil-Perret A, Fessy M, Berger C, Stéphan JL. Successful treatment via chemotherapy and surgical resection of a femoral hemangiopericytoma with pulmonary metastasis. J Pediatr Hematol Oncol 2006; 28:237-40. [PMID: 16679922 DOI: 10.1097/01.mph.0000212903.61276.4b] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hemangiopericytoma (HPC) is a soft-tissue neoplasm composed of proliferating capillary pericytes. It has variable and unpredictable malignancy and most commonly occurs in the fifth or sixth decade of life. Diagnosis is based on the histological aspect. HPC is exceedingly rare in childhood. In both adults and children, curative surgery is the most important predictor of survival. The place of chemotherapy in the treatment of HPC is not well established. We describe a case of adult-type metastatic HPC of the thigh in a 13-year-old boy. The response to neoadjuvant chemotherapy was excellent, and local control of this initially unresectable tumor was achieved without radiation therapy or mutilating surgery. The child is alive and well and has had 8 years of follow-up after treatment.
Collapse
Affiliation(s)
- N Ferigo
- Pediatric Hematology and Oncology Unit, Hôpital Nord, University of Saint Etienne, Saint Etienne 42055, France
| | | | | | | | | | | | | |
Collapse
|
34
|
Diop M, Rahmani A, Belli A, Gautheron V, Geyssant A, Cottalorda J. Influence of Speed Variation and Age on Ground Reaction Forces and Stride Parameters of Children's Normal Gait. Int J Sports Med 2005; 26:682-7. [PMID: 16158375 DOI: 10.1055/s-2004-830382] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [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: 10/25/2022]
Abstract
The aim of this study was to assess the influence of both age and speed on ground reaction forces and temporal parameters during normal gait in children. Fifteen children aged 4-6 years (group 1), 16 aged 6-8 years (group 2), and 16 aged 8-10 years (group 3) walked at 2.7 km/h, 3.6 km/h, and 4.5 km/h on a treadmill. For each child thirty successive steps were recorded. The influence of speed and age on normalized gait parameters was examined with two-way analysis of variance. The first vertical peak force (Fz1) and all the antero-posterior forces of group 1 were higher than those of the other groups for the three speeds. The minimum vertical force (Fz2), the second vertical peak force (Fz3), and the duration of stride and stance were significantly higher in groups 2 and 3. For all the groups, Fz1 and all the antero-posterior forces increased with the speed while Fz2, stride, stance, and double-stance duration decreased. Fz3 was not influenced by speed variation. The results of this study show that age and walking speed influence ground reaction forces and stride time parameters in 4- to 10-year-old children.
Collapse
Affiliation(s)
- M Diop
- Physiology Department - GIP Exercice Sport Santé, University School of Medicine, Saint-Etienne, France
| | | | | | | | | | | |
Collapse
|
35
|
Abstract
PURPOSE OF THE STUDY MacFarland fractures are known to have poor prognosis. There is a major risk of misalignment due to the formation of an epiphysiodesis bridge. The purpose of this study was to evaluate the functional and radiological outcome of these fractures in a retrospective series of patients. MATERIAL AND METHODS We analyzed retrospectively the cases of 26 patients (14 boys and 12 girls), mean age 11 years 6 months (range 7-15) with MacFarland fractures. The Salter and Harris classification was Salter III (n = 17) and Salter IV (n = 9). Surgery was used for 21 patients and cast immobilization for five. Mean follow-up was 28.4 months (19-63 months). None of the children were lost to follow-up. Outcome was noted good (no stiffness, no pain, no limp, no misalignment, no surgical complication, no healing problem), fair (stiffness and/or pain and/or limp and/or healing problem without misalignment, no surgical complication), or poor (misalignment or surgical complication). RESULTS The three-months postoperative assessment showed three patients with ankle pain, five with stiff ankles, one with a medial problem (snapping) and two with wound healing complications. The long-term outcome was considered good for 24 patients and fair in two (one wound adherence and one hypertrophic scar tissue). There were no poor outcomes. DISCUSSION We used surgery more than is generally reported by other teams, opting for surgery when the displacement was 1 mm rather than the 2 mm used by others. Surgical treatment was arthrotomy in all cases to achieve anatomic reduction under direct view, followed by osteosynthesis. For some, this therapeutic scheme may be considered too surgical. In order to achieve anatomic reduction, we use an epiphyseal lag screw for cancellous bone to achieve better compression of the fracture line. A washer is also used to improve compression and maintain perfect reduction. Theoretically, the washer could raise the risk of perichondral virola and consequently an iatrogenic epiphysiodesis bridge, but we have not had any problems in our experience. Arthrotomy did not lead to ankle stiffness, which is feared by some, in any of our patients.
Collapse
Affiliation(s)
- J-P Camilleri
- Service de Chirurgie Infantile, Hôpital Nord, Saint-Etienne
| | | | | | | | | |
Collapse
|
36
|
Abstract
A 9-year-old child presented an aggressive aneurysmal bone cyst of the humerus. Despite multiple treatments (intracystic steroid injections, curettage, Ethibloc injection), the lesion continued to progress. Surgical treatment was undertaken at the age of 19 years and enabled total tumor resection associated with reconstruction with a vascularized fibular flap. Five years later, the patient was free of recurrence. The graft was well integrated and shoulder function was normal. We present the diagnostic difficulties encountered in this case and discuss the therapeutic options. Biopsy is indispensable before instituting treatment.
Collapse
Affiliation(s)
- J Cottalorda
- Service de Chirurgie Infantile, Hôpital Nord, avenue Albert-Raimond, 42055 Saint-Etienne Cedex 2
| | | | | |
Collapse
|
37
|
Cottalorda J, Bourelle S, Vanel O, Berger C, Stéphan JL. Les tumeurs osseuses rachidiennes chez l'enfant et l'adolescent. Arch Pediatr 2005; 12:1131-8. [PMID: 15964530 DOI: 10.1016/j.arcped.2005.03.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2004] [Accepted: 03/02/2005] [Indexed: 11/17/2022]
Abstract
The occurrence of back pain in children and adolescents varies from 30 to 51% in the literature. Bone tumors can be responsible for back pain. This paper presents the more common spinal bone tumors in children and adolescents, and specifies their etiology, their natural history, and their treatment as well.
Collapse
Affiliation(s)
- J Cottalorda
- Service de chirurgie infantile, hôpital Nord, Saint-Etienne, France.
| | | | | | | | | |
Collapse
|
38
|
Affiliation(s)
- J Cottalorda
- Service de chirurgie infantile, hôpital Nord, Saint-Etienne, France.
| | | | | |
Collapse
|
39
|
Abstract
Of 23 children (35 feet) with cerebral palsy who had undergone a Grice extra-articular subtalar arthrodesis for a valgus hindfoot between 1976 and 1981, we reviewed 17 (26 feet), at a mean of 20 years (17 years 3 months to 22 years 4 months) after operation. Seven were quadriplegic, eight spastic diplegic, and two hemiplegic. They were all able to walk at the time of operation. Thirteen patients (20 feet) were pleased with the Grice procedure, 13 had no pain and 15 (23 feet) were still able to walk. The clinical results were satisfactory for most feet. Radiography showed that the results had been maintained over time but 14 feet developed a mean ankle valgus of 11° (6 to 18) with a compensatory hindfoot varus in 12 feet. No deformity of the talus or arthritis of adjacent joints was noted. The Grice procedure gives good long-term results in children with cerebral palsy.
Collapse
Affiliation(s)
- S Bourelle
- Medical School of Medicine, Saint-Etienne, France
| | | | | | | |
Collapse
|
40
|
Abstract
Back pain has become a real public health concern both for adults and children. In general, patients complain of moderate pain. While the topic was long ignored by the scientific community, the number of publications has increased over the last three Years. We reviewed the literature to separate real evidence from speculations. Recognized risk factors for spinal pain are: female gender, poor general status, family history of back pain, particular psychological patterns, time spent sitting watching television, history of spinal trauma, intense physical activity, practicing competition sports, and age (more frequent in adolescents than children). Several recent papers have drawn attention to the role of the weight of the school backpack in children, particularly when its weight exceeds 20% of the child's body weight. Many children carry heavy backpacks which for some may weigh 30% to 40% of their body weight. Several groups have estimated that the maximum should be 10% of the body weight. It appears that time spent carrying the backpack as well as its weight is an important factor favoring back pain. Backpacks can injury the head or face, as well as the hands, the elbow, the wrist, the shoulder, the foot and the ankle. Back trauma is observed as the sixth most common injury. The 'weak point' is the shoulder and not the back. A poorly positioned backpack can modify posture and gait. Carrying the backpack with two shoulder straps affects posture and gait less than carrying it on one shoulder. The posture of the spine changes when the weight of the backpack increases. This is probably one of the reasons why many parents who consult believe that there is a relationship between the weight of the backpack and scoliosis or kyphosis, observed in many of their children. It is proven that adolescents who suffer from back pain will probably have chronic back pain as adults, but there is not evidence to our knowledge demonstrating a relationship between the development of spinal deviation and the weight of the backpack. Recent studies have been conducted to design backpacks allowing a better weight distribution and comfort. This type of backpack appears to have a limited benefit. Furthermore, the question of mode must not be ignored for children and adolescents. Backpacks with one sack in front and one in back certainly provide better weight distribution but are they acceptable for children and adolescents?
Collapse
Affiliation(s)
- J Cottalorda
- Equipe d'accueil EA E2S 3062, Laboratoire de Physiologie et Physiopathologie de l'Exercice et du Handicap, Saint-Etienne.
| | | | | | | |
Collapse
|
41
|
Diop M, Rahmani A, Calmels P, Gautheron V, Belli A, Geyssant A, Cottalorda J. Influence de la vitesse et de l’âge sur la variabilité intrasujet des forces de réaction et des paramètres spatiotemporels de la marche de l’enfant sain. ACTA ACUST UNITED AC 2004; 47:72-80. [PMID: 15013601 DOI: 10.1016/j.annrmp.2003.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2003] [Accepted: 09/18/2003] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the effect of age and speed on the variability of ground reaction forces (GRF) and stride parameters of gait in normal children. MATERIAL AND METHOD Forty-seven children aged 4-10 years were split into three age groups. Each child walked at three constant speeds on a treadmill. Thirty consecutive steps of each leg were recorded. For each child, the mean parameters of the 30 steps were calculated. The mean parameter of each child was taken to calculate the mean parameters of the group. The variability was evaluated by the coefficient of variation (CV). The influence of both age and speed on the variability was examined with a to-way analysis of variance. RESULTS The cross effect of age and speed on the variability was not significant. The variability of the parameters decreased significantly with age between 4 and 8 years. The variability of vertical forces increased significantly with speed (between 2.7 and 4.5 km/h), while the variability of antero-posterior forces, the stride and the stance decreased between 2.7 and 3.6 km/h. However, the variability of double stance was not influenced by walking speed between 2.7 and 4.5 km/h. Except the time of production of the vertical force of propulsion (Tz3), the variability of temporal vertical parameters decreased significantly with speed between 2.7 and 4.5 km/h and the variability of temporal antero-posterior parameters decreased significantly between 2.7 and 3.6 km/h. DISCUSSION-CONCLUSION The variability of the GRF and spatio-temporal parameters in children was influenced by age between 4 and 8 years old and by speed between 2.7 and 3.6 km/h. Moreover, the effect of age on the GRF persists up to 8 years. The variabilities of the time of production of the antero-posterior force of propulsion (Ty2) and stance duration were lower than the variabilities of the others parameters. These two variables could be the most reliable parameters when assessing gait in children aged 4-10 years, walking at speeds between 2.7 and 4.5 km/h.
Collapse
Affiliation(s)
- M Diop
- Equipe d'accueil EA E2S 3062, laboratoire de physiologie et physiopathologie de l'exercice et du handicap, Saint-Etienne, France
| | | | | | | | | | | | | |
Collapse
|
42
|
Stéphen JL, Yakoubi Y, Cottalorda J. [Fever and neoplasms in the child]. Arch Pediatr 2003; 10 Suppl 1:189s-192s. [PMID: 14509794 DOI: 10.1016/s0929-693x(03)90434-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J L Stéphen
- Unité d'hématologie et d'oncologie pédiatrique, hôpital Nord, CHU Saint-Etienne, 42055 Saint-Etienne, France
| | | | | |
Collapse
|
43
|
Affiliation(s)
- J Cottalorda
- Service de chirurgie infantile, hôpital Nord, 42055 Saint-Etienne, France.
| | | | | | | |
Collapse
|
44
|
Cottalorda J, Bourelle S, Berger C, Richard O, Stéphan JL. [Radiologic case of the month]. Arch Pediatr 2002; 9:531-4. [PMID: 12053549 DOI: 10.1016/s0929-693x(01)00837-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- J Cottalorda
- Service de chirurgie infantile, hôpital Nord, CHU de Saint-Etienne, 42055 Saint-Etienne, France.
| | | | | | | | | |
Collapse
|
45
|
Clevenbergh P, Cua E, Dam E, Durant J, Schmit JC, Boulme R, Cottalorda J, Beyou A, Schapiro JM, Clavel F, Dellamonica P. Prevalence of nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance-associated mutations and polymorphisms in NNRTI-naïve HIV-infected patients. HIV Clin Trials 2002; 3:36-44. [PMID: 11819184 DOI: 10.1310/5h0r-udc8-8rr7-xemj] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The efficacy of treatment containing nonnucleoside reverse transcriptase inhibitors (NNRTIs) could be compromised in NNRTI-naïve patients already harboring a virus resistant to NNRTIs. On the contrary, hypersusceptibility to NNRTIs in patients having failed nucleoside reverse transcriptase inhibitor (NRTI)-containing regimens has been described and has been associated with improved outcome. METHOD We assessed the prevalence of NNRTI resistance-associated mutations or polymorphisms in 146 antiretroviral-naïve patients and in 181 HIV-infected patients who were given an NNRTI-based regimen. We phenotypically evaluated the NNRTI susceptibility of 41 strains presenting with amino acid substitutions at positions involved in NNRTI resistance. RESULTS In the 268 genotypically analyzable samples, the overall prevalence of NNRTI resistance-associated mutations was 2% (6/268 patients). The prevalence of strains with amino acid substitutions at reverse transcriptase (RT) gene positions (A98, K101, K103, V106, V108, V179) involved in NNRTI resistance was 15%. Hypersusceptibility to NNRTI was rare (2%, 1/41) in those samples. RT substitutions at positions involved in NNRTI resistance were not associated with a significantly worse virologic outcome in NNRTI-treated patients. Our understanding of small shifts in IC50 values (higher or lower) toward NNRTI is very limited. The significance of many RT mutations on NNRTI susceptibility is not clear. CONCLUSION In contrast to resistance mutations, RT substitutions at positions involved in NNRTI resistance are frequent. They are not associated with a worse virologic outcome or with decreased phenotypic susceptibility to NNRTIs. It may be prudent not to rule out the use of NNRTIs in patients with small shifts in IC50 values or poorly understood mutations.
Collapse
Affiliation(s)
- P Clevenbergh
- Department of Infectious Diseases, Nice University Hospital, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Cottalorda J, Bourelle S, Chavrier Y. [Radiology case of the month. Blount's disease]. Arch Pediatr 2001; 8:1235-8. [PMID: 11760677 DOI: 10.1016/s0929-693x(01)00616-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- J Cottalorda
- Service de chirurgie infantile, Hôpital Nord, centre hospitalier universitaire de Saint-Etienne, 42055 Saint-Etienne, France.
| | | | | |
Collapse
|
47
|
Descamps D, Calvez V, Izopet J, Buffet-Janvresse C, Schmuck A, Colson P, Ruffault A, Maillard A, Masquelier B, Cottalorda J, Harzic M, Brun-Vézinet F, Costagliola D. Prevalence of resistance mutations in antiretroviral-naive chronically HIV-infected patients in 1998: a French nationwide study. AIDS 2001; 15:1777-82. [PMID: 11579238 DOI: 10.1097/00002030-200109280-00005] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate the prevalence of resistance-conferring mutations to antiretroviral drugs in previously untreated patients with chronic HIV-1 infection as a basis for French recommendations on viral genotyping before antiretroviral treatment initiation. DESIGN Resistance mutations were sought in samples from 404 patients seen in 23 specialized centres throughout metropolitan France in 1998. METHODS The protease and reverse transcriptase (RT) genes of plasma virions were sequenced. Primary and secondary protease and RT gene mutations were identified from the International AIDS Society resistance testing - USA panel. RESULTS The prevalence of patients with primary and secondary mutations were 3.7% (95% CI 1.7-5.7) and 50.3% (95% CI 45.0-55.6), respectively. The prevalence of patients with mutations associated with resistance to nucleoside RT inhibitors (NRTI) and non-nucleoside RT inhibitors was 3.3% (95% CI 1.5-5.1) and 0.8% (95% CI 0.0-1.7), respectively. The prevalence of patients with NRTI primary mutations differed according to whether seropositivity had been diagnosed more or less than one year previously (0.2 versus 2.2% P = 0.023). Primary mutations associated with protease inhibitor resistance occurred at a prevalence of 1.9% (95% CI 0.5-3.4) with no difference according to the duration of known seropositivity. CONCLUSION In France, in 1998, the prevalence of patients with primary mutations associated with resistance to antiretroviral drugs was low. Genotyping before the initiation of therapy was not recommended in chronically HIV-1-infected naive patients. A national sentinel survey of resistance in this clinical setting is performed regularly to update the recommendations for resistance testing.
Collapse
Affiliation(s)
- D Descamps
- Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Masquelier B, Race E, Tamalet C, Descamps D, Izopet J, Buffet-Janvresse C, Ruffault A, Mohammed AS, Cottalorda J, Schmuck A, Calvez V, Dam E, Fleury H, Brun-Vézinet F. Genotypic and phenotypic resistance patterns of human immunodeficiency virus type 1 variants with insertions or deletions in the reverse transcriptase (RT): multicenter study of patients treated with RT inhibitors. Antimicrob Agents Chemother 2001; 45:1836-42. [PMID: 11353634 PMCID: PMC90554 DOI: 10.1128/aac.45.6.1836-1842.2001] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [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: 11/20/2022] Open
Abstract
Genomic rearrangements in the 5' part of the human immunodeficiency virus type 1 (HIV-1) reverse transcriptase (RT) have been involved in multidrug resistance to nucleoside RT inhibitors (NRTI). We carried out a retrospective, multicenter study to investigate the prevalence, variability, and phenotypic consequences of such rearrangements. Data concerning the HIV-1 RT genotype and the biological and clinical characteristics of NRTI-treated patients were collected from 10 virology laboratories. Sensitivities of the different HIV-1 variants to RT inhibitors were analyzed in a single-cycle recombinant virus assay. Fifty-two of 2,152 (2.4%) RT sequences had a rearrangement in the 5' part of the RT, with an extensive molecular variation. The number of codons inserted between positions 68 and 69 ranged from 1 (3 samples) or 2 (41 samples) to 5 and 11 in one case each. In four cases, codon 67 was deleted. High levels of phenotypic resistance to zidovudine (AZT), lamivudine (3TC), stavudine (d4T), abacavir (ABC), and didanosine (ddI) were found in 95, 92, 72, 62, and 15% of the 40 samples analyzed, respectively. Resistance to AZT, d4T, and ABC could be found in the absence of the T215Y/F mutations. Resistance to 3TC could develop in the absence of specific mutations. Low-level resistance to ddI was noticed in 40% of the patients. The deletions of codon 67 seemed to have little effect on NRTI sensitivity. Most of the rearrangements were shown to contribute to cross-resistance to NRTI. The results regarding susceptibility to ddI raise the question of the interpretation of the phenotypic data concerning this drug.
Collapse
Affiliation(s)
- B Masquelier
- The Virology Laboratories of the University Hospitals of Bordeaux, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Abstract
UNLABELLED Chronic recurrent multifocal osteitis (OCRM) is a rare condition in children, of unknown aetiology, which may be misdiagnosed as osteomyelitis, arthritis or tumour. PATIENTS AND METHODS We present a retrospective multicentric study of 17 patients (five boys and 12 girls) with an average follow-up of 7.5 years (six months-25 years). RESULTS A spectrum of presenting features is possible, ranging from bone lesions alone to lesions combined with arthritis, palmoplantar pustulosis or psoriasis. The diagnosis was delayed from two weeks to five years. Roentgenographic evaluation was often normal at the beginning of the disease or showed nonspecific bone reactions. Radioisotope bone scans assisted in establishing the diagnosis and in identifying lesions that were initially clinically silent. Bone biopsies were performed in seven cases. Histopathological examination showed only mild inflammatory nonspecific changes. Microbiological cultures were always negative. Treatments were different according to the evolution of the disease and the hospital. There was no response to antibiotics in seven patients. The response to nonsteroidal anti-inflammatory agents and steroids was moderate and often transient. Salazopyrine and pamidronate treatment used in two patients allowed a durable remission. We lost sight of four patients, pain persisted in three in spite of treatment, it disappeared in two with treatment, mild pain persisted in five without treatment and remission occurred in three without treatment. CONCLUSION This study clarifies the clinical and radiologic features of chronic recurrent multifocal osteomyelitis. The recognition of this rare entity is often delayed and difficulties in patient management sometimes emerge from its usual protracted course.
Collapse
Affiliation(s)
- E Coinde
- Service de pédiatrie, hôpital Edouard-Herriot, Lyon, France
| | | | | | | | | | | | | |
Collapse
|
50
|
Masquelier B, Chaix ML, Burgard M, Lechenadec J, Doussin A, Simon F, Cottalorda J, Izopet J, Tamalet C, Douard D, Fleury H, Mayaux MJ, Blanche S, Rouzioux C. Zidovudine genotypic resistance in HIV-1-infected newborns in the French perinatal cohort. J Acquir Immune Defic Syndr 2001; 27:99-104. [PMID: 11404530 DOI: 10.1097/00126334-200106010-00001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 11/27/2022]
Abstract
A retrospective study was set up to investigate the frequency of zidovudine (ZDV)-resistant HIV-1 in infected newborns after ZDV prophylaxis in the French Perinatal Cohort study. Nucleotide sequence analysis was carried out from 34 infants' isolates and 18 maternal plasma samples. Mutations related to ZDV resistance were found in the HIV-1 reverse transcriptase in 7 of 34 children (20%). Evidence of mother-child transmission of ZDV-resistant HIV-1 was found in 4 cases. Phylogenetic analysis showed that 14 of 34 HIV-1 isolates from the infants belonged to non-B subtypes. The presence of ZDV resistance-encoding mutations in the newborn isolates was associated with a longer total duration of exposure to ZDV. In a context of a wide HIV-1 variability, ZDV resistance can be one of the factors contributing to mother-child transmission.
Collapse
Affiliation(s)
- B Masquelier
- Laboratoires de Virologie, Centres Hospitaliers Universitaires de Bordeaux, Hôpital Pellegrin, Place Amelie Raba Léon, 33076 Bordeaux CEDEX France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|