1
|
Pelletier J, Koyfman A, Long B. Acute aortic occlusion: A narrative review for emergency clinicians. Am J Emerg Med 2024; 79:192-197. [PMID: 38460466 DOI: 10.1016/j.ajem.2024.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/14/2024] [Accepted: 02/22/2024] [Indexed: 03/11/2024] Open
Abstract
INTRODUCTION Acute aortic occlusion (AAO) is a rare but serious condition associated with significant morbidity and mortality. OBJECTIVE This review provides an emergency medicine focused evaluation of AAO, including presentation, assessment, and emergency department (ED) management based on current evidence. DISCUSSION AAO refers to obstruction of blood flow through the aorta due to either thrombosis or embolism. This condition primarily affects older adults ages 60-70 with cardiovascular comorbidities and most commonly presents with signs and symptoms of acute limb ischemia, though the gastrointestinal tract, kidneys, and spinal cord may be affected. The first line imaging modality includes computed tomography angiography of the chest, abdomen, and pelvis. ED resuscitative management consists of avoiding extremes of blood pressure or heart rate, maintaining normal oxygen saturation and euvolemic status, anticoagulation with heparin, and pain control. Emergent consultation with the vascular surgery specialist is recommended to establish a plan for restoration of perfusion to ischemic tissues via endovascular or open techniques. High rates of baseline comorbidities present in the affected population as well as ischemic and reperfusion injuries place AAO patients at high risk for complications in an immediate and delayed fashion after surgical management. CONCLUSIONS An understanding of AAO can assist emergency clinicians in diagnosing and managing this rare but devastating disease.
Collapse
Affiliation(s)
- Jessica Pelletier
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Alex Koyfman
- Department of Emergency Medicine, UT Southwestern, Dallas, TX, USA
| | - Brit Long
- SAUSHEC, Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
| |
Collapse
|
2
|
Long B, Pelletier J, Koyfman A, Bridwell RE. In response: Considerations regarding compounding pharmacies and GLP-1 agonists. Am J Emerg Med 2024:S0735-6757(24)00160-8. [PMID: 38600000 DOI: 10.1016/j.ajem.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 03/31/2024] [Indexed: 04/12/2024] Open
Affiliation(s)
- Brit Long
- Department of Emergency, Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
| | - Jessica Pelletier
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Alex Koyfman
- Department of Emergency Medicine, UT, Southwestern, Dallas, TX, USA
| | - Rachel E Bridwell
- Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA, USA
| |
Collapse
|
3
|
Long B, Pelletier J, Koyfman A, Bridwell RE. GLP-1 agonists: A review for emergency clinicians. Am J Emerg Med 2024; 78:89-94. [PMID: 38241775 DOI: 10.1016/j.ajem.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/21/2024] Open
Abstract
INTRODUCTION Glucagon-like peptide 1 (GLP-1) based therapies, including GLP-1 agonists, are currently in use for treatment of diabetes and obesity. However, several complications may occur with their use. OBJECTIVE This narrative review provides a focused evaluation of GLP-1 agonist therapy and associated complications for emergency clinicians. DISCUSSION GLP-1 agonists potentiate insulin release and reduce gastric emptying and food intake. These agents have demonstrated significant improvements in glucose control in diabetics and weight loss in obese patients. The two most common agents include subcutaneous semaglutide (Ozempic, approved for type 2 diabetes, and Wegovy, approved for weight loss) and liraglutide (Saxenda, approved for weight loss, and Victoza, approved for type 2 diabetes), though an oral formulation of semaglutide is available (Rybelsus). While these drugs are associated with improved long-term outcomes, there are a variety of associated adverse events. The most common include gastrointestinal (GI) adverse events such as nausea, vomiting, diarrhea, and abdominal pain. Pancreatitis and biliary disease may also occur. Hypersensitivity including injection site reactions have been associated with use, with reports of anaphylaxis and other rashes. Renal adverse events are most commonly associated with severe GI losses. Hypoglycemia may occur when these agents are used with sulfonylureas or insulin. There is also an increased risk of diabetic retinopathy. Due to the current shortage and expense of these medications, many patients have attempted to obtain these medications from non-licensed and unregulated agents, which may be associated with increased risk of serious complications. CONCLUSIONS An understanding of the indications for GLP-1 agonist use and associated adverse events can assist emergency clinicians.
Collapse
Affiliation(s)
- Brit Long
- Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
| | - Jessica Pelletier
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Alex Koyfman
- Department of Emergency Medicine, UT Southwestern, Dallas, TX, USA
| | - Rachel E Bridwell
- Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA, USA
| |
Collapse
|
4
|
Pelletier J, Sugar D, Koyfman A, Long B. Multiple Sclerosis: An Emergency Medicine-Focused Narrative Review. J Emerg Med 2024; 66:e441-e456. [PMID: 38472027 DOI: 10.1016/j.jemermed.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/15/2023] [Accepted: 12/11/2023] [Indexed: 03/14/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) is a rare but serious condition associated with significant morbidity. OBJECTIVE This review provides a focused assessment of MS for emergency clinicians, including the presentation, evaluation, and emergency department (ED) management based on current evidence. DISCUSSION MS is an autoimmune disorder targeting the central nervous system (CNS), characterized by clinical relapses and radiological lesions disseminated in time and location. Patients with MS most commonly present with long tract signs (e.g., myelopathy, asymmetric spastic paraplegia, urinary dysfunction, Lhermitte's sign), optic neuritis, or brainstem syndromes (bilateral internuclear ophthalmoplegia). Cortical syndromes or multifocal presentations are less common. Radiologically isolated syndrome and clinically isolated syndrome (CIS) may or may not progress to chronic forms of MS, including relapsing remitting MS, primary progressive MS, and secondary progressive MS. The foundation of outpatient management involves disease-modifying therapy, which is typically initiated with the first signs of disease onset. Management of CIS and acute flares of MS in the ED includes corticosteroid therapy, ideally after diagnostic testing with imaging and lumbar puncture for cerebrospinal fluid analysis. Emergency clinicians should evaluate whether patients with MS are presenting with new-onset debilitating neurological symptoms to avoid unnecessary testing and admissions, but failure to appropriately diagnose CIS or MS flare is associated with increased morbidity. CONCLUSIONS An understanding of MS can assist emergency clinicians in better diagnosing and managing this neurologically devastating disease.
Collapse
Affiliation(s)
- Jessica Pelletier
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Davis Sugar
- Department of Neurology, Virginia Tech Carilion, Roanoke, Virginia
| | - Alex Koyfman
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Brit Long
- SAUSHEC (San Antonio Uniformed Services Health Education Consortium), Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas
| |
Collapse
|
5
|
Pelletier J, Ahn J, Golden A, Astemborski C, Lall MD, Kim A, Dimeo S. Creation of a National Emergency Medicine Medical Education Journal Club. Cureus 2024; 16:e54092. [PMID: 38496089 PMCID: PMC10942130 DOI: 10.7759/cureus.54092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 03/19/2024] Open
Abstract
Background There are a relatively limited number of emergency medicine (EM) medical education (MedEd) fellowships with few trainees at each program, creating barriers to local collaboration and networking. While best practices for developing MedEd journal clubs exist, there has not been an established national EM MedEd journal club. To address this need, we created a national journal club, the Council of Residency Directors (CORD) MedEd Journal Club (MEJC), to facilitate collaboration and networking opportunities by providing a synchronous online journal club. Objectives Our primary objective was to create a network for collaboration across geographical barriers to form a virtual community of practice (CoP) around the shared domain of evidence-based MedEd. Our secondary objective was to improve MedEd fellows' knowledge, skills, and attitudes surrounding MedEd research. Tertiary objectives included (1) broadening fellow exposure to key topics within MedEd, (2) describing how to develop scholarly work within MedEd, and (3) filling a perceived need for building a national MedEd virtual CoP. Curricular design The concept and objectives of the CORD MEJC were introduced to fellows and fellowship directors through a national listserv in March of 2022. Fellows volunteered to lead virtual sessions via Zoom on a monthly basis. Session fellow leaders independently chose the topics and were asked to submit two to three journal club articles discussing the topic at least two weeks in advance of each session. No topics were repeated throughout the academic year. Impact/effectiveness Our quality improvement survey results indicated that the CORD MEJC is meeting its primary and secondary objectives. Survey results will be utilized as part of a continuous quality improvement initiative to enhance our program structure and curricula for the 2023-2024 academic year.
Collapse
Affiliation(s)
- Jessica Pelletier
- Emergency Medicine, Washington University School of Medicine, St. Louis, USA
| | - James Ahn
- Emergency Medicine, University of Chicago, Chicago, USA
| | - Andrew Golden
- Emergency Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA
| | | | - Michelle D Lall
- Emergency Medicine, Emory University School of Medicine, Atlanta, USA
| | - Albert Kim
- Emergency Medicine, Washington University School of Medicine, St. Louis, USA
| | - Sara Dimeo
- Emergency Medicine, Dignity Health, Chandler, USA
| |
Collapse
|
6
|
Long B, Pelletier J, Koyfman A, Bridwell RE. High risk and low prevalence diseases: Spontaneous cervical artery dissection. Am J Emerg Med 2024; 76:55-62. [PMID: 37995524 DOI: 10.1016/j.ajem.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION Spontaneous cervical artery dissection (sCAD) is a serious condition that carries with it a high rate of morbidity and mortality. OBJECTIVE This review highlights the pearls and pitfalls of sCAD, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence. DISCUSSION sCAD is a condition affecting the carotid or vertebral arteries and occurs as a result of injury and compromise to the arterial wall layers. The dissection most commonly affects the extracranial vessels but may extend intracranially, resulting in subarachnoid hemorrhage. Patients typically present with symptoms due to compression of local structures, and the presentation depends on the vessel affected. The most common symptom is headache and/or neck pain. Signs and symptoms of ischemia may occur, including transient ischemic attack and stroke. There are a variety of risk factors for sCAD, including underlying connective tissue or vascular disorders, and there may be an inciting event involving minimal trauma to the head or neck. Diagnosis includes imaging, most commonly computed tomography angiography of the head and neck. Ultrasound can diagnose sCAD but should not be used to exclude the condition. Treatment includes specialist consultation (neurology and vascular specialist), consideration of thrombolysis in appropriate patients, symptomatic management, and administration of antithrombotic medications. CONCLUSIONS An understanding of sCAD can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
Collapse
Affiliation(s)
- Brit Long
- Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
| | - Jessica Pelletier
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Alex Koyfman
- Department of Emergency Medicine, UT Southwestern, Dallas, TX, USA
| | - Rachel E Bridwell
- Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA, USA
| |
Collapse
|
7
|
Yoo MJ, Pelletier J, Koyfman A, Long B. High risk and low prevalence diseases: Infected urolithiasis. Am J Emerg Med 2024; 75:137-142. [PMID: 37950981 DOI: 10.1016/j.ajem.2023.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/24/2023] [Accepted: 10/31/2023] [Indexed: 11/13/2023] Open
Abstract
INTRODUCTION Infected urolithiasis is a serious condition that carries with it a high rate of morbidity and mortality. OBJECTIVE This review highlights the pearls and pitfalls of infected urolithiasis, including presentation, diagnosis, and management in the emergency department based on current evidence. DISCUSSION Although urolithiasis is common and the vast majority can be treated conservatively, the presence of a concomitant urinary tract infection significantly increases the risk of morbidity, to include sepsis and mortality. Identification of infected urolithiasis can be challenging as patients may have symptoms similar to uncomplicated urolithiasis and/or pyelonephritis. However, clinicians should consider infected urolithiasis in toxic-appearing patients with fever, chills, dysuria, and costovertebral angle tenderness, especially in those with a history of recurrent urinary tract infections. Positive urine leukocyte esterase, nitrites, and pyuria in conjunction with an elevated white blood cell count may be helpful to identify infected urolithiasis. Patients should be resuscitated with fluids and broad-spectrum antibiotics. Additionally, computed tomography and early urology consultation are recommended to facilitate definitive care. CONCLUSIONS An understanding of infected urolithiasis can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
Collapse
Affiliation(s)
- Michael J Yoo
- SAUSHEC, Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA
| | - Jessica Pelletier
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Alex Koyfman
- Department of Emergency Medicine, UT, Southwestern, Dallas, TX, USA
| | - Brit Long
- SAUSHEC, Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
| |
Collapse
|
8
|
Heilmann A, Pelletier J, Murray C, Croft A. Novel Academic Tabletop 2022 (NAT22): A Dynamic Dice-Based Emergency Medicine Education Tool. Cureus 2023; 15:e49498. [PMID: 38152781 PMCID: PMC10752340 DOI: 10.7759/cureus.49498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
Gamification is an effective teaching tool that improves engagement and knowledge retention. Tabletop role-playing games are dynamic games that use random chance and foster player/leader partnership. To date, there are no teaching tools that mimic dynamic or unpredictable patient presentations. This style of game may work well as a tool for medical education in a simulation-based modality. In this report, we document the rules, materials, and training required to reproduce a hybrid game created to combine facets of simulation and tabletop role-playing games (TRPGs) to create a dynamic medical education tool. After testing the game for flaws and fluidity of gameplay, we plan to collect data evaluating emergency medicine residents' enjoyability and knowledge retention. In this article, we describe a novel TRPG simulation hybrid game that we hypothesize will improve learner enjoyability/engagement and have similar educational benefits to standard medical education.
Collapse
Affiliation(s)
- Adam Heilmann
- Emergency Medicine, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, USA
| | - Jessica Pelletier
- Emergency Medicine, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, USA
| | - Collyn Murray
- Emergency Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA
| | - Alexander Croft
- Emergency Medicine, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, USA
| |
Collapse
|
9
|
Pelletier J, Koyfman A, Long B. Pearls for the Emergency Clinician: Posterior Circulation Stroke. J Emerg Med 2023; 65:e414-e426. [PMID: 37806810 DOI: 10.1016/j.jemermed.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 06/29/2023] [Accepted: 07/15/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Posterior circulation (PC) stroke in adults is a rare, frequently misdiagnosed, serious condition that carries a high rate of morbidity. OBJECTIVE OF THE REVIEW This review evaluates the presentation, diagnosis, and management of PC stroke in the emergency department (ED) based on current evidence. DISCUSSION PC stroke presents most commonly with dizziness or vertigo and must be distinguished from more benign diagnoses. Emergency clinicians should consider this condition in patients with dizziness, even in younger patients and those who do not have traditional stroke risk factors. Neurologic examination for focal neurologic deficit, dysmetria, dysarthria, ataxia, and truncal ataxia is essential, as is the differentiation of acute vestibular syndrome vs. spontaneous episodic vestibular syndrome vs. triggered episodic vestibular syndrome. The HINTS (head impulse, nystagmus, and test of skew) examination can be useful for identifying dizziness presentations concerning for stroke when performed by those with appropriate training. However, it should only be used in patients with continuous dizziness who have ongoing nystagmus. Contrast tomography (CT), CT angiography, and CT perfusion have limited sensitivity for identifying PC strokes, and although magnetic resonance imaging is the gold standard, it may miss some PC strokes early in their course. Thrombolysis is recommended in patients presenting within the appropriate time window for thrombolytic therapy, and although some data suggest endovascular therapy for basilar artery and posterior cerebral artery infarcts is beneficial, its applicability for all PC strokes remains to be determined. CONCLUSIONS An understanding of PC stroke can assist emergency clinicians in diagnosing and managing this disease.
Collapse
Affiliation(s)
- Jessica Pelletier
- Department of Emergency Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Alex Koyfman
- Department of Emergency Medicine, UT Southwestern, Dallas, Texas
| | - Brit Long
- San Antonio Uniformed Services Health Education Consortium, Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas.
| |
Collapse
|
10
|
Pelletier J, Romo E, Feinstein B, Smith C, Pellerito G, Croft A. Little Patients, Big Tasks - A Pediatric Emergency Medicine Escape Room. J Educ Teach Emerg Med 2023; 8:SG1-SG19. [PMID: 37969155 PMCID: PMC10631808 DOI: 10.21980/j89w70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/16/2023] [Indexed: 11/17/2023]
Abstract
Audience The target audience for this small group session is post-graduate year (PGY) 1-4 emergency medicine (EM) residents, pediatric EM (PEM) fellows, and medical students. Introduction Pediatric emergency department visits have been declining since the start of the COVID-19 pandemic, leading to decreased exposure to pediatric emergency care for EM residents and other learners in the ED.1 This is a major problem, given that the Accreditation Council for Graduate Medical Education (ACGME) mandates that a minimum of 20% of patient encounters or five months of training time for EM residents must occur with pediatric patients, with at least 50% of that time spent in the ED setting.2,3 A minimum of 12 months must be spent in the pediatric ED for PEM fellows,2 and an average of 7.1 weeks of medical school are spent in pediatric clerkships.4 This decrease in pediatrics exposure in the post-pandemic environment can be addressed through simulation and gamification. We selected the gamification method of an escape room to create an engaging environment in which learners could interface with key pediatric emergency medicine clinical concepts via group learning. Educational Objectives By the end of this small group exercise, learners will be able to:Demonstrate appropriate dosing of pediatric code and resuscitation medicationsRecognize normal pediatric vital signs by ageDemonstrate appropriate use of formulas to calculate pediatric equipment sizes and insertion depthsRecognize classic pediatric murmursAppropriately diagnose congenital cardiac conditionsRecognize abnormal pediatric electrocardiograms (ECGs)Identify life-threatening pediatric conditionsDemonstrate intraosseous line (IO) insertion on a pediatric modelDemonstrate appropriate use of the Neonatal Resuscitation Protocol (NRP®) algorithms. Educational Methods An escape room - a form of gamification - was utilized to engage the learners in active learning. Gamification is an increasingly popular educational technique being utilized in graduate medical education and refers to the conversion of serious, non-trivial material into a fun activity fashioned like a game in order to enhance engagement in learning.5 This educational method seeks to enhance knowledge, attitudes, and skills via components of games - such as puzzles and prizes - outside of the context of a traditional game.6 Though high-quality research data on the effectiveness of gamification methods in graduate medical education is limited, studies have shown that gamification enhances learning, attitudes, and behaviors.5,7 One randomized, clinical-controlled trial investigating the use of gamification to enhance patient outcomes found that patients of primary care physicians randomized to the gamification group reached blood pressure targets faster than in the control group.8 Escape rooms as a modality for education have been suggested to improve active learning and enhance learner engagement in the learning process.9 In an escape room, learners are "locked" in an artificial environment (whether digitally or in person) and must utilize their group or individual knowledge to solve puzzles and escape from their "entrapment."9,10 Escape rooms utilized as part of EM residency didactic training have demonstrated learner enthusiasm,11,12 desire to repeat the activity again,13 preference for escape rooms over traditional learning methods,14,15 improved confidence in communication and leadership skills,11,15 and improvement scores from pre- to post-testing.16We developed an escape room in which learners were divided into teams and informed that they would need to "escape" from our resident lounge by successfully completing all nine stations. The first team to complete all nine stations would win a prize. Only after the last team completed the ninth station and debriefing was complete could all teams be "freed" from the escape room. Research Methods Learners provided anonymous online survey feedback regarding the quality of the educational content and the efficacy of the delivery method. Results A post-participation survey was disseminated to 55 residents, 32 of whom attended the PEM Escape Room, with a response rate of 9% (3/32 residents). One hundred percent of respondents felt that the activity content was applicable to their needs as an emergency physician. The session was rated as excellent by 33.3% of respondents, and 66.7% of respondents rated the session as above average. A second survey was disseminated seven months after the event to the 24 remaining residents who attended the event, with a response rate of 46% (11/24 residents); eight attendees had graduated at the time of this survey dissemination. Results of the second survey indicated that 100% (24/24 residents) felt that the activity content was applicable to their needs as an emergency physician, 73% (17/24 residents) rated the session as excellent, and 27% (7/24 residents) rated the session as above average. Discussion Though we received limited survey responses (3/32 on the first survey and 11/24 on the second survey), respondents felt that the educational content met their learning needs and was of high quality. We had six faculty members present to facilitate the escape room while there were four groups of residents (eight per group). The ideal faculty to resident ratio would be one faculty member per group with three to six players, based on prior literature showing that teams of more than six players take longer to complete escape room tasks.17,18 We also recognized the importance of sending out the feedback survey link early because we believe the delay in our survey being emailed to the residents contributed to the low response rate (three trainees).One participant provided the following feedback: "I think the 'escape room' struck an excellent balance with regard to trying to address knowledge that was relevant but also obscure or difficult enough that group/collaborative effort was required. I enjoyed the process and low stakes atmosphere." This quote nicely summarizes our take-aways: That the PEM escape room incorporates key tenets of adult learning theory. Also known as andragogy, adult learning theory posits that adult learners are self-directed, have prior life experiences that shape their learning process, learn for practical reasons (ie, choose to learn in order to fulfill the demands of their social role), and are problem-oriented in their learning.19 Though andragogy does not technically apply only to adults (as many children are self-directed learners),20 having an understanding of the practical and experiential nature via which adults approach learning allows the adult educator to appropriately cater educational activities to meet the adult learner's needs.This escape room aligned with the core tenets of adult learning theory in several ways. Specifically, residents were given autonomy of participation in the escape room and thus had to take initiative to promote their own learning.21 Topics featured in the escape room stations were selected based on their clinical challenges and high-yield for board examinations and patient care, making their relevance immediately obvious to learners; this is a key feature of catering to adult learners.22 The escape room provided a comfortable and collegial environment in which residents felt comfortable learning, fostering an ideal setting for mature learners.21 Direct and immediate feedback are key components of adult learning theory, and faculty members were physically present to provide feedback at each escape room station.22 Finally, working in teams required the learners to engage in active learning rather than acting as passive recipients of cognitive information.21 Thus, the PEM escape room serves as an ideal framework to meet the needs of the adult learner. Topics Pediatrics, emergency medicine, pediatric emergency medicine.
Collapse
Affiliation(s)
- Jessica Pelletier
- Washington University, Department of Emergency Medicine, St. Louis, MO
| | - Ernesto Romo
- Washington University, Department of Emergency Medicine, St. Louis, MO
| | - Bryan Feinstein
- Washington University, Department of Emergency Medicine, St. Louis, MO
| | - Charles Smith
- Washington University, Department of Emergency Medicine, St. Louis, MO
| | - Gina Pellerito
- St. Louis Children’s Hospital, One Children’s Place, St. Louis, MO
| | - Alexander Croft
- Washington University, Department of Emergency Medicine, St. Louis, MO
| |
Collapse
|
11
|
Testud B, Fabiani N, Demortière S, Mchinda S, Medina NL, Pelletier J, Guye M, Audoin B, Stellmann JP, Callot V. Contribution of the MP2RAGE 7T Sequence in MS Lesions of the Cervical Spinal Cord. AJNR Am J Neuroradiol 2023; 44:1101-1107. [PMID: 37562829 PMCID: PMC10494945 DOI: 10.3174/ajnr.a7964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/06/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND AND PURPOSE The detection of spinal cord lesions in patients with MS is challenging. Recently, the 3D MP2RAGE sequence demonstrated its usefulness at 3T. Benefiting from the high spatial resolution provided by ultra-high-field MR imaging systems, we aimed to evaluate the contribution of the 3D MP2RAGE sequence acquired at 7T for the detection of MS lesions in the cervical spine. MATERIALS AND METHODS Seventeen patients with MS participated in this study. They were examined at both 3T and 7T. The MR imaging examination included a Magnetic Imaging in MS (MAGNIMS) protocol with an axial T2*-WI gradient recalled-echo sequence ("optimized MAGNIMS protocol") and a 0.9-mm isotropic 3D MP2RAGE sequence at 3T, as well as a 0.7-mm isotropic and 0.3-mm in-plane-resolution anisotropic 3D MP2RAGE sequences at 7T. Each data set was read by a consensus of radiologists, neurologists, and neuroscientists. The number of lesions and their topography, as well as the visibility of the lesions from one set to another, were carefully analyzed. RESULTS A total of 55 lesions were detected. The absolute number of visible lesions differed among the 4 sequences (linear mixed effect ANOVA, P = .020). The highest detection was observed for the two 7T sequences with 51 lesions each (92.7% of the total). The optimized 3T MAGNIMS protocol and the 3T MP2RAGE isotropic sequence detected 41 (74.5%) and 35 lesions (63.6%), respectively. CONCLUSIONS The 7T MP2RAGE sequences detected more lesions than the 3T sets. Isotropic and anisotropic acquisitions performed comparably. Ultra-high-resolution sequences obtained at 7T improve the identification and delineation of lesions of the cervical spinal cord in MS.
Collapse
Affiliation(s)
- B Testud
- From the Center for Magnetic Resonance in Biology and Medicine (B.T., N.F., S.D., S.M., N.L.M., J.P., M.G., B.A., J.P.S., V.C.), Aix-Marseille University, Centre national de la recherche scientifique, Marseille, France
- Assistance Publique-Hopitaux de Marseille (B.T., N.F., S.D., S.M., N.L.M., J,P., M.G., B.A., J.P.S., V.C.), Hôpital Universitaire Timone, CEMEREM, Marseille, France
| | - N Fabiani
- From the Center for Magnetic Resonance in Biology and Medicine (B.T., N.F., S.D., S.M., N.L.M., J.P., M.G., B.A., J.P.S., V.C.), Aix-Marseille University, Centre national de la recherche scientifique, Marseille, France
- Assistance Publique-Hopitaux de Marseille (B.T., N.F., S.D., S.M., N.L.M., J,P., M.G., B.A., J.P.S., V.C.), Hôpital Universitaire Timone, CEMEREM, Marseille, France
| | - S Demortière
- From the Center for Magnetic Resonance in Biology and Medicine (B.T., N.F., S.D., S.M., N.L.M., J.P., M.G., B.A., J.P.S., V.C.), Aix-Marseille University, Centre national de la recherche scientifique, Marseille, France
- Assistance Publique-Hopitaux de Marseille (B.T., N.F., S.D., S.M., N.L.M., J,P., M.G., B.A., J.P.S., V.C.), Hôpital Universitaire Timone, CEMEREM, Marseille, France
- Department of Neurology (S.D., J.P., B.A.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - S Mchinda
- From the Center for Magnetic Resonance in Biology and Medicine (B.T., N.F., S.D., S.M., N.L.M., J.P., M.G., B.A., J.P.S., V.C.), Aix-Marseille University, Centre national de la recherche scientifique, Marseille, France
- Assistance Publique-Hopitaux de Marseille (B.T., N.F., S.D., S.M., N.L.M., J,P., M.G., B.A., J.P.S., V.C.), Hôpital Universitaire Timone, CEMEREM, Marseille, France
| | - N L Medina
- From the Center for Magnetic Resonance in Biology and Medicine (B.T., N.F., S.D., S.M., N.L.M., J.P., M.G., B.A., J.P.S., V.C.), Aix-Marseille University, Centre national de la recherche scientifique, Marseille, France
- Assistance Publique-Hopitaux de Marseille (B.T., N.F., S.D., S.M., N.L.M., J,P., M.G., B.A., J.P.S., V.C.), Hôpital Universitaire Timone, CEMEREM, Marseille, France
| | - J Pelletier
- From the Center for Magnetic Resonance in Biology and Medicine (B.T., N.F., S.D., S.M., N.L.M., J.P., M.G., B.A., J.P.S., V.C.), Aix-Marseille University, Centre national de la recherche scientifique, Marseille, France
- Assistance Publique-Hopitaux de Marseille (B.T., N.F., S.D., S.M., N.L.M., J,P., M.G., B.A., J.P.S., V.C.), Hôpital Universitaire Timone, CEMEREM, Marseille, France
- Department of Neurology (S.D., J.P., B.A.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - M Guye
- From the Center for Magnetic Resonance in Biology and Medicine (B.T., N.F., S.D., S.M., N.L.M., J.P., M.G., B.A., J.P.S., V.C.), Aix-Marseille University, Centre national de la recherche scientifique, Marseille, France
- Assistance Publique-Hopitaux de Marseille (B.T., N.F., S.D., S.M., N.L.M., J,P., M.G., B.A., J.P.S., V.C.), Hôpital Universitaire Timone, CEMEREM, Marseille, France
| | - B Audoin
- From the Center for Magnetic Resonance in Biology and Medicine (B.T., N.F., S.D., S.M., N.L.M., J.P., M.G., B.A., J.P.S., V.C.), Aix-Marseille University, Centre national de la recherche scientifique, Marseille, France
- Assistance Publique-Hopitaux de Marseille (B.T., N.F., S.D., S.M., N.L.M., J,P., M.G., B.A., J.P.S., V.C.), Hôpital Universitaire Timone, CEMEREM, Marseille, France
- Department of Neurology (S.D., J.P., B.A.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - J P Stellmann
- From the Center for Magnetic Resonance in Biology and Medicine (B.T., N.F., S.D., S.M., N.L.M., J.P., M.G., B.A., J.P.S., V.C.), Aix-Marseille University, Centre national de la recherche scientifique, Marseille, France
- Assistance Publique-Hopitaux de Marseille (B.T., N.F., S.D., S.M., N.L.M., J,P., M.G., B.A., J.P.S., V.C.), Hôpital Universitaire Timone, CEMEREM, Marseille, France
| | - V Callot
- From the Center for Magnetic Resonance in Biology and Medicine (B.T., N.F., S.D., S.M., N.L.M., J.P., M.G., B.A., J.P.S., V.C.), Aix-Marseille University, Centre national de la recherche scientifique, Marseille, France
- Assistance Publique-Hopitaux de Marseille (B.T., N.F., S.D., S.M., N.L.M., J,P., M.G., B.A., J.P.S., V.C.), Hôpital Universitaire Timone, CEMEREM, Marseille, France
| |
Collapse
|
12
|
Pelletier J, Koyfman A, Long B. High risk and low prevalence diseases: Orbital cellulitis. Am J Emerg Med 2023; 68:1-9. [PMID: 36893591 DOI: 10.1016/j.ajem.2023.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023] Open
Abstract
INTRODUCTION Orbital cellulitis is an uncommon but serious condition that carries with it a potential for significant morbidity. OBJECTIVE This review highlights the pearls and pitfalls of orbital cellulitis, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence. DISCUSSION Orbital cellulitis refers to infection of the globe and surrounding soft tissues posterior to the orbital septum. Orbital cellulitis is typically caused by local spread from sinusitis but can also be caused by local trauma or dental infection. It is more common in pediatric patients compared to adults. Emergency clinicians should first assess for and manage other critical, sight-threatening complications such as orbital compartment syndrome (OCS). Following this assessment, a focused eye examination is necessary. Though orbital cellulitis is primarily a clinical diagnosis, computed tomography (CT) of the brain and orbits with and without contrast is critical for evaluation of complications such as abscess or intracranial extension. Magnetic resonance imaging (MRI) of the brain and orbits with and without contrast should be performed in cases of suspected orbital cellulitis in which CT is non-diagnostic. While point-of-care ultrasound (POCUS) may be useful in differentiating preseptal from orbital cellulitis, it cannot exclude intracranial extension of infection. Management includes early administration of broad-spectrum antibiotics and ophthalmology consultation. The use of steroids is controversial. In cases of intracranial extension of infection (e.g., cavernous sinus thrombosis, abscess, or meningitis), neurosurgery should be consulted. CONCLUSION An understanding of orbital cellulitis can assist emergency clinicians in diagnosing and managing this sight-threatening infectious process.
Collapse
Affiliation(s)
- Jessica Pelletier
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Alex Koyfman
- Department of Emergency Medicine, UT Southwestern, Dallas, TX, USA
| | - Brit Long
- SAUSHEC, Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
| |
Collapse
|
13
|
Pelletier J, Koyfman A, Long B. High risk and low prevalence diseases: Open globe injury. Am J Emerg Med 2023; 64:113-120. [PMID: 36516669 DOI: 10.1016/j.ajem.2022.11.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/20/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Open globe injury (OGI) is a rare but serious condition that carries with it a high rate of morbidity. OBJECTIVE This review highlights the pearls and pitfalls of OGI, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence. DISCUSSION OGI refers to full-thickness injury to the layers of the eye. OGI can be caused by blunt or sharp trauma, and subtypes include penetration, perforation, intraocular foreign body (IOFB), globe rupture, or mixed types. OGI is more common in males and usually secondary to work-related injury, but in women it is most commonly associated with falls. Emergency clinicians should first assess for and manage other critical, life-threatening injuries. Following this assessment, a thorough eye examination is necessary. Computed tomography (CT) may suggest the disease, but it cannot definitively exclude the diagnosis. While point-of-care ultrasound (POCUS) is highly sensitive and specific for some findings in OGI, its use is controversial due to potential globe content extrusion. Management includes protecting the affected eye from further injury, preventing Valsalva maneuvers that could extrude ocular contents, updating tetanus vaccination status, administering broad-spectrum antibiotics, and ophthalmology consultation for surgical intervention to prevent the sequelae of blindness and endophthalmitis. CONCLUSION An understanding of OGI can assist emergency clinicians in diagnosing and managing this sight-threatening traumatic process.
Collapse
Affiliation(s)
- Jessica Pelletier
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Alex Koyfman
- Department of Emergency Medicine, UT Southwestern, Dallas, TX, USA
| | - Brit Long
- SAUSHEC, Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
| |
Collapse
|
14
|
Pelletier J, Facciani J, Gines F, Kuehl D. Use of An Ophthalmology Tutorial to Improve Resident Comfort with the Emergency Eye Exam. J Educ Teach Emerg Med 2022; 7:SG1-SG14. [PMID: 37465134 PMCID: PMC10332671 DOI: 10.21980/j86h0m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/11/2022] [Indexed: 07/20/2023]
Abstract
Audience This tutorial should be utilized for emergency medicine (EM) interns and junior residents. Introduction Ophthalmology is characteristically a weak area in both medical school and resident education. Medical students are rarely given formal didactic education on the use of the slit lamp or a systematic approach to examining the eye. For EM residents, this leads to inefficient and uncomfortable encounters with patients with eye complaints. We sought to develop a comprehensive emergency ophthalmology tutorial utilizing asynchronous learning followed by a hands-on skill session that would address this need. Educational Objectives By the end of this small group didactic, learners will be able to: 1) demonstrate ability to focus on the various components of the slit lamp exam 2) demonstrate understanding of a systematic approach to the eye exam 3) demonstrate appropriate use of the Diaton, iCare, and Tonopen tonometers. Educational Methods This two-hour small group didactic combines hands-on learning sessions to learn the slit lamp exam and tonometry measurement, with a systematic review of the eye exam to help learners better organize their exams and understand the use of necessary tools. Research Methods The emergency ophthalmology tutorial was initially designed as an education project in which we collected pre- and post-participation surveys regarding resident comfort with various components of the emergency eye exam. After the course residents received a post-course survey to complete. Given the positive feedback we received from our residents regarding the tutorial, we applied for Institutional Review Board (IRB) approval to publish our retrospective survey data. Our IRB waived the need for participant consent. Results Twelve emergency medicine residents including 11 interns and one post-graduate year (PGY) 2 resident participated in the emergency ophthalmology tutorial as part of our intern boot camp in July of 2021. Twelve PGY-1 residents initially signed up for the course and filled out the pre-participation survey but one of them was not able to attend their scheduled class, so a PGY-2 resident requested to attend.Prior to the course, we used a Likert scale from 1-7, finding that 61.5% (8/13) of participants felt very uncomfortable with performing slit lamp exams, 84.6% (11/13) felt very uncomfortable with using the Diaton tonometer, 76.9% (10/13) felt very uncomfortable with using the iCare tonometer, and 69.3% (9/13) felt uncomfortable or very uncomfortable with using a systematic approach to examining the eye. After the course, 75% (9/12) of participants felt that the course exceeded expectations in ensuring their ability to perform the subcomponents of the slit lamp exam, 75% (9/12) and 83.3% (10/12) of participants felt that the course exceeded expectations in ensuring their ability to use the Diaton and iCare tonometers, respectively, and 91.7% (11/12) felt that the course exceeded expectations in ensuring their ability to perform a systematic eye exam. Discussion Participation in a 2-hour emergency ophthalmology tutorial with assigned asynchronous pre-course work improved emergency medicine resident comfort with various components of the eye exam. Topics Emergency ophthalmology, eye exam, slit lamp, tonometry.
Collapse
Affiliation(s)
- Jessica Pelletier
- Virginia Tech Carilion School of Medicine, Carilion Clinic, Department of Emergency Medicine, Roanoke, VA
| | - John Facciani
- Vistar Eye Center Vision and Surgery Specialists, Roanoke, USA
| | - Francesca Gines
- Vistar Eye Center Vision and Surgery Specialists, Roanoke, USA
| | - Damon Kuehl
- Virginia Tech Carilion School of Medicine, Carilion Clinic, Department of Emergency Medicine, Roanoke, VA
| |
Collapse
|
15
|
Milord F, Hastir M, Ouellet C, Pelletier J, Sédillot-Daniel S, Michaud-Tétreault J, Gariépy C, Lambert L, Hauyon A. Portrait de la maladie de Lyme et exposition en milieu de travail, Montérégie, 2013-2018. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
|
16
|
Pham T, Caroline P, Lafforgue P, Barral C, Maarouf A, Pelletier J, Rico A, Audoin B. AB0863 Emergence of spondyloarthritis following B cell-depleting monoclonal antibody therapy for multiple sclerosis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAnti-CD20 B-cell-depleting therapies, including rituximab and ocrelizumab, have demonstrated their efficacy in patients with relapsing–remitting multiple sclerosis (RRMS).ObjectivesHerein we report a series of patients with RRMS treated with anti-CD20 monoclonal antibodies (mAb) who developed a de novo spondyloarthritis (SpA).MethodsFollowing the presentation of an index case, we collected all cases of de novo SpA in the anti-CD20-treated RRMS cohort of our institution’s referral center.Clinical, biochemical, and imaging characteristics of the cases were identified through a clinical assessment. Information was collected via a standardized form to obtain key characteristics on the onset and type of disease development at baseline and on outcomes up to 12 months. All patients had a magnetic resonance imaging (MRI) of the sacroiliac joints and, depending on the clinical presentation, a spine MRI and/or a musculoskeletal grayscale and power Doppler (PD) ultrasound (US) examination.ResultsDe novo SpA developed in 6 of 480 patients with RRMS treated with anti-CD20 mAb, accounting for an incidence of 1.25%. All but one received rituximab treatment. The median time from the last anti-CD20 mAb infusion to SpA onset was 1.5 months [IQR: 1-4]. At the time of SpA emergence, the RRMS activity was controlled.The most frequent clinical SpA phenotype identified was peripheral SpA (4/6), with Power Doppler ultrasound-detected synovitis. The 2 patients with axial SpA phenotype had bilateral sacroiliitis on MRI. Five of the 6 patients had a personal or family history of psoriasis, whereas the prevalence of psoriasis in the entire RRMS cohort was 3.33% (16/480). No other extra-articular manifestation was observed. All patients were HLA B27 negative and fulfilled at least one classification criteria of SpA. None required hospitalization and the SpA onset did not affect the management of MS. The 2 patients with axial SpA were successfully treated with NSAIDs. Among the patients with peripheral SpA, 3 of four had inadequate response to NSAIDs, 2 were treated with methotrexate and 1 with leflunomide. Only one patient required initiation of an IL-17 inhibitor to control the SpA activity.ConclusionWe report a pattern of patients with MS successfully treated with B cell-depleting drug developing axial or peripheral SpA, predominantly HLA-B27 negativity and associated with psoriasis.Disclosure of InterestsNone declared
Collapse
|
17
|
Lefort M, Sharmin S, Andersen JB, Vukusic S, Casey R, Debouverie M, Edan G, Ciron J, Ruet A, De Sèze J, Maillart E, Zephir H, Labauge P, Defer G, Lebrun-Frenay C, Moreau T, Berger E, Clavelou P, Pelletier J, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Wahab A, Camdessanché JP, Maurousset A, Ben Nasr H, Hankiewicz K, Pottier C, Maubeuge N, Dimitri-Boulos D, Nifle C, Laplaud DA, Horakova D, Havrdova EK, Alroughani R, Izquierdo G, Eichau S, Ozakbas S, Patti F, Onofrj M, Lugaresi A, Terzi M, Grammond P, Grand'Maison F, Yamout B, Prat A, Girard M, Duquette P, Boz C, Trojano M, McCombe P, Slee M, Lechner-Scott J, Turkoglu R, Sola P, Ferraro D, Granella F, Shaygannejad V, Prevost J, Maimone D, Skibina O, Buzzard K, Van der Walt A, Karabudak R, Van Wijmeersch B, Csepany T, Spitaleri D, Vucic S, Koch-Henriksen N, Sellebjerg F, Soerensen PS, Hilt Christensen CC, Rasmussen PV, Jensen MB, Frederiksen JL, Bramow S, Mathiesen HK, Schreiber KI, Butzkueven H, Magyari M, Kalincik T, Leray E. Impact of methodological choices in comparative effectiveness studies: application in natalizumab versus fingolimod comparison among patients with multiple sclerosis. BMC Med Res Methodol 2022; 22:155. [PMID: 35637426 PMCID: PMC9150358 DOI: 10.1186/s12874-022-01623-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Natalizumab and fingolimod are used as high-efficacy treatments in relapsing–remitting multiple sclerosis. Several observational studies comparing these two drugs have shown variable results, using different methods to control treatment indication bias and manage censoring. The objective of this empirical study was to elucidate the impact of methods of causal inference on the results of comparative effectiveness studies. Methods Data from three observational multiple sclerosis registries (MSBase, the Danish MS Registry and French OFSEP registry) were combined. Four clinical outcomes were studied. Propensity scores were used to match or weigh the compared groups, allowing for estimating average treatment effect for treated or average treatment effect for the entire population. Analyses were conducted both in intention-to-treat and per-protocol frameworks. The impact of the positivity assumption was also assessed. Results Overall, 5,148 relapsing–remitting multiple sclerosis patients were included. In this well-powered sample, the 95% confidence intervals of the estimates overlapped widely. Propensity scores weighting and propensity scores matching procedures led to consistent results. Some differences were observed between average treatment effect for the entire population and average treatment effect for treated estimates. Intention-to-treat analyses were more conservative than per-protocol analyses. The most pronounced irregularities in outcomes and propensity scores were introduced by violation of the positivity assumption. Conclusions This applied study elucidates the influence of methodological decisions on the results of comparative effectiveness studies of treatments for multiple sclerosis. According to our results, there are no material differences between conclusions obtained with propensity scores matching or propensity scores weighting given that a study is sufficiently powered, models are correctly specified and positivity assumption is fulfilled. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01623-8.
Collapse
Affiliation(s)
- M Lefort
- Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Univ Rennes, EHESP, CNRS, Inserm, Rennes, France.,Univ Rennes, CHU Rennes, Investigation Clinique de Rennes)], CIC 1414 [(Centre d, 35000, InsermRennes, France
| | - S Sharmin
- Department of Medicine, University of Melbourne, Melbourne, Australia.,Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - J B Andersen
- Department of Neurology, The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
| | - S Vukusic
- Service de Neurologie, Sclérose en Plaques, Pathologies de La Myéline Et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France.,Centre Des Neurosciences de Lyon, UMR5292, Observatoire Français de La Sclérose en Plaques, INSERM, 1028 et CNRS, 69003, Lyon, France.,Université, Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69000, Lyon, France
| | - R Casey
- Service de Neurologie, Sclérose en Plaques, Pathologies de La Myéline Et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France.,Centre Des Neurosciences de Lyon, UMR5292, Observatoire Français de La Sclérose en Plaques, INSERM, 1028 et CNRS, 69003, Lyon, France.,Université, Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69000, Lyon, France.,Eugene Devic EDMUS Foundation, 69677, Lyon/Bron, France
| | - M Debouverie
- Centre Hospitalier Régional Universitaire de Nancy, Hôpital Central, Service de neurologie, Nancy, France
| | - G Edan
- Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, Service de neurologie, Rennes, France
| | - J Ciron
- Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, CRC-SEP, Département de neurologie, Toulouse, France
| | - A Ruet
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Service de neurologie, Bordeaux, France
| | - J De Sèze
- Service des maladies inflammatoires du système nerveux - neurologie, centre d'investigation clinique de Strasbourg, Hôpitaux Universitaire de Strasbourg, Hôpital de Hautepierre, INSERM 1434, Strasbourg, France
| | - E Maillart
- Assistance Publique Des Hôpitaux de Paris, Hôpital de La Pitié-Salpêtrière, Service de neurologie, Paris, France
| | - H Zephir
- Centre Hospitalier Universitaire de Lille, Hôpital Salengro, Service de neurologie D, Lille, France
| | - P Labauge
- Centre Hospitalier Universitaire de Montpellier, Hôpital Gui de Chauliac, Service de neurologie, Montpellier, France
| | - G Defer
- Centre Hospitalier Universitaire de Caen Normandie, Hôpital Côte de Nacre, Service de neurologie, Caen, France
| | - C Lebrun-Frenay
- Centre Hospitalier Universitaire de Nice, UR2CA-URRIS,, Université Nice Côte d'Azur, Hôpital, Pasteur 2, Service de neurologie, Nice, France
| | - T Moreau
- Centre Hospitalier Universitaire Dijon Bourgogne, Hôpital François Mitterrand, Maladies Inflammatoires du Système Nerveux Et Neurologie Générale, Service de neurologie, Dijon, France
| | - E Berger
- Centre Hospitalier Régional Universitaire de Besançon, Hôpital Jean Minjoz, Service de neurologie, Besançon, France
| | - P Clavelou
- Centre Hospitalier Universitaire de Clermont-Ferrand, Hôpital Gabriel-Montpied, Service de neurologie, Clermont-Ferrand, France
| | - J Pelletier
- Service de Neurologie, Aix Marseille Univ, APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, 13005, Marseille, France
| | - B Stankoff
- Assistance Publique Des Hôpitaux de Paris, Hôpital Saint-Antoine, Service de neurologie, Paris, France
| | - O Gout
- Fondation Adolphe de Rothschild de L'œil Et du Cerveau, Service de neurologie, Paris, France
| | - E Thouvenot
- Centre Hospitalier Universitaire de Nîmes, Hôpital Carémeau, Service de neurologie, Nîmes, France
| | - O Heinzlef
- Centre Hospitalier Intercommunal de Poissy Saint-Germain-en-Laye, Service de neurologie, Poissy, France
| | - A Al-Khedr
- Centre Hospitalier Universitaire d'Amiens Picardie, Site sud, Service de neurologie, Amiens, France
| | - B Bourre
- Rouen University Hospital, 76000, Rouen, France
| | - O Casez
- Centre Hospitalier Universitaire Grenoble-Alpes, Site nord, Service de neurologie, Grenoble/La Tronche, France
| | - P Cabre
- Centre Hospitalier Universitaire de Martinique, Hôpital Pierre Zobda-Quitman, Service de neurologie, Fort-de-France, France
| | - A Montcuquet
- Centre Hospitalier Universitaire Limoges, Hôpital Dupuytren, Service de neurologie, Limoges, France
| | - A Wahab
- Assistance Publique Des Hôpitaux de Paris, Hôpital Henri Mondor, Service de neurologie, Créteil, France
| | - J P Camdessanché
- Centre Hospitalier Universitaire de Saint-Étienne, Hôpital Nord, Service de neurologie, Saint-Étienne, France
| | - A Maurousset
- Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Service de neurologie, Tours, France
| | - H Ben Nasr
- Centre Hospitalier Sud Francilien, Service de neurologie, Corbeil-Essonnes, France
| | - K Hankiewicz
- Centre Hospitalier de Saint-Denis, Hôpital Casanova, Service de neurologie, Saint-Denis, France
| | - C Pottier
- Centre Hospitalier de Pontoise, Service de neurologie, Pontoise, France
| | - N Maubeuge
- Centre Hospitalier Universitaire de Poitiers, Site de La Milétrie, Service de neurologie, Poitiers, France
| | - D Dimitri-Boulos
- Assistance Publique Des Hôpitaux de Paris, Hôpital Bicêtre, Service de neurologie, Le Kremlin-Bicêtre, France
| | - C Nifle
- Centre Hospitalier de Versailles, Hôpital André-Mignot, Service de neurologie, Le Chesnay, France
| | - D A Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, 44093, Nantes, France.,INSERM CR1064, 44000, Nantes, France
| | - D Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - E K Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - R Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S Eichau
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S Ozakbas
- Dokuz Eylul University, Konak/Izmir, Turkey
| | - F Patti
- GF Ingrassia Department, University of Catania, Catania, Italy.,Policlinico G Rodolico, Catania, Italy
| | - M Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - A Lugaresi
- Dipartimento Di Scienze Biomediche E Neuromotorie, Università Di Bologna, Bologna, Italy.,IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy
| | - M Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | - P Grammond
- CISSS Chaudiere-Appalache, Levis, Canada
| | | | - B Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Prat
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - M Girard
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - P Duquette
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - C Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - P McCombe
- University of Queensland, Brisbane, Australia.,Royal Brisbane and Women's Hospital, Herston, Australia
| | - M Slee
- Flinders University, Adelaide, Australia
| | - J Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, Australia.,Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - R Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - P Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - D Ferraro
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - F Granella
- Department of Medicine and Surgery, University of Parma, Parma, Italy.,Department of Emergency and General Medicine, Parma University Hospital, Parma, Italy
| | | | - J Prevost
- CSSS Saint-Jérôme, Saint-Jerome, Canada
| | | | - O Skibina
- Monash University, Melbourne, Australia
| | - K Buzzard
- Monash University, Melbourne, Australia
| | | | | | - B Van Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium
| | - T Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - D Spitaleri
- Azienda Ospedaliera Di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy
| | - S Vucic
- Westmead Hospital, Sydney, Australia
| | - N Koch-Henriksen
- Department of Clinical Epidemiology, Aarhus University Hospital Aarhus, Aarhus, Denmark
| | - F Sellebjerg
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - P S Soerensen
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - C C Hilt Christensen
- Department of Neurology, Aalborg University Hospital, Multiple Sclerosis Unit, Aalborg, Denmark
| | - P V Rasmussen
- Aarhus University Hospital, Neurology, PJJ Boulevard, DK-8200, Aarhus N, Denmark
| | - M B Jensen
- Department of Neurology, University Hospital of Northern Sealand, Copenhagen, Denmark
| | - J L Frederiksen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - S Bramow
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - H K Mathiesen
- Department of Neurology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - K I Schreiber
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - H Butzkueven
- Central Clinical School, Monash University, Melbourne, Australia.,Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Department of Neurology, Box Hill Hospital, Monash University, Melbourne, Australia
| | - M Magyari
- Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia.,Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - T Kalincik
- Department of Medicine, University of Melbourne, Melbourne, Australia.
| | - E Leray
- Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Univ Rennes, EHESP, CNRS, Inserm, Rennes, France. .,Univ Rennes, CHU Rennes, Investigation Clinique de Rennes)], CIC 1414 [(Centre d, 35000, InsermRennes, France.
| |
Collapse
|
18
|
Pelletier J, Gottlieb M, Long B, Perkins JC. Necrotizing Soft Tissue Infections (NSTI): Pearls and Pitfalls for the Emergency Clinician. J Emerg Med 2022; 62:480-491. [PMID: 35115188 DOI: 10.1016/j.jemermed.2021.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/18/2021] [Accepted: 12/23/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Skin and soft tissue infections are common emergency department (ED) presentations. These infections cover a wide spectrum of disease, from simple cellulitis to necrotizing fasciitis. Despite the commonality, a subset of skin and soft tissue infections known as necrotizing soft tissue infections (NSTIs) can cause significant morbidity and mortality. OBJECTIVE This review evaluates the current evidence regarding the presentation, evaluation, and management of NSTI from the ED perspective. DISCUSSION NSTIs are commonly missed diagnoses. History and physical examination findings are inconsistent, and the risk factors for this high mortality disease are common amongst ED populations. Laboratory evaluation and the Laboratory Risk in Necrotizing Fasciitis (LRINEC) score is helpful but is insufficient to rule out the disease. Imaging modalities including ultrasound, computed tomography, and magnetic resonance imaging are highly sensitive and specific, but may delay definitive management. The gold standard for diagnosis includes surgical exploration. Surgical intervention and empiric broad-spectrum antibiotic coverage are the foundations of treatment. Adjuvant therapies including hyperbaric oxygen and intravenous immunoglobulin have not yet been proven to be beneficial or to improve outcome. CONCLUSION NSTIs are associated with significant morbidity and mortality. Knowledge of the history, examination, evaluation, and management is vital for emergency clinicians.
Collapse
Affiliation(s)
- Jessica Pelletier
- Department of Emergency Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois
| | - Brit Long
- San Antonio Uniformed Services Health Education Consortium (SAUSHEC); Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas
| | - John C Perkins
- Department of Emergency Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia
| |
Collapse
|
19
|
Rasoanandrianina H, Demortière S, Trabelsi A, Ranjeva JP, Girard O, Duhamel G, Guye M, Pelletier J, Audoin B, Callot V. Sensitivity of the Inhomogeneous Magnetization Transfer Imaging Technique to Spinal Cord Damage in Multiple Sclerosis. AJNR Am J Neuroradiol 2020; 41:929-937. [PMID: 32414903 DOI: 10.3174/ajnr.a6554] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 03/12/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE The inhomogeneous magnetization transfer technique has demonstrated high specificity for myelin, and has shown sensitivity to multiple sclerosis-related impairment in brain tissue. Our aim was to investigate its sensitivity to spinal cord impairment in MS relative to more established MR imaging techniques (volumetry, magnetization transfer, DTI). MATERIALS AND METHODS Anatomic images covering the cervical spinal cord from the C1 to C6 levels and DTI, magnetization transfer/inhomogeneous magnetization transfer images at the C2/C5 levels were acquired in 19 patients with MS and 19 paired healthy controls. Anatomic images were segmented in spinal cord GM and WM, both manually and using the AMU40 atlases. MS lesions were manually delineated. MR metrics were analyzed within normal-appearing and lesion regions in anterolateral and posterolateral WM and compared using Wilcoxon rank tests and z scores. Correlations between MR metrics and clinical scores in patients with MS were evaluated using the Spearman rank correlation. RESULTS AMU40-based C1-to-C6 GM/WM automatic segmentations in patients with MS were evaluated relative to manual delineation. Mean Dice coefficients were 0.75/0.89, respectively. All MR metrics (WM/GM cross-sectional areas, normal-appearing and lesion diffusivities, and magnetization transfer/inhomogeneous magnetization transfer ratios) were observed altered in patients compared with controls (P < .05). Additionally, the absolute inhomogeneous magnetization transfer ratio z scores were significantly higher than those of the other MR metrics (P < .0001), suggesting a higher inhomogeneous magnetization transfer sensitivity toward spinal cord impairment in MS. Significant correlations with the Expanded Disability Status Scale (ρ = -0.73/P = .02, ρ = -0.81/P = .004) and the total Medical Research Council scale (ρ = 0.80/P = .009, ρ = -0.74/P = .02) were observed for inhomogeneous magnetization transfer and magnetization transfer ratio z scores, respectively, in normal-appearing WM regions, while weaker and nonsignificant correlations were obtained for DTI metrics. CONCLUSIONS With inhomogeneous magnetization transfer being highly sensitive to spinal cord damage in MS compared with conventional magnetization transfer and DTI, it could generate great clinical interest for longitudinal follow-up and potential remyelinating clinical trials. In line with other advanced myelin techniques with which it could be compared, it opens perspectives for multicentric investigations.
Collapse
Affiliation(s)
- H Rasoanandrianina
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Laboratoire de Biomécanique Appliquée, Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Reseaux, Aix-Marseille Université; iLab-Spine International Associated Laboratory (H.R., J.P.R., V.C.), Marseille-Montreal, France-Canada
| | - S Demortière
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Department of Neurology (S.D., J.P., B.A.), Centre Hospitalier Universitaire Timone, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - A Trabelsi
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - J P Ranjeva
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Laboratoire de Biomécanique Appliquée, Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Reseaux, Aix-Marseille Université; iLab-Spine International Associated Laboratory (H.R., J.P.R., V.C.), Marseille-Montreal, France-Canada
| | - O Girard
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - G Duhamel
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - M Guye
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - J Pelletier
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Department of Neurology (S.D., J.P., B.A.), Centre Hospitalier Universitaire Timone, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - B Audoin
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Department of Neurology (S.D., J.P., B.A.), Centre Hospitalier Universitaire Timone, Assistance Publique-Hopitaux de Marseille, Marseille, France
| | - V Callot
- From the Center for Magnetic Resonance in Biology and Medicine (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Centre National de la Recherche Scientifique, Aix-Marseille Université, Marseille, France .,Centre d'Exploration Métabolique par Résonance Magnétique (H.R., S.D., A.T., J.P.R., O.G., G.D., M.G., J.P., B.A., V.C.), Assistance Publique-Hopitaux de Marseille, Hôpital Universitaire Timone, Marseille, France.,Laboratoire de Biomécanique Appliquée, Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Reseaux, Aix-Marseille Université; iLab-Spine International Associated Laboratory (H.R., J.P.R., V.C.), Marseille-Montreal, France-Canada
| |
Collapse
|
20
|
Brisset JC, Kremer S, Hannoun S, Bonneville F, Durand-Dubief F, Tourdias T, Barillot C, Guttmann C, Vukusic S, Dousset V, Cotton F, Ameli R, Anxionnat R, Audoin B, Attye A, Bannier E, Barillot C, Ben Salem D, Boncoeur-Martel MP, Bonhomme G, Bonneville F, Boutet C, Brisset J, Cervenanski F, Claise B, Commowick O, Constans JM, Cotton F, Dardel P, Desal H, Dousset V, Durand-Dubief F, Ferre JC, Gaultier A, Gerardin E, Glattard T, Grand S, Grenier T, Guillevin R, Guttmann C, Krainik A, Kremer S, Lion S, Champfleur NMD, Mondot L, Outteryck O, Pyatigorskaya N, Pruvo JP, Rabaste S, Ranjeva JP, Roch JA, Sadik JC, Sappey-Marinier D, Savatovsky J, Stankoff B, Tanguy JY, Tourbah A, Tourdias T, Brochet B, Casey R, Cotton F, De Sèze J, Douek P, Guillemin F, Laplaud D, Lebrun-Frenay C, Mansuy L, Moreau T, Olaiz J, Pelletier J, Rigaud-Bully C, Stankoff B, Vukusic S, Debouverie M, Edan G, Ciron J, Lubetzki C, Vermersch P, Labauge P, Defer G, Berger E, Clavelou P, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Créange A, Camdessanché JP, Bakchine S, Maurousset A, Patry I, De Broucker T, Pottier C, Neau JP, Labeyrie C, Nifle C. New OFSEP recommendations for MRI assessment of multiple sclerosis patients: Special consideration for gadolinium deposition and frequent acquisitions. J Neuroradiol 2020; 47:250-258. [DOI: 10.1016/j.neurad.2020.01.083] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 01/04/2023]
|
21
|
Demortière S, Lehmann P, Pelletier J, Audoin B, Callot V. Improved Cervical Cord Lesion Detection with 3D-MP2RAGE Sequence in Patients with Multiple Sclerosis. AJNR Am J Neuroradiol 2020; 41:1131-1134. [PMID: 32439640 DOI: 10.3174/ajnr.a6567] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/23/2020] [Indexed: 12/18/2022]
Abstract
Spinal cord lesions have a real diagnostic and prognostic role in multiple sclerosis. Thus, optimizing their detection on MR imaging has become a central issue with direct therapeutic impact. In this study, we compared the 3D-MP2RAGE sequence with the conventional Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) set for cervical cord lesion detection in 28 patients with multiple sclerosis. 3D-MP2RAGE allowed better detection of cervical lesions (+62%) in this population, with better confidence, due to optimized contrast and high spatial resolution.
Collapse
Affiliation(s)
- S Demortière
- From the Centre d'exploration métabolique par résonance magnétique (S.D., P.L., J.P., B.A., V.C.).,Departments of Neurology (S.D., J.P., B.A.)
| | - P Lehmann
- From the Centre d'exploration métabolique par résonance magnétique (S.D., P.L., J.P., B.A., V.C.).,Neuroradiology (P.L.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
| | - J Pelletier
- From the Centre d'exploration métabolique par résonance magnétique (S.D., P.L., J.P., B.A., V.C.).,Departments of Neurology (S.D., J.P., B.A.)
| | - B Audoin
- From the Centre d'exploration métabolique par résonance magnétique (S.D., P.L., J.P., B.A., V.C.).,Departments of Neurology (S.D., J.P., B.A.)
| | - V Callot
- From the Centre d'exploration métabolique par résonance magnétique (S.D., P.L., J.P., B.A., V.C.) .,Center for Magnetic Resonance in Biology and Medicine (V.C.), Aix-Marseille University, National Centre for Scientific Research, Marseille, France
| |
Collapse
|
22
|
Lebrun C, Vukusic S, Abadie V, Achour C, Ader F, Alchaar H, Alkhedr A, Andreux F, Androdias G, Arjmand R, Audoin B, Audry D, Aufauvre D, Autreaux C, Ayrignac X, Bailbe M, Benazet M, Bensa C, Bensmail D, Berger E, Bernady P, Bertagna Y, Biotti D, Blanchard-Dauphin A, Bonenfant J, Bonnan M, Bonnemain B, Borgel F, Botelho-Nevers E, Boucly S, Bourre B, Boutière C, Branger P, Brassat D, Bresch S, Breuil V, Brochet B, Brugeilles H, Bugnon P, Cabre P, Camdessanché JP, Carra-Dalière C, Casez O, Chamouard JM, Chassande B, Chataignier P, Chbicheb M, Chenet A, Ciron J, Clavelou P, Cohen M, Colamarino R, Collongues N, Coman I, Corail PR, Courtois S, Coustans M, Creange A, Creisson E, Daluzeau N, Davenas C, De Seze J, Debouverie M, Depaz R, Derache N, Divio L, Douay X, Dulau C, Durand-Dubief F, Edan G, Elias Z, Fagniez O, Faucher M, Faucheux JM, Fournier M, Gagneux-Brunon A, Gaida P, Galli P, Gallien P, Gaudelus J, Gault D, Gayou A, Genevray M, Gentil A, Gere J, Gignoux L, Giroux M, Givron P, Gout O, Grimaud J, Guennoc AM, Hadhoum N, Hautecoeur P, Heinzlef O, Jaeger M, Jeannin S, Kremer L, Kwiatkowski A, Labauge P, Labeyrie C, Lachaud S, Laffont I, Lanctin-Garcia C, Lannoy J, Lanotte L, Laplaud D, Latombe D, Lauxerois M, Le Page E, Lebrun-Frenay C, Lejeune P, Lejoyeux P, Lemonnier B, Leray E, Loche CM, Louapre C, Lubetzki C, Maarouf A, Mada B, Magy L, Maillart E, Manchon E, Marignier R, Marque P, Mathey G, Maurousset A, Mekies C, Merienne M, Michel L, Milor AM, Moisset X, Montcuquet A, Moreau T, Morel N, Moussa M, Naudillon JP, Normand M, Olive P, Ouallet JC, Outteryck O, Pacault C, Papeix C, Patry I, Peaureaux D, Pelletier J, Pichon B, Pittion S, Planque E, Pouget MC, Pourcher V, Radot C, Robert I, Rocher F, Ruet A, Ruet A, Saint-Val C, Salle JY, Salmon A, Sartori E, Schaeffer S, Stankhof B, Taithe F, Thouvenot E, Tizon C, Tourbah A, Tourniaire P, Vaillant M, Vermersch P, Vidil S, Wahab A, Warter MH, Wiertlewski S, Wiplosz B, Wittwer B, Zaenker C, Zephir H. Immunization and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society. Rev Neurol (Paris) 2019; 175:341-357. [DOI: 10.1016/j.neurol.2019.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 03/31/2019] [Accepted: 04/11/2019] [Indexed: 10/26/2022]
|
23
|
Balloy G, Pelletier J, Suchet L, Lebrun C, Cohen M, Vermersch P, Zephir H, Duhin E, Gout O, Deschamps R, Le Page E, Edan G, Labauge P, Carra-Dallieres C, Rumbach L, Berger E, Lejeune P, Devos P, N'Kendjuo JB, Coustans M, Auffray-Calvier E, Daumas-Duport B, Michel L, Lefrere F, Laplaud DA, Brosset C, Derkinderen P, de Seze J, Wiertlewski S. Inaugural tumor-like multiple sclerosis: clinical presentation and medium-term outcome in 87 patients. J Neurol 2018; 265:2251-2259. [PMID: 30054790 DOI: 10.1007/s00415-018-8984-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Tumefactive demyelinating lesions of the central nervous system can be the initial presentation in various pathological entities [multiple sclerosis (the most common), Balo's concentric sclerosis, Schilder's disease and acute disseminated encephalomyelitis] with overlapping clinical presentation. The aim of our study was to better characterize these patients. METHODS Eighty-seven patients (62 women and 25 men) from different MS centers in France were studied retrospectively. Inclusion criteria were (1) a first clinical event (2) MRI showing one or more large demyelinating lesions (20 mm or more in diameter) with mass-like features. Patients with a previous demyelinating event (i.e. confirmed multiple sclerosis) were excluded. RESULTS Mean age at onset was 26 years. The most common initial symptoms (67% of the patients) were hemiparesis or hemiplegia. Aphasia, headache and cognitive disturbances (i.e. atypical symptoms for demyelinating diseases) were observed in 15, 18 and 15% of patients, respectively. The mean largest diameter of the tumefactive lesions was 26.9 mm, with gadolinium enhancement in 66 patients (81%). Twenty-one patients (24%) had a single tumefactive lesion. During follow-up (median time 5.7 years) 4 patients died, 70 patients improved or remained stable and 12 worsened. 86% of patients received initial corticosteroid treatment, and 73% received disease-modifying therapy subsequently. EDSS at the end of the follow-up was 2.4 ± 2.6 (mean ± SD). CONCLUSION This study provides further evidence that the clinical course of MS presenting with large focal tumor-like lesions does not differ from that of classical relapsing-remitting MS, once the noisy first relapsing occurred.
Collapse
Affiliation(s)
- G Balloy
- Neurology Department, University of Nantes Hospital, Nantes, France. .,Service de Neurologie, Hopital Laennec, Boulevard Jacques Monod, 44800, Saint Herblain, France.
| | - J Pelletier
- Neurosciences Unit, Neurology Department, Timone Hospital, Aix Marseille University, APHM, Marseille, France
| | - L Suchet
- Neurosciences Unit, Neurology Department, Timone Hospital, Aix Marseille University, APHM, Marseille, France
| | - C Lebrun
- University of Nice Hospital, Nice, France
| | - M Cohen
- University of Nice Hospital, Nice, France
| | | | - H Zephir
- University of Lille Hospital, Lille, France
| | - E Duhin
- University of Lille Hospital, Lille, France
| | - O Gout
- Rothschild Foundation, Paris, France
| | | | - E Le Page
- University of Rennes Hospital, Rennes, France
| | - G Edan
- University of Rennes Hospital, Rennes, France
| | - P Labauge
- University of Montpellier Hospital, Montpellier, France
| | | | - L Rumbach
- University Besançon Hospital, Besançon, France
| | - E Berger
- University Besançon Hospital, Besançon, France
| | - P Lejeune
- La Roche sur Yon Hospital, La Roche-sur-Yon, France
| | - P Devos
- Boulogne-sur-Mer Hospital, Boulogne-sur-Mer, France
| | | | | | | | - B Daumas-Duport
- Radiology Department, University of Nantes Hospital, Nantes, France
| | - L Michel
- Neurology Department, University of Nantes Hospital, Nantes, France
| | - F Lefrere
- Neurology Department, University of Nantes Hospital, Nantes, France
| | - D A Laplaud
- Neurology Department, University of Nantes Hospital, Nantes, France
| | - C Brosset
- Military Hospital, Marseille, France
| | - P Derkinderen
- Neurology Department, University of Nantes Hospital, Nantes, France
| | - J de Seze
- University of Strasbourg Hospital, Strasbourg, France
| | - S Wiertlewski
- Neurology Department, University of Nantes Hospital, Nantes, France
| | | |
Collapse
|
24
|
Laplaud DA, Barbin L, Casey R, Debouverie M, Vukusic S, Labauge P, Brassat D, Wiertlewski S, De Seze J, Edan G, Brochet B, Moreau T, Berger E, Clavelou P, Castelnovo G, Ciron J, Pelletier J, Bourre B, Lubetzki C, Al Khedr A, Vermersch P, Lebrun-Frenay C, Defer G, Tourbah A, Camdessanche JP, Stankoff B, Labeyrie C, Patry I, Creange A, Gout O, Heinzlef O, Casez O, Magy L, Guennoc AM, De Broucker T, Nifle C, Dupel-Pottier C, Leray E, Rollot F, Foucher Y. Efficacité comparée du Teriflunomide et du Dimethyl-Fumarate : une étude observationnelle française multicentrique. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
|
25
|
Maarouf A, Boutière C, Rico A, Audoin B, Pelletier J. How much progress has there been in the second-line treatment of multiple sclerosis: A 2017 update. Rev Neurol (Paris) 2018; 174:429-440. [PMID: 29779849 DOI: 10.1016/j.neurol.2018.01.369] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 01/24/2018] [Accepted: 01/26/2018] [Indexed: 02/04/2023]
Abstract
In 1993, the US Food and Drug Administration (FDA) approved the first drug specifically for treating multiple sclerosis (MS). More than two decades later, a dozen such treatments are now available. Of these, four are considered second-line treatments for use in escalation strategies and two new drugs are currently undergoing accreditation procedures. Soon, they will provide clinicians with a range of six effective disease-modifying treatments (DMTs) to thwart the inflammatory processes in MS patients with active disease. However, while such a large number of DMTs for MS can help to control early inflammation, any decisions to be made by clinicians have also been made substantially more complex. This complexity is increased by the lack of head-to-head studies comparing these second-line therapies and the benefit-risk profiles for each of these drugs, which are likely to vary among patients. Ultimately, good awareness of the benefits and, more important, the risks of each MS DMT is crucial for the effective management of inflammation in MS.
Collapse
Affiliation(s)
- A Maarouf
- CRMBM UMR 7339 CNRS, Aix Marseille Université, 13005 Marseille, France; AP-HM, Hôpital de la Timone, Pôle d'Imagerie Médicale, CEMEREM, 13005 Marseille, France; AP-HM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France.
| | - C Boutière
- AP-HM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - A Rico
- AP-HM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - B Audoin
- CRMBM UMR 7339 CNRS, Aix Marseille Université, 13005 Marseille, France; AP-HM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - J Pelletier
- CRMBM UMR 7339 CNRS, Aix Marseille Université, 13005 Marseille, France; AP-HM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| |
Collapse
|
26
|
Monteiro B, Moreau M, Otis C, De Lorimier L, Pelletier J, Troncy E. Quantitative Sensory Testing in Animal Models of Chronic Pain: A Pilot Study. Vet Comp Orthop Traumatol 2018. [DOI: 10.1055/s-0038-1660884] [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: 10/28/2022]
Affiliation(s)
- B. Monteiro
- GREPAQ (Groupe de recherche en pharmacologie animale du Québec, Faculty of Veterinary Medicine, Université de Montréal, Canada
| | - M. Moreau
- GREPAQ (Groupe de recherche en pharmacologie animale du Québec, Faculty of Veterinary Medicine, Université de Montréal, Canada
| | - C. Otis
- GREPAQ (Groupe de recherche en pharmacologie animale du Québec, Faculty of Veterinary Medicine, Université de Montréal, Canada
| | | | - J. Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Centre, Canada
| | - E. Troncy
- GREPAQ (Groupe de recherche en pharmacologie animale du Québec, Faculty of Veterinary Medicine, Université de Montréal, Canada
| |
Collapse
|
27
|
Otis C, Monteiro B, Moreau M, Cristofanilli K, Aoudj D, Tardif M, Pelletier J, Castillo J, Lussier B, Troncy E. Effect of Conditioned Pain Modulation on Somatosensory Profile in Surgical Models of Osteoarthritis Pain in Rats and Dogs. Vet Comp Orthop Traumatol 2018. [DOI: 10.1055/s-0038-1660888] [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: 10/28/2022]
Affiliation(s)
- C. Otis
- Research Group in Animal Pharmacology of Quebec, Department of veterinary biomedicine, Faculty of veterinary medicine-Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - B. Monteiro
- Research Group in Animal Pharmacology of Quebec, Department of veterinary biomedicine, Faculty of veterinary medicine-Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - M. Moreau
- Research Group in Animal Pharmacology of Quebec, Department of veterinary biomedicine, Faculty of veterinary medicine-Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - K. Cristofanilli
- Research Group in Animal Pharmacology of Quebec, Department of veterinary biomedicine, Faculty of veterinary medicine-Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - D. Aoudj
- Research Group in Animal Pharmacology of Quebec, Department of veterinary biomedicine, Faculty of veterinary medicine-Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - M. Tardif
- Research Group in Animal Pharmacology of Quebec, Department of veterinary biomedicine, Faculty of veterinary medicine-Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - J. Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center, Montreal, Quebec, Canada
| | - J. Castillo
- Research Group in Animal Pharmacology of Quebec, Department of veterinary biomedicine, Faculty of veterinary medicine-Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - B. Lussier
- Research Group in Animal Pharmacology of Quebec, Department of veterinary biomedicine, Faculty of veterinary medicine-Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - E. Troncy
- Research Group in Animal Pharmacology of Quebec, Department of veterinary biomedicine, Faculty of veterinary medicine-Université de Montréal, St-Hyacinthe, Quebec, Canada
| |
Collapse
|
28
|
Van Obberghen E, Mchinda S, le Troter A, Prevost VH, Viout P, Guye M, Varma G, Alsop DC, Ranjeva JP, Pelletier J, Girard O, Duhamel G. Evaluation of the Sensitivity of Inhomogeneous Magnetization Transfer (ihMT) MRI for Multiple Sclerosis. AJNR Am J Neuroradiol 2018; 39:634-641. [PMID: 29472299 DOI: 10.3174/ajnr.a5563] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/22/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Inhomogeneous magnetization transfer is a new endogenous MR imaging contrast mechanism that has demonstrated high specificity for myelin. Here, we tested the hypothesis that inhomogeneous magnetization transfer is sensitive to pathology in a population of patients with relapsing-remitting MS in a way that both differs from and complements conventional magnetization transfer. MATERIALS AND METHODS Twenty-five patients with relapsing-remitting MS and 20 healthy volunteers were enrolled in a prospective MR imaging research study, whose protocol included anatomic imaging, standard magnetization transfer, and inhomogeneous magnetization transfer imaging. Magnetization transfer and inhomogeneous magnetization transfer ratios measured in normal-appearing brain tissue and in MS lesions of patients were compared with values measured in control subjects. The potential association of inhomogeneous magnetization transfer ratio variations with the clinical scores (Expanded Disability Status Scale) of patients was further evaluated. RESULTS The magnetization transfer ratio and inhomogeneous magnetization transfer ratio measured in the thalami and frontal, occipital, and temporal WM of patients with MS were lower compared with those of controls (P < .05). The mean inhomogeneous magnetization transfer ratio measured in lesions was lower than that in normal-appearing WM (P < .05). Significant (P < .05) negative correlations were found between the clinical scores and inhomogeneous magnetization transfer ratio measured in normal-appearing WM structures. Weaker nonsignificant correlation trends were found for the magnetization transfer ratio. CONCLUSIONS The sensitivity of the inhomogeneous magnetization transfer technique for MS was highlighted by the reduction in the inhomogeneous magnetization transfer ratio in MS lesions and in normal-appearing WM of patients compared with controls. Stronger correlations with the Expanded Disability Status Scale score were obtained with the inhomogeneous magnetization transfer ratio compared with the standard magnetization transfer ratio, which may be explained by the higher specificity of inhomogeneous magnetization transfer for myelin.
Collapse
Affiliation(s)
- E Van Obberghen
- From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France
| | - S Mchinda
- From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France
| | - A le Troter
- From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France
| | - V H Prevost
- From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France
| | - P Viout
- From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France
| | - M Guye
- From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France
| | - G Varma
- Department of Radiology (G.V., D.C.A.), Division of MR Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - D C Alsop
- Department of Radiology (G.V., D.C.A.), Division of MR Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - J-P Ranjeva
- From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France
| | - J Pelletier
- From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France
- Aix-Marseille University (J.P.), Assistance Publique des Hôpitaux de Marseille (APHM), Hôpital de La Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - O Girard
- From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France
| | - G Duhamel
- From Aix-Marseille Université (E.V.O., S.M., A.l.T., V.H.P., P.V., M.G., J.-P.R., J.P., O.G., G.D.), Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339 Centre National de Recherche Scientifique (CNRS), Marseille, France
| |
Collapse
|
29
|
Lavie C, Rollot F, Durand-Dubief F, Marignier R, Ionescu I, Casey R, Moreau T, Tourniaire P, Hutchinson M, D’Hooghe MB, Laplaud DA, Clavelou P, De Sèze J, Debouverie M, Brassat D, Pelletier J, Lebrun-Frenay C, Le Page E, Castelnovo G, Berger E, Hautecoeur P, Heinzlef O, Durelli L, Clerico M, Trojano M, Patti F, Vukusic S, Alpérovitch A, Carton H, d’Hooghe M, Hommes O, Hutchinson M, Adeleine P, Biron A, Cortinovis-Tourniaire P, Grimaud J, Hours M, Moreau T, Vukusic S, Confavreux C, Chauplannaz G, Confavreux C, Cortinovis-Tourniaire P, Grimaud J, Latombe D, Moreau T, Clanet M, Lau G, Rumbach L, Goas J, Rouhart F, Mazingue A, Roullet E, Madigand M, Hautecoeur P, Brunet P, Edan G, Allaire C, Riffault G, Leche J, Benoit T, Simonin C, Ziegler F, Baron J, Rivrain Y, Dumas R, Loche D, Bourrin J, Huttin B, Delisse B, Gibert I, Boulay C, Verceletto M, Durand G, Bonneviot G, Gil R, Hedreville M, Belair C, Poitevin R, Devoize J, Wyremblewski P, Delestre F, Setiey A, Comi G, Filippi M, Ghezzi A, Martinelli V, Rossi P, Zaffaroni M, Tola M, Amato M, Fioretti C, Meucci G, Inglese M, Mancardi G, Gambi D, Thomas A, Cavazzuti M, Citterio A, Heltberg A, Hansen H, Fernandez O, Romero F, Arbizu T, Hernandez J, De Andres de Frutos C, Geffner Sclarky D, Aladro Benito Y, Reyes Yanes P, Aguilar M, Burguera J, Yaya R, Bonakim Dib W, Arzua-Mouronte D, d’Hooghe M, Sindic C, Carton H, Medaer R, Roose H, Geens K, Guillaume D, Van Zandycke M, Janssens J, Cornette M, Mol L, Weilbach F, Flachenecker P, Hartung H, Haas J, Tendolkar I, Sindrn E, Kölmel H, Reichel D, Rauch M, Preuss S, Poser S, Mauch E, Strausser-Fuchs S, Kolleger H, Hawkins S, Howell S, Rees J, Thompson A, Johnson M, Boggild M, Gregory R, Bates D, Bone I, Hutchinson M, Polman C, Frequin S, Jongen P, Hommes O, Correia de Sa J, Rio M, Huber S, Lechner-Scott J, Kappos L, Ionescu I, Cornu C, Confavreux C, Vukusic S, El-Etr M, Baulieu E, El-Etr M, Schumacher M, Ionescu I, Confavreux C, Cornu C, Vukusic S, Hartung H, Miller D, Hutchinson M, Pugeat M, d’Archangues C, Conard J, Ménard J, Sitruk-Ware R, Pelissier C, Dat S, Belaïsch-Allard J, Athéa N, Büschsenschutz D, Lyon-Caen O, Gonsette R, Boissel J, Ffrench P, Durand-Dubief F, Cotton F, Pachai C, Bracoud L, Vukusic S, Ionescu I, Androdias G, Marignier R, Chauplannaz G, Laplaud D, Wiertlewski S, Lanctin-Garcia C, Moreau T, Couvreur G, Madinier G, Clavelou P, Taithe F, Aufauvre D, Guy N, Ferrier A, De Sèze J, Collongues N, Debouverie M, Viala F, Brassat D, Gerdelat-Mas A, Henry P, Pelletier J, Rico-Lamy A, Lebrun-Frenay C, Lepage E, Deburghraeve V, Edan G, Castelnovo G, Berger E, Hautecoeur P, Blondiau M, Heinzlef O, Coustans M, Clerc C, Rieu L, Lauxerois M, Hinzelin G, Ouallet J, Minier D, Vion P, Gromaire-Fayolle N, Derache N, Thouvenot E, Sallansonnet-Froment M, Tourniaire P, Toureille L, Borgel F, Stankoff B, Grimaud J, Moroianu C, Guennoc A, Tournier-Gervason C, Peysson S, Trojano M, Patti F, D’Amico E, Motti L, Zaffaroni M, Durelli L, Tavella A. Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS. Mult Scler 2018; 25:591-600. [DOI: 10.1177/1352458518763080] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Obstetrical analgesia remains a matter of controversy because of the fear of neurotoxicity of local anesthetics on demyelinated fibers or their potential relationship with subsequent relapses. Objective: To assess the impact of neuraxial analgesia on the risk of relapse during the first 3 months post-partum, with a focus on women who experienced relapses during pregnancy. Methods: We analyzed data of women followed-up prospectively during their pregnancies and at least 3 months post-partum, collected in the Pregnancy in Multiple Sclerosis (PRIMS) and Prevention of Post-Partum Relapses with Progestin and Estradiol in Multiple Sclerosis (POPARTMUS) studies between 1992–1995 and 2005–2012, respectively. The association of neuraxial analgesia with the occurrence of a post-partum relapse was estimated by logistic regression analysis. Results: A total of 389 women were included, 215 from PRIMS and 174 from POPARTMUS. In total, 156 women (40%) had neuraxial analgesia. Overall, 24% experienced a relapse during pregnancy and 25% in the 3 months post-partum. Women with a pregnancy relapse were more likely to have a post-partum relapse (odds ratio (OR) = 1.83, p = 0.02), independently of the use of neuraxial analgesia. There was no association between neuraxial analgesia and post-partum relapse (OR = 1.08, p = 0.78). Conclusion: Neuraxial analgesia was not associated with an increased risk of post-partum relapses, whatever multiple sclerosis (MS) activity during pregnancy.
Collapse
Affiliation(s)
- Caroline Lavie
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France
| | - Fabien Rollot
- Observatoire Français de la Sclérose en Plaques (OFSEP),
Lyon, France
| | | | - Romain Marignier
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France/Centre de Recherche en Neurosciences de Lyon,
INSERM U1028, CNRS UMR5292, Equipe Neuro-Oncologie et Neuro-Inflammation, Lyon, France;
Université de Lyon 1, Lyon, France
| | - Iuliana Ionescu
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France
| | - Romain Casey
- Observatoire Français de la Sclérose en Plaques (OFSEP),
Lyon, France
| | - Thibault Moreau
- Department of Neurology, EA4184, University Hospital of
Dijon, Dijon, France
| | | | - Michael Hutchinson
- School of Medicine and Medical Science, University College
Dublin, Dublin, Ireland/Department of Neurology, St Vincent’s University Hospital,
Dublin, Ireland
| | - Marie Béatrice D’Hooghe
- National MS Center Melsbroek, Melsbroek, Belgium; Center
for Neurosciences, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - David-Axel Laplaud
- Service de Neurologie, CHU de Nantes, CIC015 INSERM,
Nantes, France/INSERM UMR1064, Nantes, France
| | - Pierre Clavelou
- Service de Neurologie, CHU de Clermont-Ferrand,
Clermont-Ferrand, France/INSERM UMR1107, Clermont Université, Université d’Auvergne,
Neuro-Dol, Clermont-Ferrand, France
| | - Jérôme De Sèze
- Department of Neurology, Clinical Investigation Center
INSERM 1434, Hôpitaux Universitaires de Strasbourg, FMTS INSERM 1119, Strasbourg,
France
| | - Marc Debouverie
- EA 4360 APEMAC, University of Lorraine, Nancy,
France/Department of Neurology, Nancy University Hospital, Nancy, France
| | - David Brassat
- Pôle Neurosciences, CHU Toulouse Purpan, Toulouse,
France/INSERM U1043, CNRS UMR 5282, Université Toulouse III, Toulouse, France
| | - Jean Pelletier
- Service de Neurologie, Hôpital de la Timone, Pôle de
Neurosciences Cliniques, AP-HM, Aix-Marseille Université, Marseille, France/CNRS,
Aix-Marseille Université, CRMBM UMR7339, Marseille, France
| | | | - Emmanuelle Le Page
- Clinical Neuroscience Centre, CIC-P 1414 INSERM, Rennes
University Hospital, Rennes, France
| | | | - Eric Berger
- Department of Neurology, CHU Besançon, Besançon,
France
| | - Patrick Hautecoeur
- Service de Neurologie, Groupement des Hôpitaux de
l’Institut Catholique de Lille, Lille, France
| | - Olivier Heinzlef
- Department of Neurology, Hôpital CHI de
Poissy/Saint-Germain-en-Laye, Paris, France
| | - Luca Durelli
- Division of Neurology, Department of Clinical and
Biological Sciences, University of Torino, San Luigi Gonzaga University Hospital,
Orbassano, Italy
| | - Marinella Clerico
- Division of Neurology, Department of Clinical and
Biological Sciences, University of Torino, San Luigi Gonzaga University Hospital,
Orbassano, Italy
| | - Maria Trojano
- Department of Basic Medical Sciences, Neuroscience and
Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Patti
- Department of Medical and Surgical Sciences, and Advanced
Technologies, G.F. Ingrassia, Multiple Sclerosis Center, University of Catania, Catania,
Italy
| | - Sandra Vukusic
- Service de Neurologie A, Hôpital Pierre Wertheimer,
Hospices Civils de Lyon, Lyon, France/Observatoire Français de la Sclérose en Plaques
(OFSEP), Lyon, France/Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS
UMR5292, Equipe Neuro-Oncologie et Neuro-Inflammation, Lyon, France/Université de Lyon
1, Lyon, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Monnier J, Collet-Villette AM, Olmi X, Monestier S, Pelletier J, Mallet S, Hesse S, Gaudy-Marqueste C, Grob JJ, Richard MA. Prise en charge par laser de molluscum contagiosum génitaux profus apparus sous fingolimod. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
31
|
Wybrecht D, Reuter F, Pariollaud F, Zaaraoui W, Le Troter A, Rico A, Confort-Gouny S, Soulier E, Guye M, Maarouf A, Ranjeva JP, Pelletier J, Audoin B. New brain lesions with no impact on physical disability can impact cognition in early multiple sclerosis: A ten-year longitudinal study. PLoS One 2017; 12:e0184650. [PMID: 29149177 PMCID: PMC5693435 DOI: 10.1371/journal.pone.0184650] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 08/28/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE In early multiple sclerosis, although brain T2 lesions accrual are hallmark of the disease, only weak correlations were found between T2 lesions accrual and EDSS progression, the disability scale commonly used in multiple sclerosis studies. This may be related to the very poor sensitivity of EDSS to cognitive dysfunctions that may occur and progress from the first stage of the disease. In the present study, we aimed to demonstrate that cognitive deficits progress during the first ten years of MS and are significantly impacted by new T2 lesions. METHODS EDSS and extensive neuropsychological battery (22 measures) exploring memory, attention/speed of information processing and executive functions were assessed at baseline, Year 1 and Year 10 in 26 patients enrolled after their first clinical attack. To limit the bias of test-retest effect, only measures obtained at Year 1 and Year 10 were reported in the analysis. Raw scores of patients were transformed into z-scores using published normative data when available or scores of matched controls. Lesion probability mapping was used to assess the potential relationships between T2 lesions accumulation, cognitive decline and EDSS progression (P<0.05, FWE-corrected). RESULTS At Year 1, 27% of patients showed attention/speed of information processing deficits, 11.5% executive dysfunction and 11.5% memory impairment. During the follow-up, frequency and severity of executive dysfunction increased (from 11.5% of patients at Year 1 to 42% at Year 10, p<0.01) while no significant changes were evidenced for the other cognitive domains. Median EDSS increased from 0.5 [range: 0-3] at Year 1 to 2.5 [range: 0-6.5] at Year 10 (p<0.001). During the ten-year follow-up, lesions accumulation in the left cerebellum and semi-ovale centers was associated with EDSS progression. In contrast, most lesions accumulation in the frontal, parietal and temporal lobes were associated with cognitive decline but had no effect on EDSS progression. CONCLUSION The present study provides strong evidence that clinically silent T2 lesions impact cognition in early MS. In daily practice, early prevention of T2 lesions accrual may be useful to limit cognitive decline.
Collapse
Affiliation(s)
- D. Wybrecht
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- Hôpital d’Instruction des Armées Sainte Anne, Toulon, France
- * E-mail:
| | - F. Reuter
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - F. Pariollaud
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - W. Zaaraoui
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
| | - A. Le Troter
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
| | - A. Rico
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - S. Confort-Gouny
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
| | - E. Soulier
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
| | - M. Guye
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- APHM, Hôpital de la Timone, Pôle d’Imagerie Médicale, CEMEREM, Marseille, France
| | - A. Maarouf
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - J-P. Ranjeva
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
| | - J. Pelletier
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| | - B. Audoin
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France
- APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, Marseille, France
| |
Collapse
|
32
|
Pike KA, Hatzihristidis T, Bussières-Marmen S, Robert F, Desai N, Miranda-Saavedra D, Pelletier J, Tremblay ML. TC-PTP regulates the IL-7 transcriptional response during murine early T cell development. Sci Rep 2017; 7:13275. [PMID: 29038451 PMCID: PMC5643372 DOI: 10.1038/s41598-017-13673-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 09/27/2017] [Indexed: 01/02/2023] Open
Abstract
Cytokines play a critical role in directing the discrete and gradual transcriptional changes that define T cell development. The interleukin-7 receptor (IL-7R), via its activation of the JAK-STAT pathway, promotes gene programs that change dynamically as cells progress through T cell differentiation. The molecular mechanism(s) directing differential gene expression downstream of the IL-7R are not fully elucidated. Here, we have identified T cell protein tyrosine phosphatase (TC-PTP), also known as PTPN2, as a negative regulator of IL-7R-STAT signaling in T cell progenitors, contributing to both the quantitative and qualitative nature of STAT-gene targeting. Novel genetic strategies used to modulate TC-PTP expression demonstrate that depletion of TC-PTP expression heightens the phosphorylation of STAT family members, causing aberrant expression of an interferon-response gene profile. Such molecular re-programming results in deregulation of early development checkpoints culminating in inefficient differentiation of CD4+CD8+ double positive cells. TC-PTP is therefore shown to be required to safeguard the dynamic transcriptome necessary for efficient T cell differentiation.
Collapse
Affiliation(s)
- K A Pike
- Rosalind and Morris Goodman Cancer Centre, McGill University, Montréal, QC H3A 1A3, Canada
| | - T Hatzihristidis
- Rosalind and Morris Goodman Cancer Centre, McGill University, Montréal, QC H3A 1A3, Canada.,Division of Experimental Medicine, Department of Medicine, McGill University, Montréal, QC H3A 1A3, Canada
| | - S Bussières-Marmen
- Rosalind and Morris Goodman Cancer Centre, McGill University, Montréal, QC H3A 1A3, Canada.,Department of Biochemistry, McGill University, Montréal, QC H3A 1A3, Canada
| | - F Robert
- Rosalind and Morris Goodman Cancer Centre, McGill University, Montréal, QC H3A 1A3, Canada
| | - N Desai
- Rosalind and Morris Goodman Cancer Centre, McGill University, Montréal, QC H3A 1A3, Canada.,Department of Biochemistry, McGill University, Montréal, QC H3A 1A3, Canada
| | - D Miranda-Saavedra
- Centro de Biología Molecular Severo Ochoa, CSIC/Universidad Autónoma de Madrid, 28049, Madrid, Spain.,Department of Computer Science, University of Oxford, Wolfson Building Parks Road, OXFORD, OX1 3QD, UK
| | - J Pelletier
- Rosalind and Morris Goodman Cancer Centre, McGill University, Montréal, QC H3A 1A3, Canada.,Division of Experimental Medicine, Department of Medicine, McGill University, Montréal, QC H3A 1A3, Canada
| | - M L Tremblay
- Rosalind and Morris Goodman Cancer Centre, McGill University, Montréal, QC H3A 1A3, Canada. .,Division of Experimental Medicine, Department of Medicine, McGill University, Montréal, QC H3A 1A3, Canada. .,Department of Biochemistry, McGill University, Montréal, QC H3A 1A3, Canada.
| |
Collapse
|
33
|
van den Bruck R, Weil PP, Ziegenhals T, Schreiner P, Juranek S, Gödde D, Vogel S, Schuster F, Orth V, Dörner J, Pembaur D, Röper M, Störkel S, Zirngibl H, Wirth S, Jenke ACW, Postberg J, Boy N, Heringer J, Haege G, Glahn EM, Hoffmann GF, Garbade SF, Burgard P, Kölker S, Chao CM, Yahya F, Moiseenko A, Shrestha A, Ahmadvand N, Quantius J, Wilhelm J, El-Agha E, Zimmer KP, Bellusci S, Staufner C, Kölker S, Prokisch H, Hoffmann GF, Seeliger S, Müller M, Hippe A, Steinkraus H, Wauer R, Lachmann B, Hofmann SR, Hedrich CM, Zierk J, Arzideh F, Haeckel R, Rascher W, Rauh M, Metzler M, Thieme S, Bandoła J, Richter C, Ryser M, Jamal A, Ashton MP, von Bonin M, Kuhn M, Hedrich CM, Bonifacio E, Berner R, Brenner S, Hammersen J, Has C, Naumann-Bartsch N, Stachel D, Kiritsi D, Söder S, Tardieu M, Metzler M, Bruckner-Tuderman L, Schneider H, Bohne F, Langer D, Cencic R, Eggermann T, Zechner U, Pelletier J, Zepp F, Enklaar T, Prawitt D, Pech M, Weckmann M, Heinsen FA, Franke A, Happle C, Dittrich AM, Hansen G, Fuchs O, von Mutius E, Oliver BG, Kopp MV, Paret C, Russo A, Theruvath J, Keller B, El Malki K, Lehmann N, Wingerter A, Neu MA, Aslihan GA, Wagner W, Sommer C, Pietsch T, Seidmann L, Faber J, Schreiner F, Ackermann M, Michalik M, Rother E, Bilkei-Gorzo A, Racz I, Bindila L, Lutz B, Dötsch J, Zimmer A, Woelfle J, Fischer HS, Ullrich TL, Bührer C, Czernik C, Schmalisch G, Stein R, Hofmann SR, Hagenbuchner J, Kiechl-Kohlendorfer U, Obexer P, Ausserlechner MJ, Loges NT, Frommer AT, Wallmeier J, Omran H, Öner-Sieben S, Gimpfl M, Rozman J, Irmler M, Beckers J, De Angelis MH, Roscher A, Wolf E, Ensenauer R, Nemes K, Frühwald M, Hasselblatt M, Siebert R, Kordes U, Kool M, Wang H, Hardy H, Refai O, Barwick KES, Zimmerman HH, Weis J, Baple EL, Crosby AH, Cirak S, Hellmuth C, Uhl O, Standl M, Heinrich J, Thiering E, Koletzko B, Blümel L, Kerl K, Picard D, Frühwald MC, Liebau MC, Reifenberger G, Borkhardt A, Hasselblatt M, Remke M, Tews D, Wabitsch M, Fischer-Posovszky P, Westhoff MA, Nonnenmacher L, Langhans J, Schneele L, Trenkler N, Debatin KM. Abstracts of the 52nd Workshop for Pediatric Research : Frankfurt, Germany. 27-28 October 2016. Mol Cell Pediatr 2017; 4:5. [PMID: 28516419 PMCID: PMC5435609 DOI: 10.1186/s40348-017-0071-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Rhea van den Bruck
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Patrick P Weil
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Thomas Ziegenhals
- Chair of Biochemistry, Theodor-Boveri-Institute at the Biocenter, University of Würzburg, Würzburg, Germany
| | - Philipp Schreiner
- Chair of Biochemistry, Theodor-Boveri-Institute at the Biocenter, University of Würzburg, Würzburg, Germany
| | - Stefan Juranek
- Chair of Biochemistry, Theodor-Boveri-Institute at the Biocenter, University of Würzburg, Würzburg, Germany
| | - Daniel Gödde
- Molecular Pathology Department, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Silvia Vogel
- Molecular Pathology Department, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Frauke Schuster
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Valerie Orth
- Department of Surgery II, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Johannes Dörner
- Department of Surgery II, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Daniel Pembaur
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Meike Röper
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Stefan Störkel
- Molecular Pathology Department, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Hubert Zirngibl
- Department of Surgery II, HELIOS Medical Centre Wuppertal, Witten/Herdecke University Hospital, Wuppertal, Germany
| | - Stefan Wirth
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Andreas C W Jenke
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Jan Postberg
- Department of Paediatrics, HELIOS Medical Centre Wuppertal, Centre for Clinical and Translational Research (CCTR), Witten/Herdecke University Hospital, Centre for Biomedical Education and Research (ZBAF), Wuppertal, Germany
| | - Nikolas Boy
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Jana Heringer
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Gisela Haege
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Esther M Glahn
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Georg F Hoffmann
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Sven F Garbade
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Peter Burgard
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Stefan Kölker
- Centre for Child and Adolescent Medicine, Department of General Pediatrics, Division of Neuropaediatrics and Metabolic Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Cho-Ming Chao
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,Department for General Pediatrics and Neonatology, University Children's Hospital, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Faady Yahya
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Alena Moiseenko
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Amit Shrestha
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Negah Ahmadvand
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Jennifer Quantius
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Jochen Wilhelm
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Elie El-Agha
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Klaus-Peter Zimmer
- Department for General Pediatrics and Neonatology, University Children's Hospital, Gießen, Germany
| | - Saverio Bellusci
- Excellence Cluster Cardio-Pulmonary System, Gießen, Germany.,German Center for Lung Research (DZL), Gießen, Germany
| | - Christian Staufner
- Department of General Pediatrics, University Children's Hospital, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Stefan Kölker
- Department of General Pediatrics, University Children's Hospital, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Holger Prokisch
- Institute of Human Genetics, Helmholtz Zentrum München, 85764, Neuherberg, Germany.,Institute of Human Genetics, Technische Universität München, 81675, Munich, Germany
| | - Georg F Hoffmann
- Department of General Pediatrics, University Children's Hospital, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Stephan Seeliger
- Department of Pediatric Cardiology, Intensive Care and Neonatology, University Hospital Goettingen, 37075, Goettingen, Germany.,Clinics for children and adolescents, 86633, Neuburg/Donau, Germany
| | - Matthias Müller
- Department of Pediatric Cardiology, Intensive Care and Neonatology, University Hospital Goettingen, 37075, Goettingen, Germany
| | - Andreas Hippe
- Department of Dermatology, Heinrich Heine University, 40225, Duesseldorf, Germany
| | - Henrik Steinkraus
- Department of Anesthesiology, MSP, Surgical Intensive Care Medicine, University Hospital, Charité, Campus Virchow Clinic, 13353, Berlin, Germany
| | - Roland Wauer
- Department of Neonatology, Charité, University of Medicine, 10098, Berlin, Germany
| | - Burkhard Lachmann
- Department of Anesthesiology, MSP, Surgical Intensive Care Medicine, University Hospital, Charité, Campus Virchow Clinic, 13353, Berlin, Germany
| | - Sigrun R Hofmann
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Christian M Hedrich
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Jakob Zierk
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Farhad Arzideh
- Department of Statistics, University of Bremen, Bremen, Germany
| | - Rainer Haeckel
- Bremer Zentrum für Laboratoriumsmedizin, Klinikum Bremen Mitte, Bremen, Germany
| | - Wolfgang Rascher
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Manfred Rauh
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Markus Metzler
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Sebastian Thieme
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Joanna Bandoła
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Cornelia Richter
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Martin Ryser
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Arshad Jamal
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Michelle P Ashton
- DFG-Center for Regenerative Therapies Dresden, Cluster of Excellence, Technische Universitaet Dresden, Dresden, Germany
| | - Malte von Bonin
- Medical Clinic I, University Clinic Dresden, Dresden, Germany.,DKTK-German Cancer Consortium, Partner Site Dresden, University Clinic Dresden, Dresden, Germany.,DKFZ-German Cancer Research Center, Heidelberg, Germany
| | - Matthias Kuhn
- Institute for Medical Informatics and Biometry, Faculty of Medicine, Technische Universitaet Dresden, Dresden, Germany
| | | | - Ezio Bonifacio
- DFG-Center for Regenerative Therapies Dresden, Cluster of Excellence, Technische Universitaet Dresden, Dresden, Germany
| | - Reinhard Berner
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany
| | - Sebastian Brenner
- Department of Pediatrics, University Clinic Dresden, Dresden, Germany.,DFG-Center for Regenerative Therapies Dresden, Cluster of Excellence, Technische Universitaet Dresden, Dresden, Germany
| | - Johanna Hammersen
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | - Cristina Has
- Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Daniel Stachel
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | - Dimitra Kiritsi
- Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany
| | - Stephan Söder
- Department of Pathology, University Hospital Erlangen, Erlangen, Germany
| | - Mathilde Tardieu
- Dermatologie Pédiatrique, University Hospital Grenoble, Grenoble, France
| | - Markus Metzler
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | | | - Holm Schneider
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany
| | - F Bohne
- Centre for Paediatrics and Adolescent Medicine, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - D Langer
- Centre for Paediatrics and Adolescent Medicine, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - R Cencic
- Department of Biochemistry and The Rosalind and Morris Goodman Cancer Research; Centre, McGill University, Montreal, Quebec, H3G 1Y6, Canada
| | - T Eggermann
- Institute of Human Genetics, RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - U Zechner
- Institute of Human Genetics, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - J Pelletier
- Department of Biochemistry and The Rosalind and Morris Goodman Cancer Research; Centre, McGill University, Montreal, Quebec, H3G 1Y6, Canada
| | - F Zepp
- Centre for Paediatrics and Adolescent Medicine, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - T Enklaar
- Centre for Paediatrics and Adolescent Medicine, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - D Prawitt
- Centre for Paediatrics and Adolescent Medicine, University Medical Centre, Langenbeckstr. 1, 55101, Mainz, Germany
| | - Martin Pech
- University Medical Center Schleswig-Holstein, Division Pediatric Pneumology & Allergology, Campus Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), Member of of the German Center of Lung Research (DZL), Borstel, Germany
| | - Markus Weckmann
- University Medical Center Schleswig-Holstein, Division Pediatric Pneumology & Allergology, Campus Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), Member of of the German Center of Lung Research (DZL), Borstel, Germany
| | - Femke-Anouska Heinsen
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Christine Happle
- Hannover Medical School, Department of Pediatric Pneumology, Allergology and Neonatology, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of of the German Center of Lung Research (DZL), Hannover, Germany
| | - Anna-Maria Dittrich
- Hannover Medical School, Department of Pediatric Pneumology, Allergology and Neonatology, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of of the German Center of Lung Research (DZL), Hannover, Germany
| | - Gesine Hansen
- Hannover Medical School, Department of Pediatric Pneumology, Allergology and Neonatology, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of of the German Center of Lung Research (DZL), Hannover, Germany
| | - Oliver Fuchs
- Ludwig-Maximilians-University Munich, Dr von Hauner Children's Hospital, Munich, Germany.,Comprehensive Pneumology Center München (CPC-M), Member of of the German Center of Lung Research (DZL), Munich, Germany
| | - Erika von Mutius
- Ludwig-Maximilians-University Munich, Dr von Hauner Children's Hospital, Munich, Germany.,Comprehensive Pneumology Center München (CPC-M), Member of of the German Center of Lung Research (DZL), Munich, Germany
| | - Brian G Oliver
- Woolcock Institute of Medical Research, Sydney, Australia
| | - Matthias V Kopp
- University Medical Center Schleswig-Holstein, Division Pediatric Pneumology & Allergology, Campus Lübeck, Lübeck, Germany.,Airway Research Center North (ARCN), Member of of the German Center of Lung Research (DZL), Borstel, Germany
| | - Claudia Paret
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexandra Russo
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Johanna Theruvath
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bettina Keller
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Khalifa El Malki
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Nadine Lehmann
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Arthur Wingerter
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marie A Neu
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Gerhold-Ay Aslihan
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Wolfgang Wagner
- Section of Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Clemens Sommer
- Devision of Neuropathology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Torsten Pietsch
- Department of Neuropathology, University of Bonn, Bonn, Germany
| | - Larissa Seidmann
- Institute of Pathology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jörg Faber
- Section of Pediatric Oncology, Children's Hospital, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,UCT Mainz, Mainz, Germany
| | - Felix Schreiner
- Pediatric Endocrinology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Merle Ackermann
- Pediatric Endocrinology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Michael Michalik
- Pediatric Endocrinology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Eva Rother
- Pediatric Endocrinology, Children's Hospital, University of Cologne, Cologne, Germany
| | | | - Ildiko Racz
- Molecular Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Laura Bindila
- Institute for Physiological Chemistry, University Medical Center, Mainz, Germany
| | - Beat Lutz
- Institute for Physiological Chemistry, University Medical Center, Mainz, Germany
| | - Jörg Dötsch
- Pediatric Endocrinology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Andreas Zimmer
- Molecular Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Joachim Woelfle
- Pediatric Endocrinology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Hendrik S Fischer
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - Tim L Ullrich
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - Christoph Bührer
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - Christoph Czernik
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - Gerd Schmalisch
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - Robert Stein
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Sigrun R Hofmann
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | | | - Petra Obexer
- Department of Pediatrics II, Innsbruck, Austria.,Tyrolean Cancer Research Institute, Innsbruck, Austria
| | | | - Niki T Loges
- Department of General Pediatrics, University Children's Hospital Muenster, Muenster, Germany
| | - Adrien Tobias Frommer
- Department of General Pediatrics, University Children's Hospital Muenster, Muenster, Germany
| | - Julia Wallmeier
- Department of General Pediatrics, University Children's Hospital Muenster, Muenster, Germany
| | - Heymut Omran
- Department of General Pediatrics, University Children's Hospital Muenster, Muenster, Germany
| | - Soner Öner-Sieben
- Experimental Pediatrics, University Children's Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Martina Gimpfl
- Research Center, University Children's Hospital, Ludwig-Maximilians-Universität (LMU) München, München, Germany
| | - Jan Rozman
- Institute of Experimental Genetics, Helmholtz Zentrum München, München, Germany
| | - Martin Irmler
- Institute of Experimental Genetics, Helmholtz Zentrum München, München, Germany
| | - Johannes Beckers
- Institute of Experimental Genetics, Helmholtz Zentrum München, München, Germany
| | | | - Adelbert Roscher
- Research Center, University Children's Hospital, Ludwig-Maximilians-Universität (LMU) München, München, Germany
| | - Eckhard Wolf
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, LMU München, München, Germany
| | - Regina Ensenauer
- Experimental Pediatrics, University Children's Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Research Center, University Children's Hospital, Ludwig-Maximilians-Universität (LMU) München, München, Germany
| | - Karolina Nemes
- Children's Hospital Augsburg, Swabian Children's Cancer Center, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Michael Frühwald
- Children's Hospital Augsburg, Swabian Children's Cancer Center, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Pottkamp 2, 48149, Münster, Germany
| | - Reiner Siebert
- Department of Human Genetics, Institute of Human Genetics, University of Ulm, Ulm, Germany
| | - Uwe Kordes
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Marcel Kool
- Division of Pediatric Neurooncology (B062), German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Haicui Wang
- Uniklinik Köln, Klinik für Kinderheilkunde und Jugendmedizin, Köln, Germany
| | - Holly Hardy
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
| | | | - Katy E S Barwick
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
| | - Holly H Zimmerman
- University of Mississippi, Medical Center of Jackson, Jackson, MS, USA
| | - Joachim Weis
- Uniklinik Aachen, Institut für Neuropathologie, Aachen, Germany
| | - Emma L Baple
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
| | - Andrew H Crosby
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
| | - Sebahattin Cirak
- Uniklinik Köln, Klinik für Kinderheilkunde und Jugendmedizin, Köln, Germany
| | - C Hellmuth
- Ludwig-Maximilian-Universität Munich, Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - O Uhl
- Ludwig-Maximilian-Universität Munich, Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - M Standl
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
| | - J Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - E Thiering
- Institute of Epidemiology I, Helmholtz Zentrum München- German Research Center for Environmental Health, Neuherberg, Germany
| | - B Koletzko
- Ludwig-Maximilian-Universität Munich, Div. Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Lena Blümel
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Division of Pediatric Neuro-Oncogenomics, German Cancer Consortium and German Cancer Research Center - partner site Essen/Düsseldorf, Düsseldorf, Germany.,Institute of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Kornelius Kerl
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
| | - Daniel Picard
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Division of Pediatric Neuro-Oncogenomics, German Cancer Consortium and German Cancer Research Center - partner site Essen/Düsseldorf, Düsseldorf, Germany.,Institute of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Michael C Frühwald
- Swabian Childrens' Cancer Center, Children's Hospital Augsburg, Augsburg, Germany
| | - Max C Liebau
- Department of Pediatrics and Center for Molecular Medicine, University Hospital Cologne, Cologne, Germany
| | - Guido Reifenberger
- Institute of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Arndt Borkhardt
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Marc Remke
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Division of Pediatric Neuro-Oncogenomics, German Cancer Consortium and German Cancer Research Center - partner site Essen/Düsseldorf, Düsseldorf, Germany.,Institute of Neuropathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - D Tews
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - M Wabitsch
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - P Fischer-Posovszky
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Mike-Andrew Westhoff
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Lisa Nonnenmacher
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Julia Langhans
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Lukas Schneele
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Nancy Trenkler
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Klaus-Michael Debatin
- Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| |
Collapse
|
34
|
Foong Y, Aitken D, Humphries D, Laslett L, Pitchford N, Khan H, Abram F, Pelletier J, Martel-Pelletier J, Jin X, Jones G, Winzenberg T. Knee function, pain and magnetic resonance imaging abnormalities in Australian Rules Football players: a cohort study. Intern Med J 2017. [DOI: 10.1111/imj.5_13463] [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: 11/30/2022]
Affiliation(s)
- Y Foong
- Menzies Institute for Medical Research; University of Tasmania; Hobart Tasmania Australia
- Royal Hobart Hospital; Hobart Tasmania Australia
| | - D Aitken
- Menzies Institute for Medical Research; University of Tasmania; Hobart Tasmania Australia
| | - D Humphries
- The Sports Medicine Practice; Hobart Tasmania Australia
| | - L Laslett
- Menzies Institute for Medical Research; University of Tasmania; Hobart Tasmania Australia
| | - N Pitchford
- Institute of Sport Exercise and Active Living (ISEAL); Victoria, University Footscray Park Campus Footscray Victoria Australia
| | - H Khan
- Menzies Institute for Medical Research; University of Tasmania; Hobart Tasmania Australia
| | - F Abram
- Medical Imaging Research & Development; ArthroLab Inc.; Montreal Quebec Canada
| | - J Pelletier
- Osteoarthritis Research Unit; University of Montreal Hospital Research Centre (CRCHUM); Montreal Quebec Canada
| | - J Martel-Pelletier
- Osteoarthritis Research Unit; University of Montreal Hospital Research Centre (CRCHUM); Montreal Quebec Canada
| | - X Jin
- Australian Institute of Health Innovation; Macquarie University; Sydney Australia
| | - G Jones
- Menzies Institute for Medical Research; University of Tasmania; Hobart Tasmania Australia
| | - T Winzenberg
- Menzies Institute for Medical Research; University of Tasmania; Hobart Tasmania Australia
- Faculty of Health; University of Tasmania; Hobart Tasmania Australia
| |
Collapse
|
35
|
Cohen M, Romero G, Bas J, Ticchioni M, Rosenthal M, Lacroix R, Brunet C, Rico A, Pelletier J, Audoin B, Lebrun C. Monitoring CD27+ memory B-cells in neuromyelitis optica spectrum disorders patients treated with rituximab: Results from a bicentric study. J Neurol Sci 2017; 373:335-338. [PMID: 28131216 DOI: 10.1016/j.jns.2017.01.025] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [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: 11/18/2016] [Revised: 12/15/2016] [Accepted: 01/06/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Rituximab (RTX) is increasingly used in the treatment of neuromyelitis optica spectrum disorder (NMO-SD). Administration regimen is not consensual as there is no reliable biomarker of RTX efficacy. In most cases, after induction, RTX is administered systematically every 6months. OBJECTIVE To assess efficacy and safety of a maintenance regimen based on CD19+ CD27+ memory B-cell (mBc) detection. METHODS We conducted a study in two French centers, including patients with NMO-SD who received an induction therapy with RTX. We compared the number of administered infusions, relapses and EDSS depending on two maintenance schemes (S1: administration of 1g RTX infusion every 6months or S2: a scheme based on regular mBc detection. 1g RTX was administered if mBc was >0.05%) RESULTS: 40 patients were included (mean age: 40.2years, F/M sex ratio: 5/1). Aquaporin-4 antibodies were positive in 75% patients. Under S1 regimen, all patients received 2 infusions per year, whereas under S2, they received 1.62 infusion per year. The mean interval between infusions under S2 was 7.4months, without decrease of clinical efficacy. CONCLUSION In our study, mBc-based administration of RTX allowed personalizing treatment administration and in several cases to lower the cumulative dose without loss of efficacy.
Collapse
Affiliation(s)
- M Cohen
- Department of Neurology, Hôpital Pasteur 2, Nice, France.
| | - G Romero
- Department of Neurology, Hôpital Pasteur 2, Nice, France
| | - J Bas
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - M Ticchioni
- Department of Immunology, Hôpital l'Archet, Nice, France
| | - M Rosenthal
- Department of Immunology, Hôpital l'Archet, Nice, France
| | - R Lacroix
- Hematology and Vascular Biology Department, CHU La Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - C Brunet
- Hematology and Vascular Biology Department, CHU La Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - A Rico
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - J Pelletier
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - B Audoin
- Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France
| | - C Lebrun
- Department of Neurology, Hôpital Pasteur 2, Nice, France
| |
Collapse
|
36
|
Meunier B, Seguier J, Cauchois R, Le Dault E, Bernit E, Grados A, Micallef J, Rico A, Pelletier J, Harlé J, Ebbo M, Schleinitz N. Anémie hémolytique auto-immune retardée après traitement par alémtuzumab : un effet indésirable tardif à connaître. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
37
|
Bastos MS, Tremblay A, Agripino JM, Rabelo ILA, Barreto LP, Pelletier J, Lecka J, Silva-Júnior A, Bressan GC, Almeida MR, Sévigny J, Fietto JLR. The expression of NTPDase1 and -2 of Leishmania infantum chagasi in bacterial and mammalian cells: Comparative expression, refolding and nucleotidase characterization. Protein Expr Purif 2016; 131:60-69. [PMID: 27856402 DOI: 10.1016/j.pep.2016.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/17/2016] [Accepted: 11/11/2016] [Indexed: 12/31/2022]
Abstract
Visceral Leishmaniasis (VL) represents an important global health problem in several warm countries around the world. The main targets in this study are the two nucleoside triphosphate diphosphohydrolases (NTPDases) from Leishmania infantum chagasi that are the main etiologic agent of VL in the New World. These enzymes, called LicNTPDase1 and -2, are homologous to members 5 and 6 of the mammalian E-NTPDase/CD39 superfamily of enzymes. These enzymes hydrolyze nucleotides and accordingly can participate in the purine salvage pathways and in the modulation of purinergic signaling through the extracellular nucleotide-dependent host immune responses. They can therefore affect adhesion and infection of host cells and the parasite virulence. To further characterize these enzymes, in this work, we expressed LicNTPDase1 and -2 in the classical bacterial system Escherichia coli and mammalian cell system COS-7 cells. Our data demonstrate that changes in refolding after expression in bacteria can increase the activity of recombinant (r) rLicNTPDase2 up to 20 times but has no significant effect on rLicNTPDase1. Meanwhile, the expression in COS-7 led to a significant increase in activity for rLicNTPDase1.
Collapse
Affiliation(s)
- M S Bastos
- Biochemistry and Molecular Biology Department, Universidade Federal de Viçosa, Viçosa, MG, Brazil; Instituto Nacional de Biotecnologia Estrutural e Química Medicinal em Doenças Infecciosas- INBEQMeDI, Brazil; Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - A Tremblay
- Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - J M Agripino
- Biochemistry and Molecular Biology Department, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - I L A Rabelo
- Biochemistry and Molecular Biology Department, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - L P Barreto
- Biochemistry and Molecular Biology Department, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - J Pelletier
- Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec City, QC G1V 0A6, Canada
| | - J Lecka
- Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec City, QC G1V 0A6, Canada; Centre de recherche du CHU de Québec - Université Laval, Québec City, QC G1V 4G2, Canada
| | - A Silva-Júnior
- Veterinary Department, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - G C Bressan
- Biochemistry and Molecular Biology Department, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - M R Almeida
- Biochemistry and Molecular Biology Department, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - J Sévigny
- Département de microbiologie-infectiologie et d'immunologie, Faculté de Médecine, Université Laval, Québec City, QC G1V 0A6, Canada; Centre de recherche du CHU de Québec - Université Laval, Québec City, QC G1V 4G2, Canada
| | - J L R Fietto
- Biochemistry and Molecular Biology Department, Universidade Federal de Viçosa, Viçosa, MG, Brazil; Instituto Nacional de Biotecnologia Estrutural e Química Medicinal em Doenças Infecciosas- INBEQMeDI, Brazil.
| |
Collapse
|
38
|
Ranjeva JP, Pelletier J, Confort-Gouny S, Ibarrola D, Audoin B, Le Fur Y, Viout P, Chérif AA, Cozzone PJ. MRI/MRS of corpus callosum in patients with clinically isolated syndrome suggestive of multiple sclerosis. Mult Scler 2016; 9:554-65. [PMID: 14664467 DOI: 10.1191/1352458503ms938oa] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A trophy of corpus callosum (C C) related to axonal loss has previously been observed in patients at the early stage of clinically definite multiple sclerosis (CDMS). Atrophy increases with the progression of the disease. Nevertheless, no data concerning the onset of atrophy of C C are currently available. The purpose of this study is to determine if damage in callosal tissue was present at the earliest stage of MS, in a subgroup of patients presenting with a clinically isolated syndrome suggestive of MS (C ISSMS), fulfilling the dissemination in space criteria according to McDonald. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) techniques were applied to measure C C volume, magnetization transfer ratio (MTR), mean diffusivity (MD), N-acetyl aspartate/choline-containing compounds (NAA/C ho) ratio, N-acetyl aspartate/total creatine (NA A/C r) ratio and C ho/C r ratio inside the C C of 46 C ISSMS patients and 24 sexand age-matched controls. No atrophy of C C was observed in the C ISSMS group. C C of patients was character ized by decreased MTR and increased MD. No change in the NA A/C r ratio was observed while the NA A/C ho ratio decreased and C ho/C r ratio increased in the splenium and the central anterio r part of C C. These abnormalities were present in patients with, but also without, macroscopic lesions inside the C C. O ur results indicate that diffuse structural and metabolic changes, which may be interpreted as representing predominantly myelin patho logy, occur in the C C at the earliest stage of MS before any atrophy is detected.
Collapse
Affiliation(s)
- J P Ranjeva
- Centre de Resonance Magnétique Biologique et Médicale-UMR CNRS No. 6612, Medical School of Marseille, France
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Audoin B, Ibarrola D, Malikova I, Soulier E, Confort-Gouny S, Duong MVA, Reuter F, Viout P, Ali-Chérif A, Cozzone PJ, Pelletier J, Ranjeva JP. Onset and underpinnings of white matter atrophy at the very early stage of multiple sclerosis - a two-year longitudinal MRI/MRSI study of corpus callosum. Mult Scler 2016; 13:41-51. [PMID: 17294610 DOI: 10.1177/1352458506071215] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [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: 11/16/2022]
Abstract
Backgrounds Atrophy of corpus callosum (CC), a white matter structure linking the two hemispheres, is commonly observed in multiple sclerosis (MS). However, the occurrence and processes leading to this alteration are not yet determined. Goal and methods To better characterize the onset and progression of CC atrophy from the early stage of MS, we performed a two-year follow-up magnetic resonance imaging/magnetic resonance spectroscopic imaging (MRI/MRSI) exploration of CC in 24 patients with clinically isolated syndrome. These patients were explored using the same protocol at month (M)6, M12 and M24. MRI/MRSI techniques were applied to measure CC volume, and relative concentrations of N-acetylaspartate (NAA), creatine/phosphocreatine (Cr) and choline-containing compounds (Cho). A group of matched controls was also explored. Results Atrophy of CC, not present at baseline, was observed at M12 and progressed over the second year (M24). At baseline, a decrease in relative NAA level was observed in the anterior and posterior body of CC, with normalization during the follow-up period. In the anterior body, an increase in relative Cho level was observed, with normalization at M6. Normal relative Cr levels were observed at all time points in all sub-regions. The rate of CC atrophy was correlated with the change in the Expanded Disability Status Scale (EDSS) during the follow-up period. Conclusion These results suggest that CC atrophy appears over a period of one year after the first acute inflammatory episode, and that this atrophy is accompanied, especially in the anterior body of CC, by a normalization of the relative Cho levels, marker of acute inflammation, and NAA levels, marker of neuronal dysfunction and/or loss.
Collapse
Affiliation(s)
- B Audoin
- Centre de Résonance Magnétique Biologique et Médicale, UMR CNRS 6612, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, Marseille 13385, 05, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Freedman MS, Francis GS, Sanders EACM, Rice GPA, O'Connor P, Comi G, Duquette P, Metz L, Murray TJ, Bouchard JP, Abramsky O, Pelletier J, O'Brien F. Randomized study of once-weekly interferon β-1a therapy in relapsing multiple sclerosis: three-year data from the OWIMS study. Mult Scler 2016; 11:41-5. [PMID: 15732265 DOI: 10.1191/1352458505ms1126oa] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 11/05/2022]
Abstract
Background: Once weekly interferon β-1a for multiple sclerosis (OWIMS) demonstrated modest, but significant, magnetic resonance imaging (MRI) benefit of once-weekly (qw) interferon (IFN) β-1a at 48 weeks, but no significant effect on relapses. Objective: An OWIMS extension permitted assessment of longer-term efficacy/safety of qw IFN β-1a in relapsing-remitting multiple sclerosis (RRMS). Methods: Placebo patients were rerandomized to IFN β-1a, 22 or 44 mcg qw, for two additional 48-week intervals. Primary outcome was MRI lesion activity. Relapse rate and other MRI measures were secondary outcomes. Results: After three years, median (mean) T2 lesion count/patient/scan was 1.3 (2.6) for 44 mcg, 1.7 (3.3) for 22 mcg, 1.7 (3.4) for placebo/22 mcg, 2.0 (3.6) for placebo/44 mcg (all differences not significant). Annualized relapse rates were lowest for 44 mcg (0.77) versus other groups (0.83-0.86, not significant). Persistent neutralizing antibodies did not affect relapse rates, but MRI active lesions were increased in antibody-positive patients receiving 44 mcg compared to antibody negative patients. Conclusions: In RRMS, once weekly IFN β-1a, particularly 44 mcg, can induce a significant MRI, but not relapse, effect, compared with placebo. No significant dose effect was seen. In contrast to the significant effect observed with three-times-weekly dosing of subcutaneous IFN β-1a compared with placebo, this study confirms the lack of meaningful clinical benefit with once-weekly dosing.
Collapse
Affiliation(s)
- M S Freedman
- Ottawa Hospital - General Campus, Ottawa, Ontario, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Lee T, Paquet M, Larsson O, Pelletier J. Tumor cell survival dependence on the DHX9 DExH-box helicase. Oncogene 2016; 35:5093-105. [PMID: 26973242 PMCID: PMC5023453 DOI: 10.1038/onc.2016.52] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 01/13/2016] [Accepted: 02/01/2016] [Indexed: 12/23/2022]
Abstract
The ATP-dependent DExH/D-box helicase DHX9 is a key participant in a number of gene regulatory steps, including transcriptional, translational, microRNA-mediated control, DNA replication, and maintenance of genomic stability. DHX9 has also been implicated in tumor cell maintenance and drug response. Here, we report that inhibition of DHX9 expression is lethal to human cancer cell lines and murine Eµ−Myc lymphomas. Using a novel conditional shDHX9 mouse model, we demonstrate that sustained and prolonged (6 months) suppression of DHX9 does not result in any deleterious effects at the organismal level. Body weight, blood biochemistry, and histology of various tissues were comparable to control mice. Global gene expression profiling revealed that although reduction of DHX9 expression resulted in multiple transcriptome changes, these were relatively benign and did not lead to any discernible phenotype. Our results demonstrate a robust tolerance for systemic DHX9 suppression in vivo and support the targeting of DHX9 as an effective and specific chemotherapeutic approach.
Collapse
Affiliation(s)
- T Lee
- Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - M Paquet
- Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec
| | - O Larsson
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - J Pelletier
- Department of Biochemistry, McGill University, Montreal, Quebec, Canada.,Department of Oncology, McGill University, Montreal, Quebec, Canada.,Rosalind and Morris Goodman Cancer Research Center, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
42
|
Belle JI, Petrov JC, Langlais D, Robert F, Cencic R, Shen S, Pelletier J, Gros P, Nijnik A. Repression of p53-target gene Bbc3/PUMA by MYSM1 is essential for the survival of hematopoietic multipotent progenitors and contributes to stem cell maintenance. Cell Death Differ 2016; 23:759-75. [PMID: 26768662 PMCID: PMC4832099 DOI: 10.1038/cdd.2015.140] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/24/2015] [Accepted: 09/25/2015] [Indexed: 12/16/2022] Open
Abstract
p53 is a central mediator of cellular stress responses, and its precise regulation is essential for the normal progression of hematopoiesis. MYSM1 is an epigenetic regulator essential for the maintenance of hematopoietic stem cell (HSC) function, hematopoietic progenitor survival, and lymphocyte development. We recently demonstrated that all developmental and hematopoietic phenotypes of Mysm1 deficiency are p53-mediated and rescued in the Mysm1(-/-)p53(-/-) mouse model. However, the mechanisms triggering p53 activation in Mysm1(-/-) HSPCs, and the pathways downstream of p53 driving different aspects of the Mysm1(-/-) phenotype remain unknown. Here we show the transcriptional activation of p53 stress responses in Mysm1(-/-) HSPCs. Mechanistically, we find that the MYSM1 protein associates with p53 and colocalizes to promoters of classical p53-target genes Bbc3/PUMA (p53 upregulated modulator of apoptosis) and Cdkn1a/p21. Furthermore, it antagonizes their p53-driven expression by modulating local histone modifications (H3K27ac and H3K4me3) and p53 recruitment. Using double-knockout mouse models, we establish that PUMA, but not p21, is an important mediator of p53-driven Mysm1(-/-) hematopoietic dysfunction. Specifically, Mysm1(-/-)Puma(-/-) mice show full rescue of multipotent progenitor (MPP) viability, partial rescue of HSC quiescence and function, but persistent lymphopenia. Through transcriptome analysis of Mysm1(-/-)Puma(-/-) MPPs, we demonstrate strong upregulation of other p53-induced mediators of apoptosis and cell-cycle arrest. The full viability of Mysm1(-/-)Puma(-/-) MPPs, despite strong upregulation of many other pro-apoptotic mediators, establishes PUMA as the essential non-redundant effector of p53-induced MPP apoptosis. Furthermore, we identify potential mediators of p53-dependent but PUMA-independent Mysm1(-/-)hematopoietic deficiency phenotypes. Overall, our study provides novel insight into the cell-type-specific roles of p53 and its downstream effectors in hematopoiesis using unique models of p53 hyperactivity induced by endogenous stress. We conclude that MYSM1 is a critical negative regulator of p53 transcriptional programs in hematopoiesis, and that its repression of Bbc3/PUMA expression is essential for MPP survival, and partly contributes to maintaining HSC function.
Collapse
Affiliation(s)
- J I Belle
- Department of Physiology, McGill University, Montreal, QC, Canada.,Complex Traits Group, McGill University, Montreal, QC, Canada
| | - J C Petrov
- Department of Physiology, McGill University, Montreal, QC, Canada.,Complex Traits Group, McGill University, Montreal, QC, Canada
| | - D Langlais
- Complex Traits Group, McGill University, Montreal, QC, Canada.,Department of Biochemistry, McGill University, Montreal, QC, Canada
| | - F Robert
- Department of Biochemistry, McGill University, Montreal, QC, Canada
| | - R Cencic
- Department of Biochemistry, McGill University, Montreal, QC, Canada
| | - S Shen
- Department of Physiology, McGill University, Montreal, QC, Canada.,Complex Traits Group, McGill University, Montreal, QC, Canada
| | - J Pelletier
- Department of Biochemistry, McGill University, Montreal, QC, Canada.,The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada
| | - P Gros
- Complex Traits Group, McGill University, Montreal, QC, Canada.,Department of Biochemistry, McGill University, Montreal, QC, Canada.,The Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC, Canada
| | - A Nijnik
- Department of Physiology, McGill University, Montreal, QC, Canada.,Complex Traits Group, McGill University, Montreal, QC, Canada
| |
Collapse
|
43
|
Pelletier J. [Is it always useful to perform lumbar puncture for the diagnosis of multiple sclerosis? No]. Rev Neurol (Paris) 2015; 171:607-10. [PMID: 26343922 DOI: 10.1016/j.neurol.2015.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 05/15/2015] [Indexed: 10/23/2022]
Abstract
In the absence of a specific test for the diagnosis of multiple sclerosis (MS), cerebrospinal fluid analysis (CSF) remains discussed. There are robust evidences which demonstrated that an early diagnosis of MS must be done, due to the availability of disease-modifying drugs that could influence the natural history of the disease. However, several arguments can be put forward to assert that CSF analysis is not useful for the diagnosis of MS and thus should not be realized in a systematic way. First, MRI remains the most sensitive and specific marker to validate dissemination in space and in time and CSF analysis is not recommended by the 2010 McDonald criteria. The second argument is related to the low sensitivity and specificity of abnormalities detected in CSF analysis to confirm the diagnosis of MS. Moreover, there is currently no evidence that the presence of oligoclonal bands could represent a surrogate marker on an individual prognostic way. Furthermore, lumbar puncture could be traumatic, may entail some infrequent risks and represents unnecessary expense. Thus, there are strong reasons to not recommend systematic CSF examination to diagnose MS.
Collapse
Affiliation(s)
- J Pelletier
- Service de neurologie, pôle de neurosciences cliniques, hôpital de la Timone, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| |
Collapse
|
44
|
Siri A, Carra-Dalliere C, Ayrignac X, Pelletier J, Audoin B, Pittion-Vouyovitch S, Debouverie M, Lionnet C, Viala F, Sablot D, Brassat D, Ouallet JC, Ruet A, Brochet B, Taillandier L, Bauchet L, Derache N, Defer G, Cabre P, de Seze J, Lebrun Frenay C, Cohen M, Labauge P. Isolated tumefactive demyelinating lesions: diagnosis and long-term evolution of 16 patients in a multicentric study. J Neurol 2015; 262:1637-45. [DOI: 10.1007/s00415-015-7758-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 04/17/2015] [Accepted: 04/20/2015] [Indexed: 12/31/2022]
|
45
|
Pelletier J, Coudurier M, Kelkel E, Frappat V, Pernot J. [Pituitary metastasis revealing a lung cancer]. Rev Mal Respir 2015; 32:945-8. [PMID: 25725979 DOI: 10.1016/j.rmr.2014.11.071] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 11/17/2014] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Pituitary metastases are rare and difficult to diagnose. Their optimal approach and management remains to be defined. CASE REPORT We report the case of a 56-year-old patient suffering from squamous cell lung carcinoma who developed pituitary metastasis with secondary hypopituitarism, the symptoms of which were initially attributed to depression. CONCLUSION Pituitary metastases can be difficult to diagnose, which may lead to delays in care, which can be fatal.
Collapse
Affiliation(s)
- J Pelletier
- Service de pneumologie, centre hospitalier de Chambéry, 400, faubourg Mache, 73000 Chambéry, France.
| | - M Coudurier
- Service de pneumologie, centre hospitalier de Chambéry, 400, faubourg Mache, 73000 Chambéry, France
| | - E Kelkel
- Service de pneumologie, centre hospitalier de Chambéry, 400, faubourg Mache, 73000 Chambéry, France
| | - V Frappat
- Service de pneumologie, centre hospitalier de Chambéry, 400, faubourg Mache, 73000 Chambéry, France
| | - J Pernot
- Service de pneumologie, centre hospitalier de Chambéry, 400, faubourg Mache, 73000 Chambéry, France
| |
Collapse
|
46
|
Kuhle J, Disanto G, Dobson R, Adiutori R, Bianchi L, Topping J, Bestwick JP, Meier UC, Marta M, Costa GD, Runia T, Evdoshenko E, Lazareva N, Thouvenot E, Iaffaldano P, Direnzo V, Khademi M, Piehl F, Comabella M, Sombekke M, Killestein J, Hegen H, Rauch S, D’Alfonso S, Alvarez-Cermeño JC, Kleinová P, Horáková D, Roesler R, Lauda F, Llufriu S, Avsar T, Uygunoglu U, Altintas A, Saip S, Menge T, Rajda C, Bergamaschi R, Moll N, Khalil M, Marignier R, Dujmovic I, Larsson H, Malmestrom C, Scarpini E, Fenoglio C, Wergeland S, Laroni A, Annibali V, Romano S, Martínez AD, Carra A, Salvetti M, Uccelli A, Torkildsen Ø, Myhr KM, Galimberti D, Rejdak K, Lycke J, Frederiksen JL, Drulovic J, Confavreux C, Brassat D, Enzinger C, Fuchs S, Bosca I, Pelletier J, Picard C, Colombo E, Franciotta D, Derfuss T, Lindberg RLP, Yaldizli Ö, Vécsei L, Kieseier BC, Hartung HP, Villoslada P, Siva A, Saiz A, Tumani H, Havrdová E, Villar LM, Leone M, Barizzone N, Deisenhammer F, Teunissen C, Montalban X, Tintoré M, Olsson T, Trojano M, Lehmann S, Castelnovo G, Lapin S, Hintzen R, Kappos L, Furlan R, Martinelli V, Comi G, Ramagopalan SV, Giovannoni G. Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study. Mult Scler 2015; 21:1013-24. [DOI: 10.1177/1352458514568827] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/19/2014] [Indexed: 11/15/2022]
Abstract
Background and objective: We explored which clinical and biochemical variables predict conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS) in a large international cohort. Methods: Thirty-three centres provided serum samples from 1047 CIS cases with at least two years’ follow-up. Age, sex, clinical presentation, T2-hyperintense lesions, cerebrospinal fluid (CSF) oligoclonal bands (OCBs), CSF IgG index, CSF cell count, serum 25-hydroxyvitamin D3 (25-OH-D), cotinine and IgG titres against Epstein-Barr nuclear antigen 1 (EBNA-1) and cytomegalovirus were tested for association with risk of CDMS. Results: At median follow-up of 4.31 years, 623 CIS cases converted to CDMS. Predictors of conversion in multivariable analyses were OCB (HR = 2.18, 95% CI = 1.71–2.77, p < 0.001), number of T2 lesions (two to nine lesions vs 0/1 lesions: HR = 1.97, 95% CI = 1.52–2.55, p < 0.001; >9 lesions vs 0/1 lesions: HR = 2.74, 95% CI = 2.04–3.68, p < 0.001) and age at CIS (HR per year inversely increase = 0.98, 95% CI = 0.98–0.99, p < 0.001). Lower 25-OH-D levels were associated with CDMS in univariable analysis, but this was attenuated in the multivariable model. OCB positivity was associated with higher EBNA-1 IgG titres. Conclusions: We validated MRI lesion load, OCB and age at CIS as the strongest independent predictors of conversion to CDMS in this multicentre setting. A role for vitamin D is suggested but requires further investigation.
Collapse
Affiliation(s)
- J Kuhle
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK/ Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - G Disanto
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - R Dobson
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - R Adiutori
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - L Bianchi
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - J Topping
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - JP Bestwick
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, Barts and the London School for Medicine and Dentistry, UK
| | - U-C Meier
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - M Marta
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| | - G Dalla Costa
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - T Runia
- Department of Neurology, Erasmus MC University Medical Center, The Netherlands
| | - E Evdoshenko
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - N Lazareva
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - E Thouvenot
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - P Iaffaldano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - V Direnzo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - M Khademi
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - F Piehl
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - M Comabella
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - M Sombekke
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - J Killestein
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - H Hegen
- Department of Neurology, Innsbruck Medical University, Austria
| | - S Rauch
- Department of Radiology, Innsbruck Medical University, Austria
| | - S D’Alfonso
- Department of Health Sciences and IRCAD, Eastern Piedmont University, Italy
| | | | - P Kleinová
- Department of Neurology, Charles University in Prague, Czech Republic
| | - D Horáková
- Department of Neurology, Charles University in Prague, Czech Republic
| | - R Roesler
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - F Lauda
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - S Llufriu
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - T Avsar
- Dr Orhan Öcalgiray Molecular Biology-Biotechnology and Genetics Research Centre, Istanbul Technical University, Turkey
| | - U Uygunoglu
- Department of Neurology, Istanbul University, Turkey
| | - A Altintas
- Department of Neurology, Istanbul University, Turkey
| | - S Saip
- Department of Neurology, Istanbul University, Turkey
| | - T Menge
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - C Rajda
- Department of Neurology, University of Szeged, Hungary
| | | | - N Moll
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - M Khalil
- Department of Neurology, Medical University of Graz, Austria
| | - R Marignier
- Department of Neurology, Université de Lyon, Université Claude Bernard-Lyon 1, France
| | - I Dujmovic
- Clinic of Neurology, Belgrade University School of Medicine, Serbia
| | - H Larsson
- Unit of Functional Imaging, Glostrup Hospital, University of Copenhagen, Denmark
| | - C Malmestrom
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - E Scarpini
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - C Fenoglio
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - S Wergeland
- KG Jebsen Centre for MS-Research, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Norway
| | - A Laroni
- Department of Neurology, University of Genoa, Italy
| | - V Annibali
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - S Romano
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - AD Martínez
- Department of Neurology of Hospital Británico of Buenos Aires, Argentina
| | - A Carra
- Department of Neurology of Hospital Británico of Buenos Aires, Argentina
| | - M Salvetti
- Centre for Experimental Neurological Therapies, S. Andrea Hospital-site, Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Italy
| | - A Uccelli
- Department of Neurology, University of Genoa, Italy
| | - Ø Torkildsen
- KG Jebsen Centre for MS-Research, Department of Clinical Medicine, Haukeland University Hospital, University of Bergen, Norway
| | - KM Myhr
- Department of Neurology, University of Genoa, Italy
| | - D Galimberti
- Neurology Unit, Dept. of Pathophysiology and Transplantation, University of Milan, Fondazione Cà Granda, IRCCS Policlinico
| | - K Rejdak
- Department of Neurology, Medical University of Lublin, Poland
| | - J Lycke
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - JL Frederiksen
- Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
| | - J Drulovic
- Clinic of Neurology, Belgrade University School of Medicine, Serbia
| | - C Confavreux
- Department of Neurology, Université de Lyon, Université Claude Bernard-Lyon 1, France
| | - D Brassat
- Department of Neurology, University of Toulouse, France
| | - C Enzinger
- Department of Neurology, Medical University of Graz, Austria
| | - S Fuchs
- Department of Neurology, Medical University of Graz, Austria
| | - I Bosca
- MS Unit, Neurology Department, La Fe University and Polytechnic Hospital, Instituto de investigación Sanitaria La Fe, Spain
| | - J Pelletier
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - C Picard
- Pôle de Neurosciences Cliniques, Service de Neurologie, Centre de Résonance Magnétique Biologique et Médicale, Centre Hospitalier Universitaire Timone, Laboratoire d’histocompatibilité, Etablissement Français du Sang Alpes Méditerrannée, Aix Marseille Université, France
| | - E Colombo
- C. Mondino National Neurological Institute, Italy
| | - D Franciotta
- C. Mondino National Neurological Institute, Italy
| | - T Derfuss
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - RLP Lindberg
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - Ö Yaldizli
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - L Vécsei
- Department of Neurology, University of Szeged, Hungary
| | - BC Kieseier
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - HP Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Germany
| | - P Villoslada
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - A Siva
- Department of Neurology, Istanbul University, Turkey
| | - A Saiz
- Center for Neuroimmunology and Department of Neurology. Institut d’investigacions Biomèdiques August Pi Sunyer (IDIBAPS) – Hospital Clinic of Barcelona, Spain
| | - H Tumani
- Department of Neurology, CSF Laboratory and MS Outpatient Unit, University of Ulm, Germany
| | - E Havrdová
- Department of Neurology, Charles University in Prague, Czech Republic
| | - LM Villar
- Department of Neurology and Immunology, Hospital Ramón y Cajal, Spain
| | - M Leone
- MS Centre, SCDU Neurology, Head and Neck Department, AOU Maggiore della Carità, Italy
| | - N Barizzone
- Department of Health Sciences and IRCAD, Eastern Piedmont University, Italy
| | - F Deisenhammer
- Department of Neurology, Innsbruck Medical University, Austria
| | - C Teunissen
- Departments of Neurology and Clinical Chemistry, MS Center, Neurocampus Amsterdam, VU University Medical Centre Amsterdam, The Netherlands and BioMS-eu network
| | - X Montalban
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - M Tintoré
- Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Institut de Receca Vall d’Hebron (VHIR), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - T Olsson
- Neuroimmunology Unit, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - S Lehmann
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - G Castelnovo
- Institut de Génomique Fonctionelle, CNRS UMR5203, INSERM U661, Université Montpellier 1, Université Montpellier, France, and Hôpital Carémeau, France
| | - S Lapin
- Centre of Multiple Sclerosis, City Clinical Hospital#31, Russia
| | - R Hintzen
- Department of Neurology, Erasmus MC University Medical Center, The Netherlands
| | - L Kappos
- Departments of Neurology and Biomedicine, University Hospital Basel, University of Basel, Switzerland
| | - R Furlan
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - V Martinelli
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - G Comi
- Department of Neurology and INSPE, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Italy
| | - SV Ramagopalan
- Department of Physiology, Anatomy and Genetics and Medical Research Council Functional Genomics Unit, University of Oxford, UK
| | - G Giovannoni
- Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, UK
| |
Collapse
|
47
|
Baumstarck K, Pelletier J, Boucekine M, Auquier P. Predictors of quality of life in patients with relapsing-remitting multiple sclerosis: A 2-year longitudinal study. Rev Neurol (Paris) 2015; 171:173-80. [DOI: 10.1016/j.neurol.2014.09.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 06/04/2014] [Accepted: 09/10/2014] [Indexed: 10/24/2022]
|
48
|
Borel JC, Pelletier J, Taleux N, Briault A, Arnol N, Pison C, Tamisier R, Timsit JF, Pepin JL. Parameters recorded by software of non-invasive ventilators predict COPD exacerbation: a proof-of-concept study. Thorax 2015; 70:284-5. [DOI: 10.1136/thoraxjnl-2014-206569] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
49
|
Borel J, Pelletier J, Taleux N, Briault A, Arnol N, Pison C, Tamisier R, Timsit JF, Pepin JL. Les paramètres enregistrés dans les dispositifs de ventilation non invasive (VNI) peuvent prédire la survenue d’une exacerbation chez des patients BPCO sévères. Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2014.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
50
|
Wendel H, Singh K, Wolfe A, Zhong Y, Drewe P, Porco J, Pelletier J, Rätsch G. 558 RNA G-quadruplexes cause eIF4A-dependent oncogene translation in cancer. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70684-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|