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Abstract
Although visual examination (VE) is the preferred method for caries detection, the analysis of intraoral digital photographs in machine-readable form can be considered equivalent to VE. While photographic images are rarely used in clinical practice for diagnostic purposes, they are the fundamental requirement for automated image analysis when using artificial intelligence (AI) methods. Considering that AI has not been used for automatic caries detection on intraoral images so far, this diagnostic study aimed to develop a deep learning approach with convolutional neural networks (CNNs) for caries detection and categorization (test method) and to compare the diagnostic performance with respect to expert standards. The study material consisted of 2,417 anonymized photographs from permanent teeth with 1,317 occlusal and 1,100 smooth surfaces. All the images were evaluated into the following categories: caries free, noncavitated caries lesion, or caries-related cavitation. Each expert diagnosis served as a reference standard for cyclic training and repeated evaluation of the AI methods. The CNN was trained using image augmentation and transfer learning. Before training, the entire image set was divided into a training and test set. Validation was conducted by selecting 25%, 50%, 75%, and 100% of the available images from the training set. The statistical analysis included calculations of the sensitivity (SE), specificity (SP), and area under the receiver operating characteristic (ROC) curve (AUC). The CNN was able to correctly detect caries in 92.5% of cases when all test images were considered (SE, 89.6; SP, 94.3; AUC, 0.964). If the threshold of caries-related cavitation was chosen, 93.3% of all tooth surfaces were correctly classified (SE, 95.7; SP, 81.5; AUC, 0.955). It can be concluded that it was possible to achieve more than 90% agreement in caries detection using the AI method with standardized, single-tooth photographs. Nevertheless, the current approach needs further improvement.
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Affiliation(s)
- J Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, School of Dentistry, Ludwig-Maximilians University of Munich, Munich, Germany
| | - O Meyer
- Institute for Software Engineering, University of Duisburg-Essen, Essen, Germany
| | - M Hesenius
- Institute for Software Engineering, University of Duisburg-Essen, Essen, Germany
| | - R Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, School of Dentistry, Ludwig-Maximilians University of Munich, Munich, Germany
| | - V Gruhn
- Institute for Software Engineering, University of Duisburg-Essen, Essen, Germany
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Ciraolo G, Thin A, Bufferand H, Bucalossi J, Fedorczak N, Gunn J, Pascal J, Tamain P, Gil C, Gouin A, Meyer O, Devynck P, Vartanian S, Klepper C, Serre E, Nespoli F, Gallo A, Marandet Y, Rosato J. First modeling of strongly radiating WEST plasmas with SOLEDGE-EIRENE. Nuclear Materials and Energy 2019. [DOI: 10.1016/j.nme.2019.100685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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3
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Lollo G, Matha K, Bocchiardo M, Bejaud J, Marigo I, Virgone-Carlotta A, Dehoux T, Rivière C, Rieu JP, Briançon S, Perrier T, Meyer O, Benoit JP. Drug delivery to tumours using a novel 5-FU derivative encapsulated into lipid nanocapsules. J Drug Target 2018; 27:634-645. [PMID: 30461322 DOI: 10.1080/1061186x.2018.1547733] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In this work, a novel lipophilic 5-fluorouracil (5-FU) derivative was synthesised and encapsulated into lipid nanocapsules (LNC). 5-FU was modified with lauric acid to give a lipophilic mono-lauroyl-derivative (5-FU-C12, MW of about 342 g/mol, yield of reaction 70%). 5-FU-C12 obtained was efficiently encapsulated into LNC (encapsulation efficiency above 90%) without altering the physico-chemical characteristics of LNC. The encapsulation of 5-FU-C12 led to an increased stability of the drug when in contact with plasma being the drug detectable until 3 h following incubation. Cytotoxicity assay carried out using MTS on 2D cell culture showed that 5-FU-C12-loaded LNC had an enhanced cytotoxic effect on glioma (9L) and human colorectal (HTC-116) cancer cell line in comparison with 5-FU or 5-FU-C12. Then, HCT-116 tumour spheroids were cultivated and the reduction of spheroid volume was measured following treatment with drug-loaded LNC and drugs alone. Similar reduction on spheroids volume was observed following the treatment with drug-loaded LNC, 5-FU-C12 and 5-FU alone, while blank LNC displayed a reduction in cell viability only at high concentration. Globally, our data suggest that the encapsulation increased the activity of the 5-FU-C12. However, in-depth evaluations of LNC permeability into spheroids are needed to disclose the potential of these nanosystems for cancer treatment.
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Affiliation(s)
- Giovanna Lollo
- a Laboratoire d'Automatique et de Génie des Procédés (LAGEP) , Univ Lyon, Université Claude Bernard Lyon 1 , Villeurbanne , France.,b Institut des Sciences Pharmaceutiques et Biologiques , Lyon , France.,c MINT, INSERM U1066, CNRS UMR 6021 , Université d'Angers , Angers , France
| | - Kevin Matha
- c MINT, INSERM U1066, CNRS UMR 6021 , Université d'Angers , Angers , France.,d Pharmacy Department , Angers University Hospital , Angers , France
| | - Martina Bocchiardo
- c MINT, INSERM U1066, CNRS UMR 6021 , Université d'Angers , Angers , France
| | - Jérôme Bejaud
- c MINT, INSERM U1066, CNRS UMR 6021 , Université d'Angers , Angers , France
| | - Ilaria Marigo
- e Veneto Institute of Oncology IOV-IRCCS , Padova , Italy
| | | | - Thomas Dehoux
- f Institut Lumière Matière , Univ Lyon, Université Claude Bernard Lyon 1, CNRS , Villeurbanne , France
| | - Charlotte Rivière
- f Institut Lumière Matière , Univ Lyon, Université Claude Bernard Lyon 1, CNRS , Villeurbanne , France
| | - Jean-Paul Rieu
- f Institut Lumière Matière , Univ Lyon, Université Claude Bernard Lyon 1, CNRS , Villeurbanne , France
| | - Stephanie Briançon
- a Laboratoire d'Automatique et de Génie des Procédés (LAGEP) , Univ Lyon, Université Claude Bernard Lyon 1 , Villeurbanne , France.,b Institut des Sciences Pharmaceutiques et Biologiques , Lyon , France
| | | | | | - Jean-Pierre Benoit
- a Laboratoire d'Automatique et de Génie des Procédés (LAGEP) , Univ Lyon, Université Claude Bernard Lyon 1 , Villeurbanne , France.,b Institut des Sciences Pharmaceutiques et Biologiques , Lyon , France.,c MINT, INSERM U1066, CNRS UMR 6021 , Université d'Angers , Angers , France
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Leggett A, Meyer O, Polenick CA. TIES THAT BIND: SOURCES OF INFORMAL AND FORMAL SUPPORT AND POSITIVE OUTCOMES IN CAREGIVERS OF PERSONS WITH DEMENTIA. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2053] [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: 11/14/2022] Open
Affiliation(s)
- A Leggett
- University of Michigan, Ann Arbor, Michigan, United States
| | - O Meyer
- University of California, Davis School of Medicine, Sacramento, CA, USA
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Meyer O, Giacalone JC, Gouin A, Pascal JY, Klepper CC, Fedorczak N, Lotte P, Unterberg EA, Fehling DT, Harris JH. Visible spectroscopy diagnostics for tungsten source assessment in the WEST tokamak: First measurements. Rev Sci Instrum 2018; 89:10D105. [PMID: 30399672 DOI: 10.1063/1.5035566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/02/2018] [Indexed: 06/08/2023]
Abstract
The present work concerns the measurements obtained with the Tungsten (W) Environment in Steady-state Tokamak (WEST) visible spectroscopy system during the first experimental campaign. This system has been developed in the framework of the WEST project that equipped the existing Tore Supra device with a tungsten divertor in order to test actively cooled tungsten Plasma Facing Components (PFC) in view of preparing for ITER operation. The goal of this diagnostic is to measure the PFC sources and the deuterium recycling with spectral, spatial, and temporal resolution adapted to the predicted power deposition profiles on the objects observed. Three kinds of PFCs are monitored: the Ion Cyclotron Resonance Heating (ICRH) antenna and Low Hybrid Current Drive (LHCD) launcher W limiters; one of the 6 W inner bumpers; and the upper and lower W divertors. Large-aperture in-vessel actively cooled optical systems (f-number ∼ 3) were installed for each view and connected to optical fibres. A total of 240 optical fibers can be distributed on various detection systems including a fast response-time, multi-channel, filtered photodetector-based "Filterscope" system, developed by Oak Ridge National Laboratory (USA) as well as grating spectrometers optimized for multi-sightline analysis. The first WEST experimental campaign conducted in 2017 has been dedicated to plasma start-up development during which the visible spectroscopy system has provided crucial information related to the impurity content first and then impurity sources. The diagnostic setup for that first experimental campaign was limited to the inner bumper and outer limiters but was sufficient to demonstrate that the optical setup was in accordance with the specifications. The radiance calibration procedure allowed us to estimate fluxes from the main limiter of about 8 × 1018 atoms/(s m2) and to show a first W source radial profile along the outboard limiter.
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Affiliation(s)
- O Meyer
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | | | - A Gouin
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | - J Y Pascal
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | | | - N Fedorczak
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | - Ph Lotte
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | | | | | - J H Harris
- ORNL, Oak Ridge, Tennessee 37831-6169, USA
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Knöfler R, Eberl W, Schulze H, Bakchoul T, Bergmann F, Gehrisch S, Geisen C, Gottstein S, Halimeh S, Harbrecht U, Kappert G, Kirchmaier C, Kehrel B, Lösche W, Krause M, Mahnel R, Meyer O, Pilgrimm AK, Pillitteri D, Rott H, Santoso S, Siegemund A, Schambeck C, Scheer M, Schmugge M, Scholl T, Strauss G, Zieger B, Zotz R, Hermann M, Streif W. Diagnose angeborener Störungen der Thrombozytenfunktion. Hamostaseologie 2017; 34:201-12. [DOI: 10.5482/hamo-13-04-0024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 05/21/2014] [Indexed: 11/05/2022] Open
Abstract
ZusammenfassungAngeborene Störungen der Thrombozytenfunktion sind eine heterogene Gruppe von Erkrankungen, die oft erst bei Auftreten von Blutungen erkannt werden. Im klinischen Bereich haben sich nur wenige Methoden zur Diagnose und Klassifizierung von angeborenen Thrombozytenfunktionsstörungen bewährt. Für eine rationelle Diagnostik ist ein stufenweises Vorgehen empfehlenswert. Anamnese und klinische Untersuchung sind Grundvoraussetzungen. Das von-Willebrand-Syndrom und andere plasmatische Gerinnungsstörungen sollten vor einer spezifischen Thrombozytenfunktionsdiagnostik immer ausgeschlossen werden. Die Bestimmung von Zahl, Größe, Volumen (MPV) und Morphologie der Thrombozyten erlauben Rückschlüsse auf die zu Grunde liegende Störung.Die PFA-100®-Verschlusszeit eignet sich als Screening zum Ausschluss schwerer Thrombozytenfunktionsstörungen. Die Aggrego metrie ermöglicht die Untersuchung zahlreicher Aspekte der Thrombozytenfunktion. Die Durchflusszytometrie ist zur Diagnose von Thrombasthenie Glanzmann, Bernard-Soulier- Syndrom und Freisetzungsstörungen geeignet. Molekulargenetische Untersuchungen können die Verdachtsdiagnose bestätigen oder zum Nachweis nicht beschriebener Defekte verwendet werden. Hier wird die ungekürzte Version der inter -disziplinären Leitlinie* präsentiert.
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Abstract
ZusammenfassungZur Untersuchung der Plättchenfunktion wurde das von Wu und Hoak 1974 beschriebene Thrombozytenfunktionssystem von Grotemeyer 1983 modifiziert. Dieses System wurde gewählt, weil In-vitro-Manipulationen an den Plättchen nicht mehr notwendig sind und die Testauswertung maschinell (automatische Blutbildbestimmung) erfolgt. Die Testanordnung basiert darauf, dass Plättchenaggregate, die in vivo bestehen oder durch die Blutabnahme entstehen, durch Ethylendiamintetraessigsäure (EDTA) aufgelöst, durch EDTA-Formalin aber sofort fixiert werden. Ein Plättchenreaktivitätsindex nach Grotemeyer (PR) größer als 1,05 ist verdächtig, Werte über 1,2 sicher pathologisch. Der Test ist preiswert pro Messung (4 €) und schnell durchführbar (Blutbildmessungen und Index-Berechnung).Der PR wurde in drei prospektiven Studien zur Identifizierung von Non-Respondern bei der Sekundärprophylaxe (Hirninfarkt, PTCA bei kardialer Ischämie) arterieller Ischämien mit Azetylsalizylsäure (ASS) erfolgreich eingesetzt. So werden bei Hirninfarkt-Patienten bis 33% Non-Responder, bei Patienten mit kardialer Ischämie bis 18% erkannt. Des Weiteren finden sich in diesen Studien in der Gruppe mit pathologischem PR signifikant mehr thromboembolische Endpunkte als in der Gruppe mit normalem PR. In einer eigenen prospektiven Untersuchung zeigten sich signifikante Korrelationen zwischen PR zum RTH (Retentionstest Homburg) und PFA-100 beim therapeutischen Monitoring von ASS. Der PR scheint prädiktiv zur Beurteilung der Effizienz einer Therapie, aber nicht für die Erkennung bekannter unerwünschter Arzneimittelwirkungen von ASS (z. B. Überdosierung).
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Eichler P, Budde U, Haas S, Kroll H, Loreth RM, Meyer O, Pachmann U, Pötzsch B, Schabel A, Albrecht D, Greinacher A. First Workshop for Detection of Heparin-induced Antibodies: Validation of the Heparin-induced Platelet-activation Test (HIPA) in Comparison with a PF4/Heparin ELISA. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1614536] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Summary
Background. No data exist regarding the inter-laboratory reproducibility of the heparin-induced-platelet-activation (HIPA) test, the most widely used functional assay in Germany for the detection of heparin-induced thrombocytopenia (HIT) antibodies. Methods. Nine laboratories used an identical protocol to test eight different sera with the HIPA test. Five laboratories also tested the sera with a platelet factor 4 (PF4)/heparin-complex ELISA. Cross-reactivity with danaparoid-sodium was assessed using 0.2 aFXa units instead of heparin in the HIPA test. Results. Two of nine laboratories had no discrepant HIPA test results. Four laboratories differed in one sample, one reported two discrepant results, and two laboratories reported more than two discrepant results. Cross-reactivity with danaparoid-sodium test results differed among laboratories. PF4/heparin ELISA results were identical in all five laboratories. Conclusion. The HIPA test requires strict quality control measures. Using both a sensitive functional assay (HIPA test) and a PF4/heparin ELISA will allow detection of antibodies directed to antigens other than PF4/heparin complexes as well as detection of IgM and IgA antibodies with PF4/heparin specificity.
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9
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Moreau P, Bucalossi J, Missirlian M, Samaille F, Courtois X, Gil C, Lotte P, Meyer O, Nardon E, Nouailletas R, Ravenel N, Travere J, Alarcon T, Antusch S, Aumeunier M, Barjat P, Belsare S, Bernard J, Bhandarkar M, Bottereau C, Bourdelle C, Brémond S, Camenen Y, Chaudhari V, Chavda C, Chernyshova M, Clairet F, Colnel J, Czarski T, Choi M, Colledani G, Corre Y, Daniel R, Davis D, Dejarnac R, Devynck P, Dhongde J, Douai D, Elbeze D, Escarguel A, Fenzi C, Figacz W, Guangwu Z, Giacalone J, Guirlet R, Gunn J, Hacquin S, Hao X, Harris J, Hoang G, Houry M, Imbeaux F, Jablonski S, Jardin A, Joshi H, Kasprowicz G, Klepper C, Kowalska-Strzeciwilk E, Kubkowska M, Kumar A, Kumar V, Kumari P, Laqua H, Le-Luyer A, Lee W, Lewerentz M, Lyu B, Malard P, Manenc L, Mansuri I, Marandet Y, Masand H, Mazon D, Molina D, Moureau G, Nam Y, Park H, Pascal J, Patel K, Patel M, Pozniak K, Radloff D, Ranjan S, Rapson C, Raupp G, Rieth M, Sabot R, Santraine B, Sestac D, Sharma M, Shen J, Signoret J, Soni J, Spring A, Spuig P, Sugandhi R, Treuterrer W, Tsitrone E, Varshney S, Vartanian S, Volpe D, Wang F, Werner A, Yun G, Zabolotny W, Zhao W. Measurements and controls implementation for WEST. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.01.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Andersen NK, Meyer O, Bradley A, Dragsted N, Lassen AB, Sjögren I, Larsen JM, Harvey W, Bator R, Milne A. Evaluation of the PhysioTel™ Digital M11 cardiovascular telemetry implant in socially housed cynomolgus monkeys up to 16 weeks after surgery. J Pharmacol Toxicol Methods 2017; 87:82-92. [DOI: 10.1016/j.vascn.2017.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/06/2017] [Accepted: 04/13/2017] [Indexed: 10/19/2022]
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11
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Meyer O, Leggett A, Liu S, Zarit S. SUBJECTIVE MEMORY AND ITS RELATION TO DEPRESSION AND COGNITIVE FUNCTION IN VIETNAMESE ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1213] [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: 11/14/2022] Open
Affiliation(s)
- O. Meyer
- University of California, Davis School of Medicine, Sacramento, California,
| | - A. Leggett
- University of Michigan, Ann Arbor, Michigan,
| | - S. Liu
- University of California, Davis, Davis, California
| | - S. Zarit
- Pennsylvania State University, University Park, Pennsylvania,
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12
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Grimaldi-Bensouda L, Rossignol M, Koné-Paut I, Krivitzky A, Lebrun-Frenay C, Clet J, Brassat D, Papeix C, Nicolino M, Benhamou PY, Fain O, Costedoat-Chalumeau N, Courcoux MF, Viallard JF, Godeau B, Papo T, Vermersch P, Bourgault-Villada I, Breart G, Abenhaim L, Abbas F, Abdelmoumni A, Hilliquin P, Requeda E, Adoue D, Brassat D, Agard C, Masseau A, Aladjidi N, Clet J, Fernandes H, Lemasson G, Perel Y, Raymond I, Richer O, Vital A, Allain-Launay E, Bru M, Nicolino M, Thomas C, Altman JJ, Amsallem D, Aras N, Boukari L, Dubrel M, Fain O, Letellier E, Lucidarme N, Mekinian A, Morin AS, Stirnemann J, Atlan C, Audry D, Augustin J, Bakir R, Bartolucci P, Chevalier X, Godeau B, Guillaud C, Khellaf M, Limal N, Lousteau V, Mahevas M, Méliksetyan G, Michel M, Roumier M, Bayart S, Bonnet F, Decaux O, Bekherraz A, Brihaye B, Dachez R, Daugas E, Hayem G, Meyer O, Papo T, Pasqualoni E, Sacre K, Travert F, Bellon H, Beltrand J, Lefrere F, Simon A, Benhamou PY, Benveniste O, Bolgert F, Costedoat-Chalumeau N, De Paz R, Demeret S, Fautrel B, Jacqueminet S, Louapre C, Maillart E, Morel N, Papeix C, Rigabert J, Bensaid P, Berger C, Berquin P, Le Moing AG, Berroir S, Besson G, Boutte C, Casez O, Bonnotte B, Audia S, Bossu-Estour C, Bourgarit A, Dupuy A, Keshmandt H, Bourre B, Brac A, Perrin A, Pondarré C, Villar-Fimbel S, Bruckert I, Cosson A, Magy-Bertrand N, Tisserand G, Camu W, Carlander B, Morales RJ, Cances C, Pasquet M, Castilla Lievre MA, Chabroux S, Charif M, Chatelus E, Sibilia J, Chevrant-Breton J, Clavel S, Bille-Turc F, Cohen J, Courcoux MF, Leverger G, Machet L, Cuisset JM, Cony-Makhoul P, Darsy P, Favre S, Giraud P, Leitenschenck L, Monteiro I, Morati C, DeSeze J, Dinulescu M, Dhaoui T, Dommange-Romero F, Drevard E, Dupuis C, Dumuis ML, Durand JM, Farad S, Lecomte P, Pierre P, Fouyssac F, Gaudin P, Gautier A, Gellen-Dautremer J, Jarrin I, Richette P, Georget E, Gras P, Moreau T, Giraud E, Hacini M, Mayer A, Guillaumat C, Guillaume S, Guitton C, Kone-Paut I, Marsaud C, Rossi L, Guyot MH, Hassler P, Heimfert C, Heinzlef O, Hillion B, Hocquelet C, Husson H, Ichai P, Jeziorski E, Deslandre CJ, Le Guern V, Kamenov K, Kerlan V, Lemoine P, Misery L, Pan-Petesch B, Krivitzky A, Labauge P, Rodier M, Lacade C, Razafimahefa B, Lachgar K, Larmarau MP, Leblanc T, Lebrun-Frenay C, Lefèbvre P, Lejoyeux P, Leske C, Ly K, Magy L, Mansuy S, Marechaud R, Martin Negrier ML, Sole G, Maupetit J, Mazingue F, Mochon S, Moktar B, Morcamp D, Morlet-Barla N, Nicolas G, Pautot V, Pellier I, Verret JL, Outteryck O, Vermersch P, Pallot-Prades B, Paquet JM, Puechal X, Sortais A, Pelletier J, Rico A, Pez D, Stankoff B, Quittet P, Rémy C, Roba E, Rosario H, Roudaut N, Sonnet E, Ruel M, Sebban S, Schaepelynck P, Simonin MJ, Vial C, Viallard JF, Ladedan I, Zenone T. Risk of autoimmune diseases and human papilloma virus (HPV) vaccines: Six years of case-referent surveillance. J Autoimmun 2017; 79:84-90. [DOI: 10.1016/j.jaut.2017.01.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/08/2016] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
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Gil C, De Michelis C, Elbeze D, Fenzi C, Gunn JP, Imbeaux F, Lotte P, Mazon D, Meyer O, Missirlian M, Moreau P, Reichle R, Sabot R, Saint-Laurent F, Segui JL, Simonin A, Travere JM, Vallet JC. Diagnostic Systems on Tore Supra. Fusion Science and Technology 2017. [DOI: 10.13182/fst09-a9175] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- C. Gil
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | | | - D. Elbeze
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - C. Fenzi
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - J. P. Gunn
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - F. Imbeaux
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - Ph. Lotte
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - D. Mazon
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - O. Meyer
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | | | - Ph. Moreau
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - R. Reichle
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - R. Sabot
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | | | - J.-L. Segui
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - A. Simonin
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | | | - J.-C. Vallet
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
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Fautrel B, Morel J, Berthelot JM, Constantin A, De Bandt M, Gaudin P, Maillefert JF, Meyer O, Pham T, Saraux A, Solau-Gervais E, Vittecoq O, Wendling D, Erpelding ML, Guillemin F. Validation of FLARE-RA, a Self-Administered Tool to Detect Recent or Current Rheumatoid Arthritis Flare. Arthritis Rheumatol 2017; 69:309-319. [DOI: 10.1002/art.39850] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 08/11/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Bruno Fautrel
- Université Pierre et Marie Curie Paris 6, UFR de Médecine and AP-HP, GH Pitié Salpêtrière, Service de Rhumatologie; Paris France
| | - Jacques Morel
- CHU Lapeyronie, Département de Rhumatologie; Montpellier France
| | - Jean-Marie Berthelot
- INSERM ERI 7 (EA 3822) Centre Hospitalo-Universitaire de Nantes, Hôtel-Dieu, Service de Rhumatologie; Nantes France
| | - Arnaud Constantin
- Paul Sabatier Toulouse III University, Centre de Rhumatologie, Hôpital Purpan and UMR 1043, INSERM/UPS/CNRS, Hôpital Purpan; Toulouse France
| | - Michel De Bandt
- Centre Hospitalier La Meynard, Service de Rhumatologie; Fort de France France
| | | | - Jean-Francis Maillefert
- Centre Hospitalo-Universitaire du Dijon, Hôpital du Bocage, Service de Rhumatologie; Dijon France
| | - Olivier Meyer
- Université Denis Diderot Paris 5, UFR de Médecine and AP-HP, GH Bichat, Service de Rhumatologie; Paris France
| | - Thao Pham
- CHU Sainte-Marguerite, Department of Rheumatology; Marseilles France
| | - Alain Saraux
- Centre Hospitalo-Universitaire de Brest, Hôpital de la Cavale Blanche, Service de Rhumatologie, and EA 2216, INSERM ESPRI, ERI29 Université Bretagne Occidentale; Brest France
| | | | - Olivier Vittecoq
- Rouen University Hospital Department of Rheumatology and INSERM U905 (IFRMP 23), University of Rouen; Rouen France
| | - Daniel Wendling
- Université de Franche-Comté EA4266, Agents pathogènes et Inflammation and Centre Hospitalo-Universitaire de Besançon, Hôpital Jean Minjoz, Service de Rhumatologie; Besançon France
| | | | - Francis Guillemin
- INSERM CIC-EC 1433, University Hospital and Université de Lorraine, Université Paris Descartes, EA 4360 APEMAC; Nancy France
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Kleinmann J, Tubach F, Le Guern V, Mathian A, Richez C, Saadoun D, Sacré K, Sellam J, Seror R, Amoura Z, Andres E, Audia S, Bader-Meunier B, Blaison G, Bonnotte B, Cacoub P, Caillard S, Chiche L, Chosidow O, Costedoat-Chalumeau N, Daien C, Daugas E, Derdèche N, Doria A, Fain O, Fakhouri F, Farge D, Gabay C, Guillo S, Hachulla E, Hajjaj-Hassouni N, Hamidou M, Houssiau F, Jourde-Chiche N, Kone-Paut I, Ladjouz-Rezig A, Lambotte O, Lipsker D, Mariette X, Martin Silva N, Martin T, Maurier F, Meckenstock R, Mekinian A, Meyer O, Mohamed S, Morel J, Moulin B, Mulleman D, Papo T, Poindron V, Puéchal X, Punzi L, Quartier P, Sailler L, Smail A, Soubrier M, Sparsa A, Tazi Mezalek Z, Zakraoui L, Zuily S, Sibilia J, Gottenberg J. Recommandations francophones, internationales et multidisciplinaires d’experts pour l’utilisation de biomédicaments dans le lupus érythémateux systémique : le groupe de travail du CRI-IMIDIATE. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
In medical education, simulation is gaining increasing importance for teaching a variety of subjects. A well-founded educational approach is necessary for effective use. In addition to material aspects, simulation environment, curriculum, learning environment, and methods of debriefing have to be considered. The role of a competent instructor should be emphasized and the importance of an elaborate change management process to implement a good concept should not be underestimated.
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Affiliation(s)
- O Meyer
- Institut für Notfallmedizin und Medizinmanagement, Klinikum der Universität München, Schillerstr. 53, 80336, München, Deutschland.
| | - M Rall
- InPASS Dr. med. Marcus Rall Institut für Patientensicherheit und Simulations-Teamtraining GmbH, Reutlingen, Deutschland
| | - H Baschnegger
- Institut für Notfallmedizin und Medizinmanagement, Klinikum der Universität München, Schillerstr. 53, 80336, München, Deutschland.,Klinik für Anaesthesiologie, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
| | - M Lazarovici
- Institut für Notfallmedizin und Medizinmanagement, Klinikum der Universität München, Schillerstr. 53, 80336, München, Deutschland
| | - B Urban
- Institut für Notfallmedizin und Medizinmanagement, Klinikum der Universität München, Schillerstr. 53, 80336, München, Deutschland
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Meyer O, Jones OM, Giacalone JC, Pascal JY, Raulin D, Xu H, Aumeunier MH, Baude R, Escarguel A, Gil C, Harris JH, Hatchressian JC, Klepper CC, Larroque S, Lotte P, Moreau P, Pégourié B, Vartanian S. Development of visible spectroscopy diagnostics for W sources assessment in WEST. Rev Sci Instrum 2016; 87:11E309. [PMID: 27910500 DOI: 10.1063/1.4959780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The present work concerns the development of a W sources assessment system in the framework of the tungsten-W environment in steady state tokamak project that aims at equipping the existing Tore Supra device with a tungsten divertor in order to test actively cooled tungsten Plasma Facing Components (PFCs) in view of preparing ITER operation. The goal is to assess W sources and D recycling with spectral, spatial, and temporal resolution adapted to the PFCs observed. The originality of the system is that all optical elements are installed in the vacuum vessel and compatible with steady state operation. Our system is optimized to measure radiance as low as 1016 Ph/(m2 s sr). A total of 240 optical fibers will be deployed to the detection systems such as the "Filterscope," developed by Oak Ridge National Laboratory (USA) and consisting of photomultiplier tubes and filters, or imaging spectrometers dedicated to Multiview analysis.
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Affiliation(s)
- O Meyer
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | - O M Jones
- PIIM, Avenue Escadrille Normandie-Niemen, 13397 Marseille Cedex 20, France
| | | | - J Y Pascal
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | - D Raulin
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | - H Xu
- ASIPP, 350 Shushanhu Road, Hefei, Anhui 230031, China
| | | | - R Baude
- PIIM, Avenue Escadrille Normandie-Niemen, 13397 Marseille Cedex 20, France
| | - A Escarguel
- PIIM, Avenue Escadrille Normandie-Niemen, 13397 Marseille Cedex 20, France
| | - C Gil
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | - J H Harris
- ORNL, Oak Ridge, Tennessee 37831-6169, USA
| | | | | | - S Larroque
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | - Ph Lotte
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | - Ph Moreau
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | - B Pégourié
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
| | - S Vartanian
- CEA, IRFM, F-13108 Saint-Paul-Lez-Durance, France
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Gottenberg JE, Brocq O, Perdriger A, Lassoued S, Berthelot JM, Wendling D, Euller-Ziegler L, Soubrier M, Richez C, Fautrel B, Constantin AL, Mariette X, Morel J, Gilson M, Cormier G, Salmon JH, Rist S, Lioté F, Marotte H, Bonnet C, Marcelli C, Sellam J, Meyer O, Solau-Gervais E, Guis S, Ziza JM, Zarnitsky C, Chary-Valckenaere I, Vittecoq O, Saraux A, Pers YM, Gayraud M, Bolla G, Claudepierre P, Ardizzone M, Dernis E, Breban MA, Fain O, Balblanc JC, Aberkane O, Vazel M, Back C, Candon S, Chatenoud L, Perrodeau E, Sibilia J, Ravaud P. Non-TNF-Targeted Biologic vs a Second Anti-TNF Drug to Treat Rheumatoid Arthritis in Patients With Insufficient Response to a First Anti-TNF Drug: A Randomized Clinical Trial. JAMA 2016; 316:1172-1180. [PMID: 27654603 DOI: 10.1001/jama.2016.13512] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE One-third of patients with rheumatoid arthritis show inadequate response to tumor necrosis factor α (TNF-α) inhibitors; little guidance on choosing the next treatment exists. OBJECTIVE To compare the efficacy of a non-TNF-targeted biologic (non-TNF) vs a second anti-TNF drug for patients with insufficient response to a TNF inhibitor. DESIGN, SETTING, AND PARTICIPANTS A total of 300 patients (conducted between 2009-2012) with rheumatoid arthritis, with persistent disease activity (disease activity score in 28 joints-erythrocyte sedimentation rate [DAS28-ESR] ≥ 3.2 [range, 0-9.3]) and an insufficient response to anti-TNF therapy were included in a 52-week multicenter, pragmatic, open-label randomized clinical trial. The final follow-up date was in August 2013. INTERVENTIONS Patients were randomly assigned (1:1) to receive a non-TNF-targeted biologic agent or an anti-TNF that differed from their previous treatment. The choice of the biologic prescribed within each randomized group was left to the treating clinician. MAIN OUTCOMES AND MEASURES The primary outcome was the proportion of patients with good or moderate response according to the European League Against Rheumatism (EULAR) scale at week 24. Secondary outcomes included the EULAR response at weeks 12 and 52; at weeks 12, 24, and 52; DAS28ESR, low disease activity (DAS28 ≤3.2), remission (DAS28 ≤2.6); serious adverse events; and serious infections. RESULTS Of the 300 randomized patients (243 [83.2%] women; mean [SD] age, 57.1 [12.2] years; baseline DAS28-ESR, 5.1 [1.1]), 269 (89.7%) completed the study. At week 24, 101 of 146 patients (69%) in the non-TNF group and 76 (52%) in the second anti-TNF group achieved a good or moderate EULAR response (OR, 2.06; 95% CI, 1.27-3.37; P = .004, with imputation of missing data; absolute difference, 17.2%; 95% CI, 6.2% to 28.2%). The DAS28-ESR was lower in the non-TNF group than in the second anti-TNF group (mean difference adjusted for baseline differences, -0.43; 95% CI, -0.72 to -0.14; P = .004). At weeks 24 and 52, more patients in the non-TNF group vs the second anti-TNF group showed low disease activity (45% vs 28% at week 24; OR, 2.09; 95% CI, 1.27 to 3.43; P = .004 and 41% vs 23% at week 52; OR, 2.26; 95% CI, 1.33 to 3.86; P = .003). CONCLUSIONS AND RELEVANCE Among patients with rheumatoid arthritis previously treated with anti-TNF drugs but with inadequate primary response, a non-TNF biologic agent was more effective in achieving a good or moderate disease activity response at 24 weeks than was the second anti-TNF medication. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01000441.
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Affiliation(s)
- Jacques-Eric Gottenberg
- Department of Rheumatology, National Reference Center for Systemic Autoimmune Diseases, Strasbourg University Hospital, Université de Strasbourg, Strasbourg, France
| | - Olivier Brocq
- Department of Rheumatology, Centre Hospitalier Princesse Grâce, Monaco
| | - Aleth Perdriger
- Department of Rheumatology, Rennes University Hospital, Rennes, France
| | - Slim Lassoued
- Department of Rheumatology, Centre Hospitalier de Cahors, Cahors, France
| | | | - Daniel Wendling
- Department of Rheumatology, Besançon University Hospital, Besançon, France
| | | | - Martin Soubrier
- Department of Rheumatology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Christophe Richez
- Department of Rheumatology, Bordeaux University Hospital, Bordeaux, France
| | - Bruno Fautrel
- Department of Rheumatology, Hôpital La Pitié Salpétrière, Paris, France
| | | | - Xavier Mariette
- Department of Rheumatology, Hôpital Kremlin Bicêtre, Kremlin Bicêtre, France
| | - Jacques Morel
- Department of Rheumatology, Montpellier University Hospital, Montpellier, France
| | - Melanie Gilson
- Department of Rheumatology, Grenoble University Hospital, Grenoble, France
| | - Gregoire Cormier
- Department of Rheumatology, Centre Hospitalier de La Roche Sur Yon, La Roche Sur Yon, France
| | | | - Stephanie Rist
- Department of Rheumatology, Centre Hospitalier d'Orléans, Orléans, France
| | - Frederic Lioté
- Department of Rheumatology, Hôpital Lariboisière, Paris, France
| | - Hubert Marotte
- Department of Rheumatology, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Christine Bonnet
- Department of Rheumatology, Limoges University Hospital, Limoges, France
| | | | - Jeremie Sellam
- Department of Rheumatology, Hôpital Saint-Antoine, Paris, France
| | - Olivier Meyer
- Department of Rheumatology, Hôpital Bichat, Paris, France
| | | | - Sandrine Guis
- Department of Rheumatology, Marseille University Hospital, Marseille, France
| | - Jean-Marc Ziza
- Department of Rheumatology, Hôpital La Croix Saint Simon, Paris, France
| | - Charles Zarnitsky
- Department of Rheumatology, Centre Hospitalier du Havre, Le Havre, France
| | | | - Olivier Vittecoq
- Department of Rheumatology, Rouen University Hospital, Rouen, France
| | - Alain Saraux
- Department of Rheumatology, Brest University Hospital, Brest, France
| | - Yves-Marie Pers
- Department of Rheumatology, Montpellier University Hospital, Montpellier, France
| | - Martine Gayraud
- Department of Internal Medicine, Institut Montsouris, Paris, France
| | - Gilles Bolla
- Department of Rheumatology, Centre Hospitalier de Cannes, Cannes, France
| | | | - Marc Ardizzone
- Department of Rheumatology, Centre Hospitalier de Mulhouse, Mulhouse, France
| | - Emmanuelle Dernis
- Department of Rheumatology, Centre Hospitalier du Mans, Le Mans, France
| | - Maxime A Breban
- Department of Rheumatology, Hôpital Ambroise Paré, Paris, France
| | - Olivier Fain
- Department of Internal Medicine, Hôpital Saint-Antoine, Paris, France
| | | | - Ouafaa Aberkane
- Department of Direction de la recherche clinique et de l'innovation, Strasbourg University Hospital, Strasbourg, France
| | - Marion Vazel
- Department of Direction de la recherche clinique et de l'innovation, Strasbourg University Hospital, Strasbourg, France
| | - Christelle Back
- Department of Direction de la recherche clinique et de l'innovation, Strasbourg University Hospital, Strasbourg, France
| | - Sophie Candon
- Department of Immunology, Hôpital Necker, Paris, France
| | | | - Elodie Perrodeau
- Department of Epidemiology and Biostatistics, Hotel Dieu, Paris, France
| | - Jean Sibilia
- Department of Rheumatology, National Reference Center for Systemic Autoimmune Diseases, Strasbourg University Hospital, Université de Strasbourg, Strasbourg, France
| | - Philippe Ravaud
- Department of Epidemiology and Biostatistics, Hotel Dieu, Paris, France
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Skinner M, Milne A, Grant C, Meyer O, Stanton A, Sutherland J, Moors J, Bradley A. Evaluation of minimally invasive blood pressure telemetry devices in conscious Beagle dogs. J Pharmacol Toxicol Methods 2016. [DOI: 10.1016/j.vascn.2016.02.114] [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: 10/21/2022]
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Abstract
Even though minipigs have been used in biomedical research for nearly half a century now, no specific nutrient requirements are available. For that reason a series of studies into the nutrient requirements of Göttingen minipigs were carried out. Firstly, a pilot study was carried out to determine the ad libitum feed intake (FI) during growth, as a reference for later feed restriction studies. Four male and four female minipigs were fed two types of diet, one standard pig diet (20.6% crude protein; 11.7% crude fat; 13.5 mJ/kg DM metabolizable energy) and one diet specially designed for minipigs (12.0% crude protein; 2.9% crude fat; 11.9 MJ/kg DM metabolizable energy). When fed ad libitum for 13 weeks, female Göttingen minipigs developed a significantly ( P <0.05) higher body weight (BW) than males (27.4 vs 16.6 kg) on either diet. The large difference in growth between male and female Göttingen minipigs did not appear to be the result from differences in metabolizable energy intake. Metabolizable energy intake of male and female Göttingen minipigs could be predicted by ME = 1877 kJ × BW0.61. Both male and female Göttingen minipigs became obese when fed ad libitum, defined by relative backfat thickness. Relative backfat thickness ranged from 5 to 13 cm/100 kg. Females had thicker relative backfat layers than males. Remarkably, no large changes in haematology and clinical chemistry occurred in ad libitum fed Göttingen minipigs as compared to reference values, and no abnormalities other than enlarged fat reserves were observed at necropsy. Apparently, Göttingen minipigs do not restrain FI voluntarily, and restricted feeding is therefore indicated to prevent obesity.
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Affiliation(s)
- P J A Bollen
- Biomedical Laboratory, University of Southern Denmark, Winsloewparken 23, DK-5000 Odense C, Denmark.
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Mathian A, Arnaud L, Adoue D, Agard C, Bader-Meunier B, Baudouin V, Belizna C, Bonnotte B, Boumedine F, Chaib A, Chauchard M, Chiche L, Daugas E, Ghali A, Gobert P, Gondran G, Guettrot-Imbert G, Hachulla E, Hamidou M, Haroche J, Hervier B, Hummel A, Jourde-Chiche N, Korganow AS, Kwon T, Le Guern V, Le Quellec A, Limal N, Magy-Bertrand N, Marianetti-Guingel P, Martin T, Martin Silva N, Meyer O, Miyara M, Morell-Dubois S, Ninet J, Pennaforte JL, Polomat K, Pourrat J, Queyrel V, Raymond I, Remy P, Sacre K, Sibilia J, Viallard JF, Viau Brabant A, Hanslik T, Amoura Z. Prévention des infections au cours du lupus systémique chez l’adulte et l’adolescent : élaboration de recommandations pour la pratique clinique, à partir d’une analyse de la littérature et de l’avis d’experts. Rev Med Interne 2016; 37:307-20. [DOI: 10.1016/j.revmed.2016.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 01/03/2016] [Accepted: 01/05/2016] [Indexed: 12/21/2022]
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Audemard-Verger A, Martin Silva N, Verstuyft C, Costedoat-Chalumeau N, Hummel A, Le Guern V, Sacré K, Meyer O, Daugas E, Goujard C, Sultan A, Lobbedez T, Galicier L, Pourrat J, Le Hello C, Godin M, Morello R, Lambert M, Hachulla E, Vanhille P, Queffeulou G, Potier J, Dion JJ, Bataille P, Chauveau D, Moulis G, Farge-Bancel D, Duhaut P, Saint-Marcoux B, Deroux A, Manuzak J, Francès C, Aumaitre O, Bezanahary H, Becquemont L, Bienvenu B. Glutathione S Transferases Polymorphisms Are Independent Prognostic Factors in Lupus Nephritis Treated with Cyclophosphamide. PLoS One 2016; 11:e0151696. [PMID: 27002825 PMCID: PMC4803192 DOI: 10.1371/journal.pone.0151696] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 03/02/2016] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To investigate association between genetic polymorphisms of GST, CYP and renal outcome or occurrence of adverse drug reactions (ADRs) in lupus nephritis (LN) treated with cyclophosphamide (CYC). CYC, as a pro-drug, requires bioactivation through multiple hepatic cytochrome P450s and glutathione S transferases (GST). METHODS We carried out a multicentric retrospective study including 70 patients with proliferative LN treated with CYC. Patients were genotyped for polymorphisms of the CYP2B6, CYP2C19, GSTP1, GSTM1 and GSTT1 genes. Complete remission (CR) was defined as proteinuria ≤0.33g/day and serum creatinine ≤124 µmol/l. Partial remission (PR) was defined as proteinuria ≤1.5g/day with a 50% decrease of the baseline proteinuria value and serum creatinine no greater than 25% above baseline. RESULTS Most patients were women (84%) and 77% were Caucasian. The mean age at LN diagnosis was 41 ± 10 years. The frequency of patients carrying the GST null genotype GSTT1-, GSTM1-, and the Ile→105Val GSTP1 genotype were respectively 38%, 60% and 44%. In multivariate analysis, the Ile→105Val GSTP1 genotype was an independent factor of poor renal outcome (achievement of CR or PR) (OR = 5.01 95% CI [1.02-24.51]) and the sole factor that influenced occurrence of ADRs was the GSTM1 null genotype (OR = 3.34 95% CI [1.064-10.58]). No association between polymorphisms of cytochrome P450s gene and efficacy or ADRs was observed. CONCLUSION This study suggests that GST polymorphisms highly impact renal outcome and occurrence of ADRs related to CYC in LN patients.
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Affiliation(s)
| | | | - Céline Verstuyft
- Department of Pharmacology, Hôpital Kremlin Bicêtre, Kremlin Bicêtre, France
| | | | | | - Véronique Le Guern
- Department of Internal Medicine, Hôpital Cochin, APHP, Université Paris V, Paris, France
| | - Karim Sacré
- Department of Internal Medicine, Hôpital Bichat, Paris, France
| | - Olivier Meyer
- Department of Rheumatology, Hôpital Bichat, Paris, France
| | - Eric Daugas
- Department of Nephrology, Hôpital Bichat, Paris, France
| | - Cécile Goujard
- Department of Internal Medicine, Hôpital Kremlin Bicêtre, Kremlin Bicêtre, France
| | - Audrey Sultan
- Department of Internal Medicine, CHU Caen, Caen, France
| | | | - Lionel Galicier
- Department of Clinical Immuno-pathology, Hôpital Saint Louis, Paris, France
| | - Jacques Pourrat
- Department of Nephrology and Clinical Immunology, CHU Toulouse, Toulouse, France
| | | | - Michel Godin
- Department of Nephrology, CHU Rouen, Rouen, France
| | | | - Marc Lambert
- Department of Internal Medicine, CHU Lille, Lille, France
| | - Eric Hachulla
- Department of Internal Medicine, CHU Lille, Lille, France
| | | | | | - Jacky Potier
- Department of Nephrology, CH Cherbourg, Cherbourg, France
| | - Jean-Jacques Dion
- Department of Nephrology, CH Charleville Mézière, Charleville Mézière, France
| | - Pierre Bataille
- Department of Nephrology, CH Boulogne-sur-Mer, Boulogne-sur-Mer, France
| | - Dominique Chauveau
- Department of Nephrology and Clinical Immunology, CHU Toulouse, Toulouse, France
| | - Guillaume Moulis
- Department of Internal Medicine, CHU Toulouse, France; UMR 1027 Inserm-Univeristy of Toulouse, France; CIC 1436, Toulouse, France
| | | | - Pierre Duhaut
- Department of Internal Medicine, CHU Amiens, Amiens, France
| | | | - Alban Deroux
- Department of Internal Medicine, CHU Grenoble, Grenoble, France
| | | | | | - Olivier Aumaitre
- Department of Internal Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Holy Bezanahary
- Department of Internal Medicine, CHU Limoges, Limoges, France
| | - Laurent Becquemont
- Department of Pharmacology, Hôpital Kremlin Bicêtre, Kremlin Bicêtre, France
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Cornillet M, Ajana S, Ruyssen-Witrand A, Constantin A, Degboé Y, Cantagrel A, Meyer O, Serre G, Nogueira L. Autoantibodies to human citrullinated fibrinogen and their subfamilies to the α36-50Cit and β60-74Cit fibrin peptides similarly predict radiographic damages: a prospective study in the French ESPOIR cohort of very early arthritides. Rheumatology (Oxford) 2016; 55:1859-1870. [PMID: 26961744 DOI: 10.1093/rheumatology/kew014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate whether subfamilies of the RA-specific autoantibodies to human citrullinated fibrinogen (AhFibA) differentially associate with the RA risk factors, HLA-DRB1 shared epitope containing alleles (SE alleles) and cigarette smoking, and thus help to predict the disease outcome. METHODS AhFibA and their anti-α36-50Cit and anti-β60-74Cit subfamilies were assayed by ELISA, at baseline, in the French ESPOIR (Etude et Suivi des Polyarthrites Indifférenciées Récentes) cohort composed of undifferentiated arthritides and RA patients of < 6 months' duration. Cigarette smoking, SE alleles' presence, DAS28, HAQ and modified Sharp-van der Heijde Score data were obtained at baseline, and after follow-up. RESULTS After 3 years, 701 patients were classified as having RA according to the ACR/EULAR 2010 criteria. Among them, 349 (50%), 203 (29%) and 257 (37%) were AhFibA-, anti-α36-50Cit- and anti-β60-74Cit-positive, respectively. The presence and titres of AhFibA and their subfamilies similarly associated with SE alleles, irrespective of their fine specificity, without significant effect of smoking. Neither their presence nor their titre was associated with DAS28 or HAQ. The presence of at least one subfamily was associated with a faster Sharp/van der Heijde score progression, albeit without correlation with the titre. CONCLUSION AhFibA and their main subfamilies are similarly associated with SE alleles without additional effect of smoking. Whatever their fine specificity was, their presence (but not their titre) similarly constituted a marker of faster joint destruction.
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Affiliation(s)
- Martin Cornillet
- Laboratory of "Epidermis Differentiation and Rheumatoid Autoimmunity", UMR CNRS 5165, INSERM U 1056, Toulouse University, Laboratory of Cell Biology and Cytology, University Hospital of Toulouse
| | - Soufiane Ajana
- Laboratory of "Epidermis Differentiation and Rheumatoid Autoimmunity", UMR CNRS 5165, INSERM U 1056, Toulouse University
| | | | | | - Yannick Degboé
- Rheumatology Centre, University Hospital of Toulouse, Toulouse and
| | - Alain Cantagrel
- Rheumatology Centre, University Hospital of Toulouse, Toulouse and
| | - Olivier Meyer
- Rheumatology Centre APHP, Bichat Hospital, Paris, France
| | - Guy Serre
- Laboratory of "Epidermis Differentiation and Rheumatoid Autoimmunity", UMR CNRS 5165, INSERM U 1056, Toulouse University, Laboratory of Cell Biology and Cytology, University Hospital of Toulouse
| | - Leonor Nogueira
- Laboratory of "Epidermis Differentiation and Rheumatoid Autoimmunity", UMR CNRS 5165, INSERM U 1056, Toulouse University, Laboratory of Cell Biology and Cytology, University Hospital of Toulouse,
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de Boysson H, Martin Silva N, de Moreuil C, Néel A, de Menthon M, Meyer O, Launay D, Pagnoux C, Guillevin L, Puéchal X, Bienvenu B, Aouba A. Neutrophilic Dermatoses in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A French Multicenter Study of 17 Cases and Literature Review. Medicine (Baltimore) 2016; 95:e2957. [PMID: 26986103 PMCID: PMC4839884 DOI: 10.1097/md.0000000000002957] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
A few reports suggest combination of ANCA-associated vasculitis (AAV) and neutrophilic dermatoses (ND). We aimed to describe the main characteristics of patients presenting with both AAV and ND in a French cohort and through a systematic literature review, and to discuss the possible common pathogenic process involved. We conducted a retrospective study of patients with both conditions. Patients were selected via the French Internal Medicine Society (SNFMI) and the French Vasculitis Study Group (FVSG). A literature review focusing on a combination of both conditions, concentrated only on publications with well-established diagnoses and individual detailed data. Seventeen patients diagnosed with AAV and ND were identified in this cohort. Twelve patients had granulomatosis with polyangiitis (GPA), 4 had microscopic polyangiitis (MPA) and one had eosinophilic GPA (EGPA). Eight patients, all with GPA, displayed pyoderma gangrenosum (PG). Sweet's syndrome was observed in 6 patients (4 with MPA, one with GPA and one with EGPA) and erythema elevatum diutinum in the other three (2 with GPA and 1 with MPA). The literature review identified 33 additional patients with both conditions, including 26 with GPA. Altogether, of the 50 patients (17 from our study and 33 from the literature review), 33 (66%) patients presented with PG associated with GPA in 29 cases (89%). Corticosteroids were the first-line treatment in conjunction with an immunosuppressive agent in most cases. Outcomes were good and a total of 15 patients experienced a relapse. Patients who relapsed were more likely to have ear, nose and throat manifestation than patients who did not [12/15 (80%) relapsing patients vs. 15/35 (43%) non-relapsing patients; p = 0.03)]. In our stud, the most frequent association concerned GPA and PG. ND should be considered and specifically researched within the spectrum of cutaneous manifestations observed in AAV.
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Affiliation(s)
- Hubert de Boysson
- From the Department of Internal Medicine, Caen University Hospital, Caen (HDB, NMS, BB, AA); Department of Internal Medicine, Brest University Hospital (CDM); Department of Internal Medicine, Nantes University Hospital (AN); Department of Internal Medicine, Assistance Publique Hôpitaux de Paris, Saint-Louis Hospital, Paris, France (MDM); Department of Rheumatology, Assistance Publique Hôpitaux de Paris, Bichat University Hospital, Paris, France (OM); Department of Internal Medicine, Lille University Hospital, France (DL); Mount Sinai Hospital, University Health Network, and University of Toronto, Toronto, Ontario, Canada (CP); and Department of Internal Medicine, Assistancec Publique Hôpitaux de Paris, Cochin Hospital, Paris, France (LG, XP)
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Ottaviani S, Gardette A, Roy C, Tubach F, Gill G, Palazzo E, Meyer O, Dieudé P. Body Mass Index and response to rituximab in rheumatoid arthritis. Joint Bone Spine 2015; 82:432-6. [DOI: 10.1016/j.jbspin.2015.02.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 02/17/2015] [Indexed: 12/23/2022]
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Schröder J, Bucher M, Meyer O. Effect of the laryngeal tube on the no-flow-time in a simulated two rescuer basic life support setting with inexperienced users. Med Klin Intensivmed Notfmed 2015; 111:493-500. [PMID: 26374339 DOI: 10.1007/s00063-015-0088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 07/21/2015] [Accepted: 08/28/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Intubation with a laryngeal tube (LT) is a recommended alternative to endotracheal intubation during advanced life support (ALS). LT insertion is easy; therefore, it may also be an alternative to bag-mask ventilation (BMV) for untrained personnel performing basic life support (BLS). Data from manikin studies support the influence of LT on no-flow-time (NFT) during ALS. METHODS We performed a prospective, randomized manikin study using a two-rescuer model to compare the effects of ventilation using a LT and BMV on NFT during BLS. Participants were trained in BMV and were inexperienced in the use of a LT. RESULTS There was no significant difference in total NFT with the use of a LT and BMV (LT: mean 83.1 ± 37.3 s; BMV: mean 78.7 ± 24.5 s; p = 0.313), but we found significant differences in the progression of the scenario: in the BLS-scenario, the proportion of time spent performing chest compressions was higher when BMV was used compared to when a LT was used. The quality of chest compressions and the ventilation rate did not differ significantly between the two groups. The mean tidal volume and mean minute volume were significantly larger with the use of a LT compared with the use of BMV. CONCLUSIONS In conclusion, in a two-rescuer BLS scenario, NFT is longer with the use of a LT (without prior training) than with the use of BMV (with prior training). The probable reasons for this result are higher tidal volumes with the use of a LT leading to longer interruptions without chest compressions.
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Affiliation(s)
- J Schröder
- Department of Medicine III, University Hospital of the Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle/Saale, Germany.
| | - M Bucher
- Department of Anesthesiology, University Hospital of the Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle/Saale, Germany
| | - O Meyer
- Institute for Emergency Medicine and Management in Medicine-INM, Klinikum der Universität München, Schillerstr. 53, 80336, Munich, Germany
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Ottaviani S, Gardette A, Tubach F, Roy C, Palazzo E, Gill G, Meyer O, Dieudé P. Body mass index and response to infliximab in rheumatoid arthritis. Clin Exp Rheumatol 2015; 33:478-483. [PMID: 25962513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/10/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Excess adipose tissue in obese individuals may have immunomodulating properties and pharmacokinetics consequences. Previous studies have suggested that obesity could negatively affect the response to anti-TNF-α agents, notably infliximab (IFX). We aimed to determine whether body mass index (BMI) is involved in the response to IFX in rheumatoid arthritis (RA). METHODS We retrospectively examined data for 76 RA patients receiving IFX. BMI was calculated before treatment, and change from baseline in DAS28, pain on a visual analog scale, erythrocyte sedimentation rate, C-reactive protein level, tender and swollen joint count was analysed at 6 months after treatment. The primary outcome was decrease in DAS28 ≥1.2. Secondary outcomes were good response and remission according to EULAR. RESULTS At baseline, the median [interquartile range] BMI was 26.6 [22.6-30.6] kg/m2. The number of patients with normal weight, overweight and obesity was 25, 29 and 22. In multivariable analyses, IFX treated patients with lower BMI showed a more frequent DAS28 decrease ≥1.2 (25.5 [22.3-28.3] vs. 28.0 [23.2-32.5], p=0.02, odds ratio [OR] 0.88 [95% confidence interval 0.79-0.98]), EULAR good response (25.3 [21.9-27.5] vs. 27.5 [24.3-31.2], p=0.03, OR 0.87 [0.76-0.99]) and EULAR remission, although not significant (25.3 [21.9-26.4] vs. 27.5 [23.2-30.9], p=0.14, OR 0.88 [0.75-1.04]). CONCLUSIONS Obesity may negatively influence the response to IFX in RA. These data could help physicians to choose biologic agents for obese RA patients.
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Affiliation(s)
- Sébastien Ottaviani
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Anais Gardette
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Florence Tubach
- Département d'Epidémiologie Biostatistique et Recherche Clinique, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Carine Roy
- Département d'Epidémiologie Biostatistique et Recherche Clinique, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Elisabeth Palazzo
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Ghislaine Gill
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Olivier Meyer
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Philippe Dieudé
- Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France
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Salmon JH, Cacoub P, Combe B, Sibilia J, Pallot-Prades B, Fain O, Cantagrel A, Dougados M, Andres E, Meyer O, Carli P, Pertuiset E, Pane I, Maurier F, Ravaud P, Mariette X, Gottenberg JE. Late-onset neutropenia after treatment with rituximab for rheumatoid arthritis and other autoimmune diseases: data from the AutoImmunity and Rituximab registry. RMD Open 2015; 1:e000034. [PMID: 26509060 PMCID: PMC4612695 DOI: 10.1136/rmdopen-2014-000034] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [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: 12/04/2014] [Revised: 04/23/2015] [Accepted: 04/28/2015] [Indexed: 01/12/2023] Open
Abstract
Objectives To evaluate the prevalence of late-onset neutropenia and its complications in patients treated with rituximab (RTX) for rheumatoid arthritis (RA) and other autoimmune diseases (AIDs) in a prospective registry. Methods The AutoImmunity and Rituximab registry is an independent 7-year prospective registry promoted by the French Society of Rheumatology. For each episode of neutropenia, data were validated by the clinician in charge of the patient. Results Among 2624 patients treated with RTX for refractory AIDs, and at least 1 follow-up visit (a total follow-up of 4179 patient-years in RA and 987 patient-years in AIDs), late-onset neutropenia was observed in 40 patients (25 RA (1.3% of patients with RA, 0.6/100 patient-years), and AIDs in 15 (2.3% of patients with AIDs, 1.5/100 patient-years)). 6 patients (15%) had neutrophils <500/mm3, 8 (20%) had neutrophils between 500 and 1000/mm3, and 26 (65%) had neutrophils between 1000 and 1500/mm3. Neutropenia occurred after a median period of 4.5 (3–6.5) months after the last RTX infusion in patients with RA, and 5 (3–6.5) months in patients with AIDs. 5 patients (12.5%), 4 of them with neutrophils lower than 500/mm3, developed a non-opportunistic serious infection and required antibiotics and granulocyte colony-stimulating factor injections, with a favourable outcome. After resolution of their RTX-related neutropenia, 19 patients (47.5%) were re-treated, and neutropenia reoccurred in 3 of them. Conclusions Late-onset neutropenia might occur after RTX and may result in serious infections. Thus, monitoring of white cell count should be performed after RTX. However, in this large registry of patients with AIDs, the frequency of RTX-induced neutropenia was much lower than that previously reported in patients treated for blood malignancies or AIDs.
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Affiliation(s)
- J H Salmon
- Rheumatology Department, CHU Reims, Reims, France
| | - P Cacoub
- Departement Hospitalo-Universitaire I2B, UPMC Univ Paris 06, CNRS, UMR 7211, INSERM, UMR_S 959, Department of Internal Medicine, Groupe Hospitalier Pitié-Salpêtrière (AP-HP), Paris, France
| | - B Combe
- Rheumatology Department, Lapeyronie University Hospital, Montpellier I, University, UMR5535, Montpellier, France
| | - J Sibilia
- Rheumatology department, National Center for Rare Systemic Autoimmune Diseases, Hôpitaux Universitaires de Strasbourg, INSERM UMRS_1109, Université de Strasbourg, Strasbourg, France
| | - B Pallot-Prades
- Rheumatology Department, CHU Saint-Etienne, Saint-Etienne, France
| | - O Fain
- Department of Internal Medicine, Hôpital Jean Verdier, Bondy, France
| | - A Cantagrel
- Rheumatology Center, Purpan Hospital, Paul Sabatier University, Toulouse, France
| | - M Dougados
- Medicine Faculty, Paris-Descartes University, Paris, UPRES-EA 4058, Cochin Hospital, Rheumatology B, Paris, France
| | - E Andres
- Department of Internal Medicine, University Hospital of Strasbourg, Strasbourg, France
| | - O Meyer
- Rheumatology Department, GroupeHospitalier Bichat-Claude Bernard (AP-HP), Paris, France
| | - P Carli
- Department of Internal Medicine, Hôpital D'Instruction des Armeés Sainte-541 Anne, Toulon, France
| | - E Pertuiset
- Rheumatology Department, CH René Dubos, Pontoise, France
| | - I Pane
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - F Maurier
- Department of Internal Medicine, CHR Metz, Metz, France
| | - P Ravaud
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - X Mariette
- Rheumatology Department, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM U1184, IMVA: Center of Immunology of Viral Infections and Autoimmune Diseases, Paris, France
| | - J E Gottenberg
- Rheumatology Department, National Center for Rare Systemic Autoimmune Diseases, Hôpitaux Universitaires de Strasbourg, CNRS, Institut de Biologie Moléculaire et Cellulaire, Immunopathologie et Chimie Thérapeutique/Laboratory of Excellence Medalis, Université de Strasbourg, Strasbourg, France
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Baillet A, Gossec L, Paternotte S, Etcheto A, Combe B, Meyer O, Mariette X, Gottenberg JE, Dougados M. Evaluation of Serum Interleukin-6 Level as a Surrogate Marker of Synovial Inflammation and as a Factor of Structural Progression in Early Rheumatoid Arthritis: Results From a French National Multicenter Cohort. Arthritis Care Res (Hoboken) 2015; 67:905-12. [DOI: 10.1002/acr.22513] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 10/05/2014] [Accepted: 11/04/2014] [Indexed: 01/09/2023]
Affiliation(s)
| | - Laure Gossec
- UPMC Université Paris 06, GRC-UPMC 08 (EEMOIS), Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital; Paris France
| | - Simon Paternotte
- Paris-Descartes University, Assistance Publique Hôpitaux de Paris, Cochin Hospital; Paris France
| | - Adrien Etcheto
- Paris-Descartes University, Assistance Publique Hôpitaux de Paris, Cochin Hospital; Paris France
| | - Bernard Combe
- Lapeyronie University Hospital, Montpellier I University; Montpellier France
| | - Olivier Meyer
- Université Paris 7 Denis Diderot, UFR de Médecine, and Assistance Publique Hôpitaux de Paris, Hôpital Bichat; Paris France
| | - Xavier Mariette
- Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Université Paris-Sud, Institut Pour la Santé et la Recherche Médicale Paris, France
| | | | - Maxime Dougados
- Paris-Descartes University, Assistance Publique Hôpitaux de Paris, Cochin Hospital; Paris France
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Salmon JH, Gottenberg JE, Ravaud P, Cantagrel A, Combe B, Flipo RM, Schaeverbeke T, Houvenagel E, Gaudin P, Loeuille D, Rist S, Dougados M, Sibilia J, Le Loët X, Meyer O, Solau-Gervais E, Marcelli C, Bardin T, Pane I, Baron G, Perrodeau E, Mariette X. Predictive risk factors of serious infections in patients with rheumatoid arthritis treated with abatacept in common practice: results from the Orencia and Rheumatoid Arthritis (ORA) registry. Ann Rheum Dis 2015; 75:1108-13. [PMID: 26048170 DOI: 10.1136/annrheumdis-2015-207362] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 01/27/2015] [Accepted: 05/14/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Little data are available regarding the rate and predicting factors of serious infections in patients with rheumatoid arthritis (RA) treated with abatacept (ABA) in daily practice. We therefore addressed this issue using real-life data from the Orencia and Rheumatoid Arthritis (ORA) registry. METHODS ORA is an independent 5-year prospective registry promoted by the French Society of Rheumatology that includes patients with RA treated with ABA. At baseline, 3 months, 6 months and every 6 months or at disease relapse, during 5 years, standardised information is prospectively collected by trained clinical nurses. A serious infection was defined as an infection occurring during treatment with ABA or during the 3 months following withdrawal of ABA without any initiation of a new biologic and requiring hospitalisation and/or intravenous antibiotics and/or resulting in death. RESULTS Baseline characteristics and comorbidities: among the 976 patients included with a follow-up of at least 3 months (total follow-up of 1903 patient-years), 78 serious infections occurred in 69 patients (4.1/100 patient-years). Predicting factors of serious infections: on univariate analysis, an older age, history of previous serious or recurrent infections, diabetes and a lower number of previous anti-tumour necrosis factor were associated with a higher risk of serious infections. On multivariate analysis, only age (HR per 10-year increase 1.44, 95% CI 1.17 to 1.76, p=0.001) and history of previous serious or recurrent infections (HR 1.94, 95% CI 1.18 to 3.20, p=0.009) were significantly associated with a higher risk of serious infections. CONCLUSIONS In common practice, patients treated with ABA had more comorbidities than in clinical trials and serious infections were slightly more frequently observed. In the ORA registry, predictive risk factors of serious infections include age and history of serious infections.
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Affiliation(s)
- J H Salmon
- Rheumatology Department, CHU Reims, Reims, France
| | - J E Gottenberg
- Rheumatology Department, National Center for Rare Systemic Autoimmune Diseases, Hôpitaux Universitaires de Strasbourg, CNRS, Institut de Biologie Moléculaire et Cellulaire, Immunopathologie et Chimie Thérapeutique/Laboratory of Excellence Medalis, Université de Strasbourg, Strasbourg, France
| | - P Ravaud
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - A Cantagrel
- Rheumatology Center, Purpan Hospital, Paul Sabatier University, Toulouse, France
| | - B Combe
- Rheumatology Department, Lapeyronie University Hospital, Montpellier I University, Montpellier, France
| | - R M Flipo
- Rheumatology Department, CHRU de Lille, Université de Lille-2, Lille, France
| | | | - E Houvenagel
- Rheumatology Department, CHU Lomme, Lomme, France
| | - P Gaudin
- Rheumatology Department, CHU Grenoble, Grenoble, France
| | - D Loeuille
- Rheumatology Department, CHU Nancy, Nancy, France
| | - S Rist
- Rheumatology Department, CHR Orléans, Orléans, France
| | - M Dougados
- Medicine Faculty, Paris-Descartes University, Paris, UPRES-EA 4058, Cochin Hospital, Rheumatology B, Paris, France
| | - J Sibilia
- Rheumatology department, National Center for Rare Systemic Autoimmune Diseases, Hôpitaux Universitaires de Strasbourg, INSERM UMRS_1109, Université de Strasbourg, Strasbourg, France
| | - X Le Loët
- Rheumatology Department, Rouen University Hospital & Inserm U905, Rouen, France
| | - O Meyer
- Rheumatology Department, Groupe Hospitalier Bichat-Claude Bernard (AP-HP), Paris, France
| | | | - C Marcelli
- Rheumatology Department, CHU Caen, Caen, France
| | - T Bardin
- Rheumatology Department, Hôpital Lariboisière, Paris, France
| | - I Pane
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - G Baron
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - E Perrodeau
- Centre de Recherche en Epidémiologie et Statistiques, INSERM U1153, Centre d'Épidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Descartes University, Paris, France
| | - X Mariette
- Rheumatology Department, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM U1184, IMVA: Center of Immunology of Viral Infections and Autoimmune Diseases, Paris, France
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Che H, Combe B, Morel J, Meyer O, Cantagrel A, Gossec L, Lukas C. SAT0072 Performance of Patient Reported Outcomes in the Assessment of Rheumatoid Arthritis Disease Activity: The Experience of the Espoir Cohort. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Meyer O. Refraktärität gegen Thrombozytentransfusionen. Transfusionsmedizin 2015. [DOI: 10.1055/s-0035-1545923] [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: 10/23/2022]
Affiliation(s)
- O. Meyer
- Institut für Transfusionsmedizin, Charité – Universitätsmedizin Berlin, Berlin
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Meyer A, Lefevre G, Bierry G, Duval A, Ottaviani S, Meyer O, Tournadre A, Le Goff B, Messer L, Buchdahl AL, De Bandt M, Deligny C, Dubois M, Coquerelle P, Falgarone G, Flipo RM, Mathian A, Geny B, Amoura Z, Benveniste O, Hachulla E, Sibilia J, Hervier B. In antisynthetase syndrome, ACPA are associated with severe and erosive arthritis: an overlapping rheumatoid arthritis and antisynthetase syndrome. Medicine (Baltimore) 2015; 94:e523. [PMID: 25997035 PMCID: PMC4602869 DOI: 10.1097/md.0000000000000523] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Anticitrullinated peptide/protein antibodies (ACPA), which are highly specific for rheumatoid arthritis (RA), may be found in some patients with other systemic autoimmune diseases. The clinical significance of ACPA in patients with antisynthetase syndrome (ASS), a systemic disease characterized by the association of myositis, interstitial lung disease, polyarthralgia, and/or polyarthritis, has not yet been evaluated with regard to phenotype, prognosis, and response to treatment. ACPA-positive ASS patients were first identified among a French multicenter registry of patients with ASS. Additionally, all French rheumatology and internal medicine practitioners registered on the Club Rhumatismes et Inflammation web site were asked to report their observations of ASS patients with ACPA. The 17 collected patients were retrospectively studied using a standardized questionnaire and compared with 34 unselected ACPA-negative ASS patients in a case-control study. All ACPA-positive ASS patients suffered from arthritis versus 41% in the control group (P < 0.0001). The number of swollen joints was significantly higher (7.0 ± 5.0 vs 2.9 ± 3.9, P < 0.005), with a distribution resembling that of RA. Radiographic damages were also more frequent in ACPA-positive ASS patients (87% vs 11%, P < 0.0001). Aside from a significantly higher transfer factor for carbon monoxide in ACPA-ASS patients, lung, muscle, and skin involvements had similar incidences, patterns, and severity in both groups. Although Nonbiologic treatments were similarly used in both groups, ACPA-positive patients received biologics more frequently (59% vs 12%, P < 0.0008), mostly due to refractory arthritis (n = 9). Eight patients received anti-Cluster of differentiation 20 (CD20) monoclonal antibodies (mAbs) with good efficacy and tolerance, whereas 2 of the 5 patients treated with antitumor necrosis factor drugs had worsened myositis and/or interstitial lung disease. After a >7-year mean follow-up, extra-articular outcomes and survival were not different. ACPA-positive ASS patients showed an overlapping RA-ASS syndrome, were at high risk of refractory erosive arthritis, and might experience ASS flare when treated with antitumor necrosis factor drugs. In contrast, other biologics such as anti-CD20 mAb were effective in this context, without worsening systemic involvements.
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Affiliation(s)
- Alain Meyer
- From the Service de Rhumatologie-Centre de Référence des Maladies Autoimmunes et Systémiques Rares (AMe, JS), Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle; Service de Physiologie et d'Explorations Fonctionnelles (AM, BG), Centre Hospitalo-Universitaire de Strasbourg; EA 3072 (AM, BG), "Mitochondrie, Stress Oxydant et Protection Musculaire", Faculté de Médecine, Université de Strasbourg et Fédération de Médecine Translationnelle (FMTS), Strasbourg; Service de Médecine Interne-Centre de Référence des Maladies Autoimmunes et Systémiques Rares (GL, EH), CHRU Lille, Université Lille 2, Lille; Service de Radiologie (GB), Hôpitaux Universitaires de Strasbourg, Strasbourg; Service de Rhumatologie (AD), Hôpital Général de Dôle, Dôle; Service de Rhumatologie (SO, OM), Hôpital Bichat, APHP, Paris; Service de Rhumatologie (AT), Hôpitaux Universitaires de Clermont-Ferrand, Clermont-Ferrand; Service de Rhumatologie (BLG), Hôpitaux Universitaires de Nantes, Nantes; Service de Rhumatologie (LM), Hôpital Général de Colmar, Colmar; Service de Médecine Interne (ALB), Hôpital Général de Douai, Douai; Service de Rhumatologie (MDB); Service de Médecine Interne (CD), Hôpitaux Universitaire de Fort de France, Fort de France; Service de Pneumologie et Réanimation Médicale (MD), Hôpital Pitié-Salpêtrière, APHP, Paris; Service de Rhumatologie et Néphrologie (PC), Centre Hospitalier de Béthune, Béthune; Department de Rhumatologie (GF), Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Avicenne-Jean Verdier-René Muret; INSERM UMR1125 (GF); Sorbonne Paris Cité-Université Paris 13 (GF), Bobigny; Service de Rhumatologie Hôpitaux Universitaires de Lille (RMF), Université de Lille 2, Lille; Service de médecine interne 2, Centre de Référence National pour le Lupus et le Syndrome des Antiphospholipides, institut E3M, Hôpital Pitié Salpêtrière, APHP, Paris, F-75013 (AMa, ZA) ; Département de médecine interne et immunologie clinique, Centre de Référence Maladies Neuro-Musculaires - DHU i2B, Hôpital Pitié- Salpêtrière, APHP, Paris, F-75013 (BH, OB) INSERM UMR-S 1135 (BH, AMa, ZA) & INSERM UMRS974 (BH, OB) Sorbonne Universités, UPMC Univ Paris 06, France
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Payet J, Belkhir R, Gottenberg JE, Bergé E, Desmoulins F, Meyer O, Mariette X, Seror R. ACPA-positive primary Sjögren's syndrome: true primary or rheumatoid arthritis-associated Sjögren's syndrome? RMD Open 2015; 1:e000066. [PMID: 26509066 PMCID: PMC4613176 DOI: 10.1136/rmdopen-2015-000066] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 03/24/2015] [Accepted: 04/12/2015] [Indexed: 01/22/2023] Open
Abstract
Objectives Anticyclic citrullinated protein antibodies (ACPA) are highly specific of rheumatoid arthritis (RA). However, they have also been detected in 5–10% of primary Sjögren's syndrome (pSS). We compared ACPA-positive and negative patients with pSS and assessed the risk of evolution to RA. Patients and methods ACPA-positive and negative patients with pSS were included in this study. For ACPA-positive patients, clinical and radiological re-evaluation was systematically performed after at least 5 years of follow-up. Diagnosis was reassessed at the end of the follow-up to identify patients that developed RA according to the American College of Rheumatology 1987 classification criteria. Results At inclusion in the cohort 16 patients with pSS were ACPA positive and 278 were ACPA negative. ACPA-positive patients, had more frequently arthritis (43.7% vs 12.2%; p=0.003) but not arthralgias. They also had more frequent lung involvement (25% vs 8.1%; p=0.05). After median follow-up of 8 (5–10) years, 7/16 (43.8%) patients developed RA including 5 (31.25%) with typical RA erosions. Elevation of acute phase reactants at inclusion was the only parameter associated with progression to erosive RA. Conclusions Median term follow-up of ACPA-positive patients with pSS showed that almost half of them developed RA, particularly in the presence of elevation of acute phase reactants. These results support the usefulness of a close radiological monitoring of these patients for early detection of erosive change not to delay initiation of effective treatment. Indeed, number of these patients with ACPA-positive pSS may actually have RA and associated SS.
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Affiliation(s)
- J Payet
- Department of Rheumatology , Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hopitaux de Paris (AP-HP), Université Paris-Sud, INSERM U1184 , Le Kremlin Bicêtre , France
| | - R Belkhir
- Department of Rheumatology , Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hopitaux de Paris (AP-HP), Université Paris-Sud, INSERM U1184 , Le Kremlin Bicêtre , France
| | - J E Gottenberg
- Department of Rheumatology , Centre National de Référence des Maladies Auto-Immunes Rares, INSERM UMRS_1109, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg University Hospital, Université de Strasbourg , Strasbourg , France
| | - E Bergé
- Department of Rheumatology , Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hopitaux de Paris (AP-HP), Université Paris-Sud, INSERM U1184 , Le Kremlin Bicêtre , France
| | - F Desmoulins
- Department of Rheumatology , Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hopitaux de Paris (AP-HP), Université Paris-Sud, INSERM U1184 , Le Kremlin Bicêtre , France
| | - O Meyer
- Department of Rheumatology , Assistance Publique-Hopitaux de Paris, Bichat Hospital , Paris , France
| | - X Mariette
- Department of Rheumatology , Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hopitaux de Paris (AP-HP), Université Paris-Sud, INSERM U1184 , Le Kremlin Bicêtre , France
| | - R Seror
- Department of Rheumatology , Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hopitaux de Paris (AP-HP), Université Paris-Sud, INSERM U1184 , Le Kremlin Bicêtre , France
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Levy M, Molta C, Meyer O, Dosquet C, Danon F, Babron MC, Montes de Oca M. Antiphospholipid antibodies in patients with childhood onset systemic lupus erythematosus and their relatives. A French cooperative study. Contrib Nephrol 2015; 99:26-34. [PMID: 1458923 DOI: 10.1159/000421686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- M Levy
- Unité de Recherches d'Epidémiologie génétique, INSERM U-155, Paris, France
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Meyer O. Detection of soluble immune complexes by the technique of antibody-dependent cell-mediated cytotoxicity inhibition in glomerulonephritis. Contrib Nephrol 2015; 35:134-49. [PMID: 6831881 DOI: 10.1159/000407457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Meyer O, Dawson-Hughes B, Sidelnikov E, Egli A, Grob D, Staehelin HB, Theiler G, Kressig RW, Simmen HP, Theiler R, Bischoff-Ferrari HA. Calcifediol versus vitamin D3 effects on gait speed and trunk sway in young postmenopausal women: a double-blind randomized controlled trial. Osteoporos Int 2015; 26:373-81. [PMID: 25369890 DOI: 10.1007/s00198-014-2949-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 10/23/2014] [Indexed: 10/24/2022]
Abstract
UNLABELLED In this double-blind RCT, 4-month treatment with calcifediol compared with vitamin D3 improved gait speed by 18% among young postmenopausal women. Consistently, change in 25(OH)D blood levels over time were significantly correlated with improvement in gait speed in these women. No effect could be demonstrated for trunk sway. INTRODUCTION The aim of this study is to test the effect of calcifediol compared with vitamin D3 on gait speed and trunk sway. METHODS Twenty healthy postmenopausal women with an average 25(OH)D level of 13.2 ng/ml (SD = ±3.9) and a mean age of 61.5 years (SD = ±7.2) were randomized to either 20 μg of calcifediol or 20 μg (800 IU) of vitamin D3 per day in a double-blind manner. At baseline and at 4 months of follow-up, the same physiotherapist blinded to treatment allocation tested 8-m gait speed and a body sway test battery (Sway star pitch and roll angle plus velocity while walking 8 m, and standing on both legs on a hard and soft surface). All analyses adjusted for baseline measurement, age, and body mass index. RESULTS Mean 25(OH)D levels increased to 69.3 ng/ml (SD = ±9.5) in the calcifediol group and to 30.5 ng/ml (SD = ±5.0) in the vitamin D3 group (p < 0.0001). Women receiving calcifediol compared with vitamin D3 had an 18% greater improvement in gait speed at 4-month follow-up (p = 0.046) adjusting for baseline gait speed, age, and body mass index. Also, change in gait speed was significantly correlated with change in serum 25(OH)D concentrations (r = 0.5; p = 0.04). Across three tests of trunk sway, there were no consistent differences between groups and no significant correlation between change in 25(OH)D serum concentrations and change in trunk sway. CONCLUSIONS Calcifediol improved gait speed in early postmenopausal women compared with vitamin D3 and change in 25(OH)D level was moderately correlated with improvement in gait speed. A benefit on trunk sway could not be demonstrated.
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Affiliation(s)
- O Meyer
- Geriatric Clinic, University Hospital Zurich, Zurich, Switzerland
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Ottaviani S, Gill G, Aubrun A, Palazzo E, Meyer O, Dieudé P. Ultrasound in gout: a useful tool for following urate-lowering therapy. Joint Bone Spine 2014; 82:42-4. [PMID: 25543275 DOI: 10.1016/j.jbspin.2014.03.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 03/14/2014] [Indexed: 01/18/2023]
Abstract
OBJECTIVE We aimed to determine the ability of ultrasonography (US) to show decrease or disappearance of urate deposits in gouty patients requiring urate-lowering therapy (ULT). METHODS To be included in this prospective single-centre study, patients needed toexhibit (1) proven gout by monosodic urate (MSU) crystals in synovial fluid and (2) US-evidenced urate deposits (double contour [DC] sign and/or tophi) before starting ULT (allopurinol [n=4], febuxostat [n=12]). At baseline and after six months of ULT, one trained ultrasonographer assessed the knee and first metatarsophalangeal (MTP1s) joints. Serum uric-acid (SUA) level was assessed at baseline and at three and six months after ULT initiation. Correlation between US findings and achievement of SUA level objective (< 360μmol/L) was estimated by the kappa coefficient (κ). RESULTS We studied 16 patients (all males, mean age 61.0±18.3 years). The mean disease duration was 7.1±6.2 years. Tophi were found at clinical examination in 56% of patients. Baseline SUA levels were 688±153μmol/L. At baseline, US revealed tophi or a DC sign among 62.5 to 75% of patients in knees and 87.5% in MTP1s. After six months of ULT, none of the four patients, not achieving the SUA level objective, had disappearance of US features. Among the remaining 12 patients, US features (tophi or DC sign) disappeared or decreased in all but one with a stable DC sign in one MTP1. The correlation between the whole US examination and SUA level was excellent (κ=0.875). CONCLUSIONS US could show disappearance of urate deposits after ULT and appears to be well correlated with efficacy of ULT.
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Affiliation(s)
- Sébastien Ottaviani
- Service de rhumatologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, UFR de médecine, 75205 Paris, France.
| | - Ghislaine Gill
- Service de rhumatologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, UFR de médecine, 75205 Paris, France
| | - Aurore Aubrun
- Service de rhumatologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, UFR de médecine, 75205 Paris, France
| | - Elisabeth Palazzo
- Service de rhumatologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, UFR de médecine, 75205 Paris, France
| | - Olivier Meyer
- Service de rhumatologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, UFR de médecine, 75205 Paris, France
| | - Philippe Dieudé
- Service de rhumatologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, UFR de médecine, 75205 Paris, France
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Arnaud L, Mathian A, Adoue D, Bader-Meunier B, Baudouin V, Belizna C, Bonnotte B, Boumedine F, Chaib A, Chauchard M, Chiche L, Daugas E, Ghali A, Gobert P, Gondran G, Guettrot-Imbert G, Hachulla E, Hamidou M, Haroche J, Hervier B, Hummel A, Jourde-Chiche N, Korganow AS, Kwon T, Le Guern V, Le Quellec A, Limal N, Magy-Bertrand N, Marianetti-Guingel P, Martin T, Martin Silva N, Meyer O, Miyara M, Morell-Dubois S, Ninet J, Papo T, Pennaforte JL, Polomat K, Pourrat J, Queyrel V, Raymond I, Remy P, Sacre K, Schmidt J, Sibilia J, Viallard JF, Viau Brabant A, Wahl D, Bruckert E, Amoura Z. [Screening and management of cardiovascular risk factors in systemic lupus erythematosus: Recommendations for clinical practice based on the literature and expert opinion]. Rev Med Interne 2014; 36:372-80. [PMID: 25455954 DOI: 10.1016/j.revmed.2014.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [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: 12/05/2013] [Revised: 04/17/2014] [Accepted: 10/13/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To develop French recommendations about screening and management of cardiovascular risk factors in systemic lupus erythematosus (SLE). METHODS Thirty-nine experts qualified in internal medicine, rheumatology and nephrology have selected recommendations from a list developed based on evidence from the literature. For each recommendation, the level of evidence and the level of agreement among the experts were specified. RESULTS Experts recommended an annual screening of cardiovascular risk factors in SLE. Statins should be prescribed for primary prevention in SLE patients based on the level of LDL-cholesterol and the number of cardiovascular risk factors, considering SLE as an additional risk factor. For secondary prevention, experts have agreed on an LDL-cholesterol target of <0.7 g/L. Hypertension should be managed according to the 2013 European guidelines, using renin-angiotensin system blockers as first line agents in case of renal involvement. Aspirin can be prescribed in patients with high cardiovascular risk or with antiphospholipid antibodies. CONCLUSION These recommendations about the screening and management of cardiovascular risk factors in SLE can be expected to improve clinical practice uniformity and, in the longer term, to optimize the management of SLE patients.
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Affiliation(s)
- L Arnaud
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
| | - A Mathian
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
| | - D Adoue
- Service de médecine interne et immunopathologie clinique, hôpital Purpan, Toulouse, France
| | - B Bader-Meunier
- Service d'immunologie et rhumatologie pédiatrique, centre de référence des maladies rares rhumatologiques et inflammatoires pédiatriques (CERHUMIP), hôpital Necker, Paris, France
| | - V Baudouin
- Service de néphrologie pédiatrique, hôpital Robert-Debré, Paris, France
| | - C Belizna
- Service de médecine interne, CHU d'Angers, Angers, France
| | - B Bonnotte
- Service de médecine interne et immunologie clinique, CHU Bocage, Dijon, France
| | - F Boumedine
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Chaib
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - M Chauchard
- Service de médecine interne, hôpital Bichat, Claude-Bernard, Paris, France
| | - L Chiche
- Service de médecine interne, hôpital de la Conception, Marseille, France
| | - E Daugas
- Service de néphrologie, hôpital Bichat, Paris, France
| | - A Ghali
- Service de médecine interne, CHU d'Angers, Angers, France
| | - P Gobert
- Service de médecine interne et néphrologie, centre hospitalier d'Avignon, Avignon, France
| | - G Gondran
- Service de médecine interne A, hôpital Dupuytren, CHU de Limoges, Limoges, France
| | - G Guettrot-Imbert
- Service de médecine interne, hôpital Gabriel-Montpied, CHU, Clermont-Ferrand, France
| | - E Hachulla
- Service de médecine interne, hôpital Claude-Huriez, CHRU de Lille, Lille, France
| | - M Hamidou
- Service de médecine interne, Nantes, France
| | - J Haroche
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
| | - B Hervier
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Hummel
- Service de néphrologie adulte, hôpital Necker, Paris, France
| | - N Jourde-Chiche
- Service de néphrologie, hôpital de la Conception, Marseille, France
| | - A-S Korganow
- Service d'immunologie clinique, hôpital civil, CHU de Strasbourg, Strasbourg, France
| | - T Kwon
- Service de néphrologie pédiatrique, hôpital Robert-Debré, Paris, France
| | - V Le Guern
- Service de médecine interne, centre de référence maladies systémiques et auto-immunes rares, sclérodermies, vascularites, groupe hospitalier Cochin, Paris, France
| | - A Le Quellec
- Service de médecine interne A, hôpital Saint-Éloi, Montpellier, France
| | - N Limal
- Service de médecine interne, CHU Henri-Mondor, Créteil, France
| | - N Magy-Bertrand
- Service de médecine interne, CHU Jean-Minjoz, Besançon, France
| | | | - T Martin
- Service d'immunologie clinique, hôpital civil, CHU de Strasbourg, Strasbourg, France
| | | | - O Meyer
- Service de rhumatologie, hôpital Bichat-Claude-Bernard, Paris, France
| | - M Miyara
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - S Morell-Dubois
- Service de médecine interne, hôpital Claude-Huriez, CHRU de Lille, Lille, France
| | - J Ninet
- Service de médecine interne, hôpital Édouard-Herriot, CHRU de Lyon, Lyon, France
| | - T Papo
- Service de médecine interne, hôpital Bichat, Claude-Bernard, Paris, France
| | - J-L Pennaforte
- Service de médecine interne, CHU de Reims, Reims, France
| | - K Polomat
- Service de médecine interne 5D, CHU de Martinique, Fort-de-France, Martinique
| | - J Pourrat
- Service de néphrologie, hôpital Rangueil, CHU, Toulouse, France
| | - V Queyrel
- Service de médecine interne, hôpital de l'Archet, Nice, France
| | - I Raymond
- Service de médecine interne et maladies infectieuses, hôpital Haut-Lévêque, centre François-Magendie, Pessac, France
| | - P Remy
- Service de néphrologie, groupe hospitalier Henri-Mondor, Créteil, France
| | - K Sacre
- Service de médecine interne, hôpital Bichat, Claude-Bernard, Paris, France
| | - J Schmidt
- Service de médecine interne, CHU Nord, Amiens, France
| | - J Sibilia
- Service de rhumatologie, CHU Hautepierre, Strasbourg, France
| | - J-F Viallard
- Service de médecine interne et maladies infectieuses, hôpital Haut-Lévêque, centre François-Magendie, Pessac, France
| | - A Viau Brabant
- Service de médecine interne, CHU de Reims, Reims, France
| | - D Wahl
- Inserm U 1116, service de médecine vasculaire, département de médecine interne, institut lorrain du cœur et des vaisseaux Louis-Mathieu, centre de compétence régional des maladies systémiques et auto-immunes rares, CHU de Nancy, université de Lorraine, Vandœuvre-lès-Nancy, France
| | - E Bruckert
- Service d'endocrinologie, métabolisme et prévention cardiovasculaire, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - Z Amoura
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
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Meyer M, Sellam J, Fellahi S, Kotti S, Bastard JP, Meyer O, Lioté F, Simon T, Capeau J, Berenbaum F. Serum level of adiponectin is a surrogate independent biomarker of radiographic disease progression in early rheumatoid arthritis: results from the ESPOIR cohort. Arthritis Res Ther 2014; 15:R210. [PMID: 24314299 PMCID: PMC3978925 DOI: 10.1186/ar4404] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 11/21/2013] [Indexed: 12/15/2022] Open
Abstract
Introduction Adipokines such as adiponectin, leptin, and visfatin/nicotinamide phosphoribosyltransferase (NAMPT) have recently emerged as pro-inflammatory mediators involved in the pathophysiology of rheumatoid arthritis (RA). We aimed to determine whether serum adipokine levels independently predicted early radiographic disease progression in early RA. Methods In total, 791 patients were included from the prospective Etude et Suivi des POlyarthrites Indifférenciées Récentes (ESPOIR) cohort who met the American College of Rheumatology-European League Against Rheumatism criteria for RA (n = 632) or had undifferentiated arthritis (UA) (n = 159). Enzyme-linked immunosorbent assay (ELISA) was used to assess baseline serum levels of adiponectin, leptin, and visfatin/NAMPT. In the RA group, we tested the association of serum adipokine levels and (a) baseline radiographic damage and (b) radiographic disease progression, defined as a change >0 or ≥5 in total Sharp-van der Heijde Score (∆SHS) between inclusion and 1 year (∆SHS ≥1 or rapid radiographic progression: ∆SHS ≥5), adjusting for confounders (age, sex, body-mass index, insulin resistance, C-reactive protein level, Disease Activity Score in 28 joints, Health Assessment Questionnaire score, autoantibody status, steroid use, and radiographic evidence of RA damage at inclusion). Results Adiponectin level was independently associated with baseline total SHS (adjusted β = 0.12; P = 0.006). It was also associated with ∆SHS ≥1 (adjusted odds ratio (aOR) = 1.84 (1.25 to 2.72)) involving erosive as well as narrowing disease progression (aOR = 1.73 (1.17 to 2.55) and 1.93 (1.04 to 3.57), respectively). Serum adiponectin level predicted ∆SHS ≥5 (aOR = 2.0 (1.14 to 3.52)). Serum leptin level was independently associated only with ∆SHS >0 (aOR = 1.59 (1.05 to 2.42)). Conversely, serum visfatin/NAMPT level and radiographic disease progression were unrelated. Considering the receiver-operated characteristic curves, the best adiponectin cut-offs were 4.14 μg/ml for ∆SHS ≥1 and 6.04 μg/ml for ∆SHS ≥5, with a good specificity (58% and 75% for ∆SHS ≥1 and ∆SHS ≥5, respectively) and high negative predictive values (75% and 92% for ∆SHS ≥1 or ∆SHS ≥5, respectively). Conclusion Serum adiponectin level is a simple useful biomarker associated with early radiographic disease progression in early RA, independent of RA-confounding factors and metabolic status.
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Dumas G, Prendki V, Haroche J, Amoura Z, Cacoub P, Galicier L, Meyer O, Rapp C, Deligny C, Godeau B, Aslangul E, Lambotte O, Papo T, Pouchot J, Hamidou M, Bachmeyer C, Hachulla E, Carmoi T, Dhote R, Gerin M, Mekinian A, Stirnemann J, Charlotte F, Farge D, Molina T, Fain O. Kikuchi-Fujimoto disease: retrospective study of 91 cases and review of the literature. Medicine (Baltimore) 2014; 93:372-382. [PMID: 25500707 PMCID: PMC4602439 DOI: 10.1097/md.0000000000000220] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is a rare cause of lymphadenopathy, most often cervical. It has been mainly described in Asia. There are few data available on this disease in Europe. We conducted this retrospective, observational, multicenter study to describe KFD in France and to determine the characteristics of severe forms of the disease and forms associated with systemic lupus erythematosus (SLE). We included 91 cases of KFD, diagnosed between January 1989 and January 2011 in 13 French hospital centers (median age, 30 ± 10.4 yr; 77% female). The ethnic origins of the patients were European (33%), Afro-Caribbean (32%), North African (15.4%), and Asian (13%). Eighteen patients had a history of systemic disease, including 11 with SLE. Lymph node involvement was cervical (90%), often in the context of polyadenopathy (52%), and it was associated with hepatomegaly and splenomegaly in 14.8% of cases. Deeper sites of involvement were noted in 18% of cases. Constitutional signs consisted mainly of fever (67%), asthenia (74.4%), and weight loss (51.2%). Other manifestations included skin rash (32.9%), arthromyalgia (34.1%), 2 cases of aseptic meningitis, and 3 cases of hemophagocytic lymphohistiocytosis. Biological signs included lymphocytopenia (63.8%) and increase of acute phase reactants (56.4%). Antinuclear antibodies (ANAs) and anti-DNA antibodies were present in 45.2% and 18% of the patients sampled, respectively. Concomitant viral infection was detected in 8 patients (8.8%). Systemic corticosteroids were prescribed in 32% of cases, hydroxychloroquine in 17.6%, and intravenous immunoglobulin in 3 patients. The disease course was always favorable. Recurrence was observed in 21% of cases. In the 33 patients with ANA at diagnosis, SLE was known in 11 patients, diagnosed concomitantly in 10 cases and in the year following diagnosis in 2 cases; 6 patients did not have SLE, and 4 patients were lost to follow-up (median follow-up, 19 mo; range, 3-39 mo). The presence of weight loss, arthralgia, skin lesions, and ANA was associated with the development of SLE (p < 0.05). Male sex and lymphopenia were associated with severe forms of KFD (p < 0.05). KFD can occur in all populations, irrespective of ethnic origin. Deep forms are common. An association with SLE should be investigated. A prospective study is required to determine the risk factors for the development of SLE.
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Affiliation(s)
- Guillaume Dumas
- From the Department of Internal Medicine (GD, CR), Hôpital d'Instruction des Armées Bégin, Saint-Mandé; Department of Internal Medicine 2 (JH, ZA), Pitié-Salpêtrière University Hospital, Paris; Department of Internal Medicine (PC), Pitié-Salpêtrière University Hospital, Paris; Department of Clinical Immunology (LG), Saint-Louis University Hospital, Paris; Department of Rheumatology (OM), Bichat University Hospital, Paris; Department of Internal Medicine (CD), Martinique University Hospital, Fort-de-France; Department of Internal Medicine (BG), Mondor University Hospital, Créteil; Department of Internal Medicine (EA), Cochin University Hospital, Paris; Department of Internal Medicine (OL), Bicêtre University Hospital, Le Kremlin-Bicêtre; Department of Internal Medicine (TP), Bichat University Hospital, Paris; Hôpital Européen Georges Pompidou (JP), Paris; Department of Internal Medicine (MH), Hôtel-Dieu University Hospital, Nantes; Department of Internal Medicine (CB), Tenon University Hospital, Paris; Department of Internal Medicine (EH), Huriez University Hospital, Lille; Department of Internal Medicine (TC), Hôpital d'Instruction des Armées du Val de Grace, Paris; Department of Internal Medicine (RD), Avicenne University Hospital, Bobigny; Department of Internal Medicine (MG, AM, OF), Jean Verdier University Hospital, Bondy; Department of Pathology (FC), Pitié-Salpêtrière University Hospital, Paris; Department of Internal Medicine (DF), Saint-Louis University Hospital, Paris; Department of Pathology (TM), Necker University Hospital, Paris; France; and Department of Internal Medicine (VP), Hôpital des Trois-Chêne, Hôpitaux Universitaires de Genève, Genève; and Department of Internal Medicine (JS), Hôpitaux Universitaires de Genève, Genève, Switzerland. Drs. Prendki and Fain contributed equally
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Gardette A, Ottaviani S, Tubach F, Roy C, Nicaise-Roland P, Palazzo E, Gill G, Meyer O, Dieudé P. High anti-CCP antibody titres predict good response to rituximab in patients with active rheumatoid arthritis. Joint Bone Spine 2014; 81:416-20. [DOI: 10.1016/j.jbspin.2014.06.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 06/02/2014] [Indexed: 02/07/2023]
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Bucalossi J, Missirlian M, Moreau P, Samaille F, Tsitrone E, van Houtte D, Batal T, Bourdelle C, Chantant M, Corre Y, Courtois X, Delpech L, Doceul L, Douai D, Dougnac H, Faïsse F, Fenzi C, Ferlay F, Firdaouss M, Gargiulo L, Garin P, Gil C, Grosman A, Guilhem D, Gunn J, Hernandez C, Keller D, Larroque S, Leroux F, Lipa M, Lotte P, Martinez A, Meyer O, Micolon F, Mollard P, Nardon E, Nouailletas R, Pilia A, Richou M, Salasca S, Travère JM. The WEST project: Testing ITER divertor high heat flux component technology in a steady state tokamak environment. Fusion Engineering and Design 2014. [DOI: 10.1016/j.fusengdes.2014.01.062] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ottaviani S, Moltó A, Ea HK, Neveu S, Gill G, Brunier L, Palazzo E, Meyer O, Richette P, Bardin T, Allanore Y, Lioté F, Dougados M, Dieudé P. Efficacy of anakinra in gouty arthritis: a retrospective study of 40 cases. Arthritis Res Ther 2014; 15:R123. [PMID: 24432362 PMCID: PMC3978950 DOI: 10.1186/ar4303] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Introduction Gout is a common arthritis that occurs particularly in patients who frequently have associated comorbidities that limit the use of conventional therapies. The main mechanism of crystal-induced inflammation is interleukin-1 production by activation of the inflammasome. We aimed to evaluate the efficacy and tolerance of anakinra in gouty patients. Methods We conducted a multicenter retrospective review of patients receiving anakinra for gouty arthritis. We reviewed the response to treatment, adverse events and relapses. Results We examined data for 40 gouty patients (32 men; mean age 60.0 ± 13.9 years) receiving anakinra. Mean disease duration was 8.7 ± 8.7 years. All patients showed contraindications to and/or failure of at least two conventional therapies. Most (36; 90%) demonstrated good response to anakinra. Median pain on a 100-mm visual analog scale was rapidly decreased (73.5 (70.0 to 80.0) to 25.0 (20.0 to 32.5) mm, P <0.0001), as was median C-reactive protein (CRP) level (130.5 (55.8 to 238.8) to 16.0 (5.0 to 29.5) mg/l, P <0.0001). After a median follow-up of 7.0 (2.0 to 13.0) months, relapse occurred in 13 patients after a median delay of 15.0 (10.0 to 70.0) days. Seven infectious events, mainly with long-term use of anakinra, were noted. Conclusions Anakinra may be efficient in gouty arthritis, is relatively well tolerated with short-term use, and could be a relevant option in managing gouty arthritis when conventional therapies are ineffective or contraindicated. Its long-term use could be limited by infectious complications.
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Ottaviani S, Gill G, Aubrun A, Palazzo E, Meyer O, Dieudé P. OP0008 Ultrasound in Gout: A Useful Tool for Follow-Up with Urate-Lowering Therapy. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Del Castillo F, Caniego T, Hurtado-Nédélec M, Chollet-Martín S, Gόmez-Rosas E, Kahn MF, Meyer O, Hayem G. THU0466 Unraveling the Genetic Basis of Familial SAPHO Syndrome with Next-Generation Sequencing. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4251] [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: 11/04/2022]
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Morel J, Berthelot J, Constantin A, Debandt M, Gaudin P, Vittecoq O, Maillefert J, Meyer O, Pham T, Saraux A, Solau Gervais E, Spitz E, Wendling D, Guillemin F, Fautrel B. SAT0156 The Flare-RA (Flare in Rheumatoid Arthritis) Questionnaire is Able to Detect Disease Activity Increase, I.E., Flare, Occurring between 2 Visits to the Rheumatologist::. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ottaviani S, Gill G, Palazzo E, Meyer O, Dieudé P. Ultrasonography of shoulders in spondyloarthritis and rheumatoid arthritis: A case-control study. Joint Bone Spine 2014; 81:247-9. [DOI: 10.1016/j.jbspin.2013.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 08/02/2013] [Indexed: 11/29/2022]
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Poyet JM, Meyer O, Christnacher F. Quantification of the atmospheric scintillation for laser illumination in active imaging. Opt Lett 2014; 39:2592-2594. [PMID: 24784053 DOI: 10.1364/ol.39.002592] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Most of the analytical scintillation models used by experts to simulate the illumination performances of active imaging systems are based on the use of monochromatic, punctual, and coherent sources. These analytical models seem pessimistic regarding lightpipe-based illumination techniques. Outdoor trials have been made with 1.57 μm laser illuminators with and without lightpipe to record illumination maps and associated refractive index structure parameter C(n)2 with a propagation distance of 1 km. Analysis shows a reduction of the scintillation by a factor of 2.5 comparing analytical models and laser illumination with lightpipe.
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