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Assaraf M, Chevet B, Philippe P, Avouac J, Delacour M, Houvenagel E, Pascart T, Henry J, Roux C, Wendling D, Paccou J, Cortet B, Devauchelle-Pensec V, Flipo RM. POS0818 TREATMENT OF POLYMYALGIA RHEUMATICA WITH TOCILIZUMAB: RESULTS OF AN OBSERVATIONAL RETROSPECTIVE MULTICENTER STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:In 2017, TOCILIZUMAB (TCZ) obtained marketing authorization for treatment of giant cell arteritis (GCA); however, this doesn’t extend to polymyalgia rheumatica (PMR) therapy. Based on efficacy data for TCZ in GCA, TCZ is sometimes used as a glucocorticoid (GC) sparing agent when PMR is GC dependent or when a rapid steroid withdraw is needed. Currently, there are no available recommendations on the use of this therapeutic class in for this particular indication.Objectives:Here, we present the results of an observational French multicentric study of patients with PMR treated with TCZ.Methods:Thirteen medical centers were included in this study. The data was collected retrospectively between 2015 and 2020. The minimum duration of treatment was 3 months. Patients were included when receiving TCZ for isolated PMR or associated with a non-active GCA (asymptomatic, no vascular fixation on PET scanner).Results:Overall, 34 patients were included (24 women; mean age 70.1 years (+/-10.3)). At TCZ introduction, patients had been treated with GC for a mean duration of 27,9 months (+/-25.9) and the mean GC dose was 16,8mg/d (+/-10). Fifteen patients (44%) had one or more complications from GC therapy. Another immunosuppressant was added before TCZ treatment for 25 (74%); mostly METHOTREXATE (24/25).TCZ was initiated intravenously at 8mg/kg every 4 weeks for 27 patients (79%) and subcutaneously at 162mg/week for 7 patients (21%).The reasons for TCZ introduction included GC dependence (n=30, 88%), and necessity of quick GC sparing (n=4 patients,12%).Of all patients, 76% (26 patients) had stopped GC treatment definitively, with a mean time of 9,4 (0-32) months.The mean TCZ treatment period was 19,2 months (3-66). Fifteen patients (44%) permanently stopped TCZ at the end of the observation period (8 prolonged remissions;1 myocardial infarction; 1 cutaneous lymphoma; 1 primary failure, 3 lost to follow up).Eighteen patients (60%) benefited from an attempted tapering of TCZ (infusion spacing or dose reduction), 6 attempts (1/3) led to a relapse. 1/2 patients had side effects mostly benign (cytopenia n=6, infections n=5).Conclusion:This is the largest cohort presenting results of the use of TCZ in PMR. Despite the small number of participants, our study suggests TCZ is effective as a GC sparing agent in PMR. As there are no official recommendations of use, indications for TCZ use within this population are no defined. Randomized Controlled Trial would be beneficial to validate these first results.References:[1]Toussirot, « Biothérapies, pseudo- polyarthrite rhizomélique et artérite à cellules géantes État des lieux en 2018 ».[2]Devauchelle-Pensec et al., « Efficacy of First-Line Tocilizumab Therapy in Early Polymyalgia Rheumatica ».[3]Genovese et al., « Longterm Safety and Efficacy of Tocilizumab in Patients with Rheumatoid Arthritis ».[4]Stone et al., « Trial of Tocilizumab in Giant-Cell Arteritis ».Disclosure of Interests:None declared
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Delepine T, Philippe P, Cailliau E, Houvenagel E, Deprez X, Flipo RM, Letarouilly JG. AB0464 DRUG SURVIVAL OF TNFi AND SECUKINUMAB IN AXIAL SPONDYLARTHRITIS: A REAL-WORLD MULTICENTRIC COHORT OF 370 PATIENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:IL17 inhibitors (IL17i) are an alternative for patients with axial spondyloarthritis (axSpA) who did not respond to TNF inhibitors (TNFi). Secukinumab (SEC) is the first human monoclonal antibody that binds to the protein interleukin-17A.Objectives:The objectives of this study were to describe the characteristics of axSpA patients treated with IL17i and TNFi and to assess the persistence with IL17i and TNFi in a real world cohort.Methods:A retrospective multicenter observational study was conducted. axSpA patients (pts) according to ASAS criteria initiating a IL17i or TNFi between June 2016 and December 2019 were included. Demographic features, current and previous use of biologic Disease-modifying antirheumatic drugs (bDMARDs) were collected. Date and reasons of discontinuation – i.e., lack of efficacy, safety issue, sustained remission or others – were collected. Kaplan-Meyer analysis were performed.Results:370 pts were included. Among the 202 patients who received TNFi, 90 (44.6%) were female, mean age was 43.2 +/- 13.2 years, mean body mass index was 26.1 kg/m2 +/- 5.4, 49 pts (46.7%) were smokers. The most common SpA phenotype was axial radiographic (n = 89, 54,9%) and 114 (68.3%) pts were HLA B27 positive, mean BASDAI was 57.5 +/- 14.6, median disease duration was 8.6 years [3.0-10.5]. Among the 168 patients who received SEC, 78 (46.4%) were female, mean age was 47.7 +/- 11.8 years, mean body mass index was 27.2 kg/m2 +/- 5.8, 45 pts (44.1%) were smokers. The most common SpA phenotype was axial radiographic (n = 106, 76,3%) and 114 (78.1%) pts were HLA B27 positive, mean BASDAI was 62.8 +/- 14.8, median disease duration was 9 years [5.0-19.0]. TNFi was the first line bDMARD in 116/202 pts (57.4%) and SEC was the first line bDMARD in 15/168 pts (8.9%). SEC was prescribed at 150mg every month in 121/168 (73.3%) pts. The median persistence with TNFi and SEC were 18.0 months [11.0-27.0] and 12.0 months [6.0-22.0], respectively. During the 3-year follow-up, 130 pts (42 with TNFi and 88 with SEC) discontinued treatment: 80 (22 with TNFi and 58 with SEC) for lack of effectiveness, 41 (16 with TNFi and 25 with SEC) for adverse events. No patient treated with SEC presented a new-onset inflammatory bowel disease.Figure 1.Persistence with SEC after 3 years of follow-upConclusion:In this real world cohort of AxSpA pts, SEC was mostly prescribed at second and third-line, contrary to axSpA pts treated with TNFi. Most reason of discontinuation were related to lack of effectiveness with both therapeutic classes.Disclosure of Interests:Thibaut DELEPINE: None declared., Peggy Philippe Speakers bureau: Abbvie, MSD, Fresenius, Pfizer, UCB Pharma, Novartis, Consultant of: Abbvie, MSD, Fresenius, Pfizer, UCB Pharma, Novartis, Emeline Cailliau: None declared., Eric Houvenagel: None declared., Xavier Deprez Speakers bureau: Pfizer, UCB, Abbvie, Novartis, MSD, Consultant of: Pfizer, UCB, René-Marc Flipo Speakers bureau: Novartis, Lilly, Abbvie, Pfizer, MSD, Consultant of: Novartis, Lilly, Abbvie, Pfizer, MSD, Jean-Guillaume Letarouilly Grant/research support from: Pfizer (research grant).
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Kedra J, Seror R, Dieudé P, Constantin A, Toussirot E, Kfoury E, Masson C, Cornec D, Dubost JJ, Marguerie L, Ottaviani S, Grados F, Belkhir R, Fain O, Goupille P, Sordet C, Fautrel B, Philippe P, Piperno M, Combe B, Lambotte O, Richez C, Sellam J, Sene T, Denis G, Lequerre T, Mariette X, Nocturne G. OP0125 LYMPHOMAS COMPLICATING RHEUMATOID ARTHRITIS: RESULTS OF A FRENCH MULTI-CENTRE CASE-CONTROL STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis (RA) is associated with an increased risk of non-Hodgkin B-cell lymphoma (B-cell NHL).Objectives:1)To study the characteristics of B-cell NHL complicating RA2)To identify the factors associated with their occurrence.Methods:A multi-centre case-control study was performed in France. Cases were patients with RA fulfilling the ACR-EULAR 2010 criteria, who developed a B-cell NHL after the diagnosis of RA. Cases were reported following a call for observations by the “Club Rhumatismes et Inflammation” network, registries from the French society of Rheumatology (AIR, ORA and REGATE) and the ESPOIR cohort. For each case, 2 control patients were drawn at random from patients in the ESPOIR cohort with RA fulfilling the ACR-EULAR 2010 criteria; cases and controls were matched on age (age at lymphoma diagnosis for cases and age at the 10-year ESPOIR visit for controls). Patients with associated Sjögren’s syndrome were excluded. Cases and controls characteristics were compared for parameters associated with the occurrence of lymphoma.Results:A total of 54 cases were included and matched to 108 controls. Lymphomas were mostly diffuse large B-cell lymphomas (n=26, 48.2%)(Figure 1). EBV positivity was found in 4 cases among 27 tested (14.8%). Cases had a mean age of 63.5 years (SD=10.9), and had a mean RA duration of 12.4 years (SD=10.5) at the time of diagnosis of lymphoma; there was no significant difference with controls (p=0.47 and p=0.40 respectively). The mean duration of follow-up after the diagnosis of lymphoma was 5.2 years (SD=5.8). In univariate analysis, factors associated with occurrence of B-cell NHL were: male gender (OR=3.3, 95%CI: 1.7-6.7), positive ACPA (OR=5.1, 95%CI: 2.0-15.7), positive Rheumatoid Factor (RF) (OR=3.9, 95%CI=1.6-12.2), erosions on X-rays (OR=15.4, 95%CI: 6.9-37.7) and DAS28 (OR=2.0, 95%CI: 1.5-2.7). Methotrexate, TNF-blockers and the number of previous biologics were not associated with the occurrence of B-cell NHL. Hydroxychloroquine and sulfasalazine were more frequent in cases versus control, which could be linked to a date bias. Erosions and DAS28 remained significant in multivariate analysis(Table 1).Conclusion:This study revealed an association between markers of activity (DAS28), severity (erosions) and autoimmune B-cell activation (RF and ACPA) and the risk of B-cell NHL in patients with RA, supporting the continuum between autoimmunity and lymphomagenesis in RA.Figure 1.lymphomas histologyTable 1.association between RA characteristics and B-cell NHL in univariate and multivariate analysisVariablesCases (N=54)Controls (N=108)Univariate analysisMultivariate analysisOR (95%CI)p-valueOR (95%CI)p-valueMale gender, N (%)27 (50.0)25 (23.2)3.3(1.7-6.7)0.00062.2(0.8-6.1)0.13Positive ACPA, N (%)49 (90.7)71 (65.7)5.1(2.0-15.7)0.0006--Positive RF, N (%)49 (90.7)77 (71.3)3.9(1.6-12.2)0.005--Positive RF or ACPA, N (%)49 (90.7)80 (74.1)3.4(1.3-10.6)0.012.9(0.7-15.0)0.16Erosions on X-rays, N (%)44 (81.5)26 (24.1)15.4(6.9-37.7)< 0.00019.8(3.8-28.2)< 0.0001DAS28 at B-cell NHL diagnosis/at the 10th year visit*, mean(SD)4.1 (1.6)2.6 (1.4)2.0(1.5-2.7)< 0.00011.9(1.3-2.8)0.0007*B-cell NHL diagnosis for cases, 10thyear visit for controlsDisclosure of Interests:Joanna KEDRA: None declared, Raphaèle Seror Consultant of: BMS UCB Pfizer Roche, Philippe Dieudé: None declared, Arnaud Constantin: None declared, ERIC TOUSSIROT: None declared, Elias Kfoury: None declared, Charles Masson: None declared, Divi Cornec: None declared, Jean-Jacques Dubost: None declared, Laurent Marguerie: None declared, Sebastien Ottaviani: None declared, Franck Grados: None declared, Rakiba Belkhir: None declared, olivier fain: None declared, Philippe Goupille Grant/research support from: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Lilly, Janssen, Medac, MSD France, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Consultant of: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Lilly, Janssen, Medac, MSD France, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Speakers bureau: AbbVie, Amgen, Biogen, BMS, Celgene, Chugai, Lilly, Janssen, Medac, MSD France, Nordic Pharma, Novartis, Pfizer, Sanofi and UCB, Christelle Sordet: None declared, Bruno Fautrel Grant/research support from: AbbVie, Lilly, MSD, Pfizer, Consultant of: AbbVie, Biogen, BMS, Boehringer Ingelheim, Celgene, Lilly, Janssen, Medac MSD France, Nordic Pharma, Novartis, Pfizer, Roche, Sanofi Aventis, SOBI and UCB, Peggy Philippe: None declared, Muriel PIPERNO: None declared, Bernard Combe Grant/research support from: Novartis, Pfizer, Roche-Chugai, Consultant of: AbbVie; Gilead Sciences, Inc.; Janssen; Eli Lilly and Company; Pfizer; Roche-Chugai; Sanofi, Speakers bureau: Bristol-Myers Squibb; Gilead Sciences, Inc.; Eli Lilly and Company; Merck Sharp & Dohme; Pfizer; Roche-Chugai; UCB, Olivier Lambotte Consultant of: BMS France, MSD, Astra Zeneca, Incyte, Christophe Richez Consultant of: Abbvie, Amgen, Mylan, Pfizer, Sandoz and UCB., Jérémie SELLAM: None declared, Thomas Sene: None declared, Guillaume Denis: None declared, Thierry Lequerre: None declared, Xavier Mariette Consultant of: BMS, Gilead, Medimmune, Novartis, Pfizer, Servier, UCB, Gaetane Nocturne: None declared
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Larabi IA, Fabresse N, Etting I, Nadour L, Pfau G, Raphalen JH, Philippe P, Edel Y, Alvarez JC. Prevalence of New Psychoactive Substances (NPS) and conventional drugs of abuse (DOA) in high risk populations from Paris (France) and its suburbs: A cross sectional study by hair testing (2012-2017). Drug Alcohol Depend 2019; 204:107508. [PMID: 31670189 DOI: 10.1016/j.drugalcdep.2019.06.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/12/2019] [Accepted: 06/03/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND The aim of the present study is to describe the prevalence of NPS and conventional DOA in Paris and its suburbs over a six-year period using hair testing approach. METHOD Hair was sampled in patients admitted to different departments of Paris hospitals between 2012 and 2017. Two high-risk populations were mainly considered: 1) drug-dependent and 2) acutely intoxicated patients. Segmental hair analysis was performed by validated LC-MS/MS method to screen for DOA and 83 NPS. RESULTS 480 patients (280 M/200 F, 15-70 years) were included. 141 patients tested positive for NPS (99 M/42 F; median age: 33). NPS prevalence was 29%, that of amphetamines, cocaine and opioids were 32%, 38.5% and 52%, respectively. 27 NPS were identified, 4-MEC and mephedrone (number of cases n = 24 each) were the most detected cathinones. JWH-122 (n = 1) was the only detected synthetic cannabinoid while ketamine (n = 104) was present in numerous NPS users (67%). 3-fluorofentanyl (n = 1), furanylfentanyl (n = 1), N-ethylpentylone (n = 2), pentedrone (n = 2), mexedrone (n = 1), methcathinone (n = 3), 6-APDB (n = 2), TFMPP (n = 2), 2-CE (n = 1), 3,4-MD-αPHP (n = 1) and dextromethorphan (n = 27) were identified for the first time in hair. Users were found to have more than one NPS in 53% of cases, mostly in combination with conventional DOA. The number of detected NPS rose from 5 in 2012 to 42 in 2017. A broad range of hair concentrations (0.001-318 ng/mg) was found, but the low median concentrations seem to show an occasional exposure more than chronic use. CONCLUSION NPS screening should be assessed in routine clinical practice, especially in high-risk populations.
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Affiliation(s)
- I A Larabi
- Department of Pharmacology and Toxicology, Versailles Saint-Quentin-en-Yvelines University, Inserm U-1173, Raymond Poincaré Hospital, AP-HP, 104, Raymond Poincaré Blvd., 92380 Garches, France
| | - N Fabresse
- Department of Pharmacology and Toxicology, Versailles Saint-Quentin-en-Yvelines University, Inserm U-1173, Raymond Poincaré Hospital, AP-HP, 104, Raymond Poincaré Blvd., 92380 Garches, France
| | - I Etting
- Department of Pharmacology and Toxicology, Versailles Saint-Quentin-en-Yvelines University, Inserm U-1173, Raymond Poincaré Hospital, AP-HP, 104, Raymond Poincaré Blvd., 92380 Garches, France
| | - L Nadour
- Talan Solutions, 21 Dumont d'Urville Street, 75016, Paris, France
| | - G Pfau
- Addiction Clinic, Pitié Salpétrière Hospital, AP-HP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - J H Raphalen
- Intensive Care Unit, AP-HP, Necker Hospital, 149 Sèvres Street, 75015 Paris, France
| | - P Philippe
- Intensive Care Unit, AP-HP, Necker Hospital, 149 Sèvres Street, 75015 Paris, France
| | - Y Edel
- Addiction Clinic, Pitié Salpétrière Hospital, AP-HP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - J C Alvarez
- Department of Pharmacology and Toxicology, Versailles Saint-Quentin-en-Yvelines University, Inserm U-1173, Raymond Poincaré Hospital, AP-HP, 104, Raymond Poincaré Blvd., 92380 Garches, France.
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Jouffroy R, Saade A, Durand S, Philippe P, Carli P, Vivien B. Predicting value of prehospital body temperature for ICU admission of septic shock patients. Acute Med 2019; 18:56-58. [PMID: 32608397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To specify whether an association exists between pre-hospital body temperature collected by the emergency medical services (EMS) call centre, and intensive care unit (ICU) admission of patients with septic shock. An observational study based on data collected by the EMS of Paris. All septic shocks were included. Among, the 140 calls concerning septic shock, 22 patients (16%) were admitted to ICU. The mean core temperature was 37.4±1.6°C for ICU and 38.6±1.1°C (p<4.10^-5) for non-ICU patients. Using propensity score analysis, the relative risk for ICU admission of patients with pre-hospital fever or hypothermia was 0.31 and 2 respectively. The study highlights the potential usefulness of early temperature measurement in septic shock patients to allow early proper orientation.
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Affiliation(s)
- R Jouffroy
- Department of Anesthesia & Intensive Care Unit, SAMU, Hôpital Necker - Enfants Malades 149 rue de Sèvres 75015 Paris, University Paris Descartes, France
| | - A Saade
- Department of Anesthesia & Intensive Care Unit, SAMU, Hôpital Necker - Enfants Malades 149 rue de Sèvres 75015 Paris, University Paris Descartes, France
| | - S Durand
- Department of Anesthesia & Intensive Care Unit, SAMU, Hôpital Necker - Enfants Malades 149 rue de Sèvres 75015 Paris, University Paris Descartes, France
| | - P Philippe
- Department of Anesthesia & Intensive Care Unit, SAMU, Hôpital Necker - Enfants Malades 149 rue de Sèvres 75015 Paris, University Paris Descartes, France
| | - P Carli
- Department of Anesthesia & Intensive Care Unit, SAMU, Hôpital Necker - Enfants Malades 149 rue de Sèvres 75015 Paris, University Paris Descartes, France
| | - B Vivien
- Department of Anesthesia & Intensive Care Unit, SAMU, Hôpital Necker - Enfants Malades 149 rue de Sèvres 75015 Paris, University Paris Descartes, France
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Rochard J, Wang R, Alary A, Lecuona Y, Philippe P. Ingénierie écologique appliquée aux effuents vinicoles : exemple du dispositif de BlueSET Phytostation ® dans la cave « Les Vignerons de Buzet ». BIO Web Conf 2019. [DOI: 10.1051/bioconf/20191202002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Le traitement des effuents vinicoles est très souvent réalisé par des systèmes aérobies avec des bassins ouverts. Au-delà de la consommation d'énergie, ces dispositifs génèrent souvent des nuisances sonores, olfactives et visuelles, ce qui impose le plus souvent d'éloigner le dispositif de la cave. La coopérative « Les Vignerons de de Buzet », située dans le sud-ouest de la France, qui a déjà développé une démarche durable pour le vignoble et la cave, a souhaité intégrer une zone humide associée au traitement des effuents de cave avec le procédé breveté de la société BlueSET spécialisée dans le génie écologique. Après une première étape de traitement en aérobie, le dispositif se compose d'un ensemble de bassins dans lesquels sont implantés majoritairement de plantes locales non invasives. Il a pour objectif de favoriser la biodiversité et de permettre aux visiteurs de profiter de manière didactique d'une zone de promenade écologique qui valorise l'image environnementale de la cave. Les résultats de la première année démontrent que les performances sont compatibles avec les normes de rejet locales.
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Jouffroy R, Saade A, Alexandre P, Philippe P, Carli P, Vivien B. Epinephrine administration in non-shockable out-of-hospital cardiac arrest. Am J Emerg Med 2018; 37:387-390. [PMID: 29857945 DOI: 10.1016/j.ajem.2018.05.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/20/2018] [Accepted: 05/24/2018] [Indexed: 10/16/2022] Open
Abstract
BACKGROUND Epinephrine is recommended for the treatment of non-shockable out of hospital cardiac arrest (OHCA) to obtain return of spontaneous circulation (ROSC). Epinephrine efficiency and safety remain under debate. OBJECTIVE We propose to describe the association between the cumulative dose of epinephrine and the failure of ROSC during the first 30 min of advanced life support (ALS). METHODOLOGY A retrospective observational cohort study using the Paris SAMU 75 registry including all non-traumatic OHCA. All OHCA receiving epinephrine during the first 30 min of ALS were enrolled. Cumulative epinephrine dose given during ALS to ROSC was retrieved from medical reports. RESULTS Among 1532 patients with OHCA, 776 (51%) had initial non-shockable rhythm. Fifty-four patients were excluded for missing data. The mean value of cumulative dose of epinephrine was 10 ± 4 mg in patients who failed to achieve ROSC (ROSC-) and 4 ± 3 mg (p = 0.04) for those who achieved ROSC. ROC curve analysis indicated a cut-off point of 7 mg total cumulative epinephrine associated with ROSC- (AUC = 0.89 [0.86-0.92]). Using propensity score analysis including age, sex and no-flow duration, association with ROSC- only remained significant for epinephrine > 7 mg (p ≤10-3, OR [CI95] = 1.53 [1.42-1.65]). CONCLUSION An association between total cumulative epinephrine dose administered during OHCA resuscitation and ROSC- was reported with a threshold of 7 mg, best identifying patients with refractory OHCA. We suggest using this threshold in this context to guide the termination of ALS and early decide on the implementation of extracorporeal life support or organ harvesting in the first 30 min of ALS.
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Affiliation(s)
- R Jouffroy
- Department of Anesthesia & Critical Care - SAMU, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France.
| | - A Saade
- Department of Anesthesia & Critical Care - SAMU, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France
| | - P Alexandre
- Department of Anesthesia & Critical Care - SAMU, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France
| | - P Philippe
- Department of Anesthesia & Critical Care - SAMU, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France
| | - P Carli
- Department of Anesthesia & Critical Care - SAMU, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France
| | - B Vivien
- Department of Anesthesia & Critical Care - SAMU, Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France
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Benkirane O, Mairesse O, Schmitz R, Philippe P, Neu D. Non-invasive ventilation exerts a neurocognitive impact on the generalization of false memories in obstructive sleep apnea patients. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.083] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jouffroy R, Saade A, Carpentier A, Ellouze S, Philippe P, Idialisoa R, Carli P, Vivien B. Triage of Septic Patients Using qSOFA Criteria at the SAMU Regulation: A Retrospective Analysis. PREHOSP EMERG CARE 2017; 22:84-90. [DOI: 10.1080/10903127.2017.1347733] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Jouffroy R, Carton S, Fabresse N, Philippe P, Lamhaut L, Alvarez JC, Baud FJ. Efficacité épuratrice de la CVVHDF et du MARS au cours d’une intoxication simulée par le vérapamil. Toxicologie Analytique et Clinique 2017. [DOI: 10.1016/j.toxac.2017.03.035] [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: 10/19/2022]
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Jouffroy R, Carton S, Fabresse N, Caill N, Philippe P, Lamhaut L, Alvarez JC, Baud FJ. Efficacité épuratrice de la CVVHDF et du MARS au cours d’une intoxication simulée par le pentobarbital. Toxicologie Analytique et Clinique 2017. [DOI: 10.1016/j.toxac.2017.03.093] [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: 10/19/2022]
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Nawrot V, Vandenkerkhof L, Philippe P, Falvo G, Fontier C. INF-02 - Étude sur la peur de l’infirmier(ère) du risque de transmission du vihselon ses connaissances. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30588-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Resseguier A, Rieu V, Le Guenno G, Grobost V, Philippe P, Ruivard M. Les anticoagulants oraux directs : une alternative thérapeutique dans le syndrome des antiphospholipides ? Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Corli J, Flipo RM, Philippe P, Bera-Louville A, Wibaux C, Paccou J. THU0212 Tumor Necrosis Factor α Inhibition in Ankylosing Spondylitis and Non Radiographic Axial Spondyloarthritis: Treatment Response, Drug Survival and Patient Outcome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2156] [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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Rivière E, Arnaud L, Ebbo M, Allanore Y, Claudepierre P, Dernis E, Ziza J, Philippe P, Richez C, Soubrier M, Miceli-Richard C, Mariette X, Pavy S. SAT0244 Association Between Spondyloarthritis and Takayasu Arteritis: a Study of 14 Cases. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Philippe P, Alzieu JP, Taylor MA, Dorchies P. Comparative efficacy of diclazuril (Vecoxan®) and toltrazuril (Baycox bovis®) against natural infections of Eimeria bovis and Eimeria zuernii in French calves. Vet Parasitol 2014; 206:129-37. [PMID: 25458561 PMCID: PMC7127088 DOI: 10.1016/j.vetpar.2014.10.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 10/02/2014] [Accepted: 10/04/2014] [Indexed: 01/04/2023]
Abstract
A blinded, randomized, controlled, multi-centric field study was conducted on French dairy farms (n = 9) to evaluate the long term efficacy of metaphylactic, single oral treatments with either 1 mg/kg body weight (BW) of diclazuril (Vecoxan®), or 15 mg/kg BW of toltrazuril (Baycox®) against natural infections with Eimeria zuernii and/or Eimeria bovis, compared to untreated control animals. A total of 199 calves from nine commercial farms aged between 21 and 55 days old at the start of study were included and randomly allocated to one of three groups. Calves on all farms were observed for a period of 78 days post treatment, using both parasitological (oocyst excretion), and clinical parameters (faecal score and body weight). The assessment of efficacy was based on both control of oocyst excretion, and on the average daily weight gains throughout the study. During the whole study period, the mean number of days with diarrhoea (≥ 2) was similar (0.7 days) between treated groups. Excretion in the untreated group peaked at 21 days after treatment. In both the diclazuril and toltrazuril-treated groups, mean oocyst excretion decreased dramatically in the five days following treatment. Thereafter, particularly towards the end of the study period, oocyst counts and percentage levels of E. zuernii were highest in the toltrazuril-treated group. In pooled data from all trial sites, the average daily weight gain was significantly (p = 0.01) higher (+ 0.057 kg/day) in the diclazuril group when compared to the toltrazuril group, and the average body weight gain of the diclazuril treated group was 4.4 kg higher than the toltrazuril group. On eight of the nine trial sites, the average daily gain was greater in the diclazuril group than in the toltrazuril group. This study demonstrates that, over an extended observation period of 78 days, metaphylactic treatment with both diclazuril and toltrazuril reduces the impact of coccidiosis, but greater performance benefits based on average daily weight gains, were achieved following the use of diclazuril.
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Ramaekers VT, Thöny B, Sequeira JM, Ansseau M, Philippe P, Boemer F, Bours V, Quadros EV. Folinic acid treatment for schizophrenia associated with folate receptor autoantibodies. Mol Genet Metab 2014; 113:307-14. [PMID: 25456743 DOI: 10.1016/j.ymgme.2014.10.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 09/30/2014] [Accepted: 10/01/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Auto-antibodies against folate receptor alpha (FRα) at the choroid plexus that block N(5)-methyltetrahydrofolate (MTHF) transfer to the brain were identified in catatonic schizophrenia. Acoustic hallucinations disappeared following folinic acid treatment. Folate transport to the CNS prevents homocysteine accumulation and delivers one-carbon units for methyl-transfer reactions and synthesis of purines. The guanosine derivative tetrahydrobiopterin acts as common co-factor for the enzymes producing dopamine, serotonin and nitric oxide. METHODS Our study selected patients with schizophrenia unresponsive to conventional treatment. Serum from these patients with normal plasma homocysteine, folate and vitamin B12 was tested for FR autoantibodies of the blocking type on serial samples each week. Spinal fluid was analyzed for MTHF and the metabolites of pterins, dopamine and serotonin. The clinical response to folinic acid treatment was evaluated. RESULTS Fifteen of 18 patients (83.3%) had positive serum FR auto-antibodies compared to only 1 in 30 controls (3.3%) (χ(2)=21.6; p<0.0001). FRα antibody titers in patients fluctuated over time varying between negative and high titers, modulating folate flux to the CNS, which explained low CSF folate values in 6 and normal values in 7 patients. The mean±SD for CSF MTHF was diminished compared to previously established controls (t-test: 3.90; p=0.0002). A positive linear correlation existed between CSF MTHF and biopterin levels. CSF dopamine and serotonin metabolites were low or in the lower normal range. Administration of folinic acid (0.3-1mg/kg/day) to 7 participating patients during at least six months resulted in clinical improvement. CONCLUSION Assessment of FR auto-antibodies in serum is recommended for schizophrenic patients. Clinical negative or positive symptoms are speculated to be influenced by the level and evolution of FRα antibody titers which determine folate flux to the brain with up- or down-regulation of brain folate intermediates linked to metabolic processes affecting homocysteine levels, synthesis of tetrahydrobiopterin and neurotransmitters. Folinic acid intervention appears to stabilize the disease process.
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Affiliation(s)
- V T Ramaekers
- Division of Paediatric Neurology, Centre Hospitalier Universitaire de Liège, Liège, Belgium; Centre for Autism Liège, Centre Hospitalier Universitaire de Liège, Liège, Belgium.
| | - B Thöny
- Division of Metabolism, University Children's Hospital Zurich, Switzerland
| | - J M Sequeira
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - M Ansseau
- Department of Psychiatry, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - P Philippe
- Centre for Autism Liège, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - F Boemer
- Department of Human Genetics and Metabolism, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - V Bours
- Department of Human Genetics and Metabolism, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - E V Quadros
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA
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Segaud N, Haffner C, Philippe P, Deprez X, Houvenagel E, Coquerel P, Cortet B, Flipo RM. SAT0242 Therapeutic Response to TOCILIZUMAB in Rheumatoid Arthritis: Does Body Weight Have an Influence? Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3855] [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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Courties A, Grateau G, Philippe P, Flipo RM, Astudillo L, Aubry-Rozier B, Fabreguet I, Fahd W, Fain O, Guggenbuhl P, Hachulla E, Papo T, Richez C, Sibilia J, Morel J, Berenbaum F, Sellam J. THU0362 Aa Amyloidosis Treated by Tocilizumab: Efficacy in Inflammatory And/Or Anti-TNF Alpha Refractory Forms - an International Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2343] [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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Paccou J, Soubrier AS, Philippe P, Cortet B, Flipo RM. AB0667 Biological Therapy for Psoriatic Arthritis in Clinical Practice. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2368] [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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Schneider A, Gottrand F, Bellaiche M, Becmeur F, Lachaux A, Michel J, Dabadie A, Faure C, Philippe P, Vandenplas Y, Breton A, Dupont C, Gaudin J, Lamireau T, Muyshont L, Podevin G, Viola S, Bertrand V, Caldari D, Colinet S, Sokal E, Leteurtre E, Michaud L. SFCP CO-18 - Prévalence de l’œsophage de Barrett dans l’atrésie de l’œsophage. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71656-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kasbaoui S, Schneider A, Gomes Ferreira C, Philippe P, Sapin E, Varlet F, Demarche M, Lacreuse I, Flaum V, Ranke A, Becmeur F. SFCP CO-78 - Vaginoplastie sigmoidienne par coelioscopie : pour quelles patientes, quand et comment? Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lahaye C, Makarawiez C, Le Guenno G, Le Quang C, Rieu V, Philippe P, Ruivard M. Hépatosidérose dysmétabolique : une série de 283 patients. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.050] [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: 10/26/2022]
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Resseguier AS, Rieu V, Makarawiez C, Le Quang C, Philippe P, Le Guenno G, Ruivard M. Abcès hépatospléniques : pensez à la maladie des griffes du chat ! Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.178] [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: 10/26/2022]
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Philippe P, Cirimele V. Intoxication au sulfure d’hydrogène sur des plages costarmoricaines. Ann Fr Med Urgence 2013. [DOI: 10.1007/s13341-013-0322-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Resseguier AS, Le Quang C, Makarawiez C, Rieu V, Philippe P, Ruivard M. Myopathie nécrosante auto-immune associée aux anticorps anti SRP et grossesse. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.097] [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: 10/26/2022]
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Fraisse T, Makarawiez C, Le Quang C, Le Guenno G, Rieu V, Philippe P, Ruivard M. L’immunocompétence ne protège pas de la toxoplasmmose cérébrale ! : à propos d’un cas. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
We present here experimental results on the progressive development of a fluidized zone in a bed of grains, immersed in a liquid, under the effect of a localized upward flow injected through a small orifice at the bottom of the bed. Visualization inside the model granular medium consisting of glass beads is made possible by the combined use of two optical techniques: refractive index matching between the liquid and the beads and planar laser-induced fluorescence. Gradually increasing the injection rate, three regimes are successively observed: static bed, fluidized cavity that does not open to the upper surface of the granular bed, and finally fluidization over the entire height of the granular bed inside a fluidized chimney. The phase diagram is plotted and partially interpreted using a model previously developed by Zoueshtiagh and Merlen [F. Zoueshtiagh and A. Merlen, Phys. Rev. E 75, 053613 (2007)]. A typical sequence, where the flow rate is first increased and then decreased back to zero, reveals a strong hysteretic behavior since the stability of the fluidized cavity is considerably strengthened during the defluidization phase. This effect can be explained by the formation of force arches within the granular packing when the chimney closes up at the top of the bed. A study of the expansion rate of the fluidized cavity was also conducted as well as the analysis of the interaction between two injection orifices with respect to their spacing.
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Affiliation(s)
- P Philippe
- Irstea, UR OHAX, 3275 route de Cézanne, CS40061, Aix-en-Provence, F-13182 France
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Rieu V, Chanier S, Philippe P, Ruivard M. Systematic screening for occult cancer in elderly patients with venous thromboembolism: a prospective study. Intern Med J 2012; 41:769-75. [PMID: 21309993 DOI: 10.1111/j.1445-5994.2011.02448.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cancer is an established risk factor for venous thromboembolism (VTE) and the incidence of cancer increases in the elderly. The benefit of screening for occult cancers in this population is still not clear. AIM To evaluate a systematic screening programme for cancer in elderly patients with VTE. METHODS This was a prospective study with a 12-month follow-up period. It was conducted in a single centre in consecutive patients over the age of 70 years who had a confirmed diagnosis of VTE. Predefined non-invasive screening techniques for cancer with clinical, laboratory (including tumour markers) and radiological investigations (abdominal ultrasound, chest X-ray and a thoraco-abdominopelvic computed tomography scan) were evaluated. RESULTS Fifty patients with a median age of 80 years (range: 70 to 94 years) were included. One patient was diagnosed with chronic lymphocytic leukaemia at inclusion and cancers were found in three other patients during the follow-up period (rectosigmoid adenocarcinoma with hepatic metastases, hepatocellular carcinoma and gastric adenocarcinoma). Only one of the four cancers could have been treated at an earlier stage. The mortality rate of the entire cohort after 12 months was 28%. Two patients died as a direct consequence of cancer. DISCUSSION In this study of elderly patients, a non-invasive screening strategy did not detect several cancers that were subsequently overt clinically. A full history, clinical examination and routine laboratory investigations might be the optimal first-line strategy to detect cancer after the diagnosis of VTE in elderly patients, but regular clinical examinations during follow up are warranted.
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Affiliation(s)
- V Rieu
- Department of Internal Medicine, CHU Estaing, Clermont-Ferrand Department of Medicine, Centre Hospitalier, Riom, France.
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Mania A, Le Quang C, Rieu V, Makarawiez C, Le Guenno G, Philippe P, Ruivard M. La thrombose veineuse superficielle : la partie visible de l’iceberg à ne pas négliger ! Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Makarawiez C, Le Guenno G, Le Quang C, Rieu V, Philippe P, Ruivard M. L’hyperferritinémie en consultation de médecine interne. Étude rétrospective portant sur 523 patients. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.021] [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: 11/25/2022]
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Grobost V, Rieu V, Le Guenno G, Makarawiez C, Le Quang C, Philippe P, Ruivard M. Thromboses portes et mésentériques. Étude rétrospective de 33 cas. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.061] [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: 10/28/2022]
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Lahaye C, Sortais E, Le Guenno G, Ruivard M, Rieu V, Philippe P. Lupus érythémateux systémique révélé par un syndrome extrapyramidal et une dysmyélopoïèse. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Philippe P, Aumaitre O. [Places of interest, human, key for the dawn of time…]. Rev Med Interne 2012; 33 Suppl 1:S1-2. [PMID: 22522065 DOI: 10.1016/j.revmed.2012.03.003] [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: 10/28/2022]
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Philippe A, Ruivard M, Gallot D, Andre M, Lemery D, Philippe P. Gestion du péripartum chez les patientes sous traitement anticoagulant : les internistes sont concernés. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.03.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mrozek N, Ruivard M, Gallot D, Le Guenno G, Rieu V, Philippe P. Étiologie des thrombopénies pendant la grossesse et prise en charge des thrombopénies immunologiques. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.03.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hermet M, le Guenno G, Rieu V, Philippe P, Ruivard M. [Nasosinusal and cervical sarcoidosis: a case series of three patients and literature review]. Rev Med Interne 2011; 33:46-9. [PMID: 21601318 DOI: 10.1016/j.revmed.2011.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2010] [Revised: 01/18/2011] [Accepted: 04/11/2011] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Sinonasal sarcoidosis is difficult to treat. Infliximab seems to be useful in the treatment of sarcoidosis of the upper respiratory tract. CASE SERIES We report three cases of sinonasal sarcoidosis in two women of 36 and 42-year-old and in a 64-year-old man. Resistance or dependence to corticosteroids and absence of efficacy of methotrexate therapy in one patient led to administer anti-TNFα therapy with infliximab. Outcome was favourable on sarcoid lesions but treatment was discontinued because of infectious complications and worsening of sarcoid chest involvement. CONCLUSION This case series suggests that infliximab might be useful for the treatment of sarcoidosis with sinonasal involvement.
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Affiliation(s)
- M Hermet
- Service de médecine interne, hôpital Estaing, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
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Barnichon C, Ruivard M, Philippe P, Vidal P, Teissonière M. [Type 2 diabetes and universal health care for low-income groups: a case-control study]. Rev Med Interne 2011; 32:467-71. [PMID: 21292357 DOI: 10.1016/j.revmed.2010.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 12/13/2010] [Accepted: 12/31/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE In 2007 in France, type 2 diabetes involved 2.5 million people, and 4.5 million patients received free healthcare coverage under the universal healthcare coverage program (CMU) for low-income households. An optimal glycemic control and adequate diabetes monitoring can reduce the incidence of complications. The objective of this study was to compare the diabetes care of low-income patients (as defined by CMU coverage) with the rest of the population. METHODS A retrospective case-control study (non-CMU and CMU) over a one-year period of glycemic control for both populations through private laboratory data (number and values of HbA1c) and of individuals monitoring through data from the regional health insurance public institute. RESULTS Regarding glycemic control, 154 patients were included. The number of annual HbA1c tests was similar between CMU and non-CMU patients. The mean HbA1c value was higher for CMU patients (8.7% versus 8%; P<0.01). Regarding monitoring, 1254 patients were included. Over a one-year period, the number of HbA1c tests, lipid profile tests, serum creatinine measures and cardiology consultations were similar across groups. However, CMU patients benefited from less microalbuminuria testing (P<0.001), ophthalmologic monitoring visits (P<0.01), endocrinology consultations (P<0.01), and from more general physician consultations (P<0.001). CONCLUSIONS Receiving CMU health coverage was associated with a poorer glycemic control and lesser specialized monitoring than that was observed in control patients. Across the population, follow-up recommendations are far from being implemented satisfactorily.
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Affiliation(s)
- C Barnichon
- Département de médecine générale, faculté de médecine, 28, place Henri-Dunant, BP 38, 63001 Clermont-Ferrand cedex 1, France
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Philippe P. [General practitioner--psychiatrist: friends or enemies?]. Rev Med Liege 2011; 66:92-101. [PMID: 21661205] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The author's purpose is to highlight the role differences between a general practitioner and a psychiatrist. She bases her review on the literature as well as on her personal experience which consists of 25 years as a general practitioner followed by 10 years as a psychiatrist. The colleagues' respective opinion of one another was assessed by means of two questionnaires. One was administered to a hundred psychiatrists and the other to a hundred general practitioners on the occasion of two separate medical meetings. The results of these questionnaires, statements found in the medical literature as well as the author's personal experience confirm that, even if the collaboration between general practitioners and psychiatrists is considered important, it remains very difficult and conditioned by numerous preconceived ideas. By clarifying the roles and specificities of each practitioner, this article aims at improving this collaboration which is pivotal for the patient's mental health progression.
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Affiliation(s)
- P Philippe
- Centre de Ressource Autisme, Université de Liège, CHU de Liège, Belgium.
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Paccou J, Solau-Gervais E, Houvenagel E, Salleron J, Luraschi H, Philippe P, Duquesnoy B, Flipo RM. Efficacy in current practice of switching between anti-tumour necrosis factor- agents in spondyloarthropathies. Rheumatology (Oxford) 2010; 50:714-20. [DOI: 10.1093/rheumatology/keq377] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Makarawiez C, Le Guenno G, Rieu V, Tournilhac O, Philippe P, Ruivard M. Thromboses et purpura thrombopénique immunologique. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sibon D, Deligny C, Sarrault-Raynaud F, Launay D, Durand JM, Philippe P, Quere I, Adoue D, Roblot P, Constans J, Durant C, Farge D. Activité française comparée à l’activité européenne pour greffe de cellules souches hématopoïétiques dans le traitement des maladies auto-immunes. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Affiliation(s)
- P Philippe
- Service de médecine interne, centre de compétences cytopénies auto-immunes, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France.
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Guerin F, Podevin G, Petit T, Lopez M, Erpicum P, Delagausie P, Lardy H, Bonnard A, Thollot A, Philippe P, Larroquet M, Sapin E, Kurzenne J, Le Mandat A, Francois-Fiquet C, Gaudin J, Valioulis I, Morisson-Lacombe G, Motupet P, Demarche M. CL039 - Étude rétrospective multicentrique du GECI sur 114 duplications digestives opérées par thoracoscopie ou laparoscopie. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70255-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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46
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Deligny C, Martin T, Keshmandt H, Durand JM, Sarrot-Reynauld F, Philippe P, Adoue D, Roblot P, Quere I, Constans J, Launay D, Farge D. L’essai européen ASTIS : 151 patients (48 en France avec le soutien du GFRS et de l’AFS) inclus en 9 ans. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.126] [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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47
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Ruivard M, Vaillant-Roussel H, Ouchchane L, Dauphin C, Rieu V, Le Guenno G, Philippe P. Caractéristiques et facteurs de récidive d’une maladie thrombo-embolique veineuse survenue sous contraception œstro-progestative (172 patientes). Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.149] [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: 11/16/2022]
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48
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Tousignant M, Arsenault A, Corriveau H, Philippe P. Clinical evaluation of patient following stroke: Proposed stroke patient taxonomy based on cluster analysis method. Physiother Theory Pract 2009. [DOI: 10.1080/095939800407277] [Citation(s) in RCA: 2] [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: 10/17/2022]
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50
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Mrozek N, Ruivard M, Leguenno G, Rieu V, Philippe P. Le rituximab est-il efficace sur les anticorps antiphospholipides ? Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.03.183] [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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