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Shah S, Jatar SS, Hsueh J, Gallagher L, Pepin A, Danner M, Zwart A, Ayoob MJ, Yung T, Kumar D, Aghdam N, Leger P, Dawson N, Suy S, Collins SP. Bothersome Hot Flashes Following Neoadjuvant Androgen Deprivation Therapy and Stereotactic Body Radiotherapy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e258-e259. [PMID: 37784992 DOI: 10.1016/j.ijrobp.2023.06.1210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Androgen deprivation therapy (ADT) may improve cancer control in unfavorable localized prostate cancer treated with stereotactic body radiotherapy (SBRT). ADT is known to cause hormonally related symptoms that resolve with testosterone recovery. Hot flashes are particularly burdensome. This study sought to evaluate the timeline of hot flashes following short-course ADT and SBRT as well as its relationship with testosterone recovery. MATERIALS/METHODS Institutional IRB approval was obtained for this retrospective review of prospectively collected data (IRB#: 2009-510). ADT was initiated three months prior to the start of SBRT. Hot flashes were self-reported via question 13a a healthcare software prior to ADT initiation, the first day of robotic SBRT, and at each follow-up (1, 3, 6, 9, 12, 18, 24 and 36 months). The responses were grouped into three relevant categories (no problem, very small-small problem and moderate-big problem). Scores were transformed to a 0-100 scale with higher scores reflecting less bother. Testosterone levels were measured at each follow-up. RESULTS From 2007 to 2010, 122 localized prostate cancer patients (9 low-, 64 intermediate-, and 49 high-risk according to the D'Amico classification) at a median age of 72 years (range 54.5-88.3) were treated with short course ADT (3-6 months) and SBRT (35-36.25 Gy) at Georgetown University Hospital. Thirty-two percent were black and 27% were obese. 77% of patient received three months of ADT. At baseline, 2% of men experienced hot flashes that were a "moderate to big problem" and that proportion peaked at the start of SBRT (45%) before returning to baseline 9 months post-SBRT with a cumulative incidence of 52.4%. The median baseline healthcare software hot flash score of 94 declined to 50 at the start of SBRT but this returned to baseline by six months post SBRT. These changes were both statistically and clinically significant (MID = 9.5083). Testosterone recovery (> 230 ng/dL) occurred in approximately 70% of patients by 12 months post SBRT. Resolution of hot flashes correlated with testosterone recovery. CONCLUSION Bothersome hot flashes occur in greater than 50% of men treated with neoadjuvant ADT. Resolution of hot flashes occurs in the majority of patients within one year after treatment. Reassurance of the temporary nature of hot flashes may assist in reducing patient anxiety. Measuring testosterone levels at follow-up visits may allow for anticipatory counseling that may limit the associated bother.
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Affiliation(s)
- S Shah
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - S S Jatar
- Georgetown School Of Medicine, Washington, DC
| | - J Hsueh
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - L Gallagher
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - A Pepin
- Department of Radiation Oncology, Abramson Cancer Center, Hospital of University of Pennsylvania, Philadelphia, PA
| | - M Danner
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - A Zwart
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - M J Ayoob
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - T Yung
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - D Kumar
- Biotechnology Research Institute, North Carolina Central University, Durham, NC
| | - N Aghdam
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Washington, DC
| | - P Leger
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - N Dawson
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - S Suy
- Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, DC
| | - S P Collins
- Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, DC
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Jatar SS, Shah S, Hsueh J, Gallagher L, Danner M, Zwart A, Ayoob MJ, Yung T, Kumar D, Leger P, Aghdam N, Dawson N, Suy S, Collins SP. Bothersome Gynecomastia Following Neoadjuvant GnRH Agonists and Stereotactic Body Radiotherapy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e238-e239. [PMID: 37784943 DOI: 10.1016/j.ijrobp.2023.06.1163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Androgen deprivation therapy (ADT) is increasingly utilized in combination with stereotactic body radiotherapy (SBRT) for unfavorable prostate cancer. ADT such as gonadotropin releasing hormone (GnRH) agonists are known to cause hormonal-related side effects such as gynecomastia. The incidence of bothersome breast tenderness and/or enlargement following short course GnRH agonists and SBRT is unknown. This study sought to evaluate the timeline of gynecomastia as well as its relationship with testosterone recovery. MATERIALS/METHODS Gynecomastia was self-reported via question 13b of a healthcare software prior to ADT initiation, the first day of robotic SBRT, and at each follow-up (1, 3, 6, 9, 12, 18, 24 and 36 months). The responses were grouped into three relevant categories (no problem, very small-small problem, and moderate-big problem). Scores were transformed to a 0-100 scale with higher scores reflecting less bother. Testosterone levels were measured at each follow-up. RESULTS From 2007 to 2010, 122 localized prostate cancer patients (9 low-, 64 intermediate-, and 49 high-risk according to the D'Amico classification) at a median age of 72 years (range 54.5-88.3) were treated with short course ADT (3-6 months) and SBRT (35-36.25 Gy) at Georgetown University Hospital. Of the participants, 48% percent were non-white and 48% were overweight. 77% of patients received three months of ADT. At baseline, 2% of men experienced gynecomastia that was a "moderate to big problem" and that proportion peaked at 3 and 12 months post-SBRT (7%) before returning to less than baseline (0%) 24 months post-SBRT with a cumulative incidence of 14.75%. The median baseline healthcare software hot flash score of 98 declined to 90 at 3 months post-SBRT but this returned to baseline by 24 months post SBRT. These changes were both statistically and clinically significant (MID = 6.5). Testosterone recovery (> 230 ng/dL) occurred in approximately 70% of patients by 12 months post SBRT. The development and resolution of gynecomastia fluctuated at various timepoints and did not directly correlate with testosterone recovery. CONCLUSION Bothersome gynecomastia occurs in less than 15% of men treated with neoadjuvant ADT. Resolution of gynecomastia occurs in most patients within two years after treatment. Reassurance of the temporary nature of gynecomastia may assist in reducing patient anxiety. Institutional IRB (IRB#: 2009-510) approval was obtained for retrospective review of prospectively collected data.
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Affiliation(s)
- S S Jatar
- Georgetown School Of Medicine, Washington, DC
| | - S Shah
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - J Hsueh
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - L Gallagher
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - M Danner
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - A Zwart
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - M J Ayoob
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - T Yung
- Department of Radiation Medicine, Georgetown University Hospital, Washington, DC
| | - D Kumar
- Biotechnology Research Institute, North Carolina Central University, Durham, NC
| | - P Leger
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - N Aghdam
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Washington, DC
| | - N Dawson
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - S Suy
- Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, DC
| | - S P Collins
- Department of Radiation Medicine, MedStar Georgetown University Hospital, Washington, DC
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Bihouee T, Perrin A, David V, Constantini M, Leger P, Cassard A, Clement E. WS09-4 “Quand la muco s'invite à votre table”: a therapeutic education tool to explore the representations about food from parents of young screen children. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30169-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Honton B, Mastrokostopoulos A, Philippart R, Sauguet A, Leger P. [Lower extremity arteriopathy disease in the elderly: A systematic review]. Ann Cardiol Angeiol (Paris) 2018; 67:450-454. [PMID: 30343821 DOI: 10.1016/j.ancard.2018.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Lower Extremity Arteriopathy Disease in the elderly is frequent with an ongoing increase of it prevalence and incidence mainly due to diabetes, hypertension and aging of the population. Despite improvement of revascularization therapy, outcome in this population is poor affected by frailty of elderly patient. Aging is associated with a higher prevalence of below the knee disease and wound, often with diagnostic delay leading to a major rate of amputation, mortality and alteration of quality of life. Moreover, it leads to an important health cost for society. This review aims to describe main features of LEAD in the elderly, providing keys for early recognition and managing of such disease in this population.
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Affiliation(s)
- B Honton
- Department of Interventional Cardiology, Clinique Pasteur, 45, avenue de Lombez, 31300 Toulouse, France.
| | - A Mastrokostopoulos
- Department of Interventional Cardiology, Clinique Pasteur, 45, avenue de Lombez, 31300 Toulouse, France
| | - R Philippart
- Department of Interventional Cardiology, Clinique Pasteur, 45, avenue de Lombez, 31300 Toulouse, France
| | - A Sauguet
- Department of Interventional Cardiology, Clinique Pasteur, 45, avenue de Lombez, 31300 Toulouse, France
| | - P Leger
- Wounds Care Unit, Clinique Pasteur, 45, avenue de Lombez, 31300 Toulouse, France
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Pavie A, Muneretto C, Aupart M, Rabago G, Leger P, Tedy G, Bors V, Gandjbakhch I, Cabrol C. Prognostic Indices of Survival in Patients Supported with Temporary Devices (Tah, Vad). Int J Artif Organs 2018. [DOI: 10.1177/039139889101400507] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- A. Pavie
- Hôpital De La Pitié, Paris - France
| | | | | | | | | | - G. Tedy
- Hôpital De La Pitié, Paris - France
| | - V. Bors
- Hôpital De La Pitié, Paris - France
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Rothschild S, Leger P, Castellanos E, Pillai R, York S, Horn L. Response to salvage chemotherapy following exposure to PD-1/PD-L1 inhibitors in patients with NSCLC. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Markel D, Levesque IR, Larkin J, Leger P, El Naqa I. MO-AB-BRA-09: Temporally Realistic Manipulation a 4D Biomechanical Lung Phantom for Evaluation of Simultaneous Registration and Segmentation. Med Phys 2015. [DOI: 10.1118/1.4925279] [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: 11/07/2022] Open
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David V, Leger P, You F, Chevalier D, Loppinet V. 245 Identifying needs in education for children aged 7–8 y and their parents. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30420-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hickling S, Leger P, Naqa IE. TH-CD-304-06: Amplitude and Frequency Characteristics of Acoustic Waves Induced Following Radiotherapy Linear Accelerator Irradiation. Med Phys 2015. [DOI: 10.1118/1.4926212] [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: 11/07/2022] Open
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Leger P, David V, Le Rhun A, Chevalier D. 290 Dietary forcing and conflicts during meals for children suffering from cystic fibrosis: The psychologist's point of view. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30464-1] [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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Gonzalez-Bermejo J, Perrin C, Janssens JP, Pépin JL, Mroue G, Leger P, Langevin B, Rouault S, Rabec C, Rodenstein D. Proposition pour une analyse systématique de la polygraphie et de la polysomnographie afin d’identifier les évènements anormaux survenant pendant la ventilation non invasive. Rev Mal Respir 2014; 31:312-22. [DOI: 10.1016/j.rmr.2013.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 05/22/2013] [Indexed: 10/26/2022]
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Rabec C, Rodenstein D, Leger P, Rouault S, Perrin C, Gonzalez-Bermejo J. [Ventilator modes and settings during non-invasive ventilation: effects on respiratory events and implications for their identification. 2011]. Rev Mal Respir 2013; 30:818-31. [PMID: 24314706 DOI: 10.1016/j.rmr.2013.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 05/22/2013] [Indexed: 11/26/2022]
Abstract
Compared with invasive ventilation, non-invasive ventilation (NIV) has two unique characteristics: its non-hermetic nature and the fact that the ventilator-lung assembly cannot be considered as a single-compartment model because of the presence of variable resistance represented by the upper airways. When NIV is initiated, the ventilator settings are determined empirically based on clinical evaluation and blood gas variations. However, NIV is predominantly applied during sleep. Consequently, to assess overnight patient-machine "agreement" and efficacy of ventilation, more specific and sophisticated monitoring is needed. The effectiveness of NIV might therefore be more correctly assessed by sleep studies than by daytime assessment. The simplest monitoring can be done from flow and pressure curves from the mask or the ventilator circuit. Examination of these tracings can give useful information to evaluate if the settings chosen by the operator were the right ones for that patient. However, as NIV allows a large range of ventilatory parameters and settings, it is mandatory to have information about this to better understand patient-ventilator interaction. Ventilatory modality, mode of triggering, pressurization slope, use or not of positive end expiratory pressure and type of exhalation as well as ventilator performances may all have physiological consequences. Leaks and upper airway resistance variations may, in turn, modify these patterns. This article discusses the equipment available for NIV, analyses the effect of different ventilator modes and settings and of exhalation and connecting circuits on ventilatory traces and gives the background necessary to understand their impact on nocturnal monitoring of NIV.
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Affiliation(s)
- C Rabec
- Service de pneumologie et réanimation respiratoire, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, 21079 Dijon, France.
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Beurtheret S, Mordant P, Paoletti X, Marijon E, Celermajer DS, Leger P, Pavie A, Combes A, Leprince P. Emergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program). Eur Heart J 2012; 34:112-20. [DOI: 10.1093/eurheartj/ehs081] [Citation(s) in RCA: 208] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Evans M, Larkin J, Siva B, Leger P, Patrocinio H, Parker W. SU-E-T-300: Linac Bunker Access Control System for An Exactrac/Novalis Imaging Systems. Med Phys 2011. [DOI: 10.1118/1.3612251] [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: 11/07/2022] Open
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Abstract
Management of venous thromboembolism disease could be improved by new drugs with lower risk of bleeding and without the need of regular monitoring of anticoagulant effect. In this way, idraparinux, anti-Xa inhibitor, has been compared to conventional therapy (coumarins) for the treatment of deep vein thrombosis and pulmonary embolism. Is it worth to treat patients more than six months? This has been evaluated in an interesting study. Prophylaxis after hip replacement surgery is indicated to reduce the risk of venous thromboembolism, new drugs are under investigation. Dabigatran etexilate, a direct thrombin inhibitor, has been shown as effective as enoxaparin in reducing the risk of venous thromboembolism after total hip replacement surgery. In 2007, new european guidelines for non-STsegment elevation acute coronary syndromes have been published. Two new antithrombotic drugs, bivalirudin and fondaparinux, are now part of the different possible choices according to specific considerations. New factor Xa and factor IIa inhibitors are under investigation and are compared to heparin in PCI for NSTE-ACS. Fondaparinux and more recently otamixaban have given interesting results. These new recommendations have not yet taken into account new data published in 2007. What will be the positioning of prasugrel, a new thienopyridine, after the results of theTRITON trial? In patients with SCA treated by PCI, prasugrel reduced the ischemic events, while increasing major bleedings. In 2007, numerous publications and meta-analyses on drug-eluting stents (DES) have been published and tempered the fear about a possible increase in mortality with the use of DES.
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Affiliation(s)
- G Helft
- Institut de cardiologie, hôpital Pitié-Salpêtrière, AP-HP, 47, boulevard de l'Hôpital, 75013 Paris, France.
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Berville C, Gagnayre R, Iguenane J, Douaud P, Chevalier D, Dumas V, Vanbrabant M, Leger P, David V. Conceptual approach of an educational evaluation system for patients. J Cyst Fibros 2009. [DOI: 10.1016/s1569-1993(09)60379-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Rambouillet sheep originating from Spanish Merino have been maintained in France as a small and closed flock since their importation. After 190 years of independent evolution, the flock has markedly differentiated from its Spanish parental population. The observed differences between them were characterized by the fixation in Rambouillet of the Mb and F30 alleles, which occurred in Spanish Merino with frequencies of 0.90 and 0.80 respectively (at two distinct blood group loci M and F30) and by the absence in Rambouillet of other alleles or phenogroups (at the Tf and the A, B, C blood group loci) which were observed in Spanish Merino with frequencies ranging from 0.10 to 0.28. On the basis of their phenotypic distributions at 11 blood polymorphic loci, the two populations differed significantly from each other (total chi 2 values = 352.62, 23 df, P less than 0.001). By comparing the observed magnitude of gene frequency differences between Rambouillet and Spanish Merino with the estimate of inbreeding coefficient for Rambouillet obtained from pedigrees, it appeared that the observed genetic differences could be attributed to the evolutionary change due to random drift in the small and closed flock of Rambouillet.
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Affiliation(s)
- T C Nguyen
- Département de Génétique animale, INRA-CRJ, Jouy-en-Josas, France
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Leger P, Paulus J. [Non-invasive positive pressure ventilation for neuromuscular diseases. Recommendations for clinical practice]. Rev Mal Respir 2006; 23:14S7-14S9. [PMID: 17151544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Leger P, Paulus J. Modalités pratiques de la ventilation non invasive en pression positive, au long cours dans les maladies neuromusculaires. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72072-1] [Citation(s) in RCA: 4] [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: 11/28/2022]
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Leger P, Paulus J. Modalités pratiques de la ventilation non invasive en pression positive, au long cours dans les maladies neuromusculaires. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71805-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cacoub P, Cambou J, Belliard J, Beregi J, Branchereau A, Carpentier P, Kownator S, Leger P, Luizy F, Maiza D, Mihci E, Herrmann M, Priollet P. Prévalence de l’artériopathie oblitérante des membres inférieurs (AOMI) par la mesure de l’index de pression systolique (IPS) dans une population de patients à haut risque cardiovasculaire consultant en médecine générale: l’étude ipsilon. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s0398-0499(06)76583-0] [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: 10/22/2022]
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Leger P, Paulus J. [Recommendations of HAS: Practical issues in home non-invasive ventilation in patients with neuromuscular disease]. Rev Mal Respir 2006; 23:13S141-3. [PMID: 17057639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Pavie A, Leprince P, Bonnet N, Leger P, Gandjbakhch I. [What's new in mechanical circulatory assistance: from clinical indications to material]. Arch Mal Coeur Vaiss 2006; 99:164-70. [PMID: 16555700] [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: 05/08/2023]
Abstract
Over the years, mechanical circulatoryassistance has progressively improved with the evolution of the clinical indications and the introduction of new devices. The management of situations of extreme emergency, cardiac arrest, acute myocardial infarction with cardiogenic shock, drug overdose, acute myocarditis, postoperative cardiac failure and post-transplantation right ventricular failure, may be undertaken with relatively simple systems such as the ECMO, in the catheter laboratory or at the bedside in the intensive care unit. These systems enable stabilisation of the circulatory problems in order to pass a difficult situation and then withdraw the assistance when myocardial function has been restored. When this is not possible and there is no contra-indication to cardiac transplantation, patients may benefit from more complex assistance devices as a bridge to transplantation. Many continuous flow pumps have been introduced recently. These small mono, left ventricular, assist devices provide improved patient comfort and suggest wider indications of long duration assist devices.
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Affiliation(s)
- A Pavie
- Service de chirurgie thoracique et cardiovasculaire, Institut de cardiologie, hôpital La Pitié-Salpêtrière, 47, bd de l'Hôpital, 75013 Paris.
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David V, Berville C, Douaud P, Dumas V, Greffier C, Leger P, Marion A, de Pontbriand U. 508 Collective therapeutic education for Cystic Fibrosis children in Nantes (France). J Cyst Fibros 2006. [DOI: 10.1016/s1569-1993(06)80430-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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David V, Berville C, Douaud P, Dumas V, Leger P, De Pontbriand U, Bailly C. Éducation thérapeutique et mucoviscidose : l’expérience d’un CRCM pédiatrique. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)85595-0] [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: 11/26/2022]
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Laroche M, Moulinier L, Leger P, Lefebvre D, Mazières B, Boccalon H. Bone mineral decrease in the leg with unilateral chronic occlusive arterial disease. Clin Exp Rheumatol 2003; 21:103-6. [PMID: 12673899] [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] [Indexed: 03/01/2023]
Abstract
OBJECTIVE The links between osteoporosis and arteriosclerosis have been established by numerous epidemiological studies. Could arteriosclerosis induce bone mineral loss via ischemia or other pathological process? We carried out a comparative study of bone mineral density in both legs of patients with unilateral arterial disease of the lower limbs. METHODS We studied 25 patients, 22 men and 3 women, whose mean age was 62.3 years (range 35-88 years). These patients had unilateral lower limb arterial disease of at least 3 months duration with a systolic index at least 50% lower on the affected than on the healthy side. Bone mineral content (BMC) and bone mineral densities (BMD) of the femoral neck, femur, tibia, foot and ankle of the affected and the unaffected legs were measured by dual x-ray absorptiometry (Lunar DPXL) and the results compared. RESULTS Bone mineral density was significantly lower in the femur (-3.7%, p = 0.04), the foot and the ankle (-3%, p = 0.05) of the affected leg. There was a non-significant decrease in BMD of the whole femoral neck (-1.2%) and the trochanter (-4.4%, p = 0.08) on the affected side. Tibial bone mineral density was identical in both legs. Bone mineral content was lower on the affected side (-5.3%, p = 0.05) whereas fat mass and muscle mass were the same in both legs. CONCLUSION The ischemia resulting from arterial disease of the lower limbs appears to have a direct deleterious effect on bone mineralization.
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Affiliation(s)
- M Laroche
- Service de Rhumatologie, CHU Rangueil, 1 Avenue J. Poulhès, 31403 Toulouse, France.
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Abstract
Originating from centres charged with the care of patients with chronic respiratory insufficiency, noninvasive ventilation (NIV) has been used increasingly in chronic and acute respiratory failure during the last decade. Despite a considerable number of series and randomised studies advocating access to NIV for units that treat acute or chronic ventilatory failure, the number of units and the proportion of total ventilatory support remains poor. This is due to lack of education, as many units treat only a few patients per year. Indication, technique, education, monitoring and home care require special experience and a special environment and there is a wide range throughout Europe. With respect to home care in particular, there are many organisations, which range from totally private to hospital based or run for profit. A concerted action, funded by the European Union, will soon provide valuable information about the practice of home ventilation in Europe based on a European survey.
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Affiliation(s)
- P Leger
- Actions Médicales, Association Française Contre les Myopathies, Evry Cedex, France.
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Leger P, Cambus JP, Herault JP, Herbert JM, Boneu B. Anti-thrombotic effect of a synthetic heparin mimetic in an arterial model of thrombosis in rats: comparison with unfractionated heparin and nadroparin. Thromb Haemost 2002; 88:687-8. [PMID: 12362245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Dorent R, Tezenas S, Ghossoub JJ, Leger P, Lendvai N, Vaissier E, Levasseur JP, Eslami M, Pavie A, Gandjbakhch I. Long-term use of cyclosporine in cardiac transplantation: the Pitié experience. Transplant Proc 2002; 34:831-3. [PMID: 12034199 DOI: 10.1016/s0041-1345(01)02926-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- R Dorent
- Hôpital Pitié-Salpêtrière, Paris, France.
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31
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Leger P, Cambus JP, Herault JP, Herbert JM, Boneu B. Anti-Thrombotic Effect of a Synthetic Heparin Mimetic in an Arterial Model of Thrombosis in Rats: Comparison with Unfractionated Heparin and Nadroparin. Thromb Haemost 2002. [DOI: 10.1055/s-0037-1613277] [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: 10/17/2022]
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32
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Dorent R, Mohammadi S, Tezenas S, Silvaggio G, Ghossoub JJ, Leger P, Vaissier E, Leprince P, Carnot F, Riquet M, Pavie A, Gandjbakhch I. Lung cancer in heart transplant patients: a 16-year survey. Transplant Proc 2000; 32:2752-4. [PMID: 11134787 DOI: 10.1016/s0041-1345(00)01867-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- R Dorent
- Service de Chirurgie Cardio-Vasculaire et Thoracique, Hôpitaux Pitié-Salpêtrière, Paris, France
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33
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Dorent R, Beaudeux JL, Tezenas S, Ghossoub JJ, Roussouliere AL, Leger P, Vaissier E, Bonnet N, Leprince P, Regan M, Pavie A, Foglietti MJ, Cacoub P, Gandjbakhch I. Circulating levels of matrix metalloproteinases in heart transplant recipients. Transplant Proc 2000; 32:2750-1. [PMID: 11134786 DOI: 10.1016/s0041-1345(00)01866-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- R Dorent
- Service de Chirurgie Cardio-Vasculaire et Thoracique, Hôpital Pitié-Salpêtrière, Paris, France
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34
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Pavie A, Leger P, Regan M, Szefner J, Nataf P, Bors V, Vaissier E, Gandjbakhch I. Emergency mechanical circulatory support: still viable? J Heart Lung Transplant 2000; 19:S101-4. [PMID: 11016497 DOI: 10.1016/s1053-2498(00)00108-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- A Pavie
- Department of Thoracic and Cardiovascular Surgery, La Pitié Hospital, Paris, France
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35
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Pavie A, Dorent R, Reagan M, Akthar R, Leger P, Vaissier E, Levasseur JP, Bors V, Gandjbakhch I. La Pitié heart transplantation: 30-year single center clinical experience. Clin Transpl 1999:311-4. [PMID: 10503109] [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: 02/14/2023]
Abstract
At La Pitié Hospital, 1,184 patients underwent cardiac transplantation for end-stage cardiac disease (1,122 orthotopic and 62 heterotopic) between April 1968-November 1998. Since April 1986, 140 patients have been supported using several different mechanical assist devices as a bridge to transplantation. Twenty-four retransplantations (2.2%) were performed for primary graft failure in 4 (17%), refractory acute rejection in 7(29%), coronary graft disease in 11 (46%) and others in 2 (8%) patients. In a case-control study, retransplanted patients were matched with first transplant patients and survival rates at one and 5 years were 59.4% and 38.8% compared with survival rates for retransplanted patients of 45.4% and 31.2%, respectively. Seventy-four patients survived more than 10 years (61 males, 13 females). Mortality did not increase after 10 years. Unfortunately many suffered complications: 77% had hypertension, hypercholesterolemia (22%), hyperuricemia (41%), osteoporosis (11%), osteonecrosis (5%) and diabetes (7%). Renal function remains one of the main problems; 16% had a creatinine > 180 mumol/L and patients are on chronic dialysis.
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Affiliation(s)
- A Pavie
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpétrière Hospital, Paris, France
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36
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Arnold M, Witte H, Leger P, Boccalon H, Bertuglia S, Colantuoni A. Time-variant spectral analysis of LDF signals on the basis of multivariate autoregressive modelling. Technol Health Care 1999; 7:103-12. [PMID: 10463300] [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] [Indexed: 02/13/2023]
Abstract
Time-variant AR-modelling was used to analyse the non-stationary properties of LDF signals during provocation tests. The procedure for the estimation of time-varying AR parameters based on Kalman filtering is presented. The estimates can be used to calculate instantaneous measures, such as peak frequency, spectral band power and coherence. The resulting course of instantaneous peak frequency of a sinusoidal signal with frequency jump was compared to similar parameters derived from short-time FFT and Hilbert transformation. Univariate time-variant spectral analysis was used to investigate LDF measurements in patients with Raynaud's phenomena. The experimental protocol was splitted into phases of different room temperature. The results demonstrate time-dependent variations of spectral components (amplitude and frequency). By means of time-variant coherence analysis of LDF and diameter measurements of vessels in a hamster skin fold the existence of a main rhythm around 0.1 Hz in the LDF signals which is related to vasomotion is shown.
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Affiliation(s)
- M Arnold
- Institute of Medical Statistics, Computer Sciences and Documentation, Medical Faculty of the Friedrich Schiller University Jena, Germany
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37
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Maniewski R, Leger P, Lewandowski P, Liebert A, Bendayan P, Boccalon H, Bajorski L, Möller KO. Spectral analysis of laser-Doppler perfusion signal measured during thermal test. Technol Health Care 1999; 7:163-9. [PMID: 10463305] [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] [Indexed: 02/13/2023]
Abstract
The method of spectral analysis of laser-Doppler perfusion signal measured during thermal test is proposed. During three 20 min phases with 40, 5, and 40 degrees C of thermal test laser-Doppler perfusion signal was recorded. For each signal phase frequency spectra were calculated using the FFT method. Quantitative parameter Spectral Factor for results evaluation was proposed. In total 94 patients were measured: 69 with Raynaud's phenomenon and 25 normal subjects. Additionally in 18 Raynaud's patients the influence of Nifedipine was studied. Results suggest that proposed parameter is able to differentiate between Raynaud's patients and normal subjects and that is useful for evaluation of Nifedipine effectiveness. However, further studies are needed to improve the method to differentiate between primary and secondary Raynaud's patients.
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Affiliation(s)
- R Maniewski
- Institute of Biocybernetics and Biomedical Engineering PAS, Warsaw, Poland.
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38
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Popivanov D, Mineva A, Bendayan P, Leger P, Boccalon H, Möller KO. Dynamic characteristics of laser-Doppler flux in normal individuals and patients with Raynaud's phenomenon before and after treatment with nifedipine under different thermal conditions. Technol Health Care 1999; 7:193-203. [PMID: 10463308] [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] [Indexed: 02/13/2023]
Abstract
The study was aimed at choosing an appropriate characteristic of laser-Doppler flux (LDF) data for (1) distinguishing patients with Raynaud's disease from normal controls and (2) evaluating the effect of nifedipine under different thermal conditions. We checked the reliability of three characteristics of nonlinear dynamics as statistical dimension Ds, correlation dimension D2 and power-law index PLI. Their values depended heavily on the thermal condition. The most reliable characteristics that enabled us to distinguish the patients from normal controls and the effect of nifedipine under definite thermal condition proved to be Ds and PLI. The latter is simple for computation and is thus recommendable for clinical practice. Ds and PLI were higher in patients with Raynaud's compared to normal controls and diminished during the transitions from low to high temperature. However, the characteristics used were unable to distinguish significantly Raynaud's I from Raynaud's II patients.
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Affiliation(s)
- D Popivanov
- Institute of Physiology, BAS, Sofia, Bulgaria.
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39
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Stefanovska A, Leger P, Bracic M, Bracic T, Bendayan P, Boccalon H. Linear and nonlinear analysis of blood flow in healthy subjects and in subjects with Raynaud's phenomenon. Technol Health Care 1999; 7:225-41. [PMID: 10463311] [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] [Indexed: 02/13/2023]
Abstract
The paper presents analyses of the dynamics contained in the blood flow signals measured on healthy subjects and on subjects with primary Raynaud's phenomenon. Different signal processing methods are presented and discussed. The dynamics was evaluated in the time and frequency domains and in phase space. Additionally, changes in the basal value during temperature provocation were studied using multiresolution analysis. The analyses demonstrate differences between the blood flow dynamics in healthy subjects and subjects with Raynaud's phenomenon. Moreover, the observed decrease in the amplitude of oscillation in regions approximately 0.04 Hz and approximately 0.1 Hz suggests an impairment in the neurogenic and the myogenic regulation of the blood flow. The administration of nifedipine in subjects with Raynaud's phenomenon results in an increase in the basal value and in the amplitude of the blood flow component oscillating with the heart rate. However, it does not restore the dynamics to that found in healthy subjects.
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Affiliation(s)
- A Stefanovska
- Faculty of Electrical Engineering, University of Ljubljana, Slovenia.
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40
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Bertuglia S, Leger P, Colantuoni A, Coppini G, Bendayan P, Boccalon H. Different flowmotion patterns in healthy controls and patients with Raynaud's phenomenon. Technol Health Care 1999; 7:113-23. [PMID: 10463301] [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] [Indexed: 02/13/2023]
Abstract
Flowmotion was characterized in healthy controls and 61 Raynaud's phenomenon (RP) patients by spectral analysis of laser-Doppler perfusion monitoring (LDPM) tracings. Healthy subjects flowmotion patterns revealed a main frequency of 3 cycles per min (cpm) with another low frequency and heart rate synchronous components. A first group of RP patients presented a low frequency and heart rate frequency component but no significant difference in blood flow. The second group presented the predominating heart rate related frequency with low microvascular perfusion. The third group presented a flowmotion pattern with overlapping of heart rate and low frequency components. Patients with primary and secondary RP show specific changes in flowmotion, probably related to increased sympathetic nervous activity or vessel wall alterations causing disappearance of arteriolar tone and impairment of microvascular perfusion. The group of patients with overlapping frequency components presents an intermediate flowmotion pattern indicating a different grade of alterations in microvasculature.
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Affiliation(s)
- S Bertuglia
- CNR Institute of Clinical Physiology, University of Pisa, Italy
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41
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Alexopoulos V, Kollias S, Leger P, Boccalon H, Csiki Z. Higher-order spectral analysis in laser-Doppler flowmetry signal processing. Technol Health Care 1999; 7:85-101. [PMID: 10463299] [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] [Indexed: 02/13/2023]
Abstract
This paper presents an application of higher order statistics and spectra to the problem of laser-Doppler Flowmetry (LDF) for microcirculation monitoring. The proposed signal processing technique computes the bispectra of LDF signals after appropriate pre-processing and extracts features which can be used for classification of the signals to a normal or patient category. Bispectra are defined in terms of the third-order moments or cumulants of signals and are shown to contain valuable information for the above classification of LDF signals. Experimental studies, including (a) a set of 17 normal subjects and 69 patients with Raynaud's phenomenon and (b) 50 LDF-signals separated to four groups from patients that have different pathologic characteristics, are described and results are presented which illustrate the performance of the proposed approach when applied to the LDF signals.
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Affiliation(s)
- V Alexopoulos
- Department of Electrical and Computer Engineering, National Technical University of Athens, Greece.
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42
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Abstract
BACKGROUND Most bleeding in cardiovascular surgery is biological, not surgical, the result of disseminated intravascular coagulation in its latter phases. Disseminated intravascular coagulation bleeding affects all levels of the coagulation systems, requiring stabilization of the platelet system, balancing the procoagulant system and its regulation, and stopping the fibrinolytic system's activation. METHODS The article discusses the multisystem protocol put into place at the Cardiovascular Surgery Department of La Pitié Hospital in Paris to diagnose and treat DIC bleeding so as to slow down causes of its occurrence and prevent further deterioration of the hemostatic systems. RESULTS All biological bleeding was controlled, permitting detection of other causes of bleeding and allowing rational use of blood products. No thromboembolic accident occurred. There was an absence of iatrogenic bleeding. The protocol also detects disseminated intravascular coagulation in patients who did not bleed to take early and frequently lifesaving measures. CONCLUSIONS This demonstrates the need to treat bleeding through a multisystem approach, monitoring its evolution by means of biological tests to be able to provide appropriate treatment.
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Affiliation(s)
- A Pavie
- Department of Thoracic and Cardiovascular Surgery, La Pitié Hospital, Paris, France
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43
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Bertuglia S, Leger P, Colantuoni A, Coppini G, Bendayan P, Boccalon H. Different flowmotion patterns in healthy controls and patients with Raynaud’s phenomenon. Technol Health Care 1999. [DOI: 10.3233/thc-1999-72-303] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- S. Bertuglia
- CNR Institute of Clinical Physiology, University of Pisa, 56100 Pisa, Italy
| | - P. Leger
- Department of Angiology, Rangueil Hospital, 31054 Toulouse, Cedex, France
| | - A. Colantuoni
- CNR Institute of Clinical Physiology, University of Pisa, 56100 Pisa, Italy
| | - G. Coppini
- CNR Institute of Clinical Physiology, University of Pisa, 56100 Pisa, Italy
| | - P. Bendayan
- Department of Angiology, Rangueil Hospital, 31054 Toulouse, Cedex, France
| | - H. Boccalon
- Department of Angiology, Rangueil Hospital, 31054 Toulouse, Cedex, France
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44
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Maniewski R, Leger P, Lewandowski P, Liebert A, Bendayan P, Boccalon H, Bajorski L, Möller K. Spectral analysis of laser-Doppler perfusion signal measured during thermal test. Technol Health Care 1999. [DOI: 10.3233/thc-1999-72-307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- R. Maniewski
- Institute of Biocybernetics and Biomedical Engineering PAS, Warsaw, Poland
| | - P. Leger
- Hospital Rangueil, Toulouse, France
| | - P. Lewandowski
- Institute of Biocybernetics and Biomedical Engineering PAS, Warsaw, Poland
| | - A. Liebert
- Institute of Biocybernetics and Biomedical Engineering PAS, Warsaw, Poland
| | | | | | - L. Bajorski
- Ruhr-Universität Bochum, Biomedical Research, Lübeck, Germany
| | - K.O. Möller
- Ruhr-Universität Bochum, Biomedical Research, Lübeck, Germany
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Quéré I, de Moerloose P, Bounameaux H, Bellet H, Zittoun J, Leger P, Mercier P, Berrut G, Pinède L, Gris J, Dupuy E, Ninet J, Boccalon H, Boneu B, Conri C, Schved J, Janbon C. Homocystéine, folates et maladie thromboembolique veineuse. Rev Med Interne 1999. [DOI: 10.1016/s0248-8663(99)80192-1] [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: 11/24/2022]
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46
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Popivanov D, Mineva A, Bendayan P, Leger P, Boccalon H, Moller K. Dynamic characteristics of laser-Doppler flux in normal individuals and patients with Raynaud’s phenomenon before and after treatment with nifedipine under different thermal conditions. Technol Health Care 1999. [DOI: 10.3233/thc-1999-72-310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- D. Popivanov
- Institute of Physiology, BAS, 1113 Sofia, Bulgaria
| | - A. Mineva
- Institute of Physiology, BAS, 1113 Sofia, Bulgaria
| | | | - P. Leger
- Hospital Rangueil, Toulouse, France
| | | | - K.O. Moller
- Ruhr-University Bochum, Biomedical Research, Luebeck, Germany
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47
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Arnold M, Witte H, Leger P, Boccalon H, Bertuglia S, Colantuoni A. Time-variant spectral analysis of LDF signals on the basis of multivariate autoregressive modelling*. Technol Health Care 1999. [DOI: 10.3233/thc-1999-72-302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- M. Arnold
- Institute of Medical Statistics, Computer Sciences and Documentation, Medical Faculty of the Friedrich Schiller University Jena, Germany
| | - H. Witte
- Institute of Medical Statistics, Computer Sciences and Documentation, Medical Faculty of the Friedrich Schiller University Jena, Germany
| | - P. Leger
- Hopitaux de Toulouse, CHU Rangueil, Angiologie, France
| | - H. Boccalon
- Hopitaux de Toulouse, CHU Rangueil, Angiologie, France
| | - S. Bertuglia
- CNR Institute of Clinical Physiology, Univ. di Pisa, Italy
| | - A. Colantuoni
- CNR Institute of Clinical Physiology, Univ. di Pisa, Italy
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48
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Quéré I, de Moerloose P, Bounameaux H, Bellet H, Zittoun J, Leger P, Mercier P, Berrut G, Pinède L, Gris J, Dupuy E, Ninet J, Boccalon H, Boneu B, Conri C, Schved J, Janbon C. Vitamine B6 et maladie thromboembolique veineuse. Rev Med Interne 1999. [DOI: 10.1016/s0248-8663(99)80193-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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49
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Allouche-Cometto L, Leger P, Rousseau H, Lefebvre D, Bendayan P, Elefterion P, Boccalon H. Comparative of blood flow to the ankle-brachial index after iliac angioplasty. INT ANGIOL 1999; 18:154-7. [PMID: 10424373] [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] [Indexed: 02/13/2023]
Abstract
BACKGROUND Interest of blood flow and ankle brachial pressure index (ABPI) to evaluate result of iliac angioplasty. METHODS ABPI and blood flow rates were measured before and after angioplasty in 22 lower extremities of 16 patients with iliac stenosis. Blood flow rates were determined by means of a nuclear magnetic resonance (NMR) flow meter. RESULTS The day after angioplasty, flow and pressure were increasing significantly, whereas a month later, only blood flow was increasing significantly. In a group of patients with near-normal ABPI before angioplasty (ABPI > or = 0.8), there was, on the day following the angioplasty, a significant increase in ABPI and pulsatile blood flow rates; flow rates increased considerably a month after the operation whereas ABPI stay stable. In a group of patients with clearly abnormal ABPI before angioplasty (ABPI <0.80), there was a significant increase in ABPI and blood flow rates the day after angioplasty and again a month later. CONCLUSIONS Flow therefore seems to vary independently of pressure. The possible use of flow measurement to detect restenoses is yet to be studied.
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50
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Leger SS, Leger P. The art of interface. Tools for administering noninvasive ventilation. Med Klin (Munich) 1999; 94:35-9. [PMID: 10373733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Since the choice of interface plays a large role in the effectiveness of noninvasive ventilation, there is a need for information about what is available, how to make a selection, what to do when a problem occurs, and how to provide proper care and monitoring. MATERIAL AND METHODS Here we will present some of the different types of interfaces available, different problems presented by each, and guidelines for making choices among them.
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