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Cattan S, Lereya ST, Yoon Y, Gilbert R, Deighton J. The impact of area level mental health interventions on outcomes for secondary school pupils: Evidence from the HeadStart programme in England. Econ Educ Rev 2023; 96:None. [PMID: 37779604 PMCID: PMC10509803 DOI: 10.1016/j.econedurev.2023.102425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 05/29/2023] [Accepted: 06/07/2023] [Indexed: 10/03/2023]
Abstract
In light of the dramatic rise in mental health disorders amongst adolescents seen in the past decade across the world, there is an urgent need for robust evidence on what works to combat this trend. This paper provides the first robust evaluation of the impacts on school outcomes of 6-year funding programme (HeadStart) for area-level mental health interventions for adolescents. Exploiting educational administrative data on ten cohorts of state-educated secondary school students, we use the synthetic control method to construct counterfactual outcomes for areas that received the funding. We show that the funding did not affect students' absenteeism or academic attainment, but it prevented around 800 students (c. 10% of students typically excluded yearly) from being excluded in its first year. The transient nature of this effect suggests that sustained funding for intervention may be a necessary but not sufficient condition to maintain programme effectiveness over time.
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Affiliation(s)
- Sarah Cattan
- Institute for Fiscal Studies and IZA, United Kingdom
| | | | - Yeosun Yoon
- University College London and Anna Freud, United Kingdom
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2
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Laethem JLV, Borbath I, Karwal M, Verslype C, Van Vlierberghe H, Kardosh A, Zagonel V, Stal P, Sarker D, Palmer D, Vogel A, Edeline J, Cattan S, Kudo M, Cheng AL, Ogasawara S, Siegel A, Chisamore M, Wang A, Zhu A. 933P Updated results for pembrolizumab (pembro) monotherapy as first-line therapy for advanced hepatocellular carcinoma (HCC) in the phase II KEYNOTE-224 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.153] [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] Open
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3
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Andrew A, Cattan S, Costa Dias M, Farquharson C, Kraftman L, Krutikova S, Phimister A, Sevilla A. Inequalities in Children's Experiences of Home Learning during the COVID-19 Lockdown in England. Fisc Stud 2020; 41:653-683. [PMID: 33362314 PMCID: PMC7753283 DOI: 10.1111/1475-5890.12240] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This paper combines novel data on the time use, home-learning practices and economic circumstances of families with children during the COVID-19 lockdown with pre-lockdown data from the UK Time Use Survey to characterise the time use of children and how it changed during lockdown, and to gauge the extent to which changes in time use and learning practices during this period are likely to reinforce the already large gaps in educational attainment between children from poorer and better-off families. We find considerable heterogeneity in children's learning experiences - amount of time spent learning, activities undertaken during this time and availability of resources to support learning. Concerningly, but perhaps unsurprisingly, this heterogeneity is strongly associated with family income and in some instances more so than before lockdown. Furthermore, our analysis suggests that any impacts of inequalities in time spent learning between poorer and richer children are likely to be compounded by inequalities not only in learning resources available at home, but also in those provided by schools.
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Affiliation(s)
- Alison Andrew
- Institute for Fiscal Studies; University College London
| | | | - Monica Costa Dias
- University of Bristol; Institute for Fiscal Studies; University of Porto
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4
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Andrew A, Cattan S, Costa Dias M, Farquharson C, Kraftman L, Krutikova S, Phimister A, Sevilla A. Inequalities in Children's Experiences of Home Learning during the COVID-19 Lockdown in England. Fisc Stud 2020. [PMID: 33362314 DOI: 10.2139/ssrn.3654937] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This paper combines novel data on the time use, home-learning practices and economic circumstances of families with children during the COVID-19 lockdown with pre-lockdown data from the UK Time Use Survey to characterise the time use of children and how it changed during lockdown, and to gauge the extent to which changes in time use and learning practices during this period are likely to reinforce the already large gaps in educational attainment between children from poorer and better-off families. We find considerable heterogeneity in children's learning experiences - amount of time spent learning, activities undertaken during this time and availability of resources to support learning. Concerningly, but perhaps unsurprisingly, this heterogeneity is strongly associated with family income and in some instances more so than before lockdown. Furthermore, our analysis suggests that any impacts of inequalities in time spent learning between poorer and richer children are likely to be compounded by inequalities not only in learning resources available at home, but also in those provided by schools.
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Affiliation(s)
- Alison Andrew
- Institute for Fiscal Studies; University College London
| | | | - Monica Costa Dias
- University of Bristol; Institute for Fiscal Studies; University of Porto
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5
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Andrew A, Cattan S, Costa Dias M, Farquharson C, Kraftman L, Krutikova S, Phimister A, Sevilla A. Inequalities in Children's Experiences of Home Learning during the COVID-19 Lockdown in England. Fisc Stud 2020. [PMID: 33362314 DOI: 10.1920/bn.ifs.2020.bn0290] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This paper combines novel data on the time use, home-learning practices and economic circumstances of families with children during the COVID-19 lockdown with pre-lockdown data from the UK Time Use Survey to characterise the time use of children and how it changed during lockdown, and to gauge the extent to which changes in time use and learning practices during this period are likely to reinforce the already large gaps in educational attainment between children from poorer and better-off families. We find considerable heterogeneity in children's learning experiences - amount of time spent learning, activities undertaken during this time and availability of resources to support learning. Concerningly, but perhaps unsurprisingly, this heterogeneity is strongly associated with family income and in some instances more so than before lockdown. Furthermore, our analysis suggests that any impacts of inequalities in time spent learning between poorer and richer children are likely to be compounded by inequalities not only in learning resources available at home, but also in those provided by schools.
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Affiliation(s)
- Alison Andrew
- Institute for Fiscal Studies; University College London
| | | | - Monica Costa Dias
- University of Bristol; Institute for Fiscal Studies; University of Porto
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6
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Danielou M, Sarter H, Pariente B, Fumery M, Ley D, Mamona C, Barthoulot M, Charpentier C, Siproudhis L, Savoye G, Gower-Rousseau C, Andre JM, Antonietti M, Aouakli A, Armand A, Aroichane I, Assi F, Aubet JP, Auxenfants E, Ayafi-Ramelot F, Azzouzi K, Bankovski D, Barbry B, Bardoux N, Baron P, Baudet A, Bazin B, Bebahani A, Becqwort JP, Benet V, Benali H, Benguigui C, Ben Soussan E, Bental A, Berkelmans I, Bernet J, Bernou K, Bernou-Dron C, Bertot P, Bertiaux-Vandaële N, Bertrand V, Billoud E, Biron N, Bismuth B, Bleuet M, Blondel F, Blondin V, Bohon P, Boniface E, Bonnière P, Bonvarlet E, Bonvarlet P, Boruchowicz A, Bostvironnois R, Boualit M, Bouche B, Boudaillez C, Bourgeaux C, Bourgeois M, Bourguet A, Bourienne A, Branche J, Bray G, Brazier F, Breban P, Bridenne M, Brihier H, Brung-Lefebvre V, Bulois P, Burgiere P, Butel J, Canva JY, Canva-Delcambre V, Capron JP, Cardot F, Carpentier P, Cartier E, Cassar JF, Cassagnou M, Castex JF, Catala P, Cattan S, Catteau S, Caujolle B, Cayron G, Chandelier C, Chantre M, Charles J, Charneau T, Chavance-Thelu M, Chirita D, Choteau A, Claerbout JF, Clergue PY, Coevoet H, Cohen G, Collet R, Colombel JF, Coopman S, Corvisart J, Cortot A, Couttenier F, Crinquette JF, Crombe V, Dadamessi I, Dapvril V, Davion T, Dautreme S, Debas J, Degrave N, Dehont F, Delatre C, Delcenserie R, Delette O, Delgrange T, Delhoustal L, Delmotte JS, Demmane S, Deregnaucourt G, Descombes P, Desechalliers JP, Desmet P, Desreumaux P, Desseaux G, Desurmont P, Devienne A, Devouge E, Devred M, Devroux A, Dewailly A, Dharancy S, Di Fiore A, Djeddi D, Djedir R, Dreher-Duwat ML, Dubois R, Dubuque C, Ducatillon P, Duclay J, Ducrocq B, Ducrot F, Ducrotte P, Dufilho A, Duhamel C, Dujardin D, Dumant-Forest C, Dupas JL, Dupont F, Duranton Y, Duriez A, El Achkar K, El Farisi M, Elie C, Elie-Legrand MC, Elkhaki A, Eoche M, Evrard D, Evrard JP, Fatome A, Filoche B, Finet L, Flahaut M, Flamme C, Foissey D, Fournier P, Foutrein-Comes MC, Foutrein P, Fremond D, Frere T, Fumery M, Gallet P, Gamblin C, Ganga S, Gerard R, Geslin G, Gheyssens Y, Ghossini N, Ghrib S, Gilbert T, Gillet B, Godard D, Godard P, Godchaux JM, Godchaux R, Goegebeur G, Goria O, Gottrand F, Gower P, Grandmaison B, Groux M, Guedon C, Guillard JF, Guillem L, Guillemot F, Guimberd D, Haddouche B, Hakim S, Hanon D, Hautefeuille V, Heckestweiller P, Hecquet G, Hedde JP, Hellal H, Henneresse PE, Heyman B, Heraud M, Herve S, Hochain P, Houssin-Bailly L, Houcke P, Huguenin B, Iobagiu S, Ivanovic A, Iwanicki-Caron I, Janicki E, Jarry M, Jeu J, Joly JP, Jonas C, Katherin F, Kerleveo A, Khachfe A, Kiriakos A, Kiriakos J, Klein O, Kohut M, Kornhauser R, Koutsomanis D, Laberenne JE, Laffineur G, Lagarde M, Lalanne A, Lannoy P, Lapchin J, Laprand M, Laude D, Leblanc R, Lecieux P, Leclerc N, Le Couteulx C, Ledent J, Lefebvre J, Lefiliatre P, Legrand C, Le Grix A, Lelong P, Leluyer B, Lenaerts C, Lepileur L, Leplat A, Lepoutre-Dujardin E, Leroi H, Leroy MY, Lesage JP, Lesage X, Lesage J, Lescanne-Darchis I, Lescut J, Lescut D, Leurent B, Levy P, Lhermie M, Lion A, Lisambert B, Loire F, Louf S, Louvet A, Luciani M, Lucidarme D, Lugand J, Macaigne O, Maetz D, Maillard D, Mancheron H, Manolache O, Marks-Brunel AB, Marti R, Martin F, Martin G, Marzloff E, Mathurin P, Mauillon J, Maunoury V, Maupas JL, Mesnard B, Metayer P, Methari L, Meurisse B, Meurisse F, Michaud L, Mirmaran X, Modaine P, Monthe A, Morel L, Mortier PE, Moulin E, Mouterde O, Mudry J, Nachury M, N’Guyen Khac E, Notteghem B, Ollevier V, Ostyn A, Ouraghi A, Ouvry D, Paillot B, Panien-Claudot N, Paoletti C, Papazian A, Parent B, Pariente B, Paris JC, Patrier P, Paupart L, Pauwels B, Pauwels M, Petit R, Piat M, Piotte S, Plane C, Plouvier B, Pollet E, Pommelet P, Pop D, Pordes C, Pouchain G, Prades P, Prevost A, Prevost JC, Quesnel B, Queuniet AM, Quinton JF, Rabache A, Rabelle P, Raclot G, Ratajczyk S, Rault D, Razemon V, Reix N, Revillon M, Richez C, Robinson P, Rodriguez J, Roger J, Roux JM, Rudelli A, Saber A, Savoye G, Schlosseberg P, Segrestin M, Seguy D, Serin M, Seryer A, Sevenet F, Shekh N, Silvie J, Simon V, Spyckerelle C, Talbodec N, Techy A, Thelu JL, Thevenin A, Thiebault H, Thomas J, Thorel JM, Tielman G, Tode M, Toisin J, Tonnel J, Touchais JY, Touze Y, Tranvouez JL, Triplet C, Turck D, Uhlen S, Vaillant E, Valmage C, Vanco D, Vandamme H, Vanderbecq E, Vander Eecken E, Vandermolen P, Vandevenne P, Vandeville L, Vandewalle A, Vandewalle C, Vaneslander P, Vanhoove JP, Vanrenterghem A, Varlet P, Vasies I, Verbiese G, Vernier-Massouille G, Vermelle P, Verne C, Vezilier-Cocq P, Vigneron B, Vincendet M, Viot J, Voiment YM, Wacrenier A, Waeghemaecker L, Wallez JY, Wantiez M, Wartel F, Weber J, Willocquet JL, Wizla N, Wolschies E, Zalar A, Zaouri B, Zellweger A, Ziade C. Natural History of Perianal Fistulising Lesions in Patients With Elderly-onset Crohn's Disease: A Population-based Study. J Crohns Colitis 2020; 14:501-507. [PMID: 31637413 DOI: 10.1093/ecco-jcc/jjz173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Most studies of elderly-onset Crohn's disease [CD; diagnosed in patients aged 60 or over] have described a mild course. However, data on the natural history of perianal fistulising CD [pfCD] in this population are scarce. In a population-based cohort study, we described the prevalence, natural history, and treatment of pfCD in patients with elderly-onset CD vs patients with paediatric-onset CD. METHOD All patients diagnosed with CD at or after the age of 60 between 1988 and 2006, were included [n = 372]. Logistic regression, Cox models, and a nested case-control method were used to identify factors associated with pfCD. RESULTS A total of 34 elderly patients [9% of the 372] had pfCD at diagnosis. After a median follow-up of 6 years (interquartile range [IQR]: 3; 10), 59 patients [16%] had pfCD; the same prevalence [16%] was observed in paediatric-onset patients. At last follow-up, anal incontinence was more frequent in elderly patients with pfCD than in elderly patients without pfCD [22% vs 4%, respectively; p < 10-4]. Rectal CD at diagnosis was associated with pfCD: hazard ratio (95% confidence interval [CI] = 2.8 [1.6-5.0]). Although 37% of the patients received immunosuppressants and 17% received anti-tumour necrosis factor agents, 24% [14 out of 59] had a definitive stoma at last follow-up. CONCLUSION During the first 6 years of disease, the prevalence of pfCD was similar in elderly and paediatric patients. Rectal involvement was associated with the appearance of pfCD in elderly-onset patients. Around a quarter of patients with elderly-onset CD will have a stoma. Our results suggest that treatment with biologics should be evaluated in these patients.
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Affiliation(s)
- Marie Danielou
- Gastroenterology Unit, EPIMAD Registry, University of Rouen and Rouen University Hospital, Rouen, France
| | - Hélène Sarter
- Public Health, Epidemiology and Economic Health Unit, EPIMAD Registry, Maison Régionale de la Recherche Clinique, University of Lille and Lille University Hospital, Lille, France.,LIRIC UMR 995, Team 5, INSERM and University of Lille, Lille, France
| | - Benjamin Pariente
- Gastroenterology Unit, EPIMAD Registry, Hôpital Huriez, Lille University Hospital, Lille, France
| | - Mathurin Fumery
- Gastroenterology Unit, EPIMAD Registry, and PeriTox, UMR I-01, University of Amiens and Amiens University Hospital, Amiens, France
| | - Delphine Ley
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital and University of Lille, Lille, France
| | - Christel Mamona
- Public Health, Epidemiology and Economic Health Unit, EPIMAD Registry, Maison Régionale de la Recherche Clinique, University of Lille and Lille University Hospital, Lille, France
| | - Maël Barthoulot
- Public Health, Epidemiology and Economic Health Unit, EPIMAD Registry, Maison Régionale de la Recherche Clinique, University of Lille and Lille University Hospital, Lille, France
| | - Cloé Charpentier
- Gastroenterology Unit, EPIMAD Registry, University of Rouen and Rouen University Hospital, Rouen, France
| | | | - Guillaume Savoye
- Gastroenterology Unit, EPIMAD Registry, University of Rouen and Rouen University Hospital, Rouen, France
| | - Corinne Gower-Rousseau
- Public Health, Epidemiology and Economic Health Unit, EPIMAD Registry, Maison Régionale de la Recherche Clinique, University of Lille and Lille University Hospital, Lille, France.,LIRIC UMR 995, Team 5, INSERM and University of Lille, Lille, France
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Chanauria N, Bharmauria V, Bachatene L, Cattan S, Rouat J, Molotchnikoff S. Sound Induces Change in Orientation Preference of V1 Neurons: Audio-Visual Cross-Influence. Neuroscience 2019; 404:48-61. [PMID: 30703505 DOI: 10.1016/j.neuroscience.2019.01.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
Abstract
In the cortex, demarcated unimodal sensory regions often respond to unforeseen sensory stimuli and exhibit plasticity. The goal of the current investigation was to test evoked responses of primary visual cortex (V1) neurons when an adapting auditory stimulus is applied in isolation. Using extracellular recordings in anesthetized cats, we demonstrate that, unlike the prevailing observation of only slight modulations in the firing rates of the neurons, sound imposition in isolation entirely shifted the peaks of orientation tuning curves of neurons in both supra- and infragranular layers of V1. Our results suggest that neurons specific to either layer dynamically integrate features of sound and modify the organization of the orientation map of V1. Intriguingly, these experiments present novel findings that the mere presentation of a prolonged auditory stimulus may drastically recalibrate the tuning properties of the visual neurons and highlight the phenomenal neuroplasticity of V1 neurons.
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Affiliation(s)
- Nayan Chanauria
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC H3C 3J7, Canada
| | - Vishal Bharmauria
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC H3C 3J7, Canada
| | - Lyes Bachatene
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC H3C 3J7, Canada
| | - Sarah Cattan
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC H3C 3J7, Canada
| | - Jean Rouat
- Departement de Génie Électrique et Génie Informatique, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Stéphane Molotchnikoff
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC H3C 3J7, Canada.
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Kelley R, El-Khoueiry A, Meyer T, Rimassa L, Merle P, Chan S, Tran A, Parnis F, Tam V, Cattan S, Markby D, Clary D, Cheng AL, Abou-Alfa G. Outcomes by baseline alpha-fetoprotein (AFP) levels in the phase III CELESTIAL trial of cabozantinib (C) versus placebo (P) in previously treated advanced hepatocellular carcinoma (HCC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.085] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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9
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Milleron O, Bouleti C, Mazouz S, Brochet E, Rouzet F, Nataf P, Ghodbane W, Messika-Zeitoun D, Dilly MP, Cattan S, Vahanian A, Iung B, Jondeau G. Eclipsed mitral regurgitation: an unusual cause of acute heart failure. Eur Heart J Cardiovasc Imaging 2018; 18:1163-1169. [PMID: 27625364 DOI: 10.1093/ehjci/jew192] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 04/14/2016] [Accepted: 08/12/2016] [Indexed: 11/14/2022] Open
Abstract
Aims So far, a total of five patients with eclipsed mitral regurgitation (MR) have been reported in the literature by three different teams. The aim of this article was to detail clinical and echocardiographic characteristics, and outcome of patients presenting eclipsed MR. Methods and results We defined eclipsed MR as spontaneous appearance, at rest, from 1 min to the next of an acute restriction in the motion of mitral leaflets preventing coaptation and leading to massive MR in patients with normal left ventricular end-diastolic diameter, left ventricular ejection fraction >45%, and baseline MR ≤2. Spontaneous regression occurred within 30 min, and no obvious trigger such as acute hypertension, new-onset arrhythmia, or myocardial ischaemia is present. Clinical data, ECG, echocardiographic data, surgery report, and follow-up status of six patients with eclipsed MR are reported: all were post-menopausal women with median age of 74 [57-80] years presenting hypertension (4/6), chronic kidney disease (5/6), or chronic anaemia (4/6). Five out of six patients experienced acute pulmonary oedema requiring hospitalization and underwent mitral valve replacement because of heart failure recurrence. Two patients died in the first days after surgery while the three others are free of symptoms at, respectively, 56, 18, and 10 months follow-up. Conclusion Eclipsed MR is a clinical and echocardiographic syndrome responsible for heart failure with preserved EF. It is presently underdiagnosed and should be evoked in cases of recurrent acute pulmonary oedema without obvious trigger, in particular in patients presenting discordant evaluation of MR severity over time.
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Affiliation(s)
- O Milleron
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, 46 Rue Henri Huchard, 75018 Paris, France.,DHU Fire, Paris-Diderot University, Paris, France
| | - C Bouleti
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, 46 Rue Henri Huchard, 75018 Paris, France.,DHU Fire, Paris-Diderot University, Paris, France
| | - S Mazouz
- Department of Cardiology, Montfermeil Hospital, Paris, France
| | - E Brochet
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, 46 Rue Henri Huchard, 75018 Paris, France.,DHU Fire, Paris-Diderot University, Paris, France
| | - F Rouzet
- Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France.,INSERM U1148 Bichat Hospital, Paris, France.,Faculté de Médecine Paris-Diderot University, Paris, France
| | - P Nataf
- DHU Fire, Paris-Diderot University, Paris, France.,Faculté de Médecine Paris-Diderot University, Paris, France.,Department of Cardiac Surgery, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France
| | - W Ghodbane
- DHU Fire, Paris-Diderot University, Paris, France.,Department of Cardiac Surgery, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France
| | - D Messika-Zeitoun
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, 46 Rue Henri Huchard, 75018 Paris, France.,DHU Fire, Paris-Diderot University, Paris, France.,INSERM U1148 Bichat Hospital, Paris, France.,Faculté de Médecine Paris-Diderot University, Paris, France
| | - M P Dilly
- Department of Anaesthesiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France
| | - S Cattan
- Department of Cardiology, Montfermeil Hospital, Paris, France
| | - A Vahanian
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, 46 Rue Henri Huchard, 75018 Paris, France.,DHU Fire, Paris-Diderot University, Paris, France.,INSERM U1148 Bichat Hospital, Paris, France.,Faculté de Médecine Paris-Diderot University, Paris, France
| | - B Iung
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, 46 Rue Henri Huchard, 75018 Paris, France.,DHU Fire, Paris-Diderot University, Paris, France.,INSERM U1148 Bichat Hospital, Paris, France.,Faculté de Médecine Paris-Diderot University, Paris, France
| | - G Jondeau
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, 46 Rue Henri Huchard, 75018 Paris, France.,DHU Fire, Paris-Diderot University, Paris, France.,INSERM U1148 Bichat Hospital, Paris, France.,Faculté de Médecine Paris-Diderot University, Paris, France
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Durand-Labrunie J, Jarraya H, Boleslawski E, Cattan S, Lacornerie T, Peiffert D, Mirabel X. PV-0105: Stereotactic body radiotherapy treatment for hepatocellular carcinoma: A phase II study. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30415-8] [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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11
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Ghione S, Sarter H, Fumery M, Armengol-Debeir L, Savoye G, Ley D, Spyckerelle C, Pariente B, Peyrin-Biroulet L, Turck D, Gower-Rousseau C, Andre JM, Antonietti M, Aouakli A, Armand A, Aroichane I, Assi F, Aubet JP, Auxenfants E, Ayafi-Ramelot F, Bankovski D, Barbry B, Bardoux N, Baron P, Baudet A, Bazin B, Bebahani A, Becqwort JP, Benet V, Benali H, Benguigui C, Soussan BE, Bental A, Berkelmans I, Bernet J, Bernou K, Bernou-Dron C, Bertot P, Bertiaux-Vandaële N, Bertrand V, Billoud E, Biron N, Bismuth B, Bleuet M, Blondel F, Blondin V, Bohon P, Boniface E, Bonnière P, Bonvarlet E, Bonvarlet P, Boruchowicz A, Bostvironnois R, Boualit M, Bouche B, Boudaillez C, Bourgeaux C, Bourgeois M, Bourguet A, Bourienne A, Branche J, Bray G, Brazier F, Breban P, Brihier H, Brung-Lefebvre V, Bulois P, Burgiere P, Butel J, Canva JY, Canva-Delcambre V, Capron JP, Cardot F, Carpentier P, Cartier E, Cassar JF, Cassagnou M, Castex JF, Catala P, Cattan S, Catteau S, Caujolle B, Cayron G, Chandelier C, Chantre M, Charles J, Charneau T, Chavance-Thelu M, Chirita D, Choteau A, Claerbout JF, Clergue PY, Coevoet H, Cohen G, Collet R, Colombel JF, Coopman S, Corvisart J, Cortot A, Couttenier F, Crinquette JF, Crombe V, Dadamessi I, Dapvril V, Davion T, Dautreme S, Debas J, Degrave N, Dehont F, Delatre C, Delcenserie R, Delette O, Delgrange T, Delhoustal L, Delmotte JS, Demmane S, Deregnaucourt G, Descombes P, Desechalliers JP, Desmet P, Desreumaux P, Desseaux G, Desurmont P, Devienne A, Devouge E, Devred M, Devroux A, Dewailly A, Dharancy S, Di Fiore A, Djeddi D, Djedir R, Dreher-Duwat ML, Dubois R, Dubuque C, Ducatillon P, Duclay J, Ducrocq B, Ducrot F, Ducrotte P, Dufilho A, Duhamel C, Dujardin D, Dumant-Forest C, Dupas JL, Dupont F, Duranton Y, Duriez A, El Achkar K, El Farisi M, Elie C, Elie-Legrand MC, Elkhaki A, Eoche M, Evrard D, Evrard JP, Fatome A, Filoche B, Finet L, Flahaut M, Flamme C, Foissey D, Fournier P, Foutrein-Comes MC, Foutrein P, Fremond D, Frere T, Fumery M, Gallet P, Gamblin C, Ganga-Zandzou PS, Gérard R, Geslin G, Gheyssens Y, Ghossini N, Ghrib S, Gilbert T, Gillet B, Godard D, Godard P, Godchaux JM, Godchaux R, Goegebeur G, Goria O, Gottrand F, Gower P, Grandmaison B, Groux M, Guedon C, Guillard JF, Guillem L, Guillemot F, Guimber D, Haddouche B, Hakim S, Hanon D, Hautefeuille V, Heckestweiller P, Hecquet G, Hedde JP, Hellal H, Henneresse PE, Heyman B, Heraud M, Herve S, Hochain P, Houssin-Bailly L, Houcke P, Huguenin B, Iobagiu S, Ivanovic A, Iwanicki-Caron I, Janicki E, Jarry M, Jeu J, Joly JP, Jonas C, Katherin F, Kerleveo A, Khachfe A, Kiriakos A, Kiriakos J, Klein O, Kohut M, Kornhauser R, Koutsomanis D, Laberenne JE, Laffineur G, Lagarde M, Lannoy P, Lapchin J, Lapprand M, Laude D, Leblanc R, Lecieux P, Leclerc N, Le Couteulx C, Ledent J, Lefebvre J, Lefiliatre P, Legrand C, Le Grix A, Lelong P, Leluyer B, Lenaerts C, Lepileur L, Leplat A, Lepoutre-Dujardin E, Leroi H, Leroy MY, Lesage JP, Lesage X, Lesage J, Lescanne-Darchis I, Lescut J, Lescut D, Leurent B, Levy P, Lhermie M, Lion A, Lisambert B, Loire F, Louf S, Louvet A, Luciani M, Lucidarme D, Lugand J, Macaigne O, Maetz D, Maillard D, Mancheron H, Manolache O, Marks-Brunel AB, Marti R, Martin F, Martin G, Marzloff E, Mathurin P, Mauillon J, Maunoury V, Maupas JL, Mesnard B, Metayer P, Methari L, Meurisse B, Meurisse F, Michaud L, Mirmaran X, Modaine P, Monthe A, Morel L, Mortier PE, Moulin E, Mouterde O, Mudry J, Nachury M, Khac NE, Notteghem B, Ollevier V, Ostyn A, Ouraghi A, Ouvry D, Paillot B, Panien-Claudot N, Paoletti C, Papazian A, Parent B, Pariente B, Paris JC, Patrier P, Paupart L, Pauwels B, Pauwels M, Petit R, Piat M, Piotte S, Plane C, Plouvier B, Pollet E, Pommelet P, Pop D, Pordes C, Pouchain G, Prades P, Prevost A, Prevost JC, Quesnel B, Queuniet AM, Quinton JF, Rabache A, Rabelle P, Raclot G, Ratajczyk S, Rault D, Razemon V, Reix N, Revillon M, Richez C, Robinson P, Rodriguez J, Roger J, Roux JM, Rudelli A, Saber A, Savoye G, Schlosseberg P, Segrestin M, Seguy D, Serin M, Seryer A, Sevenet F, Shekh N, Silvie J, Simon V, Spyckerelle C, Talbodec N, Techy A, Thelu JL, Thevenin A, Thiebault H, Thomas J, Thorel JM, Tielman G, Tode M, Toisin J, Tonnel J, Touchais JY, Touze Y, Tranvouez JL, Triplet C, Turck D, Uhlen S, Vaillant E, Valmage C, Vanco D, Vandamme H, Vanderbecq E, Eecken VE, Vandermolen P, Vandevenne P, Vandeville L, Vandewalle A, Vandewalle C, Vaneslander P, Vanhoove JP, Vanrenterghem A, Varlet P, Vasies I, Verbiese G, Vernier-Massouille G, Vermelle P, Verne C, Vezilier-Cocq P, Vigneron B, Vincendet M, Viot J, Voiment YM, Wacrenier A, Waeghemaecker L, Wallez JY, Wantiez M, Wartel F, Weber J, Willocquet JL, Wizla N, Wolschies E, Zalar A, Zaouri B, Zellweger A, Ziade C. Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents. Am J Gastroenterol 2018; 113:265-272. [PMID: 28809388 DOI: 10.1038/ajg.2017.228] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 06/08/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Few data are available to describe the changes in incidence of pediatric-onset inflammatory bowel disease (IBD). The aim of this study was to describe changes in incidence and phenotypic presentation of pediatric-onset IBD in northern France during a 24-year period. METHODS Pediatric-onset IBD (<17 years) was issued from a population-based IBD study in France between 1988 and 2011. Age groups and digestive location were defined according to the Paris classification. RESULTS 1,350 incident cases were recorded (8.3% of all IBD) including 990 Crohn's disease (CD), 326 ulcerative colitis (UC) and 34 IBD unclassified (IBDU). Median age at diagnosis was similar in CD (14.4 years (Q1=11.8-Q3=16.0)) and UC (14.0 years (11.0-16.0)) and did not change over time. There were significantly more males with CD (females/males=0.82) than UC (females/males=1.25) (P=0.0042). Median time between onset of symptoms and IBD diagnosis was consistently 3 months (1-6). Mean incidence was 4.4/105 for IBD overall (3.2 for CD, 1.1 for UC and 0.1 for IBDU). From 1988-1990 to 2009-2011, a dramatic increase in incidences of both CD and UC were observed in adolescents (10-16 years): for CD from 4.2 to 9.5/105 (+126%; P<0.001) and for UC, from 1.6 to 4.1/105 (+156%; P<0.001). No modification in age or location at diagnosis was observed in either CD or UC. CONCLUSIONS In this population-based study, CD and UC incidences increased dramatically in adolescents across a 24-year span, suggesting that one or more strong environmental factors may predispose this population to IBD.
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Affiliation(s)
- Silvia Ghione
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, Lille, France
| | - Hélène Sarter
- Public Health, Epidemiology and Economic Health, Epimad registry, Regional house of clinical research, Lille Hospital and University, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm-"IBD and environmental factors: epidemiology and functional analyses", Lille University, Lille, France
| | - Mathurin Fumery
- Gastroenterology Unit, Epimad registry, Amiens Hospital and University, Amiens, France
| | - Laura Armengol-Debeir
- Gastroenterology Unit, Epimad registry, Rouen Hospital and University, Rouen, France
| | - Guillaume Savoye
- Gastroenterology Unit, Epimad registry, Rouen Hospital and University, Rouen, France
| | - Delphine Ley
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm-"IBD and environmental factors: epidemiology and functional analyses", Lille University, Lille, France
| | - Claire Spyckerelle
- Department of Pediatrics, St Vincent de Paul Hospital and Lille Catholic University, Lille, France
| | - Benjamin Pariente
- Lille Inflammation Research International Center LIRIC-UMR 995 Inserm-"IBD and environmental factors: epidemiology and functional analyses", Lille University, Lille, France.,Gastroenterology Unit, Epimad registry, Lille Hospital and University, Lille, France
| | | | - Dominique Turck
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm-"IBD and environmental factors: epidemiology and functional analyses", Lille University, Lille, France
| | - Corinne Gower-Rousseau
- Public Health, Epidemiology and Economic Health, Epimad registry, Regional house of clinical research, Lille Hospital and University, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm-"IBD and environmental factors: epidemiology and functional analyses", Lille University, Lille, France
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Duricova D, Leroyer A, Savoye G, Sarter H, Pariente B, Aoucheta D, Armengol-Debeir L, Ley D, Turck D, Peyrin-Biroulet L, Gower-Rousseau C, Fumery M, Antonietti M, Aouakli A, Armand A, Aroichane I, Assi F, Aubet JP, Auxenfants E, Ayafi-Ramelot F, Bankovski D, Barbry B, Bardoux N, Baron P, Baudet A, Bazin B, Bebahani A, Becqwort JP, Benet V, Benali H, Benguigui C, Ben Soussan E, Bental A, Berkelmans I, Bernet J, Bernou K, Bernou-Dron C, Bertot P, Bertiaux-Vandaële N, Bertrand V, Billoud E, Biron N, Bismuth B, Bleuet M, Blondel F, Blondin V, Bohon P, Boniface E, Bonnière P, Bonvarlet E, Bonvarlet P, Boruchowicz A, Bostvironnois R, Boualit M, Bouche B, Boudaillez C, Bourgeaux C, Bourgeois M, Bourguet A, Bourienne A, Branche J, Bray G, Brazier F, Breban P, Brihier H, Brung-Lefebvre V, Bulois P, Burgiere P, Butel J, Canva JY, Canva-Delcambre V, Capron JP, Cardot F, Carpentier P, Cartier E, Cassar JF, Cassagnou M, Castex JF, Catala P, Cattan S, Catteau S, Caujolle B, Cayron G, Chandelier C, Chantre M, Charles J, Charneau T, Chavance-Thelu M, Chirita D, Choteau A, Claerbout JF, Clergue PY, Coevoet H, Cohen G, Collet R, Colombel JF, Coopman S, Corvisart J, Cortot A, Couttenier F, Crinquette JF, Crombe V, Dadamessi I, Dapvril V, Davion T, Dautreme S, Debas J, Degrave N, Dehont F, Delatre C, Delcenserie R, Delette O, Delgrange T, Delhoustal L, Delmotte JS, Demmane S, Deregnaucourt G, Descombes P, Desechalliers JP, Desmet P, Desreumaux P, Desseaux G, Desurmont P, Devienne A, Devouge E, Devred M, Devroux A, Dewailly A, Dharancy S, Di Fiore A, Djeddi D, Djedir R, Dreher-Duwat ML, Dubois R, Dubuque C, Ducatillon P, Duclay J, Ducrocq B, Ducrot F, Ducrotté P, Dufilho A, Duhamel C, Dujardin D, Dumant-Forest C, Dupas JL, Dupont F, Duranton Y, Duriez A, El Achkar K, El Farisi M, Elie C, Elie-Legrand MC, Elkhaki A, Eoche M, Evrard D, Evrard JP, Fatome A, Filoche B, Finet L, Flahaut M, Flamme C, Foissey D, Fournier P, Foutrein-Comes MC, Foutrein P, Fremond D, Frere T, Fumery M, Gallet P, Gamblin C, Ganga-Zandzou S, Gerard R, Geslin G, Gheyssens Y, Ghossini N, Ghrib S, Gilbert T, Gillet B, Godard D, Godard P, Godchaux JM, Godchaux R, Goegebeur G, Goria O, Gottrand F, Gower P, Grandmaison B, Groux M, Guedon C, Guillard JF, Guillem L, Guillemot F, Guimber D, Haddouche B, Hakim S, Hanon D, Hautefeuille V, Heckestweiller P, Hecquet G, Hedde JP, Hellal H, Henneresse PE, Heyman B, Heraud M, Herve S, Hochain P, Houssin-Bailly L, Houcke P, Huguenin B, Iobagiu S, Ivanovic A, Iwanicki-Caron I, Janicki E, Jarry M, Jeu J, Joly JP, Jonas C, Katherin F, Kerleveo A, Khachfe A, Kiriakos A, Kiriakos J, Klein O, Kohut M, Kornhauser R, Koutsomanis D, Laberenne JE, Laffineur G, Lagarde M, Lannoy P, Lapchin J, Lapprand M, Laude D, Leblanc R, Lecieux P, Leclerc N, Le Couteulx C, Ledent J, Lefebvre J, Lefiliatre P, Legrand C, Le Grix A, Lelong P, Leluyer B, Lenaerts C, Lepileur L, Leplat A, Lepoutre-Dujardin E, Leroi H, Leroy MY, Lesage JP, Lesage X, Lesage J, Lescanne-Darchis I, Lescut J, Lescut D, Leurent B, Levy P, Lhermie M, Lion A, Lisambert B, Loire F, Louf S, Louvet A, Luciani M, Lucidarme D, Lugand J, Macaigne O, Maetz D, Maillard D, Mancheron H, Manolache O, Marks-Brunel AB, Marti R, Martin F, Martin G, Marzloff E, Mathurin P, Mauillon J, Maunoury V, Maupas JL, Mesnard B, Metayer P, Methari L, Meurisse B, Meurisse F, Michaud L, Mirmaran X, Modaine P, Monthe A, Morel L, Mortier PE, Moulin E, Mouterde O, Mudry J, Nachury M, N’Guyen Khac E, Notteghem B, Ollevier V, Ostyn A, Ouraghi A, Ouvry D, Paillot B, Panien-Claudot N, Paoletti C, Papazian A, Parent B, Pariente B, Paris JC, Patrier P, Paupart L, Pauwels B, Pauwels M, Petit R, Piat M, Piotte S, Plane C, Plouvier B, Pollet E, Pommelet P, Pop D, Pordes C, Pouchain G, Prades P, Prevost A, Prevost JC, Quesnel B, Queuniet AM, Quinton JF, Rabache A, Rabelle P, Raclot G, Ratajczyk S, Rault D, Razemon V, Reix N, Revillon M, Richez C, Robinson P, Rodriguez J, Roger J, Roux JM, Rudelli A, Saber A, Savoye G, Schlosseberg P, Segrestin M, Seguy D, Serin M, Seryer A, Sevenet F, Shekh N, Silvie J, Simon V, Spyckerelle C, Talbodec N, Techy A, Thelu JL, Thevenin A, Thiebault H, Thomas J, Thorel JM, Tielman G, Tode M, Toisin J, Tonnel J, Touchais JY, Touze Y, Tranvouez JL, Triplet C, Turck D, Uhlen S, Vaillant E, Valmage C, Vanco D, Vandamme H, Vanderbecq E, Vander Eecken E, Vandermolen P, Vandevenne P, Vandeville L, Vandewalle A, Vandewalle C, Vaneslander P, Vanhoove JP, Vanrenterghem A, Varlet P, Vasies I, Verbiese G, Vernier-Massouille G, Vermelle P, Verne C, Vezilier-Cocq P, Vigneron B, Vincendet M, Viot J, Voiment YM, Wacrenier A, Waeghemaecker L, Wallez JY, Wantiez M, Wartel F, Weber J, Willocquet JL, Wizla N, Wolschies E, Zalar A, Zaouri B, Zellweger A, Ziade C. Extra-intestinal Manifestations at Diagnosis in Paediatric- and Elderly-onset Ulcerative Colitis are Associated With a More Severe Disease Outcome: A Population-based Study. J Crohns Colitis 2017; 11:1326-1334. [PMID: 28981648 DOI: 10.1093/ecco-jcc/jjx092] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/05/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Data on extra-intestinal manifestations [EIM] and their impact on the disease course of ulcerative colitis [UC] in population-based cohorts are scarce, particularly in paediatric- and elderly-onset UC patients. The aims of this population-based study were to assess: 1] the occurrence of EIM in paediatric- and elderly-onset UC; 2] the factors associated with EIM; and 3] their impact on long-term disease outcome. METHODS Paediatric-onset [< 17 years at diagnosis] and elderly-onset UC patients [> 60 years at diagnosis] from a French prospective population-based registry [EPIMAD] were included. Data on EIM and other clinical factors at diagnosis and at maximal follow-up were collected. RESULTS In all, 158 paediatric- and 470 elderly-onset patients were included [median age at diagnosis 14.5 and 68.8 years, median follow-up 11.2 and 6.2 years, respectively]. EIM occurred in 8.9% of childhood- and 3% of elderly-onset patients at diagnosis and in 16.7% and 2.2% of individuals during follow-up [p < 0.01], respectively. The most frequent EIM was joint involvement [15.8% of paediatric onset and 2.6% of elderly-onset]. Presence of EIM at diagnosis was associated with more severe disease course [need for immunosuppressants or biologic therapy or colectomy] in both paediatric- and elderly-onset UC (hazard ratio [HR] = 2.0, 95% confidence interval [CI]: 1.0-4.2; and HR = 2.8, 0.9-7.9, respectively). Extensive colitis was another independent risk factor in both age groups. CONCLUSIONS Elderly-onset UC patients had lower risk of EIM either at diagnosis or during follow-up than paediatric-onset individuals. EIM at diagnosis predicted more severe disease outcome, including need for immunosuppressive or biologic therapy or surgery, in both paediatric- and elderly-onset UC.
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Affiliation(s)
- Dana Duricova
- Public Health, Epidemiology and Economic Health, Registre EPIMAD, Lille University and Hospital, Lille, France
| | - Ariane Leroyer
- Public Health, Epidemiology and Economic Health, Registre EPIMAD, Lille University and Hospital, Lille, France
| | - Guillaume Savoye
- Gastroenterology Unit, EPIMAD Registry, Rouen University Hospital, Rouen, France
| | - Hélène Sarter
- Public Health, Epidemiology and Economic Health, Registre EPIMAD, Lille University and Hospital, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France
| | - Benjamin Pariente
- Gastroenterology Unit, Hôpital Huriez, Lille University Hospital, Lille, France
| | - Djamila Aoucheta
- Associated Medical Director, Immunology, MSD France, Courbevoie cedex, France
| | | | - Delphine Ley
- Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Lille University Jeanne de Flandre Children's Hospital, University of Lille, Lille, France
| | - Dominique Turck
- Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Lille University Jeanne de Flandre Children's Hospital, University of Lille, Lille, France
| | | | - Corinne Gower-Rousseau
- Public Health, Epidemiology and Economic Health, Registre EPIMAD, Lille University and Hospital, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France
| | - Mathurin Fumery
- Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France.,Gastroenterology Unit, EPIMAD Registry, Amiens University Hospital, Amiens, France
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13
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Milleron O, Bouleti C, Mazouz S, Brochet E, Rouzet F, Nataf P, Ghobdane W, Messika-Zeitoun D, Dilly M, Cattan S, Vahanian A, Iung B, Jondeau G. Eclipsed mitral regurgitation: a new entity responsible for acute heart failure in patients with preserved left ventricular ejection fraction. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30208-2] [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: 10/19/2022]
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14
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Chanauria N, Bharmauria V, Bachatene L, Cattan S, Rouat J, Molotchnikoff S. Comparative effects of adaptation on layers II-III and V-VI neurons in cat V1. Eur J Neurosci 2016; 44:3094-3104. [PMID: 27740707 DOI: 10.1111/ejn.13439] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 06/28/2016] [Revised: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 12/23/2022]
Abstract
V1 is fundamentally grouped into columns that descend from layers II-III to V-VI. Neurons inherent to visual cortex are capable of adapting to changes in the incoming stimuli that drive the cortical plasticity. A principle feature called orientation selectivity can be altered by the presentation of non-optimal stimulus called 'adapter'. When triggered, LGN cells impinge upon layer IV and further relay the information to deeper layers via layers II-III. Using different adaptation protocols, neuronal plasticity can be investigated. Superficial neurons in area V1 are well acknowledged to exhibit attraction and repulsion by shifting their tuning peaks when challenged by a non-optimal stimulus called 'adapter'. Layers V-VI neurons in spite of partnering layers II-III neurons in cortical computation have not been explored simultaneously toward adaptation. We believe that adaptation not only affects cells specific to a layer but modifies the entire column. In this study, through simultaneous multiunit recordings in anesthetized cats using a multichannel depth electrode, we show for the first time how layers V-VI neurons (1000-1200 μm) along with layers II-III neurons (300-500 μm) exhibit plasticity in response to adaptation. Our results demonstrate that superficial and deeper layer neurons react synonymously toward adapter by exhibiting similar behavioral properties. The neurons displayed similar amplitude of shift and maintained equivalent sharpness of Gaussian tuning peaks before and the following adaptation. It appears that a similar mechanism, belonging to all layers, is responsible for the analog outcome of the neurons' experience with adapter.
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Affiliation(s)
- Nayan Chanauria
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Vishal Bharmauria
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.,The Visuomotor Neuroscience Lab, Centre for Vision Research, Faculty of Health, York University, Toronto, ON, Canada
| | - Lyes Bachatene
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.,Department of Nuclear Medicine and Radiobiology, Faculty of Medicine and Health Sciences (CHUS), SNAIL
- Sherbrooke Neuro Analysis and Imaging Lab, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Sarah Cattan
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Jean Rouat
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.,Département de Génie Électrique et Génie Informatique, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Stéphane Molotchnikoff
- Neurophysiology of Visual System, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
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15
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Kikoïne J, Lebon M, Gouffran G, Millischer D, Cattan S, Nallet O. [Not Available]. Ann Cardiol Angeiol (Paris) 2016; 65:375. [PMID: 27968759 DOI: 10.1016/j.ancard.2016.09.019] [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: 06/06/2023]
Affiliation(s)
- J Kikoïne
- Service de cardiologie, GHI Le-Raincy, 93370 Montfermeil, France
| | - M Lebon
- Service de cardiologie, GHI Le-Raincy, 93370 Montfermeil, France
| | - G Gouffran
- Service de cardiologie, GHI Le-Raincy, 93370 Montfermeil, France
| | - D Millischer
- Service de cardiologie, GHI Le-Raincy, 93370 Montfermeil, France
| | - S Cattan
- Service de cardiologie, GHI Le-Raincy, 93370 Montfermeil, France
| | - O Nallet
- Service de cardiologie, GHI Le-Raincy, 93370 Montfermeil, France.
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16
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Bachatene L, Bharmauria V, Cattan S, Chanauria N, Etindele Sosso FA, Molotchnikoff S. Le cortex visuel : entre changement et équilibre. Med Sci (Paris) 2016; 32:1026-1029. [DOI: 10.1051/medsci/20163211022] [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: 11/14/2022] Open
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17
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Kikoïne J, Lebon M, Gouffran G, Millischer D, Cattan S, Nallet O. [Measurement of fractional flow reserve in patients with severe aortic stenosis: A valid test?]. Ann Cardiol Angeiol (Paris) 2016; 65:366-369. [PMID: 27692748 DOI: 10.1016/j.ancard.2016.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/02/2016] [Indexed: 10/20/2022]
Abstract
A 54-year-old woman was hospitalized for an acute pulmonary oedema revealing a severe aortic stenosis (AS) associated with an aortic aneurysm and a left ventricular hypertrophy (LVH). The coronary angiography found an equivocal left main lesion. Fractional flow reserve (FFR) showed hemodynamic significance (FFR=0.78) and optical coherence tomography confirmed this result with a minimal lumen area of 4.9mm2. FFR-guided percutaneous intervention is reported to improve outcome in patients with stable coronary disease. However, only few data are available in cases of AS. In this condition, secondary LVH is associated with microcirculatory dysfunction, which interferes with optimal hyperemia. An elevated right atrial pressure could also modify FFR measurement. This risk of underestimation of a coronary lesion in patients with severe AS has to be taken into consideration in clinical practice.
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Affiliation(s)
- J Kikoïne
- Service de cardiologie, centre hospitalier intercommunal Le Raincy Montfermeil, rue du Général-Leclerc, 93370 Montfermeil, France
| | - M Lebon
- Service de cardiologie, centre hospitalier intercommunal Le Raincy Montfermeil, rue du Général-Leclerc, 93370 Montfermeil, France
| | - G Gouffran
- Service de cardiologie, centre hospitalier intercommunal Le Raincy Montfermeil, rue du Général-Leclerc, 93370 Montfermeil, France
| | - D Millischer
- Service de cardiologie, centre hospitalier intercommunal Le Raincy Montfermeil, rue du Général-Leclerc, 93370 Montfermeil, France
| | - S Cattan
- Service de cardiologie, centre hospitalier intercommunal Le Raincy Montfermeil, rue du Général-Leclerc, 93370 Montfermeil, France
| | - O Nallet
- Service de cardiologie, centre hospitalier intercommunal Le Raincy Montfermeil, rue du Général-Leclerc, 93370 Montfermeil, France.
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18
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Bachatene L, Bharmauria V, Cattan S, Chanauria N, Etindele-Sosso FA, Molotchnikoff S. Functional synchrony and stimulus selectivity of visual cortical units: Comparison between cats and mice. Neuroscience 2016; 337:331-338. [PMID: 27670902 DOI: 10.1016/j.neuroscience.2016.09.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 12/11/2022]
Abstract
In spite of the fact that the functional organization of primary visual cortices (V1) differs across species, the dynamic of orientation selectivity is highly structured within neuronal populations. In fact, neurons functionally connect each other in an organized Hebbian process, wherein their wiring and firing are intimately related. Moreover, neuronal ensembles have been suggested to be strongly implicated in sensory processing. Within these ensembles, neurons may be sharply or broadly tuned in relation to the stimulus. Therefore, it is important to determine the relationship between the response selectivity of neurons and their functional connectivity pattern across species. In the present investigation, we sought to compare the stimulus-evoked functional connectivity between the broadly tuned and the sharply tuned neurons in two species exhibiting different cortical organization for orientation selectivity: cats (columnar-organized) and mice (salt-and-pepper organization). In addition, we examined the distribution of connectivity weights within cell-assemblies in the visual cortex during visual adaptation. First, we report that the sharply tuned neurons exhibited higher synchrony index than the broadly tuned cells in the cat visual cortex. On the contrary, in mice, the broadly tuned cells displayed higher connectivity index. Second, a significant correlation was found between the connectivity strength and the difference of preferred orientations of neurons for both species. Finally, we observed a systematic adjustment of the connectivity weights within neuronal ensembles in mouse primary visual cortex similarly to the cat V1.
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Affiliation(s)
- Lyes Bachatene
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC H3C3J7, Canada
| | - Vishal Bharmauria
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC H3C3J7, Canada
| | - Sarah Cattan
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC H3C3J7, Canada
| | - Nayan Chanauria
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC H3C3J7, Canada
| | - Faustin Armel Etindele-Sosso
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC H3C3J7, Canada
| | - Stéphane Molotchnikoff
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC H3C3J7, Canada.
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19
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Bharmauria V, Bachatene L, Ouelhazi A, Cattan S, Chanauria N, Etindele-Sosso FA, Rouat J, Molotchnikoff S. Interplay of orientation selectivity and the power of low- and high-gamma bands in the cat primary visual cortex. Neurosci Lett 2016; 620:14-9. [PMID: 27033667 DOI: 10.1016/j.neulet.2016.03.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 03/01/2016] [Accepted: 03/21/2016] [Indexed: 01/28/2023]
Abstract
Gamma oscillations are ubiquitous in brain and are believed to be inevitable for information processing in brain. Here, we report that distinct bands (low, 30-40Hz and high gamma, 60-80Hz) of stimulus-triggered gamma oscillations are systematically linked to the orientation selectivity index (OSI) of neurons in the cat primary visual cortex. The gamma-power is high for the highly selective neurons in the low-gamma band, whereas it is high for the broadly selective neurons in the high-gamma band. We suggest that the low-gamma band is principally implicated in feed-forward excitatory flow, whereas the high-gamma band governs the flow of this excitation.
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Affiliation(s)
- Vishal Bharmauria
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC, Canada
| | - Lyes Bachatene
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC, Canada
| | - Afef Ouelhazi
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC, Canada
| | - Sarah Cattan
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC, Canada
| | - Nayan Chanauria
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC, Canada
| | - Faustin Armel Etindele-Sosso
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC, Canada
| | - Jean Rouat
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC, Canada; Département de Génie Électrique et Génie Informatique, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Stéphane Molotchnikoff
- Neurophysiology of Visual System, Université de Montréal, Département de Sciences Biologiques, Montréal, QC, Canada; Département de Génie Électrique et Génie Informatique, Université de Sherbrooke, Sherbrooke, QC, Canada.
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20
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Aissaoui N, Puymirat E, Juillière Y, Cattan S, Schiele F, Ferrieres J, Tabassome S, Danchin N. 0135: Cardiogenic shock in elderly patients with acute myocardial infarction. The FAST-MI programme. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30316-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Bharmauria V, Bachatene L, Cattan S, Brodeur S, Chanauria N, Rouat J, Molotchnikoff S. Network-selectivity and stimulus-discrimination in the primary visual cortex: cell-assembly dynamics. Eur J Neurosci 2015; 43:204-19. [DOI: 10.1111/ejn.13101] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 10/06/2015] [Accepted: 10/10/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Vishal Bharmauria
- Neurophysiology of Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale Centre-Ville Montréal QC Canada H3C 3J7
- Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS); Sherbrooke QC Canada
| | - Lyes Bachatene
- Neurophysiology of Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale Centre-Ville Montréal QC Canada H3C 3J7
- Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS); Sherbrooke QC Canada
| | - Sarah Cattan
- Neurophysiology of Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale Centre-Ville Montréal QC Canada H3C 3J7
- Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS); Sherbrooke QC Canada
| | - Simon Brodeur
- Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS); Sherbrooke QC Canada
- Département de Génie Électrique et Génie Informatique; Université de Sherbrooke; Sherbrooke QC Canada
| | - Nayan Chanauria
- Neurophysiology of Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale Centre-Ville Montréal QC Canada H3C 3J7
- Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS); Sherbrooke QC Canada
| | - Jean Rouat
- Neurophysiology of Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale Centre-Ville Montréal QC Canada H3C 3J7
- Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS); Sherbrooke QC Canada
- Département de Génie Électrique et Génie Informatique; Université de Sherbrooke; Sherbrooke QC Canada
| | - Stéphane Molotchnikoff
- Neurophysiology of Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale Centre-Ville Montréal QC Canada H3C 3J7
- Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS); Sherbrooke QC Canada
- Département de Génie Électrique et Génie Informatique; Université de Sherbrooke; Sherbrooke QC Canada
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22
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Brault-Meslin O, Mazouz S, Nallet O, Cattan S, Amara W. [Free floating thrombus in right cardiac chambers and thrombolysis]. Ann Cardiol Angeiol (Paris) 2015; 64:410-413. [PMID: 26482630 DOI: 10.1016/j.ancard.2015.09.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 09/03/2015] [Indexed: 06/05/2023]
Abstract
Free-floating thrombi in the right heart chambers is a rare phenomenon. Nearly 99% of detected cases are associated with the presence of proven pulmonary embolism. Its presence is associated with a poor outcome with a mortality between 27 to 44% according to studies. Despite the emergency of treatment, optimal management of free floating right heart thrombus remains controversial with no clear consensus. We present the case of a 84-year-old man hospitalised for acute decompensated heart failure. After an initial favourable evolution, a degradation of respiratory occurred with dyspnea and desaturation. A bedside transthoracic echocardiography showed a mobile serpiginous thrombus, 7cm size, moving to and across the tricuspid valve. A computed tomography of the chest demonstrated massive bilateral pulmonary embolism. After persistence of the thrombus and seven days of heparinotherapy, thrombolysis therapy was initiated. The thrombus disappeared 24h after thrombolysis. Without contra-indication, thrombolysis is a faster, readily available treatment for the management of floating thrombus in the right heart chambers associated with pulmonary embolism.
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Affiliation(s)
- O Brault-Meslin
- Service de cardiologie, GHI Le Raincy-Montfermeil, 10, rue du Gl-Leclerc, 93370 Montfermeil, France
| | - S Mazouz
- Service de cardiologie, GHI Le Raincy-Montfermeil, 10, rue du Gl-Leclerc, 93370 Montfermeil, France
| | - O Nallet
- Service de cardiologie, GHI Le Raincy-Montfermeil, 10, rue du Gl-Leclerc, 93370 Montfermeil, France
| | - S Cattan
- Service de cardiologie, GHI Le Raincy-Montfermeil, 10, rue du Gl-Leclerc, 93370 Montfermeil, France
| | - W Amara
- Service de cardiologie, GHI Le Raincy-Montfermeil, 10, rue du Gl-Leclerc, 93370 Montfermeil, France.
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Bachatene L, Bharmauria V, Cattan S, Chanauria N, Rouat J, Molotchnikoff S. Summation of connectivity strengths in the visual cortex reveals stability of neuronal microcircuits after plasticity. BMC Neurosci 2015; 16:64. [PMID: 26453336 PMCID: PMC4600218 DOI: 10.1186/s12868-015-0203-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Within sensory systems, neurons are continuously affected by environmental stimulation. Recently, we showed that, on cell-pair basis, visual adaptation modulates the connectivity strength between similarly tuned neurons to orientation and we suggested that, on a larger scale, the connectivity strength between neurons forming sub-networks could be maintained after adaptation-induced-plasticity. In the present paper, based on the summation of the connectivity strengths, we sought to examine how, within cell-assemblies, functional connectivity is regulated during an exposure-based adaptation. RESULTS Using intrinsic optical imaging combined with electrophysiological recordings following the reconfiguration of the maps of the primary visual cortex by long stimulus exposure, we found that within functionally connected cells, the summed connectivity strengths remain almost equal although connections among individual pairs are modified. Neuronal selectivity appears to be strongly associated with neuronal connectivity in a "homeodynamic" manner which maintains the stability of cortical functional relationships after experience-dependent plasticity. CONCLUSIONS Our results support the "homeostatic plasticity concept" giving new perspectives on how the summation in visual cortex leads to the stability within labile neuronal ensembles, depending on the newly acquired properties by neurons.
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Affiliation(s)
- Lyes Bachatene
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada. .,Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS), Département de Génie Électrique et Génie Informatique, Université de Sherbrooke, Sherbrooke, QC, Canada.
| | - Vishal Bharmauria
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada. .,Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS), Département de Génie Électrique et Génie Informatique, Université de Sherbrooke, Sherbrooke, QC, Canada.
| | - Sarah Cattan
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada. .,Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS), Département de Génie Électrique et Génie Informatique, Université de Sherbrooke, Sherbrooke, QC, Canada.
| | - Nayan Chanauria
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada. .,Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS), Département de Génie Électrique et Génie Informatique, Université de Sherbrooke, Sherbrooke, QC, Canada.
| | - Jean Rouat
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada. .,Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS), Département de Génie Électrique et Génie Informatique, Université de Sherbrooke, Sherbrooke, QC, Canada.
| | - Stéphane Molotchnikoff
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, CP 6128 Succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada. .,Neurosciences Computationnelles et Traitement Intelligent des Signaux (NECOTIS), Département de Génie Électrique et Génie Informatique, Université de Sherbrooke, Sherbrooke, QC, Canada.
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Bachatene L, Bharmauria V, Cattan S, Chanauria N, Rouat J, Molotchnikoff S. Electrophysiological and firing properties of neurons: Categorizing soloists and choristers in primary visual cortex. Neurosci Lett 2015; 604:103-8. [PMID: 26247539 DOI: 10.1016/j.neulet.2015.07.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 07/30/2015] [Accepted: 07/31/2015] [Indexed: 11/28/2022]
Abstract
Visual processing in the cortex involves various aspects of neuronal properties such as morphological, electrophysiological and molecular. In particular, the neural firing pattern is an important indicator of dynamic circuitry within a neuronal population. Indeed, in microcircuits, neurons act as soloists or choristers wherein the characteristical activity of a 'soloist' differs from the firing pattern of a 'chorister'. Both cell types correlate their respective firing rate with the global populational activity in a unique way. In the present study, we sought to examine the relationship between the spike shape (thin spike neurons and broad spike neurons) of cortical neurons recorded from V1, their firing levels and their propensity to act as soloists or choristers. We found that thin spike neurons, which exhibited higher levels of firing, generally correlate their activity with the neuronal population (choristers). On the other hand, broad spike neurons showed lower levels of firing and demonstrated weak correlations with the assembly (soloists). A major consequence of the present study is: estimating the correlation of neural spike trains with their neighboring population is a predictive indicator of spike waveforms and firing level. Indeed, we found a continuum distribution of coupling strength ranging from weak correlation-strength (attributed to low-firing neurons) to high correlation-strength (attributed to high-firing neurons). The tendency to exhibit high- or low-firing is conducive to the spike shape of neurons. Our results offer new insights into visual processing by showing how high-firing rate neurons (mostly thin spike neurons) could modulate the neuronal responses within cell-assemblies.
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Affiliation(s)
- Lyes Bachatene
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, Montréal, QC, Canada; Neurosciences Computationnelles et Traitement Intelligent des Signaux NECOTIS, Université de Sherbrooke, Québec, Canada
| | - Vishal Bharmauria
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, Montréal, QC, Canada; Neurosciences Computationnelles et Traitement Intelligent des Signaux NECOTIS, Université de Sherbrooke, Québec, Canada
| | - Sarah Cattan
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, Montréal, QC, Canada; Neurosciences Computationnelles et Traitement Intelligent des Signaux NECOTIS, Université de Sherbrooke, Québec, Canada
| | - Nayan Chanauria
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, Montréal, QC, Canada; Neurosciences Computationnelles et Traitement Intelligent des Signaux NECOTIS, Université de Sherbrooke, Québec, Canada
| | - Jean Rouat
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, Montréal, QC, Canada; Neurosciences Computationnelles et Traitement Intelligent des Signaux NECOTIS, Université de Sherbrooke, Québec, Canada
| | - Stéphane Molotchnikoff
- Laboratoire de Neurosciences de la vision, Département de Sciences Biologiques, Université de Montréal, Montréal, QC, Canada; Neurosciences Computationnelles et Traitement Intelligent des Signaux NECOTIS, Université de Sherbrooke, Québec, Canada.
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Bharmauria V, Bachatene L, Cattan S, Chanauria N, Rouat J, Molotchnikoff S. Stimulus-dependent augmented gamma oscillatory activity between the functionally connected cortical neurons in the primary visual cortex. Eur J Neurosci 2015; 41:1587-96. [DOI: 10.1111/ejn.12912] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 03/18/2015] [Accepted: 04/01/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Vishal Bharmauria
- Neurophysiology of the Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale centre-ville Montréal QC H3C 3J7 Canada
| | - Lyes Bachatene
- Neurophysiology of the Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale centre-ville Montréal QC H3C 3J7 Canada
| | - Sarah Cattan
- Neurophysiology of the Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale centre-ville Montréal QC H3C 3J7 Canada
| | - Nayan Chanauria
- Neurophysiology of the Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale centre-ville Montréal QC H3C 3J7 Canada
| | - Jean Rouat
- Neurophysiology of the Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale centre-ville Montréal QC H3C 3J7 Canada
- Département de Génie Électrique et Génie Informatique; Université de Sherbrooke; Sherbrooke QC Canada
| | - Stéphane Molotchnikoff
- Neurophysiology of the Visual System; Département de Sciences Biologiques; Université de Montréal; CP 6128 Succursale centre-ville Montréal QC H3C 3J7 Canada
- Département de Génie Électrique et Génie Informatique; Université de Sherbrooke; Sherbrooke QC Canada
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Bachatene L, Bharmauria V, Cattan S, Rouat J, Molotchnikoff S. Modulation of functional connectivity following visual adaptation: homeostasis in V1. Brain Res 2015; 1594:136-53. [PMID: 25451112 DOI: 10.1016/j.brainres.2014.10.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 10/24/2014] [Accepted: 10/26/2014] [Indexed: 11/28/2022]
Abstract
Sensory neurons exhibit remarkable adaptability in acquiring new optimal selectivity to unfamiliar features when a new stimulus becomes prevalent in the environment. In conventionally prepared adult anesthetized cats, we used visual adaptation to change the preferred orientation selectivity in V1 neurons. Cortical circuits are dominated by complex and intricate connections between neurons. Cross-correlation of cellular spike-trains discloses the putative functional connection between two neurons. We sought to investigate changes in these links following a 12 min uninterrupted application of a specific, usually non-preferred, orientation. We report that visual adaptation, mimicking training, modulates the magnitude of crosscorrelograms suggesting that the strength of inter-neuronal relationships is modified. While individual cell-pairs exhibit changes in their response correlation strength, the average correlation of the recorded cell cluster remains unchanged. Hence, visual adaptation induces plastic changes that impact the connectivity between neurons.
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Affiliation(s)
- L Bachatene
- Laboratoire de Neurosciences de la Vision, Département de Sciences Biologiques, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, QC, Canada H3C 3J7; Neurosciences Computationnelles et Traitement Intelligent des Signaux-NECOTIS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - V Bharmauria
- Laboratoire de Neurosciences de la Vision, Département de Sciences Biologiques, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, QC, Canada H3C 3J7; Neurosciences Computationnelles et Traitement Intelligent des Signaux-NECOTIS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - S Cattan
- Laboratoire de Neurosciences de la Vision, Département de Sciences Biologiques, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, QC, Canada H3C 3J7; Neurosciences Computationnelles et Traitement Intelligent des Signaux-NECOTIS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - J Rouat
- Laboratoire de Neurosciences de la Vision, Département de Sciences Biologiques, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, QC, Canada H3C 3J7; Neurosciences Computationnelles et Traitement Intelligent des Signaux-NECOTIS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - S Molotchnikoff
- Laboratoire de Neurosciences de la Vision, Département de Sciences Biologiques, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montréal, QC, Canada H3C 3J7; Neurosciences Computationnelles et Traitement Intelligent des Signaux-NECOTIS, Université de Sherbrooke, Sherbrooke, QC, Canada.
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Cattan S, Bachatene L, Bharmauria V, Jeyabalaratnam J, Milleret C, Molotchnikoff S. Comparative analysis of orientation maps in areas 17 and 18 of the cat primary visual cortex following adaptation. Eur J Neurosci 2014; 40:2554-63. [DOI: 10.1111/ejn.12616] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/07/2014] [Accepted: 04/10/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Sarah Cattan
- Département de sciences biologiques; Université de Montréal; Pavillon Marie-Victorin, C.P. 6128, succ. Centre-ville Montréal QC H3C 3J7 Canada
| | - Lyes Bachatene
- Département de sciences biologiques; Université de Montréal; Pavillon Marie-Victorin, C.P. 6128, succ. Centre-ville Montréal QC H3C 3J7 Canada
| | - Vishal Bharmauria
- Département de sciences biologiques; Université de Montréal; Pavillon Marie-Victorin, C.P. 6128, succ. Centre-ville Montréal QC H3C 3J7 Canada
| | - Jeyadarshan Jeyabalaratnam
- Département de sciences biologiques; Université de Montréal; Pavillon Marie-Victorin, C.P. 6128, succ. Centre-ville Montréal QC H3C 3J7 Canada
| | - Chantal Milleret
- Neural Bases of Spatial Memory and Navigation; CIRB - Collège de France (CNRS UMR 7241, INSERM U1050, UPMC ED 158, MEMOLIFE PSL); Paris France
| | - Stéphane Molotchnikoff
- Département de sciences biologiques; Université de Montréal; Pavillon Marie-Victorin, C.P. 6128, succ. Centre-ville Montréal QC H3C 3J7 Canada
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Bharmauria V, Bachatene L, Cattan S, Rouat J, Molotchnikoff S. Synergistic activity between primary visual neurons. Neuroscience 2014; 268:255-64. [DOI: 10.1016/j.neuroscience.2014.03.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 03/12/2014] [Accepted: 03/13/2014] [Indexed: 01/16/2023]
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Georges JL, Hanssen M, Monsegu J, Goube P, Moquet B, Carreres T, Werquin S, Akesbi A, Belle L, Cattan S. Is radial route associated with higher radiation doses to patient during percutaneous coronary interventions? Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5436] [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: 11/12/2022] Open
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Georges JL, Belle L, Orion L, Elhadad S, Marcaggi X, Funck F, Vinchon F, Maccia C, Livarek B, Cattan S. Prevalence of high and very high radiation doses to patients during percutaneous coronary interventions. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1261] [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: 11/13/2022] Open
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Puymirat E, Danchin N, Steg PG, Blanchard D, Gueret P, Cattan S, Cambou JP, Ferrieres J, Simon T. Preponderant role of reduced early mortality in the reduction of one-year mortality in STEMI from 1995 to 2010: data from 4 French nationwide surveys over 15 years. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1303] [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: 11/13/2022] Open
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Bachatene L, Bharmauria V, Cattan S, Molotchnikoff S. Fluoxetine and serotonin facilitate attractive-adaptation-induced orientation plasticity in adult cat visual cortex. Eur J Neurosci 2013; 38:2065-77. [DOI: 10.1111/ejn.12206] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 02/26/2013] [Accepted: 02/28/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Lyes Bachatene
- Department of Biological Sciences; University of Montreal; Montreal; QC; Canada
| | - Vishal Bharmauria
- Department of Biological Sciences; University of Montreal; Montreal; QC; Canada
| | - Sarah Cattan
- Department of Biological Sciences; University of Montreal; Montreal; QC; Canada
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Cattan S, Hanssen M, Dibie A, Fellinger F, Monsegu J, Dellinger A, Belle L, Georges JL, Marcaggi X, Khalife K, Charbonnel C, Steinbach M, Pesenti Rossi D, Pesenti Possi D, Ferrier N, Livarek B, Hirsch JL, Albert F, Pansieri M, Amara W, Taeib J, Georger F, Jourdain P, Ross M, Horeman H, Dujardin JJ, Monassier JP, Hanania G. [The white book of the National College of Hospital Cardiologists (NCHC) -- to respond to a public health issue]. Ann Cardiol Angeiol (Paris) 2012; 61:307-10. [PMID: 23062604 DOI: 10.1016/j.ancard.2012.09.002] [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] [Received: 08/09/2012] [Accepted: 09/05/2012] [Indexed: 11/26/2022]
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Vergès B, Avignon A, Bonnet F, Catargi B, Cattan S, Cosson E, Ducrocq G, Elbaz M, Fredenrich A, Gourdy P, Henry P, Lairez O, Leguerrier A, Monpère C, Moulin P, Vergès-Patois B, Roussel R, Steg G, Valensi P. Consensus statement on the care of the hyperglycaemic/diabetic patient during and in the immediate follow-up of acute coronary syndrome. Diabetes & Metabolism 2012; 38:113-27. [DOI: 10.1016/j.diabet.2011.11.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Accepted: 11/24/2011] [Indexed: 01/19/2023]
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Hollebecque A, Cattan S, Romano O, Sergent G, Mourad A, Louvet A, Dharancy S, Boleslawski E, Truant S, Pruvot FR, Hebbar M, Ernst O, Mathurin P. Safety and efficacy of sorafenib in hepatocellular carcinoma: the impact of the Child-Pugh score. Aliment Pharmacol Ther 2011; 34:1193-201. [PMID: 21958438 DOI: 10.1111/j.1365-2036.2011.04860.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sorafenib increases median survival and time to radiological progression in patients with advanced hepatocellular carcinoma, but its benefit for Child-Pugh B patients remains uncertain. AIM To evaluate the safety and efficacy of sorafenib in real-life clinical practice conditions and to assess the influence of Child-Pugh class B on safety and efficacy. METHODS All patients treated with sorafenib for advanced hepatocellular carcinoma in our institution were included prospectively. Adverse events, overall survival and time to progression were recorded. A case control study was performed to compare outcome of patients with comparable stages of hepatocellular carcinoma, but a different Child-Pugh class. RESULTS From March 2007 to May 2009, 120 patients were included. Overall survival was 11.1 months, Child-Pugh A patients (n=100) had significantly higher median survival than Child-Pugh B patients (n=20) (13 vs. 4.5 months, P=0.0008). In multivariate analysis, Child-Pugh class B, α-fetoprotein level and total size of lesions were independent predictive factors of death. Patients with radiological progression in the first 3 months had shorter median survival (5.4 vs. 17.4 months). In a case control study, time to symptomatic progression (2.5 vs. 3.6 months), frequency of adverse events and discontinuation of sorafenib were not correlated with Child-Pugh class. CONCLUSIONS Patients with advanced hepatocellular carcinoma treated with sorafenib had a median survival of 11 months. Sorafenib therapy must be considered with caution in Child-Pugh B patients due to their poor survival. Radiological assessment of tumour progression at an early stage may be advantageous when tailoring sorafenib therapy.
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Affiliation(s)
- A Hollebecque
- Service d'Hépato-Gastroentérologie, CHRU Lille, France
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Zidi M, Nallet O, Esteve JB, Michaud P, Cattan S. [Extensive iatrogenic coronary dissection during coronary angioplasty: a series of 19 consecutive patients]. Ann Cardiol Angeiol (Paris) 2010; 59:306-310. [PMID: 20887973 DOI: 10.1016/j.ancard.2010.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 08/11/2010] [Indexed: 05/29/2023]
Abstract
PURPOSE OF THE STUDY Extensive coronary dissection is a rare complication of intraluminal angioplasty. We report a retrospective study of 19 patients who consulted in a general hospital without cardiac surgery. PATIENTS AND METHODS After consulting our coronarography and angioplasty database, we included the extensive coronary dissections (type D, E and F) in our study. The medical files of the selected patients were analysed. RESULTS Between January 2003 and March 2010, 19 coronary angioplasty (total: 2542) were complicated with extensive dissections (incidence 0,75%). For 62,3% of the patients, the dissection was related to the guiding catheter. Eleven patients had type A and B1 lesions. The dissections affected the right coronary artery for 16 patients, the left anterior descending coronary artery for two patients and the left main coronary artery for one patient. After angioplasty, a final TIMI flow 3 was obtained for only 11 patients. In nine cases, we observed a limited extension to the aorta that did not need a chirurgical intervention and had no influence on the prognosis. The complications were common, such as death (n=1), coronary bypass (n=2), myocardial infarction (n=8), cardiogenic shock (n=2) and circulatory assistance (n=2). CONCLUSION Extensive coronary dissection is a rare complication of angioplasty. The right coronary is the most frequent vessel concerned and an extension to aorta is usual. The treatment is usually based on sealing the entry with a coronary stent. The complications are common and serious and we did not find any predicting factors to extensive coronary dissections that are unpredictable.
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Affiliation(s)
- M Zidi
- Service de cardiologie, CHI Le Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France
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Ghrissi I, Nallet O, Amara W, Michaud P, Estève JB, Cattan S. [Acute non protected main left coronary artery occlusion: a report of six cases treated by angioplasty]. Ann Cardiol Angeiol (Paris) 2009; 58:293-8. [PMID: 19793577 DOI: 10.1016/j.ancard.2009.08.005] [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] [Received: 07/31/2009] [Accepted: 08/28/2009] [Indexed: 11/24/2022]
Abstract
AIM Acute main left coronary artery occlusion is rarely observed during primary angioplasty in myocardial infarction. This retrospective study reports the results of six patients treated by angioplasty in a hospital without cardiac surgery department. PATIENTS AND METHODS From 2002 to 2009, 746 patients were treated by primary angioplasty for acute coronary syndromes with ST elevation. Among those patients, six (0,7%) had acute non protected main left coronary occlusion. We report clinical, angiographical data and follow-up. RESULTS The population was composed of six patients (five males) with an average age of 64+/-7 years. Five patients were admitted with cardiogenic shock and four were mechanically ventilated. Distal occlusion of main left coronary artery and dominant right coronary artery were noted in all cases. Sub-occluded lesion of right coronary artery was noted in one case. Successful procedure with bare metal stent was achieved in five cases. Mortality rate was 66% (n=4): three patients died in hospital and another 1 or 2 months later of congestive heart failure. Coronary artery bypass grafting was performed at 4 and 12 months later for two patients. They are alive after 12 and 72 months of follow-up. CONCLUSION We demonstrate the feasibility of percutaneous coronary intervention of acute main left coronary occlusion. Inspite successful procedure, intrahospital mortality rate is still high and prognosis is related to cardiogenic shock.
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Affiliation(s)
- I Ghrissi
- Fédération de Cardiologie, Centre Hospitalier Intercommunal Le-Raincy-Montfermeil, Montfermeil, France
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Desauw A, Christophe V, Antoine P, Cattan S, Nandrino JL. Quelle perception les praticiens ont-ils de l’annonce de mauvaises nouvelles en oncologie ? Analyse qualitative du vécu et des stratégies de régulation émotionnelle. PSYCHO-ONCOLOGIE 2009. [DOI: 10.1007/s11839-009-0143-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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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Noël B, Algalarrondo V, Safar B, Cattan S, Nallet O, Henry P, Metzger JP, Helft G. [Multidetector computed tomography coronarography: from studies to everyday life]. Ann Cardiol Angeiol (Paris) 2009; 58:203-7. [PMID: 19473649 DOI: 10.1016/j.ancard.2009.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Accepted: 02/20/2009] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Multidetector computed tomography coronarography is a promising tool, offering a non-invasive anatomic evaluation of coronary arteries. The great majority of studies conducted upon it are single-center studies, and have reported results based upon a highly selected patient population. Our aim was to determine its diagnostic accuracy among an unselected population in multicenter studies. METHODS Fifty-two patients were included in a non-randomised, retrospective study. Patients underwent multidetector computed tomography coronarography (16, 40 and 64 slices), in ten different centers (community hospitals or private centres), for clinical suspicion of coronary stenoses. The diagnostic accuracy for detecting significant coronary stenoses (> or =50%) was determined in comparison with conventional coronarography. RESULTS The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were 91.4%, 17.7%, 69.6%, 50.0%, and 67.3%, respectively, in a patient-based analysis, and 55.3%, 85.6%, 30.3%, 94.4% and 82.5% in a segment-based analysis. CONCLUSION The results of this study indicate that routine implementation of multidetector computed tomography coronarography is limited by a high false-positive rate, when performed among an unselected population of patients with a high pretest probability of having coronary stenoses, in centres with variable expertises. Its place within the range of diagnostic tools has yet to be determined by large multicenter studies, before being subject to precise recommendations framing its routine clinical application.
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Affiliation(s)
- B Noël
- Service de cardiologie, centre hospitalier territorial Gaston-Bourret, Nouméa, Nouvelle-Calédonie.
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Leyer F, Nallet O, Cattan S. [Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome]. Ann Cardiol Angeiol (Paris) 2008; 57:284-289. [PMID: 18937923 DOI: 10.1016/j.ancard.2008.08.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Accepted: 08/27/2008] [Indexed: 05/26/2023]
Abstract
Takotsubo is a reversible cardiomyopathy, often triggered by a stressful event. It combines clinical features mimicking a myocardial infarction, transient apical ballooning of the left ventricle, normal coronary arteries and a small rise in troponin level. There is a striking female predominance with mean age ranging from 65 to 76 years among series. Preceding stressful event is documented in 50 to 100% of patients. The most common clinical presentation is an angor-like chest pain with ST-segment elevation on the electrocardiogram (70%). The prognosis is excellent even if serious complications may occur: pulmonary oedema, cardiogenic shock, transient dynamic intraventricular gradient, life-threatening arrhythmias. In-hospital mortality is in the range of 0 to 10%. The recurrence rate is low. The precise physiopathology of the syndrome remains unknown but catecholamine mediated myocardial stunning is the most favored explanation.
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Affiliation(s)
- F Leyer
- Service de cardiologie, CHI Le-Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France.
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Lapostolle F, Ameur L, Gonzalez G, Lenoir G, Cattan S, Hennequin B, Beruben A, Chassery C, Lapandry C, Adnet F. [Evaluation of patients' knowledge regarding counsels provided in case of chest pain after an acute myocardial infarction]. Arch Mal Coeur Vaiss 2006; 99:1173-1177. [PMID: 18942517] [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: 05/26/2023]
Abstract
INTRODUCTION an early call to the department of urgent medical assistance--Center 15 (SAMU-centre 15) is associated to shortest delays of reperfusion in case of myocardial infarction. However, patients are not always aware of this. OBJECTIVE to assess the assimilated counsels by patients after an acute myocardial infarction. METHODS from January 1998 to June 2004, patients managed by SAMU 93 and having benefited from thrombolytic therapy prior to hospitalization and/or primary angioplasty for a ST+ acute coronary syndrome with a confirmation of acute myocardial infarction during their hospital stay were prospectively enrolled into this study. A questionnaire was administered by phone from december 2003 to july 2005, assessing the knowledge about the necessity to alert SAMU-center 15 in case of chest pain and availability of medical files data. RESULTS among the 976 patients: 111 (11%) were lost during follow-up, 162 (19%) were deceased when phone contact and 119 (12%) could not be interrogated. Among the 584 (60%) remaining subjects interrogated with a median follow-up period of 985 days (413-1596), 290 (50%) patients answered they received counseling, including 156 (27%) for taking nitrates, 19 (29%) stated they know that they should call SAMU-center 15. Patients with a high level of education and those treated by thrombolytic therapy prior to hospitalization were better informed; 464 (79%) patients declared having a prescription, 392 (67%) a hospital report, 406 (69%) an electrocardiogram, 227 (39%) a CD with their coronary angiography, and 79(14%) their medical file. CONCLUSION the level of knowledge regarding the recommended attitude in case of chest pain is poor. The availability of medical data was better. Arch Mal Cceur
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El Mahmoud R, Leyer F, Michaud P, Nallet O, Cattan S. [Transient left ventricular apical ballooning syndrome or Takotsubo cardiomyopathy. About 11 cases]. Ann Cardiol Angeiol (Paris) 2006; 55:210-5. [PMID: 16922171 DOI: 10.1016/j.ancard.2006.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Takotsubo cardiomyopathy is a clinical entity mimicking an ST elevation myocardial infarction recently identified. Are associated a chest pain, electrocardiographics abnormalities, minor elevation of enzyme biomarkers in patients who don't have any significant angiographic stenosis on the coronary angiography and where left ventricle angiography shows apical regional wallmotion abnormalities with a characteristic apical ballooning aspect. Between march 2003 and march 2005, we included 11 patients for whom this syndrom was suspected. Mean age was 70, 3 years old. Electrocardiogram was abnormal in all cases. Biological markers show for all patients an elevation of troponin I. All patients had a coronary angiography and coronary arteries were normal. Left ventricle angiography showed in all cases wall-motion abnormalities in the apex with a ballooning aspect. A psychological or physical inducing factor has been found for 8 patients. The evolution was simple for all patients with no complications noted and no recurrence with a mean follow up of 15 months. Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrom have a good long-term prognosis even if serious complications sometimes deathly can be seen. The cause of this syndrom is unknown but it must be considered as a possible diagnosis of ST elevation myocardial infarction with normal coronary arteries.
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Affiliation(s)
- R El Mahmoud
- Service de cardiologie, CHI Le-Raincy-Montfermeil, 10, rue du général-Leclerc, 93370 Montfermeil, France.
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Barbare JC, Bouché O, Bonnetain F, Lombard-Bohas C, Faroux R, Dahan L, Raoul JL, Cattan S, Lemoine A, Blanc JF. Treatment of advanced hepatocellular carcinoma with long-acting octreotide: preliminary results of a randomized placebo-controlled trial (FFCD-ANGH 2001–01 CHOC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4036] [Citation(s) in RCA: 6] [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: 11/20/2022] Open
Affiliation(s)
- J. C. Barbare
- Ctr Hospitalier, Compiègne, France; Hôpital Robert Debré, Reims, France; Inserm Epi 106, Dijon, France; Hôpital Edouard Herriot, Lyon, France; Ctr Hospitalier, La Roche sur Yon, France; CHU La Timone, Marseille, France; Ctr Eugène marquis, Rennes, France; Hôpital Claude Huriez, Lille, France; Ctr Hospitalier, Nevers, France; Hôpital Saint-André, Bordeaux, France
| | - O. Bouché
- Ctr Hospitalier, Compiègne, France; Hôpital Robert Debré, Reims, France; Inserm Epi 106, Dijon, France; Hôpital Edouard Herriot, Lyon, France; Ctr Hospitalier, La Roche sur Yon, France; CHU La Timone, Marseille, France; Ctr Eugène marquis, Rennes, France; Hôpital Claude Huriez, Lille, France; Ctr Hospitalier, Nevers, France; Hôpital Saint-André, Bordeaux, France
| | - F. Bonnetain
- Ctr Hospitalier, Compiègne, France; Hôpital Robert Debré, Reims, France; Inserm Epi 106, Dijon, France; Hôpital Edouard Herriot, Lyon, France; Ctr Hospitalier, La Roche sur Yon, France; CHU La Timone, Marseille, France; Ctr Eugène marquis, Rennes, France; Hôpital Claude Huriez, Lille, France; Ctr Hospitalier, Nevers, France; Hôpital Saint-André, Bordeaux, France
| | - C. Lombard-Bohas
- Ctr Hospitalier, Compiègne, France; Hôpital Robert Debré, Reims, France; Inserm Epi 106, Dijon, France; Hôpital Edouard Herriot, Lyon, France; Ctr Hospitalier, La Roche sur Yon, France; CHU La Timone, Marseille, France; Ctr Eugène marquis, Rennes, France; Hôpital Claude Huriez, Lille, France; Ctr Hospitalier, Nevers, France; Hôpital Saint-André, Bordeaux, France
| | - R. Faroux
- Ctr Hospitalier, Compiègne, France; Hôpital Robert Debré, Reims, France; Inserm Epi 106, Dijon, France; Hôpital Edouard Herriot, Lyon, France; Ctr Hospitalier, La Roche sur Yon, France; CHU La Timone, Marseille, France; Ctr Eugène marquis, Rennes, France; Hôpital Claude Huriez, Lille, France; Ctr Hospitalier, Nevers, France; Hôpital Saint-André, Bordeaux, France
| | - L. Dahan
- Ctr Hospitalier, Compiègne, France; Hôpital Robert Debré, Reims, France; Inserm Epi 106, Dijon, France; Hôpital Edouard Herriot, Lyon, France; Ctr Hospitalier, La Roche sur Yon, France; CHU La Timone, Marseille, France; Ctr Eugène marquis, Rennes, France; Hôpital Claude Huriez, Lille, France; Ctr Hospitalier, Nevers, France; Hôpital Saint-André, Bordeaux, France
| | - J. L. Raoul
- Ctr Hospitalier, Compiègne, France; Hôpital Robert Debré, Reims, France; Inserm Epi 106, Dijon, France; Hôpital Edouard Herriot, Lyon, France; Ctr Hospitalier, La Roche sur Yon, France; CHU La Timone, Marseille, France; Ctr Eugène marquis, Rennes, France; Hôpital Claude Huriez, Lille, France; Ctr Hospitalier, Nevers, France; Hôpital Saint-André, Bordeaux, France
| | - S. Cattan
- Ctr Hospitalier, Compiègne, France; Hôpital Robert Debré, Reims, France; Inserm Epi 106, Dijon, France; Hôpital Edouard Herriot, Lyon, France; Ctr Hospitalier, La Roche sur Yon, France; CHU La Timone, Marseille, France; Ctr Eugène marquis, Rennes, France; Hôpital Claude Huriez, Lille, France; Ctr Hospitalier, Nevers, France; Hôpital Saint-André, Bordeaux, France
| | - A. Lemoine
- Ctr Hospitalier, Compiègne, France; Hôpital Robert Debré, Reims, France; Inserm Epi 106, Dijon, France; Hôpital Edouard Herriot, Lyon, France; Ctr Hospitalier, La Roche sur Yon, France; CHU La Timone, Marseille, France; Ctr Eugène marquis, Rennes, France; Hôpital Claude Huriez, Lille, France; Ctr Hospitalier, Nevers, France; Hôpital Saint-André, Bordeaux, France
| | - J. F. Blanc
- Ctr Hospitalier, Compiègne, France; Hôpital Robert Debré, Reims, France; Inserm Epi 106, Dijon, France; Hôpital Edouard Herriot, Lyon, France; Ctr Hospitalier, La Roche sur Yon, France; CHU La Timone, Marseille, France; Ctr Eugène marquis, Rennes, France; Hôpital Claude Huriez, Lille, France; Ctr Hospitalier, Nevers, France; Hôpital Saint-André, Bordeaux, France
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Abstract
The publication in 2001 of the first in-man results showing zero restenosis after sirolimus eluting stent implantation produced enormous excitement in the cardiological community. Today, both sirolimus and paclitaxel eluting stents have been shown in randomized trials to reduce restenosis as compared with conventional metallic stents. However, since drug eluting stents become available in Europe very little has changed in the every life of almost all interventional laboratories in Europe. The limitation currently impeding more widespread use of the new technology is nontechnical, nonmedical but economic. The high price of drug eluting stents relative to bare stents has been an obstacle to more widespread utilization of drug eluting stents.
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Affiliation(s)
- S Cattan
- CHI de Le-Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France.
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Nguyen S, Flesch M, Bennamoun M, Salle F, Angellier E, Carola E, Berdah JF, Cattan S, Magherini E, Louvet C. Multicentric phase II study of epirubicin and docetaxel as first line treatment for patients with advanced gastric cancer: A GERCOR study. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S. Nguyen
- Centre Hospitalier de Beauvais, Beauvais, France; Hopital Drevon, Dijon, France; Hopital de Montfermeil, Montfermeil, France; Hopital Tenon, Paris, France; Hopital de Chartres, Chartres, France; Hopital de Senlis, Senlis, France; Hopital Huriez, Lille, France; Laboratoire Aventis, Paris, France; Hopital St Antoine, Paris, France
| | - M. Flesch
- Centre Hospitalier de Beauvais, Beauvais, France; Hopital Drevon, Dijon, France; Hopital de Montfermeil, Montfermeil, France; Hopital Tenon, Paris, France; Hopital de Chartres, Chartres, France; Hopital de Senlis, Senlis, France; Hopital Huriez, Lille, France; Laboratoire Aventis, Paris, France; Hopital St Antoine, Paris, France
| | - M. Bennamoun
- Centre Hospitalier de Beauvais, Beauvais, France; Hopital Drevon, Dijon, France; Hopital de Montfermeil, Montfermeil, France; Hopital Tenon, Paris, France; Hopital de Chartres, Chartres, France; Hopital de Senlis, Senlis, France; Hopital Huriez, Lille, France; Laboratoire Aventis, Paris, France; Hopital St Antoine, Paris, France
| | - F. Salle
- Centre Hospitalier de Beauvais, Beauvais, France; Hopital Drevon, Dijon, France; Hopital de Montfermeil, Montfermeil, France; Hopital Tenon, Paris, France; Hopital de Chartres, Chartres, France; Hopital de Senlis, Senlis, France; Hopital Huriez, Lille, France; Laboratoire Aventis, Paris, France; Hopital St Antoine, Paris, France
| | - E. Angellier
- Centre Hospitalier de Beauvais, Beauvais, France; Hopital Drevon, Dijon, France; Hopital de Montfermeil, Montfermeil, France; Hopital Tenon, Paris, France; Hopital de Chartres, Chartres, France; Hopital de Senlis, Senlis, France; Hopital Huriez, Lille, France; Laboratoire Aventis, Paris, France; Hopital St Antoine, Paris, France
| | - E. Carola
- Centre Hospitalier de Beauvais, Beauvais, France; Hopital Drevon, Dijon, France; Hopital de Montfermeil, Montfermeil, France; Hopital Tenon, Paris, France; Hopital de Chartres, Chartres, France; Hopital de Senlis, Senlis, France; Hopital Huriez, Lille, France; Laboratoire Aventis, Paris, France; Hopital St Antoine, Paris, France
| | - J. F. Berdah
- Centre Hospitalier de Beauvais, Beauvais, France; Hopital Drevon, Dijon, France; Hopital de Montfermeil, Montfermeil, France; Hopital Tenon, Paris, France; Hopital de Chartres, Chartres, France; Hopital de Senlis, Senlis, France; Hopital Huriez, Lille, France; Laboratoire Aventis, Paris, France; Hopital St Antoine, Paris, France
| | - S. Cattan
- Centre Hospitalier de Beauvais, Beauvais, France; Hopital Drevon, Dijon, France; Hopital de Montfermeil, Montfermeil, France; Hopital Tenon, Paris, France; Hopital de Chartres, Chartres, France; Hopital de Senlis, Senlis, France; Hopital Huriez, Lille, France; Laboratoire Aventis, Paris, France; Hopital St Antoine, Paris, France
| | - E. Magherini
- Centre Hospitalier de Beauvais, Beauvais, France; Hopital Drevon, Dijon, France; Hopital de Montfermeil, Montfermeil, France; Hopital Tenon, Paris, France; Hopital de Chartres, Chartres, France; Hopital de Senlis, Senlis, France; Hopital Huriez, Lille, France; Laboratoire Aventis, Paris, France; Hopital St Antoine, Paris, France
| | - C. Louvet
- Centre Hospitalier de Beauvais, Beauvais, France; Hopital Drevon, Dijon, France; Hopital de Montfermeil, Montfermeil, France; Hopital Tenon, Paris, France; Hopital de Chartres, Chartres, France; Hopital de Senlis, Senlis, France; Hopital Huriez, Lille, France; Laboratoire Aventis, Paris, France; Hopital St Antoine, Paris, France
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Cosson E, Paycha F, Paries J, Cattan S, Ramadan A, Meddah D, Attali JR, Valensi P. Detecting silent coronary stenoses and stratifying cardiac risk in patients with diabetes: ECG stress test or exercise myocardial scintigraphy? Diabet Med 2004; 21:342-8. [PMID: 15049936 DOI: 10.1111/j.1464-5491.2004.01157.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To determine whether performing a myocardial scintigraphy immediately after a maximal electrocardiogram (ECG) stress test is effective in detecting silent coronary stenoses and predicting cardiovascular events. METHODS Asymptomatic patients (n = 262) aged 57.6 +/- 8.8 years, with diabetes for 12.0 years (5-39) [median (range)] and no history of a cardiac event, underwent a maximal ECG stress test followed by a myocardial scintigraphy. The patients with an abnormal ECG stress test or abnormal imaging underwent a coronary angiography. Cardiac events were assessed in 250 (95.4%) patients followed for 37.8 months (3-101). RESULTS The ECG stress test was abnormal in 54 patients. Among them, 18 had coronary stenoses and seven had a cardiac event. Despite a normal ECG stress test, the myocardial scintigraphy was abnormal in 42 additional patients, including 16 patients with coronary stenoses. Four of these 42 patients experienced a cardiac event. Follow-up showed a poor prognosis in subjects who were abnormal on the two tests. Univariate predictors of the 15 cardiac events were the ECG stress test [odds ratio (OR) 3.9, 95% confidence interval (CI) 1.3, 11.4, P = 0.008], myocardial scintigraphy (OR 3.8, 95% CI 1.3, 11.0, P = 0.009), coronary stenoses (OR 26.6, 95% CI 7.6, 90.7, P < 0.001), and peripheral or carotid occlusive arterial disease (OR 9.5, 95% CI 2.1, 42.5, P < 0.001). CONCLUSIONS In the asymptomatic patients with diabetes, combining a myocardial scintigraphy with a maximal ECG stress test is effective in detecting more patients with coronary stenoses and predicting cardiovascular events. However, the ECG stress test has a good negative predictive value for cardiac events (97%), is cheaper, and should therefore be proposed first.
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Affiliation(s)
- E Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Paris-Nord University, Jean Verdier Hospital, Bondy, France.
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Thévenot T, Cattan S, Nguyen-Khac E, Quinton J, Tiry C, Welty S, Leroy M. Maladie de Parkinson et achalasie. Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80609-9] [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: 11/30/2022]
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Abstract
BACKGROUND AND AIMS Obesity is unusual in Crohn's disease and the particularities of the disease in obese patients have not been studied. METHODS 2065 patients were studied retrospectively. Obesity was defined by a BMI value >25.0 at disease onset and >30.0 at any time during the course of the disease. Disease characteristics, therapeutic needs, and year-by-year disease activity were determined in patients with and without obesity. RESULTS 62 patients (3%) were obese. When compared with non-obese patients, obese patients did not show differences regarding sex, intestinal disease location, and disease behavior, but at diagnosis they were older (32 vs 28 years, P = 0.01) and a larger proportion had anoperineal disease (35 vs 24%, P = 0.03). When the 62 obese patients were paired for sex, location of disease at onset, date of birth, and date of diagnosis with 124 non-obese patients, the disease severity assessed by the importance of medical therapy and excisional surgery did not differ in the two groups but time to development of anoperineal abscess or fistula was shorter in obese patients, and obese patients were more prone to develop an active disease (OR 1.50, 95% CI 1.07-2.11) and to require hospitalization (OR 2.35, 95% CI 1.56-3.52) CONCLUSION Obesity in Crohn's disease is associated with more frequent anoperineal complications and a more marked year-by-year disease activity, but does not alter significantly the long-term course of the disease.
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Affiliation(s)
- A Blain
- Service de Gastroentérologie et Nutrition, Hôpital Rothschild, 33 Boulevard de Picpus, Paris, France
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Abstract
OBJECTIVES The incidence and severity of ulcerative colitis (UC) are higher in nonsmokers than in smokers. The natural course of UC in smokers who stop smoking is not known. The aim of this study was to determine the impact of cessation of smoking on the course of UC among the cohort of patients regularly seen at our institution. METHODS The severity of UC, as judged by the occurrence of flare-ups and the need for systemic steroids, immunosuppressive drugs and colectomy, was determined in 32 patients with UC who stopped smoking after the diagnosis of UC. We compared the period after cessation of smoking (7-yr mean follow-up) with the period between the onset of the disease and the cessation of smoking (9-yr mean duration). The course of UC in this group was compared with that of 32 nonsmokers and 32 continuing smokers matched for sex, age, and age at onset. RESULTS In patients who quit, cessation of smoking was followed by an increase in the rate of years with active disease (p < 0.01), years with hospitalization (p < 0.05) and years with major medical therapy (oral steroids, intravenous steroids, and azathioprine, p < 0.01). After cessation of smoking, the rate of years with immunosuppressive therapy was significantly greater in ex-smokers and nonsmokers than in continuing smokers (p < 0.01). The risk of colectomy in ex-smokers after smoking cessation was similar to that of nonsmokers and continuing smokers. CONCLUSIONS In smokers with UC who stop smoking, the severity of the disease increases after smoking cessation, with an increase in the disease activity and the need for hospital admission and major medical therapy. In addition, the need for azathioprine therapy becomes similar to that of nonsmokers.
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Affiliation(s)
- L Beaugerie
- Department of Gastroenterology, Rothschild Hospital, Paris, France
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Louvet C, André T, Hammel P, Selle F, Landi B, Cattan S, Fonck M, Flesch M, Colin P, Balosso J, Ruszniewski P, de Gramont A. Phase II trial of bimonthly leucovorin, 5-fluorouracil and gemcitabine for advanced pancreatic adenocarcinoma (FOLFUGEM). Ann Oncol 2001; 12:675-9. [PMID: 11432627 DOI: 10.1023/a:1011139808426] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Gemcitabine alone or 5-fluorouracil (5-FU) according to several schedules are used for palliation of metastatic and locally advanced (LA) pancreatic adenocarcinoma. This study was designed to test the efficacy of the leucovorin 5-FU and gemcitabine combination. PATIENTS AND METHODS This phase II trial combined a simplified bimonthly LV5FU2 with gemcitabine: leucovorin 400 mg/m2 in a two-hour infusion, followed by 5-fluorouracil 400 mg/m2 bolus and 2 or 3 g/m2 continuous infusion over 46 hours; gemcitabine 1 g/m2 was infused over 30 min on day 3 after 5-FU. Treatment was repeated every two weeks. Gemcitabine dose could be increased (250 mg/m2 every two cycles up to 1500 mg/m2) in the absence of NCI-CTC toxicity > 2. RESULTS Among the 62 patients included in this study, 22 had LA and 40 had metastatic disease. Objective response rate for the 54 patients with measurable disease was 25.9% (95% confidence interval (CI): 14%-37.8%) and 22.6% (95% CI: 12%-33.2%) in the intent-to-treat population: the clinical benefit rate for the 59 assessable patients was 49.2%. Median progression-free survival and median overall survival were 4.8 and 9 months, respectively, with 32.3% of patients alive at 1 year. The most frequent toxicity (grade 3-4) was neutropenia (56.5%) usually asymptomatic (1.1% febrile neutropenia), but requiring decreases of 5-FU and gemcitabine doses. Unexpected complete alopecia occurred in 97% of patients. CONCLUSIONS Palliative effects, response rate and survival observed in this multicenter study seem to be superior to those obtained with gemcitabine or 5-FU alone, despite a limiting hematological toxicity.
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Affiliation(s)
- C Louvet
- Service l'Oncologie, Hĵpital Saint-Antoine, Paris, France.
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