Publications by authors named "Alain Weill"
Purpose: Various angiographic assessment scales have been used to report the results of endovascular treatment with the WEB device. We aimed to review the use and reliability of these scales.
Methods: We systematically reviewed studies reporting angiographic outcomes of WEB-treated aneurysms from January 2010 to May 2023.
Background And Purpose: Flow diversion (FD) has expanded beyond initial indications (proximal carotid artery aneurysms) to include distal circulation aneurysms (on the anterior, middle, or posterior cerebral arteries). Our objective was to examine results obtained from aneurysms in these locations in the Flow Diversion in the Treatment of Intracranial Aneurysms Trial (FIAT) which compared FD with alternative standard management options (ASMO).
Materials And Methods: FIAT was an all-inclusive parallel-group 1:1 randomized study comparing FD with one of 4 ASMOs (coiling +/-stenting, parent vessel occlusion (PVO), clipping, or observation, pre-specified by clinical judgment).
Article Synopsis
Background And Purpose: Chlormadinone acetate (CMA) is a synthetic progestin for which cases of intracranial meningioma have been reported following prolonged exposure.
Method: An observational cohort study was conducted based on the French national health data system. Women aged 10-70 years and who started CMA between 2007 and 2017 were included.
Article Synopsis
- The study aimed to track the outcomes of patients with brain arteriovenous malformations (AVMs) who were managed conservatively, revealing key statistics on related morbidity and mortality over a 10-year period.
- Out of 1010 patients initially recruited, 434 were analyzed, with a majority having unruptured low-grade AVMs, demonstrating a 5% occurrence of serious outcomes and a higher risk in those with a history of rupture or older age.
- During the follow-up of approximately 3.2 years, 8% of patients experienced major intracranial hemorrhages, highlighting the ongoing risks associated with conservative management of AVMs.
Myocarditis is the most salient serious adverse event following messenger RNA-based Covid-19 vaccines. The highest risk is observed after the second dose compared to the first, whereas the level of risk associated with more distant booster doses seems to lie in between. We aimed to assess the relation between dosing interval and the risk of myocarditis, for both the two-dose primary series and the third dose (first booster).
View Article and Find Full Text PDFBackground: COVID-19 vaccination has been inconsistently associated with an increased risk of heavy menstrual bleeding in previous studies. This study aimed to assess the risk of heavy menstrual bleeding requiring hospital care following COVID-19 vaccination according to the number of doses received and the time elapsed since vaccination.
Methods: Using comprehensive data of the French National Health Data System, we carried out a case-control study.
Importance: Although patients with myocarditis after COVID-19 mRNA vaccination appear to have a good prognosis near hospital discharge, their longer-term prognosis and management remain unknown.
Objective: To study the cardiovascular complications of post-COVID-19 mRNA vaccination myocarditis and other types of myocarditis during an 18-month follow-up, as well as disease management based on a study of the frequency of medical procedures and drug prescriptions.
Design, Setting, And Participants: In this cohort study based on the French National Health Data System, all individuals aged 12 to 49 years hospitalized for myocarditis in France between December 27, 2020, and June 30, 2022, were identified.
Article Synopsis
- - The study aimed to identify risk factors for early childhood physical abuse (CPA) in France by analyzing data from infants born between 2010 and 2019, focusing on maternal, prenatal, and postnatal factors.
- - Out of nearly 7 million infants studied, about 3,000 were diagnosed with early CPA, with significant risk factors including low financial resources, young maternal age, substance abuse, intimate partner violence, and various health issues.
- - Findings are intended to guide better understanding of CPA and to develop targeted prevention strategies that identify high-risk parents for effective intervention.
Article Synopsis
- The study analyzes the use of the French National Health Data System (SNDS), which provides healthcare data for nearly the entire population of France, focusing on the trends in pharmacoepidemiological research based on this data.
- A systematic review of articles from 2012 to 2018 revealed an upward trend in published studies, with the majority focusing on drug utilization, safety, and effectiveness, and a notable concentration on medications for the nervous and cardiovascular systems.
- The findings suggest that while the SNDS is increasingly valuable for drug safety research, there is a need for more studies involving specific populations such as children, pregnant women, and the elderly, who are usually not represented in clinical trials.
Background: In spite of major effectiveness, a residual risk after COVID-19 primary vaccination was identified, in particular, for vulnerable individuals of advanced age or with comorbidities. Less is known about the Omicron period in people protected by a booster dose. We aimed to identify the characteristics associated with severe COVID-19 during the Omicron period in a population that had received a booster dose in France and to compare differences with the previous periods of the pandemic.
View Article and Find Full Text PDFBackground: Nomegestrol acetate (NOMAC) is a synthetic potent progestogen. This study aimed to assess the risk of intracranial meningioma associated with the prolonged use of NOMAC.
Methods: Observational cohort study using SNDS data (France).
Article Synopsis
- The study aimed to compare the risk of gastrointestinal perforation (GIP) between patients using JAK inhibitors (like tofacitinib and baricitinib) and those using the TNF inhibitor adalimumab in individuals with rheumatic diseases.
- Researchers analyzed data from a large cohort (39,758 patients) sourced from the French national health database from July 2017 to December 2021, tracking GIP occurrences until May 2022.
- Results showed that the incidence rates of GIP were similar between the two groups, with no significant difference in risk levels, suggesting that both treatments are comparable concerning this rare but serious side effect.
Importance: Cancer is a leading cause of death among children worldwide. Treatments used for medically assisted reproduction (MAR) are suspected risk factors because of their potential for epigenetic disturbance and associated congenital malformations.
Objective: To assess the risk of cancer, overall and by cancer type, among children born after MAR compared with children conceived naturally.
Objective: To assess the risk of intracranial meningioma associated with the use of selected progestogens.
Design: National case-control study.
Setting: French National Health Data System (ie, ).
Background And Purpose: To evaluate the reliability and accuracy of nonaneurysmal perimesencephalic subarachnoid hemorrhage (NAPSAH) on Noncontrast Head CT (NCCT) between numerous raters.
Materials And Methods: 45 NCCT of adult patients with SAH who also had a catheter angiography (CA) were independently evaluated by 48 diverse raters; 45 raters performed a second assessment one month later. For each case, raters were asked: 1) whether they judged the bleeding pattern to be perimesencephalic; 2) whether there was blood anterior to brainstem; 3) complete filling of the anterior interhemispheric fissure (AIF); 4) extension to the lateral part of the sylvian fissure (LSF); 5) frank intraventricular hemorrhage; 6) whether in the hypothetical presence of a negative CT angiogram they would still recommend CA.
Aims: Early postpartum glucose screening of women with hyperglycaemia in pregnancy (HIP) can identify women who have the highest risk of developing impaired glucose tolerance and T2DM. This study examines the association between demographics, events during pregnancy, socioeconomic status and postpartum T2DM screening.
Methods: Using the French National Health Data System, this cross-sectional study included all deliveries where the mother had HIP in France in 2015, (n = 76,862).
Background: Rheumatoid arthritis (RA) can affect women of childbearing age. The management of patients with RA during pregnancy has evolved over the past decades, especially with the availability of new therapeutic molecules.
Objectives: To describe pregnancy in women with RA, to compare pregnancy outcomes with those of women in the general population and to compare pregnancy outcomes in women with active and inactive RA.
Safety of Vedolizumab and Ustekinumab Compared With Anti-TNF in Pregnant Women With Inflammatory Bowel Disease.
Clin Gastroenterol Hepatol
January 2025
Background & Aims: Limited data are available on the consequences of prenatal exposure to vedolizumab and ustekinumab. We aimed to compare the safety of vedolizumab and ustekinumab with that of anti-tumor necrosis factor (TNF) in pregnant women with inflammatory bowel diseases (IBD).
Methods: Using nationwide, comprehensive data of the EPI-MERES registry, we identified pregnancies in women with IBD in France, exposed to anti-TNF, vedolizumab, and ustekinumab between 2014 and 2021.
Article Synopsis
- The study aimed to evaluate the impacts of different types of hyperglycaemia in pregnancy on maternal and fetal health outcomes using extensive health data from France.
- Researchers categorized women with hyperglycaemia into groups based on whether they had overt diabetes or gestational diabetes mellitus (GDM), as well as the timing of GDM diagnosis during their pregnancy.
- Significant findings revealed that women with overt diabetes faced higher risks for complications, including increased likelihood of cesarean sections, larger-than-normal infants, and other neonatal issues compared to those with GDM.
Importance: Solid organ transplant recipients are at high risk of severe infection with SARS-CoV-2 compared with the general population. However, factors associated with COVID-19-related severity in this population are still insufficiently explored in the literature.
Objective: To examine which health conditions and immunosuppressive drugs for preventing graft rejection are associated with the risk of COVID-19-related hospitalization in solid organ transplant recipients.
Article Synopsis
- * It involved a case-control analysis of 38,839 hospitalized COVID-19 patients matched with 377,653 controls, revealing that primary vaccination offers 45% protection, and booster doses can provide varying levels of effectiveness depending on the time since administration.
- * Results indicated that while primary vaccination is beneficial, booster effectiveness declines over time, with significant protection seen within two months post-booster but dropping significantly after six months, and prior SARS-CoV-2 infection also offers long-lasting protection.
Background And Objectives: Guillain-Barré syndrome (GBS) has been inconsistently associated with some coronavirus disease 2019 (COVID-19) vaccines. We aimed to quantify the risk of GBS according to the type of COVID-19 vaccine in a large population.
Methods: Using the French National Health Data System linked to the COVID-19 vaccine database, we analyzed all individuals aged 12 years or older admitted for GBS from December 27, 2020, to May 20, 2022.
Article Synopsis
- This study examines antibiotic use in pregnant women, revealing that 35.8% of pregnancies experienced antibiotic exposure, primarily from amoxicillin.
- It found that antibiotic prescriptions were less frequent during pregnancy compared to the year before and after pregnancy, likely due to careful consideration of risks and benefits.
- Factors such as social deprivation, smoking-related health issues, and chronic diseases were linked to a higher likelihood of filling antibiotic prescriptions during pregnancy.