Publications by authors named "Dechartres A"

Article Synopsis
  • The systematic review analyzed the effects of oral fluconazole on major congenital malformations (MCM) and miscarriages during the first trimester of pregnancy, including nine studies with over 3.7 million pregnancies.
  • Findings indicated that while crude estimates suggested a slight increase in overall MCM risk with fluconazole use, adjusted estimates showed no significant association, particularly for subtypes of MCM.
  • A notable link was found between fluconazole use and miscarriages, especially at doses exceeding 150 mg, highlighting the need for cautious use during early pregnancy despite the overall low risk for MCM.
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Objectives: Many negative randomized controlled trials (RCTs) report spin in their conclusions to highlight the benefits of the experimental arm, which could correspond to a noninferiority (NI) objective. We aimed to evaluate whether some negative superiority RCTs comparing 2 active interventions could correspond to an NI situation and to explore associated trial characteristics.

Study Design And Setting: We searched PubMed for superiority RCTs comparing 2 active interventions with non-statistically significant results for the primary outcome that were published in 2021 in the 5 journals with the highest impact factor in each medical specialty.

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Objectives: Target trial emulation is an approach that is increasingly used to improve transparency in observational studies and help mitigate biases. For studies declaring that they emulated a target trial, we aimed to evaluate the specification of the target trial, examine its consistency with the observational emulation and assess the risk of bias in the observational analysis.

Design: Methodological systematic review reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

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  • The study focused on evaluating different oral antibiotic regimens for treating acute staphylococcal prosthetic joint infections (PJIs) using a debridement, antibiotics, and implant retention (DAIR) strategy.
  • Researchers conducted a systematic review and network meta-analysis (NMA) but found significant variability in the studies, making comprehensive comparisons difficult.
  • Ultimately, while five combinations of antibiotics alongside rifampicin were highlighted, the evidence was insufficient to determine the effectiveness of alternatives when rifampicin is not an option.
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Adverse neonatal outcomes following in utero antipsychotic exposure remain unclear. This systematic review and meta-analysis aimed to investigate associations between in utero first- and second-generation antipsychotic exposure and various neonatal outcomes. The primary outcome was small for gestational age.

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Study Objective: Early prognostic stratification could optimize the management of patients with upper gastrointestinal bleeding and reduce unnecessary hospitalizations. The aim of this study was to assess and compare the performance of existing prognostic scores in predicting therapeutic intervention and death.

Methods: A systematic search of the literature identified existing prognostic scores.

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Background: Morphine relieves dyspnea in various clinical circumstances. Whether or not this applies to patients admitted to intensive care units (ICUs) for acute respiratory failure (ARF) is unknown. We evaluated the efficacy and safety of low-dose morphine on dyspnea in patients admitted to the ICU for ARF.

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Article Synopsis
  • Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are serious conditions requiring treatment to prevent progression and death; this study focuses on medication adherence (MA) and its impacts.
  • A systematic review analyzed 20 studies with over 22,000 patients, revealing MA levels varied widely, with factors like increased treatment frequency and co-payment linked to lower adherence rates.
  • High MA is associated with better clinical outcomes, fewer hospitalizations, and reduced healthcare costs, highlighting the need for educational efforts to improve adherence among patients.
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Article Synopsis
  • Augusta's Oath
  • podcast consists of six episodes focusing on key areas like the patient-doctor relationship, professionalism, and ethics in healthcare, aimed at making medical humanities engaging for students.
  • * The podcast was offered as an optional module for medical students at Sorbonne University, and feedback was collected to assess its effectiveness in enhancing students' understanding of medical humanities.
  • * Students reported a positive experience, feeling that the podcast increased their knowledge and shifted their perspectives on healthcare topics, highlighting the value of podcasts in medical education.
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Purpose: The risks carried by pregnancy after bariatric surgery (BS) include small-for-gestational age (SGA) newborn and prematurity. However, the underlying mechanisms are not yet fully understood in pregnant women after BS.

Material And Methods: This single-center retrospective observational cohort study includes all women with a first and single pregnancy after BS who completed at least one clinical and biological nutritional assessment during pregnancy between 2010 and 2016.

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Background And Aims: A recent single-center study reported a significant increase in acute myeloid leukaemia (AML) cases, including mixed-phenotype acute leukaemia (MPAL), after exposure to direct acting agents (DAA). We investigated whether DAA use increased the risk of AML in patients with chronic hepatitis C virus (HCV) infection.

Methods: We conducted a disproportionality analysis of the WHO Pharmacovigilance database Vigibase up to 2020.

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Objectives: This study aimed to identify perioperative risk factors of acute kidney injury after heart transplantation and to evaluate 1-year clinical outcomes.

Design: A retrospective single-center cohort study.

Setting: At a university hospital.

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In preparation for a new version of the CRAT (Centre de référence sur les agents tératogènes) website, an evaluation of user satisfaction was carried out. An invitation to complete an online questionnaire covering the various dimensions of the website (appearance, content, interactivity, ease of use, technical performance) was sent in April 2022 to healthcare professionals who referred to CRAT for clinical expertise over the previous two years. After sending out 3224 individual e-mail invitations, 758 evaluators completed the questionnaire in full (response rate: 23.

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Article Synopsis
  • - The study investigates the use of rescue intracranial stenting (RIS) combined with best medical treatment (BMT) versus BMT alone for patients experiencing acute ischemic strokes (AIS) due to large vessel occlusions that do not respond to mechanical thrombectomy (MT).
  • - Conducted across 11 French University hospitals, the PISTAR trial involves randomizing 346 adult patients to evaluate the effectiveness of RIS in improving functional outcomes at 3 months and monitoring for complications and adverse events.
  • - The primary outcome is measured by the modified Rankin Scale, aiming to determine if RIS improves patient outcomes compared to BMT alone; this is the first randomized trial specifically targeting this issue in acute stroke management.
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Objectives: The use of secondary databases has become popular for evaluating the effectiveness and safety of interventions in real-life settings. However, the absence of important confounders in these databases is challenging. To address this issue, the high-dimensional propensity score (hdPS) algorithm was developed in 2009.

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Background: Middle meningeal artery (MMA) embolization has been proposed as a treatment of chronic subdural hematoma (CSDH). The benefit of the procedure has yet to be demonstrated in a randomized controlled trial. We aim to assess the efficacy of MMA embolization in reducing the risk of CSDH recurrence 6 months after burr-hole surgery compared with standard medical treatment in patients at high risk of postoperative recurrence.

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Background: Suboptimal prescribing, including the prescription of potentially inappropriate medications (PIM), is frequent in patients aged 65 years and older. PIMs are associated with adverse drug events, which may lead to hospital admissions and readmissions for the most serious cases. Several tools, known as lists of PIMs, can detect suboptimal prescription.

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Article Synopsis
  • * Research shows that patients with thymic epithelial tumors (TET), especially thymoma, experience ICI-related myotoxicities more frequently and with greater severity than those with other cancers.
  • * The presence of anti-acetylcholine-receptor antibodies suggests a link between thymic-related autoimmune responses and ICI myotoxicities, indicating that assessing the thymus could help predict these serious side effects in patients undergoing ICI therapy.
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Objectives: Fungal prosthetic vascular graft infections are rare and mainly supra-inguinal. Current guidelines are based on the few studies that have specifically investigated this population, with few risk factors described. The objective of this study is to compare fungal and non-fungal supra-inguinal prosthetic vascular graft infections (PVGI), describing their specificities, identifying risk factors, and evaluating outcomes.

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Rationale: Mechanical thrombectomy (MT) associated with the best medical treatment (BMT) has recently shown efficacy for the management of acute ischemic stroke (AIS) secondary to a large vessel occlusion. However, evidence is lacking regarding the benefit of MT for more distal occlusions.

Aim: To evaluate the efficacy in terms of good clinical outcome at 3 months of MT associated with the BMT over the BMT alone in AIS related to a distal occlusion.

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Objectives: Population-adjusted indirect comparisons (PAICs) were developed in the 2010s to allow for comparisons between two treatments evaluated in different trials while accounting for differences in patient characteristics if individual patient data (IPD) are available for only one trial. Such comparisons are increasingly used in market access applications when a pharmaceutical company compares its new treatment (with IPD available) to another treatment developed by a competitor (with only aggregated data available). This study aimed to describe the characteristics of these PAICs, assess their methodology, and describe the reported results.

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