Publications by authors named "Lebre A"

Healthcare-associated infections (HAIs) represent a major challenge in patient safety that affects services disproportionally. This paper aimed to assess how the HAI prevalence varies between hospital services and what contextual characteristics may explain such variance. A cross-sectional study was conducted on adult patients in Portuguese hospitals, using data from the European point prevalence survey of HAI prevalence.

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Objective: The objective of this study was to evaluate the implementation of NGS within the French mitochondrial network, MitoDiag, from targeted gene panels to whole exome sequencing (WES) or whole genome sequencing (WGS) focusing on mitochondrial nuclear-encoded genes.

Methods: Over 2000 patients suspected of Primary Mitochondrial Diseases (PMD) were sequenced by either targeted gene panels, WES or WGS within MitoDiag. We described the clinical, biochemical, and molecular data of 397 genetically confirmed patients, comprising 294 children and 103 adults, carrying pathogenic or likely pathogenic variants in nuclear-encoded genes.

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Article Synopsis
  • The study analyzes data from two groups of individuals with DDX3X variations, one from physicians (48 individuals) and the other from caregivers (44 individuals).
  • The results reveal shared symptoms between the two groups, including previously unreported early childhood issues like feeding difficulties and delayed developmental milestones.
  • The discussion emphasizes that both datasets complement each other, highlighting the importance of addressing symptoms such as ADHD, anxiety, and sleep disturbances in affected individuals.
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Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease. While biallelic variants affecting IFT140 are responsible for Mainzer-Saldino syndrome (characterized by severe ciliopathy causing skeletal abnormalities, kidney disease, and cysts), monoallelic loss-of-function (LoF) variants have been recently reported as an important cause of ADPKD beyond PKD1/2 genes. Herein, we report 6 non-family-related cases of monoallelic IFT140 LoF variants, identified from 1,340 exomes sequenced for nephrological indications in our local database.

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Objective: The incidence of surgical site infection (SSI) is highest after colorectal surgery. We assessed the impact of risk factors for SSI using the population attributable fraction (PAF).

Design: Retrospective cohort study.

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Introduction: Exome sequencing (ES) has widened the field of nephrogenomics in adult nephrology. In addition to reporting the diagnostic yield of ES in an adult cohort study, we investigated the clinical implications of molecular diagnosis and developed a clinical score to predict the probability of obtaining positive result.

Methods: From September 2018 we have used ES to prospectively perform a first-tier liberal exploration of adult nephropathies of unknown origin and/or when a genetic kidney disease was clinically suggested.

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Background: Surgical site infections (SSIs) are associated with poor health outcomes. Their incidence is highest after colorectal surgery, with little improvement in recent years. The role of hospital characteristics is undetermined.

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Background: Primary mucosal melanomas (PMMs) are rare and clinically heterogeneous, including head and neck (HNMs), vulvovaginal (VVMs), conjunctival (CjMs), anorectal (ARMs) and penile (PMs) melanomas. While the prognosis of advanced cutaneous melanoma has noticeably improved using treatments with immune checkpoint inhibitors (ICIs) and molecules targeting BRAF and MEK, few advances have been made for PMMs because of their poorer response to ICIs and their different genetic profile. This prompted us to conduct a systematic review of molecular studies of PMMs to clarify their pathogenesis and potential therapeutic targets.

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  • Wiedemann-Steiner syndrome (WDSTS) is an intellectual disability condition with features like short stature and hypertrichosis cubiti, caused by mutations in a specific gene.
  • The syndrome can present with a wide range of symptoms, making diagnosis challenging, especially in less typical cases.
  • Researchers identified a unique DNA methylation episignature in patients, which can help classify genetic variants related to WDSTS and potentially provide better diagnostic insight and understanding of the syndrome's molecular causes.
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  • The EPIGENE network, formed in 2014 by a group of specialists in genetics and neurology, aims to enhance the diagnosis of Mendelian epileptic disorders in France through advanced sequencing techniques.
  • Since its creation, the network has expanded to include more centers, resulting in the development of a multigene panel that has grown from 68 to 144 genes, with a significant diagnostic success rate of 31% from over 4,000 analyzed cases.
  • Looking ahead, the network plans to offer whole-genome sequencing for young patients with severe epilepsy as part of the upcoming 2025 French Genomic Medicine Plan, fostering collaborations with the rare epilepsies reference center.
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Prolidase deficiency (PD) is a rare autosomal recessive genodermatosis with variable clinical manifestations. It results from a mutation in the peptidase-D gene that leads to abnormal activity of the prolidase enzyme, an important player in collagen catabolism. The authors report the case of two siblings presenting with dysmorphic features, disturbed blood panel, and recalcitrant leg ulcerations of several years' duration.

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The case highlights the importance of actively obtaining informative samples at an early stage and of prompt initiation of combination therapy with antifungal drugs.

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Article Synopsis
  • * Two adult cases (a mother and daughter) were identified with kidney issues, including kidney hypoplasia and end-stage renal disease (ESRD), leading to the diagnosis of TBS confirmed through genetic testing.
  • * A literature review of 44 adult TBS cases revealed that 10 had kidney disease, often diagnosed incidentally or due to complications, suggesting TBS could be more common in adults than previously thought, emphasizing the need for ongoing monitoring.
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Objective: We aimed to delineate the phenotypic spectrum and long-term outcome of individuals with KCNB1 encephalopathy.

Methods: We collected genetic, clinical, electroencephalographic, and imaging data of individuals with KCNB1 pathogenic variants recruited through an international collaboration, with the support of the family association "KCNB1 France." Patients were classified as having developmental and epileptic encephalopathy (DEE) or developmental encephalopathy (DE).

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  • Molecular diagnosis using singleton exome sequencing (sES) in fetuses with multiple congenital abnormalities (MCA) shows a lower diagnostic yield (20%) compared to live births with developmental issues (30%), indicating potential underestimation of genetic variant impact in fetal cases.
  • In a study of 95 fetuses with MCA, a genotype-first strategy was employed, blending variant analysis and bioinformatics with reverse phenotyping to determine the clinical significance of genetic variations.
  • The results revealed causal variants in 25% of fetuses, unknown significance variants in 8%, and identified six novel candidate genes, highlighting the importance of prenatal genetic studies for understanding complex disorders.
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De novo pathogenic variants in the GATAD2B gene have been associated with a syndromic neurodevelopmental disorder (GAND) characterized by severe intellectual disability (ID), impaired speech, childhood hypotonia, and dysmorphic features. Since its first description in 2013, nine patients have been reported in case reports and a series of 50 patients was recently published, which is consistent with the relative frequency of GATAD2B pathogenic variants in public databases. We report the detailed phenotype of 19 patients from various ethnic backgrounds with confirmed pathogenic GATAD2B variants including intragenic deletions.

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The treatment of condyloma is generally a challenge in clinical practice. Although the spontaneous resolution rate is high, a significant proportion of patients seek treatment, not because of symptomatology, but mainly for aesthetic issues and concerns related to the transmission or worsening of existing lesions. The available treatments should be applied only for clinically evident macroscopic lesions.

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Objectives: In Portugal, a country with strong Catholic roots, elective termination of pregnancy at women's request is still stigmatised, especially if it is a repeat abortion. The objectives of this study were to determine the incidence of repeat abortion, taking into account the contraceptive method chosen after the index abortion event, and characterise the risk factors for repeat abortion.

Methods: This was a retrospective cohort study of 988 women who requested termination of pregnancy during 2015 in a Portuguese tertiary care public hospital.

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Article Synopsis
  • - Prolidase is an important enzyme for metabolizing proline-rich proteins, and its deficiency leads to a rare genetic disorder with various symptoms including intellectual disability and skin lesions.
  • - The condition is characterized by multiple health issues such as recurrent infections, autoimmune disorders, and abnormalities in blood cell counts (cytopenia).
  • - This study aims to provide a comprehensive review of existing clinical data and research on prolidase deficiency, focusing on patient features, treatment options, and relevant studies.
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Objective: While the most frequent mutation responsible for mitochondrial diabetes is the point mutation m.3243 A>G of mitochondrial DNA (mtDNA), few data are available about the role of rare mtDNA mutations in the pathophysiology of diabetes. The main objective of our study was to describe the phenotypic characteristics of patients suffering from diabetes linked to rare mtDNA mutations.

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  • Developmental and epileptic encephalopathies (DEE) are complex neurodevelopmental disorders linked to various genetic variations, with recent focus on KCNB1 gene mutations.
  • This study reviews 37 patients with KCNB1 variants, identifying 18 novel mutations and emphasizing the presence of mostly de novo missense changes affecting key protein regions.
  • Patients frequently experience severe neurodevelopmental issues, particularly language and behavioral challenges, with 85% developing epilepsy; notably, those with truncating variants have milder symptoms.
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