Publications by authors named "P-J Lamy"
Background: Although intravenous tranexamic acid is used in cardiac surgery to reduce bleeding and transfusion, topical tranexamic acid results in lower plasma concentrations compared with intravenous tranexamic acid, which may lower the risk of seizures. We aimed to determine whether topical tranexamic acid reduces the risk of in-hospital seizure without increasing the risk of transfusion among cardiac surgery patients.
Methods: We conducted a multicenter, double dummy, blinded, randomized controlled trial of patients recruited by convenience sampling in academic hospitals undergoing cardiac surgery with cardiopulmonary bypass.
Detection and Monitoring of Tumor-Derived Mutations in Circulating Tumor DNA Using the UltraSEEK Lung Panel on the MassARRAY System in Metastatic Non-Small Cell Lung Cancer Patients.
Int J Mol Sci
August 2023
Article Synopsis
- ctDNA analysis offers a minimally invasive method for treatment decision-making and monitoring cancer, particularly in patients with advanced-stage non-small cell lung cancer (NSCLC).
- In a study of 72 patients, the UltraSEEK Lung Panel demonstrated a high detection rate (over 90%) for tumor-specific mutations in circulating cell-free DNA (ccfDNA), showing good accuracy compared to droplet digital PCR and traditional tumor tissue testing.
- A significant decrease in ctDNA levels shortly after treatment initiation was linked to longer progression-free survival (PFS) and overall survival (OS), indicating that ccfDNA can effectively track treatment response in NSCLC patients.
Background: Among patients having noncardiac surgery, perioperative hemodynamic abnormalities are associated with vascular complications. Uncertainty remains about what intraoperative blood pressure to target and how to manage long-term antihypertensive medications perioperatively.
Objective: To compare the effects of a hypotension-avoidance and a hypertension-avoidance strategy on major vascular complications after noncardiac surgery.
Background: Perioperative bleeding is common in patients undergoing noncardiac surgery. Tranexamic acid is an antifibrinolytic drug that may safely decrease such bleeding.
Methods: We conducted a trial involving patients undergoing noncardiac surgery.
Background: Consensus recommendations regarding the threshold levels of cardiac troponin elevations for the definition of perioperative myocardial infarction and clinically important periprocedural myocardial injury in patients undergoing cardiac surgery range widely (from >10 times to ≥70 times the upper reference limit for the assay). Limited evidence is available to support these recommendations.
Methods: We undertook an international prospective cohort study involving patients 18 years of age or older who underwent cardiac surgery.
Background: Surgical occlusion of the left atrial appendage has been hypothesized to prevent ischemic stroke in patients with atrial fibrillation, but this has not been proved. The procedure can be performed during cardiac surgery undertaken for other reasons.
Methods: We conducted a multicenter, randomized trial involving participants with atrial fibrillation and a CHADS-VASc score of at least 2 (on a scale from 0 to 9, with higher scores indicating greater risk of stroke) who were scheduled to undergo cardiac surgery for another indication.
Article Synopsis
- The PVC-RAM trial aims to assess whether virtual care with remote automated monitoring (RAM) improves post-discharge outcomes for patients who have undergone nonelective surgeries during the COVID-19 pandemic.
- The study involves 900 adults from 8 Canadian hospitals, who are randomly assigned to receive either RAM or standard care, with daily monitoring of vital signs and interaction with nurses over a 30-day period.
- Results from this trial will help shape better post-surgical care strategies and will be shared through various platforms for broader impact, both during and after the pandemic.
Plasma-based tumor mutational profiling is arising as a reliable approach to detect primary and therapy-induced resistance mutations required for accurate treatment decision making. Here, we compared the FDA-approved Cobas EGFR Mutation Test v2 with the UltraSEEK™ Lung Panel on the MassARRAY System on detection of mutations, accompanied with preanalytical sample assessment using the novel Liquid IQ Panel. 137 cancer patient-derived cell-free plasma samples were analyzed with the Cobas and UltraSEEK™ tests.
View Article and Find Full Text PDFBackground: The authors previously reported that perioperative aspirin and/or clonidine does not prevent a composite of death or myocardial infarction 30 days after noncardiac surgery. Moreover, aspirin increased the risk of major bleeding and clonidine caused hypotension and bradycardia. Whether these complications produce harm at 1 yr remains unknown.
View Article and Find Full Text PDFBackground: Perioperative corticosteroid use may reduce acute kidney injury. We sought to test whether methylprednisolone reduces the risk of acute kidney injury after cardiac surgery.
Methods: We conducted a prespecified substudy of a randomized controlled trial involving patients undergoing cardiac surgery with cardiopulmonary bypass (2007-2014); patients were recruited from 79 centres in 18 countries.
Background: We previously reported that there was no significant difference at 30 days or at 1 year in the rate of the composite outcome of death, stroke, myocardial infarction, or renal failure between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report the results at 5 years (the end of the trial).
Methods: A total of 4752 patients (from 19 countries) who had coronary artery disease were randomly assigned to undergo off-pump or on-pump CABG.
Background: Persistent incisional pain is common after cardiac surgery and is believed to be in part related to inflammation and poorly controlled acute pain. Methylprednisolone is a corticosteroid with substantial antiinflammatory and analgesic properties and is thus likely to ameliorate persistent surgical pain. Therefore, the authors tested the primary hypothesis that patients randomized to methylprednisolone have less persistent incisional pain than those given placebo.
View Article and Find Full Text PDFBackground: Myocardial injury after noncardiac surgery (MINS) was defined as prognostically relevant myocardial injury due to ischemia that occurs during or within 30 days after noncardiac surgery. The study's four objectives were to determine the diagnostic criteria, characteristics, predictors, and 30-day outcomes of MINS.
Methods: In this international, prospective cohort study of 15,065 patients aged 45 yr or older who underwent in-patient noncardiac surgery, troponin T was measured during the first 3 postoperative days.