Real-life implementation and evaluation of the e-referral system SIPILINK.

Introduction: General Practitioners (GPs) play a key role of gatekeeper, as they coordinate patients' care. However, most of them reported having difficulty to refer patients to hospital, especially in semi-urgent context. To facilitate the referral of semi-urgent patients, we implemented an e-referral platform, named SIPILINK, within 4 wards from a large public French hospital (internal medicine, diabetology, gynaecological surgery and oncology wards).

Cardiovascular disease healthcare trajectories: descriptions, similarities, mortality rates of heart failure in France.

Aims: The primary objectives of this study were to analyse the nationwide healthcare trajectories of heart failure (HF) patients in France, 2 years after their first hospitalization, and to measure sequence similarities. Secondary objectives were to identify the association between trajectories and the risk of mortality.

Methods And Results: A retrospective, observational study was conducted using data extracted from the Echantillon Généraliste des Bénéficiaires database, covering the period from 1 January 2008 to 31 December 2018.

Serum endocan as a predictive biomarker of cardiovascular risk in obese pediatric patients.

Background: Endocan is a soluble dermatan sulfate proteoglycan (50 kDa) secreted by endothelial cells and expressed by dermal, coronary, pulmonary and adipose tissue microvasculature. It plays an important role in the pathogenesis of vascular disorders, inflammatory state, endothelium dysfunction and neoangiogenesis. Aims of the study were to compare fasting serum endocan levels between children with obesity and healthy controls and to investigate the relationships between endocan, body mass index (BMI) and other indices of cardiometabolic risk.

Allergen immunotherapy for food allergy: Evidence and outlook.

Food allergy represents a significant health issue characterized by a sizeable epidemiological burden, involving up to 5% of adults and up to 8% of children in the Western world. The elimination diet of the trigger food is the cornerstone of food allergy management. However, novel treatment options are most wanted to provide alternative strategies for this potentially fatal medical condition.

The effect of obesity-related allostatic changes on cardio-metabolic risk in euthyroid children.

Purpose: The hormonal thyroid changes related to obesity, even when in the euthyroid state, may contribute to the unfavorable cardio-metabolic profile of obese patients. In this retrospective study, we aim to investigate the biochemical thyroid changes and the association between serum TSH, FT4, FT3 and cardio-metabolic risk factors in euthyroid obese youths.

Methods: Four hundred ninety-one Caucasian euthyroid obese children and adolescents aged 9.

Impact of Covid-19 Pandemic on the Effectiveness of Outpatient Counseling in Childhood Obesity Management.

The Covid-19 pandemic drastically modified social life and lifestyle, in particular, among children and adolescents, promoting sedentary behaviors and unhealthy eating habits. The aims of this study were to assess the rate and the factors associated with outpatient drop-out in childhood obesity management, and to evaluate how the Covid-19 pandemic influenced weight status and lifestyle of children and adolescents with obesity. One hundred and forty-five children and adolescents with obesity were identified, including 80 subjects evaluated before the Covid-19 pandemic (group A) and 65 subjects in the period straddling the Covid-19 pandemic (group B).

IL-17 serum level in patients with chronic mucocutaneous candidiasis disease.

Background: Chronic mucocutaneous candidiasis (CMC) is defined by recurrent or persistent superficial infections involving nails, skin, and/or oral and genital mucosae. IL-17 promotes the recruitment, chemotaxis, and expansion of neutrophils and acts directly on keratinocytes and epithelial cells, driving the production of antimicrobial peptides, essential for the immune response against Candida.

Aim: To evaluate the serum level of IL-17 in a family affected by CMC restricted to the nails of the hands and feet.

The function of specialized pro-resolving endogenous lipid mediators, vitamins, and other micronutrients in the control of the inflammatory processes: Possible role in patients with SARS-CoV-2 related infection.

Inflammation is an essential protective response against harmful stimuli, such as invading pathogens, damaged cells, or irritants. Physiological inflammation eliminates pathogens and promotes tissue repair and healing. Effective immune response in humans depends on a tightly regulated balance among inflammatory and anti-inflammatory mechanisms involving both innate and adaptive arms of the immune system.

Methods to investigate advanced glycation end-product and their application in clinical practice.

Advanced glycation end-products (AGEs) are heterogeneous compounds of irreversible adducts principally derived from nonenzymatic glycation and glycoxidation of proteins. An increase in AGEs may be involved in the pathogenesis of metabolic and cardiovascular diseases, chronic degenerative diseases, neurological diseases and cancer, and it has been suggested as a biomarker of oxidative stress. AGEs have been evaluated in different biological fluids, as well as in tissues.

COVID-19, what could sepsis, severe acute pancreatitis, gender differences, and aging teach us?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a potentially life-threatening disease, defined as Coronavirus Disease 19 (COVID-19). The most common signs and symptoms of this pathological condition include cough, fever, shortness of breath, and sudden onset of anosmia, ageusia, or dysgeusia. The course of COVID-19 is mild or moderate in more than 80% of cases, but it is severe or critical in about 14% and 5% of infected subjects respectively, with a significant risk of mortality.

Is keratoconus associated to thyroid diseases? Assessment of the corneal parameters in patients with congenital hypothyroidism.

Purpose: To investigate the association between keratoconus and congenital hypothyroidism (CH).

Patients And Methods: Patients were enrolled in this study and divided into two groups. The first group comprised 31 subjects (11M:20F) with the mean age of 15.

The metabolic syndrome in pediatrics: do we have a reliable definition? A systematic review.

Objective: Metabolic syndrome is a cluster of cardio-metabolic risk factors associated with an increased risk of cardiovascular disease and type 2 diabetes. In the last two decades, several definitions of metabolic syndrome have been proposed for the pediatric population; all of them agree on the defining components but differ in the suggested criteria for diagnosis. This review aims to analyze the current diagnostic criteria of metabolic syndrome in pediatrics with reference to their feasibility and reliability in clinical practice.

Asprosin serum levels and glucose homeostasis in children with obesity.

Purpose: Asprosin is a novel adipokine involved in glucose homeostasis, food intake regulation and energy homeostasis. However, the role of asprosin in glucose homeostasis regulation remains still controversial, especially in pediatrics. Aims of the study were to compare fasting serum asprosin levels between obese children and controls and to investigate the relationships of asprosin with body mass index (BMI) and biochemical markers of insulin resistance, insulin sensitivity, β-cell function and cardio-metabolic risk in obese non-diabetic children.

Thalidomide for de novo Crohn's disease after ileal pouch anal anastomosis for ulcerative colitis.

What Is Known And The Objective: De novo Crohn's disease (CD) is an increasingly reported diagnosis after ileal pouch anal anastomosis (IPAA). Currently, no consensus exists on the best treatment strategy.

Case Summary: This report details the case of a 5-year-old child with early-onset ulcerative colitis (UC) who developed findings compatible with CD 12 months after IPAA.

Coaching of lifestyle recommendations improves sensory neurophysiological parameters in neuropathies related to glycemic disorder or metabolic syndrome. A pilot study.

Objectives: Metabolic abnormalities, such as, glycemic disorders and metabolic syndrome (GDMS) are one of the main causes of peripheral neuropathies. The objective of this study was to evaluate the impact of adding specific coaching care (CC) to standard care (SC) of therapeutic education based on lifestyle recommendations for neuropathies associated with GDMS.

Methods: This prospective randomized study included two groups of four patients (SC vs.

Carotid-femoral pulse wave velocity is not increased in obesity.

Background: There are conflicting results in the literature concerning the relationship between obesity and arterial stiffness, assessed by carotid-femoral pulse wave velocity (PWV). The discrepancies could be due to differences in carotid-femoral distance measurement and/or to the presence of pathologies frequently associated with obesity and which increase arterial stiffness. In this study, we examine the relationship between PWV and weight, without and with associated cardiovascular risk factors (diabetes and/or dyslipidemia).

Antihypertensive drug classes have different effects on short-term blood pressure variability in essential hypertension.

Increased blood pressure variability (BPV) contributes to end-organ damage, cardiovascular events and mortality associated with hypertension. In a cohort of 2780 hypertensive patients treated by either calcium channel blockers (CCBs), diuretics, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs) or β-blockers alone or in combination, we compared indices of short-term BPV according to the different treatments. Short-term BPV was calculated as the standard deviation (s.

Tensegrity model hypothesis: may this paradigm be useful to explain hepatic and pancreatic carcinogenesis in patients with persistent hepatitis B or hepatitis C virus infection?

Context: Hepatitis B (HBV) and hepatitis C virus (HCV) possess well-known oncogenic properties and may promote carcinogenesis in liver. However antigens and replicative sequences of HBV/HCV have been also detected in different extra-hepatic tissues, including the pancreas. Although epidemiological studies and meta-analyses have recently suggested that HBV/HCV may be also risk factors for pancreatic cancer and several researches have investigated the possible mechanisms and intra-/extra-cellular paths involved in pancreatic and hepatic carcinogenesis, to date, these complex processes remain largely unexplained.

Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis.

Objectives: Prevention of cognitive decline and dementia with blood pressure lowering treatments has shown inconsistent results. We compared the effects of different classes of antihypertensive drugs on the incidence of dementia, and on cognitive function.

Methods: We conducted a systematic review and included 19 randomized trials (18 515 individuals) and 11 studies (831 674 individuals) analysing the effects of antihypertensive treatment on cognition and on the incidence of dementia, respectively, in hypertensive patients without prior cerebrovascular disorders.

Crucial importance of using a sliding calliper to measure distance for carotid-femoral pulse wave velocity assessment.

Background And Objectives: In the past, different methods have been used to measure the carotid-femoral distance for the assessment of pulse wave velocity (PWV). However, the latest consensus published advises to use 80% of the direct straight carotid-femoral distance (D(0.8)) using either a flexible tape or a sliding calliper.

Target organ damage assessment in French hypertensive patients without established cardiovascular or renal disease: results of the PREVENT-A study.

Objectives: To evaluate the modalities of subclinical target organ damage (TOD) assessment in France, 2-3 years after publication of the European Society of Hypertension (ESH)/European Society of Cardiology (ESC) 2007 guidelines.

Methods: Two parallel, large, cross-sectional surveys were performed in representative samples of 516 private practice cardiologists, and 943 general practitioners (GPs), in hypertensive patients (952 and 1778, respectively) without established cardiovascular or renal disease.

Results: At least one TOD search was performed in 97.

Do all antihypertensive drugs improve carotid intima-media thickness? A network meta-analysis of randomized controlled trials.

The many clinical trials investigating the effect of various antihypertensive drugs on carotid intima-media thickness (CIMT) produced conflicting results. We used meta-analysis to evaluate CIMT changes and network meta-analysis to rank drugs according to the magnitude of these changes. We identified 31 randomized controlled trials listed in three databases as of January 2008.

Lowering of brachial pulse pressure in 9379 hypertensives with type 2 diabetes and reduction of cardiovascular events.

Objectives: Pulse pressure (PP) is a major risk factor for cardiovascular (CV) events, mainly in diabetic hypertensives. The objectives of the study were to determine which clinical characteristics could predict the fall in PP and the reduction of CV events under treatment. Design and methods.