256 results match your criteria: "AP-HP-Universite Paris[Affiliation]"

[Application of the white plan in intensive care units during the covid-19 pandemic.].

Soins

June 2021

Hôpital Raymond-Poincaré, groupe hospitalier universitaire, AP-HP Université Paris Saclay, 104 boulevard Raymond-Poincaré, 92380 Garches, France; UFR Simone-Veil Santé, Université de Versailles -Saint-Quentin-en-Yvelines, Université Paris-Saclay, 2 avenue de la Source-de-la-Bièvre, 78180 Montigny-le-Bretonneux, France.

The deployment of the white plan in intensive care as part of the management of COVD-19 required a new organisation at every level of Raymond-Poincaré hospital in Garches. The closure of certain wards enabled equipment and staff to be pooled, and support services stepped up to the plate by reinventing themselves.

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Chikungunya nephropathy is an uncommon etiology of acute kidney injury, associated with the mosquito-borne chikungunya arbovirus (CHIKV). The very limited number of pathologic reports to date have only involved postmortem analyses. We here report 5 cases of acute kidney injury for which kidney biopsies were performed in patients with confirmed acute CHIKV infection, during the recent outbreak of chikungunya disease in the French West Indies.

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Objective: To compare the risk of diverticulitis and gastrointestinal perforation (GIP) in RA treated with tocilizumab (TCZ) compared with rituximab (RTX) and abatacept (ABA).

Methods: We conducted a population-based study using three observational French registries on TCZ, RTX and ABA in RA. Using a propensity score approach, we compared the risk of diverticulitis or GIP in these patients.

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Aims: Two complementary studies were used to assess the real-life use of nalmefene in alcohol-dependent patients and its impact on alcohol use health status.

Methods: USE-PACT was a prospective cohort study designed to evaluate the real-life effectiveness of nalmefene in the management of alcohol dependence, as assessed by total alcohol consumption (TAC) and number of heavy drinking days (HDD) at 1 year. USE-AM was a cohort study using data from the French nationwide claims database and was used to evaluate the external validity of the population in the prospective study.

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Objectives: In France, dispensation is defined by the validation of a prescription associated with a pharmaceutical analysis, preparation of medication and provision of information necessary for proper use. There are very few data available in the literature that describe prescription analysis modality in radiopharmacy. The aim was to secure a place for paediatric prescription analysis in radiopharmacy by designing a flow chart validated by experts.

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Study Design: This was a prospective cohort study.

Objective: The aim of this study is to question the influence of fear avoidance beliefs on functional outcome following surgery for degenerative lumbar spine.

Background: Fear avoidance beliefs are well-studied modifiers of low back pain.

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The occurrence of resistances in Gram negative bacteria is steadily increasing to reach extremely worrying levels and one of the main causes of resistance is the massive spread of very efficient β-lactamases which render most β-lactam antibiotics useless. Herein, we report the development of a series of imino-analogues of β-lactams (namely azetidinimines) as efficient non-covalent inhibitors of β-lactamases. Despite the structural and mechanistic differences between serine-β-lactamases KPC-2 and OXA-48 and metallo-β-lactamase NDM-1, all three enzymes can be inhibited at a submicromolar level by compound 7dfm, which can also repotentiate imipenem against a resistant strain of Escherichia coli expressing NDM-1.

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A novel PHKA1 mutation associating myopathy and cognitive impairment: Expanding the spectrum of phosphorylase kinase b (PhK) deficiency.

J Neurol Sci

May 2021

APHP-GH Pitié-Salpêtrière, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, Myology Institute, Paris, France. Electronic address:

Muscle phosphorylase kinase b deficiency (PhK) is a rare disorder of glycogen metabolism characterized by exercise-induced myalgia and cramps, myoglobinuria and progressive muscle weakness. PhK deficiency is due to mutations in the PHKA1 gene inherited in an X-linked manner and is associated to glycogenosis type VIII (GSD VIII also called GSD IXd). PHKA1 gene codes for the αM subunit of the PhK, a multimeric protein complex responsible for the control of glycogen breakdown in muscle.

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Performance of 30 commercial SARS-CoV-2 serology assays in testing symptomatic COVID-19 patients.

Eur J Clin Microbiol Infect Dis

October 2021

Laboratoire de Virologie, AP-HP, Hôpital Bichat-Claude Bernard, Université de Paris, INSERM UMR 1137 IAME, F-75018, Paris, France.

We report evaluation of 30 assays' (17 rapid tests (RDTs) and 13 automated/manual ELISA/CLIA assay (IAs)) clinical performances with 2594 sera collected from symptomatic patients with positive SARS-CoV-2 rRT-PCR on a respiratory sample, and 1996 pre-epidemic serum samples expected to be negative. Only 4 RDT and 3 IAs fitted both specificity (> 98%) and sensitivity (> 90%) criteria according to French recommendations. Serology may offer valuable information during COVID-19 pandemic, but inconsistent performances observed among the 30 commercial assays evaluated, which underlines the importance of independent evaluation before clinical implementation.

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To evaluate adverse events in cancer patients with pre-existing sarcoidosis receiving immune checkpoint inhibitors (ICIs). We retrospectively reviewed cancer patients with sarcoidosis who underwent treatment with ICI to determine frequency of sarcoidosis flares. 32 patients with sarcoidosis received ICIs The median time to ICI initiation was 7 years (range: 1 month to 51 years).

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Background: Sickle cell disease (SCD) is characterized by vaso-occlusive crisis (VOC), acute chest syndrome (ACS) and multiorgan failure (MOF) complicated by thrombosis. Von Willebrand factor (VWF) is a strong marker of SCD-related endothelial injury.

Objectives: To decipher the role of VWF and its specific-cleaving metalloprotease, ADAMTS13, in the vaso-occlusive and thrombotic process of SCD.

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Early prenatal diagnosis of alveolar capillary dysplasia with misalignment of pulmonary veins due to a 16q24.1 deletion.

Am J Med Genet A

May 2021

Laboratoire de Cytogénétique, Service d'Histologie-Embryologie-Cytogénétique, Hôpital Antoine Béclère, AP-HP Université Paris Saclay, Clamart, France.

Article Synopsis
  • First trimester ultrasound screening is typically done at 11-13 weeks of pregnancy, helping to assess fetal health but not fully detailing all organ developments yet.
  • Increased nuchal translucency (INT) can indicate chromosomal abnormalities and was observed in a 14-week gestation fetus with univentricular congenital heart malformation, leading to further genetic testing.
  • Genetic analysis revealed a deletion in the FOXF1 gene, linked to specific heart and lung conditions; this case marks the first known instance of prenatal diagnosis of alveolar capillary dysplasia due to this genetic deletion.
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One third of depressive patients do not achieve remission after several steps of treatment and are considered as treatment resistant. Electroconvulsive therapy (ECT) improves symptoms in 70 to 90% of such cases. Resistant depression is associated with a dysregulation of the immune system with a dysbalance between the pro- and the anti-inflammatory cytokines.

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Defects of autophagy-lysosomal protein degradation are thought to contribute to the pathogenesis of several neurodegenerative diseases, and the accumulation of aggregation prone proteins such as MAPT/Tau in Alzheimer disease (AD). We previously showed the localization of the immunophilin FKBP4/FKBP52 in the lysosomal system of healthy human neurons suggesting its possible role in lysosome function. We also showed that decreased FKBP4 levels in AD brain neurons correlate with abnormal MAPT accumulation and aggregation.

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Background: Because of insufficient data about their benefit-risk ratio in real life, drugs used for Alzheimer's disease (AD; cholinesterase inhibitors and memantine) were withdrawn from the list of reimbursable drugs in France on 1 August 2018.

Objectives: In this context, this study aimed to investigate the effects of the removal of AD drugs from the list of reimbursed drugs among patients followed in memory centres in France, in terms of prevalence and factors associated with drug discontinuation and evolution of disease management and cognition after drug discontinuation.

Methods: This is an observational study based on data from the National Alzheimer Data Bank ('Banque Nationale Alzheimer' [BNA]), which centralizes information about patients consulting in memory centres.

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During the COVID-19 pandemic, the need to provide high-level care for a large number of patients with COVID-19 has affected resourcing for, and limited the routine care of, all other conditions. The impact of this health emergency is particularly relevant in the rare connective tissue diseases (rCTDs) communities, as discussed in this Perspective article by the multi-stakeholder European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET). The clinical, organizational and health economic challenges faced by health-care providers, institutions, patients and their families during the SARS-CoV-2 outbreak have demonstrated the importance of ensuring continuity of care in the management of rCTDs, including adequate diagnostics and monitoring protocols, and highlighted the need for a structured emergency strategy.

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Background And Aims: Most studies in English-speaking countries have found a positive association between e-cigarette experimentation and subsequent daily tobacco smoking among adolescents. However, this result may not be valid in other cultural contexts; in addition, few studies have assessed whether this association varies with the subject' age at the time of e-cigarette experimentation. This study aimed to estimate the association between experimenting first with e-cigarette (rather than tobacco) and subsequent daily smoking according to age at the time of experimentation.

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AI-driven quantification, staging and outcome prediction of COVID-19 pneumonia.

Med Image Anal

January 2021

Université Paris-Saclay, CentraleSupélec, Mathématiques et Informatique pour la Complexité et les Systémes, Gif-sur-Yvette, France, 3 Rue Joliot Curie, Gif-sur-Yvette 91190, France; Gustave Roussy-CentraleSupélec-TheraPanacea, Noesia Center of Artificial Intelligence in Radiation Therapy and Oncology, Gustave Roussy Cancer Campus, Villejuif, France; TheraPanacea, 29 Rue du Faubourg Saint-Jacques, Paris 75014, France. Electronic address:

Article Synopsis
  • COVID-19, which surfaced in 2019, spread quickly around the globe, and CT imaging is crucial for screening, quantifying, and staging the disease.
  • Effective staging is necessary for healthcare management, such as planning for ICU beds and enhancing drug development through quick assessments.
  • This study explored the use of medical imaging and AI to improve disease quantification and patient outcomes, demonstrating promising results through automated deep learning methods and combining imaging data with clinical information.
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Article Synopsis
  • The study aimed to assess the effectiveness and safety of abatacept in adults with active primary Sjögren's syndrome through a phase III trial that involved a placebo group.
  • 187 patients were enrolled, and after a treatment period of 169 days, the primary outcome (improvement in disease activity) and key secondary outcomes (patient-reported symptoms and saliva flow) showed no significant differences between the abatacept and placebo groups.
  • Although abatacept did not demonstrate clinical benefits over placebo, it did show some biological activity by affecting certain disease-related biomarkers without any new safety concerns.
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Article Synopsis
  • Biopharmaceutical products, often used to treat autoimmune diseases, face challenges with immunogenicity and the development of antidrug antibodies (ADAs), impacting treatment efficacy for many patients.
  • A study by the European consortium ABIRISK analyzed 560 patients with multiple sclerosis, rheumatoid arthritis, and inflammatory bowel diseases over a year to explore patient-related factors that influence ADA development.
  • The findings revealed that immunosuppressants and antibiotics negatively correlated with ADA development time, while infections and tobacco smoking positively correlated with an increased risk of developing ADAs.
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Assessment of respiratory muscles and motor function in children with SMA treated by nusinersen.

Pediatr Pulmonol

January 2021

Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP Hôpital Necker Enfants-Malades, Paris, France.

Introduction: Nusinersen is associated with an improvement in motor function in children with spinal muscular atrophy (SMA) but data on respiratory muscles strength are scarce. Respiratory muscles performance and lung function were evaluated in children with SMA 1c and 2 after six injections of nusinersen (M14). Results from patients with SMA2 were compared with data of age-matched historical controls.

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Fluid loading therapy to prevent spinal hypotension in women undergoing elective caesarean section: Network meta-analysis, trial sequential analysis and meta-regression.

Eur J Anaesthesiol

December 2020

From the Department of Anaesthesia, Erasmus University Medical Centre, Rotterdam, The Netherlands (KR, MK), the Department of Anaesthesia, Hôpital Antoine Béclère, GHU AP-HP. Université Paris-Saclay, Clamart, France (FJM), the Department of Anaesthesia, Northwick Park Hospital, Harrow, UK (DNL), the Department of Anaesthesia, University Hospital RWTH Aachen, Aachen, Germany (RR), and the Department of Anaesthesia, Kantonsspital Baden, Baden, Switzerland (MH).

Background: Fluid loading is one of the recognised measures to prevent hypotension due to spinal anaesthesia in women scheduled for a caesarean section.

Objective: We aimed to evaluate the current evidence on fluid loading in the prevention of spinal anaesthesia-induced hypotension.

Design: Systematic review and network meta-analysis with trial sequential analysis and meta-regression.

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