650 results match your criteria: "Centre hospitalier universitaire d'Angers[Affiliation]"

CT Imaging Assessment of Response to Treatment in Allergic Bronchopulmonary Aspergillosis in Adults With Bronchial Asthma.

Chest

June 2024

Service de Pneumologie et Oncologie Thoracique, Centre constitutif Maladies pulmonaires rares, Université Paris Sorbonne, Assistance Publique - Hôpitaux de Paris, Hôpital Tenon, Paris, France.

Background: One of the major challenges in managing allergic bronchopulmonary aspergillosis remains consistent and reproducible assessment of response to treatment.

Research Question: What are the most relevant changes in CT scan parameters over time for assessing response to treatment?

Study Design And Methods: In this ancillary study of a randomized clinical trial (NebuLamB), patients with asthma with available CT scan and without exacerbation during a 4-month allergic bronchopulmonary aspergillosis exacerbation treatment period (corticosteroids and itraconazole) were included. Changed CT scan parameters were assessed by systematic analyses of CT scan findings at initiation and end of treatment.

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Background: The architecture and composition of glial (GCI) and neuronal (NCI) α-synuclein inclusions observed in multiple system atrophy (MSA) remain to be precisely defined to better understand the disease.

Methods: Here, we used stochastic optical reconstruction microscopy (STORM) to characterize the nanoscale organization of glial (GCI) and neuronal (NCI) α-synuclein inclusions in cryopreserved brain sections from MSA patients.

Results: STORM revealed a dense cross-linked internal structure of α-synuclein in all GCI and NCI.

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Similarities and differences of interstitial lung disease associated with pathogenic variants in SFTPC and ABCA3 in adults.

Respirology

April 2024

Department of Respiratory Medicine, National Reference Centre for Rare Pulmonary Diseases, Hospices civils de Lyon, Université Lyon 1, UMR754, INRAE, ERN-LUNG, Lyon, France.

Background And Objective: Variants in surfactant genes SFTPC or ABCA3 are responsible for interstitial lung disease (ILD) in children and adults, with few studies in adults.

Methods: We conducted a multicentre retrospective study of all consecutive adult patients diagnosed with ILD associated with variants in SFTPC or ABCA3 in the French rare pulmonary diseases network, OrphaLung. Variants and chest computed tomography (CT) features were centrally reviewed.

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[First-line management of infertile couple. Guidelines for clinical practice of the French College of Obstetricians and Gynecologists 2022].

Gynecol Obstet Fertil Senol

May 2024

Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; IMBE, CNRS, IRD, Aix-Marseille université, Avignon université, Marseille, France. Electronic address:

Article Synopsis
  • The updated clinical practice guidelines aim to improve the first-line management of infertility in couples by revisiting existing recommendations based on recent research.
  • A systematic review was conducted by expert working groups on five major themes, resulting in 28 PICO-formulated questions addressing both male and female infertility assessments, environmental factors, ovulation induction, and reproductive surgery techniques.
  • Key recommendations include tailored fertility evaluations based on the woman's age, specific tests for both partners, and the dismissal of certain outdated procedures, with an emphasis on evidence-based approaches to optimize infertility treatment.
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Vacuoles in bone marrow progenitors: VEXAS syndrome and beyond.

Lancet Haematol

February 2024

Laboratoire d'Hématologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France.

The presence of vacuoles in myeloid and erythroid progenitor cells in bone marrow aspirates is a key feature of vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome. The mere observation of vacuolated progenitor cells is not specific to VEXAS syndrome; in this Viewpoint, we point out the causes to be considered in this situation. Vacuoles, in particular, can be observed in individuals with wild-type UBA1 and with persistent inflammatory features or myelodysplastic syndromes.

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Beyond MEN1, When to Think About MEN4? Retrospective Study on 5600 Patients in the French Population and Literature Review.

J Clin Endocrinol Metab

June 2024

CHU Lille, Service de Biochimie et Biologie moléculaire « Hormonologie, Métabolisme-Nutrition, Oncologie, 59000 Lille, France.

Context: Germline CDKN1B variants predispose patients to multiple endocrine neoplasia type 4 (MEN4), a rare MEN1-like syndrome, with <100 reported cases since its discovery in 2006. Although CDKN1B mutations are frequently suggested to explain cases of genetically negative MEN1, the prevalence and phenotype of MEN4 patients is poorly known, and genetic counseling is unclear.

Objective: To evaluate the prevalence of MEN4 in MEN1-suspected patients and characterize the phenotype of MEN4 patients.

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Article Synopsis
  • The SEPSISCOOL II trial aims to determine if actively cooling fevered patients in septic shock improves survival and organ function compared to not treating the fever.
  • It is a multicenter, randomized controlled trial involving 820 patients admitted to intensive care units, with the primary endpoint being mortality at day 60.
  • Funded by the French health ministry and approved by an ethics committee, the findings will be shared in peer-reviewed journals upon completion.
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Introduction: Current guidelines on clinical nutrition of ventilated patients in the intensive care unit (ICU) recommend initiating continuous enteral nutrition within 48 hours of ICU admission when feasible. However, discontinuous feeding regimens, alternating feeding and fasting intervals, may have an impact on clinical and patient centred outcomes. The ongoing "Impact of daily cyclic enteral nutrition versus standard continuous enteral nutrition in critically ill patients" (DC-SCENIC) trial aims to compare standard continuous enteral feeding with daily cyclic enteral feeding over 10 hours to evaluate if implementing a fasting-mimicking diet can decrease organ failure in ventilated patients during the acute phase of ICU management.

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Article Synopsis
  • The French National Authority for Health reviewed literature on complications from pelvic organ prolapse (POP) surgery using synthetic mesh, which are rare but can severely impact women's quality of life, leading to multidisciplinary clinical practice recommendations with graded levels of evidence.
  • Patients must be adequately informed about the risks of POP surgery, with specific guidelines suggesting against certain practices like vaginal packing and requiring alternative surgical techniques in complex cases.
  • For bladder injuries during surgery, recommended practices include suturing and monitoring ureter permeability, with potential use of a prosthetic mesh post-repair for better outcomes.
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Article Synopsis
  • In 2017, nusinersen, an injectable treatment for spinal muscular atrophy (SMA), was introduced, followed by the oral treatment risdiplam in 2020, leading to questions about appropriate care for adults with SMA due to limited data.
  • To standardize treatment access in France, a national SMA multidisciplinary team meeting (SMDT) was established in 2018 to support decision-making for adult patients.
  • An analysis of 107 patient cases showed that the SMDTs provided various treatment recommendations based on consultations, with most requests aimed at starting new treatments (nusinersen or risdiplam).
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Background: Patients with acute brain injury are at high risk of ventilator-associated pneumonia (VAP). The benefit of short-term antibiotic prophylaxis remains debated. We aimed to establish the effect of an early, single dose of the antibiotic ceftriaxone on the incidence of early VAP in patients with severe brain injury who required mechanical ventilation.

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The use of peripheral blood (PB) or bone marrow (BM) stem cells graft in haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis remains controversial. Moreover, the value of adding anti-thymoglobulin (ATG) to PTCy is unknown. A total of 1344 adult patients received an unmanipulated haploidentical transplant at 37 centers from 2012 to 2019 for hematologic malignancy.

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Objectives: To perform a detailed description of executive functioning following moderate-to-severe childhood traumatic brain injury (TBI), and to study demographic and severity factors influencing outcome.

Methods: A convenience sample of children/adolescents aged 7-16 years, referred to a rehabilitation department after a TBI ( = 43), was compared to normative data using a newly developed neuropsychological test battery (Child Executive Functions Battery-CEF-B) and the BRIEF.

Results: Performance in the TBI group was significantly impaired in most of the CEF-B subtests, with moderate to large effect sizes.

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Pregnancy and tobacco: Practice and knowledge of French midwives.

Midwifery

February 2024

Irset, Inserm UMR 1085, Equipe Ester, UFR Santé, Département de Médecine, Rue Haute de Reculée 49045 Angers Cedex, France.

Article Synopsis
  • * A survey involving over 23,000 midwives revealed that while most frequently questioned pregnant women about smoking, only a minority used advanced assessment tools like the Fagerström test.
  • * The findings suggest a need for better training for midwives in smoking cessation strategies, as those who prescribed NRT showed more concern and capability in helping pregnant women quit smoking.
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The bifocal model: A two-level clinical model of psychiatric disorders integrating diagnostic and transdiagnostic approaches.

Encephale

February 2024

Pôle de psychiatrie-addictologie, Centre régional de psychotraumatologie CVL, CHRU de Tours, Tours, France; Département de psychologie, laboratoire Qualipsy EE1901, université de Tours, Tours, France.

Nowadays, two distinct conceptualizations are available to classify, label and guide the treatment of psychiatric disorders: the diagnostic approach and the transdiagnostic approach. There are pros and cons to both approaches. We propose here to link these two conceptualizations by creating a two-level clinical model that takes advantages of both approaches, named the bifocal model (BFM).

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Intrathecal cervical analgesia for cancer pain: a 12-year follow-up study in a comprehensive cancer center.

Reg Anesth Pain Med

October 2024

Anesthesiology and Pain Department, Institut de Cancérologie de l'Ouest, Angers, France.

Background: Intrathecal analgesia plays a key role for patients suffering refractory cancer pain. Nevertheless, intrathecal drug delivery systems (IDDS), requiring a cervical catheter tip implantation, have been poorly described in medical literature.

Aims: A monocentric retrospective follow-up study was designed to evaluate results of cervical IDDS for cancer pain.

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The experience of diagnosis announcement in rare endocrine diseases: A survey of the French FIRENDO network.

Ann Endocrinol (Paris)

February 2024

Service d'endocrinologie, hôpital de la Conception, centre de référence des maladies rares de l'hypophyse HYPO, Assistance Publique-Hôpitaux de Marseille (AP-HM), 13005 Marseille, France; Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (Inserm), U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Marseille, France. Electronic address:

Context: Diagnosis announcement of a chronic disease is a crucial moment for patients as well as for their families and an important step in the management of severe conditions such as rare endocrine diseases. Little is known of how diagnosis is communicated to patients and families. The FIRENDO network was created by the third French Plan for Rare Diseases, to promote autonomy, care and research on rare endocrine diseases.

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Background: Clinical benefits of atezolizumab plus bevacizumab (atezolizumab-bevacizumab) are observed only in a subset of patients with hepatocellular carcinoma and the development of biomarkers is needed to improve therapeutic strategies. The atezolizumab-bevacizumab response signature (ABRS), assessed by molecular biology profiling techniques, has been shown to be associated with progression-free survival after treatment initiation. The primary objective of our study was to develop an artificial intelligence (AI) model able to estimate ABRS expression directly from histological slides, and to evaluate if model predictions were associated with progression-free survival.

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[Amatoxin-containing mushroom poisoning: An update].

Rev Med Interne

July 2024

Centre antipoison de Paris, fédération de toxicologie (FeTox), hôpital Fernand-Widal, AP-HP, 200, rue du Faubourg-Saint-Denis, 75010 Paris, France; Université Paris-Cité, Inserm UMR-S 1144, optimisation thérapeutique en neuropsychopharmacologie, 4, avenue de l'Observatoire, 75006 Paris, France; UFR de médecine, université de Paris, 75006 Paris, France.

Amatoxin-containing mushroom poisoning occurs after consumption of certain mushroom species, of the genera Amanita, Lepiota and Galerina. Amanita phalloides is the most implicated species, responsible for over more than 90% of mushroom-related deaths. The α-amanitin is responsible for most of the observed effects.

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Article Synopsis
  • - The study assessed XAV-19, an antibody treatment, for hospitalized COVID-19 patients with severe symptoms, focusing on its safety and effectiveness in preventing death or serious respiratory failure.
  • - Conducted across 34 hospitals in France, the trial involved 398 adult patients who were randomly assigned to receive either XAV-19 or a placebo, with no major differences in outcomes observed between the two groups after 15 days.
  • - Findings revealed that treatment with XAV-19 did not lead to a significant reduction in the incidence of severe health complications compared to placebo, and adverse events were similarly reported in both groups.
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Background: We aimed to identify patients at low risk of bloodstream infection (BSI) in the ED.

Methods: We derived and validated a prediction model to rule out BSI in the ED without the need for laboratory testing by determining variables associated with a positive blood culture (BC) and assigned points according to regression coefficients. This retrospective study included adult patients suspected of having BSI (defined by at least one BC collection) from two European ED between 1 January 2017 and 31 December 2019.

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Purpose: This study aims to investigate the uptake of transradial approach (TRA) and outpatient setting for transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) in the treatment of hepatocellular carcinoma (HCC) among French interventional radiology centers.

Materials And Methods: This cross-sectional study was based on a 34-question survey assessing center activity, radial access, and outpatient care. The survey was developed by a working group, tested by two external experts, and distributed to active members of two French radiological societies via a web-based self-reporting questionnaire in March 2022.

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Assessing late outcomes of advances in radiotherapy for paediatric cancers: Study protocol of the "HARMONIC-RT" European registry (NCT 04746729).

Radiother Oncol

January 2024

University Hospital Essen (UK Essen), Hufelandstrasse 55, Essen 45147, Germany; Department of Particle Therapy - University Hospital Essen, West German Cancer Centre (WTZ), Hufelandstrasse 55, Essen 45147, Germany; West German Proton Therapy Centre Essen (WPE), Hufelandstr. 55, Essen 45147, Germany.

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Non-alcoholic fatty liver disease (NAFLD) is the liver manifestation of the metabolic syndrome with global prevalence reaching epidemic levels. Despite the high disease burden in the population only a small proportion of those with NAFLD will develop progressive liver disease, for which there is currently no approved pharmacotherapy. Identifying those who are at risk of progressive NAFLD currently requires a liver biopsy which is problematic.

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