323 results match your criteria: "Centre Hospitalier Universitaire de Tours.[Affiliation]"

Usefulness of Cerebrospinal Fluid Alzheimer's disease biomarkers in older patients: Evidence from a national multicenter prospective study.

J Prev Alzheimers Dis

January 2025

Geriatrics Department, Fernand Widal Lariboisière University Hospital, GHU APHP.Nord, Paris, France; Paris-Cité University, Inserm U1144, Paris, France; Paris-Cité University, Inserm U1153, Paris, France.

Background: The use of cerebrospinal (CSF) biomarkers in the diagnosis of Alzheimer's disease (AD) has been gaining interest in clinical practice. Although their usefulness has been demonstrated, their potential value in older patients remains debated.

Objectives: To assess whether knowledge of the results of CSF AD biomarkers was associated with the same gain in diagnostic confidence in older adults > 80 than in younger patients.

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Background: : With more than 60 million new cases around the world each year, traumatic brain injury (TBI) causes substantial mortality and morbidity. Managing TBI is a major human, social, and economic concern. In the last 20 years, there has been an increase in clinical trials in neurocritical care, leading mostly to negative results.

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Background: Medulloblastoma (MB) is one of the most prevalent embryonal malignant brain tumors. Current classification organizes these tumors into four molecular subgroups (WNT, SHH, Group 3, and Group 4 MB). Recently, a comprehensive classification has been established, identifying numerous subtypes, some of which exhibit a poor prognosis.

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Objective: We aim to clarify potential risk factors of complications after uterine artery embolisation (UAE).

Setting: Complications after uterine artery embolisation (UAE) for symptomatic fibroids are rare, but failure of treatment occurs for approximately 13%-24% of patients at 10 years.

Design: We conducted a case-control study including all complications post UAE over 15 years in our specialised unit.

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Recurrent mutations in the CTNNB1 or APC genes leading to the activation of the Wnt/betacatenin pathway are observed in adnexal tumors with matrical differentiation. While most pilomatricomas arise sporadically and harbor CTNNB1 mutations, cutaneous hybrid cysts combining epidermal and matrical differentiations have been mostly reported in a context of the familial adenomatosis polyposis/Gardner's syndrome related to germinal mutations of APC. The objective of this study is to understand the pathogenesis of hybrid cysts combining epidermal and matrical differentiations.

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Aims: Sebaceous neoplasms constitute a group of adnexal tumours, including sebaceous adenoma, sebaceoma and sebaceous carcinoma. Although mismatch repair deficiency may be observed, the nature of the genetic alterations contributing to the development of most of these tumours is still unknown. In the present study, we describe the clinical, microscopic, and molecular features of eight sebaceomas with GRHL gene rearrangement.

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Re-evaluation of the concept of basaloid follicular hamartoma associated with naevoid basal cell carcinoma syndrome: a morphological, immunohistochemical and molecular study.

Pathology

February 2025

Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France; CARADERM Network, France; 'Biologie des infections à polyomavirus' Team, UMR INRA ISP 1282, Université de Tours, Tours, France.

Article Synopsis
  • - Naevoid basal cell carcinoma syndrome (NBCCS) is a rare genetic condition caused by mutations in the Sonic Hedgehog (SHH) pathway, leading to early development of multiple basal cell carcinomas (BCCs) and related skin tumors like basaloid follicular hamartoma (BFH).
  • - A study analyzed 140 skin tumors from NBCCS patients and 140 control BCC tumors to compare their morphological characteristics, finding that BFH was exclusively present in NBCCS patients and had distinct histopathological features.
  • - The research indicates that BFH could represent precursors to BCC, as it was identified in up to 24% of the tumors in NBCCS patients, with possible
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Article Synopsis
  • A study was conducted at Tours University Hospital to investigate an outbreak of linezolid-resistant strains of bacteria (LRSE) from 2017 to 2021, focusing on their resistance mechanisms and transmission routes.
  • Out of 34 LRSE isolates, 20 were analyzed, revealing high resistance to linezolid linked to a specific genetic mutation, with most strains being closely genetically related (95% similarity).
  • The findings suggest that prior use of linezolid may have contributed to the outbreak, and hand-to-hand transmission by healthcare workers could have played a role; the study also evaluated a new typing method, IR-Biotyper, which showed promise for future use.
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Article Synopsis
  • Campylobacteriosis is the leading bacterial cause of diarrhea in kidney transplant recipients (KTRs), but risk factors for this infection remain unclear.
  • A 10-year study in France identified 326 KTRs with campylobacteriosis, revealing an incidence rate of 2.3 cases per 1,000 patient-years, primarily occurring around 2.4 years after transplantation.
  • The main risk factors for developing campylobacteriosis include the use of corticosteroids, acute rejection episodes, low lymphocyte counts, and low estimated glomerular filtration rate (eGFR); treatment should prioritize azithromycin due to high resistance to fluoroquinolones.
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Flecainide to Prevent Atrial Arrhythmia After Patent Foramen Ovale Closure: AFLOAT Study, A Randomized Clinical Trial.

Circulation

November 2024

ACTION Study Group, INSERM UMRS1166, ICAN-Institute of Cardiometabolism and Nutrition, Sorbonne Université (P.G., M.L., T.R., Y.T., M.E.G., D.B., J.S., N.H., G.D., G.M.), Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France.

Background: The real incidence of atrial arrhythmia (AA) after patent foramen ovale (PFO) closure and whether this complication can be prevented remain unknown. We assessed whether flecainide is effective to prevent AA during the first 3 months after PFO closure, and whether 6 months of treatment with flecainide is more effective than 3 months to prevent AA after PFO closure.

Methods: AFLOAT (Assessment of Flecainide to Lower the Patent Foramen Ovale Closure Risk of Atrial Fibrillation or Tachycardia Trial) is a prospective, multicentre, randomized, open-label, superiority trial with a blind evaluation of all the end points (PROBE [Prospective Randomized Open, Blinded End Point] design).

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[Short- and medium-term tolerance of hypofractionated prostate radiotherapy with simultaneous integrated boost].

Cancer Radiother

December 2024

Service de radiothérapie, centre régional de cancérologie Henry-S.-Kaplan, centre hospitalier universitaire de Tours, 2, boulevard Tonnellé, Tours, France.

Purpose: This retrospective study was conducted to ensure that irradiation of the pelvic lymph node areas associated with simultaneous hypofractionated boost to the prostate according to the protocol implemented at the university hospital of Tours (France) does not result in excess urinary and digestive toxicity in the short and medium term.

Materials And Methods: The study population included patients with localized unfavourable intermediate or high-risk prostate cancer. The dose delivered was 65Gy in 25 fractions of 2.

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Introduction: Early assessment of the prognosis of a patient in cardiac arrest during cardiopulmonary resuscitation is highly challenging. This study aims to evaluate the predictive outcome value of early point-of-care ultrasound (POCUS) in out-of-hospital settings.

Methods: This observational, prospective, multicentre study's primary endpoint was the positive predictive value (PPV) of POCUS cardiac standstill within the first 12 min of advanced life support (ALS) initiation in determining the absence of return of spontaneous circulation (ROSC).

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MST1R/RON fusion as a potential oncogenic driver in Spitz tumours.

Pathology

December 2024

Department of Biopathology, Center Léon Bérard, Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée Ligue contre le Cancer, Lyon, France.

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Wnt/β-Catenin-Activated Nonpilomatrical Carcinoma of the Skin: A Case Series.

Mod Pathol

November 2024

Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France; "Biologie des infections à polyomavirus" Team, UMR INRA ISP 1282, Université de Tours, Tours, France.

Article Synopsis
  • The study investigates 16 primary cutaneous carcinomas with mutations in genes that activate the Wnt/β-catenin pathway, noting that these tumors lack matrical differentiation, which is typically associated with such mutations.
  • The tumors predominantly affected elderly patients, with a median age of 80, and were mainly located on the head, neck, and upper limbs, leading to metastatic cases in some patients.
  • Key findings include poor differentiation in tumor structure, distinct immunohistochemical profiles, and recurrent mutations in APC and CTNNB1, indicating that these tumors represent a unique group apart from other established skin tumor types.
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EVolution in ALS diagnosis: molecular markers in extracellular vesicles.

Trends Mol Med

December 2024

Centre de Référence sur la SLA de Tours, Centre Hospitalier Universitaire de Tours, Tours, France; UMR 1253, iBRAIN, Université de Tours, INSERM, Tours, France.

The identification of biomarkers for amyotrophic lateral sclerosis (ALS) is a central issue in disease research. In a recent article, Chatterjee et al. show that blood extracellular vesicles (EVs) with high levels of transactive response DNA-binding protein 43 (TDP-43) accurately discriminate patients with ALS from controls and correlate with disease severity, providing a promising biomarker for early diagnosis and monitoring.

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Article Synopsis
  • - Merkel cell carcinoma (MCC) is an aggressive skin cancer often linked to the Merkel cell polyomavirus, with a rare subtype presenting as combined MCCs featuring an additional tumor component, typically squamous cell carcinoma.
  • - This study reports two new cases of combined MCCs with neuroblastic differentiation, characterized by a unique tumor structure involving both a poorly differentiated carcinoma and a neuroblastic component, observed in elderly men with symptoms of isolated inguinal adenopathy.
  • - The research utilized various analyses, revealing shared mutations between the tumor components and suggesting that neuroblastic differentiation might occur due to loss of viral protein expression in certain MCC cells, indicating a potential link in their cellular origins.
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Context: Merkel cell carcinoma diagnosis is often based on microscopic examination by pathologists. While histopathologic diagnosis primarily hinges on conscious and analytical cognition, the pathologist's decision-making process is also influenced by a rapid "gist" or "gestalt" approach. In this study, using cases of Merkel cell carcinoma as a model, we aim to assess how pathologists' viewing short videos containing conceptual clues and visual aids, in conjunction with reading an original article as a reference, may enhance their diagnostic performance.

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Resilience after severe critical illness: a prospective, multicentre, observational study (RESIREA).

Crit Care

July 2024

Laboratoire de Psychologie: Dynamiques Relationnelles Et Processus Identitaires (Psy-DREPI), Université de Bourgogne Franche-Comté, EA7458, Dijon, France.

Background: Critical-illness survivors may experience post-traumatic stress disorder (PTSD) and quality-of-life impairments. Resilience may protect against psychological trauma but has not been adequately studied after critical illness. We assessed resilience and its associations with PTSD and quality of life, and also identified factors associated with greater resilience.

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Merkel cell carcinoma (MCC) is a highly aggressive skin cancer associated with integration of Merkel cell polyomavirus (MCPyV). MCPyV-encoded T-antigens (TAs) are pivotal for sustaining MCC's oncogenic phenotype, i.e.

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Background: Nivolumab is the first immune checkpoint inhibitor approved in Europe for the treatment of advanced renal cell carcinoma (aRCC) in patients resistant to prior antiangiogenic therapy. WITNESS is an ongoing, prospective, observational study designed to evaluate the effectiveness and safety of nivolumab in patients with aRCC treated in real life (or routine practice) in France (ClinicalTrials.gov identifier: NCT03455452).

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Article Synopsis
  • This study aimed to assess the effectiveness of epcoritamab, a new bispecific antibody, for treating patients with advanced follicular lymphoma who have already undergone multiple previous therapies.
  • The research was part of the EPCORE NHL-1 trial, which took place at 88 sites across 15 countries and involved patients aged 18 and older with specific eligibility criteria, including having received at least two prior treatments.
  • Treatment involved subcutaneous injections of epcoritamab in cycles, with a tailored dosing strategy to minimize the risk of cytokine release syndrome, and the primary focus was on evaluating the overall response rate and safety measures related to cytokine release.
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OGT::FOXO1-fused myoepithelioma-like hyalinising epithelioid tumour arising in non-acral skin.

Pathology

October 2024

Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France; "Biologie des Infections à Polyomavirus" Team, UMR INRA ISP 1282, Université de Tours, Tours, France; CARADERM Network, France. Electronic address:

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