1,038 results match your criteria: "Centre d'Investigations Cliniques[Affiliation]"

Children and adolescents who are being treated or have been treated for acute leukemia have a secondary immunodeficiency linked to chemotherapy, resulting in an increased risk of infections. Some of which can be prevented by vaccination but its effectiveness is not optimal during chemotherapy. Upon cessation of chemotherapy, the time required for immune reconstitution varies from three months to more than a year, depending on lymphocyte subpopulations, the patient's age, and the intensity of the treatment received.

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Article Synopsis
  • The study aims to assess the safety and efficacy of using expanded CD34+ cells for treating patients with acute myocardial infarction (AMI) and reduced left ventricular function, crucial for improving patient outcomes.
  • Patients with severe AMI (left ventricular ejection fraction <50%) are randomly assigned to receive either CD34+ cell treatment alongside standard care or standard care only, with a focus on monitoring major adverse cardiac events over six months.
  • This trial is groundbreaking as it explores the automated expansion and administration of autologous CD34+ cells, addressing current technological limitations in cell therapy for heart recovery post-AMI.
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Anaemia, erythrocytosis, and empagliflozin in heart failure with preserved ejection fraction: the EMPEROR-Preserved trial.

Eur Heart J

December 2024

Department of Cardiology (CVK) and Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany.

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The Win Ratio for Composite Outcomes in Nephrology Clinical Trials.

J Am Soc Nephrol

December 2024

INSERM, Centre d'Investigations Cliniques Plurithématique 1433, Inserm U1116, CHRU de Nancy and F-CRIN INI-CRCT, Université de Lorraine, Nancy, France.

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Article Synopsis
  • The study aims to use machine learning clustering to categorize distinct patient types among those with ischaemic heart failure and reduced ejection fraction (HFrEF) to improve personalized treatment approaches.
  • Analysis of 8,591 HFrEF patients revealed five unique clusters based on clinical and biological traits, with varying risks for hospitalization and death, highlighting the need for tailored management strategies.
  • The findings indicate that specific clusters correlate with different outcomes, suggesting that treatments like mineralocorticoid receptor antagonists may be more beneficial for certain patient groups, ultimately enhancing patient care in the future.
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Prenatal Exposure to Proton Pump Inhibitors and Risk of Serious Infections in Offspring During the First Year of Life: A Nationwide Cohort Study.

Drug Saf

December 2024

Centre Régional de Pharmacovigilance, Service de Pharmacologie périnatale, pédiatrique et adulte, Hopital Cochin, Assistance Publique-Hopitaux de Paris (AP-HP), 27, rue du Faubourg Saint Jacques, 75014, Paris, France.

Introduction And Objective: Proton pump inhibitor (PPI) use in children increases the risk of infections, prompting inquiry into the impact of prenatal PPIs exposure on serious infections in offspring. As a research gap in this area exists, this study aimed to address it by assessing the association between prenatal PPIs exposure and serious infections in infants during their first year of life.

Methods: Using the French health insurance data warehouse (SNDS) (2013-2018), we conducted a retrospective cohort study on singleton, full-term liveborn non-immunocompromised infants, stratified by PPI use during the first three months of life (early-life use).

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Mineralocorticoid Receptor and Sleep Quality in Chronic Kidney Disease.

Int J Mol Sci

November 2024

Unidad de Excelencia Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid-CSIC, 47003 Valladolid, Spain.

The classical function of the mineralocorticoid receptor (MR) is to maintain electrolytic homeostasis and control extracellular volume and blood pressure. The MR is expressed in the central nervous system (CNS) and is involved in the regulation of the hypothalamic-pituitary-adrenal (HPA) axis as well as sleep physiology, playing a role in the non-rapid eye movement (NREM) phase of sleep. Some patients with psychiatric disorders have very poor sleep quality, and a relationship between MR dysregulation and this disorder has been found in them.

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Background: Advanced Therapy Medicinal Products (ATMPs) for human use have advanced globally with the rapid adoption of Chimeric Antigen Receptor T-cell (CAR-T) therapies in haemato-oncology. CAR-T cell therapy and ATMPs have unique, significant acute and chronic toxicities, and appropriate patient care is crucial. Significant challenges, including the need for nurse education and training, accompany optimal patient success and benefits.

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Article Synopsis
  • - The study evaluated cardiologists' awareness and implementation of advanced heart failure (HF) guidelines, revealing significant knowledge gaps, especially among general cardiologists and other participants compared to heart failure specialists.
  • - An online survey collected data from 497 cardiologists across Europe, highlighting that 84% of heart failure cardiologists regularly used ESC/HFA criteria for advanced HF, while only 44% of general cardiologists did.
  • - The findings emphasize the need for increased education on advanced HF guidelines and improvements in the referral process to ensure patients receive timely and appropriate care.
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Purpose: Intensity-modulated radiation therapy or volumetric-modulated arctherapy is nowadays the recommended radiation technique for the treatment of head and neck cancers. However, by providing a significant dose gradient between target volumes and organs at risk, there is a risk of target missing and thus recurrence in case of inadequate delineation. It is therefore necessary to determine the origin of these recurrences to improve clinical practice.

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Centrally adjudicated vs. investigator-reported outcomes in randomized heart failure trials.

Eur Heart J

December 2024

Development, Novartis Pharma AG, Forum 1, Novartis Campus, CH-4056 Basel, Switzerland.

Article Synopsis
  • Heart failure events in cardiovascular trials are often evaluated through centralized review, but its impact on treatment effect accuracy (in terms of hazard ratios) is uncertain.
  • In a study of seven trials, positive adjudication rates for heart failure events were generally lower than for cardiovascular deaths, affecting subsequent mortality risk.
  • Overall, while central adjudication showed some correlation between event types, it didn’t significantly change the results, suggesting that the need for centralized review should be tailored to each trial's objectives.
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Aims: To describe the clinical practice and educational preparation of heart failure (HF) nurses across Europe and determine the key differences between countries.

Methods And Results: A survey tool was developed, in English, by the Heart Failure Association Patient Care committee of the European Society of Cardiology (ESC). It was translated into eight languages, before electronically disseminated by nurse ambassadors, presidents of HF national societies and through social media.

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Introduction: Sodium glucose co-transporter 2 inhibitors (SGLT2i) and mineralocorticoid receptor antagonists (MRAs) reduce the progression of kidney disease. Whether the combination of these agents provides additional benefits compared to SGLT2i alone is worth exploring using data from randomized trials designed for this purpose. The aim of the study was to assess the randomized treatment effect of MRAs combined with SGLT2i versus SGLT2i alone on markers of kidney and cardiovascular health.

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Despite the advances in the understanding and treatment of myeloproliferative neoplasm (MPN), the disease remains incurable with the risk of evolution to acute myeloid leukemia or myelofibrosis (MF). Unfortunately, the evolution of the disease to MF remains poorly understood, impeding preventive and therapeutic options. Recent studies in solid tumor microenvironment and organ fibrosis have shed instrumental insights on their respective pathogenesis and drug resistance, yet such precise data are lacking in MPN.

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Aims: Biomarkers associated with asymptomatic ventricular dysfunction might improve risk stratification and identify pathways leading to heart failure (HF). We explored the association between proteomic biomarkers and left ventricular hypertrophy (LVH), diastolic dysfunction (DD) and incident HF in three population-based cohorts.

Methods And Results: A chip was used to measure 92 protein biomarkers in blood samples from >1500 Malmö Preventive Project (MPP) participants, of whom 514 had LVH (34%), 462 had DD (32.

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Background: Intravenous iron improves symptoms in heart failure (HF) with iron deficiency (ID) but failed to consistently show a benefit in cardiovascular outcomes. The ID definition used may influence the response to intravenous iron. The aim of this meta-analysis is to assess the influence of ID definition on the intravenous iron effect in HF.

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Myeloproliferative neoplasms (MPNs) are characterized by an increased production of blood cells due to the acquisition of mutations such as JAK2. TGF-β, whose secretion is increased in MPN patients, is known to negatively regulate haematopoietic stem cell (HSC) proliferation. Using an isogenic JAK2 or JAK2 wild-type UT-7 cell line we observed that JAK2 cells resist to TGF-β antiproliferative activity.

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Background: Cognitive impairment is common in patients with heart failure and preserved ejection fraction but its clinical correlates and prognostic associations are poorly understood.

Methods: We analyzed cognitive function, using the Mini-Mental State Examination (MMSE), in patients with heart failure and preserved ejection fraction enrolled in a prespecified substudy of the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in Heart Failure With Preserved Ejection Fraction). Logistic regression analyses were performed to determine the variables associated with lower MMSE scores at baseline and postbaseline decline in MMSE scores at 48 weeks.

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Lung ultrasound (LUS) is a simple, fast and non-invasive tool for pulmonary congestion assessment with higher accuracy for the detection of acute heart failure (HF) compared to clinical examination and chest radiography. The integrated assessment with other ultrasound and echocardiographic parameters can lead to a better systemic and pulmonary congestion characterization. Additionally, the combination of echocardiographic and pulmonary features can identify patients at higher risk for adverse outcomes, potentially facilitating both acute and chronic HF management and prognostic stratification.

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Article Synopsis
  • - The article discusses the growing popularity of the win ratio method in cardiovascular trials, highlighting its advantages over conventional composite outcomes and its various applications for analyzing clinical data.
  • - Key topics covered include the workings and interpretation of the win ratio, guidelines for selecting clinical outcomes, and additional measures like the win difference to assess absolute benefits in studies.
  • - It emphasizes the need for correct application, discusses potential misuses, and provides recommendations for future research, complemented by examples from cardiology trials and included statistical methods.
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