929 results match your criteria: "Centre hospitalier Régional Universitaire de Nancy[Affiliation]"

Background: We sought to comprehensively describe drug-related components associated with acute kidney injury (AKI) in patients with chronic kidney disease (CKD), describing the incidence of drug-related AKI, the proportion of preventable AKI, identified the various drugs potentially associated with it, explored the risk factors, and assessed the 1-year incidences of the recurrence of drug-related AKI, kidney failure, and death.

Methods: CKD-REIN is a French national prospective cohort of 3033 nephrology outpatients with a confirmed diagnosis of CKD (eGFR <60 ml/min/1.73 m²).

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After surgery involving cranial nerves and more generally the central nervous system, nonbacterial meningitis should raise suspicion of herpes simplex virus type 1 reactivation. No time should be wasted in diagnosis and treatment; therefore, a polymerase chain reaction testing on cerebrospinal fluid should be systematic in this situation, without neglecting to consider other differential diagnoses.

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Most transplant-ineligible patients present with multiple myeloma (MM) refractory to lenalidomide and/or anti-CD38 monoclonal antibody at first relapse and represent a difficult-to-treat population. The Intergroupe Francophone du Myélome phase 2 study iberdomide, ixazomib and dexamethasone (I2D) evaluated the oral triplet iberdomide, ixazomib and dexamethasone in MM patients aged ≥70 years at first relapse (NCT04998786). Seventy patients were enrolled to receive iberdomide (1.

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How to Teach Clinical Reasoning in the Context of Rare Diseases in Undergraduate Medical Education.

Clin Teach

February 2025

Centre Universitaire d'Enseignement par Simulation - CUESim, Faculté de Médecine, Maïeutique et Métiers de la Santé, Université de Lorraine, Nancy, France.

While rare diseases are individually rare, they are collectively common. Physicians are likely to see patients presenting with rare diseases during their medical practice. Despite the fact that rare diseases present diagnostic and therapeutic challenges, they are not sufficiently addressed by undergraduate medical curricula.

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Purpose: Acute midsubstance Achilles tendon ruptures are the most common tendon injuries in adults and the choice of surgical technique is still debated. The objective of this study is to evaluate the rate of iterative ruptures and postoperative complications at a minimum follow-up of one year of percutaneous sutures of the Achilles tendon, as well as to investigate the risk factors for rupture.

Methods: In this single-center retrospective study, 142 patients (119 men and 23 women, mean age of 46 years) were reviewed at a mean follow-up of 24 (12-38) months.

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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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Background: Oximetry was proposed as an abbreviated exam, easily accepted by the child, for the diagnosis of obstructive sleep apnea (OSA) for children located in regions where access to pediatric sleep labs is limited. The objective of this study was to determine the diagnostic value of the oxygen desaturation index (ODI), the number of ≥ 3% oxygen desaturations per hour of recording, obtained by portable oximetry performed in parallel with video-polysomnography (PSG), in a cohort of children, with and without comorbidities, referred for OSA.

Methods: Data from portable oximetry performed in parallel with PSG were prospectively collected.

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Introduction: Lipodystrophy syndromes are rare diseases characterized by a generalized or partial lipoatrophic morphotype and metabolic complications. Data on health-related quality of life and impact of genetic lipodystrophy on social or psychological well-being are lacking.

Patients And Methods: Patients with genetic lipodystrophy were recruited throughout the French national reference network for rare diseases of insulin secretion and insulin sensitivity.

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Evaluating the added-value of video recording in respiratory polygraphy for the diagnosis of obstructive sleep apnea in children.

Sleep Med

January 2025

DevAH, Faculté de Médecine, Université de Lorraine, France; Service d'Explorations Fonctionnelles Pédiatriques, Hôpital d'Enfants, Centre Hospitalier Universitaire de Nancy, France. Electronic address:

Polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea (OSA) in children but not always available. Abbreviated exams exist, such as respiratory polygraphy (RP), but are less accurate for OSA diagnosis. Video recording (video-RP) may provide a more precise estimation of the total sleep time (TST) compared to RP alone.

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Background: It is unknown which maintenance therapy is the most effective option for patients admitted for an acute severe ulcerative colitis (ASUC) episode responding to intravenous steroids.

Methods: We conducted a multicentre, parallel-group, open-label randomised controlled trial among 23 French centres in thiopurine and biologics-naïve adults admitted for ASUC responding to intravenous steroids. Eligible patients were randomly assigned to receive infliximab (IFX) and azathioprine (AZA) with a 7-day steroid tapering scheme (IFX+AZA arm) or AZA and conventional standardised steroid tapering regimen (AZA arm).

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Thyroidectomy without radioiodine in patients with low-risk thyroid cancer: 5 years of follow-up of the prospective randomised ESTIMABL2 trial.

Lancet Diabetes Endocrinol

January 2025

Department of Biostatistics and Epidemiology, Gustave Roussy, Paris, France; University Paris-Saclay, Paris, France; Office of Biostatistics and Epidemiology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Inserm, Université Paris-Saclay, CESP U1018, Oncostat, labelled Ligue Contre le Cancer, Villejuif, France.

Background: ESTIMABL2, a multicentre randomised phase 3 trial in patients with low-risk differentiated thyroid cancer (ie, pT1am or pT1b, N0 [no evidence of regional nodal involvement] or Nx [involvement of regional lymph nodes that cannot be assessed in the absence of neck dissection]), showed the non-inferiority of a follow-up strategy without radioactive iodine (I) administration compared with a postoperative I administration at 3 years post-randomisation. Here, we report a pre-specified analysis after 5 years of follow-up.

Methods: Patients treated with total thyroidectomy with or without prophylactic neck lymph node dissection, without postoperative suspicious findings on neck ultrasonography, were randomly assigned to the no-radioiodine group or to the radioiodine group (1·1 GBq-30 mCi after recombinant human thyrotropin-stimulating hormone).

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The aim of our study was to analyze the potential survival benefit associated with HSCT according to clinico-biological scores which incorporate molecular data (MIPSS70 and MIPSS70+V2) to facilitate decision-making in this context. One transplant (n=241) and one non-transplant cohorts (n=239) were used to test the hypothesis that PMF patients with higher risk molecular score benefit from HSCT. A weighted propensity score was applied to balance confounding factors with the transplanted cohort as reference.

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Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia.

N Engl J Med

November 2024

From the QEII Health Sciences Centre, Dalhousie University, Halifax, NS (J.L.S., R.P., A.A.), Western University, London, ON (A.S.L.T., L.J.G.), the Population Health Research Institute (J.S.H.) and Hamilton Health Sciences Centre (G.A.), Hamilton, ON, the University of Ottawa Heart Institute (G.M.N., P.B.N.), the McGill University Health Centre (V.E.), the Montreal Heart Institute (L.R., K.D.), and Centre Hospitalier de l'Universitaire de Montreal (J.-M.R.), Montreal, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC (J.-F.R.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec (J.-F.S., I.N.), the University of British Columbia, Vancouver (M.D.), Kelowna General Hospital, Kelowna, BC (C.L.), the University of Ottawa, Ottawa (G.A.W.), and the University of Calgary, Calgary, AB (V.K., S.W.) - all in Canada; Vanderbilt University Medical Center, Nashville (W.G.S., A.K.); Centre Hospitalier Universitaire de Bordeaux, L'institut des Maladies du Rythme Cardiaque, Bordeaux (F.S.), and Centre Hospitalier Universitaire de Nancy, Nancy (C.C.) - both in France; and St. Mary's General Hospital, Passaic, NJ (U.J.).

Background: Patients with ventricular tachycardia and ischemic cardiomyopathy are at high risk for adverse outcomes. Catheter ablation is commonly used when antiarrhythmic drugs do not suppress ventricular tachycardia. Whether catheter ablation is more effective than antiarrhythmic drugs as a first-line therapy in patients with ventricular tachycardia is uncertain.

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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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Article Synopsis
  • Hematological involvement (HI) is a serious condition associated with Langerhans cell histiocytosis (LCH), and is defined by low blood cell counts indicating potential life-threatening complications.
  • A study of 2,313 children with LCH revealed that about 331 developed HI, with a distinction between mild (MHI) and severe HI (SHI), each showing different health outcomes and survival rates over 10 years.
  • Recent advances in treatment have improved mortality rates, particularly with combination therapies and targeted treatments, sparking discussions about refining HI definitions to better inform treatment strategies.
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Comparison of Dual Monoclonal Antibody Therapies for COVID-19 Evolution: A Multicentric Retrospective Study.

Viruses

September 2024

Laboratoire de Virologie, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Assitance Publique-Hôpitaux de Paris, 75013 Paris, France.

Background: Neutralizing antibodies targeting the SARS-CoV-2 Spike protein reduce COVID-19-related risk of hospitalization, particularly in high-risk individuals. The COCOPREV-R study aimed to evaluate and compare clinical outcomes in high-risk SARS-CoV-2 patients treated with dual monoclonal antibody therapies and to identify associated virological factors.

Methods: The COCOPREV-R study retrospectively collected real-world data from high-risk patients receiving Bamlanivimab/Etesevimab or Casirivimab/Imdevimab dual monoclonal antibody therapies (22 February 2021 to 15 June 2021).

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CPX-351 has been approved for patients with therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (MRC-AML). No extensive data are available on MRD and long-term clinical outcome using CPX-351 in AML in real-life. We retrospectively collected data from 168 patients in 36 centers in France and Italy who had received one or two cycles of induction with CPX-351.

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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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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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Article Synopsis
  • * This study analyzed cases of C bantiana infections in France and its territories, involving patients who were diagnosed through a comprehensive surveillance program, focusing on survival rates and the presence of central nervous system (CNS) involvement.
  • * Out of 23 patients identified from 2002 to 2022, 65% had CNS involvement, with a notable increase in cases reported in 2022, indicating a possible correlation with environmental factors like rising temperatures.
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Aims: Cardiac conduction disorders are common in haemodialysis patients, with a relatively high rate of pacemaker implantations. Pacemaker-related complications, especially lead infections and central venous stenosis, pose significant challenges in this population. This study aims to compare single-chamber leadless pacemaker to single-chamber transvenous pacemakers in terms of survival and related complications in haemodialysis patients.

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Patiromer and MRA Doses in Patients With Current or Past Hyperkalemia.

JACC Heart Fail

December 2024

UnIC@RISE, Cardiovascular Research and Development Center, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Heart Failure Clinic, Internal Medicine Department, Unidade Local de Saúde de Gaia/Espinho, Portugal and Centre d'Investigations Cliniques Plurithématique 1433, INSERM, Université de Lorraine, Nancy, France; F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), INSERM U1116, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France. Electronic address:

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