2,733 results match your criteria: "Centre hospitalier intercommunal[Affiliation]"

Nirsevimab and Hospitalization for RSV Bronchiolitis.

N Engl J Med

July 2024

From the Department of General Pediatrics, Pediatric Infectious Disease, and Internal Medicine (Z.A., A.G., N.O.), Centre d'Investigations Cliniques, INSERM Unité 1426 (Z.V.), the Pediatric Intensive Care Unit (M. Levy, P.S.), the Pediatric Emergency Department (L.L.), the Department of Microbiology (M.G.-M.), the Neonatal Intensive Care Unit (V.B.), and the Unit of Clinical Epidemiology, INSERM Unité 1123 and Epidémiologie Clinique du Centre d'Investigation Clinique 1426 (K.D., O.A.), Robert-Debré University Hospital, Paris Cité University (Z.A., C.S., A.G., Z.V., M.B., J.F.C., J.T., M.L., P.S., L.L., M.G.-M., V.B., K.D., O.A.), the Departments of General Pediatrics (A.-S.R., M. Lorrot, C.F.) and Pediatric Pulmonology (A.-S.R., M. Lorrot), Armand Trousseau University Hospital, Sorbonne University (A.-S.R., M. Lorrot), the Pediatric Emergency Department (C.S.), the Pediatric Intensive Care Unit (M.B.), and the Department of General Pediatrics and Pediatric Infectious Diseases (C.S., J.F.C., J.T.), Necker-Enfants Malades University Hospital, Saint-Antoine Research Center, INSERM Unité Mixte de Recherche (UMR) S938 (H.C., B.P.), and Assistance Publique-Hôpitaux de Paris (AP-HP), Infection, Antimicrobials, Modeling, and Evolution (IAME) Research Unit, INSERM UMR 1137 (Z.A., L.L., M.G.-M., N.O.), Épidémiologie Clinique et Évaluation Économique Appliqué aux Populations Vulnérables, INSERM UMR 1123 (C.A.), the Center of Research in Epidemiology and Statistics, INSERM UMR 1153 (J.F.C.), and Biodiversity and Epidemiology of Bacterial Pathogens Research Unit, Institut Pasteur (J.T.), Paris Cité University, Paris, Groupe de Pathologie Infectieuse Pédiatrique, Nice (Z.A., M. Lorrot, R.C., C.L., N.O.), the Pediatric Emergency Department (C.A.) and the Department of General Pediatrics (L.P., C.F.D.), Jean Verdier University Hospital, AP-HP de Paris, Bondy, the Department of General Pediatrics, Centre Hospitalier Intercommunal de Créteil (M.S., C.J.), Association Clinique et Thérapeutique Infantile du Val-de-Marne France (R.C., C.L.), Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Étude des Maladies Infectieuses Néonatales et Infantiles, Université Paris Est (R.C., C.L., C.J.), and the Clinical Research Center (M.M.E.H., C.J.) and the Neonatal Intensive Care Unit (X.D.), Centre Hospitalier Intercommunal de Créteil, Université Paris Est Créteil, Faculté de Santé de Créteil, Créteil, Association Française de Pédiatrie Ambulatoire, Orleans (R.C., C.L.), and the Departments of Pediatric Pulmonology and Allergology (G.L., N.C.) and General Pediatrics (B.H., O.M., C.B.), Children's Hospital, Toulouse University Hospital, Toulouse - all in France; and the Department of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (F.A.).

Article Synopsis
  • RSV is a major cause of bronchiolitis, leading to 3 million hospitalizations each year, and nirsevimab is a monoclonal antibody aimed at preventing severe RSV cases in infants.
  • A study compared infants hospitalized for RSV bronchiolitis with those visiting for unrelated reasons, assessing nirsevimab’s effectiveness in preventing hospitalizations in those under 12 months old.
  • Findings showed nirsevimab reduced hospitalization rates for RSV-associated bronchiolitis by 83% and critical care needs by about 70%, indicating it is an effective treatment option for vulnerable infants.
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Article Synopsis
  • * The French Association for the Study of the Liver created guidelines to summarize the best practices for managing iCCA and pCCA, based on comprehensive expert analysis and voting.
  • * These guidelines cover the epidemiology of cholangiocarcinoma and outline management strategies from diagnosis to treatment, emphasizing advancements in personalized medicine and targeted therapies.
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Epidemiology of childhood interstitial lung disease in France: the RespiRare cohort.

Thorax

August 2024

Paediatric Pulmonology Department and Reference Center for Rare Lung Diseases, RespiRare, Sorbonne University, AP-HP, Armand Trousseau Hospital, Paris, France

Article Synopsis
  • A study examined the prevalence and incidence of interstitial lung disease in children (chILD) in France, finding it affects 44 children per million in 2022 and has an incidence of 4.4 per million.
  • The research included data from 790 patients across 42 centers, noting that the median age for diagnosis was 3 months, with a significant portion having familial forms.
  • Management typically involved oxygen therapy and corticosteroids, with survival rates being 57.3% for children diagnosed before 2 years and 86% for those diagnosed between 2 and 18 years; the study highlights the need for improved international data collection and standardized practices.
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Study Question: What is the prevalence of infertility and ectopic pregnancies among individuals with primary ciliary dyskinesia (PCD)?

Summary Answer: We found that 39 of 50 men (78%) and 72 of 118 women (61%) with PCD were infertile and that women with PCD had an increased risk of ectopic pregnancies (7.6 per 100 pregnancies, 95% CI 4.7-12.

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  • Anti-TNFα therapy has transformed the treatment of inflammatory bowel disease (IBD), but it poses a risk for developing active tuberculosis (TB) and potential complications like immune reconstitution inflammatory syndrome (IRIS).
  • A French retrospective study analyzed 36 IBD patients with TB treated with anti-TNFα, finding a high incidence of disseminated TB and a significant rate of IRIS, particularly in those with miliary TB.
  • Most patients resumed anti-TNFα treatment safely after managing TB, with a favorable overall recovery rate, indicating that restarting this therapy can be an effective approach.
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Article Synopsis
  • This study aimed to explore how different aspects of asbestos exposure relate to pleural plaques (PP) in retired workers in France.
  • A large screening program conducted from 2003 to 2016 involved 5,392 participants, with HRCT scans and detailed evaluations of their work history to gauge their asbestos exposure levels.
  • The findings revealed complex, non-linear relationships where the risk of PP increased with higher cumulative asbestos exposure and longer periods since first exposure, while the odds decreased with longer times since last exposure.
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Background: Exome sequencing in prenatal context confronts with pathogenic variants associated with phenotypes that are not detectable prenatally.

Materials And Methods: A consanguineous couple was referred at 24 weeks of gestation for prenatal genetic investigations after ultrasonography findings including decreased fetal movements, hypoplastic male external genitalia, retrognathia, prefrontal edema, anomalies of the great vessels with pulmonary atresia and dilated tortuous aorta.

Result: Prenatal trio exome sequencing identified two homozygous likely pathogenic variants, i.

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[Translation into French and republication of: "Treatment of cancer-associated venous thromboembolism in patients under palliative care"].

Rev Med Interne

July 2024

F-CRIN INNOVTE network, Saint-Étienne, France; Inserm UMRS 1140 Innovations thérapeutiques en hémostase, université Paris Cité, Paris, France; Service de médecine interne, hôpital Louis-Mourier, AP-HP, Colombes, France.

Many patients with cancer require palliative care at some stage and the vast majority of people followed in palliative care are cancer patients. Patients with cancer are at high risk of venous thromboembolism (VTE), and this is particularly true during the advanced palliative phase when mobility is limited or absent. Patients with cancer in palliative care are at higher bleeding risk compared to non-cancer patients.

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Introduction: Errors in reasoning are the main causes of poor decision-making in clinical practice. To remedy this, many studies highlight the importance of supervising clinical reasoning during medical internships. Although decision-making is an ongoing process at all key moments of the perioperative period, there are no studies on the supervision of clinical reasoning during student nurse anesthetist internships.

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Objective: To assess the burden of respiratory syncytial virus (RSV)-related bronchiolitis in primary care and at 15 days and 6 months after a primary care visit.

Study Design: In this test-negative study, children <2 years old with a first episode of bronchiolitis were prospectively enrolled by 45 ambulatory pediatricians in France from February 2021 to April 2023. RSV was assessed with a rapid antigen detection test.

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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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Background: Evidence for the management of pregnant women with acute hypoxaemic respiratory failure (AHRF) is currently lacking. The likelihood of avoiding intubation and the risks of continuing the pregnancy under invasive ventilation remain undetermined. We report the management and outcome of pregnant women with pneumonia related to SARS-CoV-2 admitted to the ICU of tertiary maternity hospitals of the Paris area.

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The latest news in France before distribution of third-generation pneumococcal conjugate vaccines.

Infect Dis Now

August 2024

ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; National Reference Center for Pneumococci, Service de microbiologie, Hôpital Intercommunal de Créteil, Créteil, France.

Introduction: In 2023 in France, 15 valent- pneumococcal conjugate vaccines (PCV15) have been recommended as alternatives to PCV13 for children < 2 years. PCV20 has been recommended for at-risk adults but not yet for infants, while PCV21 targets older adults. We endeavored to estimate the potential benefit of new pneumococcal vaccines in preventing invasive pneumococcal infections by comparing serotype extension to PCV13.

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Purpose: Sensory chemotherapy-induced peripheral neuropathy (CIPN) is well-recognized, but motor CIPN remains understudied. This secondary analysis focused on the long-term severity and impact of motor disorders, their relation to sensory CIPN, neuropathic pain, psychological distress, and health-related quality of life (HRQoL) after oxaliplatin-based chemotherapy in colorectal cancer (CRC) survivors.

Methods: Data from a multicenter, cross-sectional study were re-analyzed to explore motor CIPN among CRC survivors up to 5 years post-chemotherapy, with no longitudinal follow-up.

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Anti-IL-4R versus anti-IL-5/5R after anti-IL-5/5R failure in asthma: An emulated target trial.

J Allergy Clin Immunol

October 2024

Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, équipe PEPITES, AP-HP, Hôpital Pitié-Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Paris, France. Electronic address:

Article Synopsis
  • Patients with severe eosinophilic asthma often switch from one biologic treatment to another when their current medication isn't effective, but it's unclear whether switching to a different class (anti-IL-4R) or another drug in the same class (anti-IL-5/5R) is better.
  • In a study using data from a large asthma cohort, researchers compared the outcomes of patients who switched to either anti-IL-4R mAb or a different anti-IL-5/5R after not responding to their initial treatment.
  • Results showed no significant difference in asthma control improvement at six months, but the anti-IL-4R group had a more notable reduction in corticosteroid use, suggesting it might
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ERS statement on transition of care in childhood interstitial lung diseases.

Eur Respir J

August 2024

National Heart and Lung Institute, Imperial College, Royal Brompton and Harefield NHS Foundation Trust, London, UK.

Interstitial lung diseases (ILD) are a heterogeneous group of rare diffuse diseases affecting the lung parenchyma in children and adults. Childhood interstitial lung diseases (chILD) are often diagnosed at very young age, affect the developing lung, and can have different presentations and prognosis compared to adult forms of these diseases. In addition, chILD in many cases may apparently remit, and have a better response to therapy and better prognosis than adult ILD.

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Background: Based on the findings of the PACIFIC trial, consolidation durvalumab following platinum-based chemoradiotherapy (CRT) is a global standard of care for patients with unresectable, stage III non-small-cell lung cancer (NSCLC). An earlier analysis from the ongoing PACIFIC-R study (NCT03798535) demonstrated the effectiveness of this regimen in terms of progression-free survival (PFS). Here, we report the first planned overall survival (OS) analysis.

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Background: In an open-label multicenter non-randomized non-comparative phase II study in patients with stage IIIB/IV non-squamous non-small cell lung cancer (NSCLC), oncogenic addiction (EGFR mutation or ALK/ROS1 fusion), with disease progression after tyrosine-kinase inhibitor and no prior chemotherapy (NCT04042558), atezolizumab, carboplatin, pemetrexed with or without bevacizumab showed some promising result. Beyond the clinical evaluation, we assessed safety and patient-reported outcomes (PROs) to provide additional information on the relative impact of adding atezolizumab to chemotherapy with and without bevacizumab in this population.

Materials: Patients received platinum-pemetrexed-atezolizumab-bevacizumab (PPAB cohort) or, if not eligible, platinum-pemetrexed-atezolizumab (PPA cohort).

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Article Synopsis
  • A study was conducted across 49 ICUs in France to investigate the clinical outcomes and severity of severe Pneumocystis jirovecii pneumonia (PJP), focusing on how delayed antibiotic treatment and corticosteroid therapy affect patient survival.
  • The study included 158 patients, mainly admitted due to acute respiratory failure, and found high mortality rates (31.6% in ICU, 40.5% at 6 months), with delayed antibiotic treatment beyond 96 hours linked to a significantly higher risk of death.
  • The results indicate that most patients did not receive preventive antibiotic therapy before needing intensive care, and both delayed antibiotic treatment and the use of corticosteroids worsened mortality rates in those with severe PJP.
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[Translation into French and republication of: "Central venous catheter associated upper extremity deep vein thrombosis in cancer patients: Diagnosis and therapeutic management"].

Rev Med Interne

June 2024

F-CRIN INNOVTE network, Saint-Étienne, France; Université Paris Cité, Inserm UMR S1140, innovations thérapeutiques en hémostase, Paris, France; Service de pneumologie et de soins intensifs, hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France.

Catheter-related thrombosis (CRT) is a relatively frequent and potentially fatal complication arising in patients with cancer who require a central catheter placement for intravenous treatment. In everyday practice, CRT remains a challenge for management; despite its frequency and its negative clinical impact, few data are available concerning diagnosis and treatment of CRT. In particular, no diagnostic studies or clinical trials have been published that included exclusively patients with cancer and a central venous catheter (CVC).

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Article Synopsis
  • A tyrosine-kinase inhibitor (TKI) is recommended as the primary treatment for non-small-cell lung cancer (NSCLC) patients with an epidermal growth-factor receptor mutation, and the effectiveness of combining it with chemotherapy (ChT) is being researched.
  • A meta-analysis of four phase III trials involving 1,413 NSCLC patients indicated that the combination of EGFR-TKI and ChT resulted in significantly longer progression-free survival (PFS) and overall survival (OS) compared to EGFR-TKI alone.
  • The combination treatment showed especially improved PFS for patients with brain metastases, but more research is necessary to determine which patients are most likely to benefit from this combined approach.
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