519 results match your criteria: "Centre hospitalier universitaire Grenoble Alpes[Affiliation]"

Clinical and functional spectrum of RAC2-related immunodeficiency.

Blood

April 2024

Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.

Article Synopsis
  • - Mutations in the RAC2 protein are linked to various immune disorders in patients, including neonatal SCID and infantile diseases resembling leukocyte adhesion deficiency, with 15 new mutations identified among 54 patients studied.
  • - The study highlighted that different types of mutations in RAC2 influenced disease outcomes; for instance, certain mutations led to neonatal SCID while others caused later-onset combined immune deficiency or LAD-like diseases.
  • - Clinical analysis revealed significant immune system issues among affected patients, including low levels of T and B cells, recurrent infections, and abnormalities in neutrophil function, indicating severe impacts on their immune response.
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  • This study aimed to compare patient outcomes after undergoing left atrial appendage occlusion (LAAO) versus those who did not have the procedure, focusing on patients with atrial fibrillation (AF) from a national database.
  • After matching 1216 patients who received LAAO with 1216 controls, results showed that those with LAAO had significantly lower rates of major clinical events (ischemic stroke, major bleeding, or death) overall, although they had a higher risk of ischemic stroke specifically.
  • The findings suggest that while LAAO is effective in reducing the risk of death, it is less effective for stroke prevention, especially in patients with a history of stroke or bleeding issues.
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Article Synopsis
  • * There was no increased risk of acute kidney injury (AKI) in patients receiving combination therapy, suggesting it may not be more harmful than single-drug therapy.
  • * The research utilized data from a multicenter database and included various analyses based on patient characteristics and the resistance profiles of the bacteria involved, indicating a comprehensive approach to assessing treatment outcomes.
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[Comparative study of production and control processes of parenteral nutritional admixtures in neonatology].

Ann Pharm Fr

March 2024

Pôle pharmacie, centre hospitalier universitaire Grenoble-Alpes, Grenoble, France; CNRS, TIMC-IMAG UMR 5525, THEMAS, université Grenoble-Alpes, Grenoble, France.

Objectives: To assess the impact of disparities in production and analytical control processes on the quality of parenteral nutrition (PN) preparations produced in the Auvergne-Rhône-Alpes region.

Methods: This study was carried out in four hospital pharmacies of the Auvergne-Rhône-Alpes region. To assess the impact of production processes, each centre produced ten PN preparations from the same prescription.

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Familial KCNQ2 mutation: a psychiatric perspective.

Psychiatr Genet

February 2024

Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris.

Article Synopsis
  • * The report details a case of a 5-year-old boy with a deletion mutation in the KCNQ2 gene, diagnosed with seizures, autism, and intellectual deficiency linked to KCNQ2-encephalopathy.
  • * The findings emphasize the need for genetic counseling and psychiatric evaluation to better manage the complex social and behavioral aspects of these conditions.
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Background: Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic approach remains underutilized in emergency general surgery and in abdominal trauma.

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Mind the gap: Concordance between perceptions regarding vaccination as declared by patients and their evaluation by their general practitioner.

Vaccine

January 2024

Université Grenoble Alpes, Centre Hospitalier Universitaire Grenoble Alpes, Service des Maladies Infectieuses, Grenoble, France; Groupe de Recherche en Infectiologie Clinique, CIC-1406 Inserm-CHUGA-UGA, Grenoble, France. Electronic address:

Background: The high level of vaccine hesitancy reported in the French population may lead general practitioners to anticipate difficult discussions on this topic. We aimed to assess the extent to which general practitioners' evaluation of their patients' vaccine hesitancy was correlated with the real vaccine hesitancy expressed by these patients.

Methods: The study was based on two brief paper questionnaires completed in private by the general practitioner and the patient at the beginning of a medical appointment: one for the physician to evaluate on three quantitative and non-graduated visual scales (then analysed as a 0-100 scale) their patients' perceptions regarding vaccine safety, vaccine efficacy and 'being in favour of vaccination'; and one for the patient to express their perceptions for the same three axes using the same scales.

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Prevention and management of health products shortages by the French national agency (ANSM), 10 years of experience.

Front Public Health

December 2023

Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France.

Shortages of drugs and medical devices have tended to increase in France and worldwide, with consequences for patients and healthcare professionals. Preventing shortages of health products has become a priority for regulatory authorities, including the French National Agency for Medicines and Health Products Safety (ANSM). To highlight perspectives for a better prevention, we described and analyzed the management of shortages in the availability of health products in France over the last 10 years.

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The endovascular approach is widely used in the management of aortic isthmic rupture. Even if it remains less invasive than conventional surgery, a life-threatening complications are possible. We report the case of a young female patient presenting a stent-graft migration during the deployment with total obstruction of the supra-aortic vessels.

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Effect of automated head-thorax elevation during chest compressions on lung ventilation: a model study.

Sci Rep

November 2023

Institut Mondor de Recherches Biomédicales INSERM-UPEC UMR 955 Eq13 - CNRS EMR 7000, 8 rue du Général Sarrail, 94010, Créteil, France.

Our goal was to investigate the effects of head-thorax elevation (HUP) during chest compressions (CC) on lung ventilation. A prospective study was performed on seven human cadavers. Chest was automatically compressed-decompressed in flat position and during progressive HUP from 18 to 35°.

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Background: Titinopathies are caused by mutations in the titin gene (). Titin is the largest known human protein; its gene has the longest coding phase with 364 exons. Titinopathies are very complex neuromuscular pathologies due to the variable age of onset of symptoms, the great diversity of pathological and muscular impairment patterns (cardiac, skeletal muscle or mixed) and both autosomal dominant and recessive modes of transmission.

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Article Synopsis
  • The study investigates the impact of various comorbidity scores on the survival of lung cancer patients, comparing seven different scores to determine which best predicts four-month survival rates.
  • Data was collected from patients diagnosed with lung cancer who were hospitalized between 2011 and 2015, and multiple statistical methods were employed to analyze the effectiveness of each comorbidity score.
  • Results showed that the Elixhauser score outperformed other scores in predicting survival, demonstrated by higher discrimination metrics and better overall fit to the data.
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Article Synopsis
  • - The study aimed to compare how effective and safe different treatment schedules with azathioprine (AZA) and rituximab (RTX) are in preventing relapses in patients with ANCA-associated vasculitis who are in complete remission.
  • - Researchers conducted trials that compared 18-month fixed RTX to AZA, 18-month fixed RTX to 18-month tailored RTX, and extended 36-month RTX therapy versus placebo, tracking patient outcomes over 84 months.
  • - Findings indicated that the 18-month fixed RTX regimen was significantly better at preventing major relapses compared to AZA and the tailored RTX approach, leading to a higher remission rate at the 84-month mark.
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Much ado about nothing? Discrepancy between the available data on the antiviral effect of hydroxychloroquine in March 2020 and its inclusion in COVID-19 clinical trials and outpatient prescriptions.

Public Health

December 2023

Infectious Disease Department, Université Grenoble Alpes, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France; Groupe de Recherche en Infectiologie Clinique, CIC-1406, INSERM-UGA-CHUGA, France. Electronic address:

Objectives: Many of the 2020 COVID-19 clinical trials included an (hydroxy)chloroquine ((H)CQ) arm. We aimed to juxtapose the state of science before April 2020 regarding the benefits of (H)CQ for viral infections with the number and size of the clinical trials studying (H)CQ and the volume of (H)CQ dispensed in France.

Study Design: We identified and analysed published scientific material regarding the antiviral activity of (H)CQ and publicly available data regarding clinical trials and drug dispensation in France.

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Microbeam radiation therapy (MRT) is a radiotherapy technique combining spatial fractionation of the dose distribution on a micrometric scale, X-rays in the 50-500 keV range and dose rates up to 16 × 10 Gy s. Nowadays, in vivo dosimetry remains a challenge due to the ultra-high radiation fluxes involved and the need for high-spatial-resolution detectors. The aim here was to develop a striped diamond portal detector enabling online microbeam monitoring during synchrotron MRT treatments.

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Innovative minimally invasive options to treat drug-resistant epilepsies.

Rev Neurol (Paris)

September 2024

Université Grenoble-Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France. Electronic address:

Despite the regular discovery of new molecules, one-third of epileptic patients are resistant to antiepileptic drugs. Only a few can benefit from resective surgery, the current gold standard. Although effective in 50-70% of cases, this therapy remains risky, costly, and can be associated with long-term cognitive or neurological side effects.

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Occult hepatitis B (HBV) infection (OBI), characterized by low viral loads, accounts for much of the risk of HBV transfusion-transmitted infection. With anticore antibodies (anti-HBc) screening introduced in England, the imperative to identify OBI donors has increased. We aimed to develop an ultra-sensitive PCR system and investigate risk factors for HBV DNA presence in blood donations.

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Major defects of the facial structures cause severe functional and esthetic impairment. Difficulty in head and neck reconstruction lies in cases of secondary, tertiary, or further reconstruction. This is not a rare situation for patients who had cancer of the upper airways, since the rate of recurrence, second location, or osteoradionecrosis is high.

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Clear cell Renal Cell Carcinoma (ccRCC) is one of the most prevalent kidney cancers, which is often asymptomatic and thus discovered at a metastatic state (mRCC). mRCC are highly heterogeneous tumors composed of subclonal populations that lead to poor treatment response rate. Several recent works explored the potential of ccRCC tumoroids culture derived from patients.

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Insight into the relationship between forced vital capacity and transfer of the lungs for carbon monoxide in patients with idiopathic pulmonary fibrosis.

Respir Med Res

November 2023

Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France; Laboratoire HP2, INSERM U1300, Université Grenoble Alpes, Grenoble, France. Electronic address:

Article Synopsis
  • Forced vital capacity (FVC) and lung transfer of carbon monoxide (TLCO) are both important tests for measuring how bad a lung disease called idiopathic pulmonary fibrosis (IPF) is, but TLCO is better at showing the disease's severity.
  • * In a study of 430 IPF patients, many with "normal" FVC actually had "abnormal" TLCO, meaning FVC alone might not tell the whole story about lung health.
  • * The research found that most patients with a decline in TLCO also had a decline in FVC, but the opposite was not true, suggesting TLCO should be given more attention in monitoring IPF.
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[ICU admission for cancer patients with respiratory failure: An ethical dilemma].

Rev Mal Respir

October 2023

Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon Sud, Lyon, France; Institut de recherches philosophiques de Lyon, université Lyon 3, Lyon, France.

In medicine, each decision is the result of a trade-off between medical scientific data, the rights of individuals (protection of persons, information, consent), individual desires, collective values and norms, and the economic constraints that guide our society. Whether or not to admit a cancer patient to an intensive care unit is very often an ethical dilemma. It is necessary to distinguish patients who would benefit from admission to an intensive care unit (ICU) from those for whom it would be futile.

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