180 results match your criteria: "Francois-Mitterrand University Hospital[Affiliation]"

Criteria deemed important by the relatives for designating a reference person for patients hospitalized in ICU.

J Crit Care

June 2020

Department of Intensive Care, Centre Hospitalier de Dieppe, France; Espace de Réflexion Ethique de Normandie, University Hospital Caen, France. Electronic address:

Purpose: We investigated the criteria that patients' relatives deem important for choosing, among themselves, the person best qualified to interact with the caregiving staff.

Methods: Exploratory, observational, prospective, multicentre study between 1st March and 31st October 2018 in 2 intensive care units (ICUs). A 12-item questionnaire was completed anonymously by family members of patients hospitalized in the ICU 3 and 5 days after the patient's admission.

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Loss of SMARCB1 expression in colon carcinoma.

Cancer Biomark

November 2020

Department of Pathology, Ambroise Paré Hospital, APHP, Boulogne, France.

SMARCB1 is a tumor suppressor gene, which is part of SWI/SNF complex involved in transcriptional regulation. Recently, loss of SMARCB1 expression has been reported in gastrointestinal carcinomas. Our purpose was to evaluate the incidence and prognostic value of SMARCB1 loss in colon carcinoma (CC).

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The combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) as conditioning regimen prior to autologous stem-cell transplantation (ASCT) remains the standard of care for patients with mantle cell lymphoma (MCL) who are eligible for transplantation. The replacement of carmustine with bendamustine (BeEAM) was described as a promising alternative in non-Hodgkin lymphoma. The aim of this retrospective study was to compare the BeEAM with the BEAM regimen in MCL patients in the frontline setting.

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Purpose: The aim of this study was to investigate the presence and chemical forms of residual gadolinium (Gd) in rat brain after a single dose of Gd-based contrast agent.

Methods: Four groups of healthy rats (2 sacrifice time-points, n = 10/group, 80 rats in total) were randomized to receive a single intravenous injection of 1 of the 3 Gd-based contrast agents (GBCAs) (gadoterate meglumine, gadobenate dimeglumine, or gadodiamide) or the same volume of 0.9% saline solution.

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The Artificial Kidney Initiation in Kidney Injury 2 (AKIKI2): study protocol for a randomized controlled trial.

Trials

December 2019

French National Institute of Health and Medical Research (INSERM), UMR_S1155, Remodeling and Repair of Renal Tissue, Hôpital Tenon, Sorbonne Université, F-75020, Paris, France.

Background: The Artificial Kidney Initiation in Kidney Injury (AKIKI) trial showed that a delayed renal replacement therapy (RRT) strategy for severe acute kidney injury (AKI) in critically ill patients was safe and associated with major reduction in RRT initiation compared with an early strategy. The five criteria which mandated RRT initiation in the delayed arm were: severe hyperkalemia, severe acidosis, acute pulmonary edema due to fluid overload resulting in severe hypoxemia, serum urea concentration > 40 mmol/l and oliguria/anuria > 72 h. However, duration of anuria/oliguria and level of blood urea are still criteria open to debate.

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When all else fails - Radiological management of severe gastrointestinal bleeding.

Best Pract Res Clin Gastroenterol

February 2020

Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, Dijon, France.

Although most cases of acute nonvariceal gastrointestinal bleeding (GIB) either spontaneously resolve or respond to medical management and endoscopic therapy, there are still a significant proportion of severe patients who require emergency angiography and endovascular treatment. Over the past three decades, transcatheter arterial embolization (TAE) has become the first-line therapy for the management of acute nonvariceal GIB that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer liquid embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of bleeding for a variety of indications.

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Positron emission tomography/computed tomography (PET/CT) is a nuclear medicine functional imaging technique with proven clinical value in oncology. PET/CT indications are continually evolving with fresh advances made through research. French practice on the use of PET in oncology was framed in recommendations based on Standards-Options-Recommendations methodology and coordinated by the French federation of Comprehensive Cancer Centres (FNLCC).

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Multinodular and Vacuolating Posterior Fossa Lesions of Unknown Significance.

AJNR Am J Neuroradiol

October 2019

From the Departments of Neuroradiology (A.L., J.B., L.D., J.-C.S., C.V., V.B., J.S.).

Multinodular and vacuolating neuronal tumor of the cerebrum is a rare supratentorial brain tumor described for the first time in 2013. Here, we report 11 cases of infratentorial lesions showing similar striking imaging features consisting of a cluster of low T1-weighted imaging and high T2-FLAIR signal intensity nodules, which we referred to as multinodular and vacuolating posterior fossa lesions of unknown significance. No relationship was found between the location of the lesion and clinical symptoms.

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Nephrotoxic drug burden among 1001 critically ill patients: impact on acute kidney injury.

Ann Intensive Care

September 2019

INSERM CIC 1415, CHRU de Tours, Médecine intensive réanimation, 2, Bd Tonnellé, 37044, Tours Cedex 9, France.

Article Synopsis
  • Nephrotoxic drug prescriptions are prevalent among critically ill patients, with 62% receiving at least one such drug, contributing to acute kidney injury (AKI) occurrences.
  • A significant number of patients developed or worsened AKI, revealing a clear association between the nephrotoxic drug burden and AKI incidence, particularly in patients with less severe illness.
  • This study suggests that monitoring nephrotoxic burden using a simple drug.day calculation can help clinicians evaluate risk and potentially reduce AKI in intensive care settings.
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Purpose: We sought to describe the characteristics that lead physicians to perceive a stay in the intensive care unit (ICU) as being non-beneficial for the patient.

Materials And Methods: In the first step, we used a multidisciplinary focus group to define the characteristics that lead physicians to consider a stay in the ICU as non-beneficial for the patient. In the second step, we assessed the proportion of admissions that would be perceived by the ICU physicians as non-beneficial for the patient according to our focus group's definition, in a large population of ICU admissions in 4 French ICUs over a period of 4 months.

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Fluid overload in septic intensive care unit (ICU) patients is common and strongly associated with poor outcome. There is currently no treatment for capillary leak, which is mainly responsible for high positive fluid balance (FB) in sepsis. We hypothesized that increasing interstitial pressure with extensive corporeal compression would reduce FB.

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Personalised mechanical ventilation tailored to lung morphology versus low positive end-expiratory pressure for patients with acute respiratory distress syndrome in France (the LIVE study): a multicentre, single-blind, randomised controlled trial.

Lancet Respir Med

October 2019

Department of Perioperative Medicine, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France; Laboratoire Génétique, Reproduction, et Développement, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université Clermont Auvergne, Clermont-Ferrand, France.

Background: The effect of personalised mechanical ventilation on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remains uncertain and needs to be evaluated. We aimed to test whether a mechanical ventilation strategy that was personalised to individual patients' lung morphology would improve the survival of patients with ARDS when compared with standard of care.

Methods: We designed a multicentre, single-blind, stratified, parallel-group, randomised controlled trial enrolling patients with moderate-to-severe ARDS in 20 university or non-university intensive care units in France.

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Objectives: To determine whether bi- or tri-exponential models, and full or segmented fittings, better fit the intravoxel incoherent motion (IVIM) imaging signal of healthy livers.

Methods: Diffusion-weighted images were acquired with a 3 T scanner using a respiratory-triggered echo-planar sequence and 16 b-values (0-800 s/mm ). Eighteen healthy volunteers had their livers scanned twice in the same session, and then once in another session.

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Survival and specific outcome of sickle cell disease patients after renal transplantation.

Br J Haematol

December 2019

AP-HP (Assistance Publique-Hôpitaux de Paris), Department of Nephrology and Transplantation, Rare French Disease Centre "Idiopathic Nephrotic syndrome", Henri-Mondor/Albert-Chenevier Hospital, Créteil, France.

The prognosis of sickle cell disease (SCD) patients who need dialysis is poor, but experience with kidney transplantation is limited. This study assessed the characteristics of 36 SCD patients undergoing renal transplantation. Immediate post-surgical complications occurred in 25% of cases.

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Importance: Keeping a diary for patients while they are in the intensive care unit (ICU) might reduce their posttraumatic stress disorder (PTSD) symptoms.

Objectives: To assess the effect of an ICU diary on the psychological consequences of an ICU hospitalization.

Design, Setting, And Participants: Assessor-blinded, multicenter, randomized clinical trial in 35 French ICUs from October 2015 to January 2017, with follow-up until July 2017.

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Background: Partial splenic embolization (PSE) has been used to improve thrombocytopenia related to hypersplenism. The optimal embolic agent is still debated. The purpose of this study was to evaluate the safety, hematologic response and outcomes of PSE with cyanoacrylate glue for oncological patients with hypersplenism-related thrombocytopenia requiring systemic chemotherapy (SC).

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Background: Clinical research is an essential step in the successful translation of knowledge from basic research into concrete clinical applications, yet many people are reluctant to provide consent when actually approached to actively participate in clinical trials.

Aims: We investigated the factors that influence older patient's (≥ 65 years) decisions to accept or refuse to participate in a prospective randomized clinical trial in secondary prevention after acute coronary syndrome.

Methods: Qualitative approach based on individual semi-structured interviews with patients who were approached for consent to participate in a currently ongoing clinical trial was adopted.

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Continuation versus discontinuation of first-line chemotherapy in patients with metastatic squamous cell oesophageal cancer: A randomised phase II trial (E-DIS).

Eur J Cancer

April 2019

Direction de la Recherche Clinique et de l'Innovation, Centre Oscar Lambret, Lille, France; CESP, INSERM, Paris-Sud, Paris-Saclay University, 94805 Villejuif, France.

Purpose: The role of chemotherapy has not been established in the treatment of metastatic squamous cell oesophageal cancer (mESCC).

Patients And Methods: E-DIS is a discontinuation trial, aimed at estimating efficacy, quality of life and safety of chemotherapy continuation (CT-CONT) in patients with mESCC who are free from progression after a selection phase of chemotherapy. The primary end-point was overall survival.

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Timing of Renal Replacement Therapy for Severe Acute Kidney Injury in Critically Ill Patients.

Am J Respir Crit Care Med

May 2019

2 INSERM UMR S 1155 "Common and Rare Kidney Diseases: from Molecular Events to Precision Medicine," and.

Acute kidney injury (AKI) affects many ICU patients and is responsible for increased morbidity and mortality. Although lifesaving in many situations, renal replacement therapy (RRT) may be associated with complications, and the appropriate timing of its initiation is still the subject of intense debate. An early initiation strategy can prevent some metabolic complications, whereas a delayed one may allow for renal function recovery in some patients without need for this costly and potentially dangerous technique.

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Background: The purpose of this study was to evaluate the feasibility of type II endoleak model creation and efficacy of intraoperative aneurysmal sac embolization using -butyl-2-cyanoacrylate-lipiodol-ethanol mixture (NLE) for type II endoleak in swine.

Methods: In six swine (mean body weight 53.5 kg), abdominal aortic aneurysm (AAA) was created and then end-to-side anastomosis between the left renal artery and AAA sac was performed.

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Background: In septic shock, both systemic vasodilatation and glomerular arteriole dilatation are responsible for the drop in glomerular filtration observed in early acute kidney injury. Angiotensin II has been shown to act on both mechanisms. Our objective was to evaluate the impact of renin angiotensin system activation, on hemodynamic deficiency and renal outcome in patient with septic shock and to assess whether urinary sodium could be a reliable test for high plasma renin concentration screening.

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