270 results match your criteria: "GH Hôpitaux universitaires[Affiliation]"

Formal guidelines from an expert panel: intensive care unit medical staffing, organisation and working hours to improve quality of life at work in France.

Ann Intensive Care

January 2025

Service de Réanimation Médicale GHRMSA, Hôpital Emile Muller 20 Av. du Dr Laennec, 68100, Mulhouse, France.

Background: Intensive care units (ICU) are characterized by high medical assistance costs and great complexity. Recommendations to determine the needs of medical staff are scarce, generating appreciable variability. The French Intensive Care Society (FICS) and the French National Council of Intensive Care Medicine (CNP MIR, Conseil National Professionel de Médecine Intensive Réanimation) have established a technical committee of experts, the purposes of which were to draft recommendations regarding staffing needs in ICUs and to propose optimal organisation of work hours, a key objective being improved workplace quality of life.

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The molecular diagnosis of type 1 facioscapulohumeral muscular dystrophy (FSHD1) relies on the detection of a shortened D4Z4 array at the 4q35 locus. Until recently, the diagnosis of FSHD2 relied solely on the absence of a shortened D4Z4 allele in clinically affected patients. It is now established that most FSHD2 cases carry a heterozygous variant in the SMCHD1 gene.

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Background And Objectives: Cefiderocol approved dosages are based on a prolonged infusion (PI) of 3 h that may not be adequate in all settings The objective of this study was to identify alternative cefiderocol dosage regimens based on short infusion (SI) or continuous infusion (CI).

Methods: We performed 1000-patient pharmacokinetic/pharmacodynamic (PK/PD) simulations based on a reference population model. Drug penetration into the epithelial lining fluid (ELF) was considered for pneumonia.

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Article Synopsis
  • * Researchers analyzed data from 275 CMTX1 patients across 13 centers in France, finding that those with mutations in transmembrane domains had more severe symptoms and earlier onset than those with mutations in intracellular or extracellular domains.
  • * The findings suggest that the type of genetic mutation not only helps diagnose CMTX1 but also predicts disease severity, emphasizing the need to consider these correlations in upcoming clinical research.
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Background: Myosin heavy chain 7 ()-related myopathies (-RMs) are a group of muscle disorders linked to pathogenic variants in the gene, encoding the slow/beta-cardiac myosin heavy chain, which is highly expressed in skeletal muscle and heart. The phenotype is heterogeneous including distal, predominantly axial or scapuloperoneal myopathies with variable cardiac involvement.

Methods: We retrospectively analysed the clinical, muscle MRI, genetic and myopathological features of 57 patients.

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Introduction: First-line oxygenation strategy in patients with acute hypoxaemic respiratory failure consists in standard oxygen or high-flow nasal oxygen therapy. Clinical practice guidelines suggest the use of high-flow nasal oxygen rather than standard oxygen. However, findings remain contradictory with a low level of certainty.

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Growth hormone (GH) deficiency (GHD) in children and adolescents can vary in severity and origin, with GH replacement therapy proving effective in achieving genetic target height. Optimal outcomes are seen in those treated early and with higher doses. As patients approach adult height, priorities shift towards optimizing metabolic effects, maintaining body composition, and enhancing bone mass and muscle strength.

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Current and Emerging Radiotracers in Molecular Cardiovascular Imaging.

Circ Cardiovasc Imaging

October 2024

BHF Centre for Cardiovascular Science, The University of Edinburgh, United Kingdom (S.S.J., J.G., D.E.N., M.R.D.).

Article Synopsis
  • Cardiovascular imaging has evolved significantly, with traditional methods like echocardiography and CT scans essential for assessing heart structure and function, but often lacking direct insights into disease activity.
  • Molecular nuclear imaging techniques, such as PET and SPECT, are bridging this gap by allowing visualization of disease processes at a molecular and cellular level.
  • The review emphasizes how advancements in molecular imaging are crucial for precision medicine, aiding in better understanding of diseases, developing targeted treatments, and personalizing patient care.
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Paraneoplastic Neurologic Syndromes Associated With Merkel Cell Carcinoma.

Neurol Neuroimmunol Neuroinflamm

November 2024

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (N.L.C.-P., S.M.-C., M.V.-G., A.F., V.W., L.D.D., V.R., G.P., B.J., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; MeLiS - UCBL-CNRS UMR 5284 - INSERM U1314 (N.L.C.-P., S.M.-C., M.V.-G., A.F., V.W., L.D.D., V.R., G.P., B.J., J.H.), Université Claude Bernard Lyon 1, France; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND (N.L.C.-P.); Red Andaluza de Investigación Clínica y Traslacional en Neurología (NeuroRECA) (N.L.C.-P.), Málaga, Spain; Center for Sleep Sciences and Medicine (S.M.-C.), Stanford University, Palo Alto, CA; Department of Neuroscience (A.F.), Psychology, Pharmacology and Child Health. University of Florence, Italy; Clinical Neurology (A.V.), Santa Maria della Misericordia University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC); Department of Medicine (DMED) (A.V.), University of Udine, Udine, Italy; Sorbonne Université (C.B.), Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin; OncoNeuroTox Group (C.B.), Center for Patients with Neurological Complications of Oncologic Treatments, GH Pitié-Salpetrière et Hôpital Percy, Paris; Immunology Department (D.G., F.N.), Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Service de Neurologie (O.F.), Centre Hospitalier de la Côte Basque, Bayonne; Department of Neurology (C.D.), University Hospital of Tours; and Service de Neurologie (A.B.), Centre Hospitalo-Universitaire Rennes, France.

Article Synopsis
  • The study focuses on understanding the clinical and immunologic characteristics of patients with paraneoplastic neurologic syndromes (PNSs) linked to Merkel cell carcinoma (MCC).
  • A total of 47 patients were analyzed, revealing common neurological disorders such as Lambert-Eaton myasthenic syndrome (LEMS) and encephalomyelitis, along with significant associations with specific neural antibodies.
  • The findings indicate that many patients initially presented without identifiable skin tumors but had lymph node metastases, and those without a primary tumor had a lower mortality rate compared to those with identified tumors.
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Diagnosis and management of pituitary adenomas in children and adolescents.

Eur J Endocrinol

September 2024

INSERM-U1185, Paris Sud Paris-Saclay University and AP-HP Division of Endocrinology and Diabetes for Children, Bicêtre Paris Sud Hospital, 64 Gabriel Péri Street, 94270 Le Kremlin Bicêtre, France.

Article Synopsis
  • Pituitary adenomas (PA), or Pit-NETS, are rare in children and especially unusual in those under 10, with the majority of research conducted on adult cases.
  • This review addresses the unique clinical considerations, diagnosis, and treatment of PA in young patients, highlighting the importance of involving specialized teams that include both pediatric and adult medical experts.
  • Pediatric PAs tend to be larger, more aggressive, and often lead to hormonal imbalances that can affect growth and puberty, with the most common type being prolactinomas; genetic testing is recommended for young patients due to potential hereditary mutations linked to these tumors.
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Effect of adequacy of empirical antibiotic therapy for hospital-acquired bloodstream infections on intensive care unit patient prognosis: a causal inference approach using data from the Eurobact2 study.

Clin Microbiol Infect

December 2024

OUTCOMEREA Research Group, Drancy, France; Institut National de la Santé et de la Recherche Medicale, Infection Antimicrobial Modelisation Evolution, U1137, Team Decision Science in Infectious Diseases, Paris, France; Assistance Publique Hôpitaux de Paris, Bichat hospital, Medical and infectious diseases ICU, F75018, Paris France. Electronic address:

Article Synopsis
  • Hospital-acquired bloodstream infections (HA-BSI) in ICU patients can be life-threatening, and this study aimed to see how early adequate antibiotic treatment affects 28-day mortality rates for patients who survive at least one day after infection onset.
  • Using data from a multicenter study with 2,418 patients, researchers found that those who received adequate treatment within 24 hours had a lower 28-day mortality rate (32.8%) compared to those who were inadequately treated (40%).
  • The study concluded that inadequate antibiotic therapy within 24 hours contributes significantly to 28-day mortality, indicating that quicker treatment could greatly improve patient outcomes in cases of HA-BSI.
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Article Synopsis
  • The human immune system continues to develop for several years after birth, affecting how young children respond to infections, such as SARS-CoV-2.
  • Researchers studied T cell responses in children and adults before, during, and after SARS-CoV-2 infection, revealing that younger children (under 5) had a weaker CD4 T cell response compared to older children and adults with mild disease.
  • Following infection, preschool-age children produced similar neutralizing antibodies to adults but had different T cell characteristics and fewer memory B cells, indicating a gradual maturation of their adaptive immune responses.
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Diet quality and associations with lactate and metabolic syndrome in bipolar disorder.

J Affect Disord

November 2024

Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Mitochondrial Innovation Initiative, MITO2i, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Electronic address:

Background: Nutrition is largely affected in bipolar disorder (BD), however, there is a lack of understanding on the relationship between dietary categories, BD, and the prevalence of metabolic syndrome. The objective of this study is to examine dietary trends in BD and it is hypothesized that diets with increased consumption of seafood and high-fiber carbohydrates will be correlated to improved patient outcomes, and a lower frequency of metabolic syndrome.

Methods: This retrospective cohort study includes two French cohorts.

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Introduction: We investigated the link between habitual caffeine intake with memory impairments and cerebrospinal fluid (CSF) biomarkers in mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients.

Methods: MCI (N = 147) and AD (N = 116) patients of the Biomarker of AmyLoid pepTide and AlZheimer's diseAse Risk (BALTAZAR) cohort reported their caffeine intake at inclusion using a dedicated survey. Associations of caffeine consumption with memory impairments and CSF biomarkers (tau, p-tau181, amyloid beta 1-42 [Aβ], Aβ) were analyzed using logistic and analysis of covariance models.

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We assessed cumulative detection and determinants of anal high-grade squamous intraepithelial lesions (HSILs) in men who have sex with men living with human immunodeficiency virus and who underwent 3 visits over 2 years, with cytology and high-resolution anoscopy, within the ANRS-EP57-APACHES study. The cumulative HSIL detection rate was 33% (134 of 410), of which 48% HSILs were detected at baseline. HSIL detection varied considerably by center (from 13% to 51%).

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Mitochondrial Biomarkers and Metabolic Syndrome in Bipolar Disorder.

Psychiatry Res

September 2024

Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Mitochondrial Innovation Initiative, MITO2i, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.

Article Synopsis
  • This study investigates the link between mitochondrial blood biomarkers, specifically lactate and circulating cell-free mitochondrial DNA, and markers of metabolic syndrome in bipolar disorder patients, hypothesizing that lactate levels would be higher in those with metabolic syndrome.
  • The research involved a large cohort of 837 stable bipolar disorder patients and 237 others for validation, revealing that higher lactate levels correlated significantly with factors like triglycerides and blood pressure, indicating a strong association with metabolic syndrome.
  • The findings suggest that while lactate is a key biomarker related to metabolic syndrome in bipolar patients, circulating mitochondrial DNA levels do not show this same correlation, highlighting the potential for personalized treatment strategies based on these metabolite profiles.
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Dynamics of virological and immunological markers of HIV persistence after allogeneic haematopoietic stem-cell transplantation in the IciStem cohort: a prospective observational cohort study.

Lancet HIV

June 2024

IrsiCaixa, Badalona, Spain; Germans Trias i Pujol Research Institute, Badalona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; University of Vic-Central University of Catalonia, Vic, Spain; Catalan Institution for Research and Advanced Studies, Barcelona, Spain. Electronic address:

Background: Allogeneic haematopoietic stem-cell transplantation (allo-HSCT) markedly reduces HIV reservoirs, but the mechanisms by which this occurs are only partly understood. In this study, we aimed to describe the dynamics of virological and immunological markers of HIV persistence after allo-HSCT.

Methods: In this prospective observational cohort study, we analysed the viral reservoir and serological dynamics in IciStem cohort participants with HIV who had undergone allo-HSCT and were receiving antiretroviral therapy, ten of whom had received cells from donors with the CCR5Δ32 mutation.

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Article Synopsis
  • - Primary hyperoxalurias (PH) are rare genetic disorders that can lead to significant diagnostic delays, adversely affecting patient health outcomes.
  • - A study of 52 patients revealed that adults experienced much longer diagnostic delays (30 years on average) compared to children (1.2 years), with renal colic being the main symptom for adults.
  • - The findings highlight the need for greater awareness among healthcare professionals about these conditions to improve early detection and management, despite existing support structures for rare diseases.
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Background: Among plasma biomarkers for Alzheimer's disease (AD), pTau181 and pTau217 are the most promising. However, transition from research to routine clinical use will require confirmation of clinical performance in prospective cohorts and evaluation of cofounding factors.

Method: pTau181 and pTau217 were quantified using, Quanterix and ALZpath, SIMOA assays in the well-characterised prospective multicentre BALTAZAR (Biomarker of AmyLoid pepTide and AlZheimer's diseAse Risk) cohort of participants with mild cognitive impairment (MCI).

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Objective: To develop recommendations for the routine management of patients with polymyalgia rheumatica (PMR).

Methods: Following standard procedures, a systematic review of the literature by five supervised junior rheumatologists, based on the questions selected by the steering committee (5 senior rheumatologists), was used as the basis for working meetings, followed by a one-day plenary meeting with the working group (15 members), leading to the development of the wording and determination of the strength of the recommendations and the level of agreement of the experts.

Results: Five general principles and 19 recommendations were drawn up.

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This is the third paper in the series providing updated information and recommendations for people with cystic fibrosis transmembrane conductance regulator (CFTR)-related disorder (CFTR-RD). This paper covers the individual disorders, including the established conditions - congenital absence of the vas deferens (CAVD), diffuse bronchiectasis and chronic or acute recurrent pancreatitis - and also other conditions which might be considered a CFTR-RD, including allergic bronchopulmonary aspergillosis, chronic rhinosinusitis, primary sclerosing cholangitis and aquagenic wrinkling. The CFTR functional and genetic evidence in support of the condition being a CFTR-RD are discussed and guidance for reaching the diagnosis, including alternative conditions to consider and management recommendations, is provided.

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Background: The clinical spectrum of melanoma-associated neurological autoimmunity, whether melanoma-associated paraneoplastic neurological syndromes (PNS) or induced by immune checkpoint inhibitors (ICI), is not well characterized. We aim to describe the clinical spectrum of melanoma-associated neurological autoimmunity.

Methods: A systematic review of the literature combined with patients from French databases of paraneoplastic neurological syndromes was conducted.

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In digenic inheritance, pathogenic variants in two genes must be inherited together to cause disease. Only very few examples of digenic inheritance have been described in the neuromuscular disease field. Here we show that predicted deleterious variants in SRPK3, encoding the X-linked serine/argenine protein kinase 3, lead to a progressive early onset skeletal muscle myopathy only when in combination with heterozygous variants in the TTN gene.

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Cerebral dural arteriovenous fistulas in patients with PTEN-related hamartoma tumor syndrome.

Clin Genet

July 2024

Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Paris, France.

Central nervous system (CNS) dural arteriovenous fistulas (DAVF) have been reported in PTEN-related hamartoma tumor syndrome (PHTS). However, PHTS-associated DAVF remain an underexplored field of the PHTS clinical landscape. Here, we studied cases with a PTEN pathogenic variant identified between 2007 and 2020 in our laboratory (n = 58), and for whom brain imaging was available.

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