685 results match your criteria: "Hospital of Tours[Affiliation]"

Preoperative DLCO predicts severe early complications after liver transplantation.

Respir Med Res

June 2024

Department of Pulmonology and Pulmonary Function Testing, University Hospital of Tours, France; University of Tours, Tours, France; CEPR, Inserm UMR1100, Tours, France.

Background: Severe early complications are common after liver transplantation (LT) and are a key determinant of LT-related morbidity and mortality. The aim of this study was to assess whether lung function measured in the pre-operative period predicted complicated outcomes in the first month after LT.

Material And Methods: Patients with mild-to-moderate liver disease (Model for End stage Liver Disease-MELD score≤30) who underwent LT between October 2015 and May 2020 in a single centre were retrospectively included.

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Article Synopsis
  • - This study was a retrospective analysis involving patients who had surgery for recurrent lumbar disc herniation (ReLDH) in France, aiming to compare the outcomes of repeat microdiscectomy (RD) and instrumented surgery (IS).
  • - Factors influencing the choice between RD and IS included radioclinical considerations, anatomical data, patient preference, and the surgeon's background; these factors affected surgical decisions in varying degrees for both groups.
  • - The results showed that patient satisfaction and clinical improvements in symptoms and quality of life were notable, with no significant differences between the two surgical methods 12 months post-operation, achieving satisfaction rates of 80.3% to 81.5%.
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Risk factors for emergency surgery for diverticulitis: A retrospective multicentric French study at 41 hospitals.

Surgery

June 2024

Department of Digestive Surgery, University Hospital of Caen, France; Department of Research; CHU de Caen, ANTICIPE, Inserm Unity UMR 1086, France.

Background: The observed increase in the incidence of complicated diverticulitis may lead to the performance of more emergency surgeries. This study aimed to assess the rate and risk factors of emergency surgery for sigmoid diverticulitis.

Method: The primary outcomes were the rate of emergency surgery for sigmoid diverticulitis and its associated risk factors.

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Standardized reporting for systematic global evaluation of axial spondyloarthritis: An evidence-based and consensus-driven initiative.

Joint Bone Spine

September 2024

University of Paris-Cité, Department of Rheumatology, Hôpital Cochin, Assistance publique-Hôpitaux de Paris, Inserm (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France. Electronic address:

Introduction: National and international scientific societies advocate for a regular, systematic, and standardized global evaluation of axial spondyloarthritis (axSpA) patients. However, there are no recommendations specifying the content of this global evaluation. This initiative aimed to propose a standardized reporting framework, using evidence-based and consensus approaches, to collect data on all domains of axSpA.

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Hyperhomocysteinemia and vitamin B12 deficiency have been reported in patients with phenylketonuria. In this study, total homocysteine (tHcy) and methylmalonic acid (MMA) levels were analyzed in samples from 25 phenylketonuria (PKU) patients. Comparisons were made between pre- and post-treatment values (n= 3); on treatment values, between periods with high and normal/low phenylalanine (Phe) levels (n= 20); and in women before, during and after pregnancy (n= 3).

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Traumatic brain injury (TBI) is a major public health concern globally, with significant implications for morbidity, mortality, and long-term disability. While extensive research has been conducted on TBI management in high-income countries, limited attention has been given to the specific challenges and opportunities faced by healthcare systems in sub-Saharan Africa (SSA). This perspective study aims to provide a comprehensive overview of the current status of TBI management in SSA, focusing on the unique challenges and potential opportunities for improvement.

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Objectives: Observational studies are not subject to the same requirements as randomized controlled trials, such as registration or publishing a protocol. The aim of this scoping review was to estimate the registration rate of observational studies in leading peer-reviewed medicine journals and to evaluate whether protocols were available in the public domain.

Study Design And Setting: In March 2023, we searched OVID Medline for observational studies published in 2022 in the top five general medicine journals according to impact factor (The Lancet, The British Medical Journal (BMJ), The Journal of the American Medical Association, The New England Journal of Medicine, and Annals of Internal Medicine).

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Background: Coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS) is associated with high mortality. Extracorporeal membrane oxygenation (ECMO) has been proposed in this setting, but optimal criteria to select target patients remain unknown. Our hypothesis is that evaluation of right ventricular (RV) function could be helpful.

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Osimertinib has become the standard of care for epidermal growth factor receptor ( EGFR )-mutated non-small cell lung cancer (NSCLC). In order to prevent or treat toxicity, the osimertinib dose may be reduced. However, data regarding the impact of dose reduction during treatment are limited.

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Objectives: Amyotrophic lateral sclerosis (ALS) is a severe motor neuron disorder. Diagnosis is challenging due to its clinical heterogeneity and the absence of definitive diagnostic tools, leading to delays averaging between 9.1 and 27 months.

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Long-Term Outcomes in Patients With Spontaneous Cerebellar Hemorrhage: An International Cohort Study.

Stroke

May 2024

Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands (J.R.S., S.D.S., J.P.J.D., J.T., G.J.E.R., H.B.B.).

Background: Spontaneous intracerebral hemorrhage (ICH) in the cerebellum has a poor short-term prognosis, whereas data on the long-term case fatality and recurrent vascular events are sparse. Herewith, we aimed to assess the long-term case fatality and recurrence rate of vascular events after a first cerebellar ICH.

Methods: In this international cohort study, we included patients from 10 hospitals (the United States and Europe from 1997 to 2017) aged ≥18 years with a first spontaneous cerebellar ICH who were discharged alive.

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Objective: The pathogenesis of intracranial dural arteriovenous fistulas (icDAVFs) is controversial. Cerebral vein thrombosis (CVT) and venous hypertension are recognized predisposing factors. This study aimed to evaluate the incidence of association between icDAVF and CVT and describe baseline aggressiveness and clinical outcomes for icDAVFs associated with CVT.

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During follow-up of patients treated with WEB devices, shape changes have been observed. The quantitative three-dimensional measurement of the WEB shape modification (WSM) would offer useful information to be studied in association with the anatomical results and try to better understand mechanisms implicated in this modification phenomenon. We present a methodology to quantify the morphology and position of the WEB device in relation to the vascular anatomy.

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Background And Purpose: The best management of patients with persistent distal occlusion after mechanical thrombectomy with or without IV thrombolysis remains unknown. We sought to evaluate the variability and agreement in decision-making for persistent distal occlusions.

Materials And Methods: A portfolio of 60 cases was sent to clinicians with varying backgrounds and experience.

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The clinical impact of individual dose adjustment of mycophenolate mofetil is still debated, due to conflicting results from randomized clinical trials. This retrospective study aimed to compare 3-year rejection-free survival and adverse effects between adult kidney transplant recipients (KTRs) with or without mycophenolate mofetil model-informed precision dosing (MIPD). MIPD is defined here as mycophenolic acid area under the curve (AUC) estimation using a limited sampling strategy, pharmacokinetic models and Bayesian estimators; dose recommendation to reach AUC = 45 mg.

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Background: In the decision to perform elective surgery, it is of great interest to have data about the outcomes of surgery to individualize patients who could safely undergo sigmoid resection. The aim of this study was to provide information on the outcomes of elective sigmoid resection for sigmoid diverticular disease (SDD) at a national level.

Methods: All consecutive patients who had elective surgery for SDD (2010-2021) were included in this retrospective, multicenter, cohort study.

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Background And Purpose: Iodine contrast extravasation (ICE) is common in patients with acute ischemic stroke (AIS) after endovascular-thrombectomy (EVT). The aim of our study was to evaluate the incidence of ICE assessed by dual-energy CT (DECT), its determinants, and associations with clinical outcome.

Materials And Methods: We retrospectively examined imaging parameters and clinical factors from consecutive patients with AIS treated with EVT who had a DECT 24 hours thereafter, identified at a single academic center.

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Background: Middle meningeal artery (MMA) embolization has been proposed as a treatment of chronic subdural hematoma (CSDH). The benefit of the procedure has yet to be demonstrated in a randomized controlled trial. We aim to assess the efficacy of MMA embolization in reducing the risk of CSDH recurrence 6 months after burr-hole surgery compared with standard medical treatment in patients at high risk of postoperative recurrence.

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Background: Treatment summaries and a personalized survivorship care plans based on internationally approved, organ-specific follow-up care recommendations are essential in preserving the health and quality of life for cancer survivors. Cohorts made up of survivors of childhood cancer have made significant contributions to the understanding of early mortality, somatic late complications, and psychosocial outcomes among former patients. New treatment protocols are needed to enhance survival and reduce the potential risk and severity of late effects, and working with treatment databases is crucial in doing so.

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Aims: Heart failure (HF) is a chronic disease affecting 64 million people worldwide and places a severe burden on society because of its mortality, numerous re-hospitalizations and associated costs. HeartLogic™ is an algorithm programmed into implanted devices incorporating several biometric parameters which aims to predict HF episodes. It provides an index which can be monitored remotely, allowing pre-emptive treatment of congestion to prevent acute decompensation.

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Article Synopsis
  • Patients with autoimmune gastritis (AIG) show higher rates of iron and vitamin B12 deficiencies compared to those with non-autoimmune gastritis (NAIG) and control groups.
  • Median vitamin B12 levels are significantly lower in AIG patients (367.5 pg/mL) than in NAIG (445.0 pg/mL) and controls (391.0 pg/mL), with deficiencies found in 13.3% of AIG cases versus only 1.5% and 2.8% in the other groups.
  • The study emphasizes the importance of screening and treating these micronutrient deficiencies in AIG patients, as they are at a higher risk for both vitamin B12 (OR:
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Mediation of Age and Thrombectomy Outcome by Neuroimaging Markers of Frailty in Patients With Stroke.

JAMA Netw Open

January 2024

Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada.

Importance: Age is a leading predictor of poor outcomes after brain injuries like stroke. The extent to which age is associated with preexisting burdens of brain changes, visible on neuroimaging but rarely considered in acute decision-making or trials, is unknown.

Objectives: To explore the mediation of age on functional outcome by neuroimaging markers of frailty (hereinafter neuroimaging frailty) in patients with acute ischemic stroke receiving endovascular thrombectomy (EVT).

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