142 results match your criteria: "Regional University Hospital Centre Tours: Centre Hospitalier Regional Universitaire de Tours[Affiliation]"

Classification of germline non-truncating variants: a new approach to interpretation.

J Med Genet

November 2024

Cancer Genetics Unit, Institut Bergonié, Bordeaux, Aquitaine, France.

Article Synopsis
  • PTEN hamartoma tumour syndrome (PHTS) includes syndromes like Cowden syndrome, with missense variants making up 30% of PHTS cases, yet their classification is complex.
  • A study from the Bergonie Institute identified 76 non-truncating variants in 166 patients, developing a new classification method using criteria like functional analysis, phenotypic features, and familial patterns.
  • The new approach successfully reclassifies 25 variants, revealing the need to update current classification standards based on multiple factors, and it requires further validation in future research.
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Introduction: Training novice ophthalmology residents on the EyeSi simulator increases cataract surgery safety. However, there is no consensus regarding how much training residents should perform before their first time on patients. We evaluated the French national training program through the analysis of the learning curves of novice residents.

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Background: Factors associated with severe COVID-19 infection have been identified; however, the impact of infection on longer-term outcomes is unclear. The objective of this study was to examine the impact of COVID-19 infection on the trajectory of lung function and nutritional status in people with cystic fibrosis (pwCF).

Methods: This is a retrospective global cohort study of pwCF who had confirmed COVID-19 infection diagnosed between January 1, 2020 and December 31, 2021.

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Evaluation of serum mid-infrared spectroscopy as new prognostic marker for first-line bevacizumab-based chemotherapy in metastatic colorectal cancer.

Dig Liver Dis

August 2024

Department of Hepato-Gastroenterology and Digestive Oncology, Centre Hospitalier Régional Universitaire de Tours, Université François Rabelais, Tours, France; Université de Tours, Inserm, UMR 1069, Nutrition Croissance et Cancer (N2C), Faculté de Médecine, Tours, France.

Background And Aims: Bevacizumab-based chemotherapy is a recommended first-line treatment for metastatic colorectal cancer (mCRC). Robust biomarkers with clinical practice applicability have not been identified for patients with this treatment. We aimed to evaluate the prognostic yield of serum mid-infrared spectroscopy (MIRS) on patients receiving first-line bevacizumab-based chemotherapy for mCRC.

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Portal vein thrombosis: diagnosis, management, and endpoints for future clinical studies.

Lancet Gastroenterol Hepatol

September 2024

Centre de recherche sur l'inflammation, Université Paris-Cité, Paris, France; Service d'Hépatologie, AP-HP Hôpital Beaujon, Clichy, France. Electronic address:

Portal vein thrombosis (PVT) refers to the development of a non-malignant obstruction of the portal vein, its branches, its radicles, or a combination. This Review first provides a comprehensive overview of all aspects of PVT, namely the specifics of the portal venous system, the risk factors for PVT, the pathophysiology of portal hypertension in PVT, the interest in non-invasive tests, as well as therapeutic approaches including the effect of treating risk factors for PVT or cause of cirrhosis, anticoagulation, portal vein recanalisation by interventional radiology, and prevention and management of variceal bleeding in patients with PVT. Specific issues are also addressed including portal cholangiopathy, mesenteric ischaemia and intestinal necrosis, quality of life, fertility, contraception and pregnancy, and PVT in children.

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Presentation and Outcome in S1P-RM and Natalizumab-Associated Progressive Multifocal Leukoencephalopathy: A Multicenter Cohort Study.

Neurol Neuroimmunol Neuroinflamm

September 2024

From the Service of Neurology (J.C.B., R.A.D.P., R.B.-V.), Department of Clinical Neurosciences, Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois) and University of Lausanne, Switzerland; Regional Multiple Sclerosis Center (N.N.D.R.), ASST-Spedali Civili di Brescia, Montichiari, Italy; Department of Neurology St. Josef-Hospital (R.G., I.A.), Ruhr University Bochum, Germany; Centre Hospitalier Régional Universitaire de Tours (A.M.), Hôpital Bretonneau, Service de neurologie, Tours, France; Department of Neurology (M.K.), Alfried Krupp von Bohlen und Halbach Hospital, Essen; Department of Neurology (M.K.), Medical Faculty, Heinrich Heine University of Düsseldorf, Germany; Neurology Department (L.R.-P.), Multiple Sclerosis Unit, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain; Department of Neurology (T.M.), Tohoku University Hospital, Japan; Service de Neurologie (J.-C.O.), Pôle des Neurosciences Cliniques, CHU de Bordeaux Pellegrin Tripode; Service de Neurologie et Unité Neurovasculaire (M.P.G.), Centre Hospitalier Régional d'Orléans, France; Unit of Neuroradiology (S.G.), Papa Giovanni XXIII Hospital, Bergamo, Italy; Multiple Sclerosis Center (C.B.), Second Department of Neurology, Aristotle University of Thessaloniki, Greece; Servicio de Neurología (R.P.M.), Hospital Universitario Clínico San Cecilio, Granada, Spain; Department of Neurology (B.V., I.J.), University Hospital Zurich and University of Zurich, ; Neurologic Clinic and Policlinic and Research Center for Clinical Neuroimmunology and Neuroscience (P.K., T.J.D.), Departments of Medicine, Biomedicine, and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Service de Neurologie (X.M.), Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol; Infectious and Tropical Diseases Unit (G.M.-B.), University Hospital of Toulouse, France; Department of Neurology (C.M.), State University of New York Upstate Medical University, Syracuse; and CHU Nantes (D.A.L.), Service de Neurologie, CRC-SEP, Nantes Université, INSERM, CIC 1413, Center for Research in Transplantation and Translational Immunology, UMR 1064, France.

Background And Objectives: Progressive multifocal leukoencephalopathy (PML) is a severe neurologic disease resulting from JC virus reactivation in immunocompromised patients. Certain multiple sclerosis (MS) disease-modifying therapies (DMTs) are associated with PML risk, such as natalizumab and, more rarely, sphingosine-1-phosphate receptor modulators (S1P-RMs). Although natalizumab-associated PML is well documented, information on S1P-RM-associated PML is limited.

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Background: CASSIOPEIA part 1 demonstrated superior depth of response and prolonged progression-free survival with daratumumab in combination with bortezomib, thalidomide, and dexamethasone (D-VTd) versus bortezomib, thalidomide, and dexamethasone (VTd) alone as an induction and consolidation regimen in transplant-eligible patients newly diagnosed with myeloma. In CASSIOPEIA part 2, daratumumab maintenance significantly improved progression-free survival and increased minimal residual disease (MRD)-negativity rates versus observation. Here, we report long-term study outcomes of CASSIOPEIA.

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Background: Advances in leadless pacemaker technology have enabled accelerometer-based atrioventricular (AV) synchronous pacing by sensing atrial mechanical contraction.

Objective: The purpose of this study was to report the performance of the Micra AV leadless pacemaker from the worldwide Micra AV post-approval registry (PAR) through 12 months.

Methods: The Micra AV PAR is a prospective, single-arm, observational registry designed to assess the safety and effectiveness of Micra AV in a real-world setting.

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Background: The care environment significantly influences the experiences of patients with severe mental illness and the quality of their care. While a welcoming and stimulating environment enhances patient satisfaction and health outcomes, psychiatric facilities often prioritize staff workflow over patient needs. Addressing these challenges is crucial to improving patient experiences and outcomes in mental health care.

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Introduction: We encountered a unique case of a patient with two distinct tumors coexisting in the same thigh. To the best of our knowledge, this combination of tumors in the same anatomical region has not been previously described in the literature.

Case Report: This case report describes a 38-year-old Caucasian male with a painless mass in his right thigh, which was later diagnosed as a hybrid tumor composed of low-grade fibromyxoid sarcoma and sclerosing epithelioid fibrosarcoma, as well as a second tumor, which was diagnosed as a hibernoma.

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Article Synopsis
  • The study focused on evaluating the correlation and concordance between different activity score indices for Polymyalgia Rheumatica (PMR), particularly including the C reactive protein polymyalgia rheumatica activity score (CRP-PMR-AS).
  • Data were analyzed from the SEMAPHORE trial, comparing the efficacy of tocilizumab to placebo in PMR patients while measuring various PMR-ASs at multiple visits.
  • Results showed an excellent correlation between the activity scores, indicating that in trials with drugs affecting CRP levels, these derived scores can be reliably used.
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Costs and resource utilization patterns in surgical site infections: a pre-COVID-19 perspective from France, Germany, Spain, and the UK.

J Hosp Infect

May 2024

Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn-Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany; FOM University of Applied Sciences, Essen, Germany.

Background: Surgical site infections (SSIs), mainly caused by Staphylococcus aureus, pose a significant economic burden in Europe, leading to increased hospitalization duration, mortality, and treatment costs, particularly with drug-resistant strains such as meticillin-resistant S. aureus.

Aim: To conduct a case-control study on the economic impact of S.

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Practical approach for atrial cardiomyopathy characterization in patients with atrial fibrillation.

Rev Esp Cardiol (Engl Ed)

August 2024

Centro Nacional de Investigaciones Cardiovasculares (CNIC), Programa Nuevos Mecanismos Arritmogénicos, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Instituto Cardiovascular, Madrid, Spain. Electronic address:

Atrial fibrillation (AF) causes progressive structural and electrical changes in the atria that can be summarized within the general concept of atrial remodeling. In parallel, other clinical characteristics and comorbidities may also affect atrial tissue properties and make the atria susceptible to AF initiation and its long-term persistence. Overall, pathological atrial changes lead to atrial cardiomyopathy with important implications for rhythm control.

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Background And Aims: Prior reports have demonstrated a favourable safety and efficacy profile of the Micra leadless pacemaker over mid-term follow-up; however, long-term outcomes in real-world clinical practice remain unknown. Updated performance of the Micra VR leadless pacemaker through five years from the worldwide post-approval registry (PAR) was assessed.

Methods: All Micra PAR patients undergoing implant attempts were included.

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Objective: To determine whether the relative measurement of birth weight (BW) and head circumference (HC) in preterm infants is associated with neurological outcomes.

Methods: The EPIPAGE-2 Study included 3473 infants born before 32 weeks' gestation, classified based on their Z-score of BW and HC on the Fenton curves as concordant (≤1 SD apart) or discordant (>1 SD difference). We defined four mutually exclusive categories: discordant smaller BW (sBW) with BW-1SD and concordant small measurement (CsM) with BW and HC concordant and both ≤-1SD.

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Utility of a guiding catheter for conduction system pacing: An early multicenter experience.

Heart Rhythm O2

January 2024

Santa Maria della Misericordia, Arrhythmia and Electrophysiology Unit, Rovigo, Italy.

Article Synopsis
  • Conduction system pacing (CSP) is shown to potentially outperform traditional right ventricular pacing methods, prompting exploration of a new catheter for easier implantation.
  • The BIO|MASTER.Selectra 3D study reported a 93.6% success rate for achieving CSP in 147 out of 157 patients, with no serious complications within a week post-implantation.
  • Results indicate that patient outcomes can improve with the Selectra 3D catheter, which allows flexibility between His bundle pacing (HBP) and left bundle branch area pacing (LBBAP), yielding nearly 99% success in procedures where both methods were considered.
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Metastatic profiles and survival differences between infiltrating ductal carcinoma and infiltrating lobular carcinoma in invasive breast cancer.

J Gynecol Obstet Hum Reprod

April 2024

Department of Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, 2 boulevard Tonnellé, 37044 Tours, France; François-Rabelais University, Tours, France; INSERM unit, 1069 Tours, France. Electronic address:

Background: In this study, we conducted a comprehensive evaluation of metastatic profiles and survival outcomes in patients with infiltrating ductal carcinoma (IDC) and infiltrating lobular carcinoma (ILC) treated at our university hospital center.

Methods: We collected and analyzed data from all patients diagnosed with invasive breast cancer at our center between January 1, 2007, and 31 December 2014. We specifically compared three subgroups: patients with IDC, patients with ILC and patients with mixed carcinoma, which is a combination of IDC and ILC.

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Efficacy and safety of an early oral switch in low-risk Staphylococcus aureus bloodstream infection (SABATO): an international, open-label, parallel-group, randomised, controlled, non-inferiority trial.

Lancet Infect Dis

May 2024

Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany; German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany; Institute of Translational Research, CECAD Cluster of Excellence, University of Cologne, Cologne, Germany.

Article Synopsis
  • This study investigates the effectiveness and safety of switching from intravenous to oral antibiotics after 5-7 days in patients with low-risk Staphylococcus aureus bloodstream infections.
  • Conducted across 31 hospitals in Europe, the trial aimed to determine if early oral therapy could maintain patient safety and reduce complications compared to ongoing intravenous treatment.
  • Due to slow participant recruitment, the trial was halted early with 215 participants, and the analysis was adjusted to ensure statistical validity, focusing on whether oral treatment led to acceptable complication rates compared with the traditional intravenous approach.
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The association between cardiac and kidney dysfunction has received attention over the past two decades. A putatively unique syndrome, the cardiorenal syndrome, distinguishing five subtypes on the basis of the chronology of cardiac and kidney events, has been widely adopted. This review discusses the methodologic and practical problems inherent to the current classification of cardiorenal syndrome.

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Prognostic value of axillary lymph node metastases in invasive lobular breast carcinoma.

J Gynecol Obstet Hum Reprod

December 2023

Department of Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, 2 boulevard Tonnellé 37044 Tours, France; François-Rabelais University, Tours, France; INSERM unit 1069 Tours, France. Electronic address:

Background: Axillary lymph node involvement is a well-established prognostic factor for recurrence in breast cancer, specifically the number of nodes affected and the ratio of the number of affected nodes to the number of harvested nodes for non-specific invasive breast cancer (invasive ductal carcinoma). However, there is limited information on the impact of lymph node involvement in the case of invasive lobular carcinoma.

Objectives: our study aimed to evaluate the prognostic impact of lymph node involvement on overall survival and distant metastatic-free survival according to the number of nodes affected and the ratio of positive nodes (LNR) for patients managed for invasive lobular carcinoma.

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Objective: To determine the overall and procedure-specific incidence of surgical site infections (SSI) caused by Staphylococcus aureus (S. aureus) as well as risk factors for such across all surgical disciplines in Europe.

Methods: This is a retrospective cohort of patients with surgical procedures performed at 14 European centres in 2016, with a nested case-control analysis.

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We performed a descriptive analysis of group B Streptococcus (GBS) isolates responsible for maternal and fetal infectious diseases from 2004 to 2020 at the University Hospital of Tours, France. This represents 115 isolates, including 35 isolates responsible for early-onset disease (EOD), 48 isolates responsible for late-onset disease (LOD), and 32 isolates from maternal infections. Among the 32 isolates associated with maternal infection, 9 were isolated in the context of chorioamnionitis associated with fetal death.

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