175 results match your criteria: "Toulouse-Rangueil University Hospital[Affiliation]"

Mitral valve repair with the semi-rigid Memo 4D annuloplasty ring: early clinical and echocardiographic outcomes from the MANTRA study.

Interdiscip Cardiovasc Thorac Surg

December 2024

Klinik für Herz-, Thorax- und Gefäßchirurgie Deutsches Herzzentrum der Charité, Berlin, Germany.

Objectives: Memo 4D is a semi-rigid ring with an exclusive saddle shape and progressive increased anteroposterior diameter. This preliminary analysis reports 30-day clinical and haemodynamic outcomes of the MANTRA Memo 4D sub-study.

Methods: MANTRA is an 'umbrella' prospective, multicentre, worldwide post-market study to collect real-life safety and performance data on the Corcym devices.

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Background: In the phase 3 SOLSTICE study (NCT02931539), maribavir was superior to investigator-assigned therapy (IAT) for confirmed cytomegalovirus viremia clearance at study week 8 in hematopoietic cell/solid organ transplant (HCT/SOT) recipients. We report additional efficacy and safety analyses from the SOT subgroup.

Methods: Eligible SOT recipients (n=211) received maribavir 400 mg twice daily (n=142) or IAT (n=69) for 8 weeks (12 weeks' follow-up).

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Article Synopsis
  • PCSK9 is crucial for regulating LDL-cholesterol and certain variants, like p.Ser127Arg, lead to higher cholesterol levels and are mainly found in France, with few in South Africa and Norway due to a common ancestor effect.
  • The study analyzed 14 p.Ser127Arg carriers from eight families and compared them with other variants to understand their genetic background and health impact.
  • Results indicated that the common ancestor lived about 775 years ago, and carriers of p.Ser127Arg had significantly higher LDL-C levels, suggesting it may have a stronger effect on cholesterol levels compared to other mutations.
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Background: Reconstruction of the axillary fossa represents a surgical challenge given the functional implications for mobility of the upper limb. The posterior brachial flap is a solution of choice for this indication, providing fine and functional local reconstruction, but little is known about its perforasome. This study aimed to identify the location of the perforator, analyze perfusion flow, and link vessel distribution, and propose an aesthetic refinement to the surgical technique by medializing the skin paddle to conceal aesthetic scarring at the donor site.

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Development and validation of a training course on proton pump inhibitor deprescription for general practitioners in a rural continuing medical education program: a pilot study.

BMC Med Educ

October 2024

Department of Gastroenterology and Pancreatology, Toulouse Rangueil University Hospital, Université Toulouse Paul Sabatier, 1 avenue Jean Poulhès, TSA 50032, Toulouse Cedex 9, 31059, France.

Background: Despite being cornerstone medications for managing gastrointestinal disorders, proton pump inhibitors (PPI) have raised concerns due to inappropriate prescribing and overutilization, their potential side effects, and interactions with other medications. General practitioners (GPs) provide long-term patient follow-up and are targets to promote PPI deprescribing to reach the widest possible population. GPs practicing in rural settings encounter unique challenges as their numbers dwindle and their workload increases.

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Background: In kidney transplantation, molecular diagnostics may be a valuable approach to improve the precision of the diagnosis. Using next-generation sequencing (NGS), we aimed to identify clinically relevant archetypes.

Methods: We conducted an Illumina bulk RNA sequencing on 770 kidney biopsies (540 kidney recipients) collected between 2006 and 2021 from 11 European centers.

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Background: Despite scarce data, invasive mechanical ventilation (MV) is widely suggested as first-line ventilatory support in cardiogenic shock (CS) patients. We assessed the real-life use of different ventilation strategies in CS and their influence on short and mid-term prognosis.

Methods: FRENSHOCK was a prospective registry including 772 CS patients from 49 centers in France.

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Article Synopsis
  • The study investigates how competing risks, like allograft failure and death with a functioning graft, affect the performance of prognostic models used for kidney transplant recipients.
  • The research involves 11,046 kidney transplant recipients across 10 countries, developing models using various regression techniques to predict long-term graft failure while carefully evaluating their accuracy and reliability.
  • Results indicate that both standard Cox models and competing risk models provide similar predictions for graft failure, with high concordance indices, confirming their usefulness in clinical settings.
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Validation of virtual fractional flow reserve pullback curves.

Catheter Cardiovasc Interv

November 2024

Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.

Background: Angiography-derived fractional flow reserve (virtual FFR) has shown excellent diagnostic performance compared with wire-based FFR. However, virtual FFR pullback curves have not been validated yet.

Objectives: To validate the accuracy of virtual FFR pullback curves compared to wire-based FFR pullbacks and to assess their clinical utility using patient-reported outcomes.

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Article Synopsis
  • Campylobacteriosis is the leading bacterial cause of diarrhea in kidney transplant recipients (KTRs), but risk factors for this infection remain unclear.
  • A 10-year study in France identified 326 KTRs with campylobacteriosis, revealing an incidence rate of 2.3 cases per 1,000 patient-years, primarily occurring around 2.4 years after transplantation.
  • The main risk factors for developing campylobacteriosis include the use of corticosteroids, acute rejection episodes, low lymphocyte counts, and low estimated glomerular filtration rate (eGFR); treatment should prioritize azithromycin due to high resistance to fluoroquinolones.
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Islet-after-kidney transplantation versus kidney alone in kidney transplant recipients with type 1 diabetes (KAIAK): a population-based target trial emulation in France.

Lancet Diabetes Endocrinol

October 2024

Translational Research Laboratory for Diabetes, Inserm, Institut Pasteur de Lille, Centre Hospitalier Universitaire de Lille, University of Lille, Lille, France; Department of General and Endocrine Surgery, Inserm, Institut Pasteur de Lille, Centre Hospitalier Universitaire de Lille, University of Lille, Lille, France. Electronic address:

Background: Islet transplantation has been associated with better metabolic control and quality of life than insulin treatment alone, but direct evidence of its effect on hard clinical endpoints is scarce. We aimed to assess the effect of islet transplantation on patient-graft survival in kidney transplant recipients with type 1 diabetes.

Methods: In this retrospective cohort study, we enrolled all patients with type 1 diabetes who received a kidney graft in France during the study period, identified from the CRISTAL nationwide registry.

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Background: Despite the burden of pyelonephritis after kidney transplantation, there is no consensus on initial empirical antibiotic management.

Methods: We surveyed clinicians throughout the world on their practice and opinions about the initial empirical therapy of post-transplant pyelonephritis, using clinical vignettes. A panel of experts from 19 countries on six continents designed this survey, and invited 2145 clinicians to participate.

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Article Synopsis
  • The study focuses on the rising aging population in France and Western Europe, specifically individuals aged 85 and older, and their mortality risk in trauma centers' ICUs.
  • Conducted from 2013 to 2022, the research analyzed 365 severely injured older patients in 14 ICU trauma centers, assessing their frailty and other clinical variables.
  • High mortality rates were found, with 43.5% in the ICU and 45.5% at 30 days, linked to factors like traumatic brain injury and severe hemorrhage, highlighting the need for early geriatric interventions to improve patient outcomes.
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  • There is increasing interest in analyzing kidney biopsies through transcriptomic assessments to understand gene expression changes related to rejection.
  • This study used next-generation sequencing (NGS) on RNA from 770 kidney biopsies to identify differentially expressed genes (DEGs) associated with antibody-mediated rejection (AMR) and T cell-mediated rejection (TCMR), revealing 603 and 1,186 new specific genes, respectively.
  • Pathway analysis linked established panels to immunological processes in AMR and TCMR, while NGS uncovered novel transcripts that could inform future drug design and therapeutic strategies.
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Article Synopsis
  • People who get solid organ transplants often have problems with erectile dysfunction, which can be affected by their other health issues and problems with their organ.
  • This study looked at how safe it is to use penile prostheses in these patients and found that about 11% of them had complications, mostly infections and device failures.
  • Even though there are some risks, doctors can feel more confident about using these prostheses in transplant recipients since the study showed similar reoperation rates compared to non-transplanted patients.
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Background: About 20% of patients with acute pancreatitis develop a necrotising form with a worse prognosis due to frequent appearance of organ failure(s) and/or infection of necrosis. Aims of the present study was to evaluate the "step up" approach treatment of infected necrosis in terms of: feasibility, success in resolving infection, morbidity of procedures, risk factors associated with death and long-term sequels.

Methods: In this observational retrospective monocentric study in the real life, necrotizing acute pancreatitis at the stage of infected walled-off necrosis were treated as follow: first step with drainage (radiologic and/or endoscopic-ultrasound-guided with lumen apposing metal stent); in case of failure, minimally invasive necrosectomy sessions(s) by endoscopy through the stent and/or via retroperitoneal surgery (step 2); If necessary open surgery as a third step.

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Objective: The long-term impact of type 2 diabetes mellitus (T2DM) after an acute myocardial infarction (AMI) has not been thoroughly investigated yet. This study aimed to assess the long-term impact of T2DM after AMI.

Research Design And Methods: We analyzed the data of three nationwide observational studies from the French Registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) program, conducted over a 1-month period in 2005, 2010, and 2015.

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Background: Current potential living kidney donor's assessment includes functional and anatomical evaluation. Scintigraphy is recommended in some cases and some centers include this test in the donor's protocol. Recent studies advocate for the avoidance of this test as CT or MRI volumetry showed to accurately assess donor's renal function.

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Which Hepatitis E virus to worry about in our transplant patients.

Transpl Infect Dis

June 2024

Department of Nephrology and Organ Transplantation, Toulouse Rangueil University Hospital, INSERM UMR 1291, Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), University Paul Sabatier, Toulouse, France.

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Aims: To assess whether implementation of the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) dyslipidaemia guidelines observed between 2020 and 2021 improved between 2021 and 2022 in the SANTORINI study.

Methods And Results: Patients with high or very high cardiovascular (CV) risk were recruited across 14 European countries from March 2020 to February 2021, with 1-year prospective follow-up until May 2022. Lipid-lowering therapy (LLT) and 2019 ESC/EAS risk-based low-density lipoprotein (LDL) cholesterol (LDL-C) goal attainment (defined as <1.

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Background: Sacubitril/valsartan has been demonstrated to significantly improve left ventricular performance and remodelling in patients with heart failure. However, its effects on the right ventricle in patients with chronic heart failure and sleep-disordered breathing (SDB) have not been studied.

Aim: To investigate the impact of sacubitril/valsartan treatment on right ventricular function in patients with SDB.

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Prediction models for postoperative renal function after living donor nephrectomy: a systematic review.

Minerva Urol Nephrol

April 2024

Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy -

Introduction: Living-donor nephrectomy (LDN) is the most valuable source of organs for kidney transplantation worldwide. The current preoperative evaluation of a potential living donor candidate does not take into account formal estimation of postoperative renal function decline after surgery using validated prediction models. The aim of this study was to summarize the available models to predict the mid- to long-term renal function following LDN, aiming to support both clinicians and patients during the decision-making process.

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Objectives: BK virus is a major cause of chronic renal allograft failure.Transplant ureteral stent use has been reported as a risk factorfor BK virus infection. Recently, the use of a new type of ureteral stent (Magnetic Black Star) was reported in kidney transplant recipients.

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Association of Use and Dose of Lipid-Lowering Therapy Post Acute Myocardial Infarction With 5-Year Survival in Older Adults.

Circ Cardiovasc Qual Outcomes

May 2024

Assistance Publique-Hôpitaux de Paris, Departement of Cardiology, Hôpital Européen Georges-Pompidou, France (A.F., E.P., V.T., C.C., O.W., N.D.).

Background: Older people are underrepresented in randomized trials. The association between lipid-lowering therapy (LLT) and its intensity after acute myocardial infarction and long-term mortality in this population deserves to be assessed.

Methods: The FAST-MI (French Registry of Acute ST-Elevation or Non-ST-Elevation Myocardial Infarction) program consists of nationwide French surveys including all patients admitted for acute myocardial infarction ≤48 hours from onset over a 1- to 2-month period in 2005, 2010, and 2015, with long-term follow-up.

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The Second International Consensus Guidelines on the Management of BK Polyomavirus in Kidney Transplantation.

Transplantation

September 2024

Division of Transplantation and Clinical Virology, Department of Biomedicine, Faculty of Medicine, University of Basel, Basel, Switzerland.

BK polyomavirus (BKPyV) remains a significant challenge after kidney transplantation. International experts reviewed current evidence and updated recommendations according to Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Risk factors for BKPyV-DNAemia and biopsy-proven BKPyV-nephropathy include recipient older age, male sex, donor BKPyV-viruria, BKPyV-seropositive donor/-seronegative recipient, tacrolimus, acute rejection, and higher steroid exposure.

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