1,183 results match your criteria: "Universitaire de Nantes[Affiliation]"

Triplet chemotherapy with or without bevacizumab as first line treatment for metastatic colorectal cancer: An AGEO multicenter real-world study.

Dig Liver Dis

September 2024

Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Association des Gastro-Entérologues Oncologues (AGEO), France. Electronic address:

Background: Prior trials validated triplet chemotherapy (Tri-CT) with bevacizumab as first line treatment for metastatic colorectal cancer (mCRC) but real-world data are scarce and practices remain heterogeneous.

Aims: To evaluate Tri-CT +/- bevacizumab efficacy and safety, and to identify factors influencing treatment decisions.

Methods: The COLOTRIP retrospective study enrolled mCRC patients treated from 2014 to 2019 in 14 French centers.

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The use of post-transplantation cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis is not established after reduced intensity conditioning (RIC) hematopoietic stem cell transplantation (HSCT) from fully matched donors. This was a randomized, open-label, multicenter, phase 2 trial. All patients received a RIC regimen with fludarabine, intravenous busulfan for 2 days (Flu-Bu2), and a peripheral blood stem cell (PBSC) graft from a matched related or 10/10 HLA-matched unrelated donor.

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Article Synopsis
  • Ketamine is increasingly being used non-medically, especially among individuals with substance use disorders, with a notable rise in users from 2012 to 2021 according to data from the OPPIDUM program.
  • Analysis of the French National Pharmacovigilance Database between 2020 and 2022 revealed that a significant proportion of ketamine cases involved complications like ketamine use disorder and symptoms related to urinary and liver issues.
  • The findings highlight a concerning trend of growing ketamine use among substance users and associated health complications, although the overall non-medical use rates in the general population remain unclear.
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  • Head and neck cancer significantly affects the quality of life (QoL) of older patients, with this study evaluating the impact of geriatric-assessment (GA)-based interventions on QoL over two years.
  • The study involved 475 patients aged 65 and older, comparing those who received a GA-driven intervention to those receiving standard care, using specific QoL questionnaires for measurement.
  • Results showed improvements in QoL scores overall, but no major differences between the intervention and control groups; most patients in the intervention group did not complete the full treatment, highlighting the need for better healthcare models tailored to patients' needs.
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Background: Endotracheal tube fixation in ventilated patients must be appropriate to ensure security during mechanical ventilation and prevent skin lesions. The incidence of endotracheal tube-caused pressure ulcers ranges from 7% to 45%. Various endotracheal tube fixations are used in intensive care units (ICUs) worldwide.

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BACKGROUND: Admission to the hospital is a major risk factor for the development of venous thromboembolism (VTE). Whether thromboprophylaxis with low-molecular-weight heparin prevents symptomatic VTE in medically ill, hospitalized older adults remains debated. METHODS: In a prospective, randomized, placebo-controlled, double-blind, multicenter trial, older adults (>70 years of age) hospitalized for acute medical conditions were randomly assigned to receive 40 mg a day of low-molecular-weight heparin (enoxaparin) or placebo for 6 to 14 days.

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Article Synopsis
  • Ventilator associated pneumonia (VAP) caused by wild-type AmpC-producing Enterobacterales is common in ICU patients, and the study explores the effectiveness of different antimicrobial therapies (AMT), specifically piperacillin ± tazobactam (PTZ) and third-generation cephalosporins (3GCs).
  • In a study involving 274 ICU patients, no significant differences in treatment success at day 7 were found between the groups receiving PTZ, 3GCs, or other control treatments, with all groups showing success rates around 68-74%.
  • However, patients treated with 3GCs had a higher likelihood of pneumonia recurrence by day 28 compared to those on PTZ
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Importance: Many pediatric patients with heterozygous familial hypercholesterolemia (HeFH) cannot reach recommended low-density lipoprotein cholesterol (LDL-C) concentrations on statins alone and require adjunct lipid-lowering therapy (LLT); the use of alirocumab in pediatric patients requires evaluation.

Objective: To assess the efficacy of alirocumab in pediatric patients with inadequately controlled HeFH.

Design, Setting, And Participants: This was a phase 3, randomized clinical trial conducted between May 2018 and August 2022 at 43 centers in 24 countries.

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[First-line management of infertile couple. Guidelines for clinical practice of the French College of Obstetricians and Gynecologists 2022].

Gynecol Obstet Fertil Senol

May 2024

Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; IMBE, CNRS, IRD, Aix-Marseille université, Avignon université, Marseille, France. Electronic address:

Article Synopsis
  • The updated clinical practice guidelines aim to improve the first-line management of infertility in couples by revisiting existing recommendations based on recent research.
  • A systematic review was conducted by expert working groups on five major themes, resulting in 28 PICO-formulated questions addressing both male and female infertility assessments, environmental factors, ovulation induction, and reproductive surgery techniques.
  • Key recommendations include tailored fertility evaluations based on the woman's age, specific tests for both partners, and the dismissal of certain outdated procedures, with an emphasis on evidence-based approaches to optimize infertility treatment.
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  • The French National Authority for Health reviewed literature on complications from pelvic organ prolapse (POP) surgery using synthetic mesh, which are rare but can severely impact women's quality of life, leading to multidisciplinary clinical practice recommendations with graded levels of evidence.
  • Patients must be adequately informed about the risks of POP surgery, with specific guidelines suggesting against certain practices like vaginal packing and requiring alternative surgical techniques in complex cases.
  • For bladder injuries during surgery, recommended practices include suturing and monitoring ureter permeability, with potential use of a prosthetic mesh post-repair for better outcomes.
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Adverse drug reactions (ADRs) are a major public health issue, especially when it comes to the elderly. Potentially inappropriate prescribing (PIP) are one of the causes of ADRs in older people. A PIP can be defined as a prescription for which the benefit/risk ratio is unfavourable compared to other therapeutic alternatives.

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Background: Patients with acute brain injury are at high risk of ventilator-associated pneumonia (VAP). The benefit of short-term antibiotic prophylaxis remains debated. We aimed to establish the effect of an early, single dose of the antibiotic ceftriaxone on the incidence of early VAP in patients with severe brain injury who required mechanical ventilation.

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Background And Aims: Mitral valve surgery and, more recently, mitral transcatheter edge-to-edge repair (TEER) are the two treatments of severe mitral regurgitation in eligible patients. Clinical comparison of both therapies remains limited by the number of patients analysed. The objective of this study was to analyse the outcomes of mitral TEER vs.

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The use of peripheral blood (PB) or bone marrow (BM) stem cells graft in haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis remains controversial. Moreover, the value of adding anti-thymoglobulin (ATG) to PTCy is unknown. A total of 1344 adult patients received an unmanipulated haploidentical transplant at 37 centers from 2012 to 2019 for hematologic malignancy.

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Psychological impact of medical evacuation for ICU saturation in Covid-19-related ARDS patients.

J Psychiatr Res

February 2024

Réanimation polyvalente, CHBA Vannes, Vannes, France. Electronic address:

Purpose: Psychological impact of Medical Evacuation (MEDEVAC) in Covid-19 patients is undetermined. The objectives were to evaluate: Post-traumatic Stress Disorder (PTSD) in MEDEVAC patients hospitalized in ICU for Covid-19-related acute respiratory distress syndrome (ARDS) compared to control group; anxiety, depression rates and outcomes in patients and PTSD in relatives.

Material And Methods: This is a retrospective multicentric 1/1 paired cohort performed in 10 ICUs in the West of France.

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Article Synopsis
  • * There was no increased risk of acute kidney injury (AKI) in patients receiving combination therapy, suggesting it may not be more harmful than single-drug therapy.
  • * The research utilized data from a multicenter database and included various analyses based on patient characteristics and the resistance profiles of the bacteria involved, indicating a comprehensive approach to assessing treatment outcomes.
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Atypical Anti-Glomerular Basement Membrane Nephritis: A Case Series From the French Nephropathology Group.

Am J Kidney Dis

June 2024

Department of Pathology, Centre Hospitalier Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France; INSERM U1151, CNRS UMR 8253, Institut Necker-Enfants Malades, Département Croissance et Signalisation, University of Paris Cité, Paris, France.

Article Synopsis
  • Atypical anti-glomerular basement membrane (GBM) nephritis is a rare kidney condition that presents differently than typical cases, showing bright linear immunoglobulin staining without the usual serum anti-GBM antibodies.
  • In a study involving patients diagnosed from 2003 to 2022, 25 out of 38 potential cases were confirmed, with a majority exhibiting symptoms like hematuria and varying forms of glomerulonephritis.
  • The findings suggest that atypical anti-GBM nephritis often progresses slower than typical cases, but further research is necessary to understand its complete nature and implications.
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MRI vs CT for Baseline Imaging Evaluation in Acute Large Artery Ischemic Stroke: A Subanalysis of the SWIFT-DIRECT Trial.

Neurology

January 2024

From the Stroke Center and Department of Neurology (J.F., U.F.), University Hospital Basel and University of Basel; University Institute of Diagnostic and Interventional Neuroradiology (J.K., J.G.), and Department of Neurology (T.R.M., U.F.), Inselspital, Bern University Hospital and University of Bern; CTU Bern (L.B.), University of Bern, Switzerland; Department of Neurology (D.S.), Helsinki University Hospital, University of Helsinki, Finland; Department of Neuroradiology (O.F.E.), Hospices Civils de Lyon; Department of Diagnostic and Therapeutic Neuroradiology (J.-F.A.), Centre Hospitalier Universitaire de Toulouse; Department of Diagnostic and Interventional Neuroradiology (H.D.), Centre Hospitalier Universitaire de Nantes, Nantes Université; Interventional and Diagnostic Neuroradiology (G.M.), CHU Bordeaux, University of Bordeaux; Department of Radiology (C.P.), CHU Rouen; Stroke Unit (S.R.), Department of Neurology, CHRU-Nancy, Université de Lorraine, France; Stroke Unit (M.R.), Department of Neurology, Hospital Vall d'Heborn, Barcelona, Spain; Department of Stroke and Diagnostic and Interventional Neuroradiology (B.L.), Foch Hospital, Suresnes, France; Department of Neuroradiology (P.P.), CHU Reims, France; Department of Neuroradiology (M.E.), University Medical Center Goettingen; Department of Neuroradiology (M.W.), University Hospital RWTH Aachen, Germany; Department of Neurology (M.B.), CHU Caen Normandie, University Caen Normandie, INSERM U1237, France; and Department of Neurology and Comprehensive Stroke Center (D.S.L.), David Geffen School of Medicine, University of California, Los Angeles.

Background And Objectives: Whether MRI or CT is preferable for the evaluation of patients with suspected stroke remains a matter of debate, given that the imaging modality acquired at baseline may be a relevant determinant of workflow delays and outcomes with it, in patients with stroke undergoing acute reperfusion therapies.

Methods: In this post hoc analysis of the SWIFT-DIRECT trial that investigated noninferiority of thrombectomy alone vs IV thrombolysis (IVT) + thrombectomy in patients with an acute ischemic anterior circulation large vessel occlusive stroke eligible to receive IVT within 4.5 hours after last seen well, we tested for a potential interaction between baseline imaging modality (MRI/MR-angiography [MRA] vs CT/CT-angiography [CTA]) and the effect of acute treatment (thrombectomy vs IVT + thrombectomy) on clinical and safety outcomes and procedural metrics (primary analysis).

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Background: The implementation of antimicrobial stewardship (AMS) interventions in long-term care facilities (LTCFs) is influenced by multi-level factors (resident, organizational, and external) making their effectiveness sensitive to the implementation context.

Objectives: This study assessed the strategies adopted for the implementation of AMS interventions in LTCFs, whether they considered organizational characteristics, and their effectiveness.

Data Sources: Electronic databases until April 2022.

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Laryngeal graft after total laryngectomy in humans: A SWiM analysis.

Eur Ann Otorhinolaryngol Head Neck Dis

March 2024

Groupe ECLAT, Lyon, France.

Evaluation of the results of laryngeal transplantation (LT) in humans. Analysis of 3 bibliographic databases with the keywords "larynx, transplantation, autograft". In total, 626 abstracts were read and 25 articles selected.

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A conserved transcriptional program for MAIT cells across mammalian evolution.

J Exp Med

February 2024

Institut Curie, Paris Sciences et Lettres University, Institut National de La Santé et de La Recherche Médicale U932, Immunity and Cancer , Paris, France.

Mucosal-associated invariant T (MAIT) cells harbor evolutionarily conserved TCRs, suggesting important functions. As human and mouse MAIT functional programs appear distinct, the evolutionarily conserved MAIT functional features remain unidentified. Using species-specific tetramers coupled to single-cell RNA sequencing, we characterized MAIT cell development in six species spanning 110 million years of evolution.

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Cord blood transplantation for adult mature lymphoid neoplasms in Europe and Japan.

Blood Adv

February 2024

Eurocord, Hopital Saint Louis, Assistance Publique - Hopitaux de Paris, Institut de Recherche de Saint-Louis EA3518, Université de Paris Cité, Paris, France.

To clarify the different characteristics and prognostic factors of cord blood transplantation (CBT) in adult patients with lymphoid neoplasms in Europe and Japan, we conducted a collaborative study. Patients aged 18-75 years receiving their first CBT (Europe: single CBT, n = 192; double CBT, n = 304; Japan: single CBT, n = 1150) in 2000-2017 were analyzed. Fewer patients with Hodgkin lymphoma (Europe vs Japan, 26% vs 5%), and older patients (≥50 years) (39% vs 59%) with a higher refined disease risk index (rDRI) (high-very high: 49% vs 14%) were included in the Japanese registry.

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