Philippe JEAN-PIERRE

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• Type de publi. : Communication dans un congrès
• Date de publi. : 26/08/2024
• Auteurs : Brice MarcPhilippe FoucherFlorence ForbesPierre Charbonnier
• Organismes : Evaluation non destructive des structures et des matériaux Modèles statistiques bayésiens et des valeurs extrêmes pour données structurées et de grande dimension Evaluation non destructive des structures et des matériaux Modèles statistiques bayésiens et des valeurs extrêmes pour données structurées et de grande dimension Evaluation non destructive des structures et des matériaux

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Résumé : Automatic anomaly detection on engineering structures is often carried out using supervised models, raising the issue of anomalous images acquisition and annotation. Unsupervised methods like normalizing flows achieve excellent results while trained with defect-free images only. However, normalizing flows methods, such as MSFlow, are generally applied on features extracted by an encoder pre-trained on datasets that may not be related to engineering structures images. Therefore, we investigate the possibility to derive more discriminative features with an additional fine-tuning of the feature extractor on images with synthetic anomalies. We consider two types of such anomalies and demonstrate their efficiency with MSFlow on the MVTec (Wood/Tile) and Crack500 datasets, with significantly improved predictions. Interestingly, both tasks produce similar results suggesting that pre-training is mainly improved by the healthy part of images and not very sensitive to anomaly realism. Additionally, when comparing our fine-tuned MSFlow with a reference supervised model, CT-CrackSeg, on the Crack500 dataset, we observe similar qualitative behaviours. This open a promising direction towards annotation-free, more scalable alternatives, in particular for anomaly detection in engineering structure applications.

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Fichiers liés : EUSIPCO (1).pdf

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• Type de publi. : Communication dans un congrès
• Date de publi. : 25/08/2024
• Auteurs : Amélie CrépetPhilippe QuénelMadeline CarsiqueJeanne GarricPascal SandersJean-Marc BonmatinP DuchéAlain KaufmannJulien JeanJean-Pierre CravediMatthieu SchulerRobert Barouki
• Organismes : Direction de l'Evaluation des Risques Institut de recherche en santé, environnement et travail Direction de l'Evaluation des Risques Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement Direction des affaires européennes et internationales Centre de biophysique moléculaire Université de Toulon Jeunesse - Activité Physique et Sportive, Santé Université de Lausanne = University of Lausanne Direction de l'Evaluation des Risques Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail Institut National de la Santé et de la Recherche Médicale

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Résumé : BACKGROUND AND AIM: The exposome encompasses all environmental factors encountered over the life-course to explain their role in the development of health effects, in complement of the genome. Since the emergence of the concept in 2005, the scientific community has made a lot of efforts to produce new knowledge, data, methods and tools to assess the exposome and its impact on human health. However, the exposome has not yet been widely implemented by health and safety agencies and today, one of the key challenges is to include exposome-inspired approaches in health risk assessment. METHOD: After presenting the main recommendations to integrate the exposome in the risk assessment process, we will focus on chemical mixtures to practically show how the exposome can support risk assessment methodologies. RESULTS: Several applications of the different exposure and health data derived from studies in the French population will be presented: dietary exposure to chemical mixtures in children and women, exposure to pesticide mixtures from multiple sources of the general population and from occupational activity for agricultural workers, analysis of chemical mixtures from human biomonitoring data. CONCLUSIONS: The integration of approaches and knowledge relating to the exposome will enable environmental epidemiology and risk assessment to cross a decisive threshold, taking into account the contributions of citizen and participatory science wherever possible and useful. Developing the eco-exposome will also help for a better integration of human, animals and environmental health.

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• Type de publi. :
• Date de publi. : 25/08/2024
• Auteurs : Julie BorgMohamed-Mahmoud MemmahJean-Noël AubertotPhilippe BlancStéphanie DruschPascal BorioliDanièle BevacquaValérie GalliaBertrand GauffreHélène GautierMichel GénardIsabelle GrechiPierre P. FranckBaptiste LabeyrieClaire LavigneFrançoise LescourretVincent MercierChristophe MouirenDidace Ndalla LandouFrédéric NormandMarie-Hélène RobinAntoine RollandJulien RuescheNatacha SautereauPierre ValsesiaGilles Vercambre
• Organismes : Génétique Quantitative et Evolution - Le Moulon (Génétique Végétale) Génétique et Amélioration des Fruits et Légumes AGroécologie, Innovations, teRritoires Unité Expérimentale de Recherches Intégrées en Production Fruitière Groupement Régional CETA de Basse Durance Plantes et systèmes de culture horticoles Station de Recherche Appliquée Fruits et Légumes Centre d'Études Biologiques de Chizé - UMR 7372 Plantes et systèmes de culture horticoles Plantes et systèmes de culture horticoles Plantes et systèmes de culture horticoles Plantes et systèmes de culture horticoles Station d’Expérimentation Fruits Rhône-Alpes Plantes et systèmes de culture horticoles Plantes et systèmes de culture horticoles Unité Expérimentale de Recherches Intégrées en Production Fruitière Groupement Régional des Centres d'Etudes Techniques Agricoles de Basse Durance Fonctionnement agroécologique et performances des systèmes de cultures horticoles Ecole d'Ingénieurs de Purpan AGroécologie, Innovations, teRritoires Entrepôts, Représentation et Ingénierie des Connaissances Génétique Physiologie et Systèmes d'Elevage Institut Technique de l'Agriculture Biologique Plantes et systèmes de culture horticoles Plantes et systèmes de culture horticoles

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• Type de publi. : Article dans une revue
• Date de publi. : 22/08/2024
• Auteurs : Lambert AssoumouRaghiatou BaldéChristine KatlamaBaptiste AbbarPierre DelobelThierry AllegreArmelle LavoleAlain MakinsonOlivia Zaegel-FaucherLaurent GreillierCathia SoulieMarianne VeyriMathilde BertheauMichèle Algarte GeninSéverine GibowskiAnne-Geneviève MarcelinKevin BihanMarine BaronDominique CostagliolaOlivier LambotteJean-Philippe Spano
• Organismes : Institut Pierre Louis d'Epidémiologie et de Santé Publique Institut Pierre Louis d'Epidémiologie et de Santé Publique Institut Pierre Louis d'Epidémiologie et de Santé Publique Sorbonne Université Service Maladies infectieuses et tropicales [CHU Toulouse] Centre Hospitalier d'Aix en Provence [Aix-en-Provence] INSERM U64 [AP-HP Hôpital Tenon] CHU Montpellier = Montpellier University Hospital Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes Hôpital Sainte-Marguerite [CHU - APHM] Aix Marseille Université Centre de Recherche en Cancérologie de Marseille CHU Pitié-Salpêtrière [AP-HP] Institut Pierre Louis d'Epidémiologie et de Santé Publique ANRS - Maladies infectieuses émergentes Institut Pierre Louis d'Epidémiologie et de Santé Publique ANRS - Maladies infectieuses émergentes Institut Pierre Louis d'Epidémiologie et de Santé Publique Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases Centre Régional de Pharmacovigilance Saint Louis [Paris] CHU Pitié-Salpêtrière [AP-HP] U489 Inserm [CHU Tenon, APHP] Centre d'Immunologie et des Maladies Infectieuses Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre] Institut Pierre Louis d'Epidémiologie et de Santé Publique
• Publié dans Journal for Immunotherapy of Cancer le 24/10/2020

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Résumé : Background. Immune checkpoint inhibitors (ICIs) have been a major advance in cancer management. However, we still lack prospective real-world data regarding their usage in people with HIV infection (PWH). Methods The ANRS CO24 OncoVIHAC study (NCT03354936) is an ongoing prospective observational cohort study in France of PWH with cancer treated with ICI. We assessed the incidence of grade ≥3 immune-related adverse events (irAEs). All grade ≥3 irAEs were reviewed by an event review. Results. Between January 17, 2018, and December 05, 2023, 150 participants were recruited from 33 sites and 140 were included in this analysis. At the data cut-off date of December 05, 2023, the median follow-up was 9.2 months (IQR: 3.9-18.3), with a total of 126.2 person-years. Median age was 59 years (IQR: 54-64) and 111 (79.3%) were men. Median time since HIV diagnosis was 25 years (12-31), the median duration on antiretroviral (ARV) was 19.5 years (7.7-25.4), and the CD4 nadir was 117/µL (51-240). ICI regimens comprised anti-programmed cell death protein-1 (PD-1) for 111 (79.3%) participants, antiprogrammed death-ligand 1 for 25 (17.9%), a combination of anti-PD-1 and anti-cytotoxic T-lymphocyte associated protein 4 for 3 (2.1%), and anti-PD-1 along with antivascular endothelial growth factor receptor for 1 (0.7%). The most frequent cancers were lung (n=65), head/neck (n=15), melanoma (n=12), liver (n=11) and Hodgkin's lymphoma (n=9). During follow-up, a total of 34 grade ≥3 irAEs occurred in 20 participants, leading to an incidence rate of 26.9 per 100 person-years. The Kaplan-Meier estimates of the proportion of participants with at least one episode of grade ≥3 irAEs were 13.8% at 6 months, 15.0% at 12 months and 18.7% at 18 months. One treatmentrelated death due to myocarditis was reported (0.7%). Multivariable analysis of cumulative incidence showed that participants with time since HIV diagnosis >17 years (incidence rate ratio (IRR)=4.66, p=0.002), with CD4<200 cells/µL (IRR=4.39, p<0.0001), with positive cytomegalovirus (CMV) serology (IRR=2.76, p=0.034), with history of cancer surgery (IRR=3.44, p=0.001) had a higher risk of incidence of grade ≥3 irAEs. Conclusion. This study showed that the incidence of a first episode of grade ≥3 irAE was 15.0% (95% CI: 9.6% to 22.9%) at 1 year and the cumulative incidence of all severe irAE episodes was 26.9 per 100 person-years. Low CD4 count, positive CMV serology, history of cancer surgery and a longer time since HIV diagnosis were associated with the occurrence of severe irAEs.

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Fichiers liés : Assoumou_2024.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 22/08/2024
• Auteurs : Sébastien BourdinFrançois HermetPhilippe Jean-Pierre
• Organismes : Métis Lab EM Normandie Centre d'Économie et de Management de l'Océan Indien Université de La Réunion Centre d'Économie et de Management de l'Océan Indien Institut d'Administration des Entreprises - La Réunion
• Publié dans Revue Economique le 28/10/2020

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Résumé : Les études sur l’efficacité de la politique de cohésion sont nombreuses dans la littérature. Pour autant, ces analyses excluent systématiquement les régions ultrapériphériques (RUP) de l’Union européenne. Or, compte tenu des enjeux spécifiques qui se posent dans ces régions (hyper-éloignement, pauvreté, dépendance au commerce extérieur), il semble important de pouvoir identifier si elles ont réduit leurs écarts de développement vis-à-vis du reste des régions européennes. À partir d’une étude en coupes transversales et explorant les données de panel, nous testons l’existence d’une β -convergence pour 242 régions entre 2003 et 2021. Il apparaît qu’après plusieurs décennies de subventions reçues au titre des Fonds européens structurels et d’investissement, les RUP continuent d’être en retard de développement comparées au reste du continent européen.

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• Type de publi. : Article dans une revue
• Date de publi. : 22/08/2024
• Auteurs : Vincent Jean-PierrePauline SorlinKaty JeannotRaphaël ChironJean-Philippe LavigneAlix PantelH. Marchandin
• Organismes : Hydrosciences Montpellier Centre Hospitalier Universitaire de Nîmes Centre Hospitalier Universitaire de Nantes = Nantes University Hospital Centre National de Référence de la Résistance aux Antibiotiques Hydrosciences Montpellier Centres de Ressources et de Compétences de la Mucoviscidose [Montpellier] Virulence Bactérienne et Infections Chroniques Centre Hospitalier Universitaire de Nîmes Virulence Bactérienne et Infections Chroniques Centre Hospitalier Universitaire de Nîmes Hydrosciences Montpellier Centre Hospitalier Universitaire de Nîmes
• Publié dans Annals of Clinical Microbiology and Antimicrobials le 30/10/2020

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Résumé : Background : Cefiderocol is a siderophore-conjugated cephalosporin increasingly used in the management of Achromobacter infections. Testing for cefiderocol susceptibility is challenging with distinct recommendations depending on the pathogens. Objectives : We evaluated the performance of commercial tests for testing cefiderocol susceptibility in the Achromobacter genus and reviewed the literature. Methods : Diffusion (disks, MIC gradient test strips [MTS], Liofilchem) and broth microdilution (BMD) methods (ComASP™, Liofilchem; UMIC®, Bruker) were compared with the BMD reference method according to the EUCAST guidelines on 143 Achromobacter strains from 14 species with MIC50/90 of ≤ 0.015/0.5 mg/L. A literature search was conducted regardless of method or species. Results : None of the methods tested fulfilled an acceptable essential agreement (EA). MTS displayed the lowest EA (30.8%) after UMIC® (49%) and ComASP™ (76.9%). All methods achieved an acceptable bias, with MICs either underestimated using MTS (-1.3%) and ComASP™ (-14.2%) or overestimated with UMIC® (+ 9.1%). Inhibition zone diameters ranged from 6 to 38 mm (IZD50/90=33/30 mm). UMIC® and ComASP™ failed to categorize one or the two cefiderocol-resistant strains of this study as resistant unlike the diffusion-based methods. The literature review highlighted distinct performance of the available methods according to pathogens and testing conditions. Conclusions : The use of MTS is discouraged for Achromobacter spp. Disk diffusion can be used to screen for susceptible strains by setting a threshold diameter of 30 mm. UMIC® and ComASP™ should not be used as the sole method but have to be systematically associated with disk diffusion to detect the yet rarely described cefiderocol-resistant Achromobacter sp. strains.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12941-024-00731-1.

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Fichiers liés : s12941-024-00731-1.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 17/08/2024
• Auteurs : Samuel SoubeyrandArnaud EstoupAstrid CruaudSylvie Malembic-MaherChristine MeynardVirginie RavignéMarc BarbierBenoit BarrèsKarine BerthierSimon BoitardSylvie DallotSabrina GabaMarie GrosdidierMourad HannachiMarie-Agnès JacquesMelen LeclercPhilippe LucasDavide MartinettiChristophe MougelCorinne RobertAlain RoquesJean-Pierre RossiFrédéric SuffertPierre AbadMarie-Anne Auger-RozenbergJean-Sauveur AyMarc BardinHélène BernardDavid A BohanThierry CandressePhilippe Castagnone-SerenoEtienne G.J. DanchinChloe E. L. DelmasPauline EzannoFrédéric FabreBenoît FaconEdith GabrielJonathan GaudinBertrand GauffreMathieu GautierClaire GuinatClaire LavigneOlivier LemaireCésar MartinezLucie MichelBenoît MouryKiwoong NamClaire NédellecMylène OgliastroJulien PapaïxNicolas PariseySylvain PoggiAndrea RadiciJean-Yves RasplusXavier ReboudCecile RobinMathieu RocheAdrien RuschNicolas SauvionJean‐Claude StreitoEric VerdinAnne-Sophie WalkerAnne XuérebGaël ThébaudCindy E. Morris
• Organismes : Biostatistique et Processus Spatiaux Centre de Biologie pour la Gestion des Populations Centre de Biologie pour la Gestion des Populations Biologie du fruit et pathologie Centre de Biologie pour la Gestion des Populations Plant Health Institute of Montpellier Laboratoire Interdisciplinaire Sciences, Innovations, Sociétés CAractérisation et Suivi des Phénomènes d'Evolution de Résistance aux pesticides Unité de Pathologie Végétale Centre de Biologie pour la Gestion des Populations Plant Health Institute of Montpellier Centre d'Études Biologiques de Chizé - UMR 7372 Biostatistique et Processus Spatiaux Sciences pour l'Action et le Développement : Activités, Produits, Territoires Institut de Recherche en Horticulture et Semences Institut de Génétique, Environnement et Protection des Plantes Institut d'écologie et des sciences de l'environnement de Paris Biostatistique et Processus Spatiaux Institut de Génétique, Environnement et Protection des Plantes Ecologie fonctionnelle et écotoxicologie des agroécosystèmes Zoologie forestière Centre de Biologie pour la Gestion des Populations BIOlogie et GEstion des Risques en agriculture Institut Sophia Agrobiotech Zoologie forestière Centre d'économie et de sociologie rurales appliquées à l'agriculture et aux espaces ruraux Unité de Pathologie Végétale Laboratoire d'étude des Résidus et Contaminants dans les Aliments Agroécologie [Dijon] Biologie du fruit et pathologie Institut Sophia Agrobiotech Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement Santé et agroécologie du vignoble Biologie, Epidémiologie et analyse de risque en Santé Animale Santé et agroécologie du vignoble Centre de Biologie pour la Gestion des Populations Biostatistique et Processus Spatiaux Unité de Pathologie Végétale Plantes et systèmes de culture horticoles Centre de Biologie pour la Gestion des Populations Interactions hôtes-agents pathogènes [Toulouse] Plantes et systèmes de culture horticoles Santé de la vigne et qualité du vin Biostatistique et Processus Spatiaux Biostatistique et Processus Spatiaux Unité de Pathologie Végétale Diversité, Génomes & Interactions Microorganismes - Insectes [Montpellier] Mathématiques et Informatique Appliquées du Génome à l'Environnement [Jouy-En-Josas] Diversité, Génomes & Interactions Microorganismes - Insectes [Montpellier] Biostatistique et Processus Spatiaux Institut de Génétique, Environnement et Protection des Plantes Institut de Génétique, Environnement et Protection des Plantes Biostatistique et Processus Spatiaux Centre de Biologie pour la Gestion des Populations Agroécologie [Dijon] Biodiversité, Gènes & Communautés Territoires, Environnement, Télédétection et Information Spatiale Santé et agroécologie du vignoble Plant Health Institute of Montpellier Centre de Biologie pour la Gestion des Populations Unité de Pathologie Végétale BIOlogie et GEstion des Risques en agriculture Centre de Biologie pour la Gestion des Populations Plant Health Institute of Montpellier Unité de Pathologie Végétale
• Publié dans CABI Agriculture and Bioscience le 14/04/2021

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Résumé : In an era marked by rapid global changes, the reinforcement and modernization of plant health surveillance systems have become imperative. Sixty-five scientists present here a research agenda for an enhanced and modernized plant health surveillance to anticipate and mitigate disease and pest emergence. Our approach integrates a wide range of scientific fields (from life, social, physical and engineering sciences) and identifies the key knowledge gaps, focusing on anticipation, risk assessment, early detection, and multi-actor collaboration. The research directions we propose are organized around four complementary thematic axes. The first axis is the anticipation of pest emergence, encompassing innovative forecasting, adaptive potential, and the effects of climatic and cropping system changes. The second axis addresses the use of versatile broad-spectrum surveillance tools, including molecular or imaging diagnostics supported by artificial intelligence, and monitoring generic matrices such as air and water. The third axis focuses on surveillance of known pests from new perspectives, i.e., using novel approaches to detect known species but also anticipating and detecting, within a species, the populations or genotypes that pose a higher risk. The fourth axis advocates the management of plant health as a commons through the establishment of multi-actor and cooperative surveillance systems for long-term data-driven alert systems and information dissemination. We stress the importance of integrating data and information from multiple sources through open science databases and metadata, alongside developing methods for interpolating and extrapolating incomplete data. Finally, we advocate an Integrated Health Surveillance approach in the One Health context, favoring tailored and versatile solutions to plant health problems and recognizing the interconnected risks to the health of plants, humans, animals and the environment, including food insecurity, pesticide residues, environmental pollution and alterations of ecosystem services.

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Fichiers liés : s43170-024-00273-8.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 15/08/2024
• Auteurs : Hang QuachGurdeep ParmarEnrique OcioH Miles PrinceAlbert OriolHelen CrowtherNobuhiro TsukadaPierre BoriesSumit MadanNitya NathwaniKazutaka SunamiDorothee SemiondDisa YuPaul CorderoSandrine MacéFlorence SuzanPhilippe MoreauH. Miles Prince
• Organismes : University of Melbourne Marqués de Valdecilla Research Institute - Instituto de Investigación Marqués de Valdecilla [Santander] Josep Carreras Leukaemia Research Institute Germans Trias i Pujol University Hospital [Badalona, Barcelona, Spain] Institut Universitaire du Cancer de Toulouse - Oncopole Réseau régional de cancérologie Onco-Occitanie Fraunhofer Institute for Algorithms and Scientific Computing Ecole Supérieure de Commerce de Paris Institut de Veille Sanitaire Institut des Matériaux de Nantes Jean Rouxel Nantes Université Peter Mac Callum Cancer Centre
• Publié dans Haematologica le 30/10/2020

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Fichiers liés : 1094078.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 13/08/2024
• Auteurs : Romain DeschampsJessica GuillaumeJonathan CironBertrand AudoinAurélie RuetElisabeth MaillartJulie PiqueLakhdar BenyahyaDavid-Axel LaplaudLaure MichelNicolas CollonguesMikael CohenXavier AyrignacEric ThouvenotHélène ZéphirBertrand BourreCaroline FromentThibault MoreauPaul CantagrelPhilippe KerschenSebastien CabassonNicolas MaubeugeKarolina HankiewiczChantal NifleEric BergerHana MegherbiLaurent MagyFrederic KlapczynskiMariana Sarov RiviereClaire GiannesiniLorraine HamelinMarianne GirouxPierre BrangerAude MauroussetGuillaume MatheyMaximilien MoulinNicolas MéléCaroline PapeixRomain Marignier
• Organismes : Hôpital Fondation Adolphe de Rothschild = Adolphe de Rothschild Foundation Hospital Institut Toulousain des Maladies Infectieuses et Inflammatoires Centre Hospitalier Universitaire de Toulouse CHU Marseille Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale Service de neurologie [Bordeaux] CHU Pitié-Salpêtrière [AP-HP] Observatoire Français de la Sclérose En Plaques [Lyon] Hospices Civils de Lyon Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL] Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology Centre Hospitalier Universitaire de Nantes = Nantes University Hospital Centre Hospitalier Universitaire [Rennes] Centre d'Investigation Clinique [Rennes] Microenvironment and B-cells: Immunopathology, Cell Differentiation, and Cancer Service de Neurologie [CHU Nimes] Centre Hospitalier Régional Universitaire [CHU Lille] Lille Neurosciences & Cognition - U 1172 CHU Rouen Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL] Integrative Multisensory Perception, Action and Cognition Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon) Centre Hospitalier de Luxembourg [Luxembourg]
• Publié dans Neurology le 01/11/2020

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Résumé : Background and objectives: Because myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently identified autoimmune disorder, the natural history of MOGAD is still not well described. The objective of this study was to describe the long-term outcomes of adult patients with MOGAD. In addition, we aimed to identify factors affecting relapse risk and neurologic outcomes. Methods: Clinical and biological data were obtained from patients with a first event of MOGAD and included in the French nationwide incident cohort between February 2014 and March 2017. Only patients aged 18 years or older at disease onset and with observation period of at least 3 months were included. Data were collected prospectively until July 2023 and registered in the dedicated French nationwide database. This form includes every relapse with phenotype description during follow-up, date of last assessment, final clinical outcome with Expanded Disability Status Scale score and visual acuity, and maintenance therapy. The probability of recurrence-free survival was assessed using the Kaplan-Meier method. Results: We included 128 patients. The onset phenotype was isolated optic neuritis in 81 patients (63.3%) and isolated myelitis in 25 patients (19.5%). The median follow-up duration was 77.8 months (range 3.2-111.2), with 49 patients (38.3%) experienced at least one relapse. Median times from onset to second and third attacks were 3.2 (1.0-86.2) and 13.0 (2.6-64.4) months, respectively. At the last assessment, Expanded Disability Status Scale Score was ≥3 and ≥6 in 22 (17.2%) and 6 (4.7%) patients, respectively. Eighty patients received at least one maintenance treatment. This treatment was initiated after the first attack in 47 patients (36.7% of the whole cohort) and at the time of a second attack in 25 (19.5%). Multivariate analysis revealed that initiating maintenance treatment after the first attack was associated with a lower relapse risk (OR = 0.26 [95% CI 0.11-0.62], p = 0.002). In patients receiving maintenance therapy after first attack, the 2-year, 4-year, 6-year, and 8-year relapse risks were 11%, 15%, 20%, and 20%, respectively. In other patients, the risks were 41%, 46%, 51%, and 56%. Discussion: The highest risk of a relapse in MOGAD occurs early, and initiating maintenance therapy from the first attack substantially reduced the relapse risk. Classification of evidence: This study provides Class III evidence that initiating maintenance therapy from the first attack in patients with MOGAD reduces the relapse risk.

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• Type de publi. : Article dans une revue
• Date de publi. : 09/08/2024
• Auteurs : Rabih AboukaisAntoine DevalckeneerPierre BoussemartPhilippe BourgeoisTomas MenovskyMartin BretznerMélodie-Anne KarnoubJean-Paul Lejeune
• Organismes : Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 Département de Neurochirurgie[Lille] Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 Département de Neurochirurgie[Lille] Centre Hospitalier Régional Universitaire [CHU Lille] Département de Neurochirurgie[Lille] Lille Neurosciences & Cognition - U 1172 Departement de Neuroradiologie [Lille] Département de Neurochirurgie[Lille] Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 Département de Neurochirurgie[Lille]
• Publié dans Neurosurgical Review le 01/11/2020

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Résumé : Our study aimed to evaluate the postoperative outcome of patients with unruptured giant middle cerebral artery (MCA) aneurysm revealed by intracranial hypertension associated to midline brain shift. From 2012 to 2022, among the 954 patients treated by a microsurgical procedure for an intracranial aneurysm, our study included 9 consecutive patients with giant MCA aneurysm associated to intracranial hypertension with a midline brain shift. Deep hypothermic circulatory flow reduction (DHCFR) with vascular reconstruction was performed in 4 patients and cerebral revascularization with aneurysm trapping was the therapeutic strategy in 5 patients. Early (< 7 days) and long term clinical and radiological monitoring was done. Good functional outcome was considered as mRS score ≤ 2 at 3 months. The mean age at treatment was 44 yo (ranged from 17 to 70 yo). The mean maximal diameter of the aneurysm was 49 mm (ranged from 33 to 70 mm). The mean midline brain shift was 8.6 mm (ranged from 5 to 13 mm). Distal MCA territory hypoperfusion was noted in 6 patients. Diffuse postoperative cerebral edema occurred in the 9 patients with a mean delay of 59 h and conducted to a postoperative neurological deterioration in 7 of them. Postoperative death was noted in 3 patients. Among the 6 survivors, early postoperative decompressive hemicraniotomy was required in 4 patients. Good functional outcome was noted in 4 patients. Complete aneurysm occlusion was noted in each patient at last follow-up. We suggest to discuss a systematic decompressive hemicraniotomy at the end of the surgical procedure and/or a partial temporal lobe resection at its beginning to reduce the consequences of the edema reaction and to improve the postoperative outcome of this specific subgroup of patients. A better intraoperative assessment of the blood flow might also reduce the occurrence of the reperfusion syndrome.

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Fichiers liés : s10143-024-02662-z.pdf

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