Professeur des universités en sciences de gestion
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Novel formulations of oral bisphosphonates in the treatment of osteoporosis
- Type de publi. : Article dans une revue
- Date de publi. : 04/11/2022
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Auteurs :
Nicholas FuggleNasser Al-DaghriOlivier BockJaime BrancoOlivier BruyèreEnrique CasadoEtienne CavalierBernard CortetMaarten de WitAndrea GiustiPhilippe HalboutNicholas HarveyMickaël HiligsmannJean-Marc KaufmanAndreas KurthStefania MaggiRadmila MatijevicSalvatore MinisolaSantiago PalaciosRégis Pierre RadermeckerFriederike ThomasiusSansin TuzunNicola VeroneseJohn KanisJean-Yves ReginsterRené RizzoliCyrus Cooper
Fiche détaillée
Novel formulations of oral bisphosphonates in the treatment of osteoporosis
- Type de publi. : Article dans une revue
- Date de publi. : 04/11/2022
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Auteurs :
Nicholas FuggleNasser Al-DaghriOlivier BockJaime BrancoOlivier BruyèreEnrique CasadoEtienne CavalierBernard CortetMaarten de WitAndrea GiustiPhilippe HalboutNicholas HarveyMickaël HiligsmannJean-Marc KaufmanAndreas KurthStefania MaggiRadmila MatijevicSalvatore MinisolaSantiago PalaciosRégis Pierre RadermeckerFriederike ThomasiusSansin TuzunNicola VeroneseJohn KanisJean-Yves ReginsterRené RizzoliCyrus Cooper
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Organismes :
Marrow Adiposity & Bone Lab - Adiposité Médullaire et Os - ULR 4490
- Publié dans Aging Clinical and Experimental Research le 27/10/2020
Résumé : Abstract Oral bisphosphonates are a key intervention in the treatment of osteoporosis and in reducing the risk of fragility fractures. Their use is supported by over 3 decades of evidence; however, patient adherence to oral bisphosphonates remains poor in part due to complex dosing instructions and adverse events, including upper gastrointestinal symptoms. This problem has led to the development of novel oral bisphosphonate formulations. Buffered, effervescent alendronate is dissolved in water and so seeks to reduce upper gastro-intestinal adverse events, and gastro-resistant risedronate aims to reduce the complexity of dosing procedure (e.g. fasting prior to consumption) whilst still maintaining the efficacy of fracture risk reduction. Clinical trials and real-world data have been employed to demonstrate some benefits in terms of reduced upper gastro-intestinal adverse events, adherence, persistence and health economic outcomes. This report describes the result of an ESCEO (European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis) expert working group, which explores where oral bisphosphonates sit in current clinical practice guidelines, review their risk–benefit profile and the consequences of poor adherence before exploring novel oral bisphosphonate formulations and their potential clinical and health economic impact. Further research is required but there are signs that these novel, oral bisphosphonate formulations may lead to improved tolerance of oral bisphosphonates and thus, improved adherence and fracture outcomes.
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La résistance aux antibiotiques
- Type de publi. : Autre publication
- Date de publi. : 01/11/2022
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Auteurs :
Philippe BouvetJean-Marc CavaillonJean-Claude DussauleSophie GayMarie-Pierre GosselinQuentin MerelAna NavarreteIngrid PfeiferNadia Senni
Fiche détaillée
La résistance aux antibiotiques
- Type de publi. : Autre publication
- Date de publi. : 01/11/2022
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Auteurs :
Philippe BouvetJean-Marc CavaillonJean-Claude DussauleSophie GayMarie-Pierre GosselinQuentin MerelAna NavarreteIngrid PfeiferNadia Senni
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Organismes :
Agence Nationale de la Recherche
Institut Pasteur [Paris]
Agence Nationale de la Recherche
Agence Nationale de la Recherche
Agence Nationale de la Recherche
Agence Nationale de la Recherche
Agence Nationale de la Recherche
Agence Nationale de la Recherche
Agence Nationale de la Recherche
Agence Nationale de la Recherche
- Publié dans Les Cahiers de l'ANR le 14/01/2010
Résumé : Le présent cahier dresse un historique et un état des lieux de la recherche sur l’antibiorésistance. Outre la présentation des appels à projets ayant contribué au financement de la recherche française dans ce domaine de 2011 à 2021, il propose une analyse des publications issues des projets financés ainsi qu’une sélection de projets de recherche.
Fichiers liés :
ANR_cahier_14_antibioresistance.pdf
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Tenue vestimentaire au bloc opératoire 2021
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
El-Mahdi HafianiPierre CassierSerge AhoPierre AlbaladejoHélène BeloeilEvelyne BoudotPhilippe CarencoFlorence LallemantMarie Gabrielle LeroyJane MuretCorinne TamamesMarc Garnier
Fiche détaillée
Tenue vestimentaire au bloc opératoire 2021
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
El-Mahdi HafianiPierre CassierSerge AhoPierre AlbaladejoHélène BeloeilEvelyne BoudotPhilippe CarencoFlorence LallemantMarie Gabrielle LeroyJane MuretCorinne TamamesMarc Garnier
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Organismes :
CHU Tenon [AP-HP]
Centre International de Recherche en Infectiologie
Centre International de Recherche en Infectiologie
Centre Hospitalier Universitaire de Nice
Association Française de Normalisation
Centre Hospitalier Universitaire [CHU Grenoble]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Centre d'Investigation Clinique [Rennes]
Oncogenesis, Stress, Signaling
Centre International de Recherche en Infectiologie
Centre Hospitalier Universitaire de Nice
Association Française de Normalisation
Centre Hospitalier Régional Universitaire [CHU Lille]
Institut Curie [Paris]
CHU Pitié-Salpêtrière [AP-HP]
Physiopathologie et Epidémiologie des Maladies Respiratoires
- Publié dans Anesthésie & Réanimation le 26/10/2020
Résumé : ObjectifÉmettre des recommandations pour le choix des éléments composant la tenue vestimentaire du personnel (hors casaque chirurgicale stérile) exerçant au bloc opératoire.ConceptionUn comité de neuf experts issus de la SFAR et de la SF2H a été constitué. Une politique de déclaration des liens d’intérêts a été appliquée et respectée durant tout le processus de réalisation du référentiel. De même, celui-ci n’a bénéficié d’aucun financement provenant d’une entreprise commercialisant un produit de santé (médicament ou dispositif médical). Le comité devait respecter et suivre la méthode GRADE® (Grading of Recommendations Assessment, Development and Evaluation) pour évaluer la qualité des données factuelles sur lesquelles étaient fondées les recommandations.MéthodesNous avons formulé des recommandations selon la méthodologie GRADE® en identifiant quatre champs différents : tuniques, articles coiffants, masques et chaussures/sur-chaussures. Chaque question a été formulée selon le format PICO (Patients, Intervention, Comparison, Outcome). L’analyse de la littérature et les recommandations ont été formulées selon la méthodologie GRADE®.RésultatsLe travail de synthèse des experts et l’application de la méthode GRADE® ont abouti à 13 recommandations. Pour l’ensemble des questions, la méthode GRADE® ne pouvant pas s’appliquer en totalité, les recommandations ont été formulées sous forme d’avis d’experts.ConclusionÀ partir d’un accord fort entre experts, nous avons pu formuler 13 recommandations sur la tenue vestimentaire au bloc opératoire.
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Serio ludere. Hommage à Jean-Pierre Étienvre
- Type de publi. : Ouvrage (y compris édition critique et traduction)
- Date de publi. : 01/11/2022
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Auteurs :
Marina Mestre ZaragozáPhilippe Rabaté
Fiche détaillée
Serio ludere. Hommage à Jean-Pierre Étienvre
- Type de publi. : Ouvrage (y compris édition critique et traduction)
- Date de publi. : 01/11/2022
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Auteurs :
Marina Mestre ZaragozáPhilippe Rabaté
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Organismes :
Institut d’Histoire des Représentations et des Idées dans les Modernités
Études romanes
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JWST/MIRI coronagraphic performances as measured on-sky
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Anthony BoccalettiChristophe CossouPierre BaudozPierre-Olivier LagageDaniel DickenAlistair GlasseDean C HinesJonathan Albert AguilarÖrs Hunor DetreBryony NicksonAlberto Noriega-CrespoAndrás GáspárÁlvaro LabianoChristopher StarkDaniel RouanJean-Michel ReessGillian WrightGeorge RiekeMacarena García MarínCharles-Philippe LajoieJulien H. GirardMarshall D. PerrinRémi SoummerLaurent Pueyo
Fiche détaillée
JWST/MIRI coronagraphic performances as measured on-sky
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Anthony BoccalettiChristophe CossouPierre BaudozPierre-Olivier LagageDaniel DickenAlistair GlasseDean C HinesJonathan Albert AguilarÖrs Hunor DetreBryony NicksonAlberto Noriega-CrespoAndrás GáspárÁlvaro LabianoChristopher StarkDaniel RouanJean-Michel ReessGillian WrightGeorge RiekeMacarena García MarínCharles-Philippe LajoieJulien H. GirardMarshall D. PerrinRémi SoummerLaurent Pueyo
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Organismes :
Laboratoire d'études spatiales et d'instrumentation en astrophysique = Laboratory of Space Studies and Instrumentation in Astrophysics
Astrophysique Interprétation Modélisation
Laboratoire d'études spatiales et d'instrumentation en astrophysique = Laboratory of Space Studies and Instrumentation in Astrophysics
Astrophysique Interprétation Modélisation
Royal Observatory Edinburgh
Royal Observatory Edinburgh
Space Telescope Science Institute
Space Telescope Science Institute
Max-Planck-Institut für Astronomie
Space Telescope Science Institute
Space Telescope Science Institute
Steward Observatory
Telespazio
Centro de Astrobiologia [Madrid]
NASA Goddard Space Flight Center
Laboratoire d'études spatiales et d'instrumentation en astrophysique = Laboratory of Space Studies and Instrumentation in Astrophysics
Laboratoire d'études spatiales et d'instrumentation en astrophysique = Laboratory of Space Studies and Instrumentation in Astrophysics
Royal Observatory Edinburgh
Steward Observatory
Agence Spatiale Européenne = European Space Agency
Space Telescope Science Institute
Space Telescope Science Institute
Space Telescope Science Institute
Space Telescope Science Institute
Space Telescope Science Institute
- Publié dans Astronomy & Astrophysics - A&A le 28/10/2020
Résumé : Context. Characterization of directly imaged exoplanets is one of the most eagerly anticipated science functions of the James Webb Space Telescope. MIRI, the mid-IR instrument, has the capability to provide unique spatially resolved photometric data points in a spectral range never before achieved for such objects. Aims. We aim to present the very first on-sky contrast measurements of the MIRI coronagraphs. In addition to a classical Lyot coronagraph at the longest wavelength, this observing mode implements the concept of the four-quadrant phase mask for the very first time in a space telescope. Methods. We observed single stars together with a series of reference stars to measure raw contrasts as they are delivered on the detector, as well as reference-subtracted contrasts. Results. The MIRI coronagraphs achieve raw contrasts better than 10 −3 at the smallest angular separations (within 1″) and about 10 −5 farther out (beyond 5 ~ 6″). Subtracting the residual diffracted light left behind the coronagraph has the potential to bring the final contrast down to the background- and detector-limited noise floor at most angular separations (a few times 10 −5 at less than 1″). Conclusions. The MIRI coronagraphs behave as expected from simulations. In particular, the raw contrasts for all four coronagraphs are fully consistent with the diffractive model. Contrasts obtained by subtracting reference stars also meet expectations and are fully demonstrated for two four-quadrant phase masks (F1065C and F1140C). The worst contrast, measured at F1550C, is very likely due to a variation in the phase aberrations at the primary mirror during the observations, and not an issue with the coronagraph itself. We did not perform reference star subtraction with the Lyot mask at F2300C, but we anticipate that it would bring the contrast down to the noise floor.
Fichiers liés :
aa44578-22.pdf
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Ice particle impact on solid walls: size modeling of reemited fragments
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Jean-Mathieu SenonerPierre TrontinLouis ReitterNorbert KarpenMarkus SchrembMario VargasPhilippe Villedieu
Fiche détaillée
Ice particle impact on solid walls: size modeling of reemited fragments
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Jean-Mathieu SenonerPierre TrontinLouis ReitterNorbert KarpenMarkus SchrembMario VargasPhilippe Villedieu
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Organismes :
DMPE, ONERA, Université de Toulouse [Toulouse]
Laboratoire de Mecanique des Fluides et d'Acoustique
Technische Universität Darmstadt - Technical University of Darmstadt [Darmstadt]
Technische Universität Darmstadt - Technical University of Darmstadt [Darmstadt]
Airbus Central Research and Technology [Munich]
Technische Universität Darmstadt - Technical University of Darmstadt [Darmstadt]
NASA Glenn Research Center
DMPE, ONERA, Université de Toulouse [Toulouse]
- Publié dans International Journal of Impact Engineering le 31/10/2020
Résumé : The present work deals with ice particle fragmentation resulting from impact on a solid wall. First, a semi-empirical model to predict the size of the largest reemited fragment is presented. It is based on the energy-horizon theory of fragmentation developed by Grady (1988) in combination with a strain rate scaling based on the indentation radius formed upon impact. Model predictions are in good agreement with experimental data from six different sources. In addition, an empirical fit to the ice fragment volume distribution is sought. Different candidate fits, namely power law, Weibull and lognormal are proposed and evaluated both qualitatively and quantitatively. The fragment volume distributions appear to exhibit different trends for impact conditions representative of ice crystals and hailstones. For this reason, a less accurate yet more robust power law fit is proposed to model the available fragment volume distribution data.
Fichiers liés :
DMPE22082_postprint.pdf
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Non-V600E/K BRAF Mutations in Metastatic Melanoma: Molecular Description, Frequency, and Effectiveness of Targeted Therapy in a Large National Cohort
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Manon GirodStéphane DalleLaurent MortierSophie DalacMarie-Thèrèse LecciaCaroline DutriauxHenri MontaudiéJulie de QuatrebarbesThierry LesimpleFlorence Brunet-PossentiPhilippe SaiagEve MaubecDelphine LegoupilPierre-Emmanuel StoebnerJean Philippe ArnaultWendy LefevreCeleste LebbéOlivier Dereure
Fiche détaillée
Non-V600E/K BRAF Mutations in Metastatic Melanoma: Molecular Description, Frequency, and Effectiveness of Targeted Therapy in a Large National Cohort
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Manon GirodStéphane DalleLaurent MortierSophie DalacMarie-Thèrèse LecciaCaroline DutriauxHenri MontaudiéJulie de QuatrebarbesThierry LesimpleFlorence Brunet-PossentiPhilippe SaiagEve MaubecDelphine LegoupilPierre-Emmanuel StoebnerJean Philippe ArnaultWendy LefevreCeleste LebbéOlivier Dereure
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Organismes :
Centre Hospitalier Régional Universitaire [Montpellier]
Centre de Recherche en Cancérologie de Lyon
Hôpital Claude Huriez [Lille]
Hôpital du Bocage
Hôpital la Tronche
Service de dermatologie [Bordeaux]
Service de Dermatologie [Nice]
Centre méditerranéen de médecine moléculaire
Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois]
CRLCC Eugène Marquis
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Hôpital Ambroise Paré [AP-HP]
Université de Versailles Saint-Quentin-en-Yvelines
Hôpital Avicenne [AP-HP]
Centre Hospitalier Régional Universitaire de Brest
Hôpital Universitaire Carémeau [Nîmes]
CHU Amiens-Picardie
Service de Dermatologie [AP-HP Hôpital Saint-Louis]
Service de Dermatologie [AP-HP Hôpital Saint-Louis]
Centre Hospitalier Régional Universitaire [Montpellier]
Pathogenesis and Control of Chronic and Emerging Infections
- Publié dans JCO precision oncology le 21/06/2020
Résumé : Purpose: Mitogen-activating protein kinase inhibitors (MAPKis) are largely used in V600E/K BRAF–mutated metastatic melanomas, but data regarding effectiveness of targeted therapy in patients with rare BRAF mutations and molecular description of these infrequent mutations are scarce. Patients and methods: A multicenter study was conducted on patients with metastatic melanoma harboring a well-identified mutation of BRAF and enrolled from March 2013 to June 2021 in the French nationwide prospective cohort MelBase. The molecular BRAF mutation pattern, response to MAPKis when applicable, and survival data were analyzed. Results: Of 856 selected patients, 51 (6%) harbored a non-V600E/K BRAF mutation involving codons V600 (24 of 51, 47%; V600G 27.4%, V600R 15.6%), K601 (6 of 51, 11.7%), and L597 (4 of 51, 7.8%). An objective response to MAPKis either BRAF inhibitor (BRAFi) alone or combined with MEK inhibitor was achieved in 56% (353 of 631) of V600E/K, 58% (11 of 19) of non-E/K V600, and 22% (2 of 9) of non-V600 BRAF-mutated patients, with a median progression-free survival of 7.7, 7.8, and 2.8 months, respectively. Overall, objective response rate was higher with BRAFi + MEK inhibitor combination than with BRAFi in monotherapy for each subset. Conclusion: Rare BRAF mutations are not anecdotal in the metastatic melanoma population. Although data interpretation must remain careful owing to the limited size of some subsets of patients, non-E/K V600 BRAF mutations seem to confer a high sensitivity to targeted therapy, whereas MAPKis seem less effective in patients with non-V600 BRAF mutations. However, this strategy may be used as an alternative option in the case of immunotherapy failure in the latter population.
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Characterization of lung cancers in patients with BRCA germline variants: A multicenter series
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Mateo Sanchis-BorjaVincent FalletElisabeth FabreMarie WislezStéphane CulineGérard ZalcmanJean-Philippe SpanoNathalie Chabbert-BuffetFlorence CouletPatrick R BenusiglioJacques Cadranel
Fiche détaillée
Characterization of lung cancers in patients with BRCA germline variants: A multicenter series
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Mateo Sanchis-BorjaVincent FalletElisabeth FabreMarie WislezStéphane CulineGérard ZalcmanJean-Philippe SpanoNathalie Chabbert-BuffetFlorence CouletPatrick R BenusiglioJacques Cadranel
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Organismes :
Service d'oncologie médicale [CHU HEGP]
Service de pneumologie [CHU Cochin]
Service d’oncologie thoracique et essais précoces [CHU Bichat]
Epidémiologie, Systèmes d'Information, Modélisation
- Publié dans Lung Cancer le 27/10/2020
Résumé : Introduction: BRCA1 and BRCA2 (BReast CAncer susceptibility genes) are two tumor-suppressor genes associated with the hereditary breast and ovarian cancer susceptibility syndrome. Recent studies also suggest an increased lung adenocarcinoma risk in carriers. Methods: We conducted a multi-center retrospective study in 18 different French pulmonology and/or oncology departments on medico-administrative and clinical data prospectively collected in the Clinical Data Warehouse (CDW) of Greater Paris University Hospitals (Assistance Publique-Hôpitaux de Paris, AP-HP). Clinical characteristics and outcomes of patients with LC and a previously known BRCA1/2gl variant were retrospectively evaluated. Results: 17 patients with LC and known BRCA1/2gl variant were included. Patients were most women, former smokers with localized disease and BRCA2 variants. All LC were adenocarcinoma. For patients with medical history of cancer, median time from the first cancer in the BRCA spectrum and the LC occurrence was 20 years. Median disease-free survival (DFS) and overall survival (OS) in localized tumor (Stage I and II) was not reached and 78.6 months, respectively. In advanced cancer (Stade III and IV) median progression free survival was 9.7 months and median OS was 17.8 months. Univariate OS and DFS/PFS analyses by BRCA status did not find significant differences. Conclusion: Results seem to show particular LC features in carriers of BRCA2 variants: adenocarcinoma subtype, woman, former or non-smoker.
Fichiers liés :
Characterization of lung cancers in patients with BRCA germline variants A multicenter series..pdf
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A 21L/BA.2-21K/BA.1 “MixOmicron” SARS-CoV-2 hybrid undetected by qPCR that screen for variant in routine diagnosis
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Philippe ColsonJeremy DelerceElise Marion-ParisJean-Christophe LagierAnthony LevasseurPierre-Edouard FournierBernard La ScolaDidier Raoult
Fiche détaillée
A 21L/BA.2-21K/BA.1 “MixOmicron” SARS-CoV-2 hybrid undetected by qPCR that screen for variant in routine diagnosis
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Philippe ColsonJeremy DelerceElise Marion-ParisJean-Christophe LagierAnthony LevasseurPierre-Edouard FournierBernard La ScolaDidier Raoult
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Organismes :
Microbes Evolution Phylogénie et Infections
Vecteurs - Infections tropicales et méditerranéennes
Microbes Evolution Phylogénie et Infections
Institut Hospitalier Universitaire Méditerranée Infection
Institut Hospitalier Universitaire Méditerranée Infection
Microbes Evolution Phylogénie et Infections
Microbes Evolution Phylogénie et Infections
Institut Hospitalier Universitaire Méditerranée Infection
Institut Hospitalier Universitaire Méditerranée Infection
Vecteurs - Infections tropicales et méditerranéennes
Microbes Evolution Phylogénie et Infections
Vecteurs - Infections tropicales et méditerranéennes
Microbes Evolution Phylogénie et Infections
Institut Hospitalier Universitaire Méditerranée Infection
- Publié dans Infection, Genetics and Evolution le 27/10/2020
Fichiers liés :
main (1).pdf
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Perfusion imaging and clinical outcome in acute minor stroke with large vessel occlusion
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Pierre SenersCaroline ArquizanLouis FontaineWagih Ben HassenMirjam R HeldnerDavide StramboSimon NagelEmmanuel CarreraLaura MechtouffMargy Mccullough-HicksMahmoud H MohammadenJean-Philippe CottierHilde HenonAndreea AignatoaieNadia LaksiriJérémie PapassinLudovic LucasPierre GarnierAude TriquenotGioia MioneSteven HajduVincent CostalatArne PotreckOlivier DetanteFabrice BonnevilleYves BerthezeneSerge BracardIgor SibonNicolas BricoutClaire BoutetPasquale MordasiniPatrik MichelCatherine OppenheimJean Marc OlivotRaul G NogueiraGregory W AlbersJean- Claude BaronGeorgios Tsivgoulis
Fiche détaillée
Perfusion imaging and clinical outcome in acute minor stroke with large vessel occlusion
- Type de publi. : Article dans une revue
- Date de publi. : 01/11/2022
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Auteurs :
Pierre SenersCaroline ArquizanLouis FontaineWagih Ben HassenMirjam R HeldnerDavide StramboSimon NagelEmmanuel CarreraLaura MechtouffMargy Mccullough-HicksMahmoud H MohammadenJean-Philippe CottierHilde HenonAndreea AignatoaieNadia LaksiriJérémie PapassinLudovic LucasPierre GarnierAude TriquenotGioia MioneSteven HajduVincent CostalatArne PotreckOlivier DetanteFabrice BonnevilleYves BerthezeneSerge BracardIgor SibonNicolas BricoutClaire BoutetPasquale MordasiniPatrik MichelCatherine OppenheimJean Marc OlivotRaul G NogueiraGregory W AlbersJean- Claude BaronGeorgios Tsivgoulis
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Organismes :
Groupe hospitalier universitaire Paris psychiatrie & neurosciences [Paris]
Centre Hospitalier Sainte Anne [Paris]
Institut de psychiatrie et neurosciences de Paris
FHU NeuroVasc [Site Sainte-Anne, Paris]
Hôpital de la Fondation Ophtalmologique Adolphe de Rothschild [AP-HP]
Hôpital Gui de Chauliac [CHU Montpellier]
Centre Hospitalier Universitaire de Toulouse
Toulouse NeuroImaging Center
Groupe hospitalier universitaire Paris psychiatrie & neurosciences [Paris]
Centre Hospitalier Sainte Anne [Paris]
Institut de psychiatrie et neurosciences de Paris
FHU NeuroVasc [Site Sainte-Anne, Paris]
Universität Bern = University of Bern = Université de Berne
Université de Lausanne = University of Lausanne
Heidelberg University Hospital [Heidelberg]
Klinikum Ludwigshafen [Germany]
Hôpitaux Universitaires de Genève = University Hospital of Geneva [Genève]
Hospices Civils de Lyon
Stanford University
Emory University School of Medicine
Hôpital Bretonneau
Lille Neurosciences & Cognition - U 1172
Centre Hospitalier Régional Universitaire [CHU Lille]
Centre Hospitalier Regional d'Orléans
Neurologie, maladies neuro-musculaires [Hôpital de la Timone - APHM]
Centre Hospitalier Universitaire [CHU Grenoble]
[GIN] Grenoble Institut des Neurosciences
Centre Hospitalier Universitaire de Bordeaux
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
CHU Rouen
Centre Hospitalier Régional Universitaire de Nancy
Université de Lausanne = University of Lausanne
Hôpital Gui de Chauliac [CHU Montpellier]
Heidelberg University Hospital [Heidelberg]
Centre Hospitalier Universitaire [CHU Grenoble]
[GIN] Grenoble Institut des Neurosciences
Centre Hospitalier Universitaire de Toulouse
Université Toulouse III - Paul Sabatier
Hospices Civils de Lyon
Centre Hospitalier Régional Universitaire de Nancy
Centre Hospitalier Universitaire [CHU Grenoble]
[GIN] Grenoble Institut des Neurosciences
Centre Hospitalier Régional Universitaire [CHU Lille]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
Universität Bern = University of Bern = Université de Berne
Université de Lausanne = University of Lausanne
Groupe hospitalier universitaire Paris psychiatrie & neurosciences [Paris]
Centre Hospitalier Sainte Anne [Paris]
Institut de psychiatrie et neurosciences de Paris
FHU NeuroVasc [Site Sainte-Anne, Paris]
Centre Hospitalier Universitaire de Toulouse
Toulouse NeuroImaging Center
Emory University School of Medicine
Stanford University
Groupe hospitalier universitaire Paris psychiatrie & neurosciences [Paris]
Centre Hospitalier Sainte Anne [Paris]
Institut de psychiatrie et neurosciences de Paris
FHU NeuroVasc [Site Sainte-Anne, Paris]
Groupe hospitalier universitaire Paris psychiatrie & neurosciences [Paris]
Centre Hospitalier Sainte Anne [Paris]
Institut de psychiatrie et neurosciences de Paris
FHU NeuroVasc [Site Sainte-Anne, Paris]
- Publié dans Stroke le 31/10/2020
Résumé : Background: Whether bridging therapy (intravenous thrombolysis [IVT] followed by mechanical thrombectomy) is superior to IVT alone in minor stroke with large vessel occlusion is unknown. Perfusion imaging may identify subsets of large vessel occlusion-related minor stroke patients with distinct response to bridging therapy. Methods: We conducted a multicenter international observational study of consecutive IVT-treated patients with minor stroke (National Institutes of Health Stroke Scale score ≤5) who had an anterior circulation large vessel occlusion and perfusion imaging performed before IVT, with a subset undergoing immediate thrombectomy. Propensity score with inverse probability of treatment weighting was used to account for baseline between-groups differences. The primary outcome was 3-month modified Rankin Scale score 0 to 1. We searched for an interaction between treatment group and mismatch volume (critical hypoperfusion-core volume). Results: Overall, 569 patients were included (172 and 397 in the bridging therapy and IVT groups, respectively). After propensity-score weighting, the distribution of baseline variables was similar across the 2 groups. In the entire population, bridging was associated with lower odds of achieving modified Rankin Scale score 0 to 1: odds ratio, 0.73 [95% CI, 0.55-0.96]; P=0.03. However, mismatch volume modified the effect of bridging on clinical outcome (Pinteraction=0.04 for continuous mismatch volume); bridging was associated with worse outcome in patients with, but not in those without, mismatch volume <40 mL (odds ratio, [95% CI] for modified Rankin Scale score 0-1: 0.48 [0.33-0.71] versus 1.14 [0.76-1.71], respectively). Bridging was associated with higher incidence of symptomatic intracranial hemorrhage in the entire population, but this effect was present in the small mismatch subset only (Pinteraction=0.002). Conclusions: In our population of large vessel occlusion-related minor stroke patients, bridging therapy was associated with lower rates of good outcome as compared with IVT alone. However, mismatch volume was a strong modifier of the effect of bridging therapy over IVT alone, notably with worse outcome with bridging therapy in patients with mismatch volume ≤40 mL. Randomized trials should consider adding perfusion imaging for patient selection.
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Manuscrit_MS-perf_Final.pdf
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