Philippe JEAN-PIERRE

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• Type de publi. : Article dans une revue
• Date de publi. : 01/02/2022
• Auteurs : John B WhitfieldTae-Hwi Schwantes-AnRebecca DarlayGuruprasad P AithalStephen R AtkinsonRamon BatallerGreg BotwinNaga P ChalasaniHeather J CordellAnn K DalyChristopher P DayFlorian EyerTatiana ForoudDermot GleesonDavid GoldmanPaul S HaberJean-Marc JacquetTiebing LiangSuthat LiangpunsakulSteven MassonPhilippe MathurinRomain MoirandAndrew McquillinChristophe MorenoMarsha y MorganSebastian MuellerBeat MüllhauptLaura E NagyPierre NahonBertrand NalpasSylvie NaveauPascal PerneyMunir PirmohamedHelmut K SeitzMichael SoykaFelix StickelAndrew ThompsonMark R ThurszEric TrépoTimothy R MorganDevanshi Seth
• Organismes : QIMR Berghofer Medical Research Institute Indiana University School of Medicine Newcastle University [Newcastle] University of Nottingham, UK Imperial College London University of Pittsburgh Medical Center [Pittsburgh, PA, États-Unis] California State University [Long Beach] Indiana University - Purdue University Indianapolis Newcastle University [Newcastle] Newcastle University [Newcastle] Newcastle University [Newcastle] Technische Universität Munchen = Technical University Munich = Université Technique de Munich Indiana University School of Medicine National Institute on Alcohol Abuse and Alcoholism The University of Sydney Hôpital Universitaire Carémeau [Nîmes] Indiana University - Purdue University Indianapolis Indiana University System Newcastle University [Newcastle] Hôpital Claude Huriez [Lille] Institute for Translational Research in Inflammation - U 1286 Nutrition, Métabolismes et Cancer University College London [UCL] Université libre de Bruxelles = Free University of Brussels University College London [UCL] University of Heidelberg, Medical Faculty University hospital of Zurich [Zurich] Lerner Research Institute [Cleveland, OH, USA] Génomique Fonctionnelle des Tumeurs Solides Hôpital Universitaire Carémeau [Nîmes] AP-HP - Hôpital Antoine Béclère [Clamart] Centre de recherche en épidémiologie et santé des populations Hôpital Universitaire Carémeau [Nîmes] University of Liverpool University of Heidelberg, Medical Faculty University-Hospital Munich-Großhadern [München] University hospital of Zurich [Zurich] University of Liverpool Imperial College London Université libre de Bruxelles = Free University of Brussels University of California The University of Sydney
• Publié dans Journal of Hepatology le 23/10/2020

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Résumé : Background & aims - Only a minority of excess alcohol drinkers develop cirrhosis. We developed and evaluated risk stratification scores to identify those at highest risk. Methods - Three cohorts (GenomALC-1: n = 1,690, GenomALC-2: n = 3,037, UK Biobank: relevant n = 6,898) with a history of heavy alcohol consumption (≥80 g/day (men), ≥50 g/day (women), for ≥10 years) were included. Cases were participants with alcohol-related cirrhosis. Controls had a history of similar alcohol consumption but no evidence of liver disease. Risk scores were computed from up to 8 genetic loci identified previously as associated with alcohol-related cirrhosis and 3 clinical risk factors. Score performance for the stratification of alcohol-related cirrhosis risk was assessed and compared across the alcohol-related liver disease spectrum, including hepatocellular carcinoma (HCC). Results - A combination of 3 single nucleotide polymorphisms (SNPs) (PNPLA3:rs738409, SUGP1-TM6SF2:rs10401969, HSD17B13:rs6834314) and diabetes status best discriminated cirrhosis risk. The odds ratios (ORs) and (95% CIs) between the lowest (Q1) and highest (Q2) score quintiles of the 3-SNP score, based on independent allelic effect size estimates, were 5.99 (4.18-8.60) (GenomALC-1), 2.81 (2.03-3.89) (GenomALC-2), and 3.10 (2.32-4.14) (UK Biobank). Patients with diabetes and high risk scores had ORs of 14.7 (7.69-28.1) (GenomALC-1) and 17.1 (11.3-25.7) (UK Biobank) compared to those without diabetes and with low risk scores. Patients with cirrhosis and HCC had significantly higher mean risk scores than patients with cirrhosis alone (0.76 ± 0.06 vs. 0.61 ± 0.02, p = 0.007). Score performance was not significantly enhanced by information on additional genetic risk variants, body mass index or coffee consumption. Conclusions - A risk score based on 3 genetic risk variants and diabetes status enables the stratification of heavy drinkers based on their risk of cirrhosis, allowing for the provision of earlier preventative interventions. Lay summary - Excessive chronic drinking leads to cirrhosis in some people, but so far there is no way to identify those at high risk of developing this debilitating disease. We developed a genetic risk score that can identify patients at high risk. The risk of cirrhosis is increased >10-fold with just two risk factors - diabetes and a high genetic risk score. Risk assessment using this test could enable the early and personalised management of this disease in high-risk patients.

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Fichiers liés : Whitfield et al-2021-A genetic risk score and diabetes predict development of alcohol-related.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/02/2022
• Auteurs : Jean-Pierre GangneuxEric DannaouiArnaud FekkarCharles-Edouard LuytFrançoise BotterelNicolas de ProstJean-Marc TadiéFlorian ReizineSandrine HouzéJean-François TimsitXavier IriartBéatrice Riu-PoulencBoualem SendidSaad NseirFlorence PersatFlorent WalletPatrice Le PapeEmmanuel CanetAna NovaraMelek ManaiEstelle CateauArnaud W. ThilleSophie BrunYves CohenAlexandre AlanioBruno MégarbaneMuriel CornetNicolas TerziLionel LamhautEstelle SabourinGuillaume DesoubeauxStephan EhrmannC. HennequinGuillaume VoiriotGilles NevezCécile AubronFerhat MezianiMarion BlaizeJulien MayauxAntoine MonselFrédérique BoquelFlorence Robert-GangneuxYves Le TulzoPhilippe SeguinHélène GueganBrice AutierMatthieu LesouhaitierRomain PelletierSorya BelazChristine BonnalAntoine BerryJordan LeroyNadine FrançoisJean-Christophe RichardSylvie PaulusLaurent ArgaudDamien DupontJean MenottiFlorent MorioMarie SouliéCarole SchwebelCécile GarnaudJuliette GuitardSolène Le GalDorothée QuinioJeff MorcetBruno LaviolleJean-Ralph ZaharMarie-Elizabeth Bougnoux
• Organismes : Centre Hospitalier Universitaire [Rennes] Hôpital Européen Georges Pompidou [APHP] CHU Pitié-Salpêtrière [AP-HP] CHU Pitié-Salpêtrière [AP-HP] CHU Henri Mondor [Créteil] CHU Henri Mondor [Créteil] Centre Hospitalier Universitaire [Rennes] Centre Hospitalier Universitaire [Rennes] AP-HP - Hôpital Bichat - Claude Bernard [Paris] AP-HP - Hôpital Bichat - Claude Bernard [Paris] Centre Hospitalier Universitaire de Toulouse Centre Hospitalier Universitaire de Toulouse Centre Hospitalier Régional Universitaire [CHU Lille] Centre Hospitalier Régional Universitaire [CHU Lille] Hospices Civils de Lyon Hospices Civils de Lyon Research on Healthcare Performance Cibles et Médicaments des Infections et de l'Immunité - UR 1155 Cibles et Médicaments des Infections et de l'Immunité - UR 1155 Hôpital Européen Georges Pompidou [APHP] Hôpital Européen Georges Pompidou [APHP] Centre hospitalier universitaire de Poitiers = Poitiers University Hospital Centre hospitalier universitaire de Poitiers = Poitiers University Hospital Hôpital Avicenne [AP-HP] Hôpital Avicenne [AP-HP] Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal Centre Hospitalier Universitaire [CHU Grenoble] Centre Hospitalier Universitaire [CHU Grenoble] Hôpital Necker - Enfants Malades [AP-HP] Hôpital Necker - Enfants Malades [AP-HP] CHU Trousseau [Tours] Centre d’Etude des Pathologies Respiratoires [Tours] CHU Trousseau [Tours] CHU Saint-Antoine [AP-HP] CHU Saint-Antoine [AP-HP] Centre Hospitalier Régional Universitaire de Brest SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques Infections Respiratoires Fongiques Laboratoire de Parasitologie et Mycologiede [CHRU Brest] Centre Hospitalier Régional Universitaire de Brest Centre Hospitalier Universitaire [Strasbourg] CHU Pitié-Salpêtrière [AP-HP] CHU Pitié-Salpêtrière [AP-HP] CHU Pitié-Salpêtrière [AP-HP] CHU Henri Mondor [Créteil] Centre Hospitalier Universitaire [Rennes] Centre Hospitalier Universitaire [Rennes] Centre Hospitalier Universitaire [Rennes] Centre Hospitalier Universitaire [Rennes] Centre Hospitalier Universitaire [Rennes] Centre Hospitalier Universitaire [Rennes] Centre Hospitalier Universitaire [Rennes] Centre Hospitalier Universitaire [Rennes] AP-HP - Hôpital Bichat - Claude Bernard [Paris] Centre Hospitalier Universitaire de Toulouse Centre Hospitalier Régional Universitaire [CHU Lille] Centre Hospitalier Régional Universitaire [CHU Lille] Hospices Civils de Lyon Hospices Civils de Lyon Hospices Civils de Lyon Hospices Civils de Lyon Hospices Civils de Lyon Cibles et Médicaments des Infections et de l'Immunité - UR 1155 Hôpital Avicenne [AP-HP] Centre Hospitalier Universitaire [CHU Grenoble] Centre Hospitalier Universitaire [CHU Grenoble] CHU Saint-Antoine [AP-HP] Centre Hospitalier Universitaire [Strasbourg] SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques Infections Respiratoires Fongiques Laboratoire de Parasitologie et Mycologiede [CHRU Brest] SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques Infections Respiratoires Fongiques Laboratoire de Parasitologie et Mycologiede [CHRU Brest] Centre Hospitalier Universitaire [Rennes] Centre Hospitalier Universitaire [Rennes] Hôpital Avicenne [AP-HP] Hôpital Necker - Enfants Malades [AP-HP] Institut Pasteur [Paris]
• Publié dans The Lancet Respiratory Medicine le 23/10/2020

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Résumé : BACKGROUND: Patients with severe COVID-19 have emerged as a population at high risk of invasive fungal infections (IFIs). However, to our knowledge, the prevalence of IFIs has not yet been assessed in large populations of mechanically ventilated patients. We aimed to identify the prevalence, risk factors, and mortality associated with IFIs in mechanically ventilated patients with COVID-19 under intensive care. METHODS: We performed a national, multicentre, observational cohort study in 18 French intensive care units (ICUs). We retrospectively and prospectively enrolled adult patients (aged ≥18 years) with RT-PCR-confirmed SARS-CoV-2 infection and requiring mechanical ventilation for acute respiratory distress syndrome, with all demographic and clinical and biological follow-up data anonymised and collected from electronic case report forms. Patients were systematically screened for respiratory fungal microorganisms once or twice a week during the period of mechanical ventilation up to ICU discharge. The primary outcome was the prevalence of IFIs in all eligible participants with a minimum of three microbiological samples screened during ICU admission, with proven or probable (pr/pb) COVID-19-associated pulmonary aspergillosis (CAPA) classified according to the recent ECMM/ISHAM definitions. Secondary outcomes were risk factors of pr/pb CAPA, ICU mortality between the pr/pb CAPA and non-pr/pb CAPA groups, and associations of pr/pb CAPA and related variables with ICU mortality, identified by regression models. The MYCOVID study is registered with ClinicalTrials.gov, NCT04368221. FINDINGS: Between Feb 29 and July 9, 2020, we enrolled 565 mechanically ventilated patients with COVID-19. 509 patients with at least three screening samples were analysed (mean age 59·4 years [SD 12·5], 400 [79%] men). 128 (25%) patients had 138 episodes of pr/pb or possible IFIs. 76 (15%) patients fulfilled the criteria for pr/pb CAPA. According to multivariate analysis, age older than 62 years (odds ratio [OR] 2·34 [95% CI 1·39-3·92], p=0·0013), treatment with dexamethasone and anti-IL-6 (OR 2·71 [1·12-6·56], p=0·027), and long duration of mechanical ventilation (\textgreater14 days; OR 2·16 [1·14-4·09], p=0·019) were independently associated with pr/pb CAPA. 38 (7%) patients had one or more other pr/pb IFIs: 32 (6%) had candidaemia, six (1%) had invasive mucormycosis, and one (\textless1%) had invasive fusariosis. Multivariate analysis of associations with death, adjusted for candidaemia, for the 509 patients identified three significant factors: age older than 62 years (hazard ratio [HR] 1·71 [95% CI 1·26-2·32], p=0·0005), solid organ transplantation (HR 2·46 [1·53-3·95], p=0·0002), and pr/pb CAPA (HR 1·45 [95% CI 1·03-2·03], p=0·033). At time of ICU discharge, survival curves showed that overall ICU mortality was significantly higher in patients with pr/pb CAPA than in those without, at 61·8% (95% CI 50·0-72·8) versus 32·1% (27·7-36·7; p\textless0·0001). INTERPRETATION: This study shows the high prevalence of invasive pulmonary aspergillosis and candidaemia and high mortality associated with pr/pb CAPA in mechanically ventilated patients with COVID-19. These findings highlight the need for active surveillance of fungal pathogens in patients with severe COVID-19. FUNDING: Pfizer.

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Fichiers liés : MYCOVID_20210323.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/02/2022
• Auteurs : Luigi PisaniAnna Geke AlgeraAry Serpa NetoLuciano AzevedoTài PhamFrederique PaulusMarcelo Gama de AbreuPaolo PelosiArjen DondorpGiacomo BellaniJohn LaffeyMarcus SchultzAmadeu MartinezLivia LealAntonio Jorge PereiraMarcelo de Oliveira MaiaJosè Aires NetoClaudio PirasEliana Bernadete CaserCora Lavigne MoreiraPablo Braga GusmanDyanne Moysés DalcomuneAlexandre Guilherme Ribeiro de CarvalhoLouise Aline Romão GondimLívia Mariane Castelo Branco ReisDaniel da Cunha RibeiroLeonardo de Assis SimõesRafaela Siqueira CamposJosé Carlos Fernandez Versiani dos AnjosFrederico Bruzzi CarvalhoRossine Ambrosio AlvesLilian Batista NunesÁlvaro Réa-NetoMirella Cristine de OliveiraLuana TannousBrenno Cardoso GomesFernando Borges RodriguezPriscila AbelhaMarcelo LugarinhoAndre JapiassuHélder Konrad de MeloElton Afonso LopesPedro VaraschinVicente Cés de Souza DantasMarcos Freitas KnibelMicheli PontePedro Mendes de Azambuja RodriguesRubens Carmo Costa FilhoFelipe SaddyThéia Forny Wanderley CastellõesSuzana Alves SilvaLuiz Antonio Gomes OsorioDora MannarinoRodolfo EspinozaCassia RighyMarcio SoaresJorge SalluhLilian TanakaDaniel AragãoMaria Eduarda TavaresMaura Goncalves Pereira KehdiValéria Maria Campos RezendeRoberto Carlos Cruz CarbonellCassiano TeixeiraRoselaine Pinheiro de OliveiraJuçara Gasparetto MaccariPriscylla Souza CastroPaula BertoPatricia SchwarzAndré Peretti TorellyThiago LisboaEdison MoraesFelipe Dal-PizzolCristiane Tomasi DamianiCristiane RitterJuliana Carvalho FerreiraRamon Teixeira CostaPedro CarusoCristina Prata AmendolaAmanda Maria R R de OliveiraUlysses SilvaLuciana Coelho SanchesRosana AlmeidaLuciano Cesar AzevedoMarcelo ParkGuilherme SchettinoMurillo Santucci AssunçãoEliezer SilvaCarlos Eduardo BarbozaAntonio Paulo Nassar JuniorPaulo Fernando G M Marzocchi TiernoLuis Marcelo MalbouissonLucas OliveiraDavi CristovaoManoel Leitão NetoÊnio RegoFernanda Eugênia FernandesMarcelo Luz Pereira RomanoAlexandre Biasi CavalcantiDalton de Souza BarrosÉrica Aranha SuzumuraKarla Loureiro MeiraGustavo Affonso de OliveiraPaula Menezes LucianoEvelin Drociunas PachecoBruno Franco MazzaFlavia Ribeiro MachadoElaine FerreiraRonaldo Batista dos SantosAlexandra Siqueira ColomboAntonio Carlos NogueiraJuliana Baroni FernandesRaquel Siqueira NóbregaBarbara Do Cs MartinsFrancisco SorianoRafaela Deczka MorschAndre Luiz Baptiston NunesJuliano Pinheiro de AlmeidaLudhmila HajjarSílvia MoulinFábio Poianas GianniniAndre Luiz Baptiston NunesFernando RiosFrank van HarenT SottiauxFredy LoraLuciano AzevedoP DepuydtEddy FanGuillermo BugedoHaibo QiuMarcos GonzalezJuan SileskyVladimir CernyJonas NielsenManuel JibajaTài PhamHermann WriggeDimitrios MatamisJorge Luis RaneroS HashemianPravin AminKevin ClarksonGiacomo BellaniKiyoyasu KurahashiAsisclo VillagomezAmine Ali ZeggwaghLeo HeunksJon Henrik LaakeJose Emmanuel PaloAntero Do Vale FernandesDorel SandescYaasen ArabiVesna BumbasierevicJose LorenteAnders LarssonLise PiquilloudFekri AbrougDaniel McauleyLia McnameeJavier HurtadoEd BajwaGabriel DémpaireGuy FrancoisHektor SulaLordian NunciAlma CaniAlan ZazuChristian DelleraCarolina InsaurraldeRisso AlejandroJulio DaldinMauricio VinzioRuben FernandezLuis CardonnetLisandro BettiniMariano Carboni BissoEmilio OsmanMariano SettenPablo LovazzanoJavier AlvarezVeronica VillarCesar MilsteinNorberto PozoNicolas GrubissichGustavo PlotnikowDaniela VasquezSantiago IlutovichNorberto TiribelliAriel ChenaCarlos PellegriniMaría SaenzElisa EstenssoroMatias BrizuelaHernan GianinettoPablo GomezValeria CerratoMarco BezziSilvina BorelloFlavia LoiaconoAdriana FernandezSerena KnowlesClaire ReynoldsDeborah InskipJennene MillerJing KongChristina WhiteheadShailesh BihariAylin SevenAmanda KrstevskiHelen RodgersRebecca MillarToni MckennaIrene BaileyGabrielle HanlonAnders AnemanJoan LynchRaman AzadJohn NealPaul WoodsBrigit RobertsMark KolHelen WongKatharina RissThomas StaudingerXavier WitteboleCaroline BerghePierre BulpaAlain DiveRik VerstraeteHerve LebbinckPieter DepuydtJoris VermassenPhilippe MeerssemanHelga CeunenJonas RosaDaniel BeraldoClaudio PirasAdenilton AmpinelliAntonio Nassar JrSergio MatalounMarcelo MoockMarlus ThompsonClaudio GonçalvesAna Carolina P AntônioAline AscoliRodrigo BiondiDanielle FonteneleDanielle NobregaVanessa SalesSuresh ShindheDk Maizatul Aiman B Pg Hj IsmailJohn LaffeyFrancois BeloncleKyle DaviesRob CironeVenika ManoharanMehvish IsmailEwan GoligherMandeep JassalErin NishikawaAreej JaveedGerard CurleyNuttapol RittayamaiMatteo ParottoNiall FergusonSangeeta MehtaJenny KnollAntoine PronovostSergio CanestriniAlejandro BruhnPatricio GarciaFelipe AliagaPamela FaríasJacob YumhaClaudia OrtizJavier SalasAlejandro SaezLuis VegaEduardo LabarcaFelipe MartinezNicolás CarreñoPilar LoraHaitao LiuHaibo QiuLing LiuRui TangXiaoming LuoYouzhong AnHuiying ZhaoYan GaoZhe ZhaiZheng YeWei WangWenwen LiQingdong LiRuiqiang ZhengWenkui YuJuanhong ShenXinyu LiTao YuWeihua LuYa WuXiao HuangZhenyang HeYuanhua LuHui HanFan ZhangRenhua SunHua WangShu QinBao ZhuJun ZhaoJian LiuBin LiJing LiuFa ZhouQiong LiXing ZhangZhou Li-XinQiang Xin-HuaLiangyan JiangYuan GaoXian ZhaoYuan LiXiao LiChunting WangQingchun YaoRongguo YuKai ChenHuanzhang ShaoBingyu QinQing HuangWei ZhuAi HangMa HuaYimin LiYonghao XuYu DiLong LingTie QinShou WangJunping QinYi HanSuming ZhouMonica VargasJuan Silesky JimenezManuel González RojasJaime Solis-QuesadaChristian Ramirez-AlfaroJan MácaPeter SklienkaJakob GjedstedAage ChristiansenJonas NielsenBoris VillamaguaMiguel LlanoPhilippe BurtinGautier BuzancaisPascal BeuretNicolas PelletierSatar MortazaAlain MercatJonathan ChellySébastien JochmansNicolas TerziCédric DaubinGuillaume CarteauxNicolas de ProstJean-Daniel ChicheFabrice DaviaudTài PhamMuriel FartoukhGuillaume BarberetJerome BiehlerJean DellamonicaDenis DoyenJean-Michel ArnalAnais BriquetSami HraiechLaurent PapazianArnaud FollinDamien RouxJonathan MessikaEvangelos KalaitzisLaurence DangersAlain CombesSiu-Ming AuGaetan BéduneauDorothée CarpentierElie ZogheibHervé 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NiimiTakeshi UedaYozo KashiwaAkinori UchiyamaOlegs SabelnikovsPeteris OssYoussef HaddadKong LiewSilvio Ñamendys-SilvaYves Jarquin-BadiolaLuis Sanchez-HurtadoSaira Gomez-FloresMaria MarinAsisclo VillagomezJordana LemusJonathan FierroMavy Ramirez CervantesFrancisco Javier Flores MejiaDaniel GonzalezDulce DectorClaudia EstrellaJorge Sanchez-MedinaAlvaro Ramirez-GutierrezFernando GeorgeJanet AguirreJuan BuensusesoManuel PoblanoTarek DendaneAmine Ali ZeggwaghHicham BalkhiMina ElkhayariNacer SamkaouiHanane EzzouineAbdellatif BenslamaMourad AmorWajdi MaazouziNedim CimicOliver BeckMonique BrunsJeroen SchoutenMyra RiniaMonique RaaijmakersLeo HeunksHellen van WezelSerge HeinesMarc BuiseFabienne SimonisMarcus SchultzJennifer GoodsonTroy RowneLeanlove NavarraAnna HuntRobyn HutchisonMathew BaileyLynette NewbyColin McarthurMichael KalkoffAlex McleodJonathan CasementDanielle HackingFinn AndersenMerete DolvaJon LaakeAndreas Barratt-DueKim Andre L NoremarkEldar SøreideBrit Å SjøbøAnne GuttormsenHector 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del Carmen LorenteCecilia HermosaFederico GordoMiryam Prieto-GonzálezJuan López-MessaManuel PerezCesar PereRaquel Montoiro AllueFerran Roche-CampoMarcos Ibañez-SantacruzSusana TempranoMaria PintadoRaul de PabloPilar Ricart Aroa GómezSilvia Rodriguez RuizSilvia Iglesias MolesMª Teresa JuradoAlfons ArizmendiEnrique PiacentiniNieves FrancoTeresa HonrubiaMeisy Perez ChengElena Perez LosadaJavier BlancoLuis YusteCecilia Carbayo-GorrizFrancisca Cazorla-BarranqueroJavier AlonsoRosa AldaÁngela AlgabaGonzalo NavarroEnrique CereijoEsther Diaz-RodriguezDiego Pastor MarcosLaura Alvarez MonteroLuis Herrera ParaRoberto Jimenez SanchezMiguel Angel Blasco NavalpotroRicardo Diaz AbadRaquel Montiel GonzálezDácil Parrilla ToribioAlejandro CastroMaria Jose D ArtigaOscar PenuelasTomas RoserMoreno OlgaElena Gallego CurtoRocío Manzano SánchezVallverdu ImmaGarcia ElisabetLaura ClaveriasMonica MagretAna PellicerLucia RodriguezJesús Sánchez-BallesterosÁngela González-SalamancaAntonio JimenezFrancisco HuertaJuan 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PangeniMadiha HashmiSonia JosephAftab AkhtarAayesha QadeerIqbal MemonSyed Muneeb AliFarah IdreesSaima KamalSadaf HanifAtta Ur RehmanArshad TaqiTanveer HussainAhmed FarooqSaleh KhaskheliMuhammad HayatKanishka IndraratnaAbigail BeaneRashan HaniffaUpeka SamaranayakeSathiyamoorthy MathanalaganAsoka GunaratneNimangee MithraratneKaushila ThilakasiriChamila PilimatalawweY DilhaniMarie FernandoKumudini RanatungeLoranthi SamarasingheManori VaasManoj EdirisooriyaChathurani SigeraJanaki ArumoliKesharie de SilvaBimal KudavidanageVisanthi PintoLakshman DissanayakeKaweesak ChittawatanaratNapplika KongpolpromUdomsak SilachamroonPrapaporn PornsuriyasakTananchai PetnakPongsasit SinghatasViratch TangsujaritvijitSuthat RungruanghiranyaAnnop PiriyapatsomKanokkarn JuntapingKonlawij TrongtrakulPoungrat ThungtitigulPattraporn TajarernmuangSunisa ChatmongkolchartRungsun BhurayanontachaiOsaree AkaraborwornAsma NavasakulpongKarjbundid SurasitLouise ThwaitesBehzad NadjmDat Vu QuocHa Nguyen Thi ThanhKinh Nguyen VanThuy Duong BichYen Lam Minh
• Organismes : Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
• Publié dans The Lancet global health le 26/10/2020

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• Type de publi. : Article dans une revue
• Date de publi. : 01/02/2022
• Auteurs : Sophie CousinCoralie CantarelJean-Philippe GueganThibault MazardCarlos Gomez-RocaJean-Philippe MetgesCarine BelleraAntoine AdenisIphigenie KorakisPierre-Guillaume PoureauKevin BourcierMaud ToulmondeMichele KindChristophe ReyCeline AuzanneauAlban BessedeIsabelle SoubeyranAntoine Italiano
• Organismes : Bordeaux population health
• Publié dans European Journal of Cancer le 22/10/2020

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Résumé : BACKGROUND: Regorafenib has shown substantial clinical activity in patients with advanced biliary tract cancers (BTCs). Preclinical data suggested that this drug modulates antitumour immunity and is synergistic with immune checkpoint inhibition. PATIENTS AND METHODS: This is a single-arm, multicentric phase II trial. Regorafenib was given 3 weeks/4, 160 mg quaque die (once a day) (QD); avelumab 10 mg/kg IV was given every two weeks, beginning at C1D15 until progression or unacceptable toxicity. The primary end-point was the confirmed objective response rate under treatment, as per Response Evaluation Criteria in Solid Tumours 1.1. The secondary end-points included the following: 1-year non-progression rate; progression-free survival (PFS) and overall survival; safety and biomarkers studies performed on sequential tumour samples obtained at baseline and at cycle 2 day 1. RESULTS: Thirty-four patients were enrolled in four centres. Twenty-nine patients were assessable for efficacy after central radiological review. The best response was partial response for four patients (13.8%), stable disease for 11 patients (37.9%) and progressive disease for 14 patients (48.3%). The median PFS and overall survival were 2.5 months (95% confidence interval [CI] [1.9-5.5]) and 11.9 months (95%CI [6.2-NA]) respectively. The most common grade 3 or 4 clinical adverse events related to treatment were hypertension (17.6%), fatigue (14.7%) and maculopapular rash (11.8%). High baseline levels of programmed cell death ligand 1 and of indoleamine 2, 3-dioxygénase expression were associated with improved outcomes. CONCLUSIONS: Regorafenib combined with avelumab has antitumour activity in a subset of heavily pretreated biliary tract cancer population. Further investigations are needed in patients selected based on tumour microenvironment features. CLINICAL TRIAL REGISTRATION: NCT03475953.

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Fichiers liés : S0959804921012235.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/02/2022
• Auteurs : Thomas PierreJean-Claude KrapezHelcio R.B. OrlandeChristophe RodietDylan Le MauxMickael CourtoisPhilippe Le MassonBernard Lamien
• Organismes : Institut de Recherche Dupuy de Lôme DOTA, ONERA [Salon-de-Provence] Federal University of Rio de Janeiro Institut de Thermique, Mécanique, Matériaux Institut de Recherche Dupuy de Lôme Institut de Recherche Dupuy de Lôme Institut de Recherche Dupuy de Lôme École Polytechnique de Ouagadougou
• Publié dans International Journal of Heat and Mass Transfer le 01/11/2020

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Résumé : This article presents the temperature and emissivity estimation of metals around their melting points using different techniques, which are based on deterministic (ordinary least squares) and Bayesian approaches. Linear and non-linear models are examined. The experimental data consist of radiative fluxes at six wavelengths, collected by a pyrometer. The apparatus is dedicated to the characterization of the physical properties of millimeter-sized metal samples at high temperatures, combining aerodynamic levitation and laser heating. Tests are performed on two metals: niobium with well-known temperature and steel.

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Fichiers liés : DOTA21181_vacceptee.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/02/2022
• Auteurs : Roland LandmanPierre de TruchisLambert AssoumouSidonie Lambert-niclotJonathan BelletKarine AmatBénédicte LefebvreClotilde AllavenaChristine KatlamaYazdan YazdanpanahJean-Michel MolinaVentzislava Petrov-SanchezSéverine GibowskiJean-Claude AlvarezJacques LeibowitchJacqueline CapeauSoraya FellahiMartin DuracinskyLaurence Morand-JoubertDominique CostagliolaPierre-Marie GirardIsabelle LamauryFirouzé Bani-SadrGilles ForceAmélie ChabrolFabienne CabyOlivier PateyAnne FresardAmandine Gagneux-BrunonCatherine ChirouzeClaudine DuvivierJérémie LourencoViolaine TolsmaCécile JanssenNathalie LerollePilartxo CatalanAgathe RamiLucile de PonthaudGilles PichancourtSafa NasriStéphanie LandowskiJulie BotteroFlory Mfutila KaykayGilles PialouxOlivier BouchaudSophie AbgrallCaroline GateyLaurence WeissJuliette PavieDominique Salmon-CéronDavid ZucmanJean-Daniel LelievreRomain PalichAnne SimonMarie-Caroline MeyohasJulien GrasAndré CabieMathilde PircherPhilippe MorlatMojgam HessamfarDidier NeauCharles CazenaveClaire GenetJean-François FaucherDjamila MakhloufiAndré BoibieuxSylvie Bregigeon-RonotHélène LarocheAurélie SautereauJacques ReynesAlain MakinsonFrançois RaffiOlivier Bollengier-StragierAlissa NaqviEric CuaEric RosenthalCédrick ArvieuxRodolphe BuzeleDavid ReyMarie-Laure BatardLouis BernardPierre DelobelMarie PiffautRenaud VerdonLionel PirothMathieu BlotPascale LeclercqAnne Signori-SchmuckThomas HuleuxAgnès MeybeckThierry MayPatrick MiailhesThomas PerpointAlix Greder-BelanBrigitte ElharrarMarie-Aude KhuongMarie PoupardLaurent BlumChristophe MichauThierry PrazuckPatrick PhilibertLaurence SlamaHitoto HikomboIuliana DarasteanuPierre-Marie GirardJean-Claude AlvarezDominique MathezPierre de TruchisRoland LandmanJean-Luc MeynardLaurence Morand-JoubertSidonie LambertDamien Le DuChristian PerronneLambert AssoumouDominique CostagliolaJean-Claude MelchiorMartin DuracinskiVentzislava Petrov-SanchezKarine AmatAïda BenalycherifBabacar SyllaAmbre GelleySéverine GibowskiGuillaume Le MeutRodolphe ThiebautNathan ClumeckVincent LeclercqFrancesca Ceccherini-SilbersteinLaurent DecosterIsabelle LamauryFirouzé Bani-SadrGilles ForceAmélie ChabrolFabienne CabyOlivier PateyAnne FresardAmandine Gagneux-BrunonCatherine ChirouzeClaudine DuvivierJérémie LourencoViolaine TolsmaCécile JanssenNathalie LerollePilartxo CatalanAgathe RamiLucile de PonthaudGilles PichancourtSafa NasriStéphanie LandowskiJulie BotteroFlory Mfutila KaykayGilles PialouxOlivier BouchaudSophie AbgrallCaroline GateyLaurence WeissJuliette PavieDominique Salmon-CeronDavid ZucmanJean-Daniel LelievreRomain PalichAnne SimonMarie-Caroline MeyohasJulien GrasAndré CabieMathilde PircherPhilippe MorlatMojgam HessamfarDidier NeauCharles CazenaveClaire GenetJean-François FaucherDjamila MakhloufiAndré BoibieuxSylvie Bregigeon-RonotHélène LarocheAurélie SautereauJacques ReynesAlain MakinsonFrançois RaffiOlivier Bollengier-StragierAlissa NaqviEric CuaEric RosenthalCédrick ArvieuxRodolphe BuzeleDavid ReyMarie-Laure BatardLouis BernardPierre DelobelMarie PiffautRenaud VerdonLionel PirothMathieu BlotPascale LeclercqAnne Signori-SchmuckThomas HuleuxAgnès MeybeckThierry MayPatrick MiailhesThomas PerpointAlix Greder-BelanBrigitte ElharrarMarie-Aude KhuongMarie PoupardLaurent BlumChristophe MichauThierry PrazuckPatrick PhilibertLaurence SlamaHitoto HikomboIuliana DarasteanuPierre-Marie GirardJean-Claude AlvarezDominique MathezPierre de TruchisRoland LandmanJean-Luc MeynardLaurence Morand-JoubertSidonie LambertDamien Le DuChristian PerronneLambert AssoumouDominique CostagliolaJean-Claude MelchiorMartin DuracinskiVentzislava Petrov-SanchezKarine AmatAïda BenalycherifBabacar SyllaAmbre GelleySéverine GibowskiGuillaume Le MeutRodolphe ThiebautNathan ClumeckVincent LeclercqFrancesca Ceccherini-SilbersteinLaurent Decoster
• Organismes : UFR Sciences de la santé Simone Veil UFR Sciences de la santé Simone Veil Pathogenesis and Control of Chronic and Emerging Infections Epidémiologie des Maladies Chroniques en zone tropicale
• Publié dans The Lancet HIV le 23/10/2020

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• Type de publi. : Article dans une revue
• Date de publi. : 01/02/2022
• Auteurs : Luigi PisaniAnna Geke AlgeraAry Serpa NetoLuciano AzevedoTài PhamFrederique PaulusMarcelo Gama de AbreuPaolo PelosiArjen DondorpGiacomo BellaniJohn LaffeyMarcus SchultzAmadeu MartinezLivia LealAntonio Jorge PereiraMarcelo de Oliveira MaiaJosè Aires NetoClaudio PirasEliana Bernadete CaserCora Lavigne MoreiraPablo Braga GusmanDyanne Moysés DalcomuneAlexandre Guilherme Ribeiro de CarvalhoLouise Aline Romão GondimLívia Mariane Castelo Branco ReisDaniel da Cunha RibeiroLeonardo de Assis SimõesRafaela Siqueira CamposJosé Carlos Fernandez Versiani dos AnjosFrederico Bruzzi CarvalhoRossine Ambrosio AlvesLilian Batista NunesÁlvaro Réa-NetoMirella Cristine de OliveiraLuana TannousBrenno Cardoso GomesFernando Borges RodriguezPriscila AbelhaMarcelo LugarinhoAndre JapiassuHélder Konrad de MeloElton Afonso LopesPedro VaraschinVicente Cés de Souza DantasMarcos Freitas KnibelMicheli PontePedro Mendes de Azambuja RodriguesRubens Carmo Costa FilhoFelipe SaddyThéia Forny Wanderley CastellõesSuzana Alves SilvaLuiz Antonio Gomes OsorioDora MannarinoRodolfo EspinozaCassia RighyMarcio SoaresJorge SalluhLilian TanakaDaniel AragãoMaria Eduarda TavaresMaura Goncalves Pereira KehdiValéria Maria Campos RezendeRoberto Carlos Cruz CarbonellCassiano TeixeiraRoselaine Pinheiro de OliveiraJuçara Gasparetto MaccariPriscylla Souza CastroPaula BertoPatricia SchwarzAndré Peretti TorellyThiago LisboaEdison MoraesFelipe Dal-PizzolCristiane Tomasi DamianiCristiane RitterJuliana Carvalho FerreiraRamon Teixeira CostaPedro CarusoCristina Prata AmendolaAmanda Maria R R de OliveiraUlysses SilvaLuciana Coelho SanchesRosana AlmeidaLuciano Cesar AzevedoMarcelo ParkGuilherme SchettinoMurillo Santucci AssunçãoEliezer SilvaCarlos Eduardo BarbozaAntonio Paulo Nassar JuniorPaulo Fernando G M Marzocchi TiernoLuis Marcelo MalbouissonLucas OliveiraDavi CristovaoManoel Leitão NetoÊnio RegoFernanda Eugênia FernandesMarcelo Luz Pereira RomanoAlexandre Biasi CavalcantiDalton de Souza BarrosÉrica Aranha SuzumuraKarla Loureiro MeiraGustavo Affonso de OliveiraPaula Menezes LucianoEvelin Drociunas PachecoBruno Franco MazzaFlavia Ribeiro MachadoElaine FerreiraRonaldo Batista dos SantosAlexandra Siqueira ColomboAntonio Carlos NogueiraJuliana Baroni FernandesRaquel Siqueira NóbregaBarbara Do Cs MartinsFrancisco SorianoRafaela Deczka MorschAndre Luiz Baptiston NunesJuliano Pinheiro de AlmeidaLudhmila HajjarSílvia MoulinFábio Poianas GianniniAndre Luiz Baptiston NunesFernando RiosFrank van HarenT SottiauxFredy LoraLuciano AzevedoP DepuydtEddy FanGuillermo BugedoHaibo QiuMarcos GonzalezJuan SileskyVladimir CernyJonas NielsenManuel JibajaTài PhamHermann WriggeDimitrios MatamisJorge Luis RaneroS HashemianPravin AminKevin ClarksonGiacomo BellaniKiyoyasu KurahashiAsisclo VillagomezAmine Ali ZeggwaghLeo HeunksJon Henrik LaakeJose Emmanuel PaloAntero Do Vale FernandesDorel SandescYaasen ArabiVesna BumbasierevicJose LorenteAnders LarssonLise PiquilloudFekri AbrougDaniel McauleyLia McnameeJavier 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VanThuy Duong BichYen Lam Minh
• Organismes : Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
• Publié dans The Lancet global health le 26/10/2020

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Source

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• Type de publi. : Article dans une revue
• Date de publi. : 01/02/2022
• Auteurs : Pierre DrouinAymeric StammLaurent ChevreuilVincent GraillotLaetitia BarbinPhilippe NicolasPierre-Antoine GourraudDavid-Axel LaplaudLise Bellanger
• Organismes : Laboratoire de Mathématiques Jean Leray Laboratoire de Mathématiques Jean Leray Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology Centre d'Investigation Clinique - Innovation Technologique de Lille - CIC 1403 - CIC 9301 Centre Hospitalier Universitaire de Nantes = Nantes University Hospital Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology Centre Hospitalier Universitaire de Nantes = Nantes University Hospital Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology Laboratoire de Mathématiques Jean Leray
• Publié dans Medical Case reports and Reviews le 28/02/2022

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Résumé : The walking velocity is considered as the best characterized objective measure of walking disability in MS. In this work, we present a method to extract spatial or temporal parameters that characterize gait from data collected by a wearable motion sensor. We acquired data on 30 patients diagnosed with MS with different gait impairment levels ranging from none to severe deficits. We measured their hip rotation over time with a wearable motion sensor clipped on their belt while they were instructed to walk a distance of 7.60m twice. We extracted the average duration and angular velocity of the patients’ hip during the walking test from the collected rotation time series. Simple linear regression models demonstrate a good correlation between this parameter and the walking velocity. As the device is affordable and minimally invasive, it could play a key role in the early detection of walking deficits by monitoring gait in in daily life.

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Fichiers liés : MCRR-5-175.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/02/2022
• Auteurs : Alexander EgleMaude Bouscambert-DuchampMaya HitesNathan Peiffer-SmadjaJulien PoissyDrifa BelhadiAlpha DialloMinh-Patrick LêGilles PeytavinThérèse StaubRichard GreilJérémie GuedjJose-Artur PaivaDominique CostagliolaYazdan YazdanpanahCharles BurdetFrance MentréAlexander EgleRichard GreilMichael JoannidisBernd LamprechtAntoine AltdorferLeila BelkhirVincent FraipontMaya HitesGil VerscheldenJérôme AboabFlorence AderHafid Ait-OufellaClaire AndréjakPascal AndreuLaurent ArgaudFirouzé Bani-SadrFrançois BenezitMathieu BlotElisabeth Botelho-NeversLila BouadmaOlivier BouchaudDavid BougonKevin BouillerFanny Bounes-VardonDavid BoutoilleAlexandre BoyerCédric BruelAndré CabiéEmmanuel CanetCharles CazanaveCyrille ChabartierCatherine ChirouzeRaphaël Clere-JehlJohan CourjonFlora CrockettFrançois DanionAgathe DelboveJean DellamonicaFélix DjossouClément DubostAlexandre DuvignaudOlivier EpaulardLoïc EpelboinMurielle FartoukhKarine FaureEmmanuel FaureTristan FerryCécile FickoSamy FigueiredoBenjamin GaboritRostane GaciAmandine Gagneux-BrunonSébastien GallienDenis GarotGuillaume GeriSébastien GibotFrançois GoehringerMarie GousseffDidier GrusonYves HansmannOlivier HinschbergerStéphane JaureguiberryVanessa JeanmichelSolen KernéisAntoine KimmounKada KloucheMarie LachâtreKarine LacombeFabrice LaineJ.P. LanoixOdile LaunayBruno LaviolleVincent Le MoingJérôme Le PavecYves Le TulzoPaul Le TurnierDavid LebeauxBenjamin LefevreSylvie LeroyFrançois-Xavier LescureHenry LessireBenjamin LeveauPaul LoubetAlain MakinsonDenis MalvyCharles-Hugo MarquetteGuillaume Martin-BlondelMartin MartinotJulien MayauxArmand Mekontso-DessapFerhat MezianiJean-Paul MiraJean-Michel MolinaXavier MonnetJoy MootienBruno MourvillierMarlène Murris-EspinJean-Christophe NavellouSaad NseirWalid OulehriNathan Peiffer-SmadjaThomas PerpointGilles PialouxBenoît PilmisVincent PiriouLionel PirothJulien PoissyValérie PourcherJean-Pierre QuenotFrançois RaffiJean ReignierMatthieu RevestJean-Christophe RichardBéatrice Riu-PoulencCéline RobertPierre-Alexandre RogerClaire RogerElisabeth RouveixYvon RuchNadia SaidaniNaomi SayreEric SennevilleAlbert SottoFrancois StefanCharles TacquardNicolas TerziJulien TextorisGuillaume ThieryJean-François TimsitViolaine TolsmaJean-Marie TurmelFlorent ValourFlorent WalletGuilhem WattecampsYazdan YazdanpanahYoann ZerbibMarc BernaJean ReuterThérèse StaubSandra BrazJoao-Miguel Ferreira RibeiroJosé-Artur PaivaRoberto Roncon-AlbuquerqueMaude Bouscambert-DuchampAlexandre GaymardMinh-Patrick LêBruno LinaGilles PeytavinSarah TubianaSandrine Couffin-CadièrguesHélène EsperouDrifa BelhadiCharles BurdetDominique CostagliolaAline DechanetChristelle DelmasAlpha DialloClaire FougerouJérémie GuedjFrance MentréNoémie MercierMarion NoretJuliette SaillardPriyanka Velou
• Organismes : Hospices Civils de Lyon Centre International de Recherche en Infectiologie Hospices Civils de Lyon Université libre de Bruxelles = Free University of Brussels Infection, Anti-microbiens, Modélisation, Evolution Imperial College London Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576 Infection, Anti-microbiens, Modélisation, Evolution ANRS - Maladies infectieuses émergentes Optimisation thérapeutique en Neuropsychopharmacologie Infection, Anti-microbiens, Modélisation, Evolution Centre Hospitalier de Luxembourg [Luxembourg] Paracelsus Medizinische Privatuniversität = Paracelsus Medical University Infection, Anti-microbiens, Modélisation, Evolution Universidade do Porto = University of Porto Institut Pierre Louis d'Epidémiologie et de Santé Publique Infection, Anti-microbiens, Modélisation, Evolution Infection, Anti-microbiens, Modélisation, Evolution Infection, Anti-microbiens, Modélisation, Evolution Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] Centre Hospitalier Régional Universitaire [Montpellier] Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou] Centre d'Investigation Clinique [Rennes] Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou] Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou] ARN régulateurs bactériens et médecine Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé Modeling & analysis for medical imaging and Diagnosis
• Publié dans The Lancet Infectious Diseases le 29/10/2020

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Résumé : Background: The antiviral efficacy of remdesivir against SARS-CoV-2 is still controversial. We aimed to evaluate the clinical efficacy of remdesivir plus standard of care compared with standard of care alone in patients admitted to hospital with COVID-19, with indication of oxygen or ventilator support. Methods: DisCoVeRy was a phase 3, open-label, adaptive, multicentre, randomised, controlled trial conducted in 48 sites in Europe (France, Belgium, Austria, Portugal, Luxembourg). Adult patients (aged ≥18 years) admitted to hospital with laboratory-confirmed SARS-CoV-2 infection and illness of any duration were eligible if they had clinical evidence of hypoxaemic pneumonia, or required oxygen supplementation. Exclusion criteria included elevated liver enzymes, severe chronic kidney disease, any contraindication to one of the studied treatments or their use in the 29 days before random assignment, or use of ribavirin, as well as pregnancy or breastfeeding. Participants were randomly assigned (1:1:1:1:1) to receive standard of care alone or in combination with remdesivir, lopinavir-ritonavir, lopinavir-ritonavir and interferon beta-1a, or hydroxychloroquine. Randomisation used computer-generated blocks of various sizes; it was stratified on severity of disease at inclusion and on European administrative region. Remdesivir was administered as 200 mg intravenous infusion on day 1, followed by once daily, 1-h infusions of 100 mg up to 9 days, for a total duration of 10 days. It could be stopped after 5 days if the participant was discharged. The primary outcome was the clinical status at day 15 measured by the WHO seven-point ordinal scale, assessed in the intention-to-treat population. Safety was assessed in the modified intention-to-treat population and was one of the secondary outcomes. This trial is registered with the European Clinical Trials Database, EudraCT2020-000936-23, and ClinicalTrials.gov, NCT04315948. Findings: Between March 22, 2020, and Jan 21, 2021, 857 participants were enrolled and randomly assigned to remdesivir plus standard of care (n=429) or standard of care only (n=428). 15 participants were excluded from analysis in the remdesivir group, and ten in the control group. At day 15, the distribution of the WHO ordinal scale was: (1) not hospitalised, no limitations on activities (61 [15%] of 414 in the remdesivir group vs 73 [17%] of 418 in the control group); (2) not hospitalised, limitation on activities (129 [31%] vs 132 [32%]); (3) hospitalised, not requiring supplemental oxygen (50 [12%] vs 29 [7%]); (4) hospitalised, requiring supplemental oxygen (76 [18%] vs 67 [16%]); (5) hospitalised, on non-invasive ventilation or high flow oxygen devices (15 [4%] vs 14 [3%]); (6) hospitalised, on invasive mechanical ventilation or extracorporeal membrane oxygenation (62 [15%] vs 79 [19%]); (7) death (21 [5%] vs 24 [6%]). The difference between treatment groups was not significant (odds ratio 0·98 [95% CI 0·77-1·25]; p=0·85). There was no significant difference in the occurrence of serious adverse events between treatment groups (remdesivir, 135 [33%] of 406 vs control, 130 [31%] of 418; p=0·48). Three deaths (acute respiratory distress syndrome, bacterial infection, and hepatorenal syndrome) were considered related to remdesivir by the investigators, but only one by the sponsor's safety team (hepatorenal syndrome). Interpretation: No clinical benefit was observed from the use of remdesivir in patients who were admitted to hospital for COVID-19, were symptomatic for more than 7 days, and required oxygen support.

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Fichiers liés : Ader et al - 2021 - Remdesivir plus standard of care versus standard.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/02/2022
• Auteurs : Simon PoignantBernard ViguéPatricia BalramMathieu BiaisRomain CarillonVincent CottenceauClaire Dahyot-FizelierVincent DegosThomas GeeraertsPatrick JeanjeanEmmanuel VegaSigismond LasockiFabien EspitalierMarc LaffonSamuel GayHugues de CoursonOlivier HuetNathalie LaquayRussel ChabanneAbdelouaid NadjiGilles FranconyJean François PayenGwenole AbgrallKevin ChallardPierre-François PerrigaultGérard AudibertKarim LakhalHervé QuintardEmmanuel CouadeauKhalid AzougaghFrançois BarbierNicolas EngrandFrançois Lemoyne de ForgesPhilippe SeguinRomain AsmolovPhilippe OcquidantJérôme MorelBenjamin CohenStephan EhrmannDjilali Elaroussi
• Organismes : Hôpital Bretonneau Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre] Hôpital Bretonneau Hôpital Pellegrin Hospices Civils de Lyon Centre Hospitalier Universitaire de Bordeaux Centre hospitalier universitaire de Poitiers = Poitiers University Hospital Pharmacologie des anti-infectieux et antibiorésistance [U 1070] Université de Poitiers – UFR Santé [Faculté de Médecine et de Pharmacie] CHU Pitié-Salpêtrière [AP-HP] Pôle Anesthésie Réanimation [CHU de Toulouse] CHU Amiens-Picardie Centre Hospitalier Régional Universitaire [CHU Lille] Centre Hospitalier Universitaire d'Angers Hôpital Bretonneau Hôpital Bretonneau Hôpital de la Cavale Blanche - CHRU Brest Optimisation des régulations physiologiques
• Publié dans Neurocritical Care le 29/10/2020

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Résumé : Background: Sedation/analgesia is a daily challenge faced by intensivists managing patients with brain injury (BI) in intensive care units (ICUs). The optimization of sedation in patients with BI presents particular challenges. A choice must be made between the potential benefit of a rapid clinical evaluation and the potential exacerbation of intracranial hypertension in patients with impaired cerebral compliance. In the ICU, a pragmatic approach to the use of sedation/analgesia, including the optimal titration, management of multiple drugs, and use of any type of brain monitor, is needed. Our research question was as follows: the aim of the study is to identify what is the current daily practice regarding sedation/analgesia in the management of patients with BI in the ICU in France?Methods: This study was composed of two parts. The first part was a descriptive survey of sedation practices and characteristics in 30 French ICUs and 27 academic hospitals specializing in care for patients with BI. This first step validates ICU participation in data collection regarding sedation-analgesia practices. The second part was a 1-day prospective cross-sectional snapshot of all characteristics and prescriptions of patients with BI.Results: On the study day, among the 246 patients with BI, 106 (43%) had a brain monitoring device and 74 patients (30%) were sedated. Thirty-nine of the sedated patients (53%) suffered from intracranial hypertension, 14 patients (19%) suffered from agitation and delirium, and 7 patients (9%) were sedated because of respiratory failure. Fourteen patients (19%) no longer had a formal indication for sedation. In 60% of the sedated patients, the sedatives were titrated by nurses based on sedation scales. The Richmond Agitation Sedation Scale was used in 80% of the patients, and the Behavioral Pain Scale was used in 92%. The common sedatives and opioids used were midazolam (58.1%), propofol (40.5%), and sufentanil (67.5%). The cerebral monitoring devices available in the participating ICUs were transcranial Doppler ultrasound (100%), intracranial and intraventricular pressure monitoring (93.3%), and brain tissue oxygenation (60%). Cerebral monitoring by one or more monitoring devices was performed in 62% of the sedated patients. This proportion increased to 74% in the subgroup of patients with intracranial hypertension, with multimodal cerebral monitoring in 43.6%. The doses of midazolam and sufentanil were lower in sedated patients managed based on a sedation/analgesia scale.Conclusions: Midazolam and sufentanil are frequently used, often in combination, in French ICUs instead of alternative drugs. In our study, cerebral monitoring was performed in more than 60% of the sedated patients, although that proportion is still insufficient. Future efforts should stress the use of multiple monitoring modes and adherence to the indications for sedation to improve care of patients with BI. Our study suggests that the use of sedation and analgesia scales by nurses involved in the management of patients with BI could decrease the dosages of midazolam and sufentanil administered. Updated guidelines are needed for the management of sedation/analgesia in patients with BI.

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