HAL-HCL
Not a member yet
19000 research outputs found
Sort by
Influence of the Surgeon’s First Operation of the Day on Patient Outcomes
No full textInternational audienceObjective: To investigate whether the cumulative operative time spent by a surgeon operating on patients on the same day prior to starting a new procedure was associated with surgical outcomes. Background: The impact of daily operating room workload on a surgeon’s performance and patient outcomes is uncertain. Methods: All elective patients, operated by attending surgeons across seven specialties in four French hospitals between 11/01/2020-12/31/2021, were included. Surgeons’ operative workload the same day before each operation was measured in minutes by cumulating incision-to-closure times for all their patients as the primary operator. Composite of adverse events within 30 days post-surgery, encompassed major surgical complications, unplanned reoperation, extended ICU stay, and patient death. Generalized linear mixed models estimated the association between each outcome and operative workload, considering the clustering of operations by surgeons, and adjusting for patient comorbidities, procedure complexity, and surgeon characteristics. Results: The cohort included 7,979 elective surgeries performed by 44 surgeons. Composite adverse events rates were higher in the 0-minute group compared to those with a higher duration (20.7% vs. 12.5%, P <0.001), as were rates of major complications (19.3% vs. 11.7%, P <0.001), reoperations (6.5% vs. 3.4%, P =0.005), and ICU stay (3.7% vs. 1.2%, P =0.016). When the surgeon had already spent time operating on patients prior to the procedure, adjusted relative risks were lower for composite adverse events (aRR 0.85 [95%CI 0.76–0.95]), major complications (0.86 [0.76–0.97]), reoperation (0.78 [0.63–0.97]), and ICU stay (0.69 [0.49–0.98]). Conclusions: First patient of the day may experience worse outcomes, prompting surgeons to warm up before starting surgery. Further research is needed to replicate these findings, as many surgeons may prioritize starting with the most complex and challenging cases, which inherently carry greater risks
Demyelinating neuropathy as the initial presentation of familial E200K Creutzfeldt–Jakob disease in two patients
No full textInternational audienceObjective To describe peripheral neuropathy associated with familial Creutzfeldt‐Jakob disease. Methods We report two unrelated patients with genetic Creutzfeldt–Jakob disease with demyelinating peripheral neuropathy as initial presentation, with a comprehensive clinical, electrophysiological and neuropathological description. Results Both patients exhibited gait disturbance and paresthesia. Electrodiagnostic studies revealed demyelinating abnormalities with motor conduction blocks suggestive of chronic inflammatory demyelinating polyradiculoneuropathy, with abnormal plexus MRI and elevated CSF protein levels. One of them had pes cavus and a late‐onset Charcot–Marie‐Tooth (CMT) disease was also initially hypothesized. Central nervous system involvement manifested 1–2 years after the onset of peripheral symptoms. Both patients had a heterozygous E200K mutation in the PRNP gene. Postmortem neuropathological examinations showed PrP Sc deposits in the peripheral nervous system, particularly in Schwann cells. Interpretation : Peripheral neuropathy in E200K genetic forms of Creutzfeldt‐Jakob disease can be inaugural and mimic chronic inflammatory demyelinating polyradiculoneuropathy
Actes de la conférence Extraction et Gestion des Connaissances
No full textNational audienceLa sélection d’articles publiés dans le présent recueil constitue les actes des 25e Journées Internationales Francophones sur l’Extraction et la Gestion des Connaissances (EGC 2025) qui se sont déroulées à l’université de Strasbourg du 27 janvier 2025 au 31 janvier 2025.L’objectif de ces journées est de rassembler dans un même lieu les chercheurs de disciplines connexes (Bases de Données, Statistiques, Apprentissage, Représentation des Connaissances, Gestion des Connaissances et Fouille de Données) et ceux qui mettent en œuvre sur des données réelles des méthodes d’extraction et de gestion des connaissances afin de contribuer à l’activité de recherche et à la formation de cette communauté scientifique dans le monde francophone, et à l’impact de la recherche en Science des Données
ASO Visual Abstract: Prognosis Associated with Complete Pathological Response Following Neoadjuvant Treatment for Pancreatic AdenOcarciNOma in the FOFLIRINOX Era: The Multicenter TONO Study
No full textInternational audienc
A French multicenter analytical evaluation of the automated Lumipulse G sNfL blood assay (Fujirebio®) and its comparison to four other immunoassays for serum neurofilament light chain assessment in clinical settings
No full textInternational audienceMeasurement of serum neurofilament light chain (sNfL) protein is becoming a key biomarker for many neurological diseases. Several immunoassays have been developed to meet these clinical needs, revealing significant differences in terms of variability and results. Here, we propose a French multicenter comparison of 5 sNfL assays
Development of CARRA/PReS-endorsed consensus Core and Expanded Datasets in childhood-onset systemic lupus erythematosus for international registry-based research
No full textInternational audienc
Improved glioma delineation by autofluorescence and 5-ALA-induced PpIX fluorescence spectroscopy using machine-learning data normalization and augmentation
No full textNational audienc
Amoeba plate test with Acanthamoeba castellanii as an innovative tool for Nocardia recovery from sputum samples: a proof-of-concept study
No full textInternational audienceABSTRACT Nocardia recovery from pulmonary samples is challenging due to the lack of a specific medium and the abundance of overgrown respiratory flora. This study aimed to compare the amoeba plate test (APT), an amoebic coculture with Acanthamoeba castellanii , with the axenic culture to recover Nocardia from pulmonary samples. Nocardia serial dilutions ( n = 15 strains from seven species, concentrations ranging: 10 7 –10 2 CFU/mL) in water and spiked overgrown sputa ( n = 8) were simultaneously plated on agar with amoebic monolayer (APT) and without (control). Culture positivity rates, minimal growth concentrations, growth times, and abundance of flora overgrowth were compared for each condition. In water, Nocardia culture positivity rates were not significantly different between APT (86%, 30/35) and control (94%, 33/35; P = 0.246). In sputa, APT resulted in greater Nocardia growth (63%, 22/35 vs 37%, 13/35; P = 0.008). In addition, the elimination of interfering flora was more frequent using APT (34%, 12/35 vs 11%, 4/35; P = 0.01), and the overall abundance of flora was lower (median [interquartile range, IQR]: 1 [0–2] vs 3 [1-3]; P < 0.0001). The most grown species using APT were N. mexicana and N. otitidiscaviarum, whereas N. abscessus and N. nova were the most fastidious to grow under both conditions. This study reports Nocardia’ s ability to grow in amoebic coculture, with some growth kinetic differences depending on the species, presumably implying their intra-amoebic multiplication. Furthermore, in APT, Nocardia recovery from overgrown sputa was greater, and flora decontamination was more effective. The present findings are strong arguments to implement APT as a complementary technique for Nocardia isolation from heavily contaminated samples. IMPORTANCE The culture-proven diagnosis of Nocardiosis is challenging due to the difficulties in recovering Nocardia colonies from respiratory samples containing a complex polymicrobial flora. However, the isolation of Nocardia strains remains necessary to perform antibiotic susceptibility testing and adapt the antibiotic regimen of the patients. This study provides an innovative culture method based on a solid medium amoebic coculture, the amoeba plate test (APT), to cultivate Nocardia strains from clinical sputa samples. Nocardia grew across the APT amoebic monolayer. Moreover, the APT, which is already used in a reference center for the recovery of Legionella strains, exhibited good performances for Nocardia recovery and decontamination of interfering flora, thereby representing a promising second line tool to improve Nocardia culture
Centralized investigator review of radiological and functional imaging reports in real‐world oncology studies: The SACHA‐France experience
No full textInternational audienceSACHA‐France (NCT04477681) is a prospective real‐world study that collects clinical safety and efficacy data of novel anticancer therapies prescribed off‐label or on compassionate use to patients <25 years. From March 2020 until February 2024, 640 patients with solid tumors or lymphomas were included, with 176 (28%) reported objective tumor responses. Centralized medical monitoring of local radiological/functional imaging reports by the SACHA coordinating investigator led to response modification in 45 out of 176 cases (26%), highlighting the relevance of the medical review of study data. We suggest this pragmatic approach for improving clinical trial data when centralized radiological review is not performed
Emergence and establishment of Staphylococcus haemolyticus ST29 in two Western France neonatal intensive care units
No full textInternational audiencePurpose: Since 2021, several reports of Staphylococcus haemolyticus outbreaks in neonatal intensive care units (NICUs) have been reported in France. The aim of this study was to understand how it became established in the NICUs of two facilities, which share the care of newborns.Methods: All positive S. haemolyticus clinical samples isolated from 2020 until 2023 and medical records were analysed. Phenotypic analyses consisted of typing method using the quantitative antibiogram (QA) method, and microbiological investigations using whole genome sequencing (WGS). Environmental samples and hands of healthcare workers were collected, with the same analyses realized if S. haemolyticus was identified. Observational studies of Healthcare workers (HCWs) hygiene practices were also performed.Results: One hundred and sixteen neonates were positive for S. haemolyticus, of whom 44 (38%) were infected. ST29 strains were highly predominant, and distinct clonal populations were identified. Transfers of newborns between the two centres, followed by cross-transmissions, could explain the dissemination of one population. Twenty-one environmental samples revealed the presence of the clones involved in neonates. One clonal population was also found on the hands of 15% of the healthcare workers sampled. Misconceptions about alcohol-based hand rub were observed, and daily disinfection of NICU equipment was not optimal.Conclusion: Preliminary reports point to cross-transmission within and between NICUs, either directly by healthcare worker hands or indirectly via contaminated environments, especially incubators. The ST29 lineage is identified in most NICUs with a capacity to adapt locally and to cause outbreaks