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Screening for alcohol consumption in liver transplant recipients: results of a nationwide French survey
No full textInternational audienc
Maternal and neonatal outcomes of pregnancies after metabolic bariatric surgery: a retrospective population-based study
No full textInternational audienceBackground: The incidence of post metabolic bariatric surgery (BS) pregnancies is rising. Previous studies provided conflicting results regarding the risk of prematurity, stillbirth, perinatal death and the optimal time from BS to conception. This study examined maternal and neonatal outcomes of post-BS pregnancies and influencing factors.Methods: Nationwide retrospective study of all post-BS pregnancies in France from January 1st 2013 to December 31st 2022. We compared 55,941 post-BS pregnancies with 223,712 controls matched on delivery date, parity, age, obesity, hypertension, diabetes, and socio-economic status (1:4 ratio) using generalized estimating equations. We also compared 11,777 post-BS pregnancies with 11,777 pre-BS pregnancies in the same women, using conditional logistic regression. Maternal outcomes included gestational hypertension, preeclampsia, and gestational diabetes. Neonatal outcomes included small-for-gestational-age (SGA), prematurity, stillbirth, and perinatal death. We tested for interactions with BS type, BS to pregnancy time interval and malnutrition
A Prospective Pilot Clinical Study reveals a promising non-toxic anti-biofilm activity of gentamicin-EDTA-Na₂ Central Venous Catheter Lock Solution
No full textInternational audienceObjectives: The treatment of long-term intravenous catheter-related bloodstream infections (LTIVC-related BSI) often requires catheter removal or conservative treatment using intra-catheter locks, with a 50-60% success rate. We previously demonstrated the synergistic effect of a combination of gentamicin and ethylenediaminetetraacetic acid disodium salt (EDTA-Na2) against bacterial biofilms. We conducted a phase 1/2 clinical trial to assess the tolerance and efficacy of genta-EDTA-Na2 locks for the conservative treatment of LTIVC-related BSI.Methods: Prospective study including adult patients with monomicrobial, uncomplicated LTIVC-related BSI caused by gentamicin-susceptible coagulase-negative staphylococci, Enterobacterales, or Pseudomonas aeruginosa.Primary objective: assess the safety and efficacy at genta-EDTA-Na2 locks at day 40 (D40) by evaluating the frequency of clinical and microbiological cure 30 days after the end of treatment (D40).Results: Eight patients were included. Complete follow-up was obtained for seven patients, six of whom met the criteria for cure. The single patient with incomplete follow-up met all criteria for cure at D23. A single microbiological failure occurred (relapse of P. aeruginosa LTIVC-related BSI). Two patients experienced at least one serious adverse event; none were attributed to the genta-EDTA-Na2 locks.Conclusions: Genta-EDTA-Na2, used as intra-catheter locks, may be a promising anti-biofilm candidate for evaluation in a randomized controlled trial
Evolución de la situación epidemiológica de la toxoplasmosis en embarazadas en Lyon, Francia, 2017 2023
No full textInternational audienc
Baseline characteristics of the TRANSLATE2 cohort: a prospective study on rheumatoid arthritis-associated interstitial lung disease
No full textInternational audienceObjectives: To describe the baseline characteristics of patients enrolled in the TRANSLATE2 cohort (NCT04227535), a national, multicenter, prospective case-control study designed to investigate the genetic and non-genetic determinants of interstitial lung disease (ILD) in rheumatoid arthritis (RA).Methods: Cases with RA-ILD and RA controls without ILD were consecutively included in TRANSLATE2 with a 5-year prospective follow-up. All participants fulfilled the ACR/EULAR 2010 classification criteria for RA. ILD presence or absence was confirmed for every participant by chest high-resolution computed tomography (HRCT). Baseline demographic and clinical data were collected. Blood samples were collected at enrollment for centralized biobanking of DNA, RNA, and serum to support future genetic and biomarker studies. For ILD cases, chest HRCT scans were centrally reviewed to determine HRCT pattern. For the current study, associations with ILD were tested using univariable and multivariable logistic regression models.Results: Among the 506 patients included (275 RA-ILD, 231 RA-noILD), RA-ILD cases were more frequently male (48.4% vs. 29.9%), older at enrollment (66.6 [9.9] vs. 58.5 [13.2] years) and older at RA onset (52.2 [14.7] vs. 45.8 [14.3] years). ILD was independently associated with male sex (OR 1.82; 95% CI 1.06, 3.14) and older age at RA onset (OR per 10 years 1.28; 95% CI 1.10,1.50). For ILD cases, the most frequent HRCT patterns were definite for usual interstitial pneumonia (39.3%) and non-specific interstitial pneumonia (17.8%). At enrollment, respiratory symptoms were observed in 67.3% with a mean forced vital capacity % predicted of 87.6% (21.7) and a mean diffusing capacity of the lung for carbon monoxide % predicted of 58.4% (18.8).Conclusion: The TRANSLATE2 cohort provides a comprehensive and deeply phenotyped dataset that offers a unique opportunity to investigate the genetic architecture, risk factors, and natural history of RA-ILD. 287/300 words
Early Mortality and Mid-Term Durability of Open Surgical Repair for Complex Abdominal Aortic Aneurysms in Octogenarians: A Retrospective Analysis from Two Tertiary Referral Centers
No full textInternational audienceBackground/Objectives: Complex endovascular solutions have expanded treatment options for complex abdominal aortic aneurysms (cAAA), particularly in elderly high-risk patients. However, these techniques are limited by anatomical constraints and costs, while the superiority over open repair (OSR) remains debatable. This study aimed to compare short- and mid-term outcomes of OSR for cAAA in patients aged ≥80 versus <80 years. Methods: Retrospective analysis was performed for patients who underwent OSR for cAAA between 2017 and 2022 at two tertiary vascular centers. A total of 226 patients (median age 71 years [IQR 66–80]; 89% male) were included, of whom 74 were aged ≥80 years. Primary endpoints were 30-day mortality, major adverse cardiovascular events (MACE), and early reintervention. Secondary endpoints included length of stay (LOS), acute kidney injury, new renal dysfunction, mid-term survival (≤5 years), and procedure-related reintervention. Propensity score matching (PSM) was performed to adjust for baseline differences. Results: Out of 1087 screened patients, 226 met the inclusion criteria: 74 octogenarians and 152 younger patients. Thirty-day mortality was significantly higher in octogenarians (9.5% vs. 0.7%; p < 0.001), as was the incidence of MACE (8.2% vs. 1.9%; p = 0.026). Rates of kidney impairment LOS and other major complications were comparable. During a median follow-up of 42.7 months, mid-term survival and freedom from reintervention did not differ significantly between groups. PSM analysis confirmed higher early mortality and cardiovascular events in octogenarians but similar mid-term outcomes. Conclusions: Although octogenarians undergoing OSR for cAAA face increased early mortality and cardiovascular complications, their mid-term survival and freedom from reintervention are comparable to younger patients. These results suggest that age alone should not represent a contraindication to open repair in appropriately selected individuals
TanaT : A library for the analysis of temporal sequences
No full textNational audienceThis article introduces TanaT, an open-source framework for temporal sequences analysis. Temporal sequences are made of complex events, described by qualitative and quantitative features, with a contiguous temporal footprint. Such kind of data are encountered in a wide range of applications (medicine, social science, traces analysis, education, etc.) and their analysis requires taking into account the longitudinality of the data. The proposed framework aims to empower data analysts with a coherent toolbox for handling such temporal sequences at all stages of the analysis process: data loading, data pre-processing and transformation, data analysis and data visualization. In this article, we introduce our framework, focusing on the distance-based clustering of temporal sequences. The complex nature of temporal entities requires versatility in defining distances between sequences and we highlight how \TanaT addresses this challenge
Surgeons’ physiological parameters and surgical performance: a systematic scoping review
No full textInternational audienceBackground: Wearable sensors enable objective, non-invasive and accurate measurement of surgeons’ physiological parameters that potentially impact surgeon performance and patient outcomes. This scoping review aimed to explore studies measuring surgeons’ sleep, stress or physical activity using wearable sensors and to identify research gaps.Methods: A systematic search of PubMed and Scopus was conducted following PRISMA-ScR guidelines, for English-language articles published from January 1, 1950 to June 1, 2025. We included original quantitative studies measuring sleep, stress or physical activity in practicing or training surgeons, either as a parameter to investigate, or a determinant of performance. Data on physiological parameters, surgeon and surgical procedure, operating room (OR) setting, performance, study design, objectives, and findings were extracted using a predefined form.Results: Among 100 included studies, 88 measured stress, 9 sleep, and 5 physical activity. Stress was primarily assessed intraoperatively while sleep and physical activity during extended period inside/outside the OR. Most studies investigated the relationship between physiological parameters and surgeon attributes or within team role (43%), patient or surgical procedure (32%), OR setting, specific changes, or methods (17%). Six studies (6%) examined stress-performance links, with conflicting findings. Three studies (3%) suggested poor sleep may increase medical error risk, with inconsistent conclusions on burnout. Only one study quantified the influence of these parameters on patient outcomes.Conclusion: Tangible evidence linking surgeons’ physiological parameters and performance in the OR remains limited. Available sensor technologies nowadays represent emerging opportunities to close this gap and improve understanding of how surgeon-related human factors impact patient safety
Value of molecular biology tests in community-acquired acute pneumonia
No full textInternational audienceFor patients hospitalized with community-acquired acute pneumonia (CAP), molecular tools (especially multiplex PCR syndromic panels) are associated with a significant improvement of microbiological diagnosis yield, compared with conventional methods. Two main families of tests are currently available: targeted viral PCR tests (influenza, SARS-CoV-2, RSV) performed on nasopharyngeal swabs and adapted to epidemic situations; and “upper respiratory tract” (nasopharyngeal) or “lower respiratory tract” (deep swabs) syndromic panels to detect a broad spectrum of viral and bacterial agents, sometimes including resistance genes.These tests are not recommended for routine use in CAP patients treated in ambulatory settings. In hospitalized CAP patients, their use must be guided by severity, epidemic context, and therapeutic implications. “Upper respiratory tract” panels can be useful when an atypical agent or a virus undetected by targeted PCR tests is suspected. “Lower respiratory tract” panels must only be used in case of severe forms or complex situations.Clinical trials showed real diagnostic value but variable clinical impact, which is often limited in the absence of an optimization strategy for the antibiotic therapy.Multiplex PCR syndromic panels represent a promising step forward in the management of patients hospitalized with CAP, but their clinical value still depends on several factors: type of panel and swab, quick results, presence of mobile teams of infectious diseases specialists, and capacity to correctly interpret results to guide treatment decisions
