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Impact of Clinical and Pharmacological Parameters on Faecal Microbiota Transplantation Outcome in Clostridioides difficile Infections: Results of a 5‐Year French National Survey
No full textInternational audienceDetailed comparative assessment of procedure‐related factors associated with faecal microbiota transplantation (FMT) efficacy in Clostridioides difficile infection (CDI) is limited. Aims We took advantage of the differences in procedures at the various French FMT centres to determine clinical and procedure‐related factors associated with FMT success in CDI. Methods We performed a nationwide retrospective multicentre cohort study. All FMTs performed within The French Faecal Transplant Group for CDI from 2018 to 2022 were included. Clinical data were collected retrospectively from recipient medical files, characteristics of stool transplant preparations were prospectively collected by each Pharmacy involved. Univariate and multivariate analyses were performed using Fisher's test and multiple logistic regression. Results Six hundred fifty‐eight FMTs were performed for 617 patients in 17 centres. The overall efficacy of FMT was 84.3% (520/617), with 0.5% of severe adverse events possibly related to FMT (3/658). Forty‐seven patients were treated at the first recurrence of CDI with a similar success rate (85.1%). Severe chronic kidney disease (CKD; OR: 2.18, 95%CI [1.20–3.88]), non‐severe refractory CDI (OR: 15.35, [1.94–318.2]), the use of ≥ 80% glycerol (OR: 2.52, [1.11–5.67]), insufficient bowel cleansing (OR: 5.47, [1.57–20.03]) and partial FMT retention (OR: 9.97, [2.62–48.49]) were associated with CDI recurrence within 8 weeks. Conclusions Conditions of transplant manufacturing, bowel cleansing, and a route of delivery tailored to the patient's characteristics are key factors in optimising FMT efficacy. FMT at first recurrence showed high success in real‐life practice, whereas it had lower efficacy in severe CDI and non‐severe refractory CDI
Usage unique ou réutilisable : une approche collective face à la complexité.
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Physical stability of bevacizumab solutions for intravitreal injections: Influence of conditioning material and storage conditions
No full textInternational audienceThe treatment of numerous retinal pathologies requires the use of intravitreal medications administered and compounded in medical 3-piece syringes. Particle formation influenced by storage conditions is a source of concern as it can have clinical impacts such as endophtalmitis or reduced visual acuity. The aim of this work was therefore to investigate and compare the physical stability of bevacizumab stored in syringes made of polypropylene lubricated with silicone oil (PP-SOL) or Cyclic Olefin Copolymer with crosslinked silicone at the surface of the barrel (COC-CLS). 0.2 mL of bevacizumab solutions were conditioned in both syringes types and the physical stability and particles or aggregate generation was followed after 3 days, 1 month and 3 months of storage, under three different storage conditions: refrigerated temperature (5 ± 3 °C), with or without mechanical stress after the storage period to simulate user manipulations before patient administration, and heat stress temperature (35 ± 2 °C). Particle counting, dynamic light scattering, size exclusion chromatography, size diffusion by taylor dispersion analysis, Fourier transform infrared spectroscopy, scanning electron microscopy and microanalysis X and calculated aggregation index via UV visible absorption were performed on the samples. Overall, the COC-CLS syringes generated less particles than the PP-SOL ones, in particular when submitted to a mechanical stress. The physical stability of the bevacizumab solutions was superior in COC-CLS syringes than in PP-SOL syringes
Disease activity during pregnancy in patients with rheumatoid arthritis or spondyloarthritis: results from the multicentre prospective GR2 study
No full textInternational audiencePregnancy may have a beneficial effect on disease activity in rheumatoid arthritis (RA) but the evidence is more conflicting in spondyloarthritis (SpA). The aim of this study was to analyse disease activity and relapse during pregnancy in women with RA and SpA.Methods Consecutive pregnant women with RA or SpA were enrolled in this French multicentre observational cohort from 2014 to 2022. Women who had at least two prenatal visits (including one in the first trimester) were included in the analysis. Disease relapse was defined as treatment intensification (initiation or switch of a DMARD) or increase in disease activity scores (DAS28-CRP for RA patients; ASDAS-CRP and/or BASDAI for SpA patients). ResultsOf the 124 pregnant women included, 53 had RA and 71 had SpA. A total of 18 (35%) RA and 44 (62%) SPA received a TNF inhibitor during pregnancy. At the group level, disease activity indexes remained stable in the 1st, 2nd and 3rd trimesters. Disease relapse during pregnancy occurred in 17 (32%) RA patients and 28 (39%) SpA patients, among whom 30 (24%) requiring a treatment intensification. In multivariable analysis, factors associated with disease relapse were nulliparity (odds ratio, OR: 6.5, 95%CI: 1.1 to 37.9) and a disease flare in the 12 months prior to conception (OR: 8.2, 95%CI: 1.6 to 42.7) for RA patients, and a history of bDMARD use (OR: 5.4, 95%CI: 1.1 to 27.3) for SpA patients. ConclusionDisease activity remained stable during pregnancy in women with RA and SpA but almost a quarter required major changes to their treatment
Substance use disorders in outpatients with bipolar disorder and pain complaints
No full textInternational audienceIntroduction: Pain and substance use disorders (SUDs) are common in bipolar disorder (BD), yet the associations between these comorbid conditions are poorly understood. Our hypotheses were: (1) the frequency of SUDs may vary according to pain intensity in individuals with BD, (2) individuals with BD, pain and SUDs may have specific characteristics, and (3) clinical variables could explain the associations between pain and SUDs.Method: We included outpatients from the FACE-BD cohort with a lifetime diagnosis of BD type I or II. Current pain was categorized using one item of the EQ-5D-5L scale as "no pain", "mild pain", "moderate pain", and "severe or extreme pain". Associations between pain level and other variables were tested using bivariate analyses, while multiple regression was conducted to characterize individuals with BD, pain and relevant SUDs. Finally, path analysis was performed to examine whether clinical variables could explain the associations between pain and relevant SUDs.Results: Among the 1897 BD participants, 927 reported any pain (48.9 %). Among SUDs, higher pain levels were only associated with a history of lifetime alcohol use disorder (AUD). Only individuals with both AUD and moderate to extreme pain had a greater risk of having a history of lifetime anxiety disorder and panic disorder. In path analysis, the association between lifetime AUD and pain was partly mediated by current levels of depression, anxiety, and affective lability.Conclusion: Our study highlights multiple associations in individuals with BD between the intensity of reported pain and history of lifetime AUD
Comparison of three immunochromatographic assays for the rapid detection of CTX-M in Enterobacterales
No full textInternational audiencePurposeTwo lateral flow immunochromatographic assays are currently available for the rapid detection of CTX-M enzymes in Enterobacterales, RESIST CTX-M (Coris BioConcept, Gembloux, Belgium) and NG-Test CTX-M MULTI (NG Biotech, Guipry, France). The NG-Test CTX-M MULTI is designed to detect all CTX-M enzymes. The RESIST CTX-M detects CTX-M from the M-15 and the M-14 group for V1.0, CTX-M from the M-15 and the M-14/M-8 groups for V1.1.MethodThe performances of the two versions of the RESIST CTX-M test (V1.0 and V1.1) and the NG-Test CTX-M MULTI were assessed against a collection of 140 non-redundant Enterobacterales isolates characterized for their content in beta-lactamases. beta-lactamases content was established from genotypic analysis to collect a broad diversity of resistance mechanisms and bacterial strains, including 74 ESBL-producing strains (CTX-M (n = 56), other ESBLs (n = 18) either alone or associated with other beta-lactamases), 22 strains overproducing chromosomal AmpC, 13 strains producing plasmid-encoded AmpC, 7 carbapenemase-producing strains, 3 strains combining the production of several beta-lactamases other than ESBL and 21 strains that produced other beta-lactamases.ResultsThe sensitivity and specificity of NG-Test CTX-M MULTI for detecting CTX-M were 98.2% and 85.7%, respectively. They were 87.2% and 93.5% for RESIST CTX-M V1.0 for CTX-M of the M-1 and M-9 groups versus 94.3% and 93.1% for RESIST CTX-M V1.1 for CTX-M of the M-1 and M-9/8 groups.ConclusionLateral flow immunochromatographic assays are rapid and reliable tests for the detection of CTX-M production. The NG-Test CTX-M MULTI and RESIST CTX-M V1.1 were the most efficient. However, one limitation of the different assays is the risk of false-positive results with strains belonging to the K. oxytoca and C. farmeri/sedlakii/amalonaticus complexes, which overproduce their chromosomal beta-lactamase
Passage aux lames de scie réutilisables pour prothèse de hanche : quels impacts écologique et économique ?
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Consensus on the Management of Anesthetic Agents During Digestive Motility Measurements and Proposal of a Standardized Protocol for Anesthesia (French Neuro Gastroenterology Group GFNG and Committee of Anesthetic French Experts)
No full textInternational audienceABSTRACT Introduction Techniques for measuring digestive motility are becoming increasingly precise and enable therapeutic interventions. However, while most of these interventions require general anesthesia, there is limited data on the impact of anesthetic agents on these measurements, and no standardized anesthesia protocol currently exists to guide such procedures. Our working group carried out two Delphi processes involving experts in neurogastroenterology and anesthesiology to reach a consensus on which drugs affect these measurements and to establish an anesthesia protocol. Method Two expert groups were formed, comprising 13 neurogastroenterology experts from the French Neuro‐Gastroenterology Group (GFNG) and 15 full‐ or associate professors in anesthesia and intensive care. The first Delphi process involved the neurogastroenterologists and aimed to identify which anesthetic drugs influenced digestive pressure measurements. The second Delphi process, involving anesthetists, sought to develop an anesthesia protocol. Each expert indicated their level of agreement with each statement using a 6‐point Likert scale. A statement was endorsed when at least 80% of experts agreed with it. The strength of evidence for each statement was evaluated using the GRADE system. Results The Delphi process with neurogastroenterologists was conducted over three rounds and ultimately resulted in 91 amendments. The second Delphi process with anesthetists took place over two rounds and included 28 amendments, leading to the development of an anesthesia protocol. Conclusion To our knowledge, this work is the first to establish an expert consensus on anesthetic agents that can affect digestive motility measurements and to propose an anesthesia protocol that accounts for the needs of neurogastroenterologists
Actualités 2025 par le comité de rédaction du Bulletin du Cancer : congrès ASCO, ESMO et au-delà
No full textNational audienceThe editorial board of the Bulletin du Cancer offers a summary of the latest developments in oncology in 2025, based on the main results published or presented at international conferences. The aim is not to provide an exhaustive overview of the past year’s research, but rather to highlight studies that have an immediate impact on practice and data that raise important questions for 2026.Le comité de rédaction du Bulletin du Cancer propose une synthèse de l’actualité 2025 en oncologie, rédigée à partir des principaux résultats publiés ou présentés dans les congrès internationaux. L’objectif n’est pas de proposer un panorama exhaustif des travaux de l’année écoulée mais bien d’éclairer les études ayant un impact immédiat sur les pratiques ainsi que les données soulevant des questions importantes pour l’année 2026
Bioresorbable scaffolds in interventional radiology: Current concepts and future direction
No full textInternational audienceBackground Glenzocimab is a humanized fragment of a monoclonal antibody directed against the human platelet glycoprotein VI, which has shown promising features, including thrombus growth inhibition and minimal bleeding risk. The first inpatient study suggested the benefit of glenzocimab with alteplase in subgroups of patients with acute ischemic stroke (AIS) receiving endovascular treatment (EVT), with increased reperfusion rates and decreased risk of symptomatic hemorrhagic transformation. The objective of the GREEN (Glenzocimab for REperfusion in the setting of Endovascular therapy for brain infarctioN) study is to evaluate the efficacy of glenzocimab with EVT compared with EVT plus placebo, with or without intravenous thrombolysis (IVT), on functional outcome. Methods GREEN is a multicenter, randomized, double blind, placebo controlled study. Participants presenting with AIS and a large vessel occlusion of the anterior circulation (intracranial internal carotid artery or middle cerebral artery, or both), with symptoms onset within 24 hours, will be randomized to one of two groups: intravenous glenzocimab 1000 mg with standard of care (SoC-EVT±IVT) or SoC (EVT±IVT) plus placebo. The main primary efficacy endpoint is functional outcome (assessed by the modified Rankin Scale score) at 90 days. Conclusion This is the first randomized trial evaluating the efficacy of glenzocimab with EVT. This prospective trial aims to determine whether glenzocimab with EVT improves functional outcome. Trial registration ClinicalTrials.gov NCT0555939