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Efficacy of anifrolumab in lupus erythematous panniculitis: A retrospective study of 11 patients.
No full textInternational audienc
Acute metabolic responses to high‐intensity interval training in men with overweight or obesity: Does the exercise modality matter?
No full textInternational audienceAbstract This study investigated the acute effects of two isoenergetic high‐intensity interval exercise (HIIE) sessions, running (HIIE‐RUN) and cycling (HIIE‐BIKE), on post‐exercise oxygen consumption (), carbon dioxide production (), substrate oxidation and 24‐h energy intake (EI) in men with overweight or obesity. Twelve fasted men (44.4 ± 14.5 years; body mass index: 28.3 ± 1.9 kg m −2 ) completed both HIIE sessions. and were measured before, during and after exercise, while substrate oxidation was calculated before and after exercise. The rate of perceived exertion was recorded during each exercise. Appetite was assessed throughout each session using a visual analogue scale (VAS) and EI was recorded via a 24‐h dietary questionnaire. Both exercise modalities resulted in similar energy expenditure (EE), but HIIE‐BIKE elicited a significantly higher respiratory exchange ratio ( P = 0.002). No significant effect of exercise modality or time × modality interaction was observed for and EE during the post‐exercise period. Fat oxidation was significantly increased during recovery compared with the pre‐exercise levels ( P < 0.001), but did not differ between modalities. Appetite and 24‐h EI were unaffected by the exercise modality. In men with overweight or obesity, isoenergetic HIIE‐RUN and HIIE‐BIKE seem to induce comparable post‐exercise , EE and substrate oxidation during the 2‐h recovery period. Both modalities similarly promoted fat oxidation without specific dietary compensation observed
An imported case of Haplorchis taichui infection diagnosed with molecular genomics in France
No full textInternational audienceWe report here on an imported case of Haplorchis taichui infection in a Western country. Given their rarity in these countries, such diagnoses of heterophyid flukes can be particularly difficult. Methods: The stool of a 70-year-old Laotian woman with eosinophilia was sent to the laboratory for examination. Microscopic observations based on direct examination and two concentration methods were performed on the fecal sample. After extraction of DNA from the sample, Sanger sequencing of the internal transcribed spacer 2 (ITS2) region and the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was carried out. Results: Ellipsoid eggs with a convex operculum and abopercular knob were observed on microscopic examination, suggestive of fluke eggs, but there was no morphological criterion to distinguish between opisthorchiid and heterophyid eggs. Results of ITS2 and cox1 sequencing matched the intestinal fluke Haplorchis taichui. Conclusion: This case report points out that small trematode eggs can hardly be used to distinguish between opisthorchiid and heterophyid flukes in fecal examinations, and underlines the need for molecular genomic studies to establish an accurate species diagnosis
How Sex and Body Composition Affect Mitochondrial Adipose Tissue Respiration in Digestive Cancer Patients
No full textInternational audienc
Beyond the ventilator-free days: review of several estimands
No full textInternational audienceBackgroundMortality is a critical endpoint in clinical research, but identifying meaningful differences necessitates large sample sizes. Consequently, composite outcomes such as ventilator-free days (VFDs) have been developed, combining survival and ventilation duration into a single measure. Different statistical methods used to analyse VFDs lead to different estimands. Traditionally, VFDs are treated as a count; however, some models consider time to death and time to extubation separately. This review explores the applicability of several time-to-event models and innovative approaches.Main textThe first model to consider is the competing risks approach using the Fine-Gray model. This approach focuses solely on the initial extubation event and considers death as a competing event. Second, to incorporate all extubation and reintubation events, multistate models can be employed. Specifically, the multiple-event framework, which allows for multiple transitions between intubation and extubation, while the recurrent events framework, focuses on extubation recurrence. However, these models require complete data and a sufficient number of events for analysis. Third, current ventilation-free survival estimates use methods adapted from leukaemia-free survival to evaluate the probability of remaining extubated and alive over time. Finally, the mixture cure model distinguishes between deceased and extubated individuals within the non-deceased population. It models death through logistic regression and extubation timing through survival regression among living patients.ConclusionIn critical care, especially for acute respiratory distress syndrome, three key states are intubation, extubation, and death. We do not advocate a one-size-fits-all model because the choice depends heavily on the specific goals. The key is to decide which estimand the study will target in the statistical plan, before initiating the study, and to ensure the analysis model is the most appropriate for addressing the research question.
Sperm Telomere Interactions Are Impaired in Testicular Cancer Before and After Adjuvant Therapy
No full textInternational audienceABSTRACT Background No study has yet explored telomere length or interaction in sperm nuclei of testicular cancer (TC) patients exposed to chemotherapy or radiotherapy. However, sperm telomere dynamics have emerged as a potential marker in male infertility. Objectives We aimed to investigate in a pilot and exploratory study whether TC and its adjuvant treatments alter sperm telomeres and DNA integrity during a 2‐year follow‐up after treatment. Materials and methods This ancillary study is part of the multicentric prospective and longitudinal French GAMATOX study. Twenty‐nine TC patients treated with orchiectomy and either adjuvant chemotherapy ( n = 14) or radiotherapy ( n = 15) were included, alongside ten fertile donors. Semen samples were collected before orchiectomy and adjuvant therapy, and at 3, 6, 12, and 24 months after treatment. Sperm telomere length (STL) and telomere interactions were assessed by quantitative fluorescent in situ hybridisation (FISH). Sperm DNA fragmentation (SDF) was measured using the TUNEL assay, aneuploidy by FISH, and chromatin condensation defects by aniline blue staining. Results Before adjuvant therapy, patients presented a higher number of sperm telomere signals compared with controls ( p = 0.004), persisting 2 years after treatment ( p = 0.001). STL was not affected by tumour histology. Extremely short telomeres and the highest number of telomere signals per nucleus were more frequently observed after chemotherapy. SDF and chromatin condensation defects were transient and paralleled the recovery of conventional semen parameters, regardless of treatment type. A moderate increase in sperm aneuploidy was observed 6 months after chemotherapy ( p = 0.03). Conclusion TC patients presented impaired sperm telomere interactions before and after adjuvant therapy, as reflected by a persistently elevated number of telomere signals per nucleus, and a higher prevalence of extremely short sperm telomeres, especially after chemotherapy. While relative STL remained comparable to controls, these findings raise questions about the impact of telomere architecture on germ cell tumour biology and post‐treatment fertility
Diet and clinical remission in patients with inflammatory bowel disease: A multicenter cross-sectional study
No full textInternational audienceBackground: Diet and risk of developing inflammatory bowel disease (IBD) has been extensively studied.Aims: To investigate the association between diet and IBD activity.Methods: Consecutive outpatients in 40 French and Belgian centers completed diet and IBD activity questionnaire between April and May 2023 in a cross-sectional study. Associations between diet and clinical remission were adjusted for gender, age, body mass index, education, smoking, and past CD-surgery.Results: Among 2514 patients included, 1715 had Crohn's disease (CD) and 799 had ulcerative colitis (UC). Overall, the mean age was 42.4 years, 52.3 % were women, and 56.4 % were in clinical remission. Among CD patients, clinical remission was associated with a higher intake of fruits (aOR 1.60 [1.20-2.14]) and coffee (aOR 1.57 [1.17-2.11]). Among UC patients, clinical remission was associated with a higher intake of fruits (aOR 1.72 [1.15-2.56]) and salad (aOR 1.73 [1.12-2.66]). A higher adherence to a Mediterranean diet was associated with CD (aOR 1.39 [1.06-1.84]) but not UC remission. A higher adherence to a healthy diet was not associated with either CD nor UC remission.Conclusions: CD remission was associated with higher intakes of fruits, coffee and a Mediterranean diet, while UC remission was associated with higher intakes of fruits and salad. As this was a cross-sectional study, the main limitation was the possibility of reverse causality
Predicting algorithm for GRFS after allogeneic hematopoietic stem cell transplantation: A study by the SFGM-TC
No full textInternational audienceAbstract Context : Allogeneic stem cell transplantation (alloHCT) is used in majority of acute myeloid leukemia and myelodysplastic syndromes to obtain complete remission. Graft-versus-Host disease (GVHD) and relapse are is the most important complications after alloHCT. Numerous prognostic scores are used pre-transplant to guide therapeutic strategies, but none has been sufficient to predict graft-versus-host disease/relapse-free survival (GRFS). In this study, we studied clinical, biological and therapeutic factors associated with GRFS and attempted to build a predictive score. Material & Methods : Patients over 18 years of age who received a first hematopoietic stem cell transplant between 01/01/2015 and 31/12/2022 at the University Hospitals of Saint-Etienne, Lyon, Grenoble-Alpes and Clermont-Ferrand for acute myeloid leukemia or myelodysplastic syndrome were included. Data was extracted from the allogeneic EBMT registry and patient medical records. Several parameters about clinical and biological characteristics of patient, disease, conditioning regimen and type of donor were studied. Statistics were performed with Kaplan-Meier method and Cox analysis. Regression models and supervised machine learning models were explored by the Henri Fayol Institute of the Ecole des Mines de Saint-Etienne in order to establish a predictive model. Results : Analysis included851 patients. The cohort consisted of 59% men, with a median age of 58 years. More than 70% of the patients received alloHCT for acute myeloid leukemia. The median follow-up was 938 days, and median overall survival was not reached. Median GRFS was 210 days. At the end of follow-up, GRFS was estimated at 30%. Log-rank tests found 15 significant variables. Concerning pre-transplantation characteristics, Performance Status ≥ 2, neutropenia, lymphopenia, low creatinine level, elevated lactate dehydrogenase or c-reactive protein, and pre-transplant hypoalbuminemia were associated with lower survival. Therapy-related disease or secondary to a predisposing hematologic disorder was also predictive of GRFS, as well as adverse 2022 European LeukemiaNet risk group. Patients with refractory disease or positive residual disease before transplantation had poorer survival. A mismatch unrelated donor or a graft CD3+ cell count greater than 10^7/kg were associated with reduced GRFS. Finally, alloHCT performed more than 12 months after diagnosis was linked to improved GRFS. We used these variables to develop predictive models for GRFS using linear regression and machine learning algorithms (Alternating Decision Trees, Random Forest, Support Vector Machine, Association Rules). The highest predictive performance power was achieved by association rules. Non-redundant rules, with a lift greater than 1, a minimal confidence of 0.8 and a minimal support of 0.011 (9 patients) were kept to predict GRFS at 6 months, 9 months, 1 year, 18 months and 2 years. More than 800,000 rules were generated. Accuracy was respectively 0.95, 0.96, 0.90, 0.80, and 0.73 for each timepoint. An online tool is under development to simplify the calculation of the score and will be presented at the meeting.Conclusion : Our findings are consistent with existing literature on GRFS and overall survival following alloHCT. We identified significant clinical, biological and therapeutic parameters for development of a predictive algorithm for GRFS using association rules algorithm
Rosuvastatin for intracranial aneurysms treated with flow diverters: preclinical study in rabbits
No full textInternational audienceBackground Flow diverters (FDs) revolutionized cerebral aneurysm treatment by promoting aneurysm sac sealing but have limitations, including thromboembolic complications and incomplete occlusion. Rosuvastatin enhances endothelialization via endothelial progenitor cell mobilization and nitric oxide bioavailability, potentially improving FD healing. This study assessed the effect of rosuvastatin on FD endothelialization in a rabbit aneurysm model. Methods Twenty-two rabbits with elastase-induced aneurysms underwent FD implantation in the right subclavian artery. In the same animals, FDs were placed in the descending aorta to assess side branch patency. Thirteen rabbits received rosuvastatin plus aspirin (Rosu+ASA; 10 mg/kg/day each) and nine received aspirin alone (ASA; 10 mg/kg/day). Two weeks post-implantation, aneurysm occlusion (O’Kelly-Marotta scale), side branch patency (high frequency optical coherence tomography), and histological/MPM strut coverage were evaluated. Rosuvastatin serum concentration was correlated with endothelial cell coverage. Results Complete aneurysm occlusion (OKM D) occurred in 11/13 (84.6%) of Rosu+ASA vs 6/9 (66.6%) of ASA animals. Patency of branches ≥1 mm was higher with Rosu+ASA (17/18 (94.4%) vs 9/13 (46.1%), PP=0.007), as was patency of branches <1 mm (21/22 (95.4%) vs 11/15 (73.4%), P=0.036). The composite outcome (complete occlusion+patent branches) favored Rosu+ASA (10/13 (76.9%) vs 2/9 (22.2%), P=0.011). Histology showed a trend toward greater strut coverage and neointimal thickness in Rosu+ASA (P=0.1). Rosuvastatin serum concentration strongly correlated with endothelial cell coverage (r=0.92, P=0.02). Conclusion In rabbit FD models, rosuvastatin therapy seems to improve aneurysm occlusion, preserving side branch patency. We also found an association between drug levels and endothelial cells covering the FD. These findings support further investigations
