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Stinghen A.E.M.,French Institute of Health and Medical Research | Massy Z.A.,French Institute of Health and Medical Research | Massy Z.A.,University of Versailles | Boullier A.,French Institute of Health and Medical Research | Boullier A.,Amiens University Medical Center
Journal of the American Society of Nephrology | Year: 2016

Advanced glycation end products (AGEs), a heterogeneous group of compounds formed by nonenzymatic glycation reactions between reducing sugars and amino acids, lipids, orDNA, are formed not only in the presence of hyperglycemia, but also in diseases associated with high levels of oxidative stress, such as CKD. In chronic renal failure, higher circulating AGE levels result from increased formation and decreased renal clearance. Interactions between AGEs and their receptors, incluDing advanced glycation end product-specific receptor (RAGE), trigger various intracellular events, such as oxidative stress and inflammation, leaDing to cardiovascular complications. Although patients with CKD have a higher burden of cardiovascular disease, the relationship between AGEs and cardiovascular disease in patients with CKD is not fully characterized. In this paper, we review the various deleterious effects of AGEs in CKD that lead to cardiovascular complications and the role of these AGEs in diabetic nephropathy. We also discuss potential pharmacologic approaches to circumvent these deleterious effects by reducing exogenous and endogenous sources of AGEs, increasing the breakdown of existing AGEs, or inhibiting AGE-induced inflammation. Finally, we speculate on preventive and therapeutic strategies that focus on the AGE-RAGE axis to prevent vascular complications in patients with CKD. Copyright © 2016 by the American Society of Nephrology.


Pepin A.,Amiens University Medical Center | Daouk J.,University of Picardie Jules Verne | Bailly P.,Amiens University Medical Center | Hapdey S.,University of Rouen | And 2 more authors.
Nuclear Medicine Communications | Year: 2014

Combined PET/computed tomography (CT) is of value in cancer diagnosis, follow-up, and treatment planning. For cancers located in the thorax or abdomen, the patient's breathing causes artifacts and errors in PET and CT images. Many different approaches for artifact avoidance or correction have been developed; most are based on gated acquisition and synchronization between the respiratory signal and PET acquisition. The respiratory signal is usually produced by an external sensor that tracks a physiological characteristic related to the patient's breathing. Respiratory gating is a compensation technique in which time or amplitude binning is used to exclude the motion in reconstructed PET images. Although this technique is performed in routine clinical practice, it fails to adequately correct for respiratory motion because each gate can mix several tissue positions. Researchers have suggested either selecting PET events from gated acquisitions or performing several PET acquisitions (corresponding to a breath-hold CT position). However, the PET acquisition time must be increased if adequate counting statistics are to be obtained in the different gates after binning. Hence, other researchers have assessed correction techniques that take account of all the counting statistics (without increasing the acquisition duration) and integrate motion information before, during, or after the reconstruction process. Here, we provide an overview of how motion is managed to overcome respiratory motion in PET/CT images. © 2014 Wolters Kluwer Health | Lippincott Williams &Wilkins.


Lanoix J.-P.,Amiens University Medical Center | Schmit J.-L.,Amiens University Medical Center | Douadi Y.,Saint Quentin Medical Center
Current Opinion in Pulmonary Medicine | Year: 2012

PURPOSE OF REVIEW: This review provides an update on microbiological and therapeutic data in febrile neutropenic patients in general and those with bacterial lung sepsis in particular. Although the Infectious Diseases Society of America updated its guidelines on febrile neutropenia in 2010, changing epidemiological factors and the spread of new drug resistance constitutes challenges for initial treatment of this condition. RECENT FINDINGS: Lung sepsis stands out because of the frequent absence of microbiological identification. We review the use of newly available, novel, broad-spectrum antibiotics (linezolid, tigecycline, daptomycin, etc.) in this indication. SUMMARY: Although the incidence of Gram-negative infections in neutropenic fever is leveling off, there is a worrying increase in resistance. New drugs are available but not well studied in febrile neutropenia; daptomycin and tigecycline should not be used in suspected lung sepsis in these patients. New diagnostic tools (such as the procalcitonin assay and the LightCycler SeptiFast assay, Roche Molecular Systems) appear to be unhelpful in febrile neutropenia, although more data on fungal sepsis are required. There are no specific features of the treatment of pneumonia or septic shock in neutropenic fever, but both conditions increase the mortality rate. © 2012 Lippincott Williams & Wilkins, Inc.


Fuks D.,Amiens University Medical Center | Fuks D.,University of Picardie Jules Verne | Mouly C.,Amiens University Medical Center | Robert B.,Amiens University Medical Center | And 3 more authors.
Radiology | Year: 2012

Purpose: To establish whether preoperative computed tomographic (CT) findings in patients with acute cholecystitis were associated with conversion from laparoscopic to open cholecystectomy in patients with calculous acute cholecystitis. Materials and Methods: The study protocol was approved by the local institutional review board, and written informed consent was provided by all patients at enrollment. From 2008 to 2010, all patients admitted to a university medical center with acute calculous cholecystitis and for whom a preoperative contrast material-enhanced CT study was available were prospectively included. Cholecystectomy was always initiated laparoscopically. To identify risk factors for conversion specifically related to acute cholecystitis, CT studies were analyzed according to predefined criteria by two radiologists who were blinded to the patient's conversion status. Associations between conversion and radiologic findings were assessed by using univariate and multivariate logistic models. Results: A total of 108 patients were analyzed (61 men, 47 women; median age, 58 years; age range, 17-88 years). Conversion occurred in 24 (22%) cases. On preoperative CT images, the absence of gallbladder wall enhancement was associated with the presence of gangrenous acute cholecystitis (sensitivity, 73%). The absence of gallbladder wall enhancement (58% and 40% for conversion and nonconversion, respectively; P = .02) and the presence of a gall-stone in the gallbladder infundibulum (78% and 22% for conversion and nonconversion, respectively; P = .04) were associated with acute cholecystitis-related conversion in a multivariate analysis. Interobserver agreement for CT study interpretation was very good (median k value, 0.92; range, 0.76-1.00). Conclusion: The absence of gallbladder wall enhancement (associated with the presence of gangrenous acute cholecystitis) and the presence of a gallstone in the gallbladder infundibulum are associated with conversion from laparoscopic to open cholecystectomy. © RSNA, 2012.


Bugnicourt J.-M.,Amiens University Medical Center | Bugnicourt J.-M.,French Institute of Health and Medical Research | Bugnicourt J.-M.,University of Picardie Jules Verne | Hamy O.,Amiens University Medical Center | And 3 more authors.
European Journal of Neurology | Year: 2014

Background and purpose: The present study sought to determine the impact of stroke on sexual function and well-being in a cohort of young ischaemic stroke patients and identify factors associated with impairment. Methods: Over a 2-year period, all patients aged 60 or under with ischaemic stroke or transient ischaemic attack (n = 156) were included. Information on sexual function and well-being was obtained by means of a paper questionnaire mailed to participants 1 year after their stroke. Impaired sexual activity (ISA) was defined as a decline in sexual function and/or satisfaction. Psychological well-being was evaluated on the Hospital Anxiety and Depression Scale (HADS). Results: The response rate was 67% (n = 104). Thirty of these responders (29%) reported ISA. Patients with ISA had a higher HADS score (19.7 vs. 11.2 in patients with no impairment; P < 0.001), anxiety score (10.0 vs. 6.3; P < 0.001) and depression score (8.7 vs. 4.8; P < 0.001) and were more likely to have left brain lesions (70% vs. 30%; P < 0.001) and use angiotensin-converting enzyme (ACE) inhibitors (73% vs. 31%; P < 0.001) and diuretics (50% vs. 19%; P = 0.003). In a stepwise logistic regression, depression (odds ratio 9.1, 95% confidence interval 2.45-33.46; P = 0.001) and ACE inhibitor use (odds ratio 6.0, 95% confidence interval 2.11-17.28; P = 0.001) were associated with ISA. Conclusions: Impaired sexual activity was reported by almost one-third of younger patients 1 year after ischaemic stroke. Factors associated with post-stroke ISA may include specific medications and depression rather than the characteristics of the stroke per se.© 2013 EFNS.


Morel V.,Amiens University Medical Center | Morel V.,University of Picardie Jules Verne | Duverlie G.,Amiens University Medical Center | Duverlie G.,University of Picardie Jules Verne | And 2 more authors.
Journal of Clinical Virology | Year: 2014

Background: Simeprevir (Olysio®), a second-wave protease inhibitor recently approved for the treatment of chronic hepatitis C, is not indicated in patients with genotype 1a strain harboring the Q80K protease mutation. Phase 2 and 3 studies on this molecule mainly focused on North American patients and the prevalence of Q80K is particularly high in the USA (around 50%). The prevalence of this mutation in other parts of the world is currently unknown. Objectives: The purpose of our study was to perform a detection of this mutation in a single PCR technique and to study the prevalence of this Q80K mutation in a non U.S. population. We can thus estimate the proportion of HCV positive patients who can be treated with simeprevir. Study design: We conducted a meta-analysis of response rates in the presence or absence of this mutation in randomized trials and then describe a simple and reliable method to detect this mutation. We also examined bilirubin levels in our cohort of 95 HCV genotype 1a patients. Results: Ten patients (10.5%) had a Q80K mutation and 12 patients exhibited bilirubin levels above the upper limit of normal at baseline. In our cohort, 21 patients (22%) were therefore ineligible for treatment with simeprevir. The prevalence of this mutation seems to be much lower in European patients. Conclusion: In conclusion, before considering treatment with simeprevir, physicians must be able to screen for the Q80K mutation. © 2014 Elsevier B.V.


Merviel P.,Amiens University Medical Center | Heraud M.H.,Amiens University Medical Center | Grenier N.,Amiens University Medical Center | Lourdel E.,Amiens University Medical Center | And 2 more authors.
Fertility and Sterility | Year: 2010

Objective: To determine the predictive factors for pregnancy after IUI. Design: Retrospective study. Setting: A single university medical center. Patient(s): One thousand thirty-eight IUI cycles in 353 couples were studied between 2002 and 2005. Intervention(s): Ovarian stimulation via SC injection of FSH or hMG was performed daily; IUI was then performed 36 hours after triggering ovulation if at least one follicle measuring >16 mm and an endometrial thickness of >7 mm (with triple-line development) were obtained. Main Outcome Measure(s): Clinical pregnancy rates were analyzed according to the woman's age, the type of infertility, the spermogram characteristics, the total motile spermatozoa (TMS) count, the E 2 level before hCG injection, and the number of mature follicles. Result(s): The couple with the best chance of pregnancy can be described as follows: an under 30 woman with cervical or anovulatory infertility and a man with a TMS ≥5 million spermatozoa. The "ideal" stimulation cycle enables the recruitment of two follicles measuring >16 mm with an E 2 concentration >500 pg/mL on the day of hCG administration. The best results are obtained when IUI is performed using a soft catheter. Conclusion(s): This study enabled the characterization of many prognostic factors for pregnancy and particularly those for women at risk of multiple pregnancies after IUI. © 2010 American Society for Reproductive Medicine.


Gross P.,French Institute of Health and Medical Research | Six I.,French Institute of Health and Medical Research | Kamel S.,French Institute of Health and Medical Research | Kamel S.,Amiens University Medical Center | And 2 more authors.
Circulation Journal | Year: 2014

Chronic kidney disease (CKD) is characterized by high cardiovascular morbidity/mortality, which is linked in part to vascular calcification (VC) and endothelial dysfunction (ED). Hyperphosphatemia, a feature of CKD, is a well-known inducer of VC in preclinical models and is associated with poor outcomes in epidemiological studies. However, it remains to be seen whether lowering phosphate levels in CKD patients reduces VC and the morbidity/mortality rate. Furthermore, it is now clear from preclinical and clinical studies that phosphate is involved in ED. The present article reviews the direct and indirect mechanisms (eg, via fibroblast growth factor 23 and/or parathyroid hormone) by which hyperphosphatemia influence the onset of VC and ED in CKD. © Japanese Circulation Society. All rights reserved.


Sinna R.,Amiens University Medical Center
Journal of visceral surgery | Year: 2013

Although many options are available for the management of perineal wounds after abdominoperineal resection, ranging from direct closure to flap reconstruction, treatment remains challenging. A better understanding of the aims, drawbacks and progress in perineal wound management after abdominoperineal rectal resection can help the surgeon make better choices for each patient, but it is very difficult to propose a single, optimal, evidence-based procedure for the management of pelvic exenteration. Recent progress provided by the extralevator abdominoperineal resection technique and perforator flap concepts have changed our conception of reconstruction leading to the different technical options highlighted in this review. Copyright © 2013 Elsevier Masson SAS. All rights reserved.


Fall S.,Amiens University Medical Center | Querne L.,Amiens University Medical Center | Le Moing A.-G.,Amiens University Medical Center | Berquin P.,Amiens University Medical Center
Psychiatry Research - Neuroimaging | Year: 2015

The results of several previous magnetic resonance imaging studies suggest that the fronto-striato-thalamic circuitry is involved in the pathophysiology of attention-deficit/hyperactivity disorder (ADHD). However, few studies have investigated the putative association between quantitative diffusion tensor imaging measurements of subcortical gray matter and subject task performances in children with ADHD. Here, we examined whether reaction time (RT) parameters during a flanker task were correlated with mean diffusivity (MD) measurements in the basal ganglia and thalamus in children with ADHD and in controls. For the study group as a whole, both the mean RT and the intra-individual variability in RTs were found to be significantly correlated with MD measurements in the right and left caudate, putamen and thalamus. In contrast, the correlation between the interference effect and MD failed to reach statistical significance. The present results may advance our understanding of the anatomical substrates of ADHD. © 2015 Elsevier Ireland Ltd.

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