AP HM

Saint-Pierre-du-Chemin, France
Saint-Pierre-du-Chemin, France
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Goueffic Y.,Nantes University Hospital Center | Goueffic Y.,French Institute of Health and Medical Research | Goueffic Y.,University of Nantes | Della Schiava N.,Hopital Edouard Herriot | And 12 more authors.
JACC: Cardiovascular Interventions | Year: 2017

Objectives The TECCO (Traitement des Lésions Athéromateuses de l'Artère Fémorale Commune par Technique Endovasculaire Versus Chirurgie Ouverte [Endovascular Versus Open Repair of the Common Femoral Artery]) trial is a randomized comparison of safety and efficacy of stenting versus open surgery for de novo common femoral artery (CFA) stenosis. Background Surgery for CFA lesions is considered effective and durable. Despite the widespread use of endovascular repair for infrainguinal disease, the value of this procedure for such lesions is uncertain. Methods From February 23, 2011, to September 5, 2013, a total of 117 patients with de novo atherosclerotic lesions of the CFA were randomly assigned to undergo surgery (n = 61) or stenting (n = 56). The main exclusion criteria were asymptomatic disease, restenosis, and thrombosis of the CFA. The primary outcome was the morbidity and mortality rate within 30 days. This includes any general complications or local complications that caused or prolonged hospitalization and/or re-intervention, lymphorrhea of more than 3 days, and post-operative paresthesia that required drugs. The median duration of follow-up was 2 years (interquartile range [IQR]: 19.8 to 24.9 years). Results Primary outcome events occurred in 16 of 61 patients (26%) in the surgery group and 7 of 56 patients (12.5%) in the stenting group (odds ratio: 2.5; 95% confidence interval: 0.9 to 6.6; p = 0.05). The mean duration of hospitalization was significantly lower in the stenting group (3.2 ± 2.9 days vs. 6.3 ± 3 days; p < 0.0001). At 24 months, the sustained clinical improvement, the primary patency rate, and the target lesion and extremity revascularization rates were not different in the 2 groups. Conclusions In patients with de novo atherosclerotic lesions of the CFA, the perioperative morbidity and mortality rate was significantly lower among patients who underwent endovascular therapy by stenting compared with surgery, whereas clinical, morphological, and hemodynamic outcomes were comparable at mid-term. (Traitement des Lésions Athéromateuses de l'Artère Fémorale Commune par Technique Endovasculaire Versus Chirurgie Ouverte [Endovascular Versus Open Repair of the Common Femoral Artery] [TECCO]; NCT01353651) © 2017 American College of Cardiology Foundation


Karila L.,French Institute of Health and Medical Research | Roux P.,Aix - Marseille University | Rolland B.,Lille University Hospital Center | Benyamina A.,University Paris - Sud | And 3 more authors.
Current Pharmaceutical Design | Year: 2014

Cannabis remains the most commonly used and trafficked illicit drug in the world. Its use is largely concentrated among young people (15- to 34-year-olds). There is a variety of cannabis use patterns, ranging from experimental use to dependent use. Men are more likely than women to report both early initiation and frequent use of cannabis. Due to the high prevalence of cannabis use, the impact of cannabis on public health may be significant. A range of acute and chronic health problems associated with cannabis use has been identified. Cannabis can frequently have negative effects in its users, which may be amplified by certain demographic and/or psychosocial factors. Acute adverse effects include hyperemesis syndrome, impaired coordination and performance, anxiety, suicidal ideations/tendencies, and psychotic symptoms. Acute cannabis consumption is also associated with an increased risk of motor vehicle crashes, especially fatal collisions. Evidence indicates that frequent and prolonged use of cannabis can be detrimental to both mental and physical health. Chronic effects of cannabis use include mood disorders, exacerbation of psychotic disorders in vulnerable people, cannabis use disorders, withdrawal syndrome, neurocognitive impairments, cardiovascular and respiratory and other diseases. © 2014 Bentham Science Publishers.


Reyes-Botero G.,Groupe Hospitalier Pitie Salpetriere | Dehais C.,Groupe Hospitalier Pitie Salpetriere | Idbaih A.,Groupe Hospitalier Pitie Salpetriere | Idbaih A.,University Pierre and Marie Curie | And 14 more authors.
Neuro-Oncology | Year: 2014

BackgroundThe aim of this study was to correlate MRI features and molecular characteristics in anaplastic oligodendrogliomas (AOs).MethodsThe MRI characteristics of 50 AO patients enrolled in the French national network for high-grade oligodendroglial tumors were analyzed. The genomic profiles and IDH mutational statuses were assessed using high-resolution single-nucleotide polymorphism arrays and direct sequencing, respectively. The gene expression profiles of 25 1p/19q-codeleted AOs were studied on Affymetrix expression arrays.ResultsMost of the cases were frontal lobe contrast-enhanced tumors (52%), but the radiological presentations of these cases were heterogeneous, ranging from low-grade glioma-like aspects (26%) to glioblastoma-like aspects (22%). The 1p/19q codeletion (n = 39) was associated with locations in the frontal lobe (P =. 001), with heterogeneous intratumoral signal intensities (P =. 003) and with no or nonmeasurable contrast enhancements (P =. 01). The IDH wild-type AOs (n = 7) more frequently displayed ringlike contrast enhancements (P =. 03) and were more frequently located outside of the frontal lobe (P =. 01). However, no specific imaging pattern could be identified for the 1p/19q-codeleted AO or the IDH-mutated AO. Within the 1p/19q-codeleted AO, the contrast enhancement was associated with larger tumor volumes (P =. 001), chromosome 9p loss and CDKN2A loss (P =. 006), genomic instability (P =. 03), and angiogenesis-related gene expression (P <. 001), particularly for vascular endothelial growth factor A and angiopoietin 2.ConclusionIn AOs, the 1p/19q codeletion and the IDH mutation are associated with preferential (but not with specific) imaging characteristics. Within 1p/19q-codeleted AO, imaging heterogeneity is related to additional molecular alterations, especially chromosome 9p loss, which is associated with contrast enhancement and larger tumor volume. © 2013 © The Author(s) 2013. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.


Rossi P.,AP HM | Rossi P.,Institut Universitaire de France | Rossi P.,North Hospital | Tauzin L.,Center Hospitalier Territorial Of La Nouvelle Caldonie | And 4 more authors.
Journal of Adolescent Health | Year: 2011

Purpose Recent studies show that low birth weight infants are at a risk of increased arterial blood pressure (BP) in adulthood. This study aimed to distinguish the influence of low birth weight either as a result of fetal growth restriction or preterm birth on arterial properties in adolescents. Methods The effect of low birth weight on BP and arterial stiffness was examined among 90 adolescents aged 14 years who were either born at term with an appropriate birth weight for gestational age (controls, n = 41); born preterm with an appropriate birth weight for gestational age (n = 25); or born at term and small for gestational age (SGA) (n = 24). The pulse wave velocity between the carotid and radial arteries was measured to assess arterial stiffness. Results As compared with control subjects, adolescents born with low birth weight as a result of preterm birth were found to have increased systolic BP and carotidradial pulse wave velocity (117 ± 11 mm Hg vs. 123 ± 11 mm Hg, p = .04 and 7.0 ± .9 m/s vs. 7.7 ± 1.0 m/s, p = .01, respectively), whereas those who were born at term and SGA exhibited values similar to the controls (114 ± 15 mm Hg and 6.8 ± .9 m/s). Conclusion Preterm birth, rather than being SGA at term, increases BP and arterial stiffness in adolescents. © 2011 Society for Adolescent Health and Medicine.


PubMed | University of Amsterdam, AP HM, Floating Hospital for Children at Tufts Medical Center, Masaryk University and 9 more.
Type: Review | Journal: Oncotarget | Year: 2016

Research has exposed cancer to be a heterogeneous disease with a high degree of inter-tumoral and intra-tumoral variability. Individual tumors have unique profiles, and these molecular signatures make the use of traditional histology-based treatments problematic. The conventional diagnostic categories, while necessary for care, thwart the use of molecular information for treatment as molecular characteristics cross tissue types.This is compounded by the struggle to keep abreast the scientific advances made in all fields of science, and by the enormous challenge to organize, cross-reference, and apply molecular data for patient benefit. In order to supplement the site-specific, histology-driven diagnosis with genomic, proteomic and metabolomics information, a paradigm shift in diagnosis and treatment of patients is required.While most physicians are open and keen to use the emerging data for therapy, even those versed in molecular therapeutics are overwhelmed with the amount of available data. It is not surprising that even though The Human Genome Project was completed thirteen years ago, our patients have not benefited from the information. Physicians cannot, and should not be asked to process the gigabytes of genomic and proteomic information on their own in order to provide patients with safe therapies. The following consensus summary identifies the needed for practice changes, proposes potential solutions to the present crisis of informational overload, suggests ways of providing physicians with the tools necessary for interpreting patient specific molecular profiles, and facilitates the implementation of quantitative precision medicine. It also provides two case studies where this approach has been used.


Fabre A.,Aix - Marseille University | Charroux B.,Aix - Marseille University | Martinez-Vinson C.,AP HP | Roquelaure B.,AP HM | And 14 more authors.
American Journal of Human Genetics | Year: 2012

Syndromic diarrhea (or trichohepatoenteric syndrome) is a rare congenital bowel disorder characterized by intractable diarrhea and woolly hair, and it has recently been associated with mutations in TTC37. Although databases report TTC37 as being the human ortholog of Ski3p, one of the yeast Ski-complex cofactors, this lead was not investigated in initial studies. The Ski complex is a multiprotein complex required for exosome-mediated RNA surveillance, including the regulation of normal mRNA and the decay of nonfunctional mRNA. Considering the fact that TTC37 is homologous to Ski3p, we explored a gene encoding another Ski-complex cofactor, SKIV2L, in six individuals presenting with typical syndromic diarrhea without variation in TTC37. We identified mutations in all six individuals. Our results show that mutations in genes encoding cofactors of the human Ski complex cause syndromic diarrhea, establishing a link between defects of the human exosome complex and a Mendelian disease. © 2012 The American Society of Human Genetics.


Bingenheimer K.,AP HM | Temprado J.J.,Aix - Marseille University | Harnagea M.,Aix - Marseille University | Bricot N.,Aix - Marseille University | And 2 more authors.
Neuroscience Letters | Year: 2015

We investigated the effects of lightly touching fixed and mobile supports on gait parameters and center of mass oscillations in visually restricted young adults. Fourteen healthy male and female adults of mean. = 23.6 years (SD. = 1.6 years). Twelve walking conditions were completed on the GAITRite measurement system, resulting from crossing 3 conditions of visual restriction (no restriction, partial restriction, blindfolded) and 4 conditions of haptic supplementation (no supplementation, with a cane used as "light touch", with a cane sliding on the ground, while touching a soft elastic handrail). Gait speed, stance time, step length and the basis of support were measured. Accelerations of center of mass were also recorded through an accelerometer and the displacements of center of mass were analyzed. Results showed that visual restriction decreased in gait speed, reduced step length, while it increased the base of support and the amplitude of CoM displacements. In the full restriction condition, haptic supplementation provided by the use of the classic cane improved normalized stance time (%). In addition, in the no vision condition, both the classic cane and the soft handrail increased step length and reduced medio-lateral oscillations of the CoM. These results suggest that in visually restricted healthy adults, lightly touching a fixed (soft handrail) or a mobile (classic cane) support contributes to adaptation of gait parameters and postural control during locomotion. © 2015.


PubMed | Aix - Marseille University, Salk Institute for Biological Studies, French Institute of Health and Medical Research and AP HM
Type: Journal Article | Journal: Molecular psychiatry | Year: 2016

With an onset under the age of 3 years, autism spectrum disorders (ASDs) are now understood as diseases arising from pre- and/or early postnatal brain developmental anomalies and/or early brain insults. To unveil the molecular mechanisms taking place during the misshaping of the developing brain, we chose to study cells that are representative of the very early stages of ontogenesis, namely stem cells. Here we report on MOlybdenum COfactor Sulfurase (MOCOS), an enzyme involved in purine metabolism, as a newly identified player in ASD. We found in adult nasal olfactory stem cells of 11 adults with ASD that MOCOS is downregulated in most of them when compared with 11 age- and gender-matched control adults without any neuropsychiatric disorders. Genetic approaches using in vivo and in vitro engineered models converge to indicate that altered expression of MOCOS results in neurotransmission and synaptic defects. Furthermore, we found that MOCOS misexpression induces increased oxidative-stress sensitivity. Our results demonstrate that altered MOCOS expression is likely to have an impact on neurodevelopment and neurotransmission, and may explain comorbid conditions, including gastrointestinal disorders. We anticipate our discovery to be a fresh starting point for the study on the roles of MOCOS in brain development and its functional implications in ASD clinical symptoms. Moreover, our study suggests the possible development of new diagnostic tests based on MOCOS expression, and paves the way for drug screening targeting MOCOS and/or the purine metabolism to ultimately develop novel treatments in ASD.

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