Time filter

Source Type

Roubaud-Baudron C.,University of Paris Descartes | Pagnoux C.,University of Paris Descartes | Grasland A.,Hopital Louis Mourier | Le Guen J.,University of Paris Descartes | And 8 more authors.
Journal of Rheumatology | Year: 2012

Objective. To evaluate the efficacy compared to the relapse risk and tolerance of systematic rituximab (RTX) infusions as maintenance therapy for patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA), who entered remission taking conventional immunosuppressants or RTX. Methods. A retrospective study of the main clinical characteristics, outcomes, and RTX tolerance of patients who had received &γε; 2 RTX maintenance infusions in our center, regardless of induction regimen, between 2003 and 2010. Results. We identified 28 patients [4 MPA and 24 GPA; median age 55.5 yrs (range 18-78); 17 (60%) males] who received a median of 4 (range 2-10) RTX maintenance infusions, with median followup of 38 months (range 21-97) since diagnosis or last flare. None experienced a RTX infusion-related adverse event; 15 patients (among the 21 with available data) had hypogammaglobulinemia (predominantly IgM) prior to their last RTX maintenance infusion; 3 had infectious events (1 cutaneous abscess, 1 otitis, 1 fatal H1N1 flu). Two patients suffered pulmonary relapses shortly before a planned RTX maintenance infusion (both had increased antineutrophil cytoplasmic antibody levels and 1 had CD19+ lymphocyte reconstitution). Conclusion. Rituximab maintenance therapy was well tolerated but did not completely prevent relapses and persistent "grumbling" disease. These preliminary results remain to be confirmed by a randomized controlled trial currently in progress. The Journal of Rheumatology Copyright © 2012. All rights reserved.


Morin T.,Center Hospitalier Of Bigorre | Pariente A.,Center Hospitalier Of Pau | Lahmek P.,Center Hospitalier Emile Roux | Rabaud C.,University of Lorraine | And 2 more authors.
European Journal of Gastroenterology and Hepatology | Year: 2010

Objectives: To analyze the data (epidemiology, mode of transmission, course, and outcome) of a large series of patients with acute hepatitis C (AHC) in France. Methods: Prospective multicenter register, observational study. Results: A cohort of 126 patients with AHC was prospectively enrolled between 1999 and 2007. Fifteen (12%) were HIV coinfected. Suspected modes of hepatitis C virus transmission were drug use (38%), sexual contact (21%), nosocomial transmission (18%), and occupational exposure (12%). For 40% of the patients, AHC was revealed by jaundice. Spontaneous viral clearance occurred in 40% of the 72 patients observed for 3 months without treatment. Only jaundice and nosocomial/occupational transmission were predictive of spontaneous viral clearance. Ninety patients were treated with standard or pegylated interferonα alone (58%) or in combination with ribavirin (42%), for 24 weeks or less in 90%. In intention-to-treat, a sustained viral response was obtained in 58 of 78 (74%) hepatitis C virus monoinfected patients [19 of 22 (86%) with 24 weeks of pegylated interferon-α alone], but only six of 12 (50%) of HIV coinfected patients. Conclusion: AHC remains rare, and drug and sexual transmission are predominant. A 3-month follow-up after diagnosis avoids treatment for four out of 10 patients. Antiviral treatment is highly effective, 24 weeks of pegylated interferon-α alone being a good option. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Shcherbinin S.,University of British Columbia | Chamoiseau S.,Center Hospitalier Of Bigorre | Celler A.,University of British Columbia
Physics in Medicine and Biology | Year: 2013

We investigate the quantitative accuracy of the reconstruction of absolute 99mTc and 111In activities from 99mTc/ 111In dual-isotope SPECT studies. The separate reconstruction of two images is achieved by applying Monte Carlo simulation-based corrections for self-scatter and cross-talk between energy windows. For method evaluation, a series of 99mTc/111In physical phantom experiments was performed using a clinical SPECT/CT camera. The containers were filled with different ratios of 99mTc and 111In activities to create cross-talk with varying severity levels. In addition, we illustrate the performance of our method by reconstructing images from four simultaneous 99mTc/111In SPECT/CT studies of neuroendocrine patients. Similarly to the phantom experiments, clinical cases provide examples with different severity of cross-talk. Phantom experiments showed that Monte Carlo simulation-based corrections improved both quantitative accuracy and visual properties of 99mTc and 111In images. While the errors of absolute activities for both tracers in six containers ranged from 16% to 75% if no corrections for self-scatter and cross-talk were applied, these errors decreased to below 10% when images were reconstructed with the aforementioned corrections. These activities were measured using regions of interest larger than the true sizes of the containers in order to account for the spill-out effect. Analysis of patient studies confirmed that accurate simulation-based compensations improved resolution and contrast for both 99mTc and 111In images. © 2013 Institute of Physics and Engineering in Medicine.


Shcherbinin S.,University of British Columbia | Chamoiseau S.,Center Hospitalier Of Bigorre | Celler A.,University of British Columbia
Physics in Medicine and Biology | Year: 2012

We investigated the quantitative accuracy of the model-based dual-isotope single-photon emission computed tomography (DI-SPECT) reconstructions that use Klein-Nishina expressions to estimate the scattered photon contributions to the projection data. Our objective was to examine the ability of the method to recover the absolute activities pertaining to both radiotracers: Tc-99m and I-123. We validated our method through a series of phantom experiments performed using a clinical hybrid SPECT/CT camera (Infinia Hawkeye, GE Healthcare). Different activity ratios and different attenuating media were used in these experiments to create cross-talk effects of varying severity, which can occur in clinical studies. Accurate model-based corrections for scatter and cross-talk with CT attenuation maps allowed for the recovery of the absolute activities from DI-SPECT/CT scans with errors that ranged 0-10% for both radiotracers. The unfavorable activity ratios increased the computational burden but practically did not affect the resulting accuracy. The visual analysis of parathyroid patient data demonstrated that our model-based processing improved adenoma/background contrast and enhanced localization of small or faint adenomas. © 2012 Institute of Physics and Engineering in Medicine.


Maitre J.,University of Pau and Pays de l'Adour | Serres I.,University of Pau and Pays de l'Adour | Lhuisset L.,University of Pau and Pays de l'Adour | Bois J.,University of Pau and Pays de l'Adour | And 2 more authors.
Scandinavian Journal of Medicine and Science in Sports | Year: 2015

The aim was to determine in what extent physical activity influences postural control when visual, vestibular, and/or proprioceptive systems are disrupted. Two groups of healthy older women: an active group (74.0±3.8 years) who practiced physical activities and a sedentary group (74.7±6.3 years) who did not, underwent 12 postural conditions consisted in altering information emanating from sensory systems by means of sensory manipulations (i.e., eyes closed, cervical collar, tendon vibration, electromyostimulation, galvanic vestibular stimulation, foam surface). The center of foot pressure velocity was recorded on a force platform. Results indicate that the sensory manipulations altered postural control. The sedentary group was more disturbed than the active group by the use of tendon vibration. There was no clear difference between the two groups in the other conditions. This study suggests that the practice of physical activities is beneficial as a means of limiting the effects of tendon vibration on postural control through a better use of the not manipulated sensory systems and/or a more efficient reweighting to proprioceptive information from regions unaffected by the tendon vibration. © 2014 John Wiley & Sons A/S.


Morin T.,Center Hospitalier Of Bigorre | Pariente A.,Center Hospitalier | Lahmek P.,Center Hospitalier Emile Roux
European Journal of Gastroenterology and Hepatology | Year: 2011

Background: Although risk factors and useful preventive measures are largely known, specific data about the course and prognosis of acute hepatitis C among healthcare workers is lacking. Aim: To analyze the data, course, and outcome of a series of patients with occupationally transmitted acute hepatitis C in France. Methods and Setting: An observational multicenter study based on two consecutive acute hepatitis C cohorts, retrospective then prospective, registered between 1993 and 2007, mostly in general hospitals. Results: A cohort of 23 patients with occupationally transmitted hepatitis C virus (HCV) was set up. Occupational accident registration was done in 14 (61%) cases. They were mainly women (n=14), with a mean age of 43 years. The disease was diagnosed during surveillance after exposure in 16 patients, and nine had hyperbilirubinemia. Early treatment was applied to nine of them, with eight who sustained viral response (SVR). Fourteen underwent surveillance: spontaneous viral clearance occurred in nine of them, with two relapses. Five patients with persistent HCV RNA 12 weeks after the diagnosis were then treated, with four SVR. Conclusion: Information and prevention of healthcare workers concerning occupational HCV transmission need to be improved, and all blood-exposure accidents should be registered. Spontaneous viral clearance occurred in half of the patients. Antiviral treatment was highly effective, with a SVR of 86%. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Maitre J.,University of Pau and Pays de l'Adour | Gasnier Y.,Center Hospitalier Of Bigorre | Bru N.,University of Pau and Pays de l'Adour | Jully J.-L.,University of Pau and Pays de l'Adour | Paillard T.,University of Pau and Pays de l'Adour
European Journal of Applied Physiology | Year: 2013

The purpose of the study was to compare the effects of sensory manipulations on postural control for subjects of different ages. A young group of subjects (n = 17; 20.0 ± 1.3 years) and an old group of subjects (n = 17; 74.7 ± 6.3 years) were compared in 14 postural conditions [2 reference conditions and 12 sensory manipulation conditions: eyes closed, cervical collar, tendon vibration, electromyostimulation, galvanic vestibular stimulation (2 designs), foam surface] on a force platform. Spatio-temporal parameters of the center of foot pressure displacement were analyzed. When vestibular or proprioceptive afferences were manipulated, the old group was more disturbed than the young group. In addition, when myo-articular proprioceptive afferences were the only non-manipulated information source, the old group was also more disturbed than the young group. Hence, the inability to correctly interpret proprioceptive information and/or the impairment of myo-articular information would appear to be the major factor causing postural control deterioration. Moreover, concerning the vestibular system, it may be that aging alters the central integration of vestibular afferences. These results suggest that aging differently affects the functional ability of the different neural loops in postural control. © 2013 Springer-Verlag Berlin Heidelberg.


Alfieri S.,Catholic University of the Sacred Heart | Amid P.K.,University of California at Los Angeles | Campanelli G.,University of Insubria | Izard G.,Center Hospitalier Of Bigorre | And 4 more authors.
Hernia | Year: 2011

Purpose To provide uniform terminology and definition of post-herniorrhaphy groin chronic pain. To give guidelines to the scientific community concerning the prevention and the treatment of chronic groin and testicular pain. Methods A group of nine experts in hernia surgery was created in 2007. The group set up six clinical questions and continued to work on the answers, according to evidencebased literature. In 2008, an International Consensus Conference was held in Rome with the working group, with an audience of 200 participants, with a view to reaching a consensus for each question. Results A consensus was reached regarding a definition of chronic groin pain. The recommendation was to identify and preserve all three inguinal nerves during open inguinal hernia repair to reduce the risk of chronic groin pain. Likewise, elective resection of a suspected injured nerve was recommended. There was no recommendation for a procedure on the resected nerve ending and no recommendation for using glue during hernia repair. Surgical treatment (including all three nerves) should be suggested for patients who do not respond to no-surgery pain-management treatment; it is advisable to wait at least 1 year from the previous herniorraphy. Conclusion The consensus reached on some open questions in the field of post-herniorrhaphy chronic pain may help to better analyze and compare studies, avoid sending erroneous messages to the scientific community, and provide some guidelines for the prevention and treatment of post-herniorraphy chronic pain. © 2010 Springer-Verlag.


Maitre J.,University of Pau and Pays de l'Adour | Jully J.-L.,University of Pau and Pays de l'Adour | Gasnier Y.,Center Hospitalier Of Bigorre | Paillard T.,University of Pau and Pays de l'Adour
Journal of Rehabilitation Research and Development | Year: 2013

The purpose of this study was to compare theeffects of proprioceptive disruption on postural control for participants of different ages according to their physical and/or sport activity levels. Two groups of young and old participants who practiced chronic physical and/or sport activities (young active [n = 17; average age 20.5 +/- 1.1 yr] and old active [n = 17; average age 74.0 +/- 3.8 yr]) and two groups of young and old participants who did not practice physical and/or sport activities (young sedentary [n = 17; average age 20.0 +/- 1.3 yr] and old sedentary [n = 17; average age 74.7 +/- 6.3 yr]) participated in the study. They were compared in a bipedal quiet stance reference condition and a bilateral Achilles tendon vibration condition. Center of foot pressure displacements and frequency analysis were compared between the groups. The results indicated that when proprioceptive information was disrupted, the postural control disturbance was more important for the old sedentary group than for the other groups. There were no differences between the old active group and the young sedentary group. Postural control was less altered for the young active group than for the other groups. Aging decreases the efficiency of postural control regardless of the assessment conditions. Physical and sport activities may compensate for the disturbing effects of proprioceptive perturbation through a better use of sensory information whatever the age of the participants.


PubMed | Besancon University Hospital Center, Center Hospitalier Of Bigorre and University Paris Diderot
Type: | Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology | Year: 2016

We developed a data-driven respiratory motion (RM) correction method (REGAT program) for multiple-pinhole detector CZT SPECT. We verified its clinical feasibility with myocardial perfusion imaging (MPI) and studied its impact on image characteristics.This retrospective study included 18 patients having stress/rest At both stress and rest, cranio-caudal motion was the dominant axial movement and REGAT had a positive impact on image characteristics as reflected by variations between R-SPECT and NR-SPECT in LV-Min, LV-Max, FWHM-ant, FWHM-inf, and contrast. These latter were well correlated to the amplitude of cranio-caudal motion at both stress and rest.Data-driven RM correction of MPI acquired with CZT SPECT is clinically feasible and easily applicable. It presents interesting impact on image characteristics.

Loading Center Hospitalier Of Bigorre collaborators
Loading Center Hospitalier Of Bigorre collaborators