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Vandenhende M.-A.,University of Bordeaux 1 | Buret J.,Center hospitalier regional dOrleans | Camou F.,University of Bordeaux 1 | Morlat P.,University of Bordeaux 1 | Bonnet F.,University of Bordeaux 1
Diagnostic Microbiology and Infectious Disease | Year: 2014

There are no data on how to manage implantable intra-arterial catheter (IAC) infections. We report the case of a patient with liver metastases of colon cancer treated by regional intra-arterial chemotherapy who presented a suspected IAC-related infection, in whom daptomycin systemic treatment and lock therapy allowed to cure the IAC infection. © 2014 Elsevier Inc. Source

French National Center for Scientific Research, University of Orléans and Center Hospitalier Regional Dorleans | Date: 2012-06-19

The present invention relates to a composition comprising a maxi-K potassium channel opener the use in the treatment of fragile X syndrome. More specifically the present invention relates to a composition comprising a fluoro-oxindole or a chloro-oxindole for use in the treatment of fragile X syndrome.

Richard A.,Center hospitalier regional dOrleans
Soins Cadres de Sante | Year: 2014

During their career, healthcare managers are regularly called upon to support their teams through changes. Indeed, the new organisations, new procedures, new standards and the notion of efficiency require this approach in order to guarantee the quality and safety of patient care. However, what role does the healthcare manager play during an institutional project such as the relocation of a healthcare facility? © 2014 Elsevier Masson SAS. Source

Walmsley S.L.,A+ Network | Antela A.,Hospital Clinico Universitario | Clumeck N.,Center Hospitalier University Saint Pierre | Duiculescu D.,Dr. Victor Babes Infectious and Tropical Diseases Hospital | And 10 more authors.
New England Journal of Medicine | Year: 2013

BACKGROUND: Dolutegravir (S/GSK1349572), a once-daily, unboosted integrase inhibitor, was recently approved in the United States for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in combination with other antiretroviral agents. Dolutegravir, in combination with abacavir-lamivudine, may provide a simplified regimen. METHODS: We conducted a randomized, double-blind, phase 3 study involving adult participants who had not received previous therapy for HIV-1 infection and who had an HIV-1 RNA level of 1000 copies per milliliter or more. Participants were randomly assigned to dolutegravir at a dose of 50 mg plus abacavir-lamivudine once daily (DTG-ABC-3TC group) or combination therapy with efavirenz-tenofovir disoproxil fumarate (DF)-emtricitabine once daily (EFV-TDF-FTC group). The primary end point was the proportion of participants with an HIV-1 RNA level of less than 50 copies per milliliter at week 48. Secondary end points included the time to viral suppression, the change from baseline in CD4+ T-cell count, safety, and viral resistance. RESULTS: A total of 833 participants received at least one dose of study drug. At week 48, the proportion of participants with an HIV-1 RNA level of less than 50 copies per milliliter was significantly higher in the DTG-ABC-3TC group than in the EFV-TDF-FTC group (88% vs. 81%, P = 0.003), thus meeting the criterion for superiority. The DTG-ABC-3TC group had a shorter median time to viral suppression than did the EFV-TDF-FTC group (28 vs. 84 days, P<0.001), as well as greater increases in CD4+ T-cell count (267 vs. 208 per cubic millimeter, P<0.001). The proportion of participants who discontinued therapy owing to adverse events was lower in the DTG-ABC-3TC group than in the EFV-TDF-FTC group (2% vs. 10%); rash and neuropsychiatric events (including abnormal dreams, anxiety, dizziness, and somnolence) were significantly more common in the EFV-TDF-FTC group, whereas insomnia was reported more frequently in the DTG-ABC-3TC group. No participants in the DTG-ABC-3TC group had detectable antiviral resistance; one tenofovir DF-associated mutation and four efavirenz-associated mutations were detected in participants with virologic failure in the EFV-TDF-FTC group. CONCLUSIONS: Dolutegravir plus abacavir-lamivudine had a better safety profile and was more effective through 48 weeks than the regimen with efavirenz-tenofovir DF-emtricitabine. Copyright © 2013 Massachusetts Medical Society. Source

Bretagnol A.,Center hospitalier regional dOrleans | Barbier F.,Center hospitalier regional dOrleans
Reanimation | Year: 2015

Renal failure is common in human immunodeficiency virus (HIV)-infected patients admitted to the intensive care unit (ICU). Improved life expectancy in patients receiving combination antiretroviral therapy (cART) is associated with an increasing prevalence of chronic kidney diseases (CKD) in this population, as a result of extended exposure to comorbidities that may impair renal function (including hepatic and cardiovascular diseases) and late nephrotoxic effects of certain cART regimen. Meanwhile, a decreasing trend is observed in the incidence of HIV-associated nephropathy (HIVAN) and other kidney diseases directly related to HIV infection or the acquired immunodeficiency syndrome. Acute renal failure (ARF) is present upon admission or occurs during the ICU stay in one to two-thirds of patients, and significantly increases the risk of ICU death and subsequent progression to CKD. Sepsis and exposure to nephrotoxic drugs are the main causes of ARF in this context. Renal biopsy should be discussed in each ARF episode when noninvasive methods failed to identify the underlying nephropathy. Lastly, since published data are dramatically lacking, the management of cART remains challenging in critically ill patients with altered renal function. This crucial aspect of intensive care in HIV-infected patients should be the focus of further prospective works. © 2015, Société de réanimation de langue française (SRLF) and Springer-Verlag France. Source

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