Le Touquet – Paris-Plage, France
Le Touquet – Paris-Plage, France

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PubMed | Groupe hospitalier La Pitie Salpetriere, University of Paris Descartes, University Paris - Sud and University Pierre and Marie Curie
Type: Journal Article | Journal: Bulletin du cancer | Year: 2016

The care pathway of cancer patients is complex and therefore difficult to define. The oral anticancers (AKPO) have shown their benefits to patients and health professionals, however, the risks induced on the care pathway remain unknown. The objective of the study is to define, quantify the risks from AKPO and their effects on the care pathway (breakdown [Ds], rupture [Rt]). From the proposed care pathway model, FMEA method is used to analyze risks. For the 3identified processes (1monotherapy, 2bitherapies: 2AKPO or 1AKPO/1AKIV), analysis revealed an average of 91risks, 173Ds, 147Rt, increased for 1AKPO/1AKIV therapy. The administration and delivery are the most risky steps. The lack of training and information of patients and healthcare professionals generates 80% of Ds and Rt. This model confirms the complexity, variability of the care pathway. The development of actions to improve town-hospital coordination and exchange of information is required to optimize and secure the route, confirming the objectives of Plan Cancer 3.


PubMed | Center Hospitalo University, University of Bordeaux 1, CNRS Immunology and Infectious Disease Center, Groupe Hospitalier La Pitie Salpetriere and 11 more.
Type: Journal Article | Journal: Antimicrobial agents and chemotherapy | Year: 2016

In vitro susceptibility of 933 Candida isolates, from 16 French hospitals, to micafungin was determined using the Etest in each center. All isolates were then sent to a single center for determination of MICs by the EUCAST reference method. Overall essential agreement between the two tests was 98.5% at 2 log2 dilutions and 90.2% at 1 log2 dilutions. Categorical agreement was 98.2%. The Etest is a valuable alternative to EUCAST for the routine determination of micafungin MICs in medical mycology laboratories.


PubMed | Groupe hospitalier la Pitie Salpetriere, University Pierre and Marie Curie and Paris West University Nanterre La Défense
Type: | Journal: Cerebellum (London, England) | Year: 2016

The cerebellum is involved not only in motor coordination, training, and memory, but also in cognition and emotion. Lobule VI in particular belongs to sensorimotor, salience, and executive cerebellar networks. This study aims to determine whether lobule VI would constitute an integrative interface between motor and cognitive/emotional circuits during a motor task with verbal encouragement, likely in conjunction with the basal ganglia (reward and motivational system). We used fMRI to identify specific recruitment of cerebellar and striatal systems during physical performance using two motor tasks with and without encouragement. We found that: (i) Force results were higher during verbal encouragement than during basal condition in all participants. (ii) The anterior part of the right lobule VI was activated by motor execution in both tasks, while its posterior part was specifically activated by verbal encouragement. (iii) The closed-connectivity loop maintained motivation induced by verbal encouragement between cerebral and cerebellar through the red nucleus and striatal network. Therefore, right lobule VI is a hub-controlling sensorimotor and motivates aspects of motor performance in relation with the red nucleus and the ventral striatum. These results could have important implications for extrapyramidal and multisystem degenerative diseases.


Lagaye S.,University of Paris Descartes | Shen H.,University of Paris Descartes | Saunier B.,University of Paris Descartes | Nascimbeni M.,University of Paris Descartes | And 10 more authors.
Hepatology | Year: 2012

The development of human cultured hepatitis C virus (HCV) replication-permissive hepatocarcinoma cell lines has provided important new virological tools to study the mechanisms of HCV infection; however, this experimental model remains distantly related to physiological and pathological conditions. Here, we report the development of a new ex vivo model using human adult liver slices culture, demonstrating, for the first time, the ability of primary isolates to undergo de novo viral replication with the production of high-titer infectious virus as well as Japanese fulminant hepatitis type 1, H77/C3, and Con1/C3. This experimental model was employed to demonstrate HCV neutralization or HCV inhibition, in a dose-dependent manner, either by cluster of differentiation 81 or envelope protein 2-specific antibodies or convalescent serum from a recovered HCV patient or by antiviral drugs. Conclusion: This new ex vivo model represents a powerful tool for studying the viral life cycle and dynamics of virus spread in native tissue and also allows one to evaluate the efficacy of new antiviral drugs. © 2012 American Association for the Study of Liver Diseases.


PubMed | Aix - Marseille University, APHM, APHP and Groupe Hospitalier La Pitie Salpetriere
Type: Journal Article | Journal: Journal of neuromuscular diseases | Year: 2016

GNE myopathy is a rare autosomal recessively inherited muscle disease resulting from mutations in the gene encoding GNE (UDP-N-acetylglucosamine-2-epimerase/N-acetylmannosamine kinase), a key enzyme in sialic acid biosynthesis. 154 different pathogenic variants have been previously associated with GNE myopathy.Describe novel pathogenic variants associated with GNE myopathy in a large French cohort.We analyzed mutational data from 32 GNE myopathy index patients. Novel, as well as previously published pathogenic variants, were examined for possible deleterious effects on splicing.We describe 13 novel pathogenic variants in GNE, identified in the first large French cohort reported to date. We also find that 6 published pathogenic variants might have a previously unrecognized deleterious effect on splicing.Novel pathogenic GNE variants described here raise the total number of different pathogenic variants reported to 167, complementing the recently published GNE mutation update. Our novel findings on possible splice-disrupting effects by several variants suggest that the pathogenicity mechanism of these variants could be reinterpreted, expanding our knowledge about the GNE mutational spectrum.


Diabetes is a major cardiovascular risk factor. However, hyperglycemia is much more closely associated with microangiopathy than with macrovascular complications. Epidemiologic studies have shown a 15% increase of myocardial infarction for 1% increase in HbA1c level. It is accepted but not absolutely demonstrated, that reduction of HbA1c results in an equal reduction of cardiovascular events. An initial good glycemic control has long-term benefical effects on the risk of cardiovascular disease. On the contrary, benefit of an intensive glucose control is not demonstrated in diabetic patients with previous myocardial infarction. Two recent studies (ACCORD and VADT) showed an increase of cardiovascular mortality by severe hypoglycemia. In diabetic patients with previous myocardial infarction, glycemic goal must be modulated by the hypoglycaemic risk. A goal of 7.5% HbA1c seems reasonable for the diabetic patients treated by sulfonylureas or insulin, at risk of hypoglycaemia. HbA1c target < 7% remains the general goal and HbA1c target < 6.5% is appropriated to the patients treated by insulin sensitizing medications without risk of hypoglycaemia.


Parkinson's disease is a neurodegenerative disorder characterized by a cardinal clinical triad that comprises resting tremor, akinesia and plastic hypertonia. The main lesion is a loss of midbbrain dopaminergic neurons but throughout the disease evolution, other neuronal systems will also degenerate. Starting from a typical clinical vignette, this review alms at illustrating how neurosciences helped to shape our knowledge of Parkinson's disease mechanisms at two complementary levels: first regarding the cellular dysfunctions leading to neuronal death and second regarding the neuronal networks involved in the occurrence of motor and non-motor symptoms. The paradigmatic example of subthalamic nucleus deep brain stimulation that dramatically transformed the treatment of patients with advanced Parkinson disease illustrates why the dialog between fundamental and clinical neurosciences is crucial for therapeutic advances.


Even C.,Groupe Hospitalier la Pitie Salpetriere | Taillade L.,Groupe Hospitalier la Pitie Salpetriere | Spano J.-P.,Groupe Hospitalier la Pitie Salpetriere | Vignot S.,Groupe Hospitalier la Pitie Salpetriere
Bulletin du Cancer | Year: 2010

Chemotherapy-induced febrile neutropenia represents a frequent emergency and evidence based management of this event remains an exigency for each patient. Appropriate use of antibiotics is mandatory, growth factors have to be proposed according to validated guidelines and benefits and risks of antiobioprophylaxy must be discussed. This review propose to summarize available data on these important questions, with a special focus on this management of febrile neutropenia in daily practice. ©John Libbey Eurotext.


Ciangura C.,Groupe Hospitalier La Pitie Salpetriere
Revue du Praticien | Year: 2010

There are numerous beneficial effects of physical activity for diabetes mellitus treatment and prevention. Irrespective of diet or weight loss, exercise training reduces HbA1c by an amount that should reduce diabetic complications, improves cardiorespiratory fitness that is a predictor of mortality, and improves body composition. Endurance training is usually prescribed, but resistance training is nowadays recommended Prior to initiating physical programm, medical screening (usual diabetic complications, cardiovascular status) is needed. To allow a long term behavioural change, individually tailored advice and special attention to barriers are needed.


PubMed | Groupe Hospitalier La Pitie Salpetriere and CNRS Immunology and Infectious Disease Center
Type: Journal Article | Journal: The Journal of allergy and clinical immunology | Year: 2016

Neutrophils are key effectors against the widely distributed mold Aspergillus fumigatus, which is a major threat for immunocompromised patients, including allogeneic hematopoietic stem cell transplant (HSCT) recipients. Yet little is known about neutrophil activity over time after cell transplantation, especially regarding A fumigatus.We aimed at assessing the activity of neutrophils on A fumigatus in allogeneic HSCT recipients at different posttransplantation time points.We performed a longitudinal study involving 37 patients undergoing HSCT, drawing blood samples at engraftment and at 2, 6, and 10months after the HSCT. Posttransplantation neutrophil activity in the recipients was compared with that of the respective donors. Neutrophil/Afumigatus coculture, flow cytometry, and video microscopy were used to assess neutrophil inhibition of fungal growth, cell/fungus interactions, reactive oxygen species production, major surface molecule expression, and neutrophil extracellular trap (NET) formation.The ability of neutrophils to interfere with Aspergillus species hyphal growth was impaired after HSCT. The administration of calcineurin inhibitors appeared to play an important role in this impairment. We also observed that post-HSCT neutrophils produced less NETs, which was correlated with increased fungal growth. Tapering immunosuppression led to the recuperation of inhibition capacity 10months after HSCT.In HSCT recipients neutrophil-driven innate immunity to fungi is altered in the early posttransplantation period (between recovery from neutropenia and up to 6months). This alteration is at least partly related to administration of calcineurin inhibitors and diminution of NETs production.

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