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Charkaluk M.L.,French Institute of Health and Medical Research | Charkaluk M.L.,Groupe Hospitalier Of Linstitut Catholique Lillois | Charkaluk M.L.,University Pierre and Marie Curie | Truffert P.,French Institute of Health and Medical Research | And 7 more authors.
Early Human Development | Year: 2011

Aim: To study the predictive value of a developmental assessment at 2. years corrected age (CA) for schooling at age 8 in children born very preterm and free of disability or delay; to identify other factors associated with schooling in this population. Methods: 244 children born before 33. weeks in 1997, part of the population-based EPIPAGE cohort study, free of disability or delay, had their developmental quotient (DQ) evaluated with the Brunet-Lezine scale at 2. years CA. The mental processing composite (MPC) score was evaluated at age 5 with the K-ABC battery. Data on schooling were obtained at age 8 by postal questionnaire. Schooling was considered appropriate if the child was attending age-appropriate grade level in a regular classroom environment without support at school. Results: Schooling was appropriate for 172 (70%) children. The predictive value of a DQ ≥ 100 for appropriate schooling was 0.80 [0.75;0.85]. In children with a DQ at age 2 < 100, schooling varied significantly according to their MPC score at age 5 whereas it didn't in children with a DQ ≥ 100. In multivariate analysis, the rate of appropriate schooling was significantly related to global DQ at age 2 (p< 0.01), gestational age ≥ 29 weeks (p< 0.05), head circumference at age 2 (p< 0.05) and mother's educational level (p< 0.05). Conclusion: A DQ ≥ 100 cannot be solely used for the prediction of appropriate schooling at age 8. Mother's educational level, gestational age and head circumference at age 2 could be taken account. These factors could be used to individualise follow-up. © 2011 Elsevier Ltd.

Hezode C.,French Institute of Health and Medical Research | Fontaine H.,French Institute of Health and Medical Research | Dorival C.,University Pierre and Marie Curie | Larrey D.,Liver Unit IRB INSERM1040 | And 32 more authors.
Journal of Hepatology | Year: 2013

Background & Aims In phase III trials, the safety profile of triple therapy (pegylated interferon/ribavirin with boceprevir or telaprevir) seems to be similar in HCV treatment-experienced cirrhotic and non-cirrhotic patients, but few cirrhotics were included. We report the week 16 safety and efficacy analysis in a cohort of compensated cirrhotics treated in the French Early Access Programme. Methods 674 genotype 1 patients, prospectively included, received 48 weeks of triple therapy. The analysis is restricted to 497 patients reaching week 16. Results A high incidence of serious adverse events (40.0%), and of death and severe complications (severe infection or hepatic decompensation) (6.4%), and a difficult management of anaemia (erythropoietin and transfusion use in 50.7% and 12.1%) were observed. Independent predictors of anaemia <8 g/dl or blood transfusion were: female gender (OR 2.19, 95% CI 1.11-4.33, p = 0.024), no lead-in phase (OR 2.25, 95% CI 1.15-4.39, p = 0.018), age ≥65 years (OR 3.04, 95% CI 1.54-6.02, p = 0.0014), haemoglobin level (≤12 g/dl for females, ≤13 g/dl for males) (OR 5.30, 95% CI 2.49-11.5, p = 0.0001). Death or severe complications were related to platelets count ≤100,000/mm3 (OR 3.11, 95% CI 1.30-7.41, p = 0.0105) and albumin <35 g/dl (OR 6.33, 95% CI 2.66-15.07, p = 0.0001), with a risk of 44.1% in patients with both. However, the on-treatment virological response was high. Conclusions The safety profile was poor and patients with platelet count ≤100,000/mm3 and serum albumin <35 g/L should not be treated with the triple therapy. © 2013 European Association for the Study of the Liver.

Lamotte C.,Center Hospitalier University | Lamotte C.,University of Lille Nord de France | Lamotte C.,French Institute of Health and Medical Research | Iliescu C.,Groupe Hospitalier Of Linstitut Catholique Lillois | And 6 more authors.
European Journal of Pediatrics | Year: 2011

Increased carotid intima-media thickness (cIMT) in adults may be caused by a childhood exposure to cardiovascular risk factors. We systematically reviewed observational studies to determine whether obesity, insulin-dependent diabetes mellitus (IDDM), dyslipidemia (DL), hypertension (HT), and chronic renal failure (CRF) are associated with increased cIMT in children and adolescent patients compared with control subjects. We performed a PubMed literature search from January 1986 to February 2010. Two reviewers separately verified the inclusion criteria of relevant studies for the objective of the review. The data extracted in the patient and control groups were sample size, age, gender, cIMT measurement methods, cIMT values, and statistical analysis results. From 348 citations, 65 cross-sectional studies (2 cited twice) with case-control design met the inclusion criteria: 26 in obesity, 14 in IDDM, 11 in DL, 8 in HT, and 8 in CRF. cIMT measurement protocols varied according to the studies, with measurements being performed on the common carotid artery in 65/67 cases and on the far wall in 57/67 cases. From the 67 studies cited, 22/26 reported a significantly increased cIMT in obese children and adolescents compared with the control group, 8/14 in IDDM patients, 10/11 in DL patients, 7/8 in HT patients, and 8/8 in CRF patients. Conclusion: Despite the heterogeneity of ultrasound measurement methods, cIMT was significantly increased in 55 out of the 67 cited studies, confirming early vascular damages in pediatric populations with an increased future risk for vascular diseases. © 2010 Springer-Verlag.

Callier P.,Laboratoire Of Cytogenetique | Andrieux J.,Cytogenetique | Delobel B.,Groupe Hospitalier Of Linstitut Catholique Lillois | David A.,Nantes University Hospital Center | And 14 more authors.
European Journal of Human Genetics | Year: 2013

Speech sound disorders are heterogeneous conditions, and sporadic and familial cases have been described. However, monogenic inheritance explains only a small proportion of such disorders, in particular in cases with childhood apraxia of speech (CAS). Deletions of <5Mb involving the 12p13.33 locus is one of the least commonly deleted subtelomeric regions. Only four patients have been reported with such a deletion diagnosed with fluorescence in situ hybridisation telomere analysis or array CGH. To further delineate this rare microdeletional syndrome, a French collaboration together with a search in the Decipher database allowed us to gather nine new patients with a 12p13.33 subtelomeric or interstitial rearrangement identified by array CGH. Speech delay was found in all patients, which could be defined as CAS when patients had been evaluated by a speech therapist (5/9 patients). Intellectual deficiency was found in 5/9 patients only, and often associated with psychiatric manifestations of various severity. Two such deletions were inherited from an apparently healthy parent, but reevaluation revealed abnormal speech production at least in childhood, suggesting variable expressivity. The ELKS/ERC1 gene, which encodes for a synaptic factor, is found in the smallest region of overlap. These results reinforce the hypothesis that deletions of the 12p13.33 locus may be responsible for variable phenotypes including CAS associated with neurobehavioural troubles and that the presence of CAS justifies a genetic work-up. © 2013 Macmillan Publishers Limited. All rights reserved.

Boudet S.,University of Lille Nord de France | Boudet S.,Groupe Hospitalier Of Linstitut Catholique Lillois | Peyrodie L.,University of Lille Nord de France | Peyrodie L.,School of Advanced Engineering Studies | And 8 more authors.
Computer Methods and Programs in Biomedicine | Year: 2012

Adaptive Filtering by Optimal Projection (AFOP) is an automatic method for reducing ocular and muscular artifacts on electro-encephalographic (EEG) recordings. This paper presents two additions to this method: an improvement of the stability of ocular artifact filtering and an adaptation of the method for filtering electrode artifacts. With these improvements, it is possible to reduce almost all the current types of artifacts, while preserving brain signals, particularly those characterising epilepsy. This generalised method consists of dividing the signal into several time-frequency windows, and in applying different spatial filters to each. Two steps are required to define one of these spatial filters: the first step consists of defining artifact spatial projection using the Common Spatial Pattern (CSP) method and the second consists of defining EEG spatial projection via regression. For this second step, a progressive orthogonalisation process is proposed to improve stability. This method has been tested on long-duration EEG recordings of epileptic patients. A neurologist quantified the ratio of removed artifacts and the ratio of preserved EEG. Among the 330 artifacted pages used for evaluation, readability was judged better for 78% of pages, equal for 20% of pages, and worse for 2%. Artifact amplitudes were reduced by 80% on average. At the same time, brain sources were preserved in amplitude from 70% to 95% depending on the type of waves (alpha, theta, delta, spikes, etc.). A blind comparison with manual Independent Component Analysis (ICA) was also realised. The results show that this method is competitive and useful for routine clinical practice. © 2012 Elsevier Ireland Ltd.

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