Hopital University Of Bicetre

Le Kremlin-Bicêtre, France

Hopital University Of Bicetre

Le Kremlin-Bicêtre, France

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Duracinsky M.,University Paris Diderot | Duracinsky M.,Hopital University Of Bicetre | Lalanne C.,University Paris Diderot | Lalanne C.,University Paris - Sud | And 9 more authors.
Journal of Medical Internet Research | Year: 2014

Electronic patient-reported outcomes (PRO) provide quick and usually reliable assessments of patients' health-related quality of life (HRQL). Objective: An electronic version of the Patient-Reported Outcomes Quality of Life-human immunodeficiency virus (PROQOL-HIV) questionnaire was developed, and its face validity and reliability were assessed using standard psychometric methods. Methods: A sample of 80 French outpatients (66% male, 52/79; mean age 46.7 years, SD 10.9) were recruited. Paper-based and electronic questionnaires were completed in a randomized crossover design (2-7 day interval). Biomedical data were collected. Questionnaire version and order effects were tested on full-scale scores in a 2-way ANOVA with patients as random effects. Test-retest reliability was evaluated using Pearson and intraclass correlation coefficients (ICC, with 95% confidence interval) for each dimension. Usability testing was carried out from patients' survey reports, specifically, general satisfaction, ease of completion, quality and clarity of user interface, and motivation to participate in follow-up PROQOL-HIV electronic assessments. Results: Questionnaire version and administration order effects (N=59 complete cases) were not significant at the 5% level, and no interaction was found between these 2 factors (P=.94). Reliability indexes were acceptable, with Pearson correlations greater than .7 and ICCs ranging from .708 to .939; scores were not statistically different between the two versions. A total of 63 (79%) complete patients' survey reports were available, and 55% of patients (30/55) reported being satisfied and interested in electronic assessment of their HRQL in clinical follow-up. Individual ratings of PROQOL-HIV user interface (85%-100% of positive responses) confirmed user interface clarity and usability. Conclusions: The electronic PROQOL-HIV introduces minor modifications to the original paper-based version, following International Society for Pharmacoeconomics and Outcomes Research (ISPOR) ePRO Task Force guidelines, and shows good reliability and face validity. Patients can complete the computerized PROQOL-HIV questionnaire and the scores from the paper or electronic versions share comparable accuracy and interpretation. © Omar Martinez, Elwin Wu, Andrew Z Shultz, Jonathan Capote, Javier López Rios, Theo Sandfort, Justin Manusov, Hugo Ovejero, Alex Carballo-Dieguez, Silvia Chavez Baray, Eva Moya, Jonathan López Matos, Juan J DelaCruz, Robert H Remien,Scott D Rhodes.


Bouligand J.,University Paris - Sud | Bouligand J.,Hopital University Of Bicetre | Richard C.,University Paris - Sud | Richard C.,Hopital University Of Bicetre | And 23 more authors.
Pharmaceutical Research | Year: 2016

Purpose: Busulfan-melphalan high-dose chemotherapy followed by autologous stem cell transplantation is an essential consolidation treatment of high-risk neuroblastoma in children. Main treatment limitation is hepatic veno-occlusive disease, the most severe and frequent extra-hematological toxicity. This life threatening toxicity has been related to a drug interaction between busulfan and melphalan which might be increased by prior disturbance of iron homeostasis, i.e. an increased plasma ferritin level. Methods: We performed an experimental study of busulfan and melphalan pharmacodynamic and pharmacokinetics in iron overloaded mice. Results: Iron excess dramatically increased the toxicity of melphalan or busulfan melphalan combination in mice but it did not modify the clearance of either busulfan or melphalan. We show that prior busulfan treatment impairs the clearance of melphalan. This clearance alteration was exacerbated in iron overloaded mice demonstrating a pharmacokinetic interaction. Additionally, iron overload increased melphalan toxicity without altering its pharmacokinetics, suggesting a pharmacodynamic interaction between iron and melphalan. Based on iron homeostasis disturbance, we postulated that prior induction of ferritin, through Nrf2 activation after oxidative stress, may be associated with the alteration of melphalan metabolism. Conclusion: Iron overload increases melphalan and busulfan-melphalan toxicity through a pharmacodynamic interaction and reveals a pharmacokinetic drug interaction between busulfan and melphalan. © 2016 Springer Science+Business Media New York


Garcia G.,University Paris - Sud | Garcia G.,French Institute of Health and Medical Research | Garcia G.,Hopital University Of Bicetre | Taille C.,University Paris Diderot | And 9 more authors.
European Respiratory Review | Year: 2013

Asthma is a chronic inflammatory disorder of the airways that leads to acute symptoms, exacerbations and sometimes, for a small part of the asthmatic population, fatal or near-fatal exacerbations. This as yet significant minority of individuals present with severe asthma and have persisting daily symptoms, and exacerbations despite compliance with high doses of inhaled steroids and additional treatment. For more than a decade, the pharmacological management of patients with severe asthma has focused on evaluating specific cytokines. The rationale of this approach is based on the distinguished key role played by eosinophils in the asthma inflammatory processes. Eosinophils are recruited from the circulation to airways where they cause airway damage via different mechanisms. Eosinophils are regulated in terms of their recruitment, activation, growth, differentiation and survival by interleukin (IL)-5. Abundant data from in vitro experiments, animal models and clinical trials has confirmed that IL-5 inhibition may be an effective approach for the treatment of asthma, especially severe asthma. Interfering with eosinophil function or reducing their numbers has been one of the most important goals of therapeutic monoclonal antibodies, which target cytokine receptor interactions in asthma, particularly IL-5. This review will consider new treatments options for severe asthma, particularly those targeting IL-5, that have already been evaluated in clinical trials in asthmatic patients. © ERS 2013.


We present a case of bilateral posterior shoulder dislocation after an epileptic seizure. The anterior humeral-head impression fracture was 60% of the articular surface on the right shoulder and 30% on the left shoulder. We performed an early one-stage reconstruction of both humeral heads. A cancellous autograft was used on the left side and an iliac cortico-cancellous autograft on the right side, with preservation of the patient's cartilage. Three years later, the clinical and morphological results were excellent. The discussion focuses on surgical options that range from conservative treatment with excision of the damaged cartilage to immediate hemiarthroplasty. This case is original because of the preservation of the patient's cartilage during reconstruction. © 2012 Elsevier Masson SAS.


Apostolo A.,University of Milan | Laveneziana P.,Hopital University Of Bicetre | Laveneziana P.,Paris-Sorbonne University | Laveneziana P.,French Institute of Health and Medical Research | And 21 more authors.
International Journal of Cardiology | Year: 2015

Background: Heart failure (HF) and chronic obstructive pulmonary disease (COPD) coexistence increases morbidity and mortality. The intercept of ventilation (VEint) on the VE vs. carbon dioxide production (VCO2) relationship during exercise has been found to vary in proportion with dead space (VD) in HF. Considering that increased VD is the key pathophysiological abnormality in COPD but a secondary finding in HF we hypothesized that a high VEint would be useful in suggesting COPD as HF co-morbidity. Our aim was to assess whether an elevated VEint suggests the presence of COPD in HF. Methods: In a multicenter retrospective study, the VE-VCO2 relationship was analyzed both as slope and intercept in HF (n = 108), HF-COPD (n = 106) and COPD (n = 95). Patients with pulmonary arterial hypertension (PAH) (n = 85) and healthy subjects (HF) (n = 56) served as positive and negative controls relative to VE-VCO2 abnormalities, respectively. Results: Slope and VEint varied in opposite directions in all groups (p < 0.05) being VE-VCO2 slope highest and lowest in PAH and healthy subjects, respectively. No slope differences were observed among HF, HF-COPD and COPD (32 ± 7, 31 ± 7, and 31 ± 6, respectively). VEint was higher in HF-COPD and COPD compared to HF, PAH and controls (4.8 ± 2.4 L/min, 5.9 ± 3.0 L/min, 3.0 ±2.6 L/min, 2.3 ± 3.3 L/min and 3.9 ±2.5 L/min, respectively; p < 0.01). A VEint ≥4.07 L/min identified patients with high probability of having COPD or HF-COPD (sensitivity of 71.6% and specificity of 72.0%). Conclusion: These data provide novel evidence that a high VEint (≥4.07 L/min) should be valued to suggest coexistent COPD in HF patients. © 2015 Published by Elsevier Ireland Ltd.


Chaumais M.-C.,University Paris - Sud | Chaumais M.-C.,French Institute of Health and Medical Research | Guignabert C.,French Institute of Health and Medical Research | Savale L.,French Institute of Health and Medical Research | And 10 more authors.
American Journal of Cardiovascular Drugs | Year: 2015

Pulmonary arterial hypertension (PAH) is a devastating life-threatening disorder characterized by elevated pulmonary vascular resistance leading to elevated pulmonary arterial pressures, right ventricular failure, and ultimately death. Vascular endothelial cells mainly produce and secrete endothelin (ET-1) in vessels that lead to a potent and long-lasting vasoconstrictive effect in pulmonary arterial smooth muscle cells. Along with its strong vasoconstrictive action, ET-1 can promote smooth muscle cell proliferation. Thus, ET-1 blockers have attracted attention as an antihypertensive drug, and the ET-1 signaling system has paved a new therapeutic avenue for the treatment of PAH. We outline the current understanding of not only the pathogenic role played by ET-1 signaling systems in the pathogenesis of PH but also the clinical pharmacology of endothelin receptor antagonists (ERA) used in the treatment of PAH. © 2014, Springer International Publishing Switzerland.


Soubeyrand M.,Hopital University Of Bicetre | Soubeyrand M.,University Paris Est Creteil | Thomsen L.,Hopital University Of Bicetre | Thomsen L.,University Paris Est Creteil | And 6 more authors.
Journal of Hand Surgery: European Volume | Year: 2010

Some authors recommend using an antirotation wire when performing percutaneous screw fixation of acute non-displaced scaphoid waist fractures. The aim of this study of 21 cadaveric wrists was to assess the usefulness of such a wire in Herbert's B2-type fractures. A B2-type fracture was created experimentally on each scaphoid. An antirotation wire was inserted in eight wrists. Retrograde percutaneous fixation using a double-threaded headless cannulated screw was performed on all wrists. Computed tomography was used to measure interfragmentary rotation. No interfragmentary rotation was noted in either group. Our study suggests that using an antirotation wire may be unnecessary when performing retrograde percutaneous screw fixation of isolated B2-type scaphoid fractures. © The Author(s), 2010.


Soubeyrand M.,Service de Chirurgie Orthopedique | Ciais G.,Service de Chirurgie Orthopedique | Wassermann V.,Service de Chirurgie Orthopedique | Kalouche I.,Service de Chirurgie Orthopedique | And 5 more authors.
Journal of Bone and Joint Surgery - Series B | Year: 2011

Disruption of the interosseous membrane is easily missed in patients with Essex-Lopresti syndrome. None of the imaging techniques available for diagnosing disruption of the interosseous membrane are completely dependable. We undertook an investigation to identify whether a simple intra-operative test could be used to diagnose disruption of the interosseous membrane during surgery for fracture of the radial head and to see if the test was reproducible. We studied 20 cadaveric forearms after excision of the radial head, ten with and ten without disruption of the interosseous membrane. On each forearm, we performed the radius joystick test: moderate lateral traction was applied to the radial neck with the forearm in maximal pronation, to look for lateral displacement of the proximal radius indicating that the interosseous membrane had been disrupted. Each of six surgeons (three junior and three senior) performed the test on two consecutive days. Intra-observer agreement was 77% (95% confidence interval (CI) 67 to 85) and interobserver agreement was 97% (95% CI 92 to 100). Sensitivity was 100% (95% CI 97 to 100), specificity 88% (95% CI 81 to 93), positive predictive value 90% (95% CI 83 to 94), and negative predictive value 100%). This cadaveric study suggests that the radius joystick test may be useful for detecting disruption of the interosseous membrane in patients undergoing open surgery for fracture of the radial head and is reproducible. A confirmatory study in vivo is now required. © 2011 British Editorial Society of Bone and Joint Surgery.


Thierry G.,Nantes University Hospital Center | Beneteau C.,Nantes University Hospital Center | Pichon O.,Nantes University Hospital Center | Flori E.,Service de Cytogenetique | And 28 more authors.
American Journal of Medical Genetics, Part A | Year: 2012

Patients with a submicroscopic deletion at 1q43q44 present with intellectual disability (ID), microcephaly, craniofacial anomalies, seizures, limb anomalies, and corpus callosum abnormalities. However, the precise relationship between most of deleted genes and the clinical features in these patients still remains unclear. We studied 11 unrelated patients with 1q44 microdeletion. We showed that the deletions occurred de novo in all patients for whom both parents' DNA was available (10/11). All patients presented with moderate to severe ID, seizures and non-specific craniofacial anomalies. By oligoarray-based comparative genomic hybridization (aCGH) covering the 1q44 region at a high resolution, we obtained a critical deleted region containing two coding genes-HNRNPU and FAM36A-and one non-coding gene-NCRNA00201. All three genes were expressed in different normal human tissues, including in human brain, with highest expression levels in the cerebellum. Mutational screening of the HNRNPU and FAM36A genes in 191 patients with unexplained isolated ID did not reveal any deleterious mutations while the NCRNA00201 non-coding gene was not analyzed. Nine of the 11 patients did not present with microcephaly or corpus callosum abnormalities and carried a small deletion containing HNRNPU, FAM36A, and NCRNA00201 but not AKT3 and ZNF238, two centromeric genes. These results suggest that HNRNPU, FAM36A, and NCRNA00201 are not major genes for microcephaly and corpus callosum abnormalities but are good candidates for ID and seizures. © 2012 Wiley Periodicals, Inc.


PubMed | Hopital University Of Bicetre
Type: Case Reports | Journal: Chirurgie de la main | Year: 2012

We present a case of bilateral posterior shoulder dislocation after an epileptic seizure. The anterior humeral-head impression fracture was 60% of the articular surface on the right shoulder and 30% on the left shoulder. We performed an early one-stage reconstruction of both humeral heads. A cancellous autograft was used on the left side and an iliac cortico-cancellous autograft on the right side, with preservation of the patients cartilage. Three years later, the clinical and morphological results were excellent. The discussion focuses on surgical options that range from conservative treatment with excision of the damaged cartilage to immediate hemiarthroplasty. This case is original because of the preservation of the patients cartilage during reconstruction.

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